ONE-SESSION TREATMENT FOR SPECIFIC PHOBIAS IN CHILDREN

针对儿童特定恐惧症的一次性治疗

• 批准号: 6639096
• 负责人: THOMAS H. OLLENDICK
• 金额: $ 37.11万
• 依托单位: VIRGINIA POLYTECHNIC INST AND ST UNIV
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-05-15 至 2005-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6639096
• 关键词: American; European; adolescence (12-20); behavior test; behavioral /social science research tag; child behavior disorders; child psychology; clinical research; clinical trials; cognitive behavior therapy; comorbidity; emotional dependency; human subject; human therapy evaluation; interview; middle childhood (6-11); outcomes research; parent offspring interaction; patient oriented research; phobias; psychometrics; psychopathology; quality of life; questionnaires; racial /ethnic difference; telemedicine

The overall aim of the proposed investigation is to examine the efficacy of a cognitive-behavioral treatment (One- Session Treatment; Ost, 1989a) in reducing symptoms and sequellae of Specific Phobia in children and adolescents. Findings indicate that clinically significant specific phobias are present in approximately 5 percent of children in community samples and in about 15 percent to 20 percent of children presenting at phobic and anxiety disorders clinics. Furthermore, findings indicate that clinic-referred children who present with specific phobias in specialized clinics are likely to be co-morbid with other anxiety disorders, affective disorders, and disruptive behavior disorders. For many children, the phobia results in considerable academic, social, and personal distress, as well as interference in day-to-day activities. Phobias may persist for a lifetime. One-Session Treatment has been found to be a rapid and effective treatment for adults with phobic disorders. Surprisingly, this treatment has not been evaluated in countries other than Sweden, and its utility in the treatment of childhood phobias has not been examined. A systematic evaluation of its efficacy in Virginia and Sweden is proposed. Specific aims are threefold: 1) to evaluate the efficacy of One- Session Treatment with children in a controlled, randomized trial; 2) to undertake systematic evaluation of its efficacy in Virginia and Sweden; and 3) to explore predictors of treatment outcome, including parental psychopathology, over-involved parenting styles, and child co-morbidity. One-hundred-and twenty children in Virginia (60 boys, 60 girls) and 120 children in Sweden (60 boys, 60 girls) between 8 and 14 years of age and meeting DSM-IV criteria for a primary diagnosis of specific phobia will be randomly assigned to One-Session Treatment, Education/Support, or Waitlist Control conditions. Following the waitlist period, children still meeting criteria for a Specific Phobia in the waitlist control and the Education/Support conditions will be provided One-Session Treatment. Depending upon remission and attrition rates, this strategy will permit a relatively robust examination of the efficacy of One-Session Treatment, its systematic evaluation in Sweden and Virginia, and the predictors of treatment outcome. As such, the present investigation will build on strengths in the current literature by using cognitive-behavioral procedures that have some, albeit limited, support in the treatment of phobic children (Ollendick and King, 1998, in press). At the same time, it will address shortcomings in extant studies by examining a treatment not studied heretofore with children (but with considerable support for its use with adults) and by examining the role of parental psychopathology, parental over- protectiveness, and child co-morbidity in moderating treatment outcome. Effectiveness studies in "real-world" clinical settings (Hoagwood, Hibbs, Brent, and Jensen, 1995) await results of this more laboratory-based controlled trial.

拟议的研究的总体目的是检查认知行为治疗（单会治疗； OST，1989a）在减少儿童和青少年特异性恐惧症的症状和后遗症方面的功效。 研究结果表明，在社区样本中约有5％的儿童中存在临床意义的特异性恐惧症，在恐惧和焦虑症诊所出现的儿童中约有15％至20％。 此外，发现表明，在专业诊所中出现特定恐惧症的诊所参考儿童可能与其他焦虑症，情感障碍和破坏性行为障碍合并。 对于许多儿童来说，恐惧症会导致大量的学术，社会和个人困扰，以及对日常活动的干预。 恐惧症可能会持续一生。已经发现，对恐惧症疾病的成年人进行了一种快速有效的治疗方法。 令人惊讶的是，这种治疗方法尚未在瑞典以外的其他国家进行评估，并且尚未检查其在儿童期恐惧症治疗的效用。 提出了对弗吉尼亚和瑞典有效性的系统评估。具体目的是三个方面：1）在受控的，随机的试验中评估对儿童的一会治疗的功效； 2）对弗吉尼亚和瑞典的效力进行系统评估； 3）探索治疗结果的预测因素，包括父母的心理病理学，过度涉及的育儿风格和儿童合并症。 弗吉尼亚州（60名男孩，60名女孩）和120名在8至14岁之间的儿童在弗吉尼亚州（60名男孩）和120名儿童，并满足DSM-IV标准，以便将特定恐惧症的主要诊断分配给一经诊断，教育/支持或候补控制条件。 在候补名单期间之后，儿童仍符合候补名单控制中特定恐惧症的标准，并将提供一项课程的治疗。 根据缓解和流失率，该策略将允许对单程治疗的疗效，瑞典和弗吉尼亚州的系统评估以及治疗结果的预测指标进行相对强大的检查。因此，本研究将在当前文献中的优势基础上使用认知行为，尽管有限一些，但在治疗恐惧症儿童方面的支持（Ollendick and King，1998年，印刷中）。 同时，它将通过检查未与儿童进行的未经研究的治疗（但对与成年人一起使用的大力支持），并检查父母心理病理学，父母过度保护性以及儿童在调节治疗结果中的儿童合作症的作用来解决现有研究的缺点。 在“现实世界”临床环境中的有效性研究（Hoagwood，Hibbs，Brent和Jensen，1995年）等待这项基于实验室的对照试验的结果。