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我们能提高心理健康水平吗?干预措施对心理健康的影响:一项随机对照试验的荟萃分析。

Can We Increase Psychological Well-Being? The Effects of Interventions on Psychological Well-Being: A Meta-Analysis of Randomized Controlled Trials.

作者信息

Weiss Laura A, Westerhof Gerben J, Bohlmeijer Ernst T

机构信息

Centre for eHealth and Well-being Research, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands.

出版信息

PLoS One. 2016 Jun 21;11(6):e0158092. doi: 10.1371/journal.pone.0158092. eCollection 2016.

Abstract

BACKGROUND

There is a rapidly growing interest in psychological well-being (PWB) as outcome of interventions. Ryff developed theory-based indicators of PWB that are consistent with a eudaimonic perspective of happiness. Numerous interventions have been developed with the aim to increase PWB. However, the effects on PWB measured as coherent outcome have not been examined across studies yet. This meta-analysis of randomized controlled trials of behavioral interventions aims to answer the question whether it is possible to enhance PWB.

METHODS

A systematic literature search was performed in PsycINFO, Cochrane and Web of Science. To be included, studies had to be randomized controlled trials of behavioral interventions with psychological well-being as primary or secondary outcome measure, measured with either Ryff's Psychological Well-Being Scales or the Mental Health Continuum-Short Form. The meta-analysis was performed using a random effects model. From the 2,298 articles found, 27 met the inclusion criteria. The included studies involved 3,579 participants.

RESULTS

We found a moderate effect (Cohen's d = 0.44; z = 5.62; p < .001). Heterogeneity between the studies was large (Q (26) = 134.12; p < .001; I2 = 80.62). At follow-up after two to ten months, a small but still significant effect size of 0.22 was found. There was no clear indication of publication bias. Interventions were more effective in clinical groups and when they were delivered individually. Effects were larger in studies of lower quality.

CONCLUSIONS

It appears to be possible to improve PWB with behavioral interventions. The results are promising for the further development and implementation of interventions to promote PWB. Delivering interventions face-to-face seems to be the most promising option. We recommend to keep including clinical groups in the research of psychological well-being. Heterogeneity is a limitation of the study and there is need for more high-quality studies.

摘要

背景

作为干预结果,人们对心理幸福感(PWB)的兴趣正在迅速增长。赖夫开发了基于理论的心理幸福感指标,这些指标与幸福的自我实现观点相一致。为了提高心理幸福感,人们开发了许多干预措施。然而,尚未对跨研究中作为连贯结果测量的心理幸福感的影响进行检验。这项对行为干预随机对照试验的荟萃分析旨在回答是否有可能提高心理幸福感这一问题。

方法

在心理学文摘数据库(PsycINFO)、考科蓝图书馆(Cochrane)和科学引文索引数据库(Web of Science)中进行了系统的文献检索。纳入的研究必须是以心理幸福感作为主要或次要结果测量指标的行为干预随机对照试验,使用赖夫的心理幸福感量表或心理健康连续体简表进行测量。荟萃分析采用随机效应模型。从找到的2298篇文章中,27篇符合纳入标准。纳入的研究涉及3579名参与者。

结果

我们发现了中等效应(科恩d值 = 0.44;z = 5.62;p <.001)。研究之间的异质性很大(Q(26) = 134.12;p <.001;I² = 80.62)。在两到十个月的随访中,发现了一个虽小但仍显著的效应量0.22。没有明显的发表偏倚迹象。干预措施在临床组中以及单独实施时更有效。在质量较低的研究中效果更大。

结论

通过行为干预似乎有可能改善心理幸福感。这些结果对于促进心理幸福感的干预措施的进一步发展和实施很有前景。面对面提供干预措施似乎是最有前景的选择。我们建议在心理幸福感研究中继续纳入临床组。异质性是本研究的一个局限性,需要更多高质量的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d31/4915721/577a2c0f2866/pone.0158092.g001.jpg

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