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How to develop causal directed acyclic graphs for observational health research: a scoping review. 如何为观察性健康研究开发因果有向无环图:范围综述。
IF 6.6 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-27 DOI: 10.1080/17437199.2024.2402809
Louise Poppe, Johan Steen, Wen Wei Loh, Geert Crombez, Fien De Block, Noortje Jacobs, Peter W G Tennant, Jelle Van Cauwenberg, Annick L De Paepe

Causal directed acyclic graphs (DAGs) serve as intuitive tools to visually represent causal relationships between variables. While they find widespread use in guiding study design, data collection and statistical analysis, their adoption remains relatively rare in the domain of psychology. In this paper we describe the relevance of DAGs for health psychology, review guidelines for developing causal DAGs, and offer recommendations for their development. A scoping review searching for papers and resources describing guidelines for DAG development was conducted. Information extracted from the eligible papers and resources (n = 11) was categorised, and results were used to formulate recommendations. Most records focused on DAG development for data analysis, with similar steps outlined. However, we found notable variations on how to implement confounding variables (i.e., sequential inclusion versus exclusion). Also, how domain knowledge should be integrated in the development process was scarcely addressed. Only one paper described how to perform a literature search for DAG development. Key recommendations for causal DAG development are provided and discussed using an illustrative example.

