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基于正念的创伤恢复对难民(MBTR-R)的候选作用机制:自我同情和自我批判。

Candidate mechanisms of action of mindfulness-based trauma recovery for refugees (MBTR-R): Self-compassion and self-criticism.

机构信息

Department of Psychology.

出版信息

J Consult Clin Psychol. 2022 Feb;90(2):107-122. doi: 10.1037/ccp0000716.

Abstract

OBJECTIVE

Mindfulness- and compassion-based interventions may represent a promising intervention approach to the global mental health crisis of forced displacement. Specifically, Mindfulness-Based Trauma Recovery for Refugees (MBTR-R)-a mindfulness- and compassion-based, trauma-sensitive, and socioculturally adapted intervention for refugees and asylum-seekers-has recently demonstrated randomized control evidence of therapeutic efficacy and safety. Yet, little is known about potential mechanisms underlying these therapeutic effects for trauma recovery and for refugees and asylum-seekers.

METHOD

Thus, we examined adaptive and maladaptive forms of self-referentiality, namely self-compassion and self-criticism, as mechanisms of action for trauma recovery in a randomized wait-list control trial of MBTR-R among a community sample of 158 traumatized and chronically stressed asylum-seekers (46% female) in an urban postdisplacement setting (Middle East). Self-compassion and self-criticism were measured vis-à-vis an experimental Self-Referential Encoding Task (SRET) designed to quantify cognitive processes underlying self-compassion and self-criticism using diffusion modeling, a computational modeling approach to quantify cognitive processes underlying decision-making from behavioral reaction time data.

RESULTS

Findings indicate that self-compassion and self-criticism were associated with trauma- and stress-related psychopathology at preintervention. Relative to wait-list controls, MBTR-R led to significant elevation in self-compassion, and reduction in self-criticism, from pre to postintervention. Finally, pre to postintervention change in self-criticism significantly mediated therapeutic effects of MBTR-R on depression and posttraumatic stress disorder (PTSD) outcomes, while pre to postintervention change in self-compassion only mediated therapeutic effects on PTSD outcomes.

CONCLUSIONS

Findings speak to the importance of (mal)adaptive self-referentiality as a target mechanism in MBIs and trauma recovery broadly, and among refugees and asylum-seekers specifically. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

目的

正念和慈悲为基础的干预措施可能代表着一种有前途的干预方法,可以应对被迫流离失所所带来的全球精神健康危机。具体而言,正念与慈悲为基础、创伤敏感、以及社会文化适应的难民创伤恢复(MBTR-R)——一种针对难民和寻求庇护者的正念和慈悲为基础、创伤敏感、以及社会文化适应的干预措施——最近已经证明了其治疗效果和安全性的随机对照证据。然而,对于创伤恢复以及难民和寻求庇护者而言,对于这些治疗效果的潜在机制知之甚少。

方法

因此,我们研究了自适应和适应不良的自我参照形式,即自我同情和自我批判,作为 MBTR-R 在一个城市后流离失所环境中的 158 名创伤后和长期压力下的寻求庇护者(46%为女性)的社区样本中进行的随机等待名单对照试验中,创伤恢复的作用机制。自我同情和自我批判是通过自我参照编码任务(SRET)来衡量的,该任务旨在使用扩散建模来量化自我同情和自我批判的认知过程,扩散建模是一种使用行为反应时间数据来量化决策背后认知过程的计算建模方法。

结果

研究结果表明,自我同情和自我批判与创伤和应激相关的精神病理学在干预前有关。与等待名单对照组相比,MBTR-R 导致自我同情显著升高,自我批判显著降低,从干预前到干预后。最后,自我批判的干预前到干预后的变化显著介导了 MBTR-R 对抑郁和创伤后应激障碍(PTSD)结果的治疗效果,而自我同情的干预前到干预后的变化仅介导了 PTSD 结果的治疗效果。

结论

这些发现表明,(不良)自我参照作为 MBI 和创伤恢复的目标机制的重要性,以及在难民和寻求庇护者中尤为重要。

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