Does Cognitive-Behavioral Therapy for Youth Anxiety Disorders Improve Social Functioning and Peer Relationships?
Does Cognitive-Behavioral Therapy for Youth Anxiety Disorders Improve Social Functioning and Peer Relationships?
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DOI：
10.1007/s10567-023-00454-3
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发表时间：
2023-10-14
影响因子：
6.9
通讯作者：
Silverman，Wendy K.
中科院分区：
文献类型：
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作者：
Etkin，Rebecca G.;Juel，Emily K.;Silverman，Wendy K.
儿童和青少年焦虑症（AD）导致社会功能和同伴关系受损，加剧焦虑和相关困难。认知行为疗法（CBT）在多大程度上改善了社会功能和同伴关系尚不清楚。在这篇文章中，我们报告的第一个系统的叙述性审查这一主题的结果。CBT治疗儿童和/或青少年AD的随机临床试验如果使用至少一种社会功能或同伴关系作为治疗结果，则包括在内。16项研究符合我们的纳入标准。从每项研究中，我们提取了样本特征、治疗组、社会和/或同伴结局指标以及统计结果。结果表明，在大多数研究中，社交功能和/或同伴关系随着时间的推移而得到改善，这凸显了除了减少焦虑之外治疗功效的一个重要方面。还有几种治疗特定的影响，但研究的样本，方法和结果之间存在相当大的差异，因此很难得出关于哪些特定治疗改善特定结果的确切结论。我们建议下一步的研究，以调和这些发现，包括改善社会和同伴结果的可操作性和标准化，以及对治疗特异性和机制的研究。
Child and adolescent anxiety disorders (ADs) contribute to impairment in social functioning and peer relationships, exacerbating anxiety and related difficulties. The extent to which the AD treatment with the strongest evidence-base, cognitive-behavioral therapy (CBT), improves social functioning and peer relationships is unclear. In this article, we report results of the first systematic narrative review of this topic. Randomized clinical trials of CBT for child and/or adolescent ADs were included if they used at least one measure of social functioning or peer relationships as a treatment outcome. Sixteen studies met our inclusion criteria. From each study, we extracted the sample characteristics, treatment arms, social and/or peer outcome measures, and statistical findings. Results show that social functioning and/or peer relationships improved over time in the majority of studies, highlighting an important aspect of treatment efficacy beyond anxiety reduction. There were also several treatment-specific effects, but considerable variability across studies’ samples, methods, and findings, makes it difficult to draw firm conclusions about which specific treatments improve specific outcomes. We recommend next steps for research to reconcile these findings, including improved operationalization and standardization of social and peer outcomes, and research on treatment specificity and mechanisms.