Louise Stephanie, Rossell Susan L, Thomas Neil
Centre for Mental Health,Swinburne University of Technology,Melbourne,VIC,Australia.
Behav Cogn Psychother. 2019 Mar;47(2):200-216. doi: 10.1017/S1352465818000425. Epub 2018 Jul 9.
A prominent area of advancement in the psychological treatment for people with persisting psychosis has been the application of mindfulness-based therapies. Recent literature has recommended the investigation of focused mindfulness interventions for voices (auditory hallucinations) as a specific experience. To date, only mindfulness programs in group format have been examined.
This non-randomized pilot study aimed to assess the acceptability, feasibility and potential outcomes of an individual mindfulness program for persistent voices on the negative impact of voices on the subjective experience of mental health and wellbeing, depression and voice-related distress and disruption. Also, it aimed to identify potential psychological and neurocognitive mechanisms of change.
A new 4-week individual Mindfulness Program for Voices (iMPV) was developed, and piloted with a group of 14 participants with a schizophrenia-spectrum disorder and persisting voices. Participants completed clinical and neurocognitive measures pre- and post-intervention and at 2-month follow-up.
Results revealed low attrition rates, high formal practice engagement levels and positive participant feedback. Pre-post outcomes suggested small to moderate effects for a reduction in the negative impact of voices on experience, depression and disruption. Large effects for changes in mindful responding and attentional switching were also identified.
Our findings suggest that this novel treatment protocol is appropriate, engaging and safe for persistent voice hearers. Findings for mindful responding and attentional switching suggest these to be potential mechanisms of change for further investigation. Further RCTs are warranted to ascertain the feasibility and efficacy for focused mindfulness interventions for voices of individual format.
在持续性精神病患者的心理治疗中，一个显著的进展领域是基于正念的疗法的应用。最近的文献建议对针对幻听（听觉幻觉）的专注正念干预进行研究，将其作为一种特定体验。迄今为止，仅对团体形式的正念项目进行了研究。
这项非随机试点研究旨在评估针对持续性幻听的个体正念项目在幻听对心理健康和幸福感、抑郁以及与幻听相关的痛苦和干扰的主观体验的负面影响方面的可接受性、可行性和潜在结果。此外，它旨在确定潜在的心理和神经认知变化机制。
开发了一种新的为期4周的针对幻听的个体正念项目（iMPV），并对一组14名患有精神分裂症谱系障碍且有持续性幻听的参与者进行了试点。参与者在干预前、干预后以及2个月随访时完成了临床和神经认知测量。
结果显示低损耗率、高正式练习参与度以及参与者的积极反馈。干预前后的结果表明，在减少幻听对体验、抑郁和干扰的负面影响方面有小到中等程度的效果。还发现了正念反应和注意力转换变化的显著效果。
我们的研究结果表明，这种新颖的治疗方案对持续性幻听者来说是合适、有效且安全的。正念反应和注意力转换的研究结果表明这些可能是需要进一步研究的潜在变化机制。有必要进行进一步的随机对照试验，以确定针对个体形式幻听的专注正念干预的可行性和有效性。
