School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia.
Eur Eat Disord Rev. 2017 Jan;25(1):3-12. doi: 10.1002/erv.2492. Epub 2016 Nov 16.
This systematic review synthesised the literature on predictors, moderators, and mediators of outcome following Fairburn's CBT for eating disorders. Sixty-five articles were included. The relationship between individual variables and outcome was synthesised separately across diagnoses and treatment format. Early change was found to be a consistent mediator of better outcomes across all eating disorders. Moderators were mostly tested in binge eating disorder, and most moderators did not affect cognitive-behavioural treatment outcome relative to other treatments. No consistent predictors emerged. Findings suggest that it is unclear how and for whom this treatment works. More research testing mediators and moderators is needed, and variables selected for analyses need to be empirically and theoretically driven. Future recommendations include the need for authors to (i) interpret the clinical and statistical significance of findings; (ii) use a consistent definition of outcome so that studies can be directly compared; and (iii) report null and statistically significant findings. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
本系统综述综合了关于 Fairburn 的认知行为治疗(CBT)治疗进食障碍的预测因素、调节因素和结果中介因素的文献。共纳入 65 篇文章。个体变量与结果之间的关系分别在不同的诊断和治疗方式中进行了综合分析。早期变化被发现是所有进食障碍中更好结果的一致中介因素。调节因素主要在暴食障碍中进行了测试,并且与其他治疗相比,大多数调节因素并未影响认知行为治疗的结果。没有出现一致的预测因素。研究结果表明,尚不清楚该治疗方法如何以及为何对哪些人有效。需要更多研究来测试中介因素和调节因素,并且需要对分析中选择的变量进行理论和实证驱动。未来的建议包括作者需要(i)解释研究结果的临床和统计学意义;(ii)使用一致的结果定义,以便可以直接比较研究;以及(iii)报告无效和具有统计学意义的结果。版权所有 © 2016 约翰威立父子公司和进食障碍协会。