隐喻接纳与行为激活线上干预的效果：经验性回避的中介作用
文献类型：学位论文
| 作者 | 李若楠
|
| 答辩日期 | 2024-06 |
| 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 | 张文彩 |
| 关键词 | 治疗性隐喻 经验性回避 接纳 行为激活 线上干预 |
| 学位名称 | 理学硕士 |
| 学位专业 | 应用心理学 |
| 其他题名 | The effect of online metaphorical acceptance and behavioral activation intervention: The mediating role of experiential avoidance |
| 中文摘要 | Anxiety, depression, and other emotional problems are increasingly prevalent among college students, and experiential avoidance may be an important factor leading to the development and maintenance of anxiety and depression in this population, making it a significant target for preventive interventions. Acceptance and behavioral activation have emerged as promising techniques in psychotherapy for improving experiential avoidance, providing a potential avenue for developing interventions targeting experiential avoidance. Utilizing therapeutic metaphors in intervention delivery may optimize intervention effectiveness, yet empirical research solely examining the impact of therapeutic metaphors on intervention outcomes remains limited. This study aims to develop a short-term online intervention targeting experiential avoidance based on acceptance and behavioral activation and manipulate therapeutic metaphors using a metaphorical storytelling intervention paradigm to investigate the impact of therapeutic metaphors on intervention outcomes and examine the role of experiential avoidance in alleviating anxiety and depression symptoms during the interventions. Specifically, two studies were conducted: Study 1: Employing a 3-arm controlled trial design, this study examined the effects and mechanisms of a 2-week online group acceptance and value-based behavioral activation intervention in improving anxiety and depression of the non-clinical university student population, while exploring whether therapeutic metaphors enhance the effects of the intervention. A total of 112 eligible college students were recruited and divided into three groups: metaphorical intervention group (n = 40), nonmetaphorical intervention group (n = 36), and control group (n = 36). The two intervention groups received a 2-week online group intervention, while the control group received no intervention. Anxiety, depression, experiential avoidance, and selfreported acceptance were measured at baseline (T1), post-intervention (T2), 1-week follow-up (T3), and 3-week follow-up (T4). Results show that there were statistically significant interactions between time and group in anxiety, depression, and experiential avoidance. Anxiety and depression scores in the metaphorical group continued to decrease after the intervention, whereas, in the non-metaphorical group, only anxiety scores at T3 and depression scores at T2 and T3 decreased significantly. Both groups show sustained reductions in experiential avoidance and increases in self-reported acceptance. The reduction in experiential avoidance mediated the alleviation of anxiety and depression only in the metaphorical group. Study 1 results suggest that metaphorical intervention demonstrated sustained improvements in both anxiety and depression, potentially exhibiting relative superiority in alleviating anxiety. Furthermore, reductions