Parent Mediation of Child Anxiety CBT Outcome

描述(由申请人提供)：这项申请提出了一项中介结果研究，评估父母参与减少儿童焦虑障碍的特异性、中介和治疗结果。这项研究的目标是先前临床试验中针对的相同的DSM-IV焦虑症，这些焦虑症在儿童中最常见：社交恐惧症、广泛性焦虑症和分离性焦虑症。采用对照临床试验设计，336名儿童(8-11岁)及其父母将在研究的五年内接受治疗，在一年的随访中估计有236名治疗完成者。参与者将被随机分配到三种治疗条件中的一种。父母参与的两个条件(1)ICBT+父母强化技能培训(ICBT+RFST)(即增加父母对积极强化的使用，减少负面强化)和(2)ICBT+父母关系技能培训(ICBT-RLST)(即增加父母自主权和增加父母对子女的接受度)，以及(3)没有额外父母参与成分的“基本”ICBT作为基线比较条件。儿童和父母将在治疗前、治疗中、治疗后和一年后通过问卷测量、儿童和家长版的面谈时间表和观察性措施进行评估。三组假说将会被检验。第一组测试“效果的特异性”，即添加特定的治疗成分是否对适当定向的育儿技能产生预期的特定效果；第二组测试“调解”，即假设的调节因素的变化是否与儿童治疗结果的显著积极变化有关。第三组关于差别治疗结果的检验(即，在父母参与条件下儿童治疗结果的积极变化是否显著大于在ICBT治疗条件下儿童治疗结果的积极变化，这是一个基线比较条件)。数据分析计划详细描述了将在数据分析中使用的多分析策略(包括结构方程建模和其他复杂的数据分析策略，如生长曲线建模)。本申请提出了一项中介结果儿童焦虑症治疗研究，评估了两种不同的让父母参与孩子治疗的策略相对于个人治疗的特异性、调解和治疗结果的增强。

DESCRIPTION (provided by applicant): This application proposes a mediation-outcome research study evaluating the specificity, mediation, and treatment outcome enhancement of parent involvement for reducing anxiety disorders in children. The study targets the same DSM-IV anxiety disorders targeted in previous clinical trials and that are most common in children: social phobia, generalized anxiety disorder, and separation anxiety disorder. Using a controlled clinical trial design, 336 children (ages 8-11 years) and their parents will be admitted to treatment over the five years of the study, yielding an estimated 236 treatment completers at one year follow-up. Participants will be randomly assigned to one of the three treatment conditions. Two parent involvement conditions (1) ICBT+Parent Reinforcement Skills Training (ICBT+RFST) (i.e., increasing parental use of positive reinforcement and decreasing negative reinforcement) and (2) ICBT + Parent Relationship Skills Training (ICBT- RLST) (i.e., increasing parental autonomy granting and increasing parental child acceptance), and (3) a "basic" ICBT without additional parent involvement components as a baseline comparison condition. Children and parents will be assessed at pretreatment, midtreatment, posttreatment, and one-year follow up with questionnaire measures, the child and parent versions of the interview schedules, and observational measures. Three sets of hypotheses will be tested. The first set tests for "specificity of effects," i.e., whether the addition of specific treatment components has the expected specific effects on the appropriately targeted parenting skills; the second set for "mediation," i.e., whether the effects of changes in the hypothesized mediators are related to significant positive change in child treatment outcome. The third set tests for differential treatment outcome (i.e., whether positive change in child treatment outcome in the parent involvement conditions is significantly greater than positive change in child treatment outcome in the ICBT treatment condition, a baseline comparison condition).The multi-analytic strategies that will be used in the analysis of the data (including structural equation modeling and other complex data analytic strategies e.g., growth curve modeling) are described in detail under the Data Analysis Plan. This application proposes a mediation-outcome child anxiety treatment study that evaluates the specificity, mediation, and treatment outcome enhancement of two distinct strategies for involving parents in their child's treatment relative to individual treatment.