Augmented Treatment of Specific Phobias in Children

描述（由申请人提供）：拟议研究的总体目标是比较单次治疗（OST：认知行为疗法的一种变体）与家庭增强OST（增强OST）治疗儿童特定恐惧症的疗效。在我们目前资助的NIMH项目中，我们已经证明OST在治疗青少年特定恐惧症方面比教育/支持治疗（EST）或治疗后等待名单控制条件更有效（分别为60%、26%和0%无诊断）和6个月随访时（OST为60%，EST为42%，等待名单参与者在等待1个月后随机分配到OST或EST条件）。虽然OST被证明是上级这些条件，很明显，40%的青年谁接受了这种治疗是不是诊断免费的治疗后或6个月的后续行动，他们继续经历痛苦的症状。在此，根据我们的家长利益相关者的反馈，我们建议增加标准的OST程序与家长管理补充，提供教育的性质，课程，和具体的恐惧症的原因，并配备他们有效的策略，以解决挥之不去的痛苦和避免在他们的孩子以下OST。简而言之，我们建议在一项随机临床对照试验中对154名7至12岁的儿童进行标准OST程序与父母增强的OST程序进行比较。具体目标有两个方面：1）在一项随机试验中评估OST和父母增强OST（增强OST）对儿童的疗效; 2）探索治疗结果的调节因素，包括父母精神病理学和过度保护的父母行为的影响。将154名符合DSM-IV特定恐怖症标准的7至12岁儿童（77名男孩，77名女孩）随机分配至单独OST或加强OST治疗组。(The年龄范围限于7至12岁，因为已发现以家庭为基础的增强战略对这一年龄组最有效）。将进行治疗后以及1、6和12个月随访评价。因此，该项目将招募有史以来在统一州进行的最大规模的恐惧症青年样本。它将提供有关疾病、治疗和治疗结果调节剂的有价值的信息。该有效性试验将为有效性试验奠定基础。

DESCRIPTION (provided by applicant): The overall aim of the proposed investigation is to compare the efficacy of One-Session Treatment (OST: a variant of Cognitive-Behavior Therapy) to family-enhanced OST (Augmented OST) in the treatment of Specific Phobia in children. In our presently funded NIMH project, we have shown that OST is more effective in treating specific phobias in youth than Education/Support Treatment (EST) or Wait List Control conditions at post-treatment (60%, 26%, and 0% diagnosis free, respectively) and at 6-month follow-up (60% for OST and 42% for EST, with Waitlist participants randomly assigned to either OST or EST conditions following a 1 month wait). Although OST was shown to be superior to these conditions, it is evident that 40% of the youth who received this treatment were not diagnosis free at post-treatment or 6 month follow-up and that they continued to experience distressing symptoms. Herein, based on feedback from our parent stakeholders, we propose to augment standard OST procedures with a parent-management supplement that provides education to the parents about the nature, course, and causes of specific phobias and equips them with effective strategies to address lingering distress and avoidance in their children following OST. In brief, we propose to compare the standard OST procedure to a parent-enhanced one in a randomized clinical control trial with 154 children between 7 and 12 years of age. Specific aims are twofold: 1) to evaluate the efficacy of OST and a parent-augmented OST (Augmented OST) with children in a randomized trial; and 2) to explore moderators of treatment outcome, including the effects of parental psychopathology and overprotective parenting practices. One hundred and fifty-four children (77 boys, 77 girls) between 7 and 12 years of age who meet DSM-IV criteria for a specific phobia will be randomly assigned to individual OST or to Augmented OST treatments. (The age range is restricted to 7 to 12 years of age because family-based enhancement strategies have been found to be most effective with this age group). Post-Treatment and 1,6, and 12 month follow-up evaluations will be conducted. As such, this project will recruit the largest sample of phobic youth ever undertaken in the Unified States. It will provide valuable information about the disorder, its treatment, and the moderators of treatment outcome. This efficacy trial will lay the foundation for an effectiveness trial.