Viabilidade e efeitos de uma intervenção baseada na terapia de aceitação e compromisso (ACT) para redução do estresse em universitários

Abstract

This dissertation addresses stress in university students and its relationship with psychological inflexibility. At first, a contextualization of the project and important theoretical questions that justify the relevance of this study are presented. Prevalence data on stress, stressors and psychopathologies pointed out in the literature in relation to undergraduate students and the models of mental health programs that have been implemented in universities are indicated, with emphasis on those based on mindfulness and acceptance. Acceptance and Commitment Therapy is the theoretical basis of this study, being a contextual behavioural therapy that works to reduce psychological inflexibility and promote psychological flexibility. Thus, the main concepts of this approach and their relationship with mental health in university students are also presented in the theoretical context. The main goal of this dissertation is to evaluate the feasibility and effects of an intervention based on Acceptance and Commitment Therapy to reduce stress in university students. For such, this research was divided into two complementary studies. Study 1 (paper 1) aimed to map symptoms of stress, anxiety, depression, psychological inflexibility and the relationship between these variables in university students from Rio Grande do Sul. This study had a quantitative, cross-sectional, exploratory design. It was relevant to investigate mental health issues that foster the importance of interventions with this population, including the program developed in this dissertation. Study 2 (papers 2, 3 and 4) aimed to evaluate the feasibility and effects of the intervention, entitled "Program for stress reduction in university students". This is a mixed, longitudinal study with pre and post-intervention analyses, time series and qualitative analyses. To respond to the research problems, the dissertation unfolds into four papers. Among the main results, the following stand out: The prevalence study (Study 1), had the participation of 574 students, aged 18 years and older, from different courses and universities, 357 from graduation

and 217 from graduate school. Stress, anxiety and depression levels were considered high in this sample (stress: 13,2%, high level, depression: 14,6% severe extreme level and anxiety: 18.1% severe extreme). Significant and positive correlations of psychological inflexibility were found with intensities classified as moderate of the aforementioned symptoms (0,400≤r<0,700). In addition, psychological inflexibility was significant to explain perceived stress (bp= 0,422; p<0,001; R2p=0,176). In study 2 (paper 2, 3 and 4), the following results stand out: 44 undergraduate students started the study, 21 of which completed the program. Perceived stress (p=0,017) and psychological inflexibility related to the academic context (p<0,01) showed a significant decrease after the intervention. The dropout rate was 52,3%, and the highest chance of withdrawal was explained by the presence of depression symptoms [OR: 1,185; IC95%: 1,018 – 1,380; p=0,029]. The students who completed the study reported a positive and useful experience in different aspects of life and considered it feasible to intervene in this format for undergraduate students. Thus, the program based on Acceptance and Commitment Therapy to reduce stress in university students proved to be a viable form of intervention for mental health of university students and showed positive effects in relation to decreased stress and psychological inflexibility.