Journal of Contextual Behavioral Science最新文献_第10页

Exploring the interconnectedness of depression, anxiety, diabetes distress, and related psychosocial factors in adults with type 2 diabetes: A network analysis 探索 2 型糖尿病成人患者抑郁、焦虑、糖尿病困扰及相关社会心理因素之间的相互联系：网络分析

IF 3.4 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of Contextual Behavioral Science

Pub Date : 2024-10-01 DOI: 10.1016/j.jcbs.2024.100843

Wanting Zu , Fei Li , Xiaoxuan Ma , Shiyun Zhang , Wenbo Nie , Lisheng Wang

Background and objective

Anxiety, depression, and diabetes distress are three common psychological distresses among people with type 2 diabetes. Although previous research has explored factors associated with them, most studies have viewed these factors as independent constructs, overlooking the complex interactions between these factors, which can limit our understanding of psychological symptoms and associated factors from an integrated perspective. The purpose of this study was to explore the relationships between psychological distress outcomes and related psychological factors in people with diabetes from a network analysis perspective and further provide evidence for the selection of specific psychological intervention targets.

Design and setting

A cross-sectional study was conducted in person at diabetes centers of three tertiary hospitals in China.

Participants

481 adults with type 2 diabetes (62% male; mean age 51.91 ± 13.64 years; mean HbA1c 9.34 ± 2.23%) were recruited between December 2022 and April 2023.

Methods

Psychological distress outcomes and related factors analyzed included depression (PHQ-9), anxiety (GAD-7), diabetes distress (DDS), acceptance level (AADQ), cognitive fusion (CFQ), social support (PSSS), and self-efficacy (DMSES). Correlation analyses and network analyses were used to explore complex associations among these variables.

Results

The network included ten nodes, diabetes-related interpersonal distress, anxiety, and regimen-related distress were the most influential in the network. Significant relationships emerged in networks with five nodes, with both acceptance level and cognitive fusion associated with the general psychological distress and diabetes distress; social support demonstrated stable associations with all three psychological outcomes in each network.

Conclusion

After controlling for other factors, psychological flexibility and social support could still be significantly associated with psychological distress outcomes, indicating the potential to integrate them as transdiagnostic processes into psychological interventions for this population. However, the results of this study are based on the group level, and the dynamic networks of individuals need to be further explored in order to meet the needs of individuals in different contexts.

背景和目的焦虑、抑郁和糖尿病困扰是2型糖尿病患者常见的三种心理困扰。尽管以往的研究探讨了与之相关的因素，但大多数研究将这些因素视为独立的建构，忽略了这些因素之间复杂的相互作用，这可能会限制我们从综合的角度对心理症状和相关因素的理解。本研究旨在从网络分析的角度探讨糖尿病患者的心理困扰结果与相关心理因素之间的关系，并进一步为选择特定的心理干预目标提供证据。方法分析的心理困扰结果及相关因素包括抑郁（PHQ-9）、焦虑（GAD-7）、糖尿病困扰（DDS）、接受程度（AADQ）、认知融合（CFQ）、社会支持（PSSS）和自我效能（DMSES）。结果该网络包括 10 个节点，与糖尿病相关的人际困扰、焦虑和与治疗相关的困扰在网络中影响最大。在包含五个节点的网络中，接受程度和认知融合与一般心理困扰和糖尿病困扰相关；在每个网络中，社会支持与所有三个心理结果都有稳定的关联。结论在控制了其他因素后，心理灵活性和社会支持仍与心理困扰结果有显著关联，这表明有可能将它们作为跨诊断过程整合到对该人群的心理干预中。然而，本研究的结果是基于群体层面的，个体的动态网络还需要进一步探索，以满足不同背景下个体的需求。

