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对《心理治疗试验中选择对照条件的考量:对未来研究的建议》的回应

Response to "Considerations in selecting comparison conditions in psychotherapy trials: Recommendations for future research".

作者信息

Stice Eric, Rohde Paul, Yokum Sonja, Bohon Cara, Shaw Heather

机构信息

Department of Psychiatry and Behavioral Sciences, Stanford University.

Oregon Research Institute.

出版信息

J Consult Clin Psychol. 2025 May;93(5):396-399. doi: 10.1037/ccp0000952. Epub 2025 Mar 10.

Abstract

Several researchers who have evaluated (IPT) wrote a commentary arguing that the group-delivered IPT treatment for eating disorders that we adapted and used in a recent trial (Stice, Rohde, et al., 2023) was less effective than the new dissonance-based eating disorder treatment () because the group-delivered IPT did not contain all core elements, was not developmentally appropriate, was not tailored for people with eating disorders, and because our team lacked sufficient IPT expertise. In response, we note that the group-delivered IPT that we evaluated produced higher abstinence from binge eating and compensatory weight control behaviors (40%) than did individually delivered IPT in the only trial that also evaluated this treatment with a broad range of eating disorders (33%; Fairburn et al., 2015). The fact that the group-delivered IPT produced a higher abstinence rate than individually delivered IPT for a similar spectrum of patients appears to refute the stated concerns regarding the group-delivered version of IPT because it was not less effective than individually delivered IPT. We argue it is critical to establish that a treatment significantly outperforms alternative treatments with a distinct intervention target because only an active comparator controls for the potential confounds that can drive improvement in trials, including expectancies, demand characteristics, and nonspecific therapeutic effects. We also note that IPT for the treatment of eating disorders has not significantly outperformed three alternative treatments and that the evidence base for IPT may thus be driven by expectancies, demand characteristics, and nonspecific effects. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

摘要

几位评估过人际心理治疗(IPT)的研究人员撰写了一篇评论,认为我们在最近一项试验(Stice、Rohde等人,2023年)中改编并使用的针对饮食失调的团体人际心理治疗不如新的基于认知失调的饮食失调治疗()有效,因为团体人际心理治疗没有包含所有核心要素,不符合发展阶段要求,没有针对饮食失调患者量身定制,还因为我们的团队缺乏足够的人际心理治疗专业知识。作为回应,我们指出,在唯一一项也对广泛饮食失调患者进行此治疗评估的试验中,我们评估的团体人际心理治疗在戒除暴饮暴食和代偿性体重控制行为方面的成功率(40%)高于个体人际心理治疗(33%;Fairburn等人,2015年)。对于类似患者群体,团体人际心理治疗的戒除率高于个体人际心理治疗,这一事实似乎驳斥了对团体人际心理治疗上述的担忧,因为它并不比个体人际心理治疗效果差。我们认为,至关重要的是要确定一种治疗方法在具有明确干预目标的情况下明显优于替代治疗方法,因为只有积极的对照才能控制试验中可能推动改善的潜在混杂因素,包括期望、需求特征和非特异性治疗效果。我们还指出,用于治疗饮食失调的人际心理治疗并没有明显优于三种替代治疗方法,并因此人际心理治疗的证据基础可能是由期望、需求特征和非特异性效果驱动的。(PsycInfo数据库记录(c)2025美国心理学会,保留所有权利)

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