【摘要】 目的:检验个体认知行为治疗对发生过无保护性行为中学生的无保护性行为、性态度的干预效果。方法:选取湖南长沙4所中学的1362名学生,筛选出发生过无保护性行为的学生68人[青少年健康相关危险行为问卷(HBICA)无保护性行为分量表(US)得分≥1],随机分配为认知行为治疗组(CBT组)和对照组,每组34人。由咨询师对CBT组进行一对一的认知行为治疗。治疗采用会谈形式,每周1次,每次50~60 min。在此期间对照组不接受来自咨询师的干预措施。以US、性态度量表中文版(ATSS)为评估工具,对所有入组对象在基线水平、干预后1个月、干预后3个月进行评估。结果:CBT组US得分的减分率分析结果显示,治疗有效率在80%以上。混合线性模型分析结果显示,US及ATSS评分的分组处理、测量时间、分组处理及测量时间的交互作用均有统计学意义(均P<0.05)。简单效应分析表明,CBT组的US、ATSS得分自干预后1个月开始低于基线测试水平[(2.2±2.9)vs.(4.7±3.1),(3.2±1.6)vs.(4.7±3.1);(38.2±4.9)vs.(40.9±5.1),(37.2±5.4)vs.(40.9±5.1),均P<0.01],对照组3次US、ATSS测量得分的差异均无统计学意义(均P>0.05)。在干预后1个月、干预后3个月,两组间US、ATSS得分差异的效应量均达到中等以上水平(Cohen’s d=0.50~0.70)。结论:个体认知行为治疗对发生过无保护性行为中学生的无保护性行为、性态度有较好的干预效果。更多还原

【Abstract】 Objective:To evaluate the efficacy of individualized cognitive behavioral therapy for unprotected sex and sexual attitude of middle school students having unprotected sex.Methods:A target sample of 68 adolescents having unprotected sex was recruited from 4 secondary schools in Changsha,Hunan [the unprotected sex(US) score of Health-Risk Behavior Inventory for Chinese Adolescents(HBICA)≥1].Subjects were randomized assigned to cognitive behavioral therapy group(CBT group) and control group.Each group had 34 subjects.The CBT group was giving one-on-one counseling for 6 weeks(50 to 60 minutes weekly).The control group didn’t receive intervention by counselors.The US and Attitudes Toward Sexuality Scale(ATSS) were selected as criterion measurements.Outcome assessments were made at baseline and at 1-and 3-month follow-up.Results:The reduction rate of US scores showed that the response rate of therapy was over 80%.Mixed linear model analysis showed that there were significant group effect,time effect and group×time effect in scores of US and ATSS(Ps<0.05).Simple effect analysis indicated that the scores of US and ATSS of CBT group were significant lower than those of baseline from 1-month follow-up[(2.2±2.9) vs.(4.7±3.1),(3.2±1.6) vs.(4.7±3.1);(38.2±4.9) vs.(40.9±5.1),(37.2±5.4) vs.(40.9±5.1),Ps<0.01],whereas the scores of those in the control group did not showany significant difference(Ps>0.05).At 1-month and 3 month follow-up,moderate effect sizes were found for the CBT and control groups on all the outcome measures(Cohen’s d=0.50-0.70).Conclusion:The individualized cognitive behavioral therapy could effectively reduce the level of unprotected sex and sexual attitude of adolescents having unprotected sex.更多还原