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引用次数: 0

Effects of a randomized controlled trial of mobile app-based Acceptance and Commitment Therapy on depressive symptoms and process variables in college students - Focusing on the mediating effects of acceptance and cognitive defusion- 基于手机应用的 "接纳与承诺疗法 "随机对照试验对大学生抑郁症状和过程变量的影响--关注接纳和认知化解的中介效应

IF 3.4 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of Contextual Behavioral Science

Pub Date : 2024-10-01 DOI: 10.1016/j.jcbs.2024.100842

Narae Jeong , Eunjung Kim , Jonghoon Chun

As social costs rise due to the increasing prevalence of depression, there is a growing emphasis on cost-effective and evidence-based psychotherapeutic methods. Acceptance and Commitment Therapy (ACT) for depression is an effective approach that reduces depressive symptoms and helps prevent recurrence by enhancing psychological flexibility. This study developed a mobile app-based ACT and tested its effectiveness for college students with depression. Eighty college students with depression were randomly assigned to either a treatment group (n = 41) or a control group (n = 39). The treatment group received mobile app-based ACT for 4 weeks, the control group waited without treatment. The scores from pre, post, and follow-up assessments were compared between the two groups. Significant interaction effects of time and group were found for depression and anxiety symptoms, as well as for treatment process variables such as acceptance, inflexibility, defusion, values, commitment, and mindfulness. Acceptance and cognitive defusion emerged as significant mediators in the impact of mobile app-based ACT on depression. The mobile app-based ACT effectively reduced depression and improved treatment process variables, demonstrating its cost-effectiveness. The study also discusses the implications, limitations, and directions for future research.

随着抑郁症发病率的上升导致社会成本的增加，人们越来越重视具有成本效益和以证据为基础的心理治疗方法。接受与承诺疗法（ACT）治疗抑郁症是一种有效的方法，它能减轻抑郁症状，并通过增强心理灵活性来预防抑郁症复发。本研究开发了一种基于手机应用的 ACT，并测试了其对患有抑郁症的大学生的疗效。80 名患有抑郁症的大学生被随机分配到治疗组（41 人）或对照组（39 人）。治疗组接受为期 4 周的基于手机应用的 ACT 治疗，对照组不接受治疗。两组的治疗前、治疗后和随访评估得分进行了比较。结果发现，在抑郁和焦虑症状方面，以及在治疗过程变量（如接受、不灵活、化解、价值观、承诺和正念）方面，时间和组别之间存在显著的交互效应。在基于手机应用的 ACT 对抑郁症的影响中，接受和认知化解成为重要的中介因素。基于移动应用程序的 ACT 有效减少了抑郁，改善了治疗过程变量，证明了其成本效益。本研究还讨论了其意义、局限性和未来研究方向。

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引用次数: 0

Third wave interventions for adolescents with mental health disorders: A systematic review with meta-analysis 针对有心理健康障碍的青少年的第三波干预措施：系统回顾与荟萃分析

IF 3.4 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of Contextual Behavioral Science

Pub Date : 2024-10-01 DOI: 10.1016/j.jcbs.2024.100841

Paul Sandery, John Baranoff, Diana Dorstyn

Third wave interventions have demonstrated efficacy as a treatment option to promote wellbeing in adolescents. Evidence of their effectiveness for chronic mental health disorders remains unclear. The PubMed, PsycINFO, ProQuest, Embase, and CINAHL databases were searched from inception until March 2024 for five established interventions: acceptance and commitment therapy (ACT), compassion focused therapy, dialectical behaviour therapy (DBT), mindfulness-based cognitive therapy, and mindfulness-based stress reduction (MBSR). Risk of bias was assessed (QualSyst tool), and standardized mean group differences (Hedges’ g) with associated p-values, 95% confidence intervals, and prediction intervals calculated. Three randomized controlled trials and 10 single-group designs, all assessing DBT and representing 700 adolescents (most with subthreshold or full syndrome borderline personality disorder), were included. All studies were of sound methodological quality. DBT was associated with large and significant reductions in mental health symptoms (depression, anxiety, emotional regulation, suicidal ideation, self-harm, and BPD symptoms; g range = 0.69 to 1.05) – although individual variability in treatment response was noted. Symptom improvements were maintained at follow-up (g range = 0.70 to 1.71), although based on limited data. Neither DBT intensity nor duration significantly moderated treatment effects. DBT is the most assessed intervention for adolescents with severe emotional or behavioral problems. Additional controlled studies with diverse samples are needed to confirm the unique effects of DBT relative to other promising third wave interventions. Protocol registration: Open Science Framework [https://osf.io/fgd2j/].

