拉丁美洲大学生的焦虑和抑郁的网络认知行为治疗与常规治疗:一项随机临床试验。

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of consulting and clinical psychology Pub Date : 2023-12-01 DOI:10.1037/ccp0000846

Corina Benjet, Yesica Albor, Libia Alvis-Barranco, Carlos C Contreras-Ibáñez, Gina Cuartas, Lorena Cudris-Torres, Noé González, Jacqueline Cortés-Morelos, Raúl A Gutierrez-Garcia, Maria Elena Medina-Mora, Pamela Patiño, Eunice Vargas-Contreras, Pim Cuijpers, Sarah M Gildea, Alan E Kazdin, Chris J Kennedy, Alex Luedtke, Nancy A Sampson, Maria V Petukhova, Nur Hani Zainal, Ronald C Kessler

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引用次数: 0

摘要

目的:在拉丁美洲低收入和中等收入国家(LMIC)的大学生中，未经治疗的精神障碍很重要，因为这些国家的治疗障碍很高。需要可扩展的干预措施。本研究比较了哥伦比亚和墨西哥大学生的临床显著焦虑和抑郁的跨诊断自我引导和引导互联网提供的认知行为疗法(i-CBT)与常规治疗(TAU)。方法:1319名大学生(平均[SD]年龄= 21.4[3.2])，焦虑症(由广泛性焦虑障碍-7 (GAD-7)确定= 10+和/或抑郁症(由患者健康问卷-9 (PHQ-9)确定= 10+);78.7%的女性;来自哥伦比亚和墨西哥七所大学的55.9%的第一代大学生)被随机分配到文化适应版本的自我引导i-CBT (n = 439)、引导i-CBT (n = 445)或常规治疗(TAU;N = 435)。所有随机分组的参与者在随机分组后3个月进行重新评估。主要结局是焦虑(GAD-7 = 0-4)和抑郁(PHQ-9 = 0-4)的缓解。我们假设，与其他干预措施相比，引导i-CBT的缓解率更高。结果:意向治疗分析发现，随机分配到引导i-CBT的参与者的调整缓解率(大学和随访损失)明显高于自我引导i-CBT (ARD = 13.1%， χ12 = 10.4, p = .001)或TAU (ARD = 11.2%， χ12 = 8.4, p = .004)，但自我引导i-CBT和TAU之间无显著差异(ARD = -1.9%， χ12 = 0.2, p = .63)。每个协议的敏感性分析和维度结果的分析得出了类似的结果。结论:虽然需要进一步的研究来确定哪些学生最有可能从这种干预中受益，但通过引导i-CBT可以显著减少LMIC大学生的焦虑和抑郁。(PsycInfo数据库记录(c) 2023 APA，版权所有)。

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Internet-delivered cognitive behavior therapy versus treatment as usual for anxiety and depression among Latin American university students: A randomized clinical trial.

Objective: Untreated mental disorders are important among low- and middle-income country (LMIC) university students in Latin America, where barriers to treatment are high. Scalable interventions are needed. This study compared transdiagnostic self-guided and guided internet-delivered cognitive behavioral therapy (i-CBT) with treatment as usual (TAU) for clinically significant anxiety and depression among undergraduates in Colombia and Mexico.

Method: 1,319 anxious, as determined by the Generalized Anxiety Disorder-7 (GAD-7) = 10+ and/or depressed, as determined by the Patient Health Questionnaire-9 (PHQ-9) = 10+, undergraduates (mean [SD] age = 21.4 [3.2]); 78.7% female; 55.9% first-generation university student) from seven universities in Colombia and Mexico were randomized to culturally adapted versions of self-guided i-CBT (n = 439), guided i-CBT (n = 445), or treatment as usual (TAU; n = 435). All randomized participants were reassessed 3 months after randomization. The primary outcome was remission of both anxiety (GAD-7 = 0-4) and depression (PHQ-9 = 0-4). We hypothesized that remission would be higher with guided i-CBT than with the other interventions.

Results: Intent-to-treat analysis found significantly higher adjusted (for university and loss to follow-up) remission rates (ARD) among participants randomized to guided i-CBT than either self-guided i-CBT (ARD = 13.1%, χ12 = 10.4, p = .001) or TAU (ARD = 11.2%, χ12 = 8.4, p = .004), but no significant difference between self-guided i-CBT and TAU (ARD = -1.9%, χ12 = 0.2, p = .63). Per-protocol sensitivity analyses and analyses of dimensional outcomes yielded similar results.

Conclusions: Significant reductions in anxiety and depression among LMIC university students could be achieved with guided i-CBT, although further research is needed to determine which students would most likely benefit from this intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.