【作者】 史俊研； 王珏； 胡茂荣； 熊艾； 杨发明； 王振宏；

【Author】 Jun-Yan Shi;Jue Wang;Mao-Rong Hu;Ai Xiong;Fa-ming Yang;Zhen-Hong Wang;School of Psychology,Shaanxi Normal University,Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health;Department of Medical Psychology,Mental Health Hospital affiliated to Shanxi Medical University;Developmental Science,Graduate School of Education,the University of Tokyo;Department of Psychosomatic Medicine,The First Affiliated Hospital of Nanchang University;Shanxi acupuncture and moxibustion hospital;

【机构】 陕西师范大学心理学院陕西(高校)儿童青少年心理与行为健康哲学社会科学重点研究基地； 山西医科大学附属精神卫生医院医学心理科； 东京大学教育心理学系； 南昌大学第一附属医院心身医学科； 山西省针灸医院；

【摘要】 双相情感障碍(BD)是一种常见的情感障碍,以异常的情绪波动为特征,包括躁狂、抑郁和混合状态。BD是一种高度复杂的多因素慢性疾病,发病年龄从青春期到成年中期,其病因尚不完全清楚,可严重导致生活质量下降和残疾。认知障碍是其核心特征,情绪不稳定是其临床特征。认知情绪和心理灵活性是双相情感障碍(BD)心理适应的重要预测因子。心理治疗已被用作治疗双相情感障碍(BD)的一种补充方法,但BD相关的干预研究仍比较局限。本研究探讨作为认知行为治疗第三浪潮之一的接受承诺疗法(ACT)是否能改善双相障碍的症状。研究采用治疗前和治疗后两个评估时间点的设计。将53例BD I型或II型缓解期门诊患者随机分为两组,一组采用ACT+常规治疗(TAU),另一组采用TAU。ACT+TAU组在临床中接受了9次以团队为基础的ACT干预和TAU,而TAU组只接受了常规TAU干预。在治疗前时间点(T1,基线)和治疗后时间点(T2,5周)评估YMRS、SDS、CERQ、CFQ-F和AAQ-II水平。结果显示,与TAU组相比,ACT+TAU组在躁狂(YMRS)、抑郁(SDS)、认知情绪(CERQ)和心理灵活性(CFQ-F和AAQ-II)方面的改善更为显著。本研究证实ACT干预可有效减轻双相障碍康复期患者的躁郁症状,提高其认知情绪和心理灵活性水平。本研究为临床精神及心理工作者对双相障碍患者的康复进行临床心理干预,积累实践经验并提供临床参考。更多还原

【Abstract】 Bipolar disorder(BD) is a common affective disorder characterized by abnormal mood swings,including mania,depression,and mixed states.BD is a highly complex multi-factorial chronic disease.The age of onset ranges from adolescence to mid-adulthood,and its etiology is not fully understood,which can seriously lead to decreased quality of life and disability.Cognitive impairment is its core feature,and emotional instability is its clinical feature.Cognitive emotion and psychological flexibility are important predictors of psychological adjustment among BD.Psychotherapy has been used as a complementary approach in treating BD.however,interventions related to BD remain limited.The present study explored whether acceptance and commitment therapy(ACT) which is one of the therapeutic approaches of behavioral therapy could improve the symptoms of BD.A pre-and post-treatment design with two evaluation time points was employed.Fifty-three outpatients in BD remission period type 1 or 2were divided into two groups randomly,one group was ACT+ treatment as usual(TAU) and the other one was TAU.The ACT+TAU group participated in nine team-based ACT interventions and TAU in the clinic,and the TAU group only received TAU interventions.YMRS,SDS,CERQ,CFQ-F and AAQ-II were assessed at a pre-treatment time point(T1,baseline) and a post-treatment time point(T2,5weeks).Results indicated that,after the intervention,compared to the TAU group,the ACT+TAU group exhibited more significant improvement in mania(YMRS),depression(SDS),cognitive emotion(CERQ) and psychological flexibility(CFQ-F and AAQ-II).This study indicated that ACT intervention could effectively decrease the mania and depression symptoms and increase cognitive emotion level and psychological flexibility on BD.This study provides clinical psychological intervention for clinical psychiatric and psychological workers in the rehabilitation of patients with BD,accumulating practical experience and providing clinical reference.更多还原