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压力再评估干预对压力反应性的疗效:现有证据的荟萃分析和系统评价。

The efficacy of stress reappraisal interventions on stress responsivity: A meta-analysis and systematic review of existing evidence.

机构信息

Department of Psychology, Ryerson University, Toronto, Ontario, Canada.

Institute for Stress and Wellbeing Research, Ryerson University, Toronto, Ontario, Canada.

出版信息

PLoS One. 2019 Feb 27;14(2):e0212854. doi: 10.1371/journal.pone.0212854. eCollection 2019.

Abstract

BACKGROUND

The beliefs we hold about stress play an important role in coping with stressors. Various theoretical frameworks of stress point to the efficacy of reframing stress-related information through brief reappraisal interventions in order to promote adaptive coping.

PURPOSE

The goal of the current meta-analysis and systematic review is to substantiate the efficacy of reappraisal interventions on stress responsivity compared to control conditions. Differences in experimental methodologies (e.g., type of stressor used, timing of reappraisal intervention, and content of intervention instructions) will be examined to further delineate their effects on intervention outcomes.

METHODS

The literature searches were conducted on May 16, 2018 using PsycINFO, ProQuest Dissertations and Theses, and PILOTS databases with no date restriction. The search terms included stress, reframing, reappraisal, mindset and reconceptualising. A total of 14 articles with 36 independent samples were included in the meta-analysis, while 22 articles with 46 independent samples were included in the systematic review. Random-effects model was used to test the null hypothesis using two-tailed significance testing. Fisher's Z value was reported for each corresponding test. Heterogeneity tests are reported via Cochran's Q-statistics.

RESULTS

Findings from both the meta-analysis and systematic review revealed that overall, reappraisal interventions are effective in attenuating subjective responsivity to stress. Standard differences in means across groups are 0.429 (SE = 0.185, 95% CI = 0.067 to 0.791; z = 2.320, p = .020). However, reappraisal intervention groups did not outperform control groups on measures of physiological stress, with standard differences of -0.084 (SE = 0.135, 95% CI = -0.349 to 0.180; z = -0.627, p = .531). Moderator analysis revealed heterogeneous effects suggesting large variability in findings.

CONCLUSIONS

On one hand, findings may suggest a promising avenue for the effective management of self-reported stress and optimization of stress responses. However, more research is needed to better elucidate the effects, if any, of reappraisal interventions on stress physiology. Implications for the use of reappraisal interventions on stress optimization are discussed in the context of theoretical frameworks and considerations for future studies.

摘要

背景

我们对压力的信念在应对压力源方面起着重要作用。各种压力理论框架指出,通过简短的重新评价干预来重新构建与压力相关的信息,可以有效地促进适应性应对。

目的

本 meta 分析和系统综述的目的是证实重新评价干预对压力反应性的效果优于对照条件。将检查实验方法学的差异(例如,使用的压力源类型、重新评价干预的时间以及干预指令的内容),以进一步阐明它们对干预结果的影响。

方法

文献检索于 2018 年 5 月 16 日在 PsycINFO、ProQuest Dissertations and Theses 和 PILOTS 数据库中进行,没有日期限制。搜索词包括压力、重构、重新评价、思维模式和重新概念化。共有 14 篇文章和 36 个独立样本被纳入 meta 分析,22 篇文章和 46 个独立样本被纳入系统综述。使用双尾显著性检验对零假设进行随机效应模型检验。每个相应测试的报告 Fisher's Z 值。Cochran's Q 统计量用于报告异质性检验。

结果

无论是 meta 分析还是系统综述的结果都表明,总体而言,重新评价干预措施可有效减轻对压力的主观反应。组间平均标准差异为 0.429(SE = 0.185,95%CI = 0.067 至 0.791;z = 2.320,p =.020)。然而,重新评价干预组在生理压力测量上并未优于对照组,标准差异为-0.084(SE = 0.135,95%CI = -0.349 至 0.180;z = -0.627,p =.531)。调节分析显示,存在很大的变异性,表明效果存在异质性。

结论

一方面,研究结果可能为有效管理自我报告的压力和优化压力反应提供了一个有希望的途径。然而,需要进一步的研究来更好地阐明重新评价干预对压力生理学的影响(如果有的话)。在理论框架的背景下讨论了重新评价干预对压力优化的应用意义,并考虑了未来研究的考虑因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd6b/6392321/ba891e9ad739/pone.0212854.g001.jpg

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