述情障碍影响生活质量心理中介作用模型  

The effect of alexithymia on quality of life： psychological mediator modeling

作　　者：杨文辉[1] 姚树桥[1] 刘鼎[1] 

机构地区：[1]中南大学湘雅二医院医学心理研究中心, 长沙410011

出　　处：《中国行为医学科学》2007年第10期948-950,共3页Chinese Journal of Behavioral Medical Science

摘　　要：目的探讨述情障碍对生活质量的影响及其心理中介作用模型。方法377名大二、大三学生完成多伦多20个条目述情障碍量表（TAS-20）、世界卫生组织生活质量量表（WHOQOL-100）、自评抑郁量表（SDS）、状态特质焦虑问卷（STAI）、应对方式和社会支持量表问卷调查。运用比较研究分析述情障碍对生活质量的影响;运用Pearson相关分析以及结构方程建模分析方法,确定心理中介作用最佳模型。结果（1）述情障碍高、中、低分三组之间生活质量各维度及总体生活质量差异具有显著性（躯体功能2=35.15,P=0.00;心理功能F=51.44,P=0.00;独立性F=28.75,P=0.00;社会交往F=36.82,P=0.00;生活环境F=26.69,P=0.00;生活信念2=38.89,P=0.00;总体生活质量2=33.87,P=0.00）;（2）各变量之间相关分析具有显著性（P〈0.01）;（3）最佳模型为完全心理中介作用模型,能够解释生活质量变异的87.4%,拟合指数均在理想范围内（2/df=1.72,GFI=0.927,IFI=0.967,CFI=0.967,RMSEA=0.048）,路径系数均具有显著性（述情障碍到负性情绪的路径系数β=0.30,P=0.00;述情障碍到应对方式的路径系数β=0.49,P=0.00;负性情绪到生活质量的路径系数β=-0.94,P=0.00）。结论（1）述情障碍对大学生生活质量具有广泛而显著损害作用;（2）述情障碍对生活质量的作用是一种完全中介效应,通过负性情绪、应对方式、社会支持等中介变量实现;其中负性情绪是关键性中介变量。Objective To determine the effect of alexithymia on self-report quality of life （QOL） and the psychological mediators model between alexithymia and quality of life. Methods 377 undergraduate students of grade two and three completed TAS-20, WHOQOL-100, STAI-Form Y,SDS,Coping Style Questionnaire, and Social Support Scale. Control test was used to analyze the effect of alexithymia on self-report quality of life. Pearson correlations and structural equation modeling were used to explore the fittest model. Results （ 1 ） There were significant differences among low, intermediate and high alexithymia groups on all domains of WHOQOL-100 and general QOL （ physical domain Х^2 = 35. 15, P = 0.00 ; psychological domain F = 51.44, P = 0.00 ; independence domain F = 28.75, P = 0.00 ; social relationships domain F = 36.82, P = 0.00 ; environment domain F = 26.69, P = 0.00 ; spirituality domain Z2 = 38.89, P= 0.00 ; overall QOL Х^2 = 33.87, P = 0.00 ）. （ 2 ） All variables were associated significantly with each other（ P 〈 0.01 ）. （3） The fittest model was a complete mediating model which could account for 87.4% of the variance of WHOQOL-100. Its indices met the criteria standards for adequacy of fit （ Х^2/df = 1.72, GFI = 0. 927, IFI = 0. 967, CFI = 0. 967, and RMSEA = 0. 048 ）, and all the path coefficients were significant（ the path coefficient from alexithymia to negative affectsβ = 0.30, P = 0.00; the path coefficient from alexithymia to coping styleβ =0.49, P=0.00;the path coefficient from negative affects to quality of life β = - 0.94, P = 0.00）. Conclusions （ 1 ） Alexithymia had a negative and significant influence on all aspects of the subjective quality of life in undergraduate students. （2） The effect of alexithmia on quality of life was a complete mediating effect performed by negative affects, coping style and social support.

关 键 词：述情障碍 结构方程模型 生活质量 负性情绪 应对方式 

分 类 号：R686[医药卫生—骨科学]