某医科大学学生认知特征与抑郁症状关系研究

发布时间：2018-07-14 19:24

【摘要】：目的：了解大学生抑郁症状的流行特征及其与归因风格、应对方式和功能失调性态度等认知特征的关系；分析大学生认知特征及其对抑郁症状发生的影响，探索导致抑郁症状发生的认知易感性因素。方法：以安徽省合肥市某医科大学为研究现场，以该校临床专业1-4年级1498名在校大学生为研究对象，采用流调用抑郁量表、归因风格问卷、应对方式问卷、功能失调性态度问卷对大学生进行横断面调查，了解大学生抑郁症状的流行状况及其与归因风格、应对方式和功能失调性态度的关系。以无明显抑郁症状的一年级临床医学专业大学生为研究对象建立研究队列，采用流调用抑郁量表、归因风格问卷、应对方式问卷、功能失调性态度问卷、生活事件量表和社会支持量表先后进行2次随访调查，观察认知特征的变化及其对抑郁症状发生的影响；将随访对象认知特征分为正常组和异常组，比较正常组与异常组及异常组中具备不同认知特征的大学生抑郁症状的发生率，探讨抑郁症状发生的认知易感性因素。结果：横断面调查结果显示，大学生抑郁症状检出率为28.2%，女生低于男生（χ~2=7.925，P0.01），农村生源学生高于城市生源学生（χ~2=10.269，P0.01），大一年级至大四年级学生抑郁症状的检出率分别为22.5%、31.3%、31.4%和26.1%（χ~2=10.306，，P0.05）；调查对象抑郁总分、不同性别及各年级学生的抑郁症状评分与其归因风格中的消极外归因评分之间存在正相关（γ=0.202~0.275，P0.01）；调查对象抑郁总分、不同性别及大一、大二和大三年级的学生的抑郁症状评分与其归因风格中的积极外归因评分之间呈现负相关（γ=-0.088~-0.179，P0.05）；调查对象抑郁总分、男生及大二年级学生的抑郁症状评分与其归因风格中的消极内归因评分之间呈现负相关（γ=-0.088~-0.129，P0.05）；大一学生的抑郁症状评分与归因风格中的积极内归因评分之间呈正相关（P0.01）；大学生抑郁症状评分与应对方式中的问题解决和求助两个维度评分之间呈现负相关（γ=-0.417~-0.230，P0.01），而与应对方式中的自责、幻想、退避和合理化四个维度评分之间呈现正相关（γ=0.216~0.466，P0.01）；大学生抑郁症状总分、不同性别及各年级学生的抑郁症状评分与功能失调性态度评分之间呈现正相关（γ=0.460~0.526，P0.01）。以上述大学一年级经评定没有抑郁学生为对象建立研究队列，研究队列半年和一年随访率分别为85.2%和93.3%。队列随访调查结果显示，功能失调性态度评分正常组学生在半年随访时有76.7%的学生维持正常状态，23.3%的学生转变为异常，功能失调性态度评分异常组学生中有68.2%的学生保持不变，31.8%的学生转为正常（P0.01）；功能失调性态度评分正常组学生在一年随访时，出现异常的比例为12.4%，保持正常的比例为87.6%，功能失调性态度评分异常组学生在一年随访时，转为正常和仍为异常的学生比例分别为65.4%和34.6%（P0.01）。半年随访调查研究显示，三项认知特征均正常者和至少有一项异常的大学生半年随访的抑郁症状发生率分别为5.6%和15.8%，正常组显著低于异常组（χ~2=6.383，P0.05）；一年随访的抑郁症状发生率分别为13.2%和29.3%，正常组显著低于异常组（χ~2=10.192，P0.01）。半年随访调查结果发现，采取乐观和悲观归因风格的随访对象抑郁症状发生率分别为7.9%和15.8%（χ~2=3.909，P0.05）；采用积极和消极应对方式的随访对象抑郁症状发生率分别为8.9%和21.6%（χ~2=6.502，P0.05）；功能失调性态度评分正常组学生抑郁症状发生率为9.5%，异常组抑郁症状发生率为20.5%（χ~2=4.298，P0.05）；一年的随访调查结果表明，采用消极应对方式的随访对象抑郁症状的发生率显著高于积极应对方式者，抑郁症状发生率分别为42.3%和17.7%（χ~2=14.774，P0.01）；功能失调性态度评分异常组的随访对象抑郁症状发生率显著高于正常组，抑郁症状发生率分别为48.1%和16.4%（χ~2=24.523，P0.01）。半年随访调查结果显示，有三项认知评定异常的随访对象抑郁症状发生率最高36.4%，有两项认知评定异常和一项认知评定异常的学生抑郁症状发生率分别为17.1%和12.8%（χ~2=10.639，P0.01）；一年随访调查结果表明，有三项认知评定异常者抑郁症状发生率最高（70.0%），有两项认知评定异常者次之（36.4%），有一项认知评定异常者最低（22.3%）（χ~2=21.252，P0.01）。Cox回归分析表明，采取消极应对和功能失调性态度异常者均为抑郁症状发生的危险因素（RR=1.79,95%CI：1.01~3.17和RR=2.39，95%CI：1.40~4.08）。结论：有抑郁症状大学生比例较高，抑郁症状与归因风格、应对方式和功能失调性态度间密切关联；悲观归因、消极应对方式和功能失调性态度异常是导致抑郁症状发生的高危因素，三者对抑郁症状的产生可能存在联合作用，消极应对方式和功能失调性态度异常对抑郁的发生具有预测作用。
[Abstract]:Objective: to understand the prevalence of depressive symptoms in college students and their relationship with cognitive characteristics such as attribution style, coping style and dysfunctional attitude, and to analyze the cognitive characteristics of college students and their influence on the occurrence of depressive symptoms, and to explore the cognitive susceptibility to depressive symptoms.
Methods: taking a Medical University in Hefei of Anhui as the research site and taking 1498 college students in grade 1-4 of the school as the research object, the flow call depression scale, attribution style questionnaire, coping style questionnaire and dysfunctional attitude questionnaire were used to investigate the prevalence of College Students' depressive symptoms. And its relationship with attribution style, coping style and dysfunctional attitudes.
The first grade clinical medical students who had no obvious symptoms of depression set up a study cohort for the study, using the flow call depression scale, attributable style questionnaire, coping style questionnaire, dysfunctional attitude questionnaire, life event scale and social support scale, and observed the changes of cognitive characteristics and their inhibition in 2 cases. The effect of the symptoms of depression; the cognitive characteristics of the follow-up subjects were divided into normal group and abnormal group, and the incidence of depressive symptoms in college students with different cognitive characteristics in normal group and abnormal group and abnormal group was compared, and the cognitive susceptibility factors of depressive symptoms were discussed.
Results: the cross-sectional survey showed that the prevalence rate of depressive symptoms in college students was 28.2%, girls were lower than boys (~2=7.925, P0.01), and rural students were higher than urban students (x ~2=10.269, P0.01). The detection rates of depressive symptoms from freshmen to fourth grade were 22.5%, 31.3%, 31.4% and 26.1% (x ~2=10.306, P0.05). There was a positive correlation between the scores of depressive symptoms and the negative attribution scores in the attribution style of the students of different sexes and grades (gamma =0.202~0.275, P0.01); the depression score of the subjects, the scores of depression and the positive attribution in the attribution style of the students of different sexes and freshmen, sophomores and sophomores There was a negative correlation between the scores (gamma =-0.088~-0.179, P0.05); the total score of depression in the subjects, the scores of depressive symptoms in boys and sophomores and the negative internal attribution scores in the attribution style were negatively correlated (gamma =-0.088~-0.129, P0.05); the depression score of the freshmen and the positive internal attribution score in the attribution style were between the scores of the students and the attribution style. There was a positive correlation (P0.01); there was a negative correlation between the scores of College Students' depression symptoms and the two dimensions of problem solving and help seeking in coping styles (gamma =-0.417~-0.230, P0.01), but there was a positive correlation between the scores of four dimensions of self reproach, fantasy, retreat and rationalization in coping styles (gamma =0.216~0.466, P0.01); and the total depression symptoms of college students were total. There was a positive correlation between the scores of depressive symptoms and dysfunctional attitudes among different sexes and grades (gamma =0.460~0.526, P0.01).
The study cohort was set up for the students who were not depressed in the first year of the University. The results of the half year and one year follow-up rate of the study cohort were 85.2% and 93.3%., respectively. The results showed that 76.7% of the students in the dysfunctional attitude score group were in the normal state and 23.3% of the students were abnormal. 68.2% of the students in the dysfunctional attitude score group remained unchanged, and 31.8% of the students turned to normal (P0.01). The abnormal proportion of the students in the dysfunctional attitude score group was 12.4% at one year's follow-up, and the normal proportion was 87.6%. The students in the dysfunctional attitude score group turned to the correct one year follow-up. The proportion of normal and still abnormal students was 65.4% and 34.6% (P0.01). A half year follow-up study showed that the incidence of depressive symptoms in three students with normal cognitive characteristics and at least one abnormality was 5.6% and 15.8% respectively. The normal group was significantly lower than the abnormal group (x ~2=6.383, P0.05), and the one year follow-up of depression like hair. The rate of birth was 13.2% and 29.3% respectively, and the normal group was significantly lower than that of the abnormal group (x ~2=10.192, P0.01). The results of the follow-up survey for half a year found that the incidence of depressive symptoms was 7.9% and 15.8% (x ~2=3.909, P0.05) in the follow-up subjects with optimistic and pessimistic attribution style, and the incidence of depressive symptoms was respectively in the follow-up subjects with positive and depolarization coping styles, respectively 8.9% and 21.6% (x ~2=6.502, P0.05); the incidence of depressive symptoms in students with dysfunctional attitude score was 9.5%, and the incidence of depressive symptoms in abnormal group was 20.5% (x ~2=4.298, P0.05). The results of one year follow-up survey showed that the incidence of depression symptoms in the follow-up subjects with negative coping style was significantly higher than those of the positive coping style. The incidence of depression was 42.3% and 17.7% (x ~2=14.774, P0.01), and the incidence of depressive symptoms in the patients with dysfunctional attitude score group was significantly higher than that in the normal group, and the incidence of depressive symptoms was 48.1% and 16.4% respectively (x ~2=24.523, P0.01). The highest incidence of symptoms was 36.4%. The incidence of depressive symptoms in two cognitive and cognitive abnormality was 17.1% and 12.8% respectively (x ~2=10.639, P0.01). One year follow-up survey showed that there were three cases of cognitive assessment with the highest incidence of depressive symptoms (70%), and two cognitive assessment abnormality (36.4%). The lowest (22.3%) (22.3%) (chi, P0.01).Cox regression analysis showed that negative coping and dysfunctional attitudes were all risk factors for depressive symptoms (RR=1.79,95%CI:1.01~3.17 and RR=2.39,95%CI:1.40~4.08).
Conclusion: the proportion of college students with depressive symptoms is higher, the depression symptoms and attribution style, the coping style and the dysfunctional attitude are closely related, pessimistic attribution, negative coping style and dysfunctional attitude are the high risk factors that lead to depressive symptoms, the three may have joint effect on depressive symptoms and negative coping. Abnormal attitude and dysfunctional attitude predict the occurrence of depression.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.4

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