因果有向无环图(DAG)是直观表示变量间因果关系的工具。虽然它们被广泛应用于指导研究设计、数据收集和统计分析,但在心理学领域的应用却相对较少。在本文中,我们阐述了 DAG 与健康心理学的相关性,回顾了开发因果 DAG 的指南,并提出了开发 DAG 的建议。我们对描述 DAG 开发指南的论文和资源进行了范围界定。对从符合条件的论文和资源(n = 11)中提取的信息进行了分类,并将结果用于制定建议。大多数记录都侧重于数据分析的 DAG 开发,并概述了类似的步骤。不过,我们发现在如何实施混杂变量(即顺序纳入与排除)方面存在明显差异。此外,在开发过程中如何整合领域知识也几乎没有涉及。只有一篇论文介绍了如何为 DAG 开发进行文献检索。本文提供了因果 DAG 开发的主要建议,并通过一个示例进行了讨论。
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引用次数: 0
The iterative development and refinement of health psychology theories through formal, dynamical systems modelling: a scoping review and initial expert-derived 'best practice' recommendations. 通过正式的动态系统建模迭代发展和完善健康心理学理论:范围综述和初步的专家 "最佳实践 "建议。
IF 9.8 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-11 DOI: 10.1080/17437199.2024.2400977
Olga Perski,Amber Copeland,Jim Allen,Misha Pavel,Daniel E Rivera,Eric Hekler,Nelli Hankonen,Guillaume Chevance
This scoping review aimed to synthesise methodological steps taken by researchers in the development of formal, dynamical systems models of health psychology theories. We searched MEDLINE, PsycINFO, the ACM Digital Library and IEEE Xplore in July 2023. We included studies of any design providing that they reported on the development or refinement of a formal, dynamical systems model unfolding at the within-person level, with no restrictions on population or setting. A narrative synthesis with frequency analyses was conducted. A total of 17 modelling projects reported across 29 studies were included. Formal modelling efforts have largely been concentrated to a small number of interdisciplinary teams in the United States (79.3%). The models aimed to better understand dynamic processes (69.0%) or inform the development of adaptive interventions (31.0%). Models typically aimed to formalise the Social Cognitive Theory (31.0%) or the Self-Regulation Theory (17.2%) and varied in complexity (range: 3-30 model components). Only 3.4% of studies reported involving stakeholders in the modelling process and 10.3% drew on Open Science practices. We conclude by proposing an initial set of expert-derived 'best practice' recommendations. Formal, dynamical systems modelling is poised to help health psychologists develop and refine theories, ultimately leading to more potent interventions.
本范围界定综述旨在综合研究人员在开发健康心理学理论的正式动力系统模型时所采取的方法步骤。我们检索了 2023 年 7 月的 MEDLINE、PsycINFO、ACM 数字图书馆和 IEEE Xplore。我们收录了任何设计的研究,只要这些研究报告了在个人层面上展开的正式动态系统模型的发展或完善情况,对人群或环境没有任何限制。我们对这些研究进行了叙述性综合和频率分析。共纳入了 29 项研究中的 17 个建模项目。正式建模工作主要集中在美国的少数跨学科团队(79.3%)。这些模型旨在更好地了解动态过程(69.0%)或为适应性干预措施的开发提供信息(31.0%)。模型通常旨在使社会认知理论(31.0%)或自我调节理论(17.2%)正规化,其复杂程度各不相同(范围:3-30 个模型组成部分)。只有 3.4% 的研究报告称利益相关者参与了建模过程,10.3% 的研究报告称利用了开放科学实践。最后,我们提出了一套初步的专家 "最佳实践 "建议。正式的动力系统建模有望帮助健康心理学家发展和完善理论,最终实现更有效的干预。
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引用次数: 0
Good mental health in people with intellectual disabilities: a systematic review. 智障人士的良好心理健康:系统综述。
IF 9.8 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-11 DOI: 10.1080/17437199.2024.2398021
Sophie Komenda-Schned,Sarah Jasmin Landskron,Paula Moritz,Nadine Brunevskaya,Jacopo Santambrogio,Luis Salvador-Carulla,Brigitte Lueger-Schuster,Elisabeth Lucia Zeilinger
While mental disorders have been broadly researched in people with intellectual disabilities (ID), comparatively less attention has been given to the conceptualisation of good mental health for this population. To capture existing concepts, definitions and measurement approaches of good mental health a systematic literature review was conducted following PRISMA guidelines. The search was carried out in eleven databases, using various synonyms of (i) intellectual disability, (ii) mental health, (iii) wellbeing, (iv) definition, and (v) assessment. A total of 2,046 datasets were identified, of which 37 met the inclusion criteria and were analysed using reflexive thematic analysis and content analysis. Results show four main themes: (1) environment, (2) absence of mental illness, (3) physical health, and (4) psychosocial functioning. The fourth was the most dominant theme and was further divided into five sub-themes: (1) emotionality, (2) interpersonal relations, (3) realise own potential, (4) personal resources, and (5) overall appraisal of life. Our findings reveal different conceptualisations of wellbeing, which is a vital part of good mental health, but highlight a notable research gap in the actual definition and conceptualisation of good mental health for people with ID.
虽然对智障人士(ID)的精神障碍进行了广泛的研究,但对该人群良好心理健康概念的关注却相对较少。为了了解良好心理健康的现有概念、定义和测量方法,我们按照 PRISMA 指南进行了系统的文献综述。我们使用以下各种同义词在 11 个数据库中进行了搜索:(i) 智障、(ii) 心理健康、(iii) 健康、(iv) 定义和 (v) 评估。共确定了 2,046 个数据集,其中 37 个符合纳入标准,并使用反思性主题分析和内容分析进行了分析。结果显示有四大主题:(1) 环境;(2) 无精神疾病;(3) 身体健康;(4) 社会心理功能。第四个主题是最主要的主题,并进一步分为五个次主题:(1) 情绪化,(2) 人际关系,(3) 发挥自身潜能,(4) 个人资源,以及 (5) 对生活的总体评价。我们的研究结果揭示了幸福感的不同概念,而幸福感是良好心理健康的重要组成部分,但也凸显了在智障人士良好心理健康的实际定义和概念化方面存在着明显的研究空白。
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引用次数: 0
On social health: history, conceptualization, and population patterning. 社会健康:历史、概念化和人口模式。
IF 6.6 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-01 Epub Date: 2024-02-13 DOI: 10.1080/17437199.2024.2314506
David Matthew Doyle, Bruce G Link

We propose a psychologically-informed concept of social health to join physical and mental components in a more comprehensive assessment of human health. Although there is an extensive literature on the importance of social relationships to health, a theoretical framework is needed to coalesce this work into a codified conceptualisation of social health, defined here as adequate quantity and quality of relationships in a particular context to meet an individual's need for meaningful human connection. Informing this novel conceptualisation, we outline eight key propositions to guide future research and theory on social health, including five propositions focused on the conceptualisation of social health and three focused on its population patterning. The former five propositions include that social health is an outcome in its own right, that health interventions can have divergent effects on social versus physical and mental aspects of health, that social health has independent effects on quality of life, that it is a dynamic and contextual construct, and that it is embedded and encoded in the human body (and mind). The utility of the social health concept is further revealed in its significance for understanding and addressing population health concerns, such as health inequalities experienced by marginalised groups.

