A systematic review and meta-analysis of dropout rates from dialectical behaviour therapy in randomized controlled trials

ABSTRACT

Dropout is an important factor that may compromise the validity of findings from randomized controlled trials (RCTs) of dialectical behaviour therapy (DBT). We conducted a targeted meta-analytic review of dropout from RCTs of DBT, with the aims of (1) calculating average rates of dropout from DBT; (2) investigating factors that moderate dropout; (3) examining whether dropout rates from DBT differ to control interventions; (4) synthesising reasons for dropout. Forty RCTs of DBT met full inclusion criteria. The weighted mean dropout rate was 28.0% (95% CI = 23.6, 32.9). Dropout rates were not related to target disorder, dropout definition, delivery format, therapist experience, and therapist adherence. Unexpectedly, dropout rates were significantly higher in trials that offered telephone coaching and utilized a therapist consultation team. DBT dropout rates did not significantly differ to dropout rates from control interventions. Few trials reported reasons for dropout, and there was little consistency in the reported reasons. Findings suggest that over one in four patients drop out from DBT in RCTs. This review highlights the urgency for future trials to explicitly report detail pertaining to patient dropout, as this may assist in the development of strategies designed to prevent future dropouts in RCTs of DBT.     

The Effects of Textured Insoles on Cortical Activity and Quiet Bipedal Standing With and Without Vision: An EEG Study

Abstract

Wearing textured insoles (TIs) can reduce static postural sway, but the neurophysiological mechanisms by which these changes occur are not well understood. To address this issue, cortical activity was investigated in this study using electroencephalography (EEG) recordings from 19 scalp locations, in 15 healthy young adults (5 females; mean age = 27?±?4.09 years) during quiet bipedal standing, under different insole conditions (textured versus smooth), with and without vision. Compared to smooth insoles (SIs), TIs significantly reduced postural sway in two measures; anterior–posterior range and standard deviation. In the EEG data, whole-head analyses showed cortical activity in the upper alpha power band was significantly reduced for textured compared to SIs. Exploratory analyses revealed this effect was significant both with and without vision, and was more pronounced over the parietal, compared to central regions, and over central compared to frontal regions. This trend was observed in low alpha and theta bands, but the effect of insole type was not significant. Textured insoles thus appear to affect not only balance outcomes but also cortical activity. The cortical activity adaptation may represent greater information becoming readily available at the cortical level, enhancing the representation of the body in space.     

Inferring Sublexical Correspondences from Sight Vocabulary: Evidence from 6- and 7-year-olds

We report an experiment designed to investigate 6-to-7-year-old children's ability to acquire knowledge of sublexical correspondences between print and sound from their reading experience. A computer database containing the printed word vocabulary of children taking part in the experiment was compiled and used to devise stimuli controlled for grapheme-phoneme correspondence (GPC) frequency and rime neighbourhood consistency according to the children's reading experience. Knowledge of GPC rules and rime units was compared by asking children to read aloud three types of nonword varying in regularity of GPC and consistency of rime pronunciation. Results supported the view that children can acquire knowledge of both GPC rules and rime units from their reading experience. GPC rule strength affects the likelihood of a GPC response; rime consistency affects the likelihood of a rime response.     

Developmental changes in application of the majority rule in group decisions

This study examined age-related changes in the child's application of the principle of majority rule in group decisions. Following a problem posed by Moessinger (1981), we enquired whether children routinely apply the majority rule when the majority consists of a shifting (variable) set of members across decisions, and alternate between majority and minority when the majority and minority is fixed, i.e. consists of the same individuals each time. In Geneva, Moessinger found that 8-year-olds failed to discriminate between fixed and shifting majorities, while most 13-year-olds (75 per cent) did so. An altered replication was conducted in Australia modifying Moessinger's procedure to control for extraneous variables such as ‘set’ and the need for variety in choice. It was found that on the task 7 per cent of 8-year-olds, 20 per cent of 10-year-olds, 32 per cent of 12-year-olds, and 39 per cent of 14-year-olds discriminated on a behavioural criterion between fixed and shifting majorities. Ten per cent of 8-year-olds, 40 per cent of 10-year-olds, 52 per cent of 12-year-olds, and 55 per cent of 14-year-olds made the discrimination on Moessinger's cognitive ‘reason’ criterion. The results show that development of the conceptual distinction between fixed and shifting majorities is gradual and continuous.