Rutschmann Ronja, Romanczuk-Seiferth Nina, Gloster Andrew, Richter Christoph
Clinic for Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum Kaulsdorf, Berlin, Germany.
Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Front Psychiatry. 2024 Jul 15;15:1403718. doi: 10.3389/fpsyt.2024.1403718. eCollection 2024.
Increasing psychological flexibility is considered an important mechanism of change in psychotherapy across diagnoses. In particular, Acceptance and Commitment Therapy (ACT) primarily aims at increasing psychological flexibility in order to live a more fulfilling and meaningful life. The purpose of this study is to examine 1) how psychological flexibility changes during an ACT-based treatment in a transdiagnostic day hospital and 2) how this change is related to changes in symptomatology, quality of life, and general level of functioning.
90 patients of a psychiatric day hospital participated in the study. Psychological flexibility, symptomatology, and quality of life were assessed at three measurement time points (admission, discharge, and 3-month follow-up). The level of functioning was assessed at admission and discharge. Differences in psychological flexibility were tested via two-sided paired samples -tests. Correlations of residualized change scores were calculated to detect associations between changes in psychological flexibility and other outcomes.
Psychological flexibility increased significantly from pre-treatment to post-treatment ( = .43, <.001) and from pre-treatment to follow-up ( = .54, <.001). This change was significantly correlated to a decrease in symptomatology ( = .60 -.83, <.001) and an increase in most dimensions of quality of life ( = -.43 - -.75, <.001) and general level of functioning ( =-.34, = .003).
This study adds further evidence for psychological flexibility as a transdiagnostic process variable of successful psychotherapy. Limitations are discussed.
提高心理灵活性被认为是跨诊断心理治疗中重要的改变机制。特别是，接纳与承诺疗法（ACT）主要旨在提高心理灵活性，以便过上更充实、有意义的生活。本研究的目的是检验：1）在跨诊断日间医院中基于ACT的治疗过程中心理灵活性如何变化；2）这种变化与症状、生活质量和总体功能水平的变化有何关联。
一家精神病日间医院的90名患者参与了该研究。在三个测量时间点（入院、出院和3个月随访）评估心理灵活性、症状和生活质量。在入院和出院时评估功能水平。通过双侧配对样本t检验来检验心理灵活性的差异。计算残差变化分数的相关性，以检测心理灵活性变化与其他结果之间的关联。
从治疗前到治疗后，心理灵活性显著提高（t = 0.43，p < 0.001），从治疗前到随访时也显著提高（t = 0.54，p < 0.001）。这种变化与症状的减轻显著相关（r = 0.60 - 0.83，p < 0.001），与生活质量大多数维度的提高显著相关（r = -0.43 - -0.75，p < 0.001）以及总体功能水平的提高显著相关（r = -0.34，p = 0.003）。
本研究为心理灵活性作为成功心理治疗的跨诊断过程变量提供了进一步的证据。同时也讨论了研究的局限性。
