Center for Health Equity Research and Promotion, Mental Illness Research, Education and Clinical Center, VA Pittsburgh Healthcare System.
Rutgers, Institute for Health, Health Care Policy and Aging Research, The State University of New Jersey.
J Clin Child Adolesc Psychol. 2021 Jul-Aug;50(4):498-509. doi: 10.1080/15374416.2020.1790379. Epub 2020 Jul 27.
: This brief review covers the current state of the literature on moderators of adolescent substance use disorder (SUD) treatment. These moderators provide information on "for whom" a specific treatment may work best.: We used Google Scholar, PubMed, PsycInfo, and manual search of relevant reference lists to identify eligible peer-reviewed publications from January 2005 to December 2019.: We summarize 21 published studies (including meta-analyses, randomized clinical trials, and correlational work) testing moderators and/or predictors of adolescent SUD treatment outcomes. Conclusions are, thus, limited by the relatively small number of studies. Results suggest that, for adolescents with co-occurring externalizing pathology or those higher in SUD severity, more intensive treatment appears to be more effective. Other findings were often inconsistent (e.g., examining sex or race/ethnicity as a moderator) between studies, making it challenging to provide clear recommendations for personalizing SUD treatment choice.: Future research may need to shift focus from exploring often unchangeable moderators (e.g., race/ethnicity) to factors that are potentially modifiable with treatment. Additionally, testing models that include mediators of treatment effects-that is, factors that help to explain "how" treatment works-along with moderators (moderated-mediation) may provide the most benefit in understanding both "for whom" and "how" to tailor SUD treatment to optimally meet an adolescent's personal needs.
这篇简要综述涵盖了当前关于青少年物质使用障碍(SUD)治疗调节剂的文献状况。这些调节剂提供了关于“对谁”特定治疗可能效果最好的信息。
我们使用 Google Scholar、PubMed、PsycInfo 和相关参考文献的手动搜索,以确定 2005 年 1 月至 2019 年 12 月期间符合条件的同行评议出版物。
我们总结了 21 项发表的研究(包括荟萃分析、随机临床试验和相关性工作),这些研究测试了青少年 SUD 治疗结果的调节剂和/或预测因素。因此,结论受到研究数量相对较少的限制。结果表明,对于同时存在外在病理或 SUD 严重程度较高的青少年,更密集的治疗似乎更有效。其他发现往往在不同研究之间不一致(例如,研究性别或种族/民族作为调节剂),这使得很难为个性化 SUD 治疗选择提供明确的建议。
未来的研究可能需要将重点从探索经常不可改变的调节剂(例如种族/民族)转移到潜在可通过治疗改变的因素上。此外,测试包括治疗效果中介的模型——即有助于解释“如何”治疗的因素——以及调节剂(调节中介),可能会在理解“对谁”和“如何”方面提供最大的好处,以优化满足青少年的个人需求。