基于互联网的自助接纳与承诺疗法项目对医学生心理健康的有效性：随访随机对照试验

Effectiveness of an Internet-Based Self-Help Acceptance and Commitment Therapy Program on Medical Students' Mental Well-Being: Follow-Up Randomized Controlled Trial.

作者信息

Wang Difan, Lin Bingyan, Zhang Shuangxi, Xu Wei, Liu Xinying

机构信息

Department of Internal Medicine, Psychological Counseling and Service Center, Graduate School of Medical College of Chinese PLA General Hospital, Beijing, China.

Faculty of Psychology, Beijing Normal University, Beijing, China.

出版信息

J Med Internet Res. 2024 Dec 4;26:e50664. doi: 10.2196/50664.

DOI:10.2196/50664

PMID:39631061

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11656501/

Abstract

BACKGROUND

Psychological distress is a growing problem among medical students worldwide. This highlights the need for psychological interventions to focus on mental health and improve well-being in this population.

OBJECTIVE

This study developed an internet-based, self-help, acceptance and commitment therapy program (iACT 2.0), aiming to examine its effectiveness in reducing depression, anxiety, stress, psychological inflexibility (PI), and obsessive-compulsive symptoms (OCSs) among medical students.

METHODS

A total of 520 Chinese postgraduate medical students were randomly assigned to either an iACT 2.0 intervention group (n=260; six online lessons, once every 5 days) or a control condition (n=260; without intervention). Participants completed questionnaires including the 21-item Depression Anxiety Stress Scale, the revised Obsessive-Compulsive Inventory, and the Multidimensional Psychological Flexibility Inventory at the preintervention (T1), postintervention (T2), and 1-month follow-up time points (T3). No therapist support was provided during the 1-month iACT 2.0 intervention period. Data were collected via an online platform and analyzed using repeated-measures ANOVA.

RESULTS

Participants in the intervention group demonstrated a significant decrease in depression, anxiety, stress, PI, and OCSs compared to the control group after the intervention (F=22.9-672.04, all P<.001). Specifically, the intervention group showed significant reductions in all measured outcomes from the preintervention to postintervention time point and at the 1-month follow-up (all P<.001). In contrast, no significant changes were observed in the control group over the same period (all P>.05). The groups did not differ significantly at baseline (all P>.05). Significant differences were noted at both the postintervention and follow-up time points (all P<.001).

CONCLUSIONS

This study demonstrated that the newly developed iACT 2.0 was effective in reducing depression, anxiety, stress, PI, and OCSs. Notably, the positive effects of the intervention persisted at the 1-month follow-up. This program can offer a useful addition to existing mental illness treatment and lead to improvements in clinical and psychotherapy planning while simultaneously reducing the burden on traditional counseling and services.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2300070725; https://tinyurl.com/2h75wx8n.

摘要

背景

心理困扰在全球医学生中是一个日益严重的问题。这凸显了心理干预关注该人群心理健康和改善幸福感的必要性。

目的

本研究开发了一个基于互联网的自助式接纳与承诺疗法项目（iACT 2.0），旨在检验其在减轻医学生抑郁、焦虑、压力、心理僵化（PI）和强迫症状（OCS）方面的有效性。

方法

总共520名中国医学研究生被随机分为iACT 2.0干预组（n = 260；六节在线课程，每5天一次）或对照组（n = 260；无干预）。参与者在干预前（T1）、干预后（T2）和1个月随访时间点（T3）完成问卷，包括21项抑郁焦虑压力量表、修订后的强迫观念与行为量表以及多维心理灵活性量表。在为期1个月的iACT 2.0干预期间未提供治疗师支持。数据通过在线平台收集，并使用重复测量方差分析进行分析。

结果

与对照组相比，干预组参与者在干预后抑郁、焦虑、压力、PI和OCS显著降低（F = 22.9 - 672.04，所有P <.001）。具体而言，干预组从干预前到干预后时间点以及1个月随访时所有测量结果均显著降低（所有P <.001）。相比之下，同期对照组未观察到显著变化（所有P >.05）。两组在基线时无显著差异（所有P >.05）。在干预后和随访时间点均观察到显著差异（所有P <.001）。