Both positive mental health and psychopathology should be monitored in psychotherapy: Confirmation for the dual-factor model in acceptance and commitment therapy
Both positive mental health and psychopathology should be monitored in psychotherapy: Confirmation for the dual-factor model in acceptance and commitment therapy
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DOI：
10.1016/j.brat.2017.01.008
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发表时间：
2017-04-01
影响因子：
4.1
通讯作者：
Bohlmeijer, E. T.
中科院分区：
文献类型：
--
作者：
Trompetter, H. R.;Lamers, S. M. A.;Bohlmeijer, E. T.
心理健康的双因素模型表明，增强积极的心理健康和减轻精神病理并不是自动同步的。本研究旨在探讨接受与承诺疗法（ACT）对抑郁/焦虑症状的治疗效果与积极心理健康的关系。它利用自助ACT的RCT数据（n = 250）。患者的抑郁/焦虑症状和积极的心理健康在基线、干预后9周和5个月后的随访时完成。使用回归分析和可靠变化指数（RCI）检验了积极心理健康（反之亦然）解释的抑郁/焦虑症状的独特方差百分比，以及积极心理健康和抑郁/焦虑的改善之间的分类一致程度。积极的心理健康，即基线和变化，解释了随访抑郁和焦虑症状差异的15%和12%，超出了基线抑郁和焦虑水平解释的7%和9%。抑郁和焦虑症状，即基线和变化，解释了后续积极心理健康差异的10%和9%，而积极心理健康基线水平解释了35%的差异。可靠变化的交叉分类显示，在act干预期间改善的参与者中，64%的参与者在抑郁症状或积极心理健康方面有所改善，72%的参与者在焦虑症状或积极心理健康方面有所改善。研究结果支持了双因素模型，并提示在精神卫生保健和治疗评估中系统地实施精神病理学和积极心理健康的措施是重要的。(C) 2017 Elsevier Ltd.版权所有。
The dual-factor model of mental health suggests that enhancing positive mental health and alleviating psychopathology do not automatically go hand-in-hand. This study investigates the relationship between the effectiveness on depression/anxiety symptoms and positive mental health of Acceptance and Commitment Therapy (ACT). It draws on RCT data (n = 250) of a self-help ACT. Patients' depression/anxiety symptoms and positive mental health were completed at baseline, at post-intervention after nine weeks, and at follow-up after five months. Percentage of unique variance of depression/anxiety symptoms explained, by positive mental health (and vice versa), and the degree of classificatory agreement between improvements in positive mental health and depression/anxiety, were examined using regression analysis and Reliable Change Index (RCI). Positive mental health, i.e. baseline and change, explained 15% and 12% of the variance in follow-up depression and anxiety symptoms, beyond the 7% and 9% that was explained by baseline levels of depression and anxiety. Depression and anxiety symptoms, i.e., baseline and change, explained 10% and 9% of the variance in follow-up positive mental health, on top of the 35% that was explained by baseline levels of positive mental health. Cross classification of the Reliable Changes showed that 64% of the participants that improved during the ACT-intervention, improved on either depression symptoms or positive mental health, and 72% of the participants improved on either anxiety symptoms or positive mental health. The findings support the dual-factor model and suggest that it is important to systematically implement measures of both psychopathology and positive mental health in mental health care and therapy evaluations. (C) 2017 Elsevier Ltd. All rights reserved.