Fares-Otero Natalia E, Amoretti Silvia, Solé Brisa, Halligan Sarah L, Vieta Eduard, Leucht Stefan, Seedat Soraya, Harrer Mathias
Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clínic, Institute of Neurosciences (UBNeuro), Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain.
Section for Evidence-Based Medicine in Psychiatry and Psychotherapy, School of Medicine and Health, Technical University of Munich (TUM), Munich, Germany.
Eur J Psychotraumatol. 2025 Dec;16(1):2508548. doi: 10.1080/20008066.2025.2508548. Epub 2025 Jun 6.
Several psychosocial interventions have shown promising effects in treating people affected by childhood maltreatment (CM); however, their comparative efficacy on social functioning remains largely unknown. To address this issue, a systematic review and network meta-analysis (NMA) will be conducted to investigate the comparative efficacy of different psychosocial interventions on global social functioning and specific domains of social functioning, including behavioural, emotional, cognitive and physiological processes. We aim to develop a hierarchical ranking of existing psychosocial interventions concerning their efficacy and acceptability which could inform treatment guidelines. Randomised controlled trials (RCTs) investigating psychosocial interventions for individuals with exposure to CM when they were younger than age 18 will be included. Primary outcomes will be global and domains of social functioning (measured up to 3, 6, 12 months and at the longest follow-up). Study drop-out will be a secondary outcome that will serve as a measure of acceptability. Study selection and data extraction will be performed by at least two independent reviewers. We will assess the risk of bias for each study using the Cochrane Risk of Bias tool 2 (RoB2) and evaluate the confidence in the results using Confidence in Network Meta-Analysis (CINeMA). The effects of potential moderators, such as age (children/adolescents adults), population type (clinical non-clinical samples), or sex (% males), socioeconomic status (low-income middle-high-income countries), and intervention characteristics (individual group training, number of sessions) will be analysed using subgroup-analyses or meta-regressions. Other candidate moderators/mediators (personality, post-traumatic symptoms, brain structure/function, cognitive reserve) will also be explored and narratively summarised. Sensitivity analyses will be conducted to explore further heterogeneity and assess the robustness of our findings. This systematic review and NMA aims to compare multiple existing psychosocial interventions in individuals affected by CM and establish the relative rankings of these interventions for social functioning. Our results may provide practical guidance concerning the most effective psychosocial interventions to reduce the societal burden associated with CM. PROSPERO CRD42022347034.
几种心理社会干预措施在治疗受童年虐待(CM)影响的人群方面已显示出有前景的效果;然而,它们对社会功能的相对疗效在很大程度上仍不清楚。为解决这一问题,将进行一项系统评价和网状Meta分析(NMA),以调查不同心理社会干预措施对整体社会功能以及社会功能特定领域(包括行为、情感、认知和生理过程)的相对疗效。我们旨在针对现有心理社会干预措施的疗效和可接受性制定一个分层排名,为治疗指南提供参考。将纳入针对18岁以下有童年虐待经历个体的心理社会干预措施的随机对照试验(RCT)。主要结局将是整体社会功能及其各个领域(在3个月、6个月、12个月及最长随访期进行测量)。研究失访将作为次要结局,作为可接受性的一项衡量指标。研究选择和数据提取将由至少两名独立评审员进行。我们将使用Cochrane偏倚风险工具2(RoB2)评估每项研究的偏倚风险,并使用网状Meta分析置信度(CINeMA)评估结果的可信度。将使用亚组分析或Meta回归分析潜在调节因素的影响,如年龄(儿童/青少年/成人)、人群类型(临床/非临床样本)、性别(男性百分比)、社会经济地位(低收入/中高收入国家)以及干预特征(个体/团体培训、疗程数)。还将探索并以叙述方式总结其他候选调节因素/中介因素(人格、创伤后症状、脑结构/功能、认知储备)。将进行敏感性分析以进一步探索异质性并评估我们研究结果的稳健性。这项系统评价和NMA旨在比较多种现有的针对受CM影响个体的心理社会干预措施,并确定这些干预措施在社会功能方面的相对排名。我们的结果可能为最有效的心理社会干预措施提供实用指导,以减轻与CM相关的社会负担。国际前瞻性注册系统编号CRD42022347034。
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