ABSTRACT

Objective

Two lines of research, on outcome moderators and on novel treatment targets, seek to improve the overall efficacy of child anxiety treatment, with mixed results. We propose that an integration of both lines of research can lead to improved treatment efficacy. In a first proof of concept of this approach, we studied whether the interaction between baseline levels and targeted changes in peripheral oxytocin (OT) can predict differential responses to two childhood anxiety treatments.

Method

A total of 124 mother-child dyads participated in the study. Children’s salivary OT levels were measured at baseline and again, immediately after an experimental dyadic interaction in the lab. Dyads were subsequently randomized to receive one of two treatments, differing in their targets: SPACE (Supportive Parenting for Anxious Childhood Emotions) and CBT (cognitive-behavioral therapy). Treatment outcomes were assessed using the Childhood Anxiety Related Emotional Disorders scale, reported by both mother and child.

Results

The findings suggest that in SPACE, where the mother is the main agent of change, higher baseline levels of child OT, coupled with increases in OT following a positive mother-child interaction, predicted greater treatment efficacy. By contrast, in CBT, where the child is the main agent of change, higher baseline levels of child OT, coupled with a decrease in OT following the interaction, predicted greater treatment efficacy.

Conclusions

The findings highlight the importance of the integration between moderators and targets of treatments for progress toward improving treatment efficacy through precision medicine.

中文翻译：

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催产素作为生物标志物对儿童焦虑症的 SPACE 与 CBT 治疗有不同的影响

摘要

客观的

关于结果调节因素和新治疗目标的两项研究旨在提高儿童焦虑治疗的整体疗效，但结果好坏参半。我们建议整合这两种研究可以提高治疗效果。在这种方法的第一个概念验证中，我们研究了基线水平和外周催产素（OT）目标变化之间的相互作用是否可以预测对两种儿童焦虑治疗的不同反应。

方法

共有 124 名母子参与了这项研究。儿童的唾液 OT 水平在基线时被测量，并在实验室进行实验性二元相互作用后立即再次测量。随后，二人被随机接受两种治疗方法中的一种，其目标不同：SPACE（针对童年焦虑情绪的支持性养育）和 CBT（认知行为治疗）。使用母亲和孩子报告的儿童期焦虑相关情绪障碍量表评估治疗结果。

结果

研究结果表明，在母亲是变革的主要推动者的 SPACE 中，儿童 OT 基线水平较高，加上积极的母子互动后 OT 增加，预示着更好的治疗效果。相比之下，在儿童是变化的主要推动者的 CBT 中，儿童 OT 的基线水平较高，加上互动后 OT 的减少，预示着治疗效果会更好。

结论

研究结果强调了调节因子和治疗目标之间的整合对于通过精准医学提高治疗效果的进展的重要性。