预测认知分析指导自助与认知行为指导自助的最佳治疗分配。

IF 3.8 3区 心理学 Q1 PSYCHOLOGY, CLINICAL
Caroline Wojnarowski, Melanie Simmonds-Buckley, Stephen Kellett
{"title":"预测认知分析指导自助与认知行为指导自助的最佳治疗分配。","authors":"Caroline Wojnarowski, Melanie Simmonds-Buckley, Stephen Kellett","doi":"10.1111/bjc.12508","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Given the ubiquity in routine services of low-intensity guided self-help (GSH) psychological interventions, better patient selection for these brief interventions would be organizationally efficient. This study therefore sought to define who would respond best to two different types of GSH for anxiety to enable better future treatment matching.</p><p><strong>Methods: </strong>The study used outcome data from a patient preference trial (N = 209) comparing cognitive analytic therapy-guided self-help (CAT-GSH) with cognitive behavioural therapy-guided self-help (CBT-GSH). Elastic Net regularization and Boruta random forest variable selection methods were applied. Regression models calculated the patient advantage index (PAI) to designate which GSH was likely the most effective for each patient. Outcomes were compared for those receiving their PAI-indicated optimal and non-optimal GSH.</p><p><strong>Results: </strong>Lower baseline depression and anxiety severity predicted better outcomes for both types of GSH. Patient preference status was not associated with outcome during either GSH. Sixty-three % received their model indicating optimal GSH and these had significantly higher rates of reliable and clinically significant reductions in anxiety at both post-treatment (35.9% vs. 16.6%) and follow-up (36.6% vs. 19.2%). No single patient with a large PAI had a reliable and clinically significant reduction in anxiety at post-treatment or follow-up when they did not receive their optimal GSH.</p><p><strong>Conclusions: </strong>Treatment matching algorithms have the potential to support evidenced-based treatment selection for GSH. Treatment selection and supporting patient choice needs to be integrated. Future research needs to investigate the use of the PAI for GSH treatment matching, but with larger and more balanced samples.</p>","PeriodicalId":48211,"journal":{"name":"British Journal of Clinical Psychology","volume":" ","pages":""},"PeriodicalIF":3.8000,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predicting optimal treatment allocation for cognitive analytic-guided self-help versus cognitive behavioural-guided self-help.\",\"authors\":\"Caroline Wojnarowski, Melanie Simmonds-Buckley, Stephen Kellett\",\"doi\":\"10.1111/bjc.12508\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Given the ubiquity in routine services of low-intensity guided self-help (GSH) psychological interventions, better patient selection for these brief interventions would be organizationally efficient. This study therefore sought to define who would respond best to two different types of GSH for anxiety to enable better future treatment matching.</p><p><strong>Methods: </strong>The study used outcome data from a patient preference trial (N = 209) comparing cognitive analytic therapy-guided self-help (CAT-GSH) with cognitive behavioural therapy-guided self-help (CBT-GSH). Elastic Net regularization and Boruta random forest variable selection methods were applied. Regression models calculated the patient advantage index (PAI) to designate which GSH was likely the most effective for each patient. Outcomes were compared for those receiving their PAI-indicated optimal and non-optimal GSH.</p><p><strong>Results: </strong>Lower baseline depression and anxiety severity predicted better outcomes for both types of GSH. Patient preference status was not associated with outcome during either GSH. Sixty-three % received their model indicating optimal GSH and these had significantly higher rates of reliable and clinically significant reductions in anxiety at both post-treatment (35.9% vs. 16.6%) and follow-up (36.6% vs. 19.2%). No single patient with a large PAI had a reliable and clinically significant reduction in anxiety at post-treatment or follow-up when they did not receive their optimal GSH.</p><p><strong>Conclusions: </strong>Treatment matching algorithms have the potential to support evidenced-based treatment selection for GSH. Treatment selection and supporting patient choice needs to be integrated. Future research needs to investigate the use of the PAI for GSH treatment matching, but with larger and more balanced samples.</p>\",\"PeriodicalId\":48211,\"journal\":{\"name\":\"British Journal of Clinical Psychology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-10-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"British Journal of Clinical Psychology\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1111/bjc.12508\",\"RegionNum\":3,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHOLOGY, CLINICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Clinical Psychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1111/bjc.12508","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
引用次数: 0

