POSTERS

EFFECTIVENESS OF TRANS-DIAGNOSTIC COGNITIVE BEHAVIORAL TREATMENTS IN EMOTIONAL DISORDERS

Objectives: The “trans-diagnostic” approach to mental disorders is focused on the cognitive, emotional and behavioural dysfunctions underlying several psychopathological conditions. It has been recently introduced into clinical practice with the aim of overcoming limitations in classical nosography and in diagnosis-specific treatments. However, it is still unclear whether and to what extent such treatments have better outcomes when compared to classical diagnosis-specific approaches. The present review aims to analyse the clinical efficacy of cognitive-behavioural trans-diagnostic treatments in patients suffering from emotional disorders.

Method: The following bibliographic databases were searched: Pubmed, Google Scholar and Discovery Sapienza. The randomized clinical trials published from 2017 to 2020 and addressing the efficacy of the trans-diagnostic approach to emotional disorders were reviewed.
Results: The selected studies showed that the efficacy of trans-diagnostic approach in emotional disorders is higher when compared with classical treatments and that both trans-diagnostic and diagnosis-specific treatments are equally effective.

Discussion: The trans-diagnostic cognitive-behavioral treatments can be considered as an effective alternative to diagnosis-specific ones, especially when comorbidity between different emotional disorders is present.

RESEARCH METHODOLOGY IN PSYCHOTHERAPY: USES AND ABUSES OF META-ANALYSIS

Aims: The presence of conflicts of interest in psychotherapy, with the consequent errors and/or falsifications, has not been adequately considered in psychotherapy. In this work, a much cited study by Jonathan Shedler of mega-analyses of efficacy studies of various treatments in psychiatry, both psychotherapeutic and pharmacological, is taken into consideration for in-depth examination, in which two Authors declared conflicts of interest: General psychotherapy, CBT, Psychodynamic Psychotherapy (PP), Antidepressant Psychopharmacotherapy (PTAD).

Method: Examination of the method and results of the studies considered in J. Shedler’s mega-analysis in the light of statistical methodology. We then proceeded to examine: a) the method used for merging the results, b) the correctness of the calculations, c) the congruence between results and conclusions.
Results: Numerous meta-analyses included in this study do not have the sufficient number to consider reliable the calculation of the Effect Size (ES or Degree of Effect), one in the PTAD group, six in the PP group. Furthermore, meta-analysis studies are included together with some mega-analyses, and a meta-analysis study of PP does not have control groups, therefore it is not comparable to the others. Therefore, only one of the meta-analyses has characteristics that can lend themselves to verifying the efficacy of the PP, that of Abbas & coll. (2006), but many sub-analyses of this study do not have the sufficient number to consider the calculation of the ES reliable, therefore they should be excluded. Finally, the final result (ES = .77) is erroneously reported in the conclusions as ES = .97.

Discussion: In view of the above, the study presents numerous errors, which can sometimes be interpreted as manipulation or falsification of data, and represents a real example of abuse of the meta-analysis method.

Historical Archive

Vic Meyer, of Polish origin, was a British psychologist at the Middlesex Hospital Medical School of the University of London (now UCL Medical School) and is considered the “spiritual father” of clinical case formulation, an approach to understanding complex psychiatric problems using learning principles derived from experimental psychological research and idiographically adapted to the individual case to develop an effective intervention regimen.