第三波干预作为一种促进青少年健康的治疗方法，已被证明具有疗效。但其对慢性精神疾病的疗效证据仍不明确。我们在 PubMed、PsycINFO、ProQuest、Embase 和 CINAHL 数据库中检索了从开始到 2024 年 3 月的五种成熟的干预方法：接受与承诺疗法 (ACT)、同情疗法、辩证行为疗法 (DBT)、正念认知疗法和正念减压疗法 (MBSR)。对偏倚风险进行了评估（QualSyst 工具），并计算了标准化平均组间差异（Hedges'g）及相关的 P 值、95% 置信区间和预测区间。共纳入了 3 项随机对照试验和 10 项单组设计，所有试验都对 DBT 进行了评估，代表了 700 名青少年（大多数患有阈下或完全综合征边缘型人格障碍）。所有研究都具有良好的方法质量。DBT 能显著减少心理健康症状（抑郁、焦虑、情绪调节、自杀意念、自残和 BPD 症状；g 范围 = 0.69 至 1.05），但治疗反应存在个体差异。尽管数据有限，但症状改善在随访中得以保持（g 范围 = 0.70 至 1.71）。DBT 的强度和持续时间都没有明显调节治疗效果。DBT 是针对有严重情绪或行为问题的青少年进行的评估最多的干预措施。还需要进行更多不同样本的对照研究，以确认 DBT 相对于其他有前途的第三波干预措施的独特效果。协议注册：开放科学框架[https://osf.io/fgd2j/]。

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引用次数: 0

Web-based Acceptance and Commitment Therapy (ACT) for adults living with cancer: A single case experimental design (SCED) 针对成人癌症患者的网络接受与承诺疗法（ACT）：单例实验设计（SCED）

IF 3.4 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of Contextual Behavioral Science

Pub Date : 2024-10-01 DOI: 10.1016/j.jcbs.2024.100849

Hannah Taylor , Jessica Kingston , Michelle D. Taylor

A randomised multiple-baseline design assessed the preliminary efficacy of a low-intensity, minimally-guided, online, self-help Acceptance and Commitment Therapy (ACT) intervention for people affected by cancer on quality of life (QoL), psychological symptoms, psychological flexibility, and level of interference from pain and fatigue. Acceptability and feasibility was also assessed. Adult participants (n = 7) had either completed cancer treatment within the last 18 months or were currently receiving treatment. Participants were randomly assigned to a baseline length of 1–3 weeks prior to completing the six-week ACT intervention, followed by a one-month follow-up. At pre- and post-intervention, and one-month follow-up, cancer-specific QoL, psychological symptoms (anxiety and depression), and psychological flexibility were assessed using standardised questionnaires. Single-item daily ratings of mood, anxiety, psychological flexibility, and bother ratings of pain and fatigue were also assessed. Questionnaire data were analysed using reliable and clinically significant change. Daily measures were analysed using visual and Tau-U analysis. Participants reported less negative impact of cancer on QoL (n = 3: CancerDQoL), fewer depressive symptoms (n = 5: HADS depression), less anxiety (n = 3; HADS anxiety) and greater psychological flexibility (n = 3: MPFI) at follow-up. Daily measures showed improvements in self-reported mood (n = 3), anxiety (n = 3) and psychological flexibility (n = 5) across different phase comparisons. Most participants (n = 5) were significantly less bothered by fatigue at follow-up, and two were significantly less bothered by pain. Feedback from participants supported the acceptability of the intervention. The results provide preliminary support for the efficacy of the ACT intervention in reducing the negative impact of cancer on QoL, and improving self-reported psychological outcomes and psychological flexibility. Longitudinal studies utilising a larger sample are warranted.

