Table_4_Psychological Flexibility in Depression Relapse Prevention: Processes of Change and Positive Mental Health in Group-Based ACT for Residual Symptoms.DOCX

Relapse rates following a depressive episode are high, with limited treatments available aimed at reducing such risk. Acceptance and commitment therapy (ACT) is a cognitive-behavioral approach that has gained increased empirical support in treatment of depression, and thus represents an alternative in relapse prevention. Psychological flexibility (PF) plays an important role in mental health according to the model on which ACT is based. This study aimed to investigate the role of PF and its subprocesses in reducing residual symptoms of depression and in improving positive mental health following an 8-week group-based ACT treatment. Adult participants (75.7% female) with a history of depression, but currently exhibiting residual symptoms (N = 106) completed measures before and after intervention, and at 6 and 12-month follow-up. A growth curve model showed that positive mental health increased over 12-months. Multilevel mediation modeling revealed that PF significantly mediated these changes as well as the reduction of depressive symptoms, and that processes of acceptance, cognitive defusion, values and committed action, in turn, mediated increased PF.

抑郁发作后的复燃率居高不下，而旨在降低此类风险的疗法却为数有限。接受与承诺疗法（ACT）作为一种认知行为治疗方法，在抑郁症的治疗中获得了越来越多的实证支持，因此成为预防复燃的替代方案。根据ACT所基于的理论模型，心理灵活性（PF）在心理健康领域扮演着至关重要的角色。本研究旨在探讨PF及其子过程在减少抑郁残留症状以及改善8周小组式ACT治疗后的积极心理健康方面的作用。患有抑郁症病史但当前表现出残留症状的成年参与者（女性占比75.7%，共106人）在干预前后，以及6个月和12个月的随访中完成了测量。增长曲线模型显示，积极心理健康在12个月内有所提升。多层次中介模型揭示了PF显著中介了这些变化以及抑郁症状的减少，并且接纳、认知解离、价值观和承诺行动的过程反过来又中介了PF的提升。