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认知解离及其应用研究
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Abstract:
认知解离是接纳承诺疗法中用于改变语境中的事件对个体认知、情绪和行为等影响的治疗技术。对认知解离及其应用的分析发现：需要从认知融合来更深入理解认知解离；认知解离的疗愈机制是将认知的字面意义与其不良功能分离开来，改变语言对个体的僵化影响；认知解离运用的准备条件为认知解离原理的介绍；认知解离步骤包括注意、命名和中和三步；认知解离有暴露、替代反应差异强化和引入语境线索三种类型；认知解离与认知重建和正念训练等要区别运用。未来可以进一步完善与六类认知融合对应的六类认知解离的研究，开展多种认知解离技术联合使用和认知解离技术与其他技术的联合使用的研究，推进认知解离的神经机制研究。
Cognitive defusionis a therapeutic technique used in acceptance and commitment therapy to change the impact of events in context on individual cognition, emotions, and behavior. The analysis of cognitive defusion and its application reveals that it requires a deeper understanding of cognitive defusion through cognitive fusion. The healing mechanism of cognitive defusion is to separate the literal meaning of cognition from its negative functions, and to change the rigid impact of language on individuals. The preparation condition for the application of cognitive defusion is the introduction of the principle of cognitive defusion. The three steps of cognitive defusion include: notice, naming, and neutralizing. The three types of cognitive defusion include: exposure, differential reinforcement of alternative responses, and introduction of contextual cue. Cognitive defusion should be used differently from cognitive reappraisal and mindfulness training. In the future, research on the six types of cognitive defusion corresponding to the six types of cognitive fusion and the combined use of cognitive defusion techniques with other technologies can be further improved, and the research on the neural mechanisms underlying cognitive defusion can be advanced.
| [1] | 段文杰(2014). 正念研究的分歧: 概念与测量. 心理科学进展, 22(10), 1616-1627. |
| [2] | 任志洪, 赵春晓, 卞诚, 朱文臻, 江光荣, 祝卓宏(2019). 接纳承诺疗法的作用机制——基于元分析结构方程模型. 心理学报, 51(6), 662-676. |
| [3] | 孙立阳, 刘健, 唐文新, 朱丞, 徐莲莲, 赵侠(2022). 强迫症患者的病情程度与源检测能力、认知融合、正念的关系. 中国心理卫生杂志, 36(5), 397-403. |
| [4] | 曾祥龙, 刘翔平, 于是(2011). 接纳与承诺疗法的理论背景、实证研究与未来发展. 心理科学进展, 19(7), 1020-1026. |
| [5] | 张婍, 王淑娟, 祝卓宏(2012). 接纳与承诺疗法的心理病理模型和治疗模式. 中国心理卫生杂志, 26(5), 377-381. |
| [6] | 祖泽元, 方美欣, 吴思衡, 刘静怡, 刘电芝(2023). 接纳承诺疗法对孤独症儿童母亲情绪、认知、行为的改善——基于解释现象学研究. 中国临床心理学杂志, 31(6), 1501-1509. |
| [7] | Arch, J. J., Eifert, G. H., Davies, C., Vilardaga, J. C. P., Rose, R. D., & Craske, M. G. (2012). Randomized Clinical Trial of Cognitive Behavioral Therapy (CBT) versus Acceptance and Commitment Therapy (ACT) for Mixed Anxiety Disorders. Journal of Consulting and Clinical Psychology, 80, 750-765. https://doi.org/10.1037/a0028310 |
| [8] | Assaz, D. A., Roche, B., Kanter, J. W., & Oshiro, C. K. B. (2018). Cognitive Defusion in Acceptance and Commitment Therapy: What Are the Basic Processes of Change? The Psychological Record, 68, 405-418. https://doi.org/10.1007/s40732-017-0254-z |
| [9] | Bernstein, A., Hadash, Y., Lichtash, Y., Tanay, G., Shepherd, K., & Fresco, D. M. (2015). Decentering and Related Constructs: A Critical Review and Metacognitive Processes Model. Perspectives on Psychological Science, 10, 599-617. https://doi.org/10.1177/1745691615594577 |
| [10] | Blackledge, J. T. (2007). Disrupting Verbal Processes: Cognitive Defusion in Acceptance and Commitment Therapy and Other Mindfulness-Based Psychotherapies. Psychological Record, 57, 555-576. https://doi.org/10.1007/BF03395595 |
| [11] | Blackledge, J. T. (2015). Cognitive Defusion in Practice: A Clinician’s Guide to Assessing, Observing, and Supporting Change in Your Client. New Harbinger Publications. |
| [12] | Brown, K. J., Gonsalvez, C. J., Harris, A. W., Williams, L. M., & Gordon, E. (2002). Target and Non-Target ERP Disturbances in First Episode vs. Chronic Schizophrenia. Clinical Neurophysiology, 113, 1754-1763. https://doi.org/10.1016/S1388-2457(02)00290-0 |
| [13] | Clark, D. A. (2013). Cognitive Restructuring. In The Wiley Handbook of Cognitive Behavioral Therapy. Wiley. https://doi.org/10.1002/9781118528563.wbcbt02 |
