基于网络的接纳与承诺疗法对精神健康影响的Meta分析

魏莎; 倪世芬; 肖明朝; 高云峰; 罗庆华

doi:10.16016/j.1000-5404.201802150

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基于网络的接纳与承诺疗法对精神健康影响的Meta分析

医学心理学 | 更新时间：2026-01-09

- 基于网络的接纳与承诺疗法对精神健康影响的Meta分析
- Effectiveness of internet-delivered acceptance and commitment therapy for improving mental health: a meta-analysis
- 第三军医大学学报 2018年40卷第14期页码：1332-1342
- 作者机构：
  
  1.400016 重庆，重庆医科大学：附属第一医院精神科
  2.400016 重庆，重庆医科大学：附属第一医院泌尿外科
  3.400016 重庆，重庆医科大学：第一临床学院
- 作者简介：
  
  [倪世芬，E-mail:1821156229@qq.com NI Shifen, E-mail:1821156229@qq.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201802150
  中图分类号： R181.23;R749.055
- 收稿：2018-02-27，
  
  修回：2018-04-10，
  
  纸质出版：2018-07-30
- 稿件说明：
移动端阅览
魏莎, 倪世芬, 肖明朝, 等. 基于网络的接纳与承诺疗法对精神健康影响的Meta分析[J]. 第三军医大学学报, 2018,40(14):1332-1342.

Sha WEI, Shifen NI, Mingzhao XIAO, et al. Effectiveness of internet-delivered acceptance and commitment therapy for improving mental health: a meta-analysis[J]. Journal of Third Military Medical University, 2018, 40(14): 1332-1342.
魏莎, 倪世芬, 肖明朝, 等. 基于网络的接纳与承诺疗法对精神健康影响的Meta分析[J]. 第三军医大学学报, 2018,40(14):1332-1342. DOI： 10.16016/j.1000-5404.201802150.

Sha WEI, Shifen NI, Mingzhao XIAO, et al. Effectiveness of internet-delivered acceptance and commitment therapy for improving mental health: a meta-analysis[J]. Journal of Third Military Medical University, 2018, 40(14): 1332-1342. DOI： 10.16016/j.1000-5404.201802150.

摘要

目的

系统评价基于网络的接纳与承诺疗法(internet-delivered acceptance and commitment therapy，IACT)对改善抑郁、焦虑和提升幸福感的影响。

方法

计算机检索Cochrane Library、PubMed、EMbase、PsycoINFO、中国知网、万方数据库、维普数据库中有关IACT的随机对照试验(randomized controlled trail，RCT)；采用抑郁和焦虑为第一结局指标，幸福感为第二结局指标。采用标准化均数差(standard mean difference，SMD)和95%可信区间(confidence intervals，CIs)描述统计结果。

结果

共纳入14个RCTs，包括1497名研究对象。Meta分析结果显示，IACT能够改善抑郁[SMD= -0.33，95%

(-0.55，-0.12)，

=0.003

]

和焦虑[SMD=-0.23，95%

(-0.42，-0.04)，

=0.02

]

，提升幸福感[SMD=0.21，95%

(0.05，0.36)，

=0.01

]

。亚组分析结果显示，IACT对改善精神症状人群的抑郁、焦虑并提升幸福感有效，差异具有统计学意义(

＜0.01)；有指导的IACT对改善抑郁和提升幸福感有效，差异具有统计学意义(

＜0.01)。

结论

IACT可以改善人群的抑郁、焦虑并提升幸福感。

Abstract

Objective

To systematically evaluate the effects of internet-delivered acceptance and commitment therapy (IACT) on depression

anxiety and well-being.

Methods

PubMed

EMbase

CENTRAL

PsycoINFO

CSTJ

CNKI and WanFang databases were searched for randomized controlled trials (RCTs) evaluating the effects of IACT on depression

anxiety or well-being

with depression and anxiety as the primary outcome indicators and well-being as the secondary outcome indicator. The outcomes were calculated using the standard mean difference (SMD) with 95% confidence intervals (95%

Results

Fourteen RCTs involving a total of 1 497 patients were included in the analysis. The results of meta-analysis showed that IACT could significantly improve depression [SMD=-0.33

95%

(-0.55

-0.12)

=0.003

]

anxiety [SMD=-0.23

95%

(-0.42

-0.04)

=0.02

]

and well-being [SMD=0.21

95%

(0.05

0.36)

=0.01

]

. Subgroup analyses suggested that IACT had significant effects in improving depression

anxiety and well-being in healthy populations (

0.01); self-administered IACT with assistance by therapists could significantly improve depression and promote well-being (

0.05).

