Järvelä-Reijonen Elina, Puttonen Sampsa, Karhunen Leila, Sairanen Essi, Laitinen Jaana, Kolehmainen Mikko, Pihlajamäki Jussi, Kujala Urho M, Korpela Riitta, Ermes Miikka, Lappalainen Raimo, Kolehmainen Marjukka
Institute of Public Health and Clinical Nutrition, Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland.
Finnish Institute of Occupational Health, P.O. Box 40, FI-00251, Helsinki, Finland.
Int J Behav Med. 2020 Oct;27(5):539-555. doi: 10.1007/s12529-020-09891-8.
Psychological processes can be manifested in physiological health. We investigated whether acceptance and commitment therapy (ACT), targeted on psychological flexibility (PF), influences inflammation and stress biomarkers among working-age adults with psychological distress and overweight/obesity.
Participants were randomized into three parallel groups: (1) ACT-based face-to-face (n = 65; six group sessions led by a psychologist), (2) ACT-based mobile (n = 73; one group session and mobile app), and (3) control (n = 66; only the measurements). Systemic inflammation and stress markers were analyzed at baseline, at 10 weeks after the baseline (post-intervention), and at 36 weeks after the baseline (follow-up). General PF and weight-related PF were measured with questionnaires (Acceptance and Action Questionnaire, Acceptance and Action Questionnaire for Weight-Related Difficulties).
A group × time interaction (p = .012) was detected in the high-sensitivity C-reactive protein (hsCRP) level but not in other inflammation and stress biomarkers. hsCRP decreased significantly in the face-to-face group from week 0 to week 36, and at week 36, hsCRP was lower among the participants in the face-to-face group than in the mobile group (p = .035, post hoc test). Age and sex were stronger predictors of biomarker levels at follow-up than the post-intervention PF.
The results suggest that ACT delivered in group sessions may exert beneficial effects on low-grade systemic inflammation. More research is needed on how to best apply psychological interventions for the health of both mind and body among people with overweight/obesity and psychological distress.
ClinicalTrials.gov Identifier: NCT01738256, Registered 17 August, 2012.
心理过程可在生理健康中表现出来。我们调查了以心理灵活性（PF）为目标的接纳与承诺疗法（ACT）是否会影响有心理困扰且超重/肥胖的工作年龄成年人的炎症和应激生物标志物。
参与者被随机分为三个平行组：（1）基于ACT的面对面组（n = 65；由心理学家主持六次小组会议），（2）基于ACT的移动组（n = 73；一次小组会议和移动应用程序），以及（3）对照组（n = 66；仅进行测量）。在基线、基线后10周（干预后）和基线后36周（随访）时分析全身炎症和应激标志物。使用问卷（接纳与行动问卷、与体重相关困难的接纳与行动问卷）测量一般PF和与体重相关的PF。
在高敏C反应蛋白（hsCRP）水平中检测到组×时间交互作用（p = 0.012），但在其他炎症和应激生物标志物中未检测到。面对面组中hsCRP从第0周显著下降至第36周，并且在第36周时，面对面组参与者的hsCRP低于移动组（p = 0.035，事后检验）。随访时，年龄和性别比干预后的PF更能预测生物标志物水平。
结果表明，小组会议形式的ACT可能对低度全身炎症产生有益影响。对于如何在超重/肥胖且有心理困扰的人群中最佳地应用心理干预以促进身心健康，还需要更多研究。
ClinicalTrials.gov标识符：NCT01738256，于2012年8月17日注册。
