网络认知行为干预对青少年抑郁的效果、机制及过程评价
文献类型：学位论文
| 作者 | 吴炼 |
| 答辩日期 | 2022-12 |
| 文献子类 | 硕士 |
| 授予单位 | 中国科学院大学 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 黄峥 |
| 关键词 | 青少年抑郁 网络认知行为干预 效果 中介机制 质性研究 |
| 学位名称 | 理学硕士 |
| 学位专业 | 健康心理学 |
| 其他题名 | The effect, mechanism and evaluation of implementation process of the Internet-based Cognitive Behavioral Intervention for adolescent depression |
| 中文摘要 | Adolescent depression has attracted the attention of the whole society day by day. However, many teenagers who are suffering from depression can not get effective help. Internet-based cognitive behavioural treatment (ICBT) is a new intervention method. Existing studies abroad have found that it can improve the depression of adolescents, but the research on its regulatory effect and mediating mechanism is not mature, and there are still few studies in China. Based on these situations, this study was carried out. Objective: Develop a localized ICBT program aimed at the current situation of depression among Chinese adolescents, and verify its intervention effect on depression; And the moderating effects of guiding, compliance, learning style and personality traits on the intervention effect were analyzed, and the mediating effects of automated thinking and cognitive skills in ICBT were explored; Finally, based on the Normalization Process Theory (NPT), this paper explores the influencing factors of each link in the implementation process of ICBT in schools. Methods: In study I, a randomized controlled experiment was conducted to recruit young students with obvious depression in two middle schools. They were randomly divided into four groups: Guided ICBT group, self-help ICBT group, health education group and control group, with 74 people in each group. The self-developed adolescent depression ICBT program was used to intervene the two ICBT groups for 4 weeks and twice a week. The Guided ICBT group gave additional one-to-one conversation support to the counselor every week. The health education group synchronously distributed the self-help book materials of depression that were similar to the program content but more simplified for self reading. The Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), Neuroticism and Conscientiousness questionnaire in Five一Factor Inventory(NEO), Automatic Thoughts Questionnaire(ATQ) and the Frequency of Thoughts and Actions Scale(FATS)were used to evaluate all subjects at baseline and after intervention. Referring to the results and research background of study 1，study 2 was conducted to explore the promotion factors and obstacles in the implementation process using qualitative research methods. Interviews were conducted with 4 ICBT school implementers (implementers) and 13 students (recipients) who participated in program learning. NVivo 12 software was used to analyze the text transcribed from the interview recordings, and the theme analysis method was used for analysis, and the sub themes were summarized according to the NPT framework. Results: After the 4-week intervention of study I, there was a statistically significant difference in the change of BDI-II scores of the four groups (p <0.001), and there was a statistically significant difference in the pre-test and post test of BDI-II both in the two ICBT groups (p<0.001). The course completion rate of the Guided group was higher than that of the self-help group, but there was no statistically significant difference in the improvement of depression （）p=0.85); The course completion rate of subjects in