1University of Adelaide, Australia.
J Atten Disord. 2014 May;18(4):275-82. doi: 10.1177/1087054712444732. Epub 2012 May 29.
The authors replicated and expanded on Fabiano et al.'s meta-analysis of behavioral treatments for ADHD, systematically comparing the efficacy of 7 nonpharmacological interventions.
A total of 14 controlled treatment studies conducted post-1994-evaluating behavior modification, neurofeedback therapy, multimodal psychosocial treatment, school-based programs, working memory training, parent training, and self-monitoring-were identified, primarily by searching electronic English-language databases. The results were meta-analyzed: mean-weighted effect sizes for the treatment outcomes of 625 participants (382 treatment, 243 controls) were calculated, and moderator analyses examined contributions of gender, ADHD subtype, and treatment "dosage" to outcome.
Behavior modification and neurofeedback treatments were most supported by this evidence. Interventions were generally more efficacious for girls, and least efficacious for the "combined" ADHD subtype. The authors found no dose or age effects.
Based on the small, published literature, this study supports some nonpharmacological interventions for ADHD, and indicates directions for more evaluation research into psychological treatments.
作者对 Fabiano 等人关于 ADHD 的行为治疗的荟萃分析进行了复制和扩展,系统比较了 7 种非药物干预措施的疗效。
共确定了 14 项 1994 年后进行的对照治疗研究,评估行为矫正、神经反馈疗法、多模式心理社会治疗、学校为基础的项目、工作记忆训练、家长培训和自我监测,主要通过搜索电子英文数据库。对结果进行荟萃分析:对 625 名参与者(382 名治疗组,243 名对照组)的治疗结果进行了平均加权效应量计算,并进行了调节分析,以检验性别、ADHD 亚型和治疗“剂量”对结果的影响。
行为矫正和神经反馈治疗最受该证据支持。干预措施对女孩通常更有效,对“混合型”ADHD 亚型最无效。作者没有发现剂量或年龄的影响。
基于已发表的小型文献,本研究支持 ADHD 的一些非药物干预措施,并为更多的心理治疗评估研究指明了方向。