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一项关于愤怒心理治疗的荟萃分析:制定循证实践指南。

A meta-analysis of the psychological treatment of anger: developing guidelines for evidence-based practice.

机构信息

Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1A1, Canada.

出版信息

J Am Acad Psychiatry Law. 2009;37(4):473-88.

Abstract

There is no clear evidence to guide mental health professionals in assessing and treating angry clients. Recent reviews have considered cognitive and behavioral approaches to the treatment of anger, but little is known about the potential effectiveness of other treatment modalities. A meta-analytic review was conducted to examine the effects of treating dimensions of anger by using various psychological treatments found in the scientific literature. The final analysis included 96 studies and 139 treatment effects. The nine types of psychological treatments included cognitive, cognitive behavior therapy, exposure, psychodynamic, psychoeducational, relaxation-based, skills-based, stress inoculation, and multicomponent. The overall weighted standardized mean difference across all treatments was 0.76 (95% confidence interval [CI], 0.67-0.85, Q = 403.13, df 138, p < .001, I(2) = 65.76), which suggests that psychological treatments are generally effective in treating anger. The results also suggest a considerable degree of variability in the effect sizes of specific treatments for anger. The results show that at least some of the variability may be explained by the number of treatment sessions offered to participants, the use of manuals to guide delivery of the treatment, the use of fidelity checks, the setting of the research, and whether the study was published or unpublished. This review builds on previous evidence of the effectiveness of psychological treatments of maladaptive anger, and it provides the basis for developing evidence-based guidelines for specific populations with anger problems.

摘要

目前,心理健康专业人员在评估和治疗愤怒患者时,缺乏明确的指导依据。最近的综述考虑了认知和行为方法在愤怒治疗中的应用,但对于其他治疗方式的潜在有效性知之甚少。本研究进行了荟萃分析,以评估通过各种心理治疗方法来治疗愤怒的不同维度的效果,这些治疗方法均来源于科学文献。最终分析纳入了 96 项研究和 139 个治疗效果。这 9 种心理治疗方法包括认知疗法、认知行为疗法、暴露疗法、心理动力学疗法、心理教育疗法、放松疗法、技能训练疗法、应激接种疗法和多成分疗法。所有治疗方法的加权标准化均数差总体为 0.76(95%置信区间 [CI],0.67-0.85,Q=403.13,df 138,p<.001,I²=65.76),这表明心理治疗通常对治疗愤怒有效。研究结果还表明,针对愤怒的特定治疗方法的效果大小存在相当大的差异。结果表明,至少有一些变异性可以通过向参与者提供的治疗次数、使用手册来指导治疗的实施、使用保真度检查、研究环境以及研究是否发表或未发表来解释。本综述建立在之前关于心理治疗方法对适应不良愤怒的有效性的证据之上,并为针对愤怒问题的特定人群制定基于证据的指南提供了基础。

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