in experiential avoidance are a critical mechanism for the alleviation of anxiety and depression in the metaphorical intervention group. Study 2: Employing a more rigorous randomized controlled trial (RCT) design combined with the daily diary approach, this study investigates the effects and mechanisms of a 15-day online self-directed acceptance and value-based behavioral activation intervention in improving anxiety and depression symptoms in the subclinical university student population, while examining whether the effect of the metaphorical intervention remains superior to that of non-metaphorical intervention. A total of 110 university students with mild or higher levels of anxiety symptoms and concurrent mild to moderately severe levels of depression symptoms were recruited and randomly assigned to three groups: metaphorical intervention group (n = 37), nonmetaphorical intervention group (n = 37), and waitlist control group (n = 36). Both intervention groups received a 15-day online self-directed intervention, while the waitlist control group received no intervention but received equivalent compensatory intervention after the study. Daily changes in state anxiety, state depression, state experiential avoidance, state activation, and state acceptance were recorded during the intervention period for both intervention groups. Anxiety, depression symptoms, experiential avoidance, activation, and acceptance were measured at baseline (T1), post-intervention (T2), 1-week follow-up (T3), 2-week follow-up (T4), and 1-month follow-up (T5). Results show that: (1) In terms of dynamic intervention effect, state anxiety, state depression, and state experiential avoidance in both metaphorical and non-metaphorical groups decreased significantly with time, while state activation increased significantly with time, while state acceptance did not change significantly in both groups. There was no significant difference between the two intervention groups in the variation of state variables over time. (2) In terms of long-term intervention effect, there were statistically significant interactions between time and group in anxiety, depression, and experiential avoidance. Anxiety and depression scores in the metaphorical group continued to decrease after intervention. In contrast, only anxiety scores at T3 and T4 in the non-metaphorical group significantly decreased compared to baseline, with sustained decreases in depression scores after intervention. Experiential avoidance scores decreased significantly at T4 and T5 in the metaphorical group, while experiential avoidance scores decreased significantly at T2, T3, and T4 in the nonmetaphorical group. (3) In terms of the mechanisms of the interventions, the reduction in experiential avoidance mediated the improvement of anxiety and depression symptoms in both intervention groups. The decrease in cognitive avoidance mediated the improvement of anxiety symptoms in both intervention groups, while the decrease in behavioral avoidance mediated the improvement of depression symptoms in the nonmetaphorical intervention group. Study 2 results suggest that metaphorical intervention has a better effect on consistently improving anxiety symptoms, with the reduction