接纳承诺疗法联合健康教育在首诊孤独症患儿父母心理治疗中的应用

Application of Acceptance Commitment Therapy Combined with Health Education In Psychotherapy For Parents of Children with Autism First Diagnosed

目的 探讨接纳承诺疗法对首诊孤独症患儿父母的心理干预效果。方法 首诊孤独症儿童父母60名随机分为干预组和对照组,对照组采用一般健康教育,干预组采用在一般健康教育基础加用接纳承诺疗法(ACT),两组前后复测症状自评量表(SCL-90)、抑郁自评量表(SDS)、焦虑自评量表(SAS)、一般自我效能感量表(GSES)、接纳行动问卷第二版(AAQ-II)、认知融合问卷(CFQ-F)进行效果评定。结果 (1)干预后干预组在SCL-90、SDS、SAS、AAQ-II、CFQ-F评分均低于对照组的评分,而干预组GSES评分又高于对照组的评分,差异有统计学意义(P<0.05);(2)干预组干预后在躯体化、强迫症状、人际关系、抑郁、焦虑、敌对、饮食和睡眠评分及SCL-90、SDS、SAS、AAQ-II、CFQ-F评分均低于ACT干预前评分(P<0.05),而GSES评分高于ACT干预前评分(P<0.05);(3)对照组干预前后在SCL-90各因子评分及SCL-90、SDS、SAS、GSES、AAQII、CFQ-F评分中均无统计学差异(P>0.05);(4)干预组的自我效能GSES与SAS、SDS呈负相关(P<0.05);(5)经验性回避(AAQ-II)、认知融合(CFQ-F)评分与SCL-90评分及各因子评分呈正相关(P<0.05)。结论 接纳承诺疗法干预后可以提高首诊孤独症患儿父母的心理韧性,增强处理生活中各种压力的能力,降低经验性回避和认知融合程度,整体优于常规心理健康宣教组。

Objective To investigate the psychological status of parents of children with autism at first diagnosis and its influencing factors,and to explore the effect of psychological intervention on parents of children with autism at first diagnosis. Methods A total of 60 parents of autistic children who were first diagnosed in the Third Hospital of Fuzhou,Jiangxi were randomly divided into the intervention group and the control group,SCL-90,SDS,SAS,GSES,AAQ-II and CFQ-F scales were retested before and after treatment. Results(1) The scores of SCL-90,SDS,SAS,AAQ-II and CFQ-F in the intervention group were lower than those in the control group,while the scores of GSES in the intervention group were higher than those in the control group(P< 0.05).(2) The scores of somatization,obsessive-compulsive symptoms,interpersonal relationship,depression,anxiety,hostility,diet and sleep,SCL-90,SDS,SAS,AAQ-II and CFQ-F in the intervention group were lower than those before ACT(P< 0.05),GSES scores were higher than those before ACT intervention(P< 0.05).(3) There was no significant difference in SCL-90,SDS,SAS,GSES,AAQ-II and CFQ-F scores before and after intervention in the control group(P> 0.05).(4)self-efficacy was negatively correlated with SAS and SDS in the experimental group(P< 0.05).(5) Empirical Avoidance and cognitive fusion were positively correlated with the total score of SCL-90 and various factors(P< 0.05).Conclusion Acceptance And Commitment therapy intervention can improve the psychological resilience of parents of first-diagnosed autistic children,enhance the ability to deal with various kinds of stress in life,and reduce the degree of experiential avoidance and cognitive fusion,overall,it was better than the routine mental health education group.