该研究采用随机多基线设计，评估了针对癌症患者的低强度、微引导、在线自助式接受与承诺疗法（ACT）干预对生活质量（QoL）、心理症状、心理灵活性以及疼痛和疲劳干扰程度的初步疗效。此外，还对可接受性和可行性进行了评估。成人参与者（n = 7）在过去 18 个月内完成了癌症治疗或正在接受治疗。在完成为期六周的 ACT 干预之前，参与者被随机分配到一个为期 1-3 周的基线期，然后进行为期一个月的随访。在干预前、干预后和一个月的随访中，使用标准化问卷对癌症特异性 QoL、心理症状（焦虑和抑郁）以及心理灵活性进行了评估。此外，还对情绪、焦虑、心理灵活性的单项日常评分以及疼痛和疲劳的困扰评分进行了评估。问卷数据采用可靠且具有临床意义的变化进行分析。日常测量采用视觉和 Tau-U 分析法进行分析。在随访中，参与者报告癌症对 QoL 的负面影响较小（n = 3：CancerDQoL），抑郁症状较少（n = 5：HADS 抑郁症），焦虑较少（n = 3；HADS 焦虑症），心理灵活性较高（n = 3：MPFI）。日常测量结果显示，在不同阶段的比较中，自我报告的情绪（3 人）、焦虑（3 人）和心理灵活性（5 人）均有所改善。大多数参与者（5 人）在随访中明显感到疲劳减轻，两人明显感到疼痛减轻。参与者的反馈支持干预的可接受性。这些结果初步证明了 ACT 干预在减少癌症对 QoL 的负面影响、改善自我报告的心理结果和心理灵活性方面的有效性。有必要利用更多的样本进行纵向研究。

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引用次数: 0

Evaluating the core processes of a hybrid trauma-informed acceptance and commitment therapy intervention for college students 评估针对大学生的混合创伤信息接受与承诺疗法干预的核心过程

IF 3.4 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of Contextual Behavioral Science

Pub Date : 2024-10-01 DOI: 10.1016/j.jcbs.2024.100852

Jacob Schachter, Alex A. Ajayi, Jesus E. Delgado

Acceptance and commitment therapy (ACT) is based on the psychological flexibility model, underpinned by six core processes: contact with the present moment, acceptance, cognitive defusion, self as context, values, and committed action. The current study examined the roles of these processes in the first randomized controlled trial to examine the efficacy of a mental health promotion intervention for college students based on Trauma-Focused ACT (TFACT; Ajayi et al., 2024; Harris, 2021). The hybrid intervention combined web-based modules with peer coaching in a research laboratory setting. This current study aimed to extend those findings by empirically evaluating the theoretical components of the ACT model of psychological flexibility. Participants were 78 college students ranging between 18 and 32 years of age. It was found that the level of changes in awareness, self as context, values, and committed action were significantly different between the intervention and control groups, while psychological inflexibility, acceptance, and cognitive fusion were not. Simple regressions suggested that changes in psychological inflexibility significantly predicted changes in life satisfaction at post-intervention and 3-month follow-up. Whereas, changes in psychological inflexibility predicted changes in psychological distress only at follow-up. Furthermore, penalized regressions suggested awareness and cognitive fusion significantly predicted changes in psychological distress, but did not predict changes in psychological inflexibility or life satisfaction. The current study adds to the knowledge base regarding the process of change in ACT interventions to inform the design and implementation of more targeted and effective mental health interventions.

