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首页> 外文期刊>The International journal of eating disorders >Moderators and mediators of outcome in treatments for anorexia nervosa and bulimia nervosa in adolescents: A systematic review of randomized controlled trials
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Moderators and mediators of outcome in treatments for anorexia nervosa and bulimia nervosa in adolescents: A systematic review of randomized controlled trials

机译：青少年厌食症神经治疗治疗方法的调节剂和介质：对随机对照试验的系统综述

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Objective To critically appraise papers reporting on moderators and mediators of recommended psychological treatments for anorexia nervosa (AN) and bulimia nervosa (BN) in adolescents. Method A systematic search of databases was conducted including PsycINFO, Embase, MEDLINE, AMED, CINAHL, and the Cochrane Library. Studies were included where a randomized controlled trial (RCT) compared therapies for AN or BN and reported on moderators or mediators of treatment effect. Twenty-one eligible papers were included, all based on data from eight RCTs. Results Family therapies were dominant in the literature. Individual or separated treatment appeared superior for families with more difficult relationships, whereas conjoint family treatment appeared to be superior where good family relationships were reported. Where there was greater eating disorder psychopathology in AN, including eating disorder-related obsessions and compulsions, the response was better to a family approach than to individual therapies. There was some evidence that a family treatment was superior for those engaging in purging behaviors in BN. Measures of family relationships, parental self-efficacy, and early change emerged as possible mediators; however, the quality of evidence was mixed and the findings, in some cases, arguably circular. Moderator and mediator analyses were underpowered in all studies, with multiple, and post-hoc, analyses being run, and a broad range of outcome measures used. Discussion This review recommends that emerging findings are explored further in adequately powered trials of the different recommended therapies, with a move toward focusing on effect sizes. A consensus on acceptable definitions of outcome, including remission and recovery, would benefit future research.
机译：目的批判性评估论文的主持人和调解员对青少年厌食症（AN）和贪食症（BN）的推荐心理治疗。方法进行了系统搜索数据库，包括PSYCINFO，EMBASE，MEDLINE，CAMED，CINAHL和Cochrane图书馆。将随机对照试验（RCT）与AN或BN的比较和报告的治疗效果的介质或治疗效果的介质报道，包括研究。包括二十一篇符合条件的论文，全部基于8个RCT的数据。结果家庭疗法在文献中占主导地位。个人或分离的治疗对于具有更困难的关系的家庭出现优越，而联合家庭治疗似乎是优越的，良好的家庭关系。在含有更大的饮食障碍精神病理学的情况下，包括饮食紊乱相关的痴迷和强迫，对家庭方法更好的反应比个体疗法更好。有一些证据表明家庭治疗对于在BN中吹扫吹扫行为的人来说是优越的。家庭关系的措施，父母自我疗效和早期变革的培养委员会出现了;然而，在某些情况下，有证据和调查结果，可以说是可动性的通知。主持人和介体分析在所有研究中有多次和患者分析，分析正在运行，以及使用的广泛结果措施。讨论本综述建议在不同推荐疗法的充分动力试验中进一步探讨新兴调查结果，旨在关注效果大小。关于成果可接受的定义，包括缓解和恢复，将使未来的研究有所共识。

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