Behavioral skill practice as a predictor of mood and family functioning in adolescents with bipolar and depressive mood disorders: Results of a 6-month randomized trial of family-focused therapy.

IF 5 2区 医学 Q1 CLINICAL NEUROLOGY
Bipolar Disorders Pub Date : 2024-11-01 Epub Date: 2024-07-25 DOI:10.1111/bdi.13466
Marc J Weintraub, John A Merranko, Megan C Ichinose, Danielle M Denenny, Patricia D Walshaw, Georga Morgan-Fleming, Robin D Brown, Armen C Arevian, David J Miklowitz
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Abstract

Objective: Behavioral interventions require considerable practice of treatment skills in between therapy sessions. The effects of these treatments may vary with the degree to which patients are able to implement these practices. In offspring of parents with bipolar and major depressive disorders, we examined whether youth who frequently practiced communication and problem-solving skills between family-focused therapy (FFT) sessions had less severe mood symptoms and better psychosocial functioning over 6 months than youth who practiced less frequently.

Methods: We randomly assigned offspring (ages 12-19) of parents with mood disorders to 12 sessions of FFT plus a mobile app that encouraged the practice of communication, problem-solving and mood management skills (FFT-MyCoachConnect [MCC] condition) or 12 sessions of FFT with an app that only allowed for tracking of symptoms and stress (FFT-Track condition). Independent evaluators assessed youths' mood and psychosocial functioning at 9-week intervals over 27 weeks. Clinicians rated participants' between-session skill practice at each FFT session.

Results: FFT-MCC was associated with more frequent skill practice than FFT-Track over 18 weeks of treatment. Skill practice was associated with reductions in youths' mood instability and perceptions of family conflict over 27 weeks in both app conditions. Skill practice mediated the effects of app condition on youths' mood instability and family functioning.

Conclusions: Mobile applications as adjuncts to family therapy for youth with mood disorders can help increase skill practice. These findings provide preliminary causal evidence for behavioral skill practice improving mood symptoms and family functioning among youth with mood disorders.

行为技能练习可预测患有双相情感障碍和抑郁情绪障碍的青少年的情绪和家庭功能:为期6个月的家庭焦点疗法随机试验结果。
目标:行为干预需要在治疗间隙进行大量的治疗技能练习。这些治疗方法的效果可能会随着患者实施这些练习的程度而变化。在患有双相情感障碍和重度抑郁症的父母的后代中,我们研究了在家庭焦点疗法(FFT)疗程之间经常练习沟通和解决问题技能的青少年是否比不经常练习的青少年在 6 个月内情绪症状更轻、社会心理功能更好:我们将患有情绪障碍的父母的后代(12-19 岁)随机分配到 12 次家庭焦点疗法和一个鼓励练习沟通、解决问题和情绪管理技能的移动应用程序(FFT-MyCoachConnect [MCC] 条件)或 12 次家庭焦点疗法和一个仅允许跟踪症状和压力的应用程序(FFT-Track 条件)中。独立评估人员在 27 周内每隔 9 周对青少年的情绪和社会心理功能进行评估。临床医生在每次FFT训练中对参与者在两次训练之间的技能练习情况进行评分:结果:在为期 18 周的治疗中,FFT-MCC 与 FFT-Track 相比,技能练习更为频繁。在两种应用条件下,技能练习都能在 27 周内降低青少年的情绪不稳定性和家庭冲突感。技能练习在应用条件对青少年情绪不稳定性和家庭功能的影响中起着中介作用:结论:移动应用程序作为情绪障碍青少年家庭治疗的辅助工具,有助于增加技能练习。这些发现为行为技能练习改善情绪障碍青少年的情绪症状和家庭功能提供了初步的因果证据。
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来源期刊
Bipolar Disorders
Bipolar Disorders 医学-精神病学
CiteScore
8.20
自引率
7.40%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Bipolar Disorders is an international journal that publishes all research of relevance for the basic mechanisms, clinical aspects, or treatment of bipolar disorders and related illnesses. It intends to provide a single international outlet for new research in this area and covers research in the following areas: biochemistry physiology neuropsychopharmacology neuroanatomy neuropathology genetics brain imaging epidemiology phenomenology clinical aspects and therapeutics of bipolar disorders Bipolar Disorders also contains papers that form the development of new therapeutic strategies for these disorders as well as papers on the topics of schizoaffective disorders, and depressive disorders as these can be cyclic disorders with areas of overlap with bipolar disorders. The journal will consider for publication submissions within the domain of: Perspectives, Research Articles, Correspondence, Clinical Corner, and Reflections. Within these there are a number of types of articles: invited editorials, debates, review articles, original articles, commentaries, letters to the editors, clinical conundrums, clinical curiosities, clinical care, and musings.
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