正念认知疗法对广泛性焦虑障碍患者正念注意觉知、经验性回避与认知融合的干预研究  

The intervention study of mindfulness-based cognitive therapy on mindful attention awareness,experiential avoidance and cognitive fusion in patients with generalized anxiety disorder

作　　者：范瑞娟 刘健[2] 唐光政[2] 吴满花[2] 陈碧君 孙丽君[2] 侯瑞[2] Fan Ruijuan;Liu Jian;Tang Guangzheng;Wu Manhua;Chen Bijun;Sun Lijun;Hou Rui(School of Mental Health and Psychological Sciences,Anhui Medical University,Hefei 230032,China;The Seventh People's Hospital of Hangzhou,Hangzhou 310013,China;School of Medicine,Zhejiang University,Hangzhou 310011,China)

机构地区：[1]安徽医科大学精神卫生与心理科学学院,合肥230032 [2]杭州市第七人民医院科教部,杭州310013 [3]浙江大学医学院,杭州310011

出　　处：《中华行为医学与脑科学杂志》2023年第12期1093-1098,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：杭州市科技计划引导项目(农业与社会发展)(20201231Y043)。

摘　　要：目的探讨正念认知疗法(mindfulness-based cognitive therapy,MBCT)对广泛性焦虑障碍(generalized anxiety disorder,GAD)患者正念注意觉知、经验性回避、认知融合的干预效果。方法选取2021年5月至2022年9月在杭州市第七人民医院焦虑障碍门诊就诊的年龄在18~60岁之间的符合DSM-5诊断标准的GAD患者53例,在常规治疗的基础上,采用随机数字表法分为两组,一组为MBCT组(n=26),进行为期8周的正念认知治疗的团体心理辅导;另一组为健康教育组(n=27),进行为期8周的健康教育。分别于干预前、干预后采用广泛性焦虑量表(general anxiety disorder-7,GAD-7)、接纳与行动问卷第二版(acceptance and action questionnaire-2nd edition,AAQ-Ⅱ)、认知融合问卷(cognitive fusion questionnaire,CFQ)、正念注意觉知量表(mindful attention awareness scale,MAAS)对两组被试进行评估。采用SPSS 26.0对数据进行卡方检验、独立样本t检验、配对样本t检验。结果(1)干预前两组MAAS得分差异无统计学意义[(42.63±10.18)分,(47.67±9.52)分,t=-1.55,P=0.13];干预后MBCT组的MAAS得分显著高于健康教育组[(54.42±9.87)分,(47.83±7.59)分,t=-2.27,P=0.03]。(2)干预前两组CFQ得分差异无统计学意义[(57.11±15.97)分,(53.50±12.01)分,t=-0.77,P=0.45];干预后MBCT组的CFQ得分显著低于健康教育组[(38.32±10.31)分,(47.11±10.66)分,t=-2.57,P<0.01]。(3)干预前两组AAQ-Ⅱ得分差异无统计学意义[(33.79±7.90)分,(30.00±7.23)分,t=1.52,P=0.14];干预后MBCT组的AAQ-Ⅱ得分显著低于健康教育组[(21.89±8.69)分,(30.22±8.68)分,t=-3.51,P<0.01]。结论MBCT团体心理辅导对GAD患者的正念注意觉知、认知融合、经验性回避有一定的改善作用。ObjectiveTo investigate the effect of mindfulness-based cognitive therapy(MBCT)on mindfulness attention awareness,experiential avoidance,and cognitive fusion in individuals with general anxiety disorder(GAD).MethodsA total of 53 patients aged 18-60 years who met the GAD diagnostic criteria of DSM-5 were selected from the Seventh People's Hospital of Hangzhou from May 2021 to September 2022.After receiving routine treatment,patients were randomly assigned to two groups:MBCT group(n=26)for an 8-week mindfulness cognitive therapy and health education group(n=27)for an 8-week health education program.Participants were evaluated using the generalized anxiety disorder scale(GAD-7),acceptance and action questionnaire-2nd edition(AAQ-Ⅱ),cognitive fusion questionnaire(CFQ),and mindful attention awareness scale(MAAS)before and after the intervention.Data were analyzed using SPSS 26.0 software,with the chi-square test,independent sample t-test,and paired sample t-test.Results(1)There was no significant difference in MAAS score between the two groups before the intervention(42.63±10.18,47.67±9.52,t=-1.55,P=0.13).However,after the intervention,the MAAS score in MBCT group was significantly higher than that in the health education group(54.42±9.87,47.83±7.59,t=-2.27,P=0.03).(2)No significant difference was observed in CFQ score between the two groups before the intervention(57.11±15.97,53.50±12.01,t=-0.77,P=0.45).However,after the intervention,the CFQ score in the MBCT group was significantly lower than that in the health education group(38.32±10.31,47.11±10.66,t=-2.51,P<0.01).(3)There was no significant difference in AAQ-Ⅱscores between the two groups before the intervention(33.79±7.90,30.00±7.23,t=1.52,P=0.14).After the intervention,the AAQ-Ⅱscore in the MBCT group was significantly lower than that in the health education group(21.89±8.69,30.22±8.68,t=-3.51,P<0.01).ConclusionMBCT has a positive effect on enhancing mindfulness attention awareness,reducing cognitive fusion,and mitigating experiential avoidanc

关 键 词：正念注意觉知 认知融合 经验性回避 广泛性焦虑障碍 正念认知疗法 

分 类 号：R749.72[医药卫生—神经病学与精神病学]