Parent-teen communication predicts treatment benefit for depressed and suicidal adolescents.
Parent-teen communication predicts treatment benefit for depressed and suicidal adolescents.
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家长与青少年的沟通可以预测抑郁症和自杀青少年的治疗效果。
DOI：
10.1037/ccp0000457
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发表时间：
2019
影响因子：
5.9
通讯作者：
Kobak,Roger
中科院分区：
文献类型：
--
作者：
Zisk,Abigail;Abbott,CarolineH;Bounoua,Nadia;Diamond,GuyS;Kobak,Roger
目的：虽然目前有几种有效的治疗青少年抑郁和自杀的方法，但对青少年治疗反应的预测因素和调节因素知之甚少。越来越多的文献已经确定家庭功能作为青少年从治疗中获益的可能性的预后指标。目前的研究测试了家庭功能作为青少年对两种治疗条件反应的指标的观察性和感知性措施。样本包括129名抑郁和自杀青少年（M年龄= 14.96,82.9%为女性，56%为黑人/非裔美国人），随机分为基于依恋的家庭治疗和家庭强化的非指导性支持治疗（Diamond et al., 2019）。家庭功能的基线评估包括使用青少年编码系统中目标纠正伙伴关系编码的父母-青少年沟通评分（Lyons-Ruth, Hennighausen, & Holmes, 2005）和家庭功能自我报告中青少年和父母关于家庭冲突和凝聚力的报告（Bloom, 1985）。结果在10分钟的冲突讨论中与父母进行更多不合作交流的青少年在两种治疗中都表现出更大的抑郁症状减轻。来自传统服务不足（非白人或低收入）家庭的青少年在两种治疗中都表现出更大的自杀意念减少。结论以依恋为基础的家庭治疗和家庭强化的非指导性支持治疗对来自传统服务不足家庭的青少年和与照顾者合作沟通较少的青少年最有效。与自我报告的整体家庭功能指标相比，父母-青少年沟通的观察性评分是更好的治疗反应预后指标。讨论了将这些结果推广到抑郁症和自杀青少年的其他治疗方法的意义。
ObjectiveAlthough there are currently several efficacious treatments for depressed and suicidal adolescents, less is known about predictors and moderators of adolescents’ treatment response. A growing literature has identified family functioning as a prognostic indicator of adolescents’ likelihood of benefiting from treatment. The current study tested both observational and perceived measures of family functioning as indicators of adolescents’ response to 2 treatment conditions.MethodThe sample consisted of 129 depressed and suicidal adolescents (M age= 14.96, 82.9% female, 56% Black/African American) who were randomized to attachment-based family therapy or family-enhanced nondirective supportive therapy (Diamond et al., 2019). Baseline assessments of family functioning included ratings of parent–adolescent communication coded with the Goal-Corrected Partnership in Adolescence Coding System (Lyons-Ruth, Hennighausen, & Holmes, 2005) and adolescent and parent reports of Family Conflict and Cohesion from the Self-Report of Family Functioning (Bloom, 1985).ResultsAdolescents who engaged in more uncooperative communication with their parents during a 10-min conflict discussion showed greater reductions in depressive symptoms in both treatments. Adolescents from traditionally underserved (non-White or lower income) families showed greater reductions in suicidal ideation in both treatments.ConclusionsAttachment-based family therapy and family-enhanced nondirective supportive therapy were most effective for adolescents from traditionally underserved families and adolescents who engaged in less cooperative communication with their caregivers. Observational ratings of parent–adolescent communication were better prognostic indicators of treatment response than were self-reported indicators of global family functioning. Implications for generalizing these results to other treatments for depressed and suicidal adolescents are discussed.