我们提出了一个以心理学为基础的社会健康概念,以便在对人类健康进行更全面的评估时,将生理和心理因素结合起来。尽管已有大量文献论述了社会关系对健康的重要性,但仍需要一个理论框架来将这些工作凝聚成一个成文的社会健康概念,在这里,社会健康被定义为在特定环境中具有足够数量和质量的人际关系,以满足个人对有意义的人际联系的需求。在这一新颖概念的基础上,我们概述了指导未来社会健康研究和理论的八个关键命题,其中五个命题侧重于社会健康的概念化,三个命题侧重于其人口模式。前五个命题包括:社会健康本身就是一种结果;健康干预对社会健康、身体健康和精神健康的影响可能不同;社会健康对生活质量有独立的影响;社会健康是一个动态的、与环境相关的概念;社会健康嵌入并编码在人体(和心理)中。社会健康概念的实用性进一步体现在它对理解和解决人口健康问题(如边缘化群体经历的健康不平等)的重要意义上。
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引用次数: 0
The concept of treatment beliefs in children and adolescents with chronic health conditions: a scoping review. 患有慢性疾病的儿童和青少年的治疗信念概念:范围界定综述。
IF 6.6 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-01 Epub Date: 2023-09-07 DOI: 10.1080/17437199.2023.2253300
Gloria Metzner, Rieka von der Warth, Manuela Glattacker

Children and adolescents with chronic health conditions are faced with ongoing challenges, making self-regulation crucial. As children grow up, they gradually develop differentiated beliefs about illness and treatment. While research indicates treatment beliefs as relevant factor on outcomes like adherence, the specific contents and dimensions of children's and adolescents' treatment beliefs remained unclear. This scoping review therefore aimed at the identification of treatment beliefs dimensions in children and adolescents with chronic health conditions, the underlying theoretical frameworks, and methodological operationalisation. Published literature was examined by applying systematic searches in electronic databases (Medline, PsycINFO, CINAHL) and comprehensive selection criteria, resulting in 49 included studies. The predominant treatment beliefs dimensions were necessity, concerns, perceived benefits and costs/barriers, and expectations. The latter can be differentiated into outcome, social, process, and structural expectations, and expectations of one's own role in the treatment process. In addition, dimensions that cover emotions and reasons for treatment were identified. The results are related to the methods and theoretical models applied, which were often adapted from adult research. However, additional and possibly more child-specific dimensions such as social expectations and emotions were found. This scoping review indicates several research gaps and discusses practical implications.

患有慢性疾病的儿童和青少年面临着持续不断的挑战,因此自我调节至关重要。随着儿童的成长,他们逐渐形成了对疾病和治疗的不同信念。虽然研究表明治疗信念是影响坚持治疗等结果的相关因素,但儿童和青少年治疗信念的具体内容和维度仍不清楚。因此,本次范围界定综述旨在确定患有慢性疾病的儿童和青少年的治疗信念维度、基本理论框架和方法操作化。通过在电子数据库(Medline、PsycINFO、CINAHL)中进行系统检索并采用综合筛选标准,对已发表的文献进行了审查,最终纳入了 49 项研究。治疗信念的主要维度包括必要性、顾虑、感知到的益处和成本/障碍以及期望。后者可分为对结果、社会、过程和结构的期望,以及对自己在治疗过程中所扮演角色的期望。此外,还确定了涵盖情绪和治疗原因的维度。研究结果与所采用的方法和理论模型有关,这些方法和理论模型通常是从成人研究中改编而来的。不过,我们也发现了其他可能更适合儿童的维度,如社会期望和情绪。本次范围界定审查指出了一些研究空白,并讨论了实际影响。
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引用次数: 0
Barriers and enablers to maintaining self-management behaviours after attending a self-management support intervention for type 2 diabetes: a systematic review and qualitative evidence synthesis. 参加2型糖尿病自我管理支持干预后维持自我管理行为的障碍和促成因素:系统综述和定性证据综合。
IF 6.6 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-01 Epub Date: 2023-11-03 DOI: 10.1080/17437199.2023.2268731
Márcia Carvalho, Pauline Dunne, Dominika Kwasnicka, Molly Byrne, Jenny McSharry

Attendance at type 2 diabetes self-management interventions is associated with improved outcomes. However, difficulties maintaining self-management behaviours attenuate long-term impact. This review aimed to identify and synthesise qualitative research on barriers and enablers to maintaining type 2 diabetes self-management behaviours after attending a self-management intervention. Eight electronic databases were searched to identify relevant peer-reviewed and grey literature studies. Data were synthesised using the best-fit framework synthesis approach guided by the themes and constructs identified by Kwasnicka et al. (2016) on their review of theoretical explanations for behaviour change maintenance. Study methodological limitations and confidence in findings were assessed using an adapted version of the Critical Appraisal Skills Programme (CASP) tool and the GRADE-CERQual approach respectively. Eleven articles reporting on 10 studies were included. Twenty-eight barriers and enablers were coded to the a priori themes. Barriers were commonly coded to the themes self-regulation, resources, and environmental and social influences. Enablers were commonly coded to the themes habits and maintenance motives. Methodological limitations of included studies varied, leading to moderate or low confidence in most findings. Interventions may improve behavioural maintenance by providing post-intervention support, promoting positive behaviour change motives, self-regulation, habit formation, and facilitating access to resources and support.