接纳与承诺疗法（ACT）以心理弹性模型为基础，由六个核心过程支撑：与当下接触、接纳、认知化解、自我为背景、价值观和承诺行动。本研究在首个随机对照试验中考察了这些过程的作用，该试验以创伤为重点的 ACT（TFACT；Ajayi 等人，2024 年；Harris，2021 年）为基础，考察了大学生心理健康促进干预的效果。该混合干预将基于网络的模块与研究实验室环境中的同伴辅导相结合。本研究旨在通过对心理灵活性 ACT 模型的理论组成部分进行实证评估来扩展这些研究结果。参与者为 78 名大学生，年龄在 18 岁至 32 岁之间。研究发现，干预组和对照组在意识、作为情境的自我、价值观和承诺行动方面的变化水平有显著差异，而心理不灵活、接受和认知融合则没有差异。简单的回归结果表明，在干预后和 3 个月的随访中，心理不灵活程度的变化能明显预测生活满意度的变化。而心理不灵活度的变化只能预测随访时心理困扰的变化。此外，惩罚回归表明，意识和认知融合可显著预测心理困扰的变化，但不能预测心理不灵活度或生活满意度的变化。本研究补充了有关 ACT 干预变化过程的知识库，为设计和实施更有针对性、更有效的心理健康干预措施提供了参考。

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引用次数: 0

Contextual-compassion training for borderline personality disorder with long lasting symptoms: A randomized clinical trial 针对边缘型人格障碍长期持续症状的情境同情训练：随机临床试验

IF 3.4 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of Contextual Behavioral Science

Pub Date : 2024-10-01 DOI: 10.1016/j.jcbs.2024.100846

Elisabet Casellas-Pujol , Joaquim Soler , Carlos Schmidt , Anna Soria-Madrid , Matilde Elices , Juan Carlos Pascual

Long-term follow-up studies have shown that the symptoms of borderline personality disorder (BPD) tend to remit over time. However, many patients present long lasting symptoms (LLS), including low mood, emptiness, and persistent impairment in psychosocial adjustment. Given the high rate of LLS in BPD patients, new treatment strategies are needed. We conducted a randomized clinical trial (RCT) to evaluate the efficacy of a novel intervention that combines self-compassion and contextual-based skills for patients with persistent symptoms. Sixty BPD individuals with LLS who had received dialectical behavior therapy skills training (DBT-ST) in the previous six months were recruited and randomized to receive the experimental intervention or treatment as usual (TAU) for 12 weeks. All participants were evaluated pre- and post-intervention and at 3-months follow-up. The primary outcome measure was self-reported well-being. Other clinical variables were also evaluated, including depressive symptoms, BPD symptoms, functionality, self-compassion, and self-criticism. Participants in the experimental arm showed a significant increase in indicators of well-being (e.g., happiness and quality of life) and a significant decrease in depressive symptoms. These results were sustained—and even continued to improve—at the three-month follow-up. No significant changes were observed in BPD severity, self-criticism, or self-compassion. More RCTs are needed to test the efficacy of new interventions targeting this population with persistent symptoms, not only to reduce symptoms but also to promote well-being and personal recovery.

长期跟踪研究表明，边缘型人格障碍（BPD）的症状往往会随着时间的推移而缓解。然而，许多患者会出现长期持久的症状（LLS），包括情绪低落、空虚和持续的社会心理适应障碍。鉴于 BPD 患者的 LLS 发生率很高，因此需要新的治疗策略。我们进行了一项随机临床试验（RCT），以评估一种结合了自我同情和基于情境的技能的新型干预措施对持续症状患者的疗效。我们招募了 60 名在过去 6 个月中接受过辩证行为疗法技能训练（DBT-ST）的患有 LLS 的 BPD 患者，并随机分配他们接受为期 12 周的实验干预或常规治疗（TAU）。所有参与者均在干预前、干预后和 3 个月随访时接受评估。主要结果指标是自我报告的幸福感。同时还评估了其他临床变量，包括抑郁症状、BPD 症状、功能、自我同情和自我批评。实验组的参与者在幸福感指标（如幸福感和生活质量）方面有显著提高，而抑郁症状则有显著下降。这些结果在三个月的随访中得以保持，甚至继续改善。在 BPD 严重程度、自我批评或自我同情方面没有观察到明显的变化。我们需要进行更多的研究性试验，以检验针对这一具有持续症状的人群的新干预措施的有效性，这些干预措施不仅能减轻症状，还能促进幸福感和个人康复。

