ACT Online: Stress Reduction for Parents who have Children with DD

描述（由申请人提供）：养育孩子可能是一项压力很大的工作。一组是相当多的研究的焦点，包括发育障碍（DD）儿童的父母，尤其是自闭症儿童。这些父母比没有残疾的孩子的父母更有育儿压力。患有自闭症和其他类型发育障碍儿童的家庭面临着过多的照顾需求、经济负担、休闲和社交活动的限制以及家庭计划的中断。这些父母所经历的压力增加往往是慢性的，持续很长一段时间。最近的压力管理方法是基于正念的概念——意识到并不加评判地接受一个人正在经历的事情。以正念为基础的干预措施最近得到了实证支持，并有可能帮助父母更加意识到他们与照顾者负担增加相关的负面想法和感受，同时支持改变他们与残疾孩子的关系的方法。作为这个项目框架的一个突出的、研究得很好的正念干预是接受和承诺治疗- act。该项目的总体目标是“接受和承诺在线培训：为患有发育障碍儿童的父母减轻压力”，目的是证明干预措施在减少父母因抚养残疾儿童而产生的压力方面是有效的。在第一阶段，研究团队将通过测试模块1来确定ACT在线考试的可行性。该测试将在40名患有DD儿童的父母（20名患有自闭症儿童的父母和20名患有其他发育障碍儿童的父母）中进行。计划的可行性将通过达到以下基准来证明：(a)计划的高水平使用；(b)消费者满意度高；(c)在知识、自我效能、状态焦虑和父母困扰方面有临床意义的变化。第二阶段将进行大规模随机试验，以评估九个模块压力管理程序的有效性。二期试验将有足够的统计能力来检验潜在的调节作用（例如，儿童残疾的严重程度，适应功能的水平）和假定的调节机制（例如，应对和压力管理技能的增加）。结果评估将扩大到包括全球功能和调整的有效措施（例如，社会适应量表），抑郁症状（例如，流行病学研究中心抑郁量表），以及紧张的日常烦恼（例如，不愉快事件表）。此外，疗效试验将包括一段相当长的随访期（如三个月），以检查方案效果的维持情况。公共卫生相关性：子女患有自闭症和其他发育障碍（DD）的父母面临着巨大的心理挑战，然而，对这些需求的关注却很少。患有自闭症和其他发育障碍的孩子的父母会经历高水平的慢性压力，往往会为孩子的状况感到责任和指责。提出的研究将通过开发一个基于接受和承诺训练（ACT）的减压计划来解决这一主要问题。

DESCRIPTION (provided by applicant): Parenting a child can be a stressful undertaking. One group that is the focus of considerable study consists of parents of children with developmental disabilities (DD) especially autism. These parents report more parenting stress than do parents of children without disabilities. Families of children with autism and other types of DD experience excessive caretaking demands, financial burden, restrictions on leisure and social activities, and disruptions of family plans. The increased stress experienced by these parents tends to be chronic and last over significant periods of time. Recent approaches to the management of stress have been based on the concept of mindfulness - the awareness and nonjudgmental acceptance of one's ongoing experiences. Mindfulness-based interventions have received recent empirical support and have the potential to help parents become more aware of their negative thoughts and feelings associated with increased caregiver burden while at the same time supporting ways to change how they relate to their child with a disability. One prominent and well researched mindfulness intervention that will serve as the framework for this project is Acceptance and Commitment Therapy-ACT. The overall aim of this project, Acceptance and Commitment Training Online: Stress Reduction for Parents who have Children with DD, will be to demonstrate that the intervention is effective in reducing parental stress associated with raising a child with disabilities. In Phase I, the research team will determine the feasibility of ACT Online by testing Module 1. The test will be conducted with 40 parents who have children with DD (20 parents of children with autism and 20 parents of children with other developmental disabilities). Program feasibility will be demonstrated by the achievement of the following benchmarks: (a) a high level of program usage; (b) a high degree of consumer satisfaction; and (c) clinically meaningful changes in knowledge, self-efficacy, state anxiety, and parental distress. A large scale randomized trial will be conducted in Phase II to evaluate the efficacy of the nine module stress management program. The Phase II trial will have sufficient statistical power to test for potential moderating effects (e.g., severity of child disability, level of adaptive functioning) and putative mediating mechanisms (e.g., increases in coping and stress management skills). The outcome assessment will be expanded to include validated measures of global functioning and adjustment (e.g., the Social Adjustment Scale), depressive symptomatology (e.g., the Center for Epidemiologic Studies-Depression scale), and stressful daily hassles (e.g., the Unpleasant Events Schedule). In addition, the efficacy trial will include a substantial follow-up period (e.g., three months) in order to examine the maintenance of program effects. PUBLIC HEALTH RELEVANCE: Parents with who have children with autism and other developmental disabilities (DD) face enormous psychological challenges, however little attention has been paid to these needs. Parents of children with autism and other DD experience high levels of chronic stress and tend to feel responsible and blamed for their children's conditions. The proposed research will address this major problem by developing a stress reduction program based on Acceptance and Commitment Training (ACT).