参加2型糖尿病自我管理干预与改善结果相关。然而,维持自我管理行为的困难会减弱长期影响。这篇综述旨在确定和综合关于参加自我管理干预后维持2型糖尿病自我管理行为的障碍和促成因素的定性研究。搜索了八个电子数据库,以确定相关的同行评审和灰色文献研究。在Kwasnicka等人确定的五个理论主题和十四个行为变化维持结构的指导下,使用最佳拟合框架综合方法对数据进行综合。(2016)。分别使用关键评估技能计划(CASP)工具和GRADE CERQual方法的改编版本评估研究方法的局限性和对研究结果的信心。收录了11篇关于10项研究的文章。28个障碍和促成因素被编码为五个先验主题。障碍通常被编码为自律、资源、环境和社会影响等主题。促成因素通常根据主题、习惯和维护动机进行编码。纳入研究的方法学局限性各不相同,导致对大多数综述结果的置信度适中或较低。干预措施可以通过提供干预后支持、促进积极的行为改变动机、自我调节、习惯养成以及促进获得资源和支持来改善行为维持。
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引用次数: 0
Compendium of dyadic intervention techniques (DITs) to change health behaviours: a systematic review. 改变健康行为的干群干预技术(DIT)汇编:系统综述。
IF 6.6 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-01 Epub Date: 2024-03-04 DOI: 10.1080/17437199.2024.2307534
Sally Di Maio, Karoline Villinger, Nina Knoll, Urte Scholz, Gertraud Stadler, Caterina Gawrilow, Corina Berli

Background: Dyadic interventions for health behaviour change involving the romantic partner are promising. However, it often remains unclear how exactly the partner is involved in dyadic interventions. We propose a novel compendium of dyadic intervention techniques (DITs) that facilitates systematic description of dyadic interventions in terms of who performs what for whom during intervention delivery and subsequent implementation.

Objective: We aimed to systematically characterise dyadic interventions along their degree of partner involvement and to provide a comprehensive list of DITs used in dyadic interventions with romantic partners.

Methods: We systematically reviewed dyadic health behaviour change interventions with controlled designs. We included 165 studies describing 122 distinct dyadic interventions with romantic partners. Interventions were classified along their degree of partner involvement, 160 DITs were extracted, and their frequencies of use counted.

Results: The majority of interventions (n = 90, 74%) explicitly instructed partners to interact. Half of the DITs were performed jointly by the couple and also targeted the couple. Mostly, couples were instructed to jointly practice communication skills and to jointly perform problem solving for the couple.

Discussion: The present review contributes to the development of a shared and systematic way of describing dyadic interventions to facilitate cumulation of evidence.

背景:有恋爱伴侣参与的改变健康行为的双向干预很有前景。然而,人们往往仍不清楚伴侣究竟是如何参与伴侣干预的。我们提出了一个新颖的伴侣干预技术(DITs)汇编,该汇编有助于系统地描述伴侣干预,即在干预实施和后续实施过程中,谁为谁做什么:我们的目的是根据伴侣参与的程度系统地描述伴侣干预的特点,并提供一份在与恋爱伴侣进行伴侣干预时使用的 DIT 的综合清单:我们系统回顾了采用对照设计的伴侣健康行为改变干预措施。我们纳入了 165 项研究,这些研究描述了 122 种不同的恋爱伴侣双向干预措施。根据伴侣的参与程度对干预措施进行了分类,提取了 160 项 DIT,并统计了其使用频率:大多数干预措施(n = 90,74%)都明确指示伴侣进行互动。有一半的 DIT 是由夫妻共同完成的,也是针对夫妻的。大多数情况下,夫妻被指导共同练习沟通技巧,并共同为夫妻解决问题:本综述有助于发展一种共同的、系统的方法来描述夫妻干预,以促进证据的积累。
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引用次数: 0
Dyadic processes and adjustment of couples experiencing a neurodegenerative disease: a meta-synthesis. 经历神经退行性疾病的夫妇的互动过程和适应:元综合。
IF 6.6 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-01 Epub Date: 2024-01-30 DOI: 10.1080/17437199.2024.2307044
Charlotte Manceau, Pascal Antoine, Justine Deleruyelle, Pierre Gérain

