Multi-Component Early Intervention for Socially Inhibited Preschool Children

描述(申请人提供)：行为抑制/社交沉默(BI/RET)是儿童时期报道的最稳定的性格特征之一。早期BI/RET往往因儿童在发育过程中与父母的互惠互动而得到加强和加剧。重要的是，稳定的BI/RET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)的后续风险，这种风险通过(A)过度指导/控制父母和(B)儿童缺乏社交能力和情绪调节技能来缓解。建议项目的目的是进行和评估一项全面的随机对照试验，在此期间，我们将随机分配150名45-60个月大的儿童和他们的父母参加“海龟计划”(组合适应亲子互动疗法和促进社交技能游戏(PCIT和SSFP))或参加强度较低的6节家长心理教育小组，这是学龄前BI的最佳治疗方案。海龟方案的组成部分强调了技能的发展，以干预导致焦虑发展的亲子和同伴互动的互惠循环。重要的是，SSFP以小组为基础的性质提供了一个社交环境，父母可以在治疗师的指导下与孩子练习行为技能。这项试验将检查调解人和治疗反应的调解人.结果衡量标准(在治疗前、治疗中期、治疗后和一年的随访中收集)将包括家长和教师对儿童焦虑症状/障碍、气质和社交功能的评分/问卷；对父母教养和儿童在课堂上的社交行为的观察衡量；以及心率生理学(情绪反应和调节的生物指数)。

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).