The systematic review by Alpert and colleagues (Clinical Psychology Reviews, https://doi.org/10.1016/j.cpr.2023.102300) suggests methodological standards for mediation analysis and evaluates the evidence for mediation of PTSD treatment effects in published research. Although the article articulates important methodological guidelines related to timing of treatment, mediator, and outcome, it fails to incorporate the insights of causal mediation analysis into the methodological standards. In particular, the systematic review does not recognize the limitations of using time, rather than PTSD treatment type, in mediation analyses and does not include an assessment of the potential impact of uncontrolled confounding between the mediator and the outcome in the included studies. The conclusions about mediators of PTSD treatments from this systematic review should be considered carefully.

Alpert 及其同事的系统综述（临床心理学评论，https://doi.org/10.1016/j.cpr.2023.102300）提出了中介分析的方法学标准，并评估了已发表研究中 PTSD 治疗效果中介的证据。尽管该文章阐明了与治疗时机、中介和结果相关的重要方法学指南，但它未能将因果中介分析的见解纳入方法学标准。特别是，系统评价没有认识到在调解分析中使用时间而不是 PTSD 治疗类型的局限性，并且没有包括对纳入研究中调解者和结果之间不受控制的混杂因素的潜在影响的评估。应仔细考虑本次系统评价中有关 PTSD 治疗中介因素的结论。