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引用次数: 0

Understanding suicidal ideation through psychological flexibility and inflexibility: A network analysis perspective 通过心理灵活性和非灵活性理解自杀意念：网络分析视角

IF 3.4 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of Contextual Behavioral Science

Pub Date : 2024-10-01 DOI: 10.1016/j.jcbs.2024.100853

Alberto Misitano , Giovanni Michelini , Annalisa Oppo

Background

psychological flexibility and inflexibility represent complex sets of modifiable processes that may influence suicidal ideation, a major risk factor for suicide in clinical and non-clinical populations. The relationship between each psychological (in)flexibility process, suicidal ideation, and two ideation-specific risk factors (thwarted belongingness and perceived burdensomeness) was investigated.

Methods

409 Italian participants from the general population (M_age = 30.1, SD = 12.3, 76.5% female; 24.7% reporting recent suicidal ideation) completed an online battery of questionnaires, including the Multidimensional Psychological Flexibility Inventory, the Patient Health Questionnaire-9, and the Interpersonal Needs Questionnaire-15. Relationships between variables were explored using network analysis.

Results

cognitive fusion (responding to mental contents as objectively true) and Self-as-Context (flexible perspective-taking) emerged as the most central inflexibility and flexibility processes, respectively. Both processes were directly connected to suicidal ideation.

Conclusion

cognitive fusion and Self-as-Context may be suitable processes to be targeted in future research about suicidal ideation. Further long-term studies, possibly conducted with larger and more diverse samples and including a wider range of suicide-specific risk factors, are warranted to better elucidate the role of psychological (in)flexibility processes in suicidal individuals and to inform clinical practice.

背景心理灵活性和不灵活性代表着一系列复杂的可改变过程，它们可能会影响自杀意念，而自杀意念是临床和非临床人群自杀的一个主要风险因素。方法 409 名来自普通人群的意大利参与者（平均年龄 30.1 岁，平均标准偏差 12.3 岁，76.5% 为女性；24.7% 近期有自杀倾向）完成了一系列在线问卷，包括多维心理灵活性量表、患者健康问卷-9 和人际需求问卷-15。结果认知融合（将心理内容反应为客观真实）和 "自我即背景"（灵活的视角）分别成为最核心的不灵活和灵活过程。结论认知融合和 "自我即情境 "可能是未来有关自杀意念研究的合适目标过程。为了更好地阐明心理（不）灵活性过程在自杀者中的作用并为临床实践提供参考，我们有必要开展进一步的长期研究，这些研究可能会使用更大、更多样化的样本，并包括更广泛的自杀特定风险因素。

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引用次数: 0

Existential therapies and the extended evolutionary meta-model: Turning existential philosophy into process-based therapy 存在主义疗法和扩展进化元模型：将存在主义哲学转化为基于过程的疗法

IF 3.4 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of Contextual Behavioral Science

