University of Twente, Faculty of Behavioural Sciences, Department Psychology, Health & Technology, P.O. Box 217, 7500 AE Enschede, The Netherlands.
Behav Res Ther. 2013 Mar;51(3):142-51. doi: 10.1016/j.brat.2012.11.007. Epub 2012 Dec 17.
This study examined the role of psychological flexibility, as a risk factor and as a process of change, in a self-help Acceptance and Commitment Therapy (ACT) intervention for adults with mild to moderate depression and anxiety. Participants were randomized to the self-help programme with e-mail support (n=250), or to a waiting list control group (n=126). All participants completed measures before and after the intervention to assess depression, anxiety and psychological flexibility. Participants in the experimental condition also completed these measures during the intervention (after three and six weeks) and at a three-month follow-up. With multilevel modelling, it was shown that the effects of the intervention on psychological distress were stronger for participants with higher levels of psychological flexibility. Furthermore, our study showed that improved psychological flexibility mediated the effects of the ACT intervention. With a cross-lagged panel design, it was shown that especially improvements in psychological flexibility in the last three sessions of the intervention were important for further reductions in anxiety. To conclude, our study showed the importance of targeting psychological flexibility during an ACT intervention for a reduction in depressive and anxiety symptoms.
本研究考察了心理灵活性在自助式接受与承诺疗法（ACT）干预中的作用，该干预针对的是轻度至中度抑郁和焦虑的成年人，其作用既可以作为风险因素，也可以作为一种改变过程。参与者被随机分配到有电子邮件支持的自助式方案组（n=250）或等待名单对照组（n=126）。所有参与者在干预前和干预后完成了抑郁、焦虑和心理灵活性的评估。实验组的参与者还在干预期间（第 3 周和第 6 周）和 3 个月的随访中完成了这些评估。采用多层次建模，结果表明，对于心理灵活性水平较高的参与者，干预对心理困扰的影响更强。此外，我们的研究表明，ACT 干预的效果是通过提高心理灵活性来实现的。采用交叉滞后面板设计，结果表明，干预的最后三个疗程中心理灵活性的提高对于进一步降低焦虑非常重要。总之，我们的研究表明，在 ACT 干预中针对心理灵活性进行干预对于减轻抑郁和焦虑症状非常重要。
