PREVENTION FOR FAMILIES WITH AFFECTIVE DISORDER

情感障碍家庭的预防

• 批准号: 2248313
• 负责人: William R. Beardslee
• 金额: $ 41.6万
• 依托单位: JUDGE BAKER CHILDREN'S CENTER
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-04-01 至 1997-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2248313
• 关键词: adolescence (12-20); behavior modification; behavior test; child behavior; child mental disorders; cognitive behavior therapy; disease /disorder proneness /risk; family; family medicine; family structure /dynamics; health education; human subject; interview; longitudinal human study; mental disorder diagnosis; mental disorder prevention; mental health epidemiology; middle childhood (6-11); mood disorders; questionnaires; self concept; statistics /biometry

The negative effects on children of serious affective disorder in parents have been conclusively demonstrated. Strategies that can be used by a wide range of practitioners to assist families are needed. This application requests funds to test the effectiveness of one such strategy, a manual-based cognitive psychoeducational preventive intervention for families with a recent episode of parental affective disorder. The intervention is designed to: (1) teach recent findings about affective illness, (2) link this factual information to the family's own illness experience, (3) help families to enhance the resiliencies of their children, and (4) help families recognize and seek appropriate services for disorder in their children (in particular depression) when it develops. The intervention is designed to be used by family physicians, internists, and pediatricians, as well as mental health professionals. Pilot work has established the safety, feasibility, and standardization of the preventive intervention approach and of a design to examine its effectiveness. A pilot study of 40 families which uses the same random assignment design and assessment strategy as the proposed study is under way with support from the William T. Grant Foundation. In order to adequately test the intervention's prevention effects on children, a much larger sample, followed over several years, is needed. We propose to enroll an additional 100 families in which a parent has experienced recent affective disorder and in which at least one child is 9-14 years old. These families will be randomly assigned either to the clinician-based cognitive psychoeducational preventive intervention program (clinician intervention families) or to a series of lectures about affective illness in families (lecture families). The two groups will be followed longitudinally with assessments of both parents and children every six months for the length of the study, at least three years for all subjects. In addition, the 40 families already enrolled in the pilot will be followed throughout the study. Modelled on assessment strategies developed in studies of children at risk for affective disorder, proposed assessment includes standard diagnostic interview schedules for the parents (SADS-L, Schedule of Affective Disorder and Schizophrenia - Lifetime Version) and children (Kiddie-SADS- E-R), standard rating scales of child functioning (Child Behavior Checklist, Youth Self Report), standard ratings of marital functioning and communication (Spanier Dyadic Adjustment Scale(, and semistructured interviews about the illness experience, response to intervention and concerns about children. Children in clinician intervention families are expected to show primary (e.g., fewer cases of depression), secondary and tertiary prevention effects over time that exceed those in lecture families. The data set from the proposed study will be combined with the data from the pilot study to obtain a large enough sample followed for a sufficient period to test preventive intervention effects.

父母严重情感障碍对孩子的负面影响 已被最终证明。 可以使用的策略 需要广泛的从业人员来帮助家庭。 这 申请要求资金来测试此类项目的有效性 策略，一种基于手册的认知心理教育预防策略 对最近出现父母情感问题的家庭进行干预 紊乱。干预措施旨在：(1) 传授最新发现 关于情感疾病，（2）将此事实信息与 家人自身的患病经历，（3）帮助家人增强 孩子的适应力，以及（4）帮助家庭认识并寻求 针对儿童的障碍（特别是 抑郁症）当它出现时。 该干预措施旨在用于 由家庭医生、内科医生、儿科医生以及精神科医生 卫生专业人员。 试点工作已建立了安全、 预防性干预方法的可行性和标准化 并设计一个检查其有效性的设计。一项针对 40 人的试点研究 使用相同的随机分配设计和评估的家庭 拟议的研究正在威廉姆斯的支持下进行 T.格兰特基金会。 为了充分检验干预措施的预防效果 儿童，需要一个更大的样本，并进行数年的跟踪。 我们建议另外招募 100 个家庭，其中父母有 最近经历过情感障碍，并且至少有一个孩子患有 9-14岁。 这些家庭将被随机分配到 基于临床医生的认知心理教育预防干预 计划（临床医生干预家庭）或一系列讲座 关于家庭中的情感疾病（讲座家庭）。 两组 将纵向跟踪父母双方的评估 在研究期间，每六个月至少有 3 名儿童 所有科目的年数。 此外，已有40个家庭报名 试点工作将贯穿整个研究过程。 仿照 在对有风险的儿童的研究中制定的评估策略 情感障碍，建议的评估包括标准诊断 家长面谈时间表（SADS-L，情感时间表） 障碍和精神分裂症 - 终身版本）和儿童（Kiddie-SADS- E-R），儿童功能标准评定量表（儿童行为 检查表，青少年自我报告），婚姻功能的标准评级 和沟通（西班牙二元调整量表（和半结构化 关于疾病经历、对干预的反应以及 对孩子的担忧。 临床医生干预家庭中的儿童 预计会显示原发性（例如，抑郁症病例较少）、继发性和 随着时间的推移，三级预防效果超过了讲座中的效果 家庭。 拟议研究的数据集将与 来自试点研究的数据，以获得足够大的样本，然后 有足够的时间来检验预防性干预的效果。