基于心态化的治疗治疗自我伤害的有效性:系统性审查和元分析
Carola Hajek Gross1, Sofia-Marie Oehlke1, Karin Prillinger1
1Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria.
Suicide & life-threatening behavior
|January 27, 2024
概括
基于心态化的治疗 (MBT) 和其适应青少年的版本 (MBT-A) 显示出降低自我伤害和边缘性人格障碍 (BPD) 症状的潜力. 然而,这次审查没有发现明显优于对照条件的优势,质疑其对自我伤害治疗的优先考虑.
科学领域:
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
- 心理健康研究 心理健康研究
背景情况:
- 基于心态化的治疗 (MBT) 和其青少年适应 (MBT-A) 被认为有可能减少边缘性人格障碍 (BPD) 中的自我伤害.
- 之前的元分析报告了关于MBT的混合发现――A) 减少自我伤害的有效性.
- 为了澄清治疗有效性,进行了系统性审查和元分析.
研究的目的:
- 评估MBT和MBT-A在减少自我伤害,BPD症状和抑郁症方面的有效性.
- 在青少年和成年人群中,将MBT ((-A) 与控制干预措施进行比较.
- 确定影响治疗结果的潜在调节者.
主要方法:
- 在主要数据库 (Web of Science,Scopus,Embase,PubMed/Medline,Cochrane) 进行了系统的搜索,搜索到2022年9月发表的研究.
- 分析了14项研究 (612名参与者),包括随机对照试验 (RCT) 和前后设计.
- 随机效应模型被用于计算聚合效应大小,而元回归则探索调节效应.
主要成果:
- 无论是MBT还是MBT-A,都显示了自我伤害,BPD和抑郁症症状的显著减少 (g范围从-0.82到-1.1).
- 然而,在减少自我伤害方面,MBT ((-A) 没有被发现优于对照条件 (TAU,SCM).
- 值得注意的一项例外是,与对照组相比,MBT对成年BPD症状产生了更好的影响 (g = -0.56).
结论:
- 虽然前后评估表明了积极的结果,但RCT的纳入表明MBT (A) 缺乏对自我伤害治疗的控制条件的优越性.
- 这些发现不支持优先考虑MBT(-A) 治疗自我伤害.
- 需要进一步的研究,以了解MBT的细微差别(-A) 效果及其在临床实践中的应用.
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