Department of Psychology, Loyola University Chicago.
J Couns Psychol. 2017 Mar;64(2):121-140. doi: 10.1037/cou0000190.
This meta-analysis found empirical support for the effectiveness of indicated prevention programs for higher education students at risk for subsequent mental health difficulties based on their current subclinical levels of various presenting problems, such as depression, anxiety, or interpersonal difficulties. A systematic literature search identified 79 controlled published and unpublished interventions involving 4,470 college, graduate, or professional students. Programs were effective at post-intervention overall (ES = 0.49, CI [0.43, 0.55]), and for both targeted outcomes (ES = 0.58, CI [0.51, 0.64]) as well as additional nontargeted outcomes assessed in the studies (ES = 0.32, CI [0.25, 0.39]). Interventions compared with a no-intervention or a wait-list control (ES = 0.64, CI [0.57, 0.71], k = 68) demonstrated significantly larger effects overall than did interventions compared with an attention-placebo control (ES = 0.27, CI [0.11, 0.43], k = 11), although both were significant. Among the former group, modality and presenting problem emerged as significant moderators of intervention effectiveness, and among the 43 of these that assessed effectiveness at an average follow-up period of 35 weeks, the positive effects from intervention remained strong (ES = 0.59, CI [0.50, 0.68]). Overall, programs were fairly brief, attracted and retained students, were positively rated by students, and effective when administered by paraprofessionals as well as professionals. Current findings are promising and stimulate recommendations for improving future research, such as expanding the range of outcomes assessed, and clarifying moderators and mediators of intervention impact. (PsycINFO Database Record
这项荟萃分析为高等教育中存在心理健康潜在问题的学生提供了有针对性预防计划的有效性的实证支持,这些学生目前处于各种表现问题(如抑郁、焦虑或人际困难)的亚临床水平。系统的文献检索确定了 79 项涉及 4470 名大学生、研究生或专业学生的对照性已发表和未发表的干预措施。总体而言,这些项目在干预后是有效的(ES = 0.49,CI [0.43,0.55]),且对于目标结果(ES = 0.58,CI [0.51,0.64])以及研究中评估的其他非目标结果(ES = 0.32,CI [0.25,0.39])均如此。与无干预或等待对照相比,干预措施的效果明显更大(ES = 0.64,CI [0.57,0.71],k = 68),与注意安慰剂对照相比(ES = 0.27,CI [0.11,0.43],k = 11)也有显著差异。在前一组中,干预模式和表现问题成为干预效果的重要调节因素,在 43 项评估平均 35 周随访期效果的研究中,干预的积极效果仍然很强(ES = 0.59,CI [0.50,0.68])。总体而言,这些项目相当简短,吸引并留住了学生,学生对其评价积极,并且由非专业人员和专业人员实施都有效。目前的研究结果很有希望,激发了改进未来研究的建议,如扩大评估结果的范围,并阐明干预效果的调节因素和中介因素。