背景:简短的正念生态瞬时干预(EMIs)改善同理心和心理理论的效用尚未得到充分研究,特别是广泛性焦虑症(GAD)。
目的:在这项随机对照试验中,我们的目的是检查14天的疗效,完全自我引导,正念EMI对GAD的移情和心理理论领域的影响。
方法:诊断为GAD的成年人(年龄≥18岁)随机分为正念EMI(68/110,61.8%)或自我监测应用(42/110,38.2%)。他们在预随机化时完成了人际反应指数自我报告移情测量和心理理论测试(Bell-Lysaker情绪识别任务),干预后,和1个月随访(1MFU)时间点。采用意向治疗原则进行分层线性建模,以确定干预后(干预前)的前随机化和1MFU(1MFU前)的变化。将正念EMI与自我监测进行比较。
结果:从1MFU前观察到的效果通常强于干预后的时间点。从干预前的时间点开始,正念EMI比幻想中的自我监测应用程序更有效(想象在他人中的能力;干预间效应大小:Cohend=0.26,P=.007;干预内效应大小:正念EMI的Cohend=0.22,P=.02,自我监测应用程序的Cohend=-0.16,P=.10)。从1MFU之前的时间点开始,正念EMI,但不是自我监控应用程序,改进的心理理论(通过抽象,了解他人思想和意图的窗口,关于他们精神状态的命题知识,包含破译社交线索的能力)和幻想,个人痛苦(目睹他人负面经历时的压力),和透视(理解他人的视角)移情领域。从1MFU前的时间点开始,干预之间的显着效应大小为小到中等(Cohend=0.15-0.36;P<.001至P=.01)。此外,在1个MFU前的时间点,正念EMI(Cohend=0.30-0.43;P<.001~P=.03)的干预内效应大小比自我监测应用(Cohend=-0.12~0.21;P=.001~P>.99)更强.对移情关注没有干预间和干预内的影响(感觉感情,同情,在观察别人处于困境时关心,主要关注他们的情绪健康)从干预前和1MFU前的时间点观察到。
结论:简短的正念EMI改善了移情的特定领域(例如,幻想,个人困扰,和透视)和心理理论在GAD患者中具有小到中等的效应大小。更高强度,自我指导或教练协助,针对社会关系优化的多组分正念EMIs对于改善该人群的共情关注领域可能是必要的。
背景:ClinicalTrials.govNCT04846777;https://clinicaltrials.gov/study/NCT04846777。
BACKGROUND: The utility of brief mindfulness ecological momentary interventions (EMIs) to improve empathy and theory-of-mind has been underinvestigated, particularly in generalized anxiety disorder (GAD).
OBJECTIVE: In this randomized controlled trial, we aimed to examine the efficacy of a 14-day, fully self-guided, mindfulness EMI on the empathy and theory-of-mind domains for GAD.
METHODS: Adults (aged ≥18 y) diagnosed with GAD were randomized to a mindfulness EMI (68/110, 61.8%) or self-monitoring app (42/110, 38.2%) arm. They completed the Interpersonal Reactivity Index self-report empathy measure and theory-of-mind test (Bell-Lysaker Emotion Recognition Task) at prerandomization, postintervention, and 1-month follow-up (1MFU) time points. Hierarchical linear modeling was conducted with the intent-to-treat principle to determine prerandomization to postintervention (pre-post intervention) and prerandomization to 1MFU (pre-1MFU) changes, comparing the mindfulness EMI to self-monitoring.
RESULTS: Observed effects were generally stronger from pre-1MFU than from pre-post intervention time points. From pre-post intervention time points, the mindfulness EMI was more efficacious than the self-monitoring app on fantasy (the ability to imagine being in others\' shoes; between-intervention effect size: Cohen d=0.26, P=.007; within-intervention effect size: Cohen d=0.22, P=.02 for the mindfulness EMI and Cohen d=-0.16, P=.10 for the self-monitoring app). From pre-1MFU time points, the mindfulness EMI, but not the self-monitoring app, improved theory-of-mind (a window into others\' thoughts and intentions through abstract, propositional knowledge about their mental states, encompassing the ability to decipher social cues) and the fantasy, personal distress (stress when witnessing others\' negative experiences), and perspective-taking (understanding others\' perspective) empathy domains. The effect sizes were small to moderate (Cohen d=0.15-0.36; P<.001 to P=.01) for significant between-intervention effects from pre-1MFU time points. Furthermore, the within-intervention effect sizes for these significant outcomes were stronger for the mindfulness EMI (Cohen d=0.30-0.43; P<.001 to P=.03) than the self-monitoring app (Cohen d=-0.12 to 0.21; P=.001 to P>.99) from pre-1MFU time points. No between-intervention and within-intervention effects on empathic concern (feeling affection, compassion, and care when observing others in distress, primarily attending to their emotional well-being) were observed from pre-post intervention and pre-1MFU time points.
CONCLUSIONS: The brief mindfulness EMI improved specific domains of empathy (eg, fantasy, personal distress, and perspective-taking) and theory-of-mind with small to moderate effect sizes in persons with GAD. Higher-intensity, self-guided or coach-facilitated, multicomponent mindfulness EMIs targeting the optimization of social relationships are likely necessary to improve the empathic concern domain in this population.
BACKGROUND: ClinicalTrials.gov NCT04846777; https://clinicaltrials.gov/study/NCT04846777.