Neurodegenerative diseases (NDDs) pose significant challenges to couple relationships. Existing research has predominantly focused on the impact of Alzheimer's disease (AD) on various types of dyads, resulting in significant advances in the field. However, despite a keen interest in transdiagnostic approaches , a comprehensive review addressing dyadic processes underlying the functioning of couple relationships across different NDDs is lacking. This meta-synthesis aimed to fill this gap by identifying, analysing, and integrating findings from qualitative studies examining couples facing different NDDs. Searches were conducted in four databases, identifying 35 articles meeting several inclusion criteria. A thematic synthesis was performed, identifying three interdependent themes : 'Disease-related challenges', 'Dyadic interactions', and 'Dyadic identity'. They emphasise that stress, social changes, the perception of time, and uncertainty are major challenges for partners.They also show how dyadic interactions such as communication are transformed and how partners strive to maintain their shared identity despite the progressive loss of the relationship's core components. This synthesis highlights key implications for clinical practice and future research, including the need to integrate disease-specific characteristics to interventions and understand the couple's functioning patterns and their evolution throughout the disease.

摘要神经退行性疾病(NDDs)对夫妻关系构成重大挑战。现有的研究主要集中于阿尔茨海默病(AD)对各种类型的夫妻关系的影响,从而在该领域取得了重大进展。然而,尽管人们对跨诊断方法有着浓厚的兴趣,但针对不同 NDDs 的夫妻关系运作所依赖的双亲过程的全面综述却十分缺乏。本荟萃综述旨在通过识别、分析和整合对面临不同 NDD 的夫妇进行定性研究的结果来填补这一空白。我们在四个数据库中进行了搜索,共发现了 35 篇符合多项纳入标准的文章。进行了主题综合,确定了三个相互依存的主题:"与疾病相关的挑战"、"家庭互动 "和 "家庭认同"。他们强调,压力、社会变化、对时间的感知以及不确定性是伴侣面临的主要挑战。他们还展示了交流等双向互动是如何转变的,以及伴侣是如何在逐渐丧失关系核心要素的情况下努力维持共同身份的。这篇综述强调了对临床实践和未来研究的重要影响,包括需要将疾病的特定特征纳入干预措施,并了解夫妇的功能模式及其在整个疾病期间的演变。
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引用次数: 0
Relations of body dissatisfaction with self-injurious thoughts and behaviours in clinical and non-clinical samples: a meta-analysis of studies published between 1995 and 2022. 临床和非临床样本中身体不满意与自我伤害想法和行为的关系:对 1995 年至 2022 年间发表的研究的荟萃分析。
IF 6.6 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-01 Epub Date: 2024-01-30 DOI: 10.1080/17437199.2024.2310140
Yaoxiang Ren, Shuqi Cui, Tianxiang Cui, Chanyuan Tang, Jianwen Song, Todd Jackson, Jinbo He

Body dissatisfaction is a global public health concern. Self-injurious thoughts and behaviours (SITB), including suicidal ideation, suicide attempts and non-suicidal self-injury (NSSI), have been documented as potentially significant correlates of body dissatisfaction. However, prior findings regarding associations between body dissatisfaction and SITB have been somewhat inconsistent. Therefore, this meta-analysis was conducted to determine the nature and strength of such associations in both clinical and non-clinical samples. A literature search identified 83 relevant articles and extracted 234 effect sizes. Using a three-level random-effects model, mean effect sizes (r values) for relationships between body dissatisfaction and suicidal ideation, suicide attempts, and NSSI in clinical samples were 0.29 (95% CI, 0.22-0.37), 0.16 (95% CI, 0.13-0.20) and 0.26 (95% CI, 0.19-0.34), respectively. In non-clinical samples, these values were 0.22 (95% CI, 0.16-0.28), 0.24 (95% CI, 0.17-0.30) and 0.22 (95% CI, 0.15-0.29), respectively. Several study features (e.g., participant age, geographic region and instrument validity) emerged as significant moderators. This meta-analysis provides robust support for body dissatisfaction as a significant correlate of SITB across clinical and non-clinical samples in addition to identifying study characteristics that contribute to effect size variability. Implications are discussed for SITB research, prevention and intervention.

