Serfaty Shirley, Gale Grace, Beadman Matthew, Froeliger Brett, Kamboj Sunjeev K
1Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
2Department of Neuroscience, Medical University of South Carolina, Charleston, SC USA.
Mindfulness (N Y). 2018;9(1):44-58. doi: 10.1007/s12671-017-0767-1. Epub 2017 Jul 17.
The psychological flexibility model (PFM) provides a framework for understanding and treating behavioural dysregulation in addictions. Rather than modulating the intensity of subjective experience, interventions based on, or consistent with, the PFM (PFM interventions) seek to alter the individual's relationship to internal states, such as craving, negative affect and drug-related thoughts, using mindfulness, acceptance and related strategies. Experimental (non-clinical) studies in smokers have examined the effects of specific isolated strategies informed by or consistent with the PFM (PFM strategies). Here, we systematically review these studies and determine the extent to which they conform to methodological standards indicative of high levels of internal validity. Eligible studies were identified through electronic database searches and assessed for the presence of specific methodological features. Provisional aggregate effect sizes were determined depending on availability of data. Of 1499 screened publications, 12 met the criteria. All examined aspects of private subjective experience relevant to abstinence (craving = 12; negative affect = 10), demonstrating effects favouring PFM strategies relative to inactive control conditions. However, only six assessed outcome domains consistent with the PFM and provided no consistent evidence favouring PFM strategies. Overall, most studies had methodological limitations. As such, high-quality experimental studies continue to be needed to improve our understanding of necessary and/or sufficient constituents of PFM-guided smoking cessation interventions. Recommendations for future research are discussed.
心理灵活性模型（PFM）为理解和治疗成瘾行为失调提供了一个框架。基于PFM或与之相符的干预措施（PFM干预）并非调节主观体验的强度，而是试图运用正念、接纳及相关策略来改变个体与诸如渴望、消极情绪和与药物相关的想法等内部状态的关系。针对吸烟者的实验性（非临床）研究考察了由PFM启发或与之相符的特定孤立策略（PFM策略）的效果。在此，我们系统回顾这些研究，并确定它们在多大程度上符合表明高内部效度水平的方法学标准。通过电子数据库检索确定符合条件的研究，并评估其是否存在特定的方法学特征。根据数据的可得性确定临时总体效应量。在筛选的1499篇出版物中，有12篇符合标准。所有研究都考察了与戒烟相关的个人主观体验的各个方面（渴望=12项；消极情绪=10项），表明相对于无活性对照条件，PFM策略具有效果优势。然而，只有6项研究评估了与PFM一致的结果领域，且未提供支持PFM策略的一致证据。总体而言，大多数研究存在方法学局限性。因此，仍需要高质量的实验研究来增进我们对PFM指导的戒烟干预措施的必要和/或充分组成部分的理解。文中讨论了对未来研究的建议。