| [14] | Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing Exposure Therapy: An Inhibitory Learning Approach. Behaviour Research and Therapy, 58, 10-23. https://doi.org/10.1016/j.brat.2014.04.006 |
| [15] | Cullen, C. (2008). Acceptance and Commitment Therapy (ACT): A Third Wave Behaviour Therapy. Behavioural and Cognitive Psychotherapy, 36, 667-673. https://doi.org/10.1017/S1352465808004797 |
| [16] | De Young, K. P., Lavender, J. M., Washington, L. A., Looby, A., & Anderson, D. A. (2010). A Controlled Comparison of the Word Repeating Technique with a Word Association Task. Journal of Behavior Therapy and Experimental Psychiatry, 41, 426-432. https://doi.org/10.1016/j.jbtep.2010.04.006 |
| [17] | Deacon, B. J., Fawzy, T. I., Lickel, J. J., & Wolitzky-Taylor, K. B. (2011). Cognitive Defusion versus Cognitive Restructuring in the Treatment of Negative Self-Referential Thoughts: An Investigation of Process and Outcome. Journal of Cognitive Psychotherapy, 25, 218-232. https://doi.org/10.1891/0889-8391.25.3.218 |
| [18] | Harris, R. (2009). ACT Made Simple: An Easy-to-Read Primer on Acceptance and Commitment Therapy (Professional). New Harbinger Publications. |
| [19] | Hayes, S. C. (2004). Acceptance and Commitment Therapy, Relational Frame Theory, and the Third Wave of Behavioral and Cognitive Therapies. Behavior Therapy, 35, 639-665. https://doi.org/10.1016/S0005-7894(04)80013-3 |
| [20] | Hayes, S. C., & Strosahl, K. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change (2nd ed.). Guilford Press. |
| [21] | Hayes, S. C., Barnes-Holmes, D., & Wilson, K. G. (2012). Contextual Behavioral Science: Creating a Science More Adequate to the Challenge of the Human Condition. Journal of Contextual Behavioral Science, 1, 1-16. https://doi.org/10.1016/j.jcbs.2012.09.004 |
| [22] | Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and Commitment Therapy: Model, Processes and Outcomes. Behaviour Research and Therapy, 44, 1-25. https://doi.org/10.1016/j.brat.2005.06.006 |
| [23] | Healy, H., Barnes-Holmes, Y., Barnes-Holmes, D., Keogh, C., Luciano, C., & Wilson, K. (2008). An Experimental Test of Cognitive Defusion Exercise: Coping with Negative and Positive Self-Statements. The Psychological Record, 58, 623-640. https://doi.org/10.1007/BF03395641 |
| [24] | Hellberg, S. N., Buchholz, J. L., & Twohig. (2020). Not Just Thinking, Butbelieving: Obsessive Beliefs and Domains of Cognitive Fusion in the Prediction of OCD Symptom Dimensions. Clinical Psychology & Psychotherapy, 27, 69-78. https://doi.org/10.1002/cpp.2409 |
| [25] | Hinojosa-Aguayo, I., & Gonzalez, F. (2022). Cognitive Defusion as Strategy to Reduce the Intensity of Craving Episodes and Improve Eating Behavior. Spanish Journal of Psychology, 25, e1. https://doi.org/10.1017/SJP.2021.47 |
| [26] | Hinton, M. J., & Gaynor, S. T. (2010). Cognitive Defusion for Psychological Distress, Dysphoria, and Low Self-Esteem: A Randomized Technique Evaluation Trial of Vocalizing Strategies. International Journal of Behavioral Consultation and Therapy, 6, 164-185. https://doi.org/10.1037/h0100906 |
| [27] | Holzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How Does Mindfulness Meditation Work? Proposing Mechanisms of Action from a Conceptual and Neural Perspective. Perspectives on Psychological Science, 6, 537-559. https://doi.org/10.1177/1745691611419671 |
| [28] | Hooper, N., & McHugh, L. (2013). Cognitive Defusion versus Thought Distraction in the Mitigation of Learned Helplessness. Psychological Record, 63, 209-217. https://doi.org/10.11133/j.tpr.2013.63.1.016 |
| [29] | Ito, D., Watanabe, A., & Osawa, K. (2023). Mindful Attention Awareness and Cognitive Defusion Are Indirectly Associated with Less PTSD-Like Symptoms via Reduced Maladaptive Posttraumatic Cognitions and Avoidance Coping. Current Psychology, 42, 1182-1192. https://doi.org/10.1007/s12144-021-01521-0 |
| [30] | Kabat-Zinn, J. (2003). Mindfulness-Based Interventions in Context: Past, Present, and Future. Clinical Psychology, 10, 144-156. https://doi.org/10.1093/clipsy.bpg016 |
