Treatment moderators of child-and family-focused cognitive-behavioral therapy for pediatric bipolar disorder
SM Weinstein, DB Henry, AC Katz, AT Peters… - Journal of the American …, 2015 - Elsevier
SM Weinstein, DB Henry, AC Katz, AT Peters, AE West
Journal of the American Academy of Child & Adolescent Psychiatry, 2015•ElsevierObjective Prior work has demonstrated the efficacy of child-and family-focused cognitive-
behavioral therapy (CFF-CBT) versus enhanced treatment as usual (TAU; unstructured
psychotherapy) for pediatric bipolar disorder (PBD). The current study builds on primary
findings by examining baseline child, parent, and family characteristics as moderators of
symptom response trajectories. Method A total of 69 youth aged 7 to 13 years (mean= 9.19
years, SD= 1.61 years) with DSM-IV-TR bipolar I, II, or not otherwise specified (NOS) were …
behavioral therapy (CFF-CBT) versus enhanced treatment as usual (TAU; unstructured
psychotherapy) for pediatric bipolar disorder (PBD). The current study builds on primary
findings by examining baseline child, parent, and family characteristics as moderators of
symptom response trajectories. Method A total of 69 youth aged 7 to 13 years (mean= 9.19
years, SD= 1.61 years) with DSM-IV-TR bipolar I, II, or not otherwise specified (NOS) were …
Objective
Prior work has demonstrated the efficacy of child- and family-focused cognitive-behavioral therapy (CFF-CBT) versus enhanced treatment as usual (TAU; unstructured psychotherapy) for pediatric bipolar disorder (PBD). The current study builds on primary findings by examining baseline child, parent, and family characteristics as moderators of symptom response trajectories.
Method
A total of 69 youth aged 7 to 13 years (mean = 9.19 years, SD = 1.61 years) with DSM-IV-TR bipolar I, II, or not otherwise specified (NOS) were randomly assigned, with family members, to CFF-CBT or TAU. Both treatments consisted of 12 weekly sessions and 6 monthly booster sessions. Participants were assessed at baseline, 4, 8, and 12 weeks, and 6-month follow-up on mania and depression symptoms and overall psychiatric severity. Parents and youth also provided self-report data on baseline characteristics.
Results
CFF-CBT demonstrated greater efficacy for youth depressive symptoms relative to TAU for parents with higher baseline depressive symptoms and lower income, and marginally for families with higher cohesion. In addition, youth with lower baseline depression and youth with higher self-esteem showed a poorer response to TAU versus CFF-CBT on mania symptom outcomes. Age, sex, baseline mania symptoms, comorbidity, and suicidality did not moderate treatment response.
Conclusion
Results indicate that CFF-CBT was relatively immune to the presence of treatment moderators. Findings suggest the need for specialized treatment to address symptoms of PBD in the context of parental symptomatology and financial stress.
Elsevier
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