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Effectiveness of Brief and Standard School-Based Cognitive-Behavioral Interventions for Adolescents With Anxiety: A Randomized Noninferiority Study.
Journal of the American Academy of Child and Adolescent Psychiatry ( IF 13.3 ) Pub Date : 2020-01-08 , DOI: 10.1016/j.jaac.2019.12.003
Bente Storm Mowatt Haugland 1 , Åshild Tellefsen Haaland 2 , Valborg Baste 3 , Jon Fauskanger Bjaastad 4 , Asle Hoffart 5 , Ronald M Rapee 6 , Solfrid Raknes 3 , Joseph A Himle 7 , Elisabeth Husabø 8 , Gro Janne Wergeland 9
Affiliation  

OBJECTIVE We examined the effectiveness of targeted school-based cognitive-behavioral therapy (CBT) for adolescents (12-16 years of age) with anxiety, and tested whether brief CBT was noninferior to standard duration CBT. METHOD A randomized controlled study of 313 adolescents (mean 14.0 years, SD = 0.84, 84% girls) were recruited through school health services to 10 weeks CBT group interventions. Groups of 5 to 8 adolescents were randomly allocated to brief (5 sessions, comprising 5.5 hours) or standard CBT (10 sessions, comprising 15 hours), or 10 weeks waitlist (WL). Self-reported and parent-reported youth anxiety symptoms, impairment from anxiety, depressive symptoms,and clinical severity were assessed pre- and postintervention, after WL, and at 1-year follow-up. RESULTS Targeted school based CBT significantly reduced adolescents' anxiety symptoms with small to moderate effect sizes compared to WL (Cohen d = 0.34 for youth report and d = 0.53 for parent report). According to the parents, also adolescents' impairment from anxiety was significantly reduced compared to WL (d = 0.51). Pre to post changes in anxiety symptoms were small to moderate (within-group effect sizes between d = 0.41 and d = 0.67). Although no significant differences in effects were found between brief and standard CBT, brief CBT was not noninferior to standard CBT. Outcomes from both interventions were sustained at 1-year follow-up. CONCLUSION Targeted school-based CBT interventions reduced anxiety, impairment, and depressive symptoms in adolescents. Both brief and standard CBT demonstrated efficacy, but brief CBT was not noninferior to standard CBT. By administering school-based CBT to youths with anxiety symptoms, we may reach young people with effective interventions at an earlier phase in their lives. CLINICAL TRIAL REGISTRATION INFORMATION School Based Low-intensity Cognitive Behavioral Intervention for Anxious Youth (LIST); http://clinicalrials.gov/; NCT02279251.

中文翻译:

简短和标准的基于学校的认知行为干预对青少年焦虑症的有效性:随机非劣效性研究。

目的我们研究了针对青少年焦虑症(12-16岁)的针对性校本认知行为疗法(CBT)的有效性,并测试了简短CBT是否不低于标准持续时间CBT。方法通过学校卫生服务对CBT组进行为期10周的干预,对313名青少年(平均14.0岁,SD = 0.84,84%的女孩)进行了随机对照研究。5至8个青少年组被随机分配到简短(5节,包括5.5小时)或标准CBT(10节,包括15小时)或10周等待清单(WL)。在WL前后,干预后和1年随访中,对自我报告和父母报告的青年焦虑症状,焦虑障碍,抑郁症状和临床严重性进行了评估。结果有针对性的基于学校的CBT大大减少了青少年的 与WL相比,焦虑症状的影响范围小到中度(青年报告的Cohen d = 0.34,父母报告的d = 0.53)。父母认为,与WL相比,青少年的焦虑障碍也显着减少(d = 0.51)。焦虑症状发生前后的变化从小到中等(组内效应大小在d = 0.41和d = 0.67之间)。尽管简短的CBT与标准的CBT在效果上没有发现显着差异,但简短的CBT并不逊色于标准CBT。两种干预措施的结果在随访1年后均得以维持。结论有针对性的基于学校的CBT干预措施可以减少青少年的焦虑,障碍和抑郁症状。简短的CBT和标准CBT均显示出疗效,但简短的CBT并不逊色于标准CBT。通过对患有焦虑症的年轻人进行基于学校的CBT管理,我们可以在他们生命的早期阶段对年轻人进行有效的干预。临床试验注册信息基于学校的焦虑青年低强度认知行为干预(清单);http://clinicalrials.gov/; NCT02279251。
更新日期:2020-01-09
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