ISSN 0439-755X
CN 11-1911/B
主办:中国心理学会
   中国科学院心理研究所
出版:科学出版社

心理学报 ›› 2018, Vol. 50 ›› Issue (3): 283-305.doi: 10.3724/SP.J.1041.2018.00283

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 正念冥想对焦虑症状的干预: 效果及其影响因素元分析

 任志洪1,2;  张雅文1,3;  江光荣4   

  1.  (1福州大学人文社会科学学院应用心理学系, 福州 350108) (2 Department of Counseling Psychology, University of Wisconsin-Madison, Wisconsin 53704, USA) (3北京大学医学人文研究院医学心理系, 北京 100191) (4青少年网络心理与行为教育部重点实验室, 华中师范大学心理学院, 湖北省人的发展与心理健康重点实验室, 武汉 430079)
  • 收稿日期:2017-03-29 出版日期:2018-03-25 发布日期:2018-02-01
  • 通讯作者: 江光荣, E-mail: grjiang@yeah.net E-mail:E-mail: grjiang@yeah.net
  • 基金资助:
     国家社科基金项目(16CSH051)资助。

 Effectiveness of mindfulness meditation in intervention for anxiety: A meta-analysis

 REN Zhihong1,2; Zhang Yawen1,3; JIANG Guangrong4   

  1.  (1 School of Humanities and Social Sciences, Fuzhou University, Fuzhou 350108, China) (2 Department of Counseling Psychology, University of Wisconsin-Madison, Wisconsin 53704, USA) (3 Institute of Medical Humanities, Peking University, Beijing 100191, China) (4 Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education; School of Psychology, Central China Normal University; Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan 430079, China)
  • Received:2017-03-29 Online:2018-03-25 Published:2018-02-01
  • Contact: JIANG Guangrong, E-mail: grjiang@yeah.net E-mail:E-mail: grjiang@yeah.net
  • Supported by:
     

摘要:  正念冥想对焦虑的干预效果结论不一, 系统考察其干预效果及影响因素, 有助于理解其作用机制, 并为正念冥想干预焦虑提供实践指导。本研究遵循PRISMA-Protocol, 运用元分析技术, 以即时效果与追踪效果为结果变量, 考察被试特征、干预特征、研究特征和结果分析4个方面(11个变量)的调节作用。通过数据库检索与筛选, 最终纳入东西方国家实证研究共55项(68个独立效应量, 4595名被试)。结果发现:正念冥想对焦虑干预的整体即时效果量达到显著的中等到大效果(g = 0.60), 但追踪效果不显著。单因素回归模型分析表明, 研究质量、国家地域、年龄、干预形式(团体练习vs.个体练习)、家庭练习与脱落率显著调节干预即时效果, 其中国家地域变量对效果量影响程度最大; 多元回归分析显示, 对照组类型、国家地域、练习经验、数据分析方式(ITT vs. PP)对干预效果存在调节作用; 此外, 国家地域与其他变量存在交互作用。后续研究需在研究质量、成本效益、不同焦虑类型及其他调节变量和提供客观评价指标上作改进。

关键词: 正念冥想, 焦虑, 干预, 调节作用, 文化差异, 元分析

Abstract:  Mindfulness meditation (MM) has enjoyed a growing popularity in healthcare in recent years when bio-psycho-social approaches are becoming more and more emphasized in modern medicine. There has been mounting empirical evidence showing MM’s significant effectiveness in alleviating anxiety for both nonclinical and clinical populations. However, the effect size of the available empirical investigation results has remained inconsistent and possible moderators have yet to be explored comprehensively. In order to determine the immediate and long-term efficacy of MM in overcoming anxiety, we conducted a meta-analysis based on a systematic and comprehensive review of the published studies on mindfulness-based interventions for anxiety. We also examined whether some characteristics of research participants (e.g. age, geographic areas) and interventions (e.g. format, duration, at-home practice), and specifics of the study (i.e. types of control, quality of the study) and data analysis (e.g. attrition rate) moderate the magnitude of the effectiveness of MM interventions (11variables). The review was performed following the rigorous PRISMA Protocol. Published studies using randomized controlled trial were selected from major databases worldwide to include investigations conducted in both Western and Eastern countries. Databases used include VIP Journal Integration Platform, Wan fang, China National Knowledge Infrastructure, Scopus, Web of Science, Embase, the Cochrane Library, and PubMed. Keywords used are mindfulness, meditation, MBSR, MBCT, anxi*, mood, intervention, therapy, program. Using the random effect model, we pooled the effect size (Hedge’s g), and conducted a publication bias evaluation, a moderating effect analysis and an interaction analysis in CMA 3.3. Results of our analyses revealed fifty-five RCTs from both Eastern and Western countries (k = 68 samples, N = 4595 participants). Mindfulness meditation for treating anxiety is shown to be efficacious with a medium to large immediate effect (g = 0.60), but the effect is not reliably shown at follow-up assessments. The post-heterogeneity test result suggests that using the random effect model is reasonable. Univariate meta-regression analysis yielded that study quality, geographic areas, participants’ age, intervention format (Group vs. Individual), amount of at-home practice, and attrition rate shown in data analysis remarkably influenced the effect size of MM’s immediate effect, while types of control, health condition, mindfulness practice experience, intervention duration, or statistical analysis methods used (ITT vs. PP) did not appear to moderate MM’s immediate effectiveness for reducing anxiety. Additionally, geographic areas affect the effect size the most. Multiple meta-regression models suggested that type of control and geographic areas, as well as statistical analysis methods significantly moderate the effect size of intervention effectiveness. Overall, the study results demonstrated high immediate effect of mindfulness-based practices for alleviating anxiety, but the effect did not seem to last. In addition, geographic area turns out to be the strongest moderator, and practitioners in the East seem to benefit more than those who are in the West. Study quality, participants’ age, mindfulness practice experience, intervention format, at-home practice quantity and attrition rate also affect the effect size to a certain extent. Future research is warranted to improve methodological quality of outcome studies, to provide more clear and replicable evidence of MM efficacy, and to explore more underlying moderators for the intervention effect size, such as participant satisfaction and so forth.

Key words: mindfulness meditation, anxiety, intervention, moderating effect, cultural differences, meta-analysis

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