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群组 4 健康预防精神健康的意外威胁:在 COVID-19 封锁期间评估针对有抑郁和孤独史的年轻人的两项干预措施。

Groups 4 Health protects against unanticipated threats to mental health: Evaluating two interventions during COVID-19 lockdown among young people with a history of depression and loneliness.

机构信息

Research School of Psychology, The Australian National University, Australia.

School of Psychology, The University of Queensland, Australia.

出版信息

J Affect Disord. 2021 Dec 1;295:316-322. doi: 10.1016/j.jad.2021.08.029. Epub 2021 Aug 24.


DOI:10.1016/j.jad.2021.08.029
PMID:34488085
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8413117/
Abstract

BACKGROUND: Decades of research indicate that when social connectedness is threatened, mental health is at risk. However, extant interventions to tackle loneliness have had only modest success, and none have been trialled under conditions of such threat. METHOD: 174 young people with depression and loneliness were randomised to one of two evidence-based treatments: cognitive behaviour therapy (CBT) or Groups 4 Health (G4H), an intervention designed to increase social group belonging. Depression, loneliness, and well-being outcomes were evaluated at one-year follow-up; COVID-19 lockdown restrictions were imposed partway through follow-up assessments. This provided a quasi-experimental test of the utility of each intervention in the presence (lockdown group) and absence (control group) of a threat to social connectedness. RESULTS: At one-year follow-up, participants in lockdown reported significantly poorer wellbeing than controls who completed follow-up before lockdown, t(152)=2.41, p=.017. Although both CBT and G4H led to symptom improvement, the benefits of G4H were more robust following an unanticipated threat to social connectedness for depression (χ(16)=31.35, p=.001), loneliness (χ(8)=21.622, p=.006), and wellbeing (χ(8)=22.938, p=.003). LIMITATIONS: Because the COVID-19 lockdown was unanticipated, this analysis represents an opportunistic use of available data. As a result, we could not measure the specific impact of restrictions on participants, such as reduced income, degree of isolation, or health-related anxieties. CONCLUSIONS: G4H delivered one year prior to COVID-19 lockdown offered greater protection than CBT against relapse of loneliness and depression symptoms. Implications are discussed with a focus on how these benefits might be extended to other life stressors and transitions.

摘要

背景:几十年来的研究表明,当社会联系受到威胁时,心理健康就会面临风险。然而,现有的孤独干预措施收效甚微,而且没有一种措施是在这种威胁下进行试验的。

方法:174 名患有抑郁症和孤独感的年轻人被随机分配到两种基于证据的治疗方法之一:认知行为疗法(CBT)或团体健康 4(G4H),这是一种旨在增加社会群体归属感的干预措施。在一年的随访中评估抑郁、孤独和幸福感结果;在随访评估过程中,COVID-19 封锁限制被部分实施。这在存在(封锁组)和不存在(对照组)对社会联系的威胁的情况下,对每种干预措施的效用进行了准实验测试。

结果:在一年的随访中,封锁组的参与者报告的幸福感明显低于在封锁前完成随访的对照组,t(152)=2.41,p=.017。尽管 CBT 和 G4H 都导致症状改善,但在社会联系受到意外威胁后,G4H 对抑郁(χ(16)=31.35,p=.001)、孤独(χ(8)=21.622,p=.006)和幸福感(χ(8)=22.938,p=.003)的改善更为显著。

局限性:由于 COVID-19 封锁是意料之外的,因此本分析代表了对现有数据的机会性利用。因此,我们无法衡量限制对参与者的具体影响,例如收入减少、隔离程度或与健康相关的焦虑。

结论:G4H 在 COVID-19 封锁前一年提供的保护比 CBT 更能防止孤独和抑郁症状的复发。讨论了这些结果的意义,重点关注如何将这些益处扩展到其他生活应激源和过渡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1efd/8413117/5d8a826a088e/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1efd/8413117/d51c09ad4006/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1efd/8413117/26f051a91644/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1efd/8413117/90bea5b23892/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1efd/8413117/5d8a826a088e/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1efd/8413117/d51c09ad4006/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1efd/8413117/26f051a91644/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1efd/8413117/90bea5b23892/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1efd/8413117/5d8a826a088e/gr4_lrg.jpg

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[1]
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[6]
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[9]
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本文引用的文献

[1]
Groups 4 Health versus cognitive-behavioural therapy for depression and loneliness in young people: randomised phase 3 non-inferiority trial with 12-month follow-up.

Br J Psychiatry. 2022-3

[2]
United We Stand, Divided We Fall: Sociopolitical Predictors of Physical Distancing and Hand Hygiene During the COVID-19 Pandemic.

Polit Psychol. 2021-10

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Pandemic fatigue? How adherence to covid-19 regulations has been misrepresented and why it matters.

BMJ. 2021-1-18

[4]
Reduced Hedonic Tone and Emotion Dysregulation Predict Depressive Symptoms Severity during the COVID-19 Outbreak: An Observational Study on the Italian General Population.

Int J Environ Res Public Health. 2020-12-31

[5]
The Effect of COVID-19 on Mental Health and Wellbeing in a Representative Sample of Australian Adults.

Front Psychiatry. 2020-10-6

[6]
Loneliness in the UK during the COVID-19 pandemic: Cross-sectional results from the COVID-19 Psychological Wellbeing Study.

PLoS One. 2020-9-24

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Life Change, Social Identity, and Health.

Annu Rev Psychol. 2021-1-4

[8]
Three months of loneliness during the COVID-19 lockdown.

Psychiatry Res. 2020-8-17

[9]
Social Prescribing as 'Social Cure': A longitudinal study of the health benefits of social connectedness within a Social Prescribing pathway.

J Health Psychol. 2022-2

[10]
Review: Alleviating loneliness in young people - a meta-analysis of interventions.

Child Adolesc Ment Health. 2021-2

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