门诊焦虑障碍患者的成人依恋和自我分化的关系研究

发布时间：2018-07-15 22:41

【摘要】：目的：探索焦虑障碍患者的成人依恋类型、自我分化水平以及两者的关系。为探索焦虑障碍的病理心理学机制以及心理治疗模式提供研究依据。方法：采取病例对照研究，对符合简要国际神经精神科访谈工具（MINI）中文版诊断的123名门诊焦虑障碍患者和120名健康对给予问卷调查：①采用亲密关系体验问卷中文版修订版（ECR-R）评定依恋的焦虑和回避两个维度，然后再将其转换成依恋类型；②采用自我分化量表修订版的中文版(DSI-R)，评定区分理智和情感的能力以及在亲密关系中即体验亲密又保持自我独立性的能力；③采用状态-特质焦虑量表(STAI)评定焦虑情绪状态和人格特质性焦虑倾向。结果：①焦虑障碍组患者的ECR-R焦虑维度、回避维度及STAI分值显著高于正常对照组，，DSI-R总分、情绪反应性、自我位置维度分值显著低于正常对照组。②焦虑障碍组不安全依恋类型占多数（57%），其中迷恋型占18.4%，淡漠型占24.6%，恐惧型占14%。不安全依恋类型者罹患焦虑障碍的风险是安全型的4.88倍，其中恐惧型风险最大，是安全型的15.02倍，迷恋型者是4.38倍,淡漠型是3.76倍。③在病例组，迷恋型和恐惧型患者的DSI-R总分和情绪反应性维度分值低于安全型和淡漠型,迷恋型患者的情感断绝维度分值最低，恐惧型患者的特质焦虑分值最高。④对照组安全型被试与病例组安全型被试相比，DSI-R总分和情绪反应性维度分值高，STAI分值低。病例组安全型被试和病例组不安全型被试相比，DSI-R总分、情绪反应性和情感断绝维度分值高而STAI分值低。⑤患者组的ECR-R焦虑维度分值与DSI-R总分及各维度分值呈负相关⑥患者组的DSI-R总分和情感断绝维度分值分别与ECR-R焦虑维度分值有线性回归关系，后者能预测前者的41%、29%，DSI-R情绪反应性维度分值与ECR-R焦虑维度和回避维度分值有线性回归关系，后者可联合预测前者的36%。结论：焦虑障碍患者相对于健康对照组不安全依恋类型占多数，自我分化水平低，状态和特质焦虑水平高；迷恋型和恐惧型患者相对于安全型和淡漠型患者的自我分化水平低而焦虑水平高；病例组安全型被试的自我分化水平低于对照组安全型而高于病例组不安全型，其焦虑水平也在两者之间；焦虑障碍患者的成人依恋焦虑维度与自我分化呈显著负相关。
[Abstract]:Objective: to explore the types of adult attachment, self-differentiation and the relationship between them in patients with anxiety disorder. To explore the pathophysiological mechanism and psychotherapy model of anxiety disorder. Methods: a case-control study was conducted. 123 outpatients with anxiety disorder and 120 healthy subjects who were diagnosed with the Chinese version of the brief International Neuropsychiatric interview tool (mini) were investigated by using the Chinese version of the revised Chinese version of the intimate relationship experience questionnaire (ECR-R) to assess attachment. Two dimensions of worry and avoidance, Then it was transformed into attachment type. The Chinese version of the revised version of Self-differentiation scale (DSI-R) was used to evaluate the ability to distinguish between reason and emotion, as well as the ability to experience intimacy and maintain self-independence in intimate relationships. 3. State-trait anxiety scale (STAI) was used to assess anxiety state and personality trait anxiety tendency. Results the ECR-R anxiety dimension, avoidance dimension and STAI score in the anxiety disorder group were significantly higher than those in the normal control group. The score of self-position dimension was significantly lower than that of the normal control group (57%), including infatuation type (18.4%), indifferent type (24.6%) and fear type (14%). The risk of anxiety disorder was 4.88 times that of safety type, and the risk of fear type was 15.02 times that of safety type, that of infatuation type was 4.38 times, and that of indifferent type was 3.76 times. The total score of DSI-R and the score of emotional reactivity in infatuation and fear type patients were lower than those in safety type and apathy type, and the score of affective severance dimension in infatuation type was the lowest. The score of trait anxiety was highest in the fear type group. 4 the total score of DSI-R and the score of emotional reactivity dimension were higher and the score of STAI was lower in the safety type subjects in the control group than in the safety type subjects in the case group. The total score of DSI-R was compared between the safety type subjects of the case group and the unsafe type subjects of the case group. ECR-R anxiety dimension score was negatively correlated with DSI-R total score and each dimension score of patients with lower STAI score, DSI-R total score and affective severance dimension score were negatively correlated with ECR-R anxiety in patients with lower STAI score. The dimension scores have linear regression relation, The latter can predict that there is a linear regression relationship between the scores of DSI-R emotional reactivity dimension and ECR-R anxiety dimension and avoidance dimension of the former, and the latter can jointly predict the 36th dimension of the former. Conclusion: compared with the healthy control group, the patients with anxiety disorder have the majority of unsafe attachment types, low self-differentiation level and high level of state and trait anxiety. The self-differentiation level of infatuation type and fear type was lower than that of safety type and apathy type, and the self-differentiation level of safety type subjects in case group was lower than that of control group, but higher than that of unsafe type in case group. There was a significant negative correlation between the dimension of adult attachment anxiety and self-differentiation in patients with anxiety disorder.
【学位授予单位】：首都医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.72

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