身体不满意是一个全球性的公共健康问题。自伤想法和行为(SITB),包括自杀意念、自杀企图和非自杀性自伤(NSSI),已被记录为身体不满意的潜在重要相关因素。然而,之前关于身体不满意和 SITB 之间关联的研究结果并不一致。因此,本荟萃分析旨在确定临床和非临床样本中此类关联的性质和强度。通过文献检索发现了 83 篇相关文章,并提取了 234 个效应大小。使用三级随机效应模型,在临床样本中,身体不满意度与自杀意念、自杀企图和非自残行为之间关系的平均效应大小(r 值)分别为 0.29(95% CI,0.22-0.37)、0.16(95% CI,0.13-0.20)和 0.26(95% CI,0.19-0.34)。在非临床样本中,这些数值分别为 0.22(95% CI,0.16-0.28)、0.24(95% CI,0.17-0.30)和 0.22(95% CI,0.15-0.29)。一些研究特征(如参与者年龄、地理区域和工具有效性)成为重要的调节因素。这项荟萃分析为身体不满意度在临床和非临床样本中作为 SITB 的重要相关因素提供了强有力的支持,此外还确定了导致效应大小变化的研究特征。本文还讨论了 SITB 研究、预防和干预的意义。
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引用次数: 0
Acceptance and commitment therapy processes and their association with distress in cancer: a systematic review and meta-analysis. 癌症接受和承诺治疗过程及其与痛苦的关系:一项系统综述和荟萃分析。
IF 6.6 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Pub Date : 2024-09-01 Epub Date: 2023-10-04 DOI: 10.1080/17437199.2023.2261518
Sophie Fawson, Zoe Moon, Katherine Novogrudsky, Faye Moxham, Katie Forster, Insun Tribe, Rona Moss-Morris, Caroline Johnson, Lyndsay D Hughes

Around 42% of individuals with cancer experience distress. Acceptance and commitment therapy (ACT) can reduce distress, but effects are small, and mechanisms unclear. This review aimed to identify associations between ACT processes and distress in cancer. Search terms included cancer, ACT processes, self-compassion, and distress. Six online databases and grey literature were searched until March 2022. Of 6555 papers screened, 108 studies were included with 17,195 participants. Five meta-analyses of 77 studies were conducted. Random effects meta-analyses of correlations revealed higher scores on flexible processes (acceptance, present moment awareness, self-compassion) were associated with lower distress (rpooled = -0.24, -0.39, -0.48, respectively); whilst higher scores on inflexible processes (experiential avoidance, cognitive fusion) were associated with higher distress (rpooled = 0.58, 0.57, respectively). Meta-analyses displayed moderate-to-high heterogeneity with most studies assessed as low risk of bias. Meta-regressions revealed no significant moderators (stage, time since diagnosis, gender and age). This review provides a theoretically aligned evidence base for associations between ACT processes and distress in cancer, supporting elements of ACT theory and providing targeted directions for intervention development. Due to limited evidence, future research should focus on self-as-context, values and committed action and conduct mediation analysis in controlled trials of ACT processes on distress in cancer.

大约42%的癌症患者经历了痛苦。接受和承诺疗法(ACT)可以减少痛苦,但效果很小,机制也不清楚。这篇综述旨在确定癌症ACT过程和痛苦之间的关系。搜索词包括癌症、ACT过程、自我同情和痛苦。搜索了六个在线数据库和灰色文献,直到2022年3月。在筛选的6555篇论文中,108项研究被纳入,17195名参与者。对77项研究进行了5项荟萃分析。相关性的随机效应荟萃分析显示,在灵活的过程(接受、当下意识、自我同情)上得分越高,痛苦越低(rpoled = -0.24,-0.39,-0.48);而在不灵活的过程(经验回避、认知融合)上得分越高,痛苦程度越高(rpoold = 分别为0.58、0.57)。荟萃分析显示中度至高度异质性,大多数研究被评估为低偏倚风险。荟萃回归显示没有显著的调节因素(阶段、诊断后的时间、性别和年龄)。这篇综述为癌症ACT过程与痛苦之间的关联提供了理论上一致的证据基础,支持ACT理论的要素,并为干预发展提供了有针对性的方向。由于证据有限,未来的研究应侧重于自我情境、价值观和承诺行动,并在癌症痛苦ACT过程的对照试验中进行中介分析。
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引用次数: 0
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Health Psychology Review
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