Factores associados à eficácia da terapia cognitivo-comportamental em crianças e adolescentes com perturbação de oposição-desafiante: uma revisão sistemática
DOI:
https://doi.org/10.51247/pdlc.v7i1.543Palavras-chave:
Perturbação desafiante opositiva; terapia cognitivo-comportamental; crianças; adolescentes; fatores associadosResumo
A terapia cognitivo-comportamental (TCC) é um tratamento de primeira linha para a perturbação opositivo-desafiante (TOD); no entanto, a variabilidade na resposta dificulta a identificação dos perfis que podem beneficiar de cada intervenção. Este estudo teve como objetivo sintetizar a evidência científica sobre os fatores clínicos, demográficos, familiares, terapêuticos e contextuais associados à eficácia das intervenções baseadas na TCC em crianças e adolescentes com TOD, considerando o seu papel preditivo, moderador ou mediador. Uma revisão sistemática foi conduzida de acordo com as diretrizes PRISMA e registada no PROSPERO. As pesquisas foram realizadas no Scopus, Web of Science, PubMed, EBSCO, PsycINFO e Redalyc, utilizando as ferramentas JBI para avaliar o risco de viés. Foram incluídos 12 estudos com aproximadamente 2026 participantes. A gravidade dos sintomas basais, a comorbilidade com PHDA, os défices de regulação emocional e a atividade neural pré-frontal dorsolateral foram associados a diferenças nos resultados terapêuticos. As práticas parentais, como a supervisão, o afeto, a hostilidade e a disciplina inconsistente, moderaram a aquisição de competências adaptativas. A adesão e determinados comportamentos terapêuticos estiveram associados a resultados específicos, embora algumas análises não tenham apresentado significância estatística. Os programas focados no relacionamento e nas emoções melhoraram os resultados. A idade e o sexo não apresentaram evidências consistentes de moderação. O estudo conclui que a resposta terapêutica está relacionada com fatores clínicos, familiares e de implementação, apoiando modelos personalizados que integram a regulação emocional e as práticas parentais no planeamento terapêutico.
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