Stockton Daniel, Kellett Stephen, Berrios Raul, Sirois Fuschia, Wilkinson Nicolas, Miles Georgina
Mid Yorkshire Hospitals NHS Trust.
Psychological Healthcare,Keresforth Centre,Barnsley,UK.
Behav Cogn Psychother. 2019 May;47(3):332-362. doi: 10.1017/S1352465818000553. Epub 2018 Oct 4.
Mediation studies test the mechanisms by which interventions produce clinical outcomes. Consistent positive mediation results have previously been evidenced (Hayes et al., 2006) for the putative processes that compromise the psychological flexibility model of acceptance and commitment therapy (ACT).
The present review aimed to update and extend the ACT mediation evidence base by reviewing mediation studies published since the review of Hayes et al. (2006).
ACT mediation studies published between 2006 and 2015 were systematically collated, synthesized and quality assessed.
Twelve studies met inclusion criteria and findings were synthesized by (a) the putative processes under investigation, and (b) the outcomes on which processes were tested for mediation. Mediation results were found to be generally consistent with the psychological flexibility model of ACT. However, studies were limited in methodological quality and were overly focused on a small number of putative processes.
Further research is required that addresses the identified methodological limitations and also examines currently under-researched putative processes.
中介效应研究旨在检验干预措施产生临床结果的机制。此前已有一致的积极中介效应结果（海斯等人，2006年）证明，那些损害接纳与承诺疗法（ACT）心理灵活性模型的假定过程存在中介效应。
本综述旨在通过回顾自海斯等人（2006年）的综述发表以来的中介效应研究，更新并扩展ACT中介效应的证据基础。
对2006年至2015年间发表的ACT中介效应研究进行系统整理、综合分析和质量评估。
12项研究符合纳入标准，并根据以下两方面对研究结果进行了综合分析：（a）所研究的假定过程；（b）对这些过程进行中介效应检验的结果。中介效应结果总体上与ACT的心理灵活性模型一致。然而，这些研究在方法学质量上存在局限性，并且过度集中于少数假定过程。
需要进一步开展研究，解决已发现的方法学局限性，并对目前研究较少的假定过程进行考察。
