Mode deactivation therapy (MDT) comprehensive meta-analysis.

Abstract

Mode Deactivation Therapy (MDT) is a derivative of Cognitive Behavior Therapy, Acceptance and Commitment Therapy, Dialectical Behavior Therapy, Functional Analytic Psychotherapy and Mindfulness and Meditation from ancient Buddhist practices. Since its earliest conception (Apsche & Ward, 2002) MDT has evolved into a so called Third Wave Therapy. This evolution has produced what appears to be ever more robust and efficacious results in studies (Apsche & DiMeo, 2010)Apsche & DiMeo (2010) completed a rudimentary meta -analysis including thirty-eight published and unpublished studies on MDT. They included any MDT article with reported data and then examined data from unpublished MDT studies. The results were promising, yet incomplete. That meta-analysis examined all related articles and was, at the time of writing, current and updated. Since that publication, Apsche has completed a large data analysis study that was not included in the Apsche & DiMeo (2010) publication. In this meta-analysis only MDT studies with N's over seventeen and comprehensive data analysis were examined, as well as the large unpublished study with an N of 143. All previous unpublished studies with smaller N's were not included and were removed for clarity and to not rely on nonpublished studies or case studies with small data basis. This meta-analysis includes nineteen published and one unpublished MDT studies. The unpublished study includes data for both meta and mediation analysis. The purpose of this study is to examine the overall effectiveness of MDT individual and family groups with a diverse group of male adolescents. METHODS All published and unpublished MDT studies were evaluated for inclusion. Only studies implementing MDT, in residential and outpatients units, were selected resulting in a total of 20 studies included in the meta-analysis. All the studies included in the meta-analysis are listed in Table 1. The selected studies were divided into three categories: Individual, Family, and Replication studies. A separate meta-analysis was conducted for each category. All data was extracted by the first author and an associate. The data was entered and calculated using the Cohen's d and Effect Size r methodologies (Cohen, 1988). The present meta-analysis used the DSTAT statistical package for the computation of effect sizes (Johnson, 1993). Participants The 21 studies yielded a sample population of 573 male adolescents between the ages of 14 through 17. Participant characteristics included Axes I and II diagnoses, many with comorbid presentation (Table 2). Conduct disorder (51%), oppositional defiant disorder (42%), and post-traumatic stress disorder (54%) were prevalent among the population. Additionally, 56% of the population presented mixed personality traits. Fifty-four percent of participants were African American, 43% Caucasian, 4% were Hispanic American and one percent are listed as other (mixed race). Ninety percent of participants had experienced all four types of abuse--sexual, physical, verbal, and neglect. Furthermore, 56% had witnessed violence and 24% were parasuicidal. General participant recidivism was less than 7%, and sexual offense recidivism less than 4% after two years post MDT treatment. Procedure The meta-analysis measured the effectiveness of MDT on two separate, although similar, adolescent populations--adolescent sexual abusers and adolescents with conduct disorder. In the individual studies the data was gathered and the effect size and Cohen's d were calculated using the standard Cohen (1988) methodology: Cohen's d = [[bar.x].sub.1] - [[bar.x].sub.2]/s, (1) with the pooled standard deviation given by s = [square root of ([n.sub.1] - 1)[s.sup.2.sub.1] + [square root of ([n.sub.2] - 1)[s.sup.2.sub.2]/ [n.sub.1] + [n.sub.2] (2) [MATHEMATICAL EXPRESSION NOT REPRODUCIBLE IN ASCII] (3) The effect size r was calculated by the following: [r. …