丧亲人群网络化心理干预效果的系统综述与元分析

doi:10.3724/SP.J.1042.2025.0256

摘要/Abstract

摘要： 网络化心理干预近年来逐渐应用于改善丧亲人群的心理健康状况, 系统考察其干预效果及其调节因素有助于指导临床实践。这项研究通过文献检索与筛选, 选取了47个丧亲人群网络化心理干预研究, 其中19项随机对照试验满足了元分析标准(N = 1222), 元分析共包括68个效应值。结果发现, 干预对总体心理健康的效应达到显著的中等水平(g = 0.54; 95% CI = [0.39, 0.70]); 具体而言, 干预对病理性哀伤(g = 0.56; 95% CI = [0.39, 0.74])、抑郁(g = 0.51; 95% CI = [0.36, 0.67])和创伤后应激(g = 0.63; 95% CI = [0.45, 0.81])症状的改善都达到显著的中等效果。在改善总体心理健康水平方面, 未使用意义建构、干预次数大于或等于10次和给予治疗反馈的网络化心理干预效果更好, 干预频率为一周多于一次的干预效果要好于一周一次。但是, 理论取向、干预过程中是否包含暴露练习、认知重构和行为激活的干预策略、是否设置提醒以及脱落率的高低均不存在调节作用。本研究说明网络化心理干预对改善丧亲人群的心理健康状况效果较为理想, 并且在不同条件下网络化心理干预具有不同的效果。

关键词: 丧亲, 网络化心理干预, 病理性哀伤, 创伤后应激障碍, 抑郁

Abstract: The death of the loved one is one of the important turning points of people's life. Although most people can recover from bereavement without professional help, a few bereaved people might experience a wide range of mental disorders, including depression, prolonged grief disorder, and posttraumatic stress disorder. The supply of traditional bereavement psychological services is far from meeting the demand of these people. In recent years, Internet-based interventions have gradually been applied to improve the mental health of bereaved people. They can provide therapy for more people, which may greatly ease the imbalance between supply and demand. Systematically investigating the effectiveness of Internet-based interventions for bereaved people and what will influence their effectiveness helps guide clinical practice. However, although there were two reviews on the effectiveness of internet-based intervention for bereaved people, they only relied on a small number of studies published before 2021. With a sudden upsurge in online psychotherapeutic intervention during the COVID-19 pandemic and the growing interest in psychotherapy research for internet-based interventions, more studies were published and needed to be included. In addition, the investigation of moderating effects on the effectiveness of internet-based interventions for bereaved people was still missing. Thus, this study conducted a systematic review and meta-analysis aims to examine the effectiveness of Internet-based mental-health interventions for bereaved people and explore whether the effectiveness was influenced by intervention theories, intervention strategies (the use of exposure, cognitive reappraisal, behavioral activation, or meaning reconstruction within the intervention), the number of sessions, frequency of session completion, therapeutic feedback, the reminder, and dropout rate.
Systematic searches were conducted in PubMed, PsycINFO, EMBASE, CINAHL, Scopus, Web of Science, CNKI (China National Knowledge Infrastructure), WFD (Wanfang Data), and Weipu database. Then, we searched reference lists and bibliographies of all included articles to ascertain articles not retrieved by the primary search. Comprehensive Meta-Analysis 3 was used for meta-analysis. Publication bias was assessed by funnel plots, Egger's regression test, and the trim and fill technique.
47 studies of Internet-based interventions for bereaved people were included in the systematic review through literature search and screening, of which 19 randomized controlled trials met the criteria of meta-analysis (N = 1222 participants). The meta-analysis included a total of 68 effect sizes. The results showed that the interventions had a significant moderate effect on mental health (g = 0.54; 95% CI = [0.39, 0.70]). Specifically, the interventions showed significant moderate effects for symptoms of pathologic grief (g = 0.56; 95% CI = [0.39, 0.74]), depression (g = 0.51; 95% CI = [0.36, 0.67]), and posttraumatic stress disorder (g = 0.63; 95% CI = [0.45, 0.81]). In terms of improving mental health, the effectiveness of Internet-based interventions for bereaved people was moderated by the use of meaning reconstruction, the number of sessions, frequency of session completion, and therapeutic feedback. Without using meaning reconstruction, having 10 sessions or more, and therapeutic feedback was associated with a larger effect of the Internet-based interventions, and contacting more than once a week showed a stronger effect than once a week. However, whether an intervention was based on cognitive behavior therapy, set reminders, had a high or low dropout rate, included exposure exercises, cognitive reconstruction, or behavioral activation had no moderating effect.
This study shows that Internet-based interventions have positive effects on improving the mental health of bereaved people and have different effects under different conditions. It supports that Internet-based interventions can be used as alternative options to face-to-face intervention for bereaved people to alleviate the problem of lacking bereavement service resources, which helps promote Internet-based interventions for bereaved people in clinical practice in China. Additionally, it provides directions for how to develop more effective Internet-based interventions for bereaved people in the future.

Key words: bereavement, Internet-based intervention, pathologic grief, posttraumatic stress disorder, depression

唐苏勤, 彭闻捷, 余茵琪, 符仲芳. (2025). 丧亲人群网络化心理干预效果的系统综述与元分析. 心理科学进展 , 33(2), 256-273.

TANG Suqin, PENG Wenjie, YU Yinqi, FU Zhongfang. (2025). The effectiveness of Internet-based interventions for bereaved people: A systematic review and meta-analysis. Advances in Psychological Science, 33(2), 256-273.

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