Department of Psychology, Sam Houston State University, Huntsville, TX 77341, USA.
J Consult Clin Psychol. 2010 Dec;78(6):885-97. doi: 10.1037/a0020620.
We used growth mixture modeling to examine heterogeneity in treatment response in a secondary analysis of 2 randomized controlled trials testing multidimensional family therapy (MDFT), an established evidence-based therapy for adolescent drug abuse and delinquency.
The first study compared 2 evidence-based adolescent substance abuse treatments: individually focused cognitive-behavioral therapy and MDFT in a sample of 224 urban, low-income, ethnic minority youths (average age = 15 years, 81% male, 72% African American). The second compared a cross-systems version of MDFT (MDFT-detention to community) with enhanced services as usual for 154 youths, also primarily urban and ethnic minority (average age = 15 years, 83% male, 61% African American, 22% Latino), who were incarcerated in detention facilities.
In both studies, the analyses supported the distinctiveness of 2 classes of substance use severity, characterized primarily by adolescents with higher and lower initial severity; the higher severity class also had greater psychiatric comorbidity. In each study, the 2 treatments showed similar effects in the classes with lower severity/frequency of substance use and fewer comorbid diagnoses. Further, in both studies, MDFT was more effective for the classes with greater overall substance use severity and frequency and more comorbid diagnoses.
Results indicate that for youths with more severe drug use and greater psychiatric comorbidity, MDFT produced superior treatment outcomes.
我们使用增长混合物建模在对两项测试多维家庭治疗（MDFT）的随机对照试验的二次分析中检查治疗反应的异质性，MDFT 是一种针对青少年药物滥用和犯罪的成熟循证治疗方法。
第一项研究比较了两种基于证据的青少年药物滥用治疗方法：针对个人的认知行为疗法和 MDFT，在一项由 224 名城市、低收入、少数民族青年（平均年龄为 15 岁，81%为男性，72%为非裔美国人）组成的样本中进行。第二项研究比较了 MDFT 的跨系统版本（MDFT-拘留到社区）与 154 名主要来自城市和少数民族的青年（平均年龄为 15 岁，83%为男性，61%为非裔美国人，22%为拉丁裔）的增强服务，他们被监禁在拘留设施中。
在这两项研究中，分析支持了物质使用严重程度的两个类别的独特性，主要由初始严重程度较高和较低的青少年为特征；严重程度较高的类别还具有更大的精神共病。在每项研究中，两种治疗方法在物质使用严重程度和共病诊断较低的类别中均显示出相似的效果。此外，在这两项研究中，MDFT 对总体物质使用严重程度和频率更高且共病诊断更多的类别更为有效。
结果表明，对于药物使用更严重且精神共病更多的青少年，MDFT 产生了更好的治疗效果。
