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局部疗效是否等同于整体疗效?一项针对部分治疗研究的荟萃分析。

Are the parts as good as the whole? A meta-analysis of component treatment studies.

机构信息

Department of Psychology, University of Southern Mississippi, USA.

出版信息

J Consult Clin Psychol. 2013 Aug;81(4):722-36. doi: 10.1037/a0033004. Epub 2013 May 20.

Abstract

OBJECTIVE

Component studies compare standard treatments to treatments with added components or dismantled components. A previous meta-analysis (Ahn & Wampold, 2001) failed to find any differences in outcome between treatments with more components and those with fewer components, leading the authors to conclude that common factors and not specific ingredients account for therapeutic change.

METHOD

The current random effects model meta-analysis of psychotherapy component studies conducted between 1980 and 2010 included more than 3 times as many studies as Ahn and Wampold's (2001) meta-analysis (k = 66). Unlike the previous meta-analysis, this study conducted separate meta-analyses for additive and dismantling studies and also examined treatment outcomes at follow-up.

RESULTS

For the dismantling studies, there were no significant differences between the full treatments and the dismantled treatments. For the additive studies, the treatment with the added component yielded a small, but significant, effect at completion (d = 0.14) and a slightly larger effect at follow-up (d = 0.28), but only for the specific problems that were targeted for treatment. Despite the diversity of populations studied, problems treated, and treatments examined, there was little heterogeneity among the results of these studies.

CONCLUSION

These findings suggest that added specific ingredients may contribute modestly to treatment outcomes.

摘要

目的

成分研究将标准治疗与添加成分或拆分成分的治疗进行比较。先前的荟萃分析(Ahn 和 Wampold,2001)未能发现具有更多成分的治疗与具有较少成分的治疗之间在结果上有任何差异,这导致作者得出结论,共同因素而不是特定成分解释了治疗变化。

方法

本研究对 1980 年至 2010 年间进行的心理治疗成分研究进行了随机效应模型荟萃分析,纳入的研究数量是 Ahn 和 Wampold(2001)荟萃分析的 3 倍以上(k=66)。与之前的荟萃分析不同,本研究对附加研究和拆分研究分别进行了荟萃分析,并检查了随访时的治疗结果。

结果

对于拆分研究,完整治疗与拆分治疗之间没有显著差异。对于附加研究,添加成分的治疗在完成时产生了较小但显著的效果(d=0.14),在随访时效果略大(d=0.28),但仅针对针对治疗的特定问题。尽管研究的人群、治疗的问题和检查的治疗方法存在多样性,但这些研究的结果之间几乎没有异质性。

结论

这些发现表明,添加特定的成分可能会对治疗结果产生适度的影响。

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