Effect of third-wave cognitive behavioral therapy in adults with acquired brain injury: A systematic review and meta-analysis of randomized controlled trials.
Cecilie Rask Buskbjerg, Alice Munk, Robert Zachariae, Sofie Hedegaard Klausen, Ali Amidi, Lisa Maria Wu
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引用次数: 0
Abstract
Objective: Third-wave cognitive behavioral therapies may be beneficial for relieving psychological symptoms in adults with acquired brain injury, but no comprehensive overview and pooled estimate of their effects exist. We conducted a systematic review and meta-analysis of randomized controlled trials to address this gap.
Method: Three databases (Pubmed, APA PsycInfo, and the Cochrane Library) were searched. Included studies were quality-assessed and frequentist and Bayesian analytical strategies were employed for data synthesis and interpretation. Effects were evaluated for outcomes reported in ≥7 studies, and potential moderating influences of study characteristics were explored when available in ≥10 studies.
Results: Twenty-eight randomized controlled trials (N = 1,869) were included. Statistically significant effects at postintervention were observed for depression (K = 20, Hedges's g = 0.49, 95% CI [0.17, 0.81]), anxiety (K = 13, g = 0.48, 95% CI [0.01, 0.95]), mindfulness skills (K = 7, g = 0.33, 95% CI [0.12, 0.54]), and health-related quality of life (QoL; K = 11, g = 0.62, 95% CI [0.21, 1.03]). At follow-up, effects were significant for depression (K = 12, g = 0.42, 95% CI [0.12, 0.72]), psychological flexibility (K = 4, g = 0.47, 95% CI [0.13, 0.81]), and stress (K = 3, g = 0.39, 95% CI [0.02, 0.77]). The observed effects were generally smaller after adjusting for outliers (±2 SDs; g = 0.23-0.29). After adjusting for outliers, Bayesian meta-analysis provided strong to very strong support (Bayes factors values: 16-90) for effects on depression at posttreatment and follow-up and QoL at posttreatment. The only moderator analysis reaching statistical significance was for study quality, with higher values being associated with smaller effects on anxiety and QoL.
Conclusion: Third-wave cognitive behavioral therapies are likely to be beneficial for relieving psychological symptoms in adults with acquired brain injury, particularly depression and QoL. However, more research is needed to establish robust evidence for their efficacy and clinical relevance. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
期刊介绍：
The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.
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