Imel Zac E, Wampold Bruce E, Miller Scott D, Fleming Reg R
Department of Counseling Psychology, University of Wisconsin-Madison, 53706, USA.
Psychol Addict Behav. 2008 Dec;22(4):533-43. doi: 10.1037/a0013171.
To estimate the relative efficacy of alcohol use disorder treatments, the authors meta-analyzed studies that directly compared 2 bona fide psychological treatments. The authors accommodated problems with the inclusion of multiple treatment comparisons by randomly assigning a positive/negative sign to the effect size derived from each comparison and then estimating the extent to which effect sizes were heterogeneous. The authors' primary hypothesis was that the variability in effect sizes of bona fide psychological treatments for alcohol use disorders that were directly compared would be zero. For both alcohol measures and measures of abstinence, analyses indicate that effects were homogenously distributed about zero (I(2) = 10.61, 0.00, respectively), indicating that different treatment comparisons yielded a common effect size that was not significantly different from zero. Analyses also indicate that allegiance accounted for a significant portion of variability in differences between treatments. Implications for the treatment of alcohol use disorders as well as research on the mechanisms responsible for the benefit of treatment are discussed.
为评估酒精使用障碍治疗方法的相对疗效，作者对直接比较两种真正心理治疗方法的研究进行了荟萃分析。作者通过对每次比较得出的效应量随机赋予正/负号，解决了纳入多种治疗比较带来的问题，然后估计效应量的异质性程度。作者的主要假设是，直接比较的酒精使用障碍真正心理治疗方法的效应量变异性为零。对于酒精测量指标和戒酒指标，分析表明效应围绕零呈均匀分布（I(2)分别为10.61、0.00），这表明不同的治疗比较产生了一个与零无显著差异的共同效应量。分析还表明，治疗师的偏好解释了治疗差异变异性的很大一部分。本文讨论了对酒精使用障碍治疗的启示以及对治疗获益机制的研究。
