Multi-Component Early Intervention for Socially Inhibited Preschool Children

描述（由申请人提供）：行为抑制/社交沉默（BI/RET）是儿童期报告的最稳定的性格特征之一。早期BI/RET往往会因儿童在整个发展过程中与父母的相互作用而得到加强和加剧。重要的是，稳定的BI/RET会使幼儿在青春期和成年期面临可诊断的焦虑症（即社交恐惧症）的风险，这种风险受到以下因素的调节：（a）过度指导/控制的父母和（B）儿童缺乏社交和情绪调节技能。本项目的目的是进行一项全面的随机对照试验，并对其进行评估。在此期间，我们将150名45-60个月大的儿童及其父母随机分配到“海龟计划”中，（结合改编的亲子互动疗法和社交技能促进游戏（PCIT和SSFP）或强度较低的6节家长心理教育小组，学龄前BI的最佳治疗方法。海龟计划的组成部分强调了干预父母与孩子和同伴互动的相互循环的技能的发展，这些互动有助于焦虑的发展。重要的是，SSFP基于群体的性质提供了一个社会背景，在这个背景下，父母可以在治疗师的指导下与孩子一起练习行为技能。本试验将检查治疗反应的中介者和调节者。结果测量（在治疗前、治疗中、治疗后和一年随访时收集）将包括父母和教师对儿童焦虑症状/障碍、气质和社会功能的评分/问卷;父母养育和儿童在课堂上的社会行为的观察测量;以及心率生理学（情绪反应和调节的生物学指标）。

DESCRIPTION (provided by applicant): Behavioral inhibition/social reticence (BI/RET) is one of the most stable dispositional characteristics reported in childhood. Early BI/RET is often reinforced and exacerbated by children's reciprocal interactions with parents across development. Importantly, stable BI/RET places young children at subsequent risk for diagnosable anxiety disorders (namely, social phobia) during adolescence and adulthood and this risk is moderated by (a) overly directive/controlling parenting and (b) the child' lack of socal and emotion-regulation skills. The purpose of the proposed project is to conduct and evaluate a full-scale, randomized controlled trial during which we will randomly assign 150 45-60 month old children and their parents to either the "Turtle Program" (combined adapted Parent Child Interaction Therapy and Social Skills Facilitated Play (PCIT and SSFP) or to a less intensive, 6-session parent psychoeducation group, the best available treatment for preschool BI. The Turtle Program components highlight the development of skills to intervene in the reciprocal cycle of parent-child and peer interactions that contribute to the development of anxiety. Importantly, the group- based nature of SSFP provides a social context in which parents can practice behavioral skills with their child while being coached by the therapists. This trial will examine mediators an moderators of treatment response. Outcome measures (collected at pre-treatment, mid-treatment, post-treatment, and one-year follow-up) will include parent and teacher ratings/questionnaires of child anxiety symptoms/disorders, temperament, and social functioning; observational measures of parenting and children's social behaviors in the classroom; and heart rate physiology (a biological index of emotional reactivity and regulation).