Pub Date : 2024-09-14 DOI: 10.1016/j.jcbs.2024.100840

Ross G. Menzies , Rachel E. Menzies

This article reviews the central theoretical claims found in the various psychotherapeutic approaches broadly referred to as the existential therapies. Despite substantial differences across existential packages, these therapies broadly arise from the theoretical position that the pain and suffering common to our species arises, not from illnesses hypothesized in traditional medical and psychiatric accounts, but rather from a set of existential concerns that all humans must face. These ‘givens’ of existence include death, identity, isolation, meaning, and freedom. From this theoretical perspective, all branches and brands of psychotherapy need to include some procedures to address these issues. Evidence for the importance of these constructs in human experience is presented, followed by evidence for existential therapies themselves. A dearth of quality research trials establishing a strong evidence base for this branch of therapy was noted. Further, process-based research in this area was shown to be weak. That is, few researchers have sought to show that the hypothesized processes are responsible for the changes observed in existential therapy. We describe how viewing existential therapy through a Process-Based Therapy (PBT) framework and the Extended Evolutionary Meta-Model (EEMM) will encourage: (1) a greater examination of the processes of change occurring; (2) an expansion in the way in which existential therapies operate, enabling the inclusion of procedures drawn from other therapeutic modalities; and (3) more nuanced targeting of existential processes in any given case.

本文回顾了被广泛称为存在主义疗法的各种心理治疗方法的核心理论主张。尽管不同的存在主义疗法之间存在很大差异，但这些疗法的理论立场大致相同，即我们人类共有的痛苦和苦难并非来自传统医学和精神病学所假设的疾病，而是来自全人类都必须面对的一系列存在主义问题。这些存在的 "给定 "包括死亡、身份、孤独、意义和自由。从这个理论角度来看，所有心理疗法的分支和品牌都需要包含一些解决这些问题的程序。本文提出了这些概念在人类经验中的重要性的证据，随后提出了存在主义疗法本身的证据。我们注意到，缺乏为这一疗法分支建立坚实证据基础的高质量研究试验。此外，该领域基于过程的研究也很薄弱。也就是说，很少有研究人员试图证明假设的过程是存在主义疗法中观察到的变化的原因。我们描述了如何通过基于过程的疗法（PBT）框架和扩展进化元模型（EEMM）来看待存在主义疗法，从而鼓励：（1）更深入地研究发生变化的过程；（2）扩展存在主义疗法的运作方式，从而能够纳入从其他治疗方式中汲取的程序；以及（3）在任何特定案例中更细致地针对存在主义过程。

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引用次数: 0

Avoiding the unwanted: A cross-cultural comprehensive analysis of experiential avoidance and a meta-analysis 回避不受欢迎的人：体验性回避的跨文化综合分析和荟萃分析

IF 3.4 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of Contextual Behavioral Science

Pub Date : 2024-09-06 DOI: 10.1016/j.jcbs.2024.100838

Sunkyung Yoon , Sooyeon Kim , Sinhae Cho , Hyewon Choi

Experiential avoidance, a central treatment target of Acceptance and Commitment Therapy (ACT), involves avoiding uncomfortable internal states and trying to control them. While some researchers suggest several components of ACT align with East Asian values, indicating the possibility of lower experiential avoidance among East Asians compared to Westerners, previous cross-cultural studies have challenged this notion. This study aimed to draw conclusions regarding cultural differences in experiential avoidance between East Asian and Western cultures through two studies. Using a meta-analysis in Study 1, we systematically reviewed previous cross-cultural studies that compared experiential avoidance between the two cultures. Six cross-cultural studies were included in the meta-analysis. In Study 2, we sought to replicate the findings using a large sample of college students. Across studies, East Asians reported greater experiential avoidance compared to Westerners, with significant heterogeneity in effect sizes observed (Study 1). Results from Study 2 showed that being an East Asian predicted greater experiential avoidance when accounting for distress and other covariates. Further, the correlation between experiential avoidance and distress was weaker among East Asian students relative to White students. Our results highlight that elevated levels of experiential avoidance in East Asians may need to be interpreted differently in clinical setting, while within-culture individual differences also need to be considered.

