University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent Psychiatry, Groningen, The Netherlands.
University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, Groningen, The Netherlands.
J Intellect Disabil Res. 2020 Aug;64(8):561-578. doi: 10.1111/jir.12736. Epub 2020 Jun 17.
Non-pharmacological interventions are recommended for the treatment of challenging behaviours in individuals with intellectual disabilities by clinical guidelines. However, evidence for their effectiveness is ambiguous. The aim of the current meta-analysis is to update the existing evidence, to investigate long-term outcome, and to examine whether intervention type, delivery mode, and study design were associated with differences in effectiveness.
An electronic search was conducted using the databases Medline, Eric, PsychINFO and Cinahl. Studies with experimental or quasi-experimental designs were included. We performed an overall random-effect meta-analysis and subgroup analyses.
We found a significant moderate overall effect of non-pharmacological interventions on challenging behaviours (d = 0.573, 95% CI [0.352-0.795]), and this effect appears to be longlasting. Interventions combining mindfulness and behavioural techniques showed to be more effective than other interventions. However, this result should be interpreted with care due to possible overestimation of the subgroup analysis. No differences in effectiveness were found across assessment times, delivery modes or study designs.
Non-pharmacological interventions appear to be moderately effective on the short and long term in reducing challenging behaviours in adults with intellectual disabilities.
临床指南建议采用非药物干预措施来治疗智力障碍个体的挑战性行为。然而，其有效性的证据并不明确。本荟萃分析的目的是更新现有证据，调查长期结果，并研究干预类型、实施模式和研究设计是否与疗效差异相关。
使用 Medline、Eric、PsychINFO 和 Cinahl 数据库进行电子检索。纳入了实验或准实验设计的研究。我们进行了总体随机效应荟萃分析和亚组分析。
我们发现非药物干预对挑战性行为有显著的中等总体效果（d=0.573，95%CI [0.352-0.795]），且这种效果似乎是持久的。将正念和行为技术相结合的干预措施比其他干预措施更有效。然而，由于可能高估了亚组分析，因此应谨慎解释这一结果。在评估时间、实施模式或研究设计方面，干预效果没有差异。
非药物干预措施在短期和长期内似乎对减少智力障碍成人的挑战性行为有中等效果。
