针对有边缘型人格症状的成人和青少年的辩证行为疗法干预基准。

Benchmarks for dialectical behavioural therapy intervention in adults and adolescents with borderline personality symptoms.

作者信息

Azevedo Julieta, Carreiras Diogo, Hibbs Caitlin, Guiomar Raquel, Osborne Joshua, Hibbs Richard, Swales Michaela

机构信息

School of Human and Behavioural Sciences - Bangor University, UK.

British Isles DBT Training, UK.

出版信息

Int J Clin Health Psychol. 2024 Apr-Jun;24(2):100446. doi: 10.1016/j.ijchp.2024.100446. Epub 2024 Feb 6.

Abstract

BACKGROUND

Dialectical Behaviour Therapy (DBT) is a multi-component cognitive behavioural intervention with proven efficacy in treating people with borderline personality disorder symptoms. Establishing benchmarks for DBT intervention with both adults and adolescents is essential for bridging the gap between research and clinical practice, improving teams' performance and procedures.

AIM

This study aimed to establish benchmarks for DBT using the EQ-5D, Borderline Symptoms List (BSL) and Difficulties in Emotion Regulation Scale (DERS) for adults and adolescents.

METHODS

After searching four databases for randomised controlled trials and effectiveness studies that applied standard DBT to people with borderline symptoms, a total of 589 studies were included (after duplicates' removal), of which 16 met our inclusion criteria. A meta-analysis and respective effect-size pooling calculations (Hedges-g) were undertaken, and heterogeneity between studies was assessed with I and Q tests. Benchmarks were calculated using pre-post treatment means of the studies through aggregation of adjusted effect sizes and critical values.

RESULTS

DBT aggregated effect sizes per subsample derived from RCTs and effectiveness studies are presented, along with critical values, categorised by age group (adults vs adolescents), mode of DBT treatment (full-programme vs skills-training) and per outcome measure (EQ-5D, BSL and DERS).

CONCLUSIONS

Practitioners from routine clinical practice delivering DBT and researchers can now use these benchmarks to evaluate their teams' performance according to their clients' outcomes, using the EQ-5D, BSL and DERS. Through benchmarking, teams can reflect on their teams' efficiency and determine if their delivery needs adjustment or if it is up to the standards of current empirical studies.

摘要

背景

辩证行为疗法(DBT)是一种多成分认知行为干预方法,在治疗有边缘型人格障碍症状的人群中已证实具有疗效。为成人和青少年的DBT干预建立基准对于弥合研究与临床实践之间的差距、提高团队绩效和程序至关重要。

目的

本研究旨在使用EQ-5D、边缘症状清单(BSL)和情绪调节困难量表(DERS)为成人和青少年建立DBT的基准。

方法

在搜索四个数据库以查找将标准DBT应用于有边缘症状人群的随机对照试验和有效性研究后,共纳入589项研究(去除重复项后),其中16项符合我们的纳入标准。进行了荟萃分析和相应的效应量合并计算(Hedges-g),并使用I和Q检验评估研究之间的异质性。通过汇总调整后的效应量和临界值,使用研究的治疗前后均值计算基准。

结果

呈现了从随机对照试验和有效性研究得出的每个子样本的DBT合并效应量,以及按年龄组(成人与青少年)、DBT治疗模式(全程序与技能培训)和每个结局指标(EQ-5D、BSL和DERS)分类的临界值。

结论

提供DBT的常规临床实践从业者和研究人员现在可以使用这些基准,根据客户的结局,使用EQ-5D、BSL和DERS来评估他们团队的绩效。通过基准测试,团队可以反思其团队的效率,并确定其服务是否需要调整或是否符合当前实证研究的标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62f9/10859295/ff8efadf1f39/gr1.jpg

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