OBJECTIVE To examine the preliminary effectiveness of a modular, transdiagnostic, behavioral/cognitive-behavioral intervention (MATCH) compared with standard manualized treatments (SMT) and usual care (UC) for treating youth with severe irritability. METHOD We analyzed data from an effectiveness trial in which treatment-referred youths (N = 174; Mage = 10.6 years; 70% boys) were randomized to receive MATCH, SMT, or UC (ns = 53-62). Masked assessments of irritability, diagnoses, impairment, and internalizing, externalizing, total, and top problems were collected from caregivers and youths at pre- and posttreatment, weekly during treatment, and quarterly through 2-year follow-up. Baseline measures of irritability and impairment were used to identify a subsample characterized by severe irritability and mood dysregulation (SIMD; n = 81; Mage = 10.2 years; 69% boys; ns = 24-31 across conditions). Longitudinal multilevel models and ANOVAs were estimated to examine numerous clinical outcomes within and between conditions. RESULTS Among youth with SIMD, MATCH produced faster improvements than UC and SMT, with medium or large effect sizes in two thirds of all comparisons tested (Mdn ES = 0.60). Although SIMD youths in all conditions showed reductions in DSM diagnoses, only MATCH predicted significantly fewer posttreatment diagnoses than UC (averaging 1.0 fewer; ES = 0.93). Finally, among the entire sample, MATCH and SMT equivalently outperformed UC in reducing irritability (ES = 0.49) and the effects of each treatment condition on other outcomes were not moderated by baseline irritability. CONCLUSIONS Extant behavioral/cognitive-behavioral psychotherapies-already well-established and widely used-may be helpful for treating youths with severe irritability. A transdiagnostic, modular format showed the most consistently favorable pattern of results across multiple outcomes, informants, and measurement schedules. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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标准和模块化心理治疗对严重易怒青年的治疗效果。

目的探讨模块化，经诊断，行为/认知行为干预（MATCH）与标准手动治疗（SMT）和常规护理（UC）相比对严重易怒青年的初步疗效。方法我们分析了一项有效性试验的数据，在该试验中，将接受治疗的青年（N = 174；法师= 10.6岁； 70％的男孩）随机接受MATCH，SMT或UC（ns = 53-62）。在治疗前和治疗后，治疗期间每周以及每两年至2年的随访期间，从看护者和青年中收集了对烦躁，诊断，损伤和内在，外在，总和最严重问题的隐蔽评估。使用易激惹和障碍的基线测量来确定特征为严重易怒和情绪失调的子样本（SIMD； n = 81； Mage = 10。2年; 69％的男孩; ns = 24-31）。估计纵向多水平模型和方差分析以检查条件内和条件之间的许多临床结果。结果在患有SIMD的年轻人中，MATCH的改善比UC和SMT更快，在所有测试的比较中，三分之二具有中等或较大的效应值（Mdn ES = 0.60）。尽管在所有情况下SIMD青年都显示出DSM诊断的减少，但只有MATCH预测的治疗后诊断要比UC少得多（平均少1.0例； ES = 0.93）。最后，在整个样本中，MATCH和SMT在降低烦躁性方面均优于UC（ES = 0.49），并且每种治疗条件对其他结局的影响都不会因基线烦躁而减慢。结论现有的行为/认知-行为心理治疗方法已经建立并广泛使用，可能有助于治疗患有严重烦躁情绪的年轻人。经诊断的模块化格式显示了跨多个结果，线人和测量时间表的最一致的有利结果模式。（PsycINFO数据库记录（c）2020 APA，保留所有权利）。