centralized learning was higher than that of subjects in autonomous learning, but there was no significant difference in the improvement of depression (p=0.64); The influence of neuroticism and conscientiousness on the intervention results was not statistically significant (neuroticism, (p=0.35; conscientiousness, p=0.57). The difference between the pre-test and post test scores of atq and fat in the two ICBT groups was statistically significant (p<0.001), and the mediating effect of the changes of atq and fat on the reduction of BDI一II score was statistically significant. The sub themes generated by the thematic analysis method in Study）II can be summarized into four core themes (Coherence, Cognitive participation, Collective action and Reflexive monitoring) according to the NPT. All participants basically agree with the value of ICBT. Recipients think that the program is interesting, meets their own needs, and is easy to operate. But participation motivation and academic pressure will affect their input and benefit. The leader's support and the implementer's voice are insufficient, and the role of the head teacher has not been fully played; Collective learning is conducive to the implementation and management of ICBT, but privacy and autonomy also need to be taken into account; There is a lack of collection and Reflection on the implementation process and the feelings of the recipients. Conclusion: The 4-week ICBT intervention can significantly improve adolescent depression. Weekly counselor support and centralized learning can improve compliance, but have no significant impact on the intervention effect. At the same time, automated thinking and cognitive skills play an intermediary role in adolescent depression ICBT. The implementation of ICBT in schools is supported by participants, and the specific implementation mode and the selection of participants need to be further optimized. |
| 英文摘要 | 青少年抑郁问题已日渐引起全社会的关注，然而很多因抑郁问题感到痛苦的青少年得不到有效的帮助。网络认知行为治疗(Internet-based cognitive behavioural treatment, ICBT)是一种新兴的干预方式，国外现有研究已发现其对青少年抑郁情绪有改善效果，但对其调节效应和中介机制的研究尚不成熟，且国内这方面研究 还较少。基于这些现状，开展了本项研究。 目的:研发针对中国青少年抑郁问题现状的本土化ICBT程序，并验证其对抑郁情绪的干预效果;同时分析人工支持、依从性、学习方式及人格特质对干预效果的调节作用，并探索自动化思维和认知技能在ICBT中的中介作用;最后，基于标准化过程理论((NPT)探索ICBT在学校的实施过程中各环节的影响因素。 方法:在研究一中，采用随机对照实验方法，招募两所中学存在明显抑郁情绪的青少年学生，随机分为人工支持ICBT组、自助ICB T组、健康教育组和等待组共4组，每组74人。使用自主研发的青少年抑郁ICB T程序对两个ICBT组进行为期4周、每周2次的干预，人工支持ICBT组每周额外给予咨询师的一对一谈话支持，健康教育组同步发放与程序内容接近但更简化的抑郁自助书面材料自行阅读，等待组不做任何干预。采用贝克抑郁问卷(BDI-II)、贝克焦虑问卷(BAI)、大五人格中的神经质和尽责性问卷、自动化思维问卷(ATQ)和思维行动频率量表(FATS)对所有受试者进行基线和干预后测评。 参照研究一的结果和研究背景，进行了研究二，使用质性研究方法探索实施过程中的促进因素和障碍。对4名ICBT学校实施人员(实施者)、13名参加程序学习的学生(接受者)进行访谈。使用NVivo 12软件分析由访谈录音所转录的文本，采用主题分析方法进行分析，并根据标准化过程理论困PT)框架对子主题进行归纳整理。 结果:研究一在4周干预后，四组的BDI-II得分变化差异有统计学意义勿<0.001，两个ICBT组BDI-II前后测差异均具有统计学意义勿<0.001)，人工支持组课程完成率高于自助组，但抑郁改善差异无统计学意义勿一0.85);集中学习的被试课程完成率高于自主学习的被试，但抑郁改善的差异无统计学意义勿-0.64);神经质及尽责性水平对干预结果的影响无统计学意义(神经质，P-0.35 ;尽责性，P-0.57) o ATQ和FATS二者的改变在BDI-II得分降低上的中介作用有统计学意义。 研究二使用主题分析方法生成的子主题均可以根据NPT的框架归纳到四个核心主题(一致性、认知参与、集体行动、反思性监控)。所有参与者基本都认同ICBT的价值，接受者认为程序有趣，符合自己的需要，也易于操作，但参与动机和学业压力会影响他们的投入和获益。领导支持力度和实施者的话语权不足，班主任的作用也未得到充分发挥;集体学习有利于ICBT的实施和管理，但私密性和自主性也需要兼顾;对实施过程和接受者感受的收集和反思较为缺乏。 结论:为期4周的ICBT干预能显著改善青少年抑郁，每周一次的咨询师支持和集中学习的方式能够提高依从性，但对干预效果无明显影响，同时自动化思维和认知技能在青少年抑郁ICB T中起中介作用。ICBT在学校的实施受到参与者的支持，具体实施方式和参与对象的选择还需要进一步优化。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/45076]  |
| 专题 | 心理研究所_健康与遗传心理学研究室 |
| 推荐引用方式 GB/T 7714 | 吴炼. 网络认知行为干预对青少年抑郁的效果、机制及过程评价[D]. 中国科学院心理研究所. 中国科学院大学. 2022. |
入库方式： OAI收割
来源：心理研究所
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