健康焦虑的移动网络化解释偏向矫正: 一项随机对照试验

doi:10.3724/SP.J.1041.2024.01351

摘要/Abstract

摘要： 本研究旨在考察移动网络化解释偏向矫正(internet-based Cognitive Bias Modification-Interpretation, iCBM-I)对健康焦虑的干预效果、影响因素及灾难化解释在干预起效中的机制作用。采用随机对照试验, 将符合健康焦虑标准的被试(N = 228)随机分配到iCBM-I干预组(100%积极反馈, N = 76)、注意控制组(50%积极50%消极反馈, N = 76)以及等待组(N = 76)。干预组和注意控制组进行为期12天的在线任务训练, 等待组不做训练。在干预前、干预后及干预后一个月对被试的健康焦虑、灾难化解释、一般焦虑和抑郁进行测量。结果发现: 与等待组相比, iCBM-I干预对健康焦虑个体的灾难化解释、一般焦虑和抑郁症状存在显著的即时效果和一个月后的追踪效果; 基于潜在增长曲线模型的纵向中介检验显示, 相对于注意控制组, iCBM-I干预通过降低个体的灾难化解释进而改善健康焦虑。本研究为健康焦虑的网络化干预提供了新视角, 未来研究可以考虑联合“自上而下”和“自下而上”的干预方法, 以提高健康焦虑的干预效果。

关键词: 健康焦虑, 解释偏向矫正, 随机对照试验, 潜在增长曲线模型, 纵向中介

Abstract: Health anxiety, characterized by excessive fear and worry about one's health, is closely linked to interpretation bias as outlined in the comprehensive model of health anxiety. Research suggests that individuals with health anxiety often exhibit catastrophizing interpretations, and mitigating these interpretations can alleviate health anxiety symptoms. This study aims to examine the effects of internet-based cognitive bias modification of interpretation (iCBM-I) training on health anxiety, catastrophizing interpretation, anxiety, and depression symptoms. It also explores the longitudinal mediating mechanism of catastrophizing interpretation, providing insights for internet-based interventions for health anxiety.
In this randomized controlled trial, 228 participants with health anxiety (Short Health Anxiety Inventory [SHAI] scores ≥ 15) were randomly assigned to an iCBM-I group (100% positive feedback, N = 76), an attention control group (50% positive and 50% negative feedback, N = 76), or a wait-list control group (N = 76). Participants in the iCBM-I and attention control groups completed internet-based tasks over 12 days (one session every three days, totaling four sessions). Health anxiety, catastrophizing interpretation, anxiety, and depression were measured at pre-treatment, post-treatment, and a one-month follow-up to assess the immediate and long-term effects of the iCBM-I program.
The intent-to-treat principle was employed, and the generalized linear mixed model analyzed the intervention effects. Two-factor analysis of variance and hierarchical regression examined the moderating effects of demographic and baseline symptom variables. Additionally, the parallel development latent growth curve model analyzed the longitudinal mediating effect of catastrophizing interpretation.
Results indicated that the iCBM-I group with 100% positive feedback showed significant immediate effects on reducing catastrophizing interpretation, anxiety, and depression symptoms compared to the wait-list group. One-month follow-up results revealed significant effects on health anxiety, catastrophizing interpretation, anxiety, and depression. Marital status, baseline health anxiety symptoms, and catastrophizing interpretation moderated the iCBM-I intervention effects, with catastrophizing interpretation serving as a longitudinal mediator.
This study developed an iCBM-I self-help intervention mini-program for health anxiety, demonstrating its feasibility, efficacy, and psychological mechanisms. The findings provide empirical support for cognitive theories of emotion and offer a novel perspective for networked interventions in health anxiety. Future research should consider integrating “top-down” and “bottom-up” combined intervention therapies to further investigate their effects and mechanisms in health-anxious individuals.

Key words: health anxiety, cognitive bias modification of interpretation, randomized controlled trials, latent growth curve model, longitudinal mediation

中图分类号:

R395

杜夏雨, 赖丽足, 史从戎, 郭子涵, 韩菁, 张涛, 任志洪. (2024). 健康焦虑的移动网络化解释偏向矫正: 一项随机对照试验. 心理学报, 56(10), 1351-1366.

DU Xiayu, LAI Lizu, SHI Congrong, GUO Zihan, HAN Jing, ZHANG Tao, REN Zhihong. (2024). Internet-based cognitive bias modification of interpretation in health anxiety: A randomized controlled trial. Acta Psychologica Sinica, 56(10), 1351-1366.

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