Six-year follow-up of preventive interventions for children of divorce: a randomized controlled trial.
Six-year follow-up of preventive interventions for children of divorce: a randomized controlled trial.
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DOI：
10.1001/jama.288.15.1874
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发表时间：
2002-10
期刊：
影响因子：
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通讯作者：
S. Wolchik;I. Sandler;R. Millsap;B. Plummer;S. Greene;E. Anderson;Spring R. Dawson-McClure;K. Hipke;R. Haine
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文献类型：
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作者：
S. Wolchik;I. Sandler;R. Millsap;B. Plummer;S. Greene;E. Anderson;Spring R. Dawson-McClure;K. Hipke;R. Haine
背景与父母未离婚的同龄人相比，父母离异的青少年更有可能出现心理健康问题、辍学和怀孕。干预计划对这一人群的长期影响尚不清楚。目的评价两种预防离异儿童心理健康问题的方案的远期效果。设计和设置一项为期6年的随机对照试验，包括2个干预方案(母亲方案：11个小组和2个个体；母子方案：母亲方案和11个儿童小组)和一个对照条件(离婚后调整书籍)，于1998-04-2000-03在美国一个大城市进行。研究对象共218个家庭(占原始样本的91%)的青少年年龄在15岁到19岁之间。主要结果衡量外在化和内在化问题、诊断的精神障碍、药物和酒精使用以及性伴侣数量。结果母子结合计划中有11%的青少年(95%可信区间，3.8%~18.2%)有1年的精神障碍，而对照组青少年中有23.5%(95%可信区间，13.8%~33.2%)有精神障碍(P=0.007)。与对照计划中的青少年(1.65[0.37]；P=.01)相比，母亲加孩子计划中的青少年的性伴侣较少(平均[SE]，0.68[0.16])。与对照组相比，家庭为母婴计划的青少年初始心理健康问题较高，外化问题较少(P=0.007)，精神障碍症状较少(P=0.02)。与对照组相比，母亲参加母亲计划且有较高初始心理健康问题的青少年外化问题水平较低(P<；.001)，精神障碍症状较少(P=.005)，酒精(P=.005)、大麻(P=.02)和其他药物使用(P=.01)较少。结论在离异父母的青少年中，母亲计划和母子计划减少了精神障碍的症状、精神障碍的诊断率、外化问题的水平、大麻、酒精和其他药物的使用以及性伴侣的数量。
CONTEXT Compared with their peers with nondivorced parents, adolescents with divorced parents are more likely to have mental health problems, drop out of school, and become pregnant. The long-term effects of intervention programs for this population are unknown. OBJECTIVE To evaluate the long-term effectiveness of 2 programs designed to prevent mental health problems in children with divorced parents. DESIGN AND SETTING Six-year follow-up of a randomized controlled trial of 2 intervention programs (mother program: 11 group and 2 individual sessions; mother plus child program: mother program and 11 group sessions for children) and a control condition (books on postdivorce adjustment), which was conducted in a large metropolitan US city from April 1998 through March 2000. PARTICIPANTS A total of 218 families (91% of the original sample) with adolescents aged between 15 and 19 years were reinterviewed. MAIN OUTCOME MEASURES Externalizing and internalizing problems, diagnosed mental disorders, drug and alcohol use, and number of sexual partners. RESULTS Eleven percent of adolescents in the mother plus child program (95% confidence interval [CI], 3.8%-18.2%) had a 1-year prevalence of diagnosed mental disorder compared with 23.5% (95% CI, 13.8%-33.2%) of adolescents in the control program (P =.007). Adolescents in the mother plus child program had fewer sexual partners (mean [SE], 0.68 [0.16]) compared with adolescents in the control program (1.65 [0.37]; P =.01). Adolescents with higher initial mental health problems whose families were in the mother plus child program had lower externalizing problems (P =.007) and fewer symptoms of mental disorder (P =.02) compared with those in the control program. Compared with controls, adolescents whose mothers participated in the mother program and who had higher initial mental health problems had lower levels of externalizing problems (P<.001); fewer symptoms of mental disorder (P =.005); and less alcohol (P =.005), marijuana (P =.02), and other drug use (P =.01). CONCLUSIONS In adolescents of divorced parents, the mother program and the mother plus child program reduced symptoms of mental disorder; rates of diagnoses of mental disorder; levels of externalizing problems; marijuana, alcohol, and other drug use; and number of sexual partners.