More than 50 years of randomized clinical trials for youth psychotherapies have resulted in moderate effect sizes for treatments targeting the most common mental health problems in children and adolescents (i.e., anxiety, depression, conduct problems, and attention disorders). Despite having psychotherapies that are effective for many children, there has been a dearth of progress in identifying the contextual factors that likely influence who will respond to a given psychotherapy, and under what conditions. The developmental psychopathology evidence base consistently demonstrates that psychosocial risk exposures (e.g., childhood adversities, interpersonal stressors, family dysfunction) significantly influence the onset and course of youth psychopathology. However, the developmental psychopathology framework remains to be well integrated into treatment development and psychotherapy research. We argue that advances in basic developmental psychopathology research carry promising implications for the design and content of youth psychotherapies. Research probing the effects of psychosocial risks on youth development can enrich efforts to identify contextual factors in psychotherapy effectiveness and to personalize treatment. In this article we review empirically supported and hypothesized influences of individual- and family-level risk factors on youth psychotherapy outcomes, and we propose a framework for leveraging developmental psychopathology to strengthen psychotherapies.

中文翻译：

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利用心理社会风险的发展科学加强青少年心理治疗


超过 50 年的青少年心理治疗随机临床试验针对儿童和青少年最常见的心理健康问题（即焦虑、抑郁、品行问题和注意力障碍）的治疗取得了中等效果。尽管心理治疗对许多儿童有效，但在确定可能影响谁会对特定心理治疗做出反应以及在什么条件下做出反应的背景因素方面仍缺乏进展。发展精神病理学证据基础一致表明，心理社会风险暴露（例如，童年逆境、人际压力、家庭功能障碍）显着影响青少年精神病理学的发生和进程。然而，发展精神病理学框架仍有待很好地融入治疗开发和心理治疗研究。我们认为，基础发展精神病理学研究的进展对青少年心理治疗的设计和内容具有良好的影响。探讨心理社会风险对青少年发展的影响的研究可以丰富我们的努力，以确定心理治疗有效性的背景因素并进行个性化治疗。在本文中，我们回顾了个人和家庭层面的风险因素对青少年心理治疗结果的实证支持和假设影响，并提出了一个利用发展精神病理学来加强心理治疗的框架。