| [31] | Krafft, J., Klimczak, K. S., & Levin, M. E. (2022). Effects of Cognitive Restructuring and Defusion for Coping with Difficult Thoughts in a predominantly White Female College Student Sample. Cognitive Therapy and Research, 46, 86-94. https://doi.org/10.1007/s10608-021-10242-4 |
| [32] | Larsson, A., Hooper, N., Osborne, L. A., Bennett, P., & McHugh, L. (2016). Using Brief Cognitive Restructuring and Cognitive Defusion Techniques to Cope with Negative Thoughts. Behavior Modification, 40, 452-482. https://doi.org/10.1177/0145445515621488 |
| [33] | Lavelle, J., Dunne, N., Mulcahy, H. E., & McHugh, L. (2022). Chatbot-Delivered Cognitive Defusion versus Cognitive Restructuring for Negative Self-Referential Thoughts: A Pilot Study. The Psychological Record, 72, 247-261. https://doi.org/10.1007/s40732-021-00478-7 |
| [34] | Levin, M. E., Haeger, J., An, W., & Twohig, M. P. (2018). Comparing Cognitive Defusion and Cognitive Restructuring Delivered through a Mobile App for Individuals High in Self-Criticism. Cognitive Therapy and Research, 42, 844-855. https://doi.org/10.1007/s10608-018-9944-3 |
| [35] | Levin, M. E., Hildebrandt, M. J., Lillis, J., & Hayes, S. C. (2012). The Impact of Treatment Components Suggested by the Psychological Flexibility Model: A Meta-Analysis of Laboratory-Based Component Studies. Behavior Therapy, 43, 741-756. https://doi.org/10.1016/j.beth.2012.05.003 |
| [36] | Masuda, A., Hayes, S. C., Sackett, C. F., & Twohig, M. P. (2004). Cognitive Defusion and Self-Relevant Negative Thoughts: Examining the Impact of a Ninety Year Old Technique. Behaviour Research and Therapy, 42, 477-485. https://doi.org/10.1016/j.brat.2003.10.008 |
| [37] | Masuda, A., Twohig, M. P., Stormo, A. R., Feinstein, A. B., Chou, Y., & Wendell, J. W. (2010). The Effects of Cognitive Defusion and Thought Distraction on Emotional Discomfort and Believability of Negative Self-Referential Thoughts. Journal of Behavior Therapy and Experimental Psychiatry, 41, 11-17. https://doi.org/10.1016/j.jbtep.2009.08.006 |
| [38] | Mischkowski, D., Kross, E., & Bushman, B. J. (2012). Flies on the Wall Are Less Aggressive: Self-Distancing “In the Heat of the Moment” Reduces Aggressive Thoughts, Angry Feelings and Aggressive Behavior. Journal of Experimental Social Psychology, 48, 1187-1191. https://doi.org/10.1016/j.jesp.2012.03.012 |
| [39] | Moffitt, R., Brinkworth, G., Noakes, M., & Mohr, P. (2012). A Comparison of Cognitive Restructuring and Cognitive Defusion as Strategies for Resisting a Craved Food. Psychology and Health, 27, 74-90. https://doi.org/10.1080/08870446.2012.694436 |
| [40] | Nitzan-Assayag, Y., Aderka, I. M., & Bernstein, A. (2015). Dispositional Mindfulness in Trauma Recovery: Prospective Relations and Mediating Mechanisms. Journal of Anxiety Disorders, 36, 25-32. https://doi.org/10.1016/j.janxdis.2015.07.008 |
| [41] | Nitzan-Assayag, Y., Yuval, K., Tanay, G., Aderka, I. M., Vujanovic, A. A., Litz, B., & Bernstein, A. (2017). Reduced Reactivity to and Suppression of Thoughts Mediate the Effects of Mindfulness Training on Recovery Outcomes Following Exposure to Potentially Traumatic Stress. Mindfulness, 8, 920-932. https://doi.org/10.1007/s12671-016-0666-x |
| [42] | Pilecki, B. C., & McKay, D. (2012). An Experimental Investigation of Cognitive Defusion. Psychological Record, 62, 19-40. https://doi.org/10.1007/BF03395784 |
| [43] | Reuman, L., Buchholz, J., Blakey, S., & Abramowitz, J. S. (2017). Uncertain and Fused: Cognitive Fusion, Thought-Action Fusion, and the Intolerance of Uncertaintyas Predictors of Obsessive-Compulsive Symptom Dimensions. Journal of Cognitive Psychotherapy, 31, 191-203. https://doi.org/10.1891/0889-8391.31.3.191 |
| [44] | Yovel, I., Mor, N., & Shakarov, H. (2014). Examination of the Core Cognitive Components of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy: An Analogue Investigation. Behavior Therapy, 45, 482-494. https://doi.org/10.1016/j.beth.2014.02.007 |
