Baker Timothy B, Bolt Daniel M, Smith Stevens S
University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, 1930 Monroe St., Suite 200, Madison, WI 53711.
Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705.
Clin Psychol Sci. 2021 Nov 1;9(6):995-1020. doi: 10.1177/2167702621994551. Epub 2021 Apr 26.
Meaningfully improved mental and behavioral health treatment is an unrealized dream. Across three factorial experiments, inferential tests in prior studies showed a pattern of negative interactions suggesting that better clinical outcomes are obtained when participants receive fewer rather than more intervention components. Further, relatively few significant main effects were found in these experiments. Modeling suggested that negative interactions amongst components may account for these patterns. This paper evaluates factors that may contribute to such declining benefit: increased attentional or effort burden; components that produce their effects via the same capacity limited mechanisms, making their effects subadditive; and a tipping point phenomenon in which those near a hypothesized "tipping point" for change will benefit markedly from weak intervention while those far from the tipping point will benefit little from even strong intervention. New research should explore factors that cause negative interactions amongst components and constrain the development of more effective treatments.
有意义地改善心理和行为健康治疗仍是一个未实现的梦想。在三项析因实验中,先前研究中的推断性测试显示出一种负向交互作用模式,表明参与者接受较少而非较多干预成分时能获得更好的临床结果。此外,在这些实验中发现的显著主效应相对较少。建模表明,成分之间的负向交互作用可能解释了这些模式。本文评估了可能导致效益下降的因素:注意力或努力负担增加;通过相同能力受限机制产生效果的成分,使其效果呈次可加性;以及一种临界点现象,即那些接近假设的变化“临界点”的人将从弱干预中显著受益,而那些远离临界点的人即使接受强干预也受益甚微。新的研究应探索导致成分之间负向交互作用的因素,并限制更有效治疗方法的发展。