Are Psychotherapies for Young People Growing Stronger? Tracking Trends Over Time for Youth Anxiety, Depression, Attention-Deficit/Hyperactivity Disorder, and Conduct Problems

Are Psychotherapies for Young People Growing Stronger? Tracking Trends Over Time for Youth Anxiety, Depression, Attention-Deficit/Hyperactivity Disorder, and Conduct Problems

Forfattere
Weisz, J. R. Kuppens, S. Ng, M. Y. Vaughn-Coaxum, R. A. Ugueto, A. M. Eckshtain, D. Corteselli, K. A.
Årstall
2018
Tidsskrift
Volum
Sider
1745691618805436
With the development of empirically supported treatments over the decades, have youth psychotherapies grown stronger? To investigate, we examined changes over time in treatment effects for four frequently treated youth mental-health problems: anxiety, depression, attention-deficit hyperactivity disorder (ADHD), and conduct disorders. We used PubMed and PsycINFO to search for randomized controlled trials (RCTs) that were published between January 1960 and May 2017 involving youths between the ages of 4 and 18 years. We also searched reviews and meta-analyses of youth psychotherapy research, followed reference trails in the reports we identified, and obtained additional studies identified by therapy researchers whom we contacted. We identified 453 RCTs (31,933 participants) spanning 53 years (1963-2016). Effect sizes for the problem-relevant outcome measures were synthesized via multilevel meta-analysis. We tracked temporal trends for each problem domain and then examined multiple study characteristics that might moderate those trends. Mean effect size increased nonsignificantly for anxiety, decreased nonsignificantly for ADHD, and decreased significantly for depression and conduct problems. Moderator analyses involving multiple study subgroups showed only a few exceptions to these surprising patterns. The findings suggest that new approaches to treatment design and intervention science may be needed, especially for depression and conduct problems. We suggest intensifying the search for mechanisms of change, making treatments more transdiagnostic and personalizable, embedding treatments within youth ecosystems, adapting treatments to the social and technological changes that alter youth dysfunction and treatment needs, and resisting old habits that can make treatments unduly skeuomorphic.

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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Psykiske vansker og lidelser

Atferdsproblemer

Utagerende/utfordrende atferd (uro, bråk)

Følelsesmessige problemer

Depresjon og nedstemthet (inkl. både vansker og lidelse)

Angstproblematikk

Angst og engstelighet (inkl. både vansker og lidelse)

ADHD

Tiltak

Psykologiske behandlingsmetoder

Kognitiv atferdsterapi, atferdsterapi og kognitiv terapi

Psykodynamisk/interpersonlig terapi

Aldersgruppe

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

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