Acceptance as a Mediator for Change in Acceptance and Commitment Therapy for Persons with Chronic Pain?
Acceptance as a Mediator for Change in Acceptance and Commitment Therapy for Persons with Chronic Pain?
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DOI：
10.1007/s12529-015-9494-y
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发表时间：
2016-02
影响因子：
2.7
通讯作者：
Ljungman G
中科院分区：
文献类型：
--
作者：
Cederberg JT;Cernvall M;Dahl J;von Essen L;Ljungman G
认知行为疗法(CBT)被认为对慢性疼痛有效，但对积极治疗成分知之甚少。尽管接受与慢性疼痛患者更好的健康结局相关，但还没有研究在实验设计中检验其中介作用。本研究的目的是调查接受和承诺疗法(ACT)的接受度，作为慢性疼痛的第三波CBT干预措施。一种自举的系数交叉积方法被用于先前发表的RCT慢性疼痛评估ACT的数据。为了解决接受作为中介的特殊性，焦虑和抑郁也被作为中介进行了测试。结果变量是对生活和身体功能的满意度。采用评估前至6个月随访(n = 53)和评估前至12个月随访(n = 32)两个变化评分。接受性被发现在治疗对身体功能变化的影响中起到中介作用，从预评估到6个月的随访。此外，从预评估到12个月的随访呈现出趋势。未发现接受治疗对生活满意度的改变有间接影响。这项研究增加了一项使用中介分析来调查慢性疼痛治疗中的中介因素的小型但不断增长的研究主体。综上所述，这些结果表明，接受可能对慢性疼痛患者的ACT的身体功能变化起到中介作用。然而，考虑到这项研究的样本量很小，这些发现需要重复。
Cognitive behavior therapy (CBT) is considered effective for chronic pain, but little is known about active treatment components. Although acceptance correlates with better health outcomes in chronic pain patients, no study has examined its mediating effect in an experimental design. The aim of the present study is to investigate acceptance as a mediator in acceptance and commitment therapy (ACT), a third wave CBT intervention, for chronic pain. A bootstrapped cross product of coefficients approach was used on data from a previously published RCT evaluating ACT for chronic pain. To address the specificity of acceptance as a mediator, anxiety and depression were also tested as mediators. Outcome variables were satisfaction with life and physical functioning. Two change scores, pre-assessment to 6-month follow-up (n = 53) and pre-assessment to 12-month follow-up (n = 32), were used. Acceptance was found to mediate the effect of treatment on change in physical functioning from pre-assessment to follow-up at 6 months. Further, a trend was shown from pre-assessment to follow-up at 12 months. No indirect effect of treatment via acceptance was found for change in satisfaction with life. This study adds to a small but growing body of research using mediation analysis to investigate mediating factors in the treatment of chronic pain. In summary, the results suggest that acceptance may have a mediating effect on change in physical functioning in ACT for persons with chronic pain. However, given the small sample size of the study, these findings need to be replicated.