Conclusion

IACT can effectively improve depression

anxiety and well-being.

关键词

Keywords

references

陆佩丽, 范建红, 蒋怡华, 等.上海市闵行区精神障碍患者流行病学特征分析[J].上海预防医学, 2017, 29(2): 134-138. DOI:10.3969/j.issn.1004-9231.2017.02.013.

LU P L, FAN J H, JIANG Y H, et al. Epidemiological characteristics of patients with mental disorders in communities of Minhang District[J]. Shanghai J Prev Med, 2017, 29(2): 134-138. DOI:10.3969/j.issn.1004-9231.2017.02.013.j.issn.1004-9231.2017.02.013.

KHANNA M S, KENDALL P C. Computer-assisted cognitive behavioral therapy for child anxiety: results of a randomized clinical trial[J]. J Consult Clin Psychol, 2010, 78(5): 737-745. DOI: 10.1037/a0019739.

SMITH J, NEWBY J M, BURSTON N, et al. Help from home for depression: a randomised controlled trial comparing internet-delivered cognitive behaviour therapy with bibliotherapy for depression[J]. Internet Interv, 2017, 9: 25-37. DOI: 10.1016/j.invent.2017.05.001.

HEDMAN E, HESSER H, ANDERSSON E, et al. The mediating effect of mindful non-reactivity in exposure-based cognitive behavior therapy for severe health anxiety[J]. J Anxiety Disord, 2017, 50: 15-22. DOI: 10.1016/j.janxdis.2017.04.007.

HAYES S C. Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies[J]. Behav Ther, 2005, 35(4):639-665. DOI: 10.1016/S0005-7894(04)80013-3.

HAYES S C, LUOMA J B, BOND F W, et al. Acceptance and commitment therapy: model, processes and outcomes[J]. Behav Res Ther, 2006, 44(1): 1-25. DOI: 10.1016/j.brat.2005.06.006.

GRIST R, CAVANAGH K. Computerised cognitive behavioural therapy for common mental health disorders, what works, for whom under what circumstances? A systematic review and meta-analysis[J]. J Contemp Psychother, 2013, 43(4): 243-251. DOI: 10.1007/s10879-013-9243-y.

任志洪. 基于ACT的抑郁症计算机化治疗: 效果、匹配及改变机制[D]. 武汉: 华中师范大学, 2012. [http://cdmd.cnki.com.cn/Article/CDMD-10511-1013174727.htm .

REN Z H. ACT-based computerized treatment for depression: effects, optimal matching and changing mechanisms[D]. Wuhan: Central China Normal University, 2012.

LEVIN M E, HAEGER J A, PIERCE B G, et al. Web-based acceptance and commitment therapy for mental health problems in college students[J]. Behav Modif, 41(1): 141-162. DOI: 10.1177/0145445516659645.

LEVIN M E, HAYES S C, PISTORELLO J, et al. Web-based self-help for preventing mental health problems in universities: comparing acceptance and commitment training to mental health education [J]. J Clin Psychol, 2016, 72(3): 207-225. DOI: 10.1002/jclp.22254.

LEVIN M E, PISTORELLO J, SEELEY J R, et al. Feasibility of a prototype web-based acceptance and commitment therapy prevention program for college students [J]. J ACH, 2013, 62(1): 20-30. DOI: 10.1080/07448481.2013.843533.

LY K H, ASPLUND K, ANDERSSON G. Stress management for middle managers via an acceptance and commitment-based smartphone application: A randomized controlled trial[J]. Internet Interv, 2014, 1(3): 95-101. DOI: 10.1016/j.invent.2014.06.003.

HIGGINS J P T, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0[M]. London: The Cochrane Collaboration, 2011: 156-160.

DERSIMONIAN R, LAIRD N. Meta-analysis in clinical trials[J]. Control Clin Trials, 1986, 7(3): 177-188. DOI: 10.1016/0197-2456(86)90046-2.

COHEN J. A power primer[J]. Psychol Bull, 1992, 112(1): 155-159. DOI: 10.1037//0033-2909.112.1.155.

LAPPALAINEN P, LANGRIAL S, OINAS-KUKKONEN H, et al. Web-based acceptance and commitment therapy for depressive symptoms with minimal support: a randomized controlled trial[J]. Behav Modif, 2015, 39(6): 805-834. DOI: 10.1177/0145445515598142.

POTS W T, FLEDDERUS M, MEULENBEEK P A, et al. Acceptance and commitment therapy as a web-based intervention for depressive symptoms: randomised controlled trial[J]. Br J Psychiatry, 2016, 208(1): 69-77. DOI: 10.1192/bjp.bp.114.146068.

