School of Psychology, Deakin University, Geelong, VIC, Australia.
School of Population Health, University of Auckland, Auckland, New Zealand.
Addiction. 2022 Sep;117(9):2393-2414. doi: 10.1111/add.15825. Epub 2022 Feb 21.
Individuals impacted by someone else's alcohol, illicit drug, gambling and gaming problems (affected others) experience extensive harms. To our knowledge, this is the first systematic review and meta-analysis to determine the effectiveness of psychosocial interventions delivered to affected others across addictions.
This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. An electronic database search (PsycInfo, Medline, Cinahl and EMBASE) of randomized controlled trials (RCTs) published until August 2021 was conducted. RCTs with passive control groups, evaluating psychosocial tertiary interventions delivered to affected others of people with addictions (problematic alcohol use, substance use, gambling or gaming) that did not require the involvement of the addicted person, were included.
Twenty included studies, published in 22 articles, mainly evaluated interventions for alcohol use, followed by gambling and illicit drugs, with none investigating gaming interventions. The interventions mainly targeted partners/spouses and focused upon improving affected other outcomes, addicted person outcomes or both. Meta-analyses revealed beneficial intervention effects over control groups on some affected other (depressive symptomatology [standardized mean difference (SMD) = -0.48, 95% confidence interval (CI) = -0.67, -0.29], life satisfaction (SMD = -0.37, 95% CI = -0.71, -0.03) and coping style (SMD = -1.33, 95% CI = -1.87, -0.79), addicted person [treatment entry, risk ratio (RR) = 0.86, 95% CI = 0.75-0.98] and relationship functioning outcomes (marital discord, SMD = -0.40, 95% CI = -0.61, -0.18) at post-intervention. No beneficial intervention effects were identified at short-term follow-up (4-11 months post-treatment). The beneficial intervention effects identified at post-treatment remained when limiting to studies of alcohol use and therapist-delivered interventions.
Psychosocial interventions delivered to affected others of people with addictions (problematic alcohol use, substance use, gambling or gaming) may be effective in improving some, but not all, affected other (depression, life satisfaction, coping), addicted person (treatment) and relationship functioning (marital discord) outcomes for affected others across the addictions, but the conclusion remains tentative due to limited studies and methodological limitations.
受到他人酗酒、吸毒、赌博和游戏问题影响的个体（受影响者）会经历广泛的伤害。据我们所知，这是第一项针对所有成瘾领域中针对受影响者的心理社会干预措施进行评估的系统评价和荟萃分析。
本综述遵循系统评价和荟萃分析的首选报告项目。对截至 2021 年 8 月发表的随机对照试验（RCT）进行了电子数据库搜索（PsycInfo、Medline、Cinahl 和 EMBASE）。包括使用被动对照组的 RCT，评估针对成瘾者（酗酒、物质使用、赌博或游戏）的受影响者的心理社会三级干预措施，这些干预措施不要求成瘾者参与。
纳入的 20 项研究共发表在 22 篇文章中，主要评估了针对酒精使用的干预措施，其次是赌博和非法药物，均未涉及游戏干预措施。这些干预措施主要针对伴侣/配偶，重点是改善受影响者的结局、成瘾者的结局或两者兼而有之。荟萃分析显示，与对照组相比，一些受影响者（抑郁症状[标准化均数差（SMD）=-0.48，95%置信区间（CI）=-0.67，-0.29]、生活满意度[SMD=-0.37，95%CI=-0.71，-0.03]和应对方式[SMD=-1.33，95%CI=-1.87，-0.79]、成瘾者（治疗进入，风险比（RR）=0.86，95%CI=0.75-0.98]和关系功能结局（婚姻不和，SMD=-0.40，95%CI=-0.61，-0.18]）在干预后有获益。在短期随访（治疗后 4-11 个月）时，未发现干预有获益。当限制在针对酗酒和治疗师提供的干预措施的研究中时，治疗后发现的有益干预效果仍然存在。
针对成瘾者（酗酒、物质使用、赌博或游戏）的受影响者的心理社会干预措施可能会改善一些，但不是所有的受影响者（抑郁、生活满意度、应对方式）、成瘾者（治疗）和关系功能结局（婚姻不和）。然而，由于研究数量有限且存在方法学限制，结论仍然不确定。
