Effect and Mechanism of an ACT-Based Psychological Resilience Intervention Targeting Students Failing in Postgraduate Entrance Examinations in China: A Randomized Controlled Trial

Abstract

The postgraduate entrance examination frenzy is a widespread and intense phenomenon in China. As the number of students who failed the examination surged, the ensuing mental health problems became prominent. This study aimed to evaluate the effectiveness of an online ACT-based group resilience course, which incorporated the six core components of ACT and integrated elements of Chinese culture, in alleviating psychological distress among students who failed the examination. It also explored the mechanism by which the intervention affected changes in psychological distress. A total of 61 participants were randomly assigned to the intervention group (n = 31) and the control group (n = 30). They attended an 8-day group course, with 2-h sessions each day. The study outcomes were psychological distress, resilience, psychological flexibility (PF), and psychological inflexibility (PI). These outcomes were measured at baseline, post-intervention, and 1-month follow-up. Linear mixed models (LMMs) showed significant group × time interactions for all outcome variables, except for stress, which showed a marginally significant interaction. Post hoc analyses revealed significant improvements in depression, resilience, and PF at both post-intervention and at the 1-month follow-up. Additionally, significant reductions in anxiety and a marginally significant reduction in stress were observed at the 1-month follow-up. However, no significant reduction was found in PI. The multiple mediation model showed that the intervention improved psychological distress by increasing resilience and PF. These findings suggest that online resilience group intervention is generally effective in enhancing resilience and alleviating psychological distress and is acceptable to students who have failed the postgraduate entrance examination, as evidenced by high participant engagement and satisfaction.

Keywords: acceptance and commitment therapy; online intervention; psychological distress; psychological resilience.