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基于功能行为评估的成人妄想、幻觉和言语紊乱干预:一项单案例荟萃分析。

Functional Behavioral Assessment-based interventions on adults' delusions, hallucinations and disorganized speech: A single case meta-analysis.

机构信息

Universidad Autónoma de Madrid, Spain.

Universidad Autónoma de Madrid, Spain.

出版信息

Behav Res Ther. 2019 Sep;120:103444. doi: 10.1016/j.brat.2019.103444. Epub 2019 Jul 27.

Abstract

The Functional Behavioral Assessment (FBA) approach involves the use of single-case designs (SCD) to study the problem behavior-environment contingencies and conduct interventions that consider this functional relationship. Although this approach has been considered an evidence-based practice (EBP) for the treatment of several psychological problems, no meta-analytic studies of FBA-based interventions on delusions, hallucinations and disorganized speech -commonly operationalized as "atypical vocalizations"- have been carried out. Therefore, the purpose of this study was to review and synthesize the results of FBA-based interventions on adults' atypical vocalizations. We conducted a systematic review and a multi-level meta-analysis of these interventions, using a recently developed effect size estimator for SCD studies (i.e., log response ratio). All the studies that met our eligibility criteria provided evidence supporting the effectiveness of FBA-based interventions on atypical vocalizations, with an overall average effect size of a 72% reduction. Both the publication year and the methodological quality were found to be significant moderators. Despite some methodological limitations, we can conclude that FBA-based interventions are effective to reduce atypical vocalizations. The implications of these results could be of interest for the mental health community.

摘要

功能行为评估(FBA)方法涉及使用单一案例设计(SCD)来研究问题行为-环境关系,并进行干预,以考虑这种功能关系。尽管这种方法被认为是治疗几种心理问题的循证实践(EBP),但尚未对基于 FBA 的干预措施对妄想、幻觉和思维紊乱的言语——通常被定义为“异常发声”——进行元分析研究。因此,本研究的目的是回顾和综合基于 FBA 的干预措施对成年人异常发声的效果。我们对这些干预措施进行了系统回顾和多层次元分析,使用了最近开发的用于 SCD 研究的效应量估计器(即对数反应比)。所有符合我们入选标准的研究都提供了支持基于 FBA 的干预措施对异常发声有效性的证据,总体平均效应量为减少 72%。出版年份和方法学质量被发现是显著的调节因素。尽管存在一些方法学限制,但我们可以得出结论,基于 FBA 的干预措施对于减少异常发声是有效的。这些结果的意义可能对心理健康社区具有重要意义。

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