摘要

目的:鉴于低强度的指导性自助(GSH)心理干预在常规服务中无处不在,更好地选择患者接受这些简短的干预将提高组织效率。因此,本研究试图确定哪些患者对两种不同类型的焦虑症指导自助疗法反应最佳,以便今后更好地进行治疗匹配:研究使用了一项患者偏好试验(N = 209)的结果数据,该试验比较了认知分析疗法指导下的自助(CAT-GSH)和认知行为疗法指导下的自助(CBT-GSH)。应用了弹性网正则化和 Boruta 随机森林变量选择方法。回归模型计算了患者优势指数(PAI),以确定哪种GSH对每位患者最有效。结果比较了接受 PAI 指示的最佳和非最佳 GSH 治疗的患者的疗效:结果:基线抑郁和焦虑严重程度越低,两种 GSH 的疗效越好。患者的偏好状况与两种 GSH 的疗效无关。63%的患者接受了其模型显示的最佳GSH治疗,这些患者在治疗后(35.9%对16.6%)和随访中(36.6%对19.2%)的焦虑程度均有明显的临床显著降低。没有一名PAI较大的患者在治疗后或随访时,如果没有接受最佳的GSH治疗,其焦虑程度都没有得到可靠且有临床意义的缓解:治疗匹配算法有可能支持基于证据的GSH治疗选择。治疗选择和支持患者选择需要结合起来。未来的研究需要调查PAI在GSH治疗匹配中的应用,但需要更大、更均衡的样本。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predicting optimal treatment allocation for cognitive analytic-guided self-help versus cognitive behavioural-guided self-help.

Objectives: Given the ubiquity in routine services of low-intensity guided self-help (GSH) psychological interventions, better patient selection for these brief interventions would be organizationally efficient. This study therefore sought to define who would respond best to two different types of GSH for anxiety to enable better future treatment matching.

Methods: The study used outcome data from a patient preference trial (N = 209) comparing cognitive analytic therapy-guided self-help (CAT-GSH) with cognitive behavioural therapy-guided self-help (CBT-GSH). Elastic Net regularization and Boruta random forest variable selection methods were applied. Regression models calculated the patient advantage index (PAI) to designate which GSH was likely the most effective for each patient. Outcomes were compared for those receiving their PAI-indicated optimal and non-optimal GSH.

Results: Lower baseline depression and anxiety severity predicted better outcomes for both types of GSH. Patient preference status was not associated with outcome during either GSH. Sixty-three % received their model indicating optimal GSH and these had significantly higher rates of reliable and clinically significant reductions in anxiety at both post-treatment (35.9% vs. 16.6%) and follow-up (36.6% vs. 19.2%). No single patient with a large PAI had a reliable and clinically significant reduction in anxiety at post-treatment or follow-up when they did not receive their optimal GSH.

Conclusions: Treatment matching algorithms have the potential to support evidenced-based treatment selection for GSH. Treatment selection and supporting patient choice needs to be integrated. Future research needs to investigate the use of the PAI for GSH treatment matching, but with larger and more balanced samples.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
5.80
自引率
3.20%
发文量
57
期刊介绍: The British Journal of Clinical Psychology publishes original research, both empirical and theoretical, on all aspects of clinical psychology: - clinical and abnormal psychology featuring descriptive or experimental studies - aetiology, assessment and treatment of the whole range of psychological disorders irrespective of age group and setting - biological influences on individual behaviour - studies of psychological interventions and treatment on individuals, dyads, families and groups
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信