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首页> 外文期刊>Journal of abnormal child psychology >Latent Profiles of Cognitive and Interpersonal Risk Factors for Adolescent Depression and Implications for Personalized Treatment
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Latent Profiles of Cognitive and Interpersonal Risk Factors for Adolescent Depression and Implications for Personalized Treatment

机译：青少年抑郁症认知和人际危险因素的潜在概况及个性化治疗的影响

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A personalized approach to treatment with patients being matched to the best-fit treatment has been proposed as one possible solution to the currently modest treatment response rates for adolescent depression. Personalized treatment involves identifying and characterizing subgroups likely to respond differently to different treatments. We investigated the feasibility of this approach, by focusing on two key risk factors that are the purported treatment targets of cognitive behavioral therapy (CBT) and interpersonal psychotherapy for depressed adolescents (IPT-A): negative unrealistic cognitions and interpersonal relationship difficulties, respectively. We sought to learn whether subgroups high and low on the two risk factors, respectively, might be identified in a large sample of depressed, treatment-seeking adolescents. Latent class analysis (LCA) was conducted on measures of the two risk factors among 431 adolescents (age 12-17) in the Treatment for Adolescents with Depression Study. LCA identified three classes: (1) adolescents with high levels of problems in both family relationships and cognitions (21.6% of sample), (2) adolescents with moderate levels of problems in both domains (52.4%), and (3) adolescents with low levels of problems in both domains (26.0%). These subgroups did not predict treatment outcome with CBT or CBT + fluoxetine (COMB). The results challenge a current assumption about how treatments could be personalized, and they support a multi-causal model of depression rather than a risk-factor-specific model. Strategies other than risk factor-based personalizing for case assignment to CBT vs. IPT-A are discussed.
机译：已经提出了与符合最佳拟合处理匹配的患者的个性化方法是对青少年抑郁症目前适度的治疗响应率的一种可能解决方案。个性化的治疗涉及识别和表征可能对不同治疗不同的可能反应的亚组。我们通过专注于两个关键危险因素来调查这种方法的可行性，这些方法是令人抑制青少年的认知行为治疗（CBT）和人际心理治疗（IPT-A）的毒性治疗靶点（IPT-A）：负不切实际的认知和人际关系的困难。我们试图在两个风险因素分别在两个风险因素的情况下，在大量抑郁的治疗青少年样本中，可以了解亚组。潜在阶级分析（LCA）是对431名青少年（12-17岁）的两个危险因素的措施进行了抑郁症研究的青少年的措施。 LCA确定了三个类：（1）家庭关系和认知（样品的21.6％），（2）青少年在域名（52.4％）和（3）青少年中存在适中问题的青少年（2）青少年的青少年两个域中的低水平（26.0％）。这些亚组没有预测CBT或CBT +氟西汀（梳子）的治疗结果。结果挑战目前关于治疗如何是个性化的现有假设，它们支持多因果模型的抑郁症，而不是特定风险因素模型。讨论了基于风险因子的策略，以便对CBT与IPT-A分配进行个性化。

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