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对格劳韦、多纳蒂和贝尔瑙尔所著《心理治疗的变革:从忏悔到专业》中统计方法的批判性评论

[Critical comments on the statistical methods in Grawe, Donati and Bernauer: "Change in psychotherapy. From confession to profession"].

作者信息

Rüger B

机构信息

Institut für Statistik, München.

出版信息

Z Psychosom Med Psychoanal. 1994;40(4):368-83.

PMID:7817634
Abstract

In the meta-analysis "Changing Psychotherapy" by Grawe, Donati and Bernauer different psychotherapeutic methods are compared based upon published therapy studies. Hereby the authors claim also to have proven with statistical methods that certain kinds of therapy are more effective than others. I show here that the descriptive and inductive methods used are not able to withstand a critical examination; they are incorrect and in most cases even inadmissible. The results of my examination show that there are four points of critique: 1. The question of how effective a kind of therapy is, according to Grawe's criteria, depends more on the number of variables and their measurements with which a therapy is judged than on the number of patients examined in the single studies. 2. Grawe does not distinguish between dependent and independent variables or measurements; every measurement of each variable is included in his methods with the same weight. 3. The different effect variables used to evaluate the therapic process are mostly represented on varying ordinal scales which are incomparable with each other. Grawe treats these scales as if they were comparable, often even as if they were metric. 4. All five statistical methods (counting significances, binomial test, profile of difference values, t-test, Wilcoxon-test) with which Grawe evaluates the results of the single studies are inadmissible because the conditions required are not met. In sum: The conclusions stated in the meta-analysis cannot be seen as being statistically validated or statistically proven.

摘要

在格劳韦、多纳蒂和贝尔瑙尔所做的“心理治疗的变革”元分析中,基于已发表的治疗研究对不同的心理治疗方法进行了比较。在此,作者们还声称已用统计方法证明某些类型的治疗比其他治疗更有效。我在此表明,所使用的描述性和归纳性方法经不起批判性审视;它们是不正确的,而且在大多数情况下甚至是不可接受的。我的审查结果表明有四点可批评之处:1. 根据格劳韦的标准,一种治疗方法有多有效这个问题,更多地取决于用于评判一种治疗的变量数量及其测量方式,而非单个研究中所检查的患者数量。2. 格劳韦没有区分因变量和自变量或测量;每个变量的每次测量在他的方法中都被赋予相同的权重。3. 用于评估治疗过程的不同效果变量大多以不同的顺序量表表示,这些量表彼此不可比。格劳韦对待这些量表就好像它们是可比的,甚至常常好像它们是等距量表。4. 格劳韦用于评估单个研究结果的所有五种统计方法(统计显著性、二项式检验、差值剖面图、t检验、威尔科克森检验)都是不可接受的,因为所需条件未满足。总之:元分析中陈述的结论不能被视为经过了统计验证或统计证明。

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