基于儿童心理复原力提升的学校普遍性干预可有效改善儿童心理健康

Effectiveness of a universal resilience-focused intervention for children in the school setting: a randomized controlled trial

基于儿童心理复原力提升的学校普遍性心理干预的有效性：随机对照试验

Author: Wenjuan Huang, Peipei Wu, Jing Li, Yi Zhou, Zhou Xiong, Puyu Su, Yuhui Wan, Fangbiao Tao, Ying Sun

Source: Journal of Affective Disorders

DOI: 10.1016/j.jad.2024.09.120

Abstract

Background: Psychological resilience can be augmented through the acquisition of specific cognitive or emotional regulation skills, enabling children to adapt to or recover from stressful events, disadvantages, or adversities. We aimed to evaluate the efficacy of a Tianchang Resilience-focused inTervention program (TRT1 program) on resilience and mental health conditions of Chinese children.

Methods: This study was a two-arm cluster-randomized controlled trial, performed in Tianchang, a county in China. Students from 20 classes in a local primary school (aged 8.7-11.2 years) were randomly allocated to receive a resilience-focused intervention or waitlist group. The intervention comprised weekly 40-min sessions for 14 weeks and co-led by lay counsellors. Measures of emotional symptoms, behavioral difficulties, and resilience were collected at pre-, post-intervention, 6-months, and 12-months follow-up.

Results: Between June 16, 2022, and September 4, 2022, 775 eligible students were recruited (mean age 9.93 years; 420 [54.2 %] boys). Relative to the waitlist group (N = 391), the intervention group (N = 384) reported a significant reduction in depressive and anxiety symptoms at post-intervention (all p < 0.001), 6-months (p = 0.007; p = 0.002) and 12-months follow-up (p = 0.018; p = 0.018), respectively. The intervention group effects were also observed on resilience at post-intervention follow-up (p = 0.006), and remained stable over 6-months (p < 0.001) and 12-months follow-up (p = 0.022).

Conclusions: This study demonstrated that the TRT program, a universal resilience-focused intervention for children in the school setting, showed long-term effectiveness in improving resilience and mental health conditions. This minimally trained laypersons-delivered intervention might enhance the program's generalizability to other communities.

Keywords: Child; Intervention; Mental health; Psychological resilience; Randomized controlled trial.

摘要

背景：心理复原力（psychological resilience）是指个体能够适应逆境或应激源、或从中恢复的能力，可以通过学习某些技能得到提升。本文旨在评估天长市开展的基于心理复原力提升的干预项目（TRT项目）对改善中国儿童心理复原力及心理健康状况的有效性。

方法：本研究采用双臂随机对照试验设计，在中国天长市进行。从当地一所小学的20个班级中招募了775名学生（年龄范围8.7－11.2岁），随机分配到干预组或等待干预组。干预组接受由非专业人员共同开展为期14周、每周40分钟的干预课程。在干预前、干预后即刻、6个月及12个月进行随访调查，包括情绪症状、行为问题及心理复原力水平。

结果：在2022年6月16日至2022年9月4日期间，共招募775名符合条件的学生（平均年龄9.93岁；男童420人，占54.2%）。与等待干预组（N = 391）相比，干预组（384 人）在干预后即刻（p ＜ 0.001; p ＜ 0.001）、6个月（p = 0.007；p = 0.002）和12个月的随访（p = 0.018；p = 0.018）中，抑郁症状和焦虑症状均显著降低。在干预后即刻的随访中，也观察到干预组对复原力的影响（p = 0.006），并在6个月（p < 0.001）和12个月的随访（p = 0.022）中保持稳定。

结论：这项研究表明，TRT 项目是一项基于学校开展的儿童心理复原力提升的普遍性干预措施，它在改善心理复原力和心理健康状况方面具有长期效果。这种由训练有素的非专业人员提供的干预措施可能会增强该项目在其他地区的推广性。