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重建对生物学解释的抑郁症的心理治疗的信任:一项检验在线心理教育干预持久性的两部分实验研究。

Rebuilding trust in psychotherapy for biologically explained depression: A two-part experimental study examining the durability of an online psychoeducational intervention.

机构信息

Department of Psychology, Yale University, 100 College Street, New Haven, CT, 06510, USA.

出版信息

Soc Sci Med. 2024 Sep;357:117202. doi: 10.1016/j.socscimed.2024.117202. Epub 2024 Aug 8.

Abstract

Biological explanations of mental disorders, which are gaining prominence, can decrease trust in psychotherapy. To rebuild trust, this experimental study tests a psychoeducational intervention targeting misconceptions that (1) psychotherapy cannot change the brain; (2) people rarely have agency over biology while psychotherapy requires agency; (3) psychosocial causes, addressed in psychotherapy, are less probable given biological causes. U.S. adults (N = 602) rated psychotherapy's effectiveness for depression before and after learning about depression's biological causes. Absent any intervention, control-condition participants rated psychotherapy to be less effective post biological-causes-information. However, participants who viewed an intervention video explaining why the misconceptions are flawed judged psychotherapy as more effective even after learning about depression's biological causes. Active-control-condition participants, who viewed a video about psychotherapy's effectiveness, without directly addressing the misconceptions, also increased psychotherapy ratings, albeit significantly less than the intervention group. Approximately four weeks later, intervention-condition participants maintained their enhanced trust, without any reminder of the video, whereas the two control conditions showed reduced trust. The study offers a practical tool for broader public use with a lasting effect.

摘要

生物因素对精神障碍的解释正日益受到重视,这可能会降低人们对心理治疗的信任。为了重建信任,这项实验研究测试了一种针对误解的心理教育干预措施,这些误解包括:(1)心理治疗不能改变大脑;(2)在心理治疗需要自主性的情况下,人们很少对生物学有自主性;(3)心理社会因素在心理治疗中被认为不太可能是生物因素引起的。本研究在美国成年人(N=602)中测试了心理治疗对抑郁症的有效性,这些成年人在了解抑郁症的生物学原因之前和之后都对其进行了评估。在没有任何干预的情况下,对照组参与者在了解生物原因信息后,对心理治疗的有效性评价较低。然而,观看了一段解释为什么这些误解有缺陷的干预视频的参与者,即使在了解了抑郁症的生物学原因后,也认为心理治疗更有效。观看了一段关于心理治疗有效性的视频但没有直接解决这些误解的积极对照组参与者,他们对心理治疗的评价也有所提高,尽管显著低于干预组。大约四周后,干预组的参与者保持了增强的信任,而无需任何视频提醒,而另外两个对照组则显示出信任度下降。该研究为更广泛的公众使用提供了一种实用的工具,且具有持久的效果。

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