J Consult Clin Psychol. 2016 Sep;84(9):838. doi: 10.1037/ccp0000143.
Reports an error in "Meta-analysis of dropout in treatments for posttraumatic stress disorder" by Zac E. Imel, Kevin Laska, Matthew Jakupcak and Tracy L. Simpson (, 2013[Jun], Vol 81[3], 394-404). There are two errors in the Results section. Each is described alongside the corrected results. Corrections did not influence interpretation of the results. Neither the magnitude of effects nor statistical significance of any results is substantively altered. (The following abstract of the original article appeared in record 2013-01522-001.) Objective: Many patients drop out of treatments for posttraumatic stress disorder (PTSD); some clinicians believe that trauma-focused treatments increase dropout.
We conducted a meta-analysis of dropout among active treatments in clinical trials for PTSD (42 studies; 17 direct comparisons).
The average dropout rate was 18%, but it varied significantly across studies. Group modality and greater number of sessions, but not trauma focus, predicted increased dropout. When the meta-analysis was restricted to direct comparisons of active treatments, there were no differences in dropout. Differences in trauma focus between treatments in the same study did not predict dropout. However, trauma-focused treatments resulted in higher dropout compared with present-centered therapy (PCT), a treatment originally designed as a control but now listed as a research-supported intervention for PTSD.
Dropout varies between active interventions for PTSD across studies, but variability is primarily driven by differences between studies. There do not appear to be systematic differences across active interventions when they are directly compared in the same study. The degree of clinical attention placed on the traumatic event does not appear to be a primary cause of dropout from active treatments. However, comparisons of PCT may be an exception to this general pattern, perhaps because of a restriction of variability in trauma focus among comparisons of active treatments. More research is needed comparing trauma-focused interventions to trauma-avoidant treatments such as PCT. (PsycINFO Database Record
报告了扎克·E·伊梅尔、凯文·拉斯卡、马修·雅库普卡克和特蕾西·L·辛普森所著的《创伤后应激障碍治疗中脱落情况的荟萃分析》(《咨询与临床心理学杂志》,2013年[6月],第81卷[3],第394 - 404页)中的一处错误。结果部分存在两处错误。每处错误均与修正后的结果一同描述。修正不会影响对结果的解读。任何结果的效应大小和统计显著性均未实质性改变。(原始文章的以下摘要出现在记录2013 - 01522 - 001中。)目的:许多患者退出创伤后应激障碍(PTSD)治疗;一些临床医生认为,以创伤为重点的治疗会增加脱落率。
我们对PTSD临床试验中积极治疗的脱落情况进行了荟萃分析(42项研究;17项直接比较)。
平均脱落率为18%,但各研究之间差异显著。团体治疗方式和疗程数较多可预测脱落增加,但以创伤为重点并非如此。当荟萃分析仅限于积极治疗的直接比较时,脱落情况没有差异。同一研究中治疗方法在创伤重点方面的差异并不能预测脱落情况。然而,与以当下为中心的疗法(PCT)相比,以创伤为重点的治疗导致更高的脱落率,PCT这种治疗最初设计为对照,但现在被列为PTSD的一种有研究支持的干预措施。
在不同研究中,PTSD积极干预措施的脱落情况各不相同,但变异性主要由研究间差异驱动。当在同一研究中直接比较时,积极干预措施之间似乎没有系统性差异。对创伤事件的临床关注程度似乎不是积极治疗脱落的主要原因。然而,PCT的比较可能是这一总体模式的例外,也许是因为在积极治疗比较中创伤重点的变异性受到限制。需要更多研究来比较以创伤为重点的干预措施与诸如PCT等避免创伤的治疗方法。(《心理学文摘数据库记录》