社会与工程心理学研究室知识库

以真实动作方法为代表的舞蹈治疗和以习练规定动作为主的舞蹈动作类干预都能减轻抑郁症患者的抑郁症状。舞蹈治疗在舞蹈本身激发活力、传达美感的基础上，更强调对潜意识内容的发掘转化、基于创造性过程的身心整合以及具身治疗关系的作用，这可能是舞蹈治疗相对于舞蹈动作类干预而言对心理健康改善效果更稳定的原因。真实动作是舞蹈治疗最经典的方法之一，通过关注身体感受、发展自我意识来释放和处理潜意识内容，借由即兴发挥的自由舞动来创造性地整合身体感受、情绪与思维，适用于高功能抑郁症患者的心理治疗与个人成长，但在其对舞动带领人的整体要求和总体实施难度上高于单纯的舞蹈动作类干预。过往研究表明单次无目标即兴动作与有目标动作都有助于大学生参与者减轻压力感知、提升幸福感、增强身体自我效能感，而无目标即兴动作比有目标动作的效果更显著。但在临床环境中，尚未有研究直接比较舞蹈治疗与舞蹈动作类干预在疗效上的差异。本研究梳理了真实动作的理论机制，考察了接近舞蹈治疗的真实动作和接近舞蹈动作类干预的规定动作对抑郁患者心理状态的不同影响，并依据 具身审美理论模型对造成二者影响差异的作用过程展开初步探索。通过回顾正念意义理论等有关内感受在压力产生、调控中所起作用的阐释，推断内感受性知觉的改善可能是真实动作相较于规定动作更有助于减轻压力感知的关键之一。

在综合医院精神科门诊招募26名抑郁患者按照随机区组分为实验组与对照组，每组13例。基于舞蹈治疗方法，实验组实施单次真实动作干预，对照组实施单次规定动作干预。干预前后采用压力感知量表、海德堡状态问卷、身体自我效能感量表以及内感受性知觉多维评估量表中的注意分量表、注意调节分量表和信任分量表对两组进行测评。结果表明相较于前测，实验组后测的压力感知显著改善，幸福感显著提高，内感受性知觉显著增强，身体自我效能感变化不显著;对照组压力感知显著改善，幸福感显著提高，内感受性知觉与身体自我效能感变化不显著。实验组相较于对照组，压力感知与内感受性知觉的改善更显著。并且，内感受性知觉完全中介了动作方式(真实动作相较于规定动作)对压力感知的影响。

结论:单次真实动作与规定动作均能帮助抑郁患者减轻压力感知、提升幸福感;真实动作相较于规定动作对于抑郁患者压力感知、内感受性知觉的改善更显著;内感受性知觉的中介作用可能是真实动作相较于规定动作更有利于抑郁患者减轻压力感知的重要作用机制。

Both dance/movement therapy represented by authentic movement, and dance movement intervention mainly practicing compulsory movement can reduce depressive symptoms in patients with depression. In addition to vitality stimulation and aesthetic communication which can be realized by dance per se, dance/movement therapy put more emphasis on the discovery and transformation of subconscious content, the integration of body and mind based on creative process, and the role of embodied therapeutic relationship. This may be the reason why dance/movement therapy produces more consistent positive effect than dance movement intervention does on mental health improvement. Authentic movement is one of the most classic methods of dance/movement therapy. It releases and processes subconscious content by paying attention to body sensations and developing self-awareness, creatively integrates the physical self, emotional self, and thinking self through improvisational movement, and is appropriate for application in psychotherapy and personal growth of high-functioning patients with depression. However, its overall requirements for therapists and difficulty of implementation are higher than those of pure dance movement intervention. Previous studies have shown that both a single intervention of non-goal-directed improvisational dance movement and a single intervention of goal-directed dance movement can help college participants reduce perceived stress, improve well-being and enhance body self-efficacy, while non-goal-directed dance movement has a more significant effect than goal-directed dance movement. Nevertheless, researchers have not directly compared the different therapeutic effects of dance/movement therapy and dance movement intervention in a clinical setting. This study synthesizes the theoretical mechanisms of authentic movement, examines the different effects of authentic movement experience as an example of dance/movement therapy and compulsory movement experience as an example of dance movement intervention on the mental state of depressed patients, and conducts preliminary exploration of the two different processes based on the theory framework of embodied aesthetics. By reviewing the theoretical interpretations of the role of interoception in stress generation and regulation, such as mindfulness-to-meaning theory, it is deduced that the improvement of interoceptive awareness may be one of the key factors resulting in the fact that authentic movement is more effective than compulsory movement in reducing perceived stress.

Twenty-six outpatients with depression were recruited from the Psychiatry Department of a General Hospital, and then randomly assigned into either an experimental group or a control group. Each group consisted of 13 cases. The experimental group received a single authentic movement intervention. The control group received a single compulsory movement intervention. Before and after the intervention respectively, the participants completed the Chinese version of Perceived Stress Questionnaire, Heidelberg State Inventory, Body Self-Efficacy Scale as well as the Noticing Scale, Attention Regulation Scale and Trusting Scale of the Multidimensional Assessment of Interoceptive Awareness Version 2. After the intervention, a significant improvement on perceived stress, well-being, and interoceptive awareness were observed in the experimental group, but no significant change in body self-efficacy was registered there; while a significant improvement on perceived stress and well-being were observed in the control group, however, no significant change in interoceptive awareness or body self-efficacy was registered there. The experimental group improved more significantly in perceived stress and interoceptive awareness compared to the control group. Interoceptive awareness has completely mediated the effects of different movement styles (authentic movement versus compulsory movement) on the improvement of the participants' perceived stress.

Conclusion: A single intervention of authentic movement and a single intervention of compulsory movement can both improve the psychological state of depressed patients in terms of perceived stress and well-being. Authentic movement intervention is more effective than compulsory movement intervention in improving the perceived stress and interoceptive awareness of depressed patients. The mediation effect of interoceptive awareness may help explain the mechanism of why authentic movement intervention is more effective than compulsory movement intervention in alleviating perceived stress of psychiatric patients with depression.