体验回避是接纳与承诺疗法（ACT）的核心治疗目标，它涉及回避不舒服的内心状态并试图控制它们。一些研究人员认为，接纳与承诺疗法的一些内容与东亚人的价值观相吻合，这表明东亚人的体验回避程度可能低于西方人，但以往的跨文化研究却对这一观点提出了质疑。本研究旨在通过两项研究就东亚人和西方人在体验回避方面的文化差异得出结论。在研究 1 中，我们采用了荟萃分析法，系统地回顾了以往比较两种文化间体验性回避的跨文化研究。荟萃分析包括六项跨文化研究。在研究 2 中，我们试图使用大量的大学生样本来复制研究结果。在所有研究中，与西方人相比，东亚人的体验性回避程度更高，但在效应大小上存在显著的异质性（研究 1）。研究 2 的结果显示，当考虑到困扰和其他协变量时，东亚人的身份预示着更大的体验性回避。此外，相对于白人学生，东亚学生的体验性回避与困扰之间的相关性较弱。我们的研究结果突出表明，在临床环境中，可能需要对东亚人较高的体验回避水平做出不同的解释，同时也需要考虑文化内部的个体差异。

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引用次数: 0

Feasibility, acceptability and outcomes of a contextual schema therapy-based mobile program for depressive symptoms in adults 基于情境图式疗法的移动程序对成人抑郁症状的可行性、可接受性和结果

IF 3.4 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of Contextual Behavioral Science

Pub Date : 2024-09-06 DOI: 10.1016/j.jcbs.2024.100839

Paula I. Stroian , Daniel O. David , Adriana Hora , Berfin Erenler , Ella W. Tuominen , Konstantinos Vlachantonis , Tea Žagar

Background

Given the high prevalence of depression worldwide, there is a pressing need for increasing treatment accessibility and identifying treatment modalities that can sustainably address depression. The present study aims to test the feasibility, acceptability, outcomes and mechanisms of a brief online self-help program for depressive symptoms in adults (nCompass), based on Contextual Schema Therapy principles.

Method

102 participants scoring above 14 on the Beck Depression Inventory – Second Version were recruited online and randomly allocated to either the 15-day nCompass intervention or a self-administered online psychoeducation group. Participants filled in self-report measures of depression, schema coping and psychological flexibility at baseline, immediately following the intervention and at a two-week follow-up. Additionally, nCompass participants were administered an instrument measuring the acceptability of the program.

Results

The nCompass intervention was overall feasible and acceptable, with most participants completing the intervention and assessing it as easy to use, satisfactory and useful. Furthermore, results indicate higher decreases in depression and schema coping in the nCompass group by follow-up, compared to the control group. Changes in depressive symptoms from pre-test to post-test and follow-up in the nCompass group were explained by changes in surrender coping. There were no significant differences in psychological flexibility between the groups at either post-test or follow-up.

Discussion

Our results highlight the nCompass program as a promising option for treating depressive symptoms in the general population.

背景鉴于抑郁症在全球的高发病率，迫切需要提高治疗的可及性，并确定可持续解决抑郁症的治疗模式。本研究旨在测试基于情境模式疗法原则的简短成人抑郁症状在线自助项目（nCompass）的可行性、可接受性、结果和机制。方法在线招募贝克抑郁量表（第二版）得分超过 14 分的 102 名参与者，并随机分配到为期 15 天的 nCompass 干预项目或自控在线心理教育组。受试者在基线、干预结束后和两周的随访中填写了关于抑郁、模式应对和心理灵活性的自我报告测量。此外，还对 nCompass 参与者进行了程序可接受性测量。结果 nCompass 干预总体上是可行和可接受的，大多数参与者都完成了干预，并认为它易于使用、令人满意且有用。此外，结果表明，与对照组相比，nCompass 组的抑郁症状和模式应对能力在随访中的下降幅度更大。nCompass 小组抑郁症状从测试前到测试后以及随访期间的变化可以用投降应对方式的变化来解释。我们的研究结果表明，nCompass 计划是治疗普通人群抑郁症状的一种很有前景的选择。

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