in experiential avoidance being a critical mechanism for the improvement of anxiety and depression symptoms in both intervention groups. Furthermore, the reduction of cognitive avoidance was an important mechanism for the improvement of anxiety symptoms in both intervention groups, while the reduction of behavioral avoidance was an important mechanism for the improvement of depression symptoms in the nonmetaphorical intervention group. In summary, the results of the study indicate that short-term online acceptance and behavioral activation interventions effectively improve anxiety and depression symptoms in non-clinical and subclinical university student populations, with metaphorical interventions having a better effect on consistently enhancing the effects of anxiety symptom improvement compared to non-metaphorical intervention. Additionally, the study confirms that reductions in experiential avoidance are critical mechanisms underlying the improvement of anxiety and depression symptoms in acceptance and behavioral activation interventions. |
| 英文摘要 | 焦虑、抑郁等情绪问题在大学生群体中日益突出，而经验性回避可能是导致 该群体焦虑和抑郁发展和维持的重要因素，被视为重要的预防干预靶点。接纳和 行为激活是心理治疗中有望改善个体经验性回避的重要技术，为开发以经验性回 避为靶点的干预提供了思路。在干预中借助治疗性隐喻传递治疗信息，可能起到 优化干预效果的作用，但目前单独探讨治疗性隐喻对干预效果影响的实证研究仍 然较少。本研究欲以接纳和行为激活技术为基础，开发以经验性回避为靶点的短 期线上心理干预方案，同时运用隐喻故事干预范式操纵干预方案中的治疗性隐喻 成分，以探究有无治疗性隐喻对干预效果的影响并检验经验性回避在干预改善焦 虑和抑郁情绪中所起的作用。具体通过以下两个研究进行： 研究一：采用 3 臂的对照试验设计，探讨 2 周接纳线上团体干预改善非临 床大学生群体的焦虑、抑郁等负性情绪的效果及起效机制，同时探究治疗性隐喻 是否对接纳干预效果具有促进作用。招募并筛选 112 名符合条件的在校大学生， 将其分为三组：隐喻干预组 (n = 40)、非隐喻干预组 (n = 36) 和空白对照组 (n = 36)。干预组接受为期 2 周的接纳线上团体干预，对照组不进行干预。在基线 (T1)、 2 周干预后 (T2)、1 周随访 (T3) 和 3 周随访 (T4) 时测量参与者的焦虑、抑郁 情绪及经验性回避和自评接纳。结果发现：在焦虑、抑郁和经验性回避上，时间 与组别的交互效应显著。隐喻组的焦虑、抑郁得分在干预后持续降低，非隐喻组 仅 T3 的焦虑得分显著低于 T1，仅 T2 和 T3 的抑郁得分显著低于 T1；两组 在干预后的经验性回避得分均持续降低，自评接纳得分均持续升高。经验性回避 的减少仅对隐喻接纳干预改善焦虑和抑郁情绪具有中介作用。研究一的结果表明， 隐喻接纳干预能持续改善焦虑和抑郁情绪，且其在改善焦虑情绪上可能更具优势； 经验性回避的减少是隐喻接纳干预改善焦虑和抑郁情绪的重要机制。 研究二：采用更为严格的随机对照试验 (RCT) 设计，同时结合日记法，探 讨 15 天接纳与行为激活线上自助式干预改善亚临床大学生群体的焦虑、抑郁等 负性情绪症状的效果及起效机制，并检验隐喻干预的效果是否仍优于非隐喻干预。 招募并筛选 110 名具有轻度及以上焦虑症状且同时具有轻度至中重度抑郁症状 的在校大学生，在匹配性别、入组情绪症状的基础上，将其随机分配至三组：隐 喻干预组 (n = 37)、非隐喻干预组 (n = 37) 和等待对照组 (n = 36)。两干预组接 受为期 15 天的接纳与行为激活线上自助式干预，等待对照组在此期间不接受干 预，但在研究结束后获得与干预组等同的补偿干预。在两干预组接受干预期间， 采用日记法记录参与者每日的状态焦虑、状态抑郁以及状态经验性回避、状态激 活和状态接纳的动态变化。在基线 (T1)、15 天干预后 (T2)、1 周随访 (T3)、2周随访 (T4) 和 1 月随访 (T5) 时测量参与者的焦虑、抑郁症状以及经验性回避、 激活和接纳。结果发现：(1) 在动态干预效应上，隐喻组和非隐喻组在干预期间 的状态焦虑、状态抑郁和状态经验性回避都随时间显著下降，状态激活随时间显 著上升，而两组的状态接纳无显著变化。两干预组各状态变量随时间的变化不存 在显著差异。(2) 在长时干预效应上，时间与组别对焦虑、抑郁和经验性回避的 交互效应显著。隐喻组的焦虑、抑郁得分在干预后持续降低，而非隐喻组仅 T3 和 T4 的焦虑得分显著低于 T1，其抑郁得分在干预后持续降低；隐喻组 T4 和 T5 的经验性回避得分显著低于 T1，而非隐喻组 T2、T3 和 T4 的经验性回避 得分显著低于 T1。时间与组别对接纳和激活的交互效应均不显著。(3) 在干预起 效机制上，经验性回避的减少在隐喻干预和非隐喻干预改善焦虑及抑郁症状时均 起到了中介作用；其中，认知回避的减少对隐喻干预和非隐喻干预改善焦虑症状 具有中介作用，而行为回避的减少则对非隐喻干预改善抑郁症状具有中介作用。 研究二的结果表明，隐喻接纳与行为激活线上自助干预持续改善焦虑症状的效果 更优；经验性回避的减少是两组干预改善焦虑和抑郁症状的重要机制，其中，认 知回避的减少是两组干预改善焦虑症状的重要机制，而行为回避的减少则是非隐 喻干预改善抑郁症状的重要机制。 综上所述，本研究的结果表明短期接纳与行为激活线上干预可有效改善非临 床和亚临床大学生群体的焦虑、抑郁情绪，且隐喻干预持续改善焦虑情绪的效果 更优，同时验证了经验性回避的减少是接纳与行为激活线上干预改善焦虑和抑郁 情绪的重要机制。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/47953]  |
| 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 | 李若楠. 隐喻接纳与行为激活线上干预的效果：经验性回避的中介作用[D]. 中国科学院心理研究所. 中国科学院大学. 2024. |
入库方式： OAI收割
来源：心理研究所
浏览0
下载0
收藏0
其他版本
除非特别说明，本系统中所有内容都受版权保护，并保留所有权利。