Sanabria-Mazo Juan P, Giné-Vázquez Iago, Cristobal-Narváez Paula, Suso-Ribera Carlos, García-Palacios Azucena, McCracken Lance M, Hayes Steven C, Hofmann Stefan G, Ciarrochi Joseph, Luciano Juan V
Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.
Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Psychother Res. 2024 Jul 30:1-16. doi: 10.1080/10503307.2024.2382429.
This study explored the extent to which within-patient changes in processes targeted in Acceptance and Commitment Therapy (ACT) and Behavioral Activation Therapy for Depression (BATD) are associated with changes within-patient in pain intensity and depressed mood and evaluated the extent that process-outcome relationships differed between patients.
An idiographic analysis embedded within a randomized controlled trial comparing ACT, BATD, and treatment-as-usual (TAU) was conducted to examine the strength of the relationship between outcomes and process variables in patients with chronic low back pain (CLBP) plus depressive symptoms. Based on data from ecological momentary assessment in patients ( = 82), the level of heterogeneity and the pooled effects of these relationships during the intervention period (70 days) were explored.
Overall, a high level of heterogeneity was identified in the relationship between pain intensity or depressed mood and psychological inflexibility or behavioral activation. Individual differences in the relationships between outcomes and process variables were identified in individual people during the intervention period. These individual differences appear independent of the group (ACT, BATD, and TAU) and other definable differences (responders/non-responders, completers/non-completers, and clinical depression/non-clinical depression).
These findings suggest the potential utility of personalizing psychological interventions according to the therapeutic needs of these patients.
本研究探讨了接受与承诺疗法（ACT）和抑郁症行为激活疗法（BATD）所针对的患者内部过程变化与患者内部疼痛强度和抑郁情绪变化之间的关联程度，并评估了患者之间过程-结果关系的差异程度。
在一项比较ACT、BATD和常规治疗（TAU）的随机对照试验中进行了个案分析，以检验慢性腰痛（CLBP）伴抑郁症状患者的结果与过程变量之间关系的强度。基于患者（n = 82）生态瞬时评估的数据，探讨了干预期间（70天）这些关系的异质性水平和合并效应。
总体而言，在疼痛强度或抑郁情绪与心理灵活性或行为激活之间的关系中发现了高度异质性。在干预期间，个体之间的结果与过程变量之间的关系存在个体差异。这些个体差异似乎独立于组（ACT、BATD和TAU）以及其他可定义的差异（应答者/无应答者、完成者/未完成者以及临床抑郁症/非临床抑郁症）。
这些发现表明根据这些患者的治疗需求个性化心理干预具有潜在效用。
