社交焦虑障碍P300研究及自信心团体心理干预的效果探讨

发布时间：2018-07-03 18:44

  本文选题：社交焦虑障碍 + 自信心团体心理干预　； 参考：《山西医科大学》2014年硕士论文

【摘要】：研究目的： 1.使用脑诱发电位仪对被试进行听觉事件相关诱发电位检查,探讨社交焦虑障碍患者事件相关电位P300与正常对照的异同，研究患者听觉事件相关电位的特点。 2.设计自信心团体心理干预方案对社交焦虑患者进行干预，研究自信心团体心理干预后社交焦虑障碍患者症状的改变及事件相关电位的改变，探讨自信心团体心理干预对社交焦虑障碍病人的干预效果。 研究对象： 所有社交焦虑障碍患者均来源于山西医科大学第一医院精神卫生科心理咨询门诊和武警山西总队医院门诊，共80例。正常对照以公开招募的方式来源于山西医科大学第一医院病人家属，山西医科大学学生和职工医学院学生，共76例。将80例社交焦虑障碍患者按照随机排列表法随机分为实验组和对照组各40人。 研究方法： 本研究整合心理学、社会学、医学及生物学相关技术和方法，采用横向（病例对照）、纵向（干预追踪评价）相结合的实验设计，建立自信心团体心理干预方法。实验组共进行十次干预，每次三小时，持续五周；对照组不进行干预。 采用美国Nicolet Bravo脑诱发电位仪对社交焦虑障碍患者和正常对照进行P300测试。并采用《社交焦虑量表》《社交回避与苦恼量表》《焦虑自评量表》《自尊量表》及P300在心理干预前、结束后三个月、结束后半年对社交焦虑患者进行测量。 运用卡方检验，独立样本t检验、重复测量的方差分析等方法对数据进行统计分析。 研究结果： 1.社交焦虑障碍患者事件相关电位P300的特征研究结果： 由独立样本t检验得出：病人和正常对照P300潜伏期和波幅均有显著差异（P0.05）。在潜伏期方面,社交焦虑障碍患者N2、P3a、P3b潜伏期较正常人延长，N1、P2较正常人缩短；在波幅方面, P3a、P3b波幅降低，N2、P2波幅较正常组增高。 2.自信心团体心理干预对改善社交焦虑障碍症状的研究结果： 由重复测量方差分析得出：实验组和对照组的社交焦虑、社交回避及苦恼、焦虑、自尊评分在处理间的差异显著（F=20.422，P0.001；F=33.754，P0.001；F=65.404，P0.001；F=11.239，，P=0.001）；社交焦虑、社交回避及苦恼、焦虑、自尊水平有随时间变化的趋势（F=120.080，P0.001；F=7.099，P0.001；F=54.068，P0.001；F=143.503，P0.001），并且时间因素的作用随着分组的不同而不同（F=18.777，P0.001；F=16.827，P0.001；F=52.275，P0.001；F=24.864，P0.001）。进一步两两比较后发现：在后测和追踪研究中实验组和对照组之间都存在显著差异，实验组较对照组的社交焦虑、社交回避及苦恼、焦虑、自尊水平改变显著（P0.001）。 3.自信心团体心理干预对改变社交焦虑障碍P300的研究结果 由重复测量方差分析得出：实验组和对照组的N1、N2、P2、P3a、P3b潜伏期在处理间的差异显著（F=6.824，P=0.012；F=8.028，P=0.007；F=4.498，P=0.040；F=5.850，P=0.020；F=8.038，P=0.007）；P300潜伏期有随时间变化的趋势（F=4.391，P=0.022；F=18.934，P0.001；F=4.358，P=0.016；F=6.133，P=0.003；F=3.754，P=0.033），并且时间因素的作用随着分组的不同而不同（F=4.822，P=0.016；F=7.143，P=0.001；F=4.292，P=0.017；F=4.552，P=0.013；F=12.845，P0.001）。进一步两两比较后发现：对不同时间点上实验组和对照组P300水平比较可知，两组P300在追踪后测中有显著差异。对两组在不同时间点上的差异进行两两比较得出，实验组前测与后测之间的差异无统计学意义、前测与追踪之间的差异有统计学意义；对照组在不同时间点的差异没有统计学意义。P300波幅实验前后，实验组和对照组无显著差异。 结论： 1.社交焦虑患者事件相关电位P300存在异常改变，与正常人相比，社交焦虑患者存在认知功能异常。 2.自信心团体心理干预有助于社交焦虑障碍患者提高自尊和自信水平，改善社交焦虑、回避、苦恼等不良情绪。自信心团体心理干预对缓解患者症状和相关问题有明显效果。 3.自信心团体心理干预对社交焦虑障碍患者P300潜伏期有显著改变，说明其对改善社交焦虑障碍的认知功能具有一定效果，同时提示P300可以作为衡量社交焦虑认知水平的参照指标。
[Abstract]:Purpose of study :

1 . The auditory event - related evoked potentials were examined by using the brain evoked potential instrument , and the differences between the event - related potentials and the normal controls in the patients with social anxiety disorder were investigated . The characteristics of the related potential of auditory event were studied .

2 . To design the psychological intervention program of self - confidence group to intervene in social anxiety patients , to study the change of symptoms and the change of event - related potential in patients with social anxiety disorder after psychological intervention of self - confidence group , and to explore the effect of psychological intervention of self - confidence group on patients with social anxiety disorder .

Study Object :

All patients with social anxiety disorder were from the first hospital of Shanxi Medical University , the psychological consultation clinic of the first hospital of Shanxi Medical University and the outpatient department of Shanxi General Hospital of the Armed Police Force , and 80 cases were enrolled in the normal control . The normal controls were from the family members of the first hospital of Shanxi Medical University , the students of Shanxi Medical University and the students of the staff and staff medical school , and 76 cases . Eighty patients with social anxiety disorder were randomly divided into experimental group and 40 control group according to the random arrangement table method .

Study method :

This study integrates psychology , sociology , medicine and biology - related techniques and methods , and adopts a combination of lateral ( case - control ) and longitudinal ( intervention - tracking evaluation ) to establish the psychological intervention method of self - confidence group . The experimental group carries out ten interventions each time , three hours each time , lasting five weeks ;
The control group did not intervene .

The social anxiety disorder patients and normal controls were tested by using the American Nilet Bravo brain evoked potential instrument . The self - esteem scale of anxiety self - esteem scale ( SCL - 90 ) was measured in three months after the end of psychological intervention , and the patients with social anxiety were measured half a year after the end of psychological intervention .

Statistical analysis of data was carried out by means of Chi - square test , independent sample t test and variance analysis of repeated measurements .

Results of the study :

1 . Results of the study on the characteristics of event - related potential 300 in patients with social anxiety disorder :

The latency and amplitude of P3a and P3b in patients with social anxiety disorder were significantly longer than those in normal controls ( P0.05 ) .
In terms of amplitude , the amplitude of P3a , P3b decreased , and the amplitude of N2 and P2 was higher than that of the normal group .

2 . Research results of self - confidence group psychological intervention to improve symptoms of social anxiety disorder :

The difference of social anxiety , social avoidance and distress , anxiety and self - esteem scores between the experimental group and the control group was significant ( F = 20.422 , P0.001 ) .
F=33.754,P0.001锛

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