DAHLIN M, ANDERSSON G, MAGNUSSON K, et al. Internet-delivered acceptance-based behaviour therapy for generalized anxiety disorder: a randomized controlled trial[J]. Behav Res Ther, 2016, 77: 86-95. DOI: 10.1016/j.brat.2015.12.007.

IVANOVA E, LINDNER P, LY K H, et al.. Guided and unguided Acceptance and Commitment Therapy for social anxiety disorder and/or panic disorder provided via the Internet and a smartphone application: a randomized controlled trial [J]. J Anxiety Disord, 2016, 44: 27-35. DOI: 10.1016/j.janxdis.2016.09.012.

HESSER H, GUSTAFSSON T, LUND N C, et al. A randomized controlled trial of Internet-delivered cognitive behavior therapy and acceptance and commitment therapy in the treatment of tinnitus[J]. J Consult Clin Psychol, 2012, 80(4): 649-661. DOI: 10.1037/a0027021.

BUHRMAN M, SKOGLUND A, HUSELL J, et al. Guided internet-delivered acceptance and commitment therapy for chronic pain patients: a randomized controlled trial[J]. Behav Res Ther, 2013, 51(6): 307-315. DOI: 10.1016/j.brat.2013.02.010.

TROMPETTER H R, BOHLMEIJER E T, VEEHOF M M, et al. Internet-based guided self-help intervention for chronic pain based on Acceptance and Commitment Therapy: a randomized controlled trial[J]. J Behav Med, 2015, 38(1): 66-80. DOI: 10.1007/s10865-014-9579-0.

R S NEN P, LAPPALAINEN P, MUOTKA J, et al. An online guided ACT intervention for enhancing the psychological wellbeing of university students: a randomized controlled clinical trial[J]. Behav Res Ther, 2016, 78: 30-42. DOI: 10.1016/j.brat.2016.01.001.

LAPPALAINEN P, GRANLUND A, SILTANEN S, et al. ACT Internet-based vs face-to-face? A randomized controlled trial of two ways to deliver Acceptance and Commitment Therapy for depressive symptoms: an 18-month follow-up[J]. Behav Res Ther, 2014, 61: 43-54. DOI: 10.1016/j.brat.2014.07.006.

BROWN M, GLENDENNING A, HOON A E, et al. Effectiveness of web-delivered acceptance and commitment therapy in relation to mental health and well-being: a systematic review and meta-analysis[J]. J Med Internet Res, 2016, 18(8): e221. DOI: 10.2196/jmir.6200.

BARAK A, HEN L, BONIEL-NISSIM M, et al. A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions [J]. J Technol Hum Serv, 2008, 26(2): 109-160. DOI: 10.1080/15228830802094429.

ANDERSSON G, GUIJPERS P. Internet-based and other computerized psychological treatments for adult depression: a meta-analysis[J]. Cogn Behav Ther, 2009, 38(4): 196-205. DOI:10.1080/16506070903318960.

RICHARDS D, RICHARDSON T. Computer-based psychological treatments for depression: a systematic review and meta-analysis[J]. Clin Psychol Rev, 2012, 32(4): 329-342. DOI:10.1016/j.cpr.2012.02.004.

LILLEVOLL K R, WILHELMSEN M, KOLSTRUP N, et al. Patients' experiences of helpfulness in guided internet-based treatment for depression: qualitative study of integrated therapeutic dimensions [J]. J Med Internet Res, 2013, 15(6): e126. DOI: 10.2196/jmir.2531.

KELDERS S M, KOK R N, OSSEBAARD H C, et al. Persuasive system design does matter: a systematic review of adherence to web-based interventions[J]. J Med Internet Res, 2012, 14(6): e152. DOI: 10.2196/jmir.2104.

MORGAN A J, JORM AF, MACKINNON A J. Email-based promotion of self-help for subthreshold depression: Mood Memos randomised controlled trial[J]. Br J Psychiatry, 2012, 200(5): 412-418. DOI: 10.1192/bjp.bp.111.101394.

KELDERS S M, BOHLMEIJER E T, POTS W T, et al. Comparing human and automated support for depression: fractional factorial randomized controlled trial[J]. Behav Res Ther, 2015, 72: 72-80. DOI: 10.1016/j.brat.2015.06.014.

OST L G. The efficacy of Acceptance and Commitment Therapy: an updated systematic review and meta-analysis[J]. Behav Res Ther, 2014, 61: 105-121. DOI: 10.1016/j.brat.2014.07.018.

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