Lajmi Nahed, Duan Suqian, Moll Jorge, Zahn Roland
Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Cognitive and Behavioral Neuroscience Unit, D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
Front Psychol. 2025 Jan 7;15:1438896. doi: 10.3389/fpsyg.2024.1438896. eCollection 2024.
Many people with depression, for which self-blame plays a key role, are not amenable to current standard psychological treatments. This calls for novel self-guided interventions, which require less attention and motivation. The present study sought to establish proof-of-concept for a novel self-guided intervention in a non-clinical sample, which prompts people to transform self-blaming feelings into "longing," as a related unpleasant, but presumably more adaptive and approach-related emotion, which plays a key role in many musical and literary genres but has been largely overlooked in clinical research.
Thirty nine participants with no previous self-reported history of mental disorders, but who experienced frequent feelings of self-blame were enrolled remotely ( = 3 lost to follow-up). Self-blaming thoughts, along with depressive symptoms and other outcomes, were assessed pre- and post-intervention to determine the potential of the intervention, which consisted of creating a 10-min video starting with self-blame evoking materials, transitioning to sadness and finally longing. Participants were then asked to watch their video daily for 7 days.
The number of participants lost to follow-up was low ( = 3) and engagement with the intervention was very high. As predicted, the intervention significantly reduced depressive symptoms on our primary outcome measure (Beck's Depression Inventory, BDI-II, Cohen's = 0.40) after 1 week. This was further confirmed by a reduction on the Maudsley-modified Patient Health Questionnaire-9. Unexpectedly, no changes were observed on the non-clinical measures.
A randomized controlled trial design is needed to determine whether these symptom reductions were causally related to the intervention. Additionally, our findings may not generalize to men, due to our inability to recruit a sex-balanced sample.
As predicted, participants benefited from being prompted to transform self-blaming feelings into those related to longing which shows the feasibility and potential to be further developed in people with clinical depression. Our study highlights the adaptive potential of unpleasant approach-related emotions such as longing, which are rarely considered in standard psychotherapies.
许多患有抑郁症的人,自责在其中起着关键作用,他们对当前的标准心理治疗方法并不适用。这就需要新颖的自我引导干预措施,这类措施所需的注意力和动力较少。本研究旨在在非临床样本中为一种新颖的自我引导干预措施建立概念验证,该干预措施促使人们将自责情绪转化为“渴望”,这是一种相关的不愉快但可能更具适应性且与接近相关的情绪,在许多音乐和文学体裁中起着关键作用,但在临床研究中在很大程度上被忽视了。
招募了39名此前无精神障碍自我报告病史但经常有自责情绪的参与者(通过远程方式;3人失访)。在干预前后评估自责想法以及抑郁症状和其他结果,以确定干预措施的潜力,该干预措施包括制作一个10分钟的视频,从唤起自责的材料开始,过渡到悲伤,最后是渴望。然后要求参与者连续7天每天观看他们的视频。
失访的参与者数量较少(3人),对干预措施的参与度非常高。如预期的那样,干预1周后,在我们的主要结局指标(贝克抑郁量表,BDI-II,科恩d值 = 0.40)上,抑郁症状显著减轻。莫兹利改良的患者健康问卷-9的得分降低进一步证实了这一点。出乎意料的是,在非临床指标上未观察到变化。
需要采用随机对照试验设计来确定这些症状减轻是否与干预措施存在因果关系。此外,由于我们无法招募到性别均衡的样本,我们的研究结果可能不适用于男性。
如预期的那样,参与者受益于被促使将自责情绪转化为与渴望相关的情绪,这表明了在临床抑郁症患者中进一步发展的可行性和潜力。我们的研究强调了诸如渴望等不愉快的与接近相关的情绪的适应性潜力,而这些情绪在标准心理治疗中很少被考虑。