正念干预起效机制的系统综述:基于多时间点测量的证据

A System Review of the Mechanism of Mindfulness Intervention:Evidence from Multiple Assessments

正念干预显著改善身心症状,然而正念机制研究方法严谨性不足。机制与效果应满足时间优先等准则。检验时间优先准则,须采用多时间点(≥3)测量的临床试验设计。本研究回顾多时间点测量的研究,发现正念水平的提升可能是正念干预起效的独特机制,情绪因素(如压力和担忧的减少)和认知因素(如自悯和积极重评的增加)可能是干预起效的其他机制。未来研究应基于明确的理论,采用操作化的方案,结合客观测量和神经生理指标,以更好地检验时间优先准则。这将有助于揭示正念起效的本质,提升干预效果。

Mindfulness-based interventions have efficacy on reducing physical and psychological symptoms.However,the research methods of mechanism of mindfulness-based interventions were not rigorous enough.A mechanism of psychological intervention should meet a serial of criteria,including"time priority"criteria.To examine the criteria of"time priority"between the mechanism and outcomes,researchers should design clinical trials consisting of multiple assessments(time points≥3)on mechanism and outcomes.The present study reviewed previous studies using multiple assessments,and found that improvements on mindfulness levels might be the specific mediator that explained the mechanism of mindfulness-based interventions.Moreover,emotional factors(e.g.reduction of stress and worry)and cognitive factors(e.g.improvements on self-compassion and positive reappraisal)might also be potential mediators.Future study should be established on theoretical basis,use operationalized mindfulness intervention protocols and combine the objective measurements and neurophysiological indexes,to better examine the criteria of"time priority"between the mechanism and outcomes.Investigating the process that leads to therapeutic change will help to characterize the nature of mechanism of mindfulness-based interventions,so as to improve the effectiveness of mindfulness-based interventions.