叙事疗法治疗情绪障碍患儿初步探讨  

Narrative therapy in treatment of adolescents with emotional disorder

作　　者：赵兆[1] 陈一心[2] 杜文东[1] 陈图农[2] 吴丹丹[2] 李沙沙[2] 

机构地区：[1]南京中医药大学心理学院,210046 [2]南京医科大学附属脑科医院

出　　处：《精神医学杂志》2012年第6期404-407,共4页Journal of Psychiatry

基　　金：国家科技支撑计划心理疾患防治研究与示范项目(编号:2009BAI77B05)

摘　　要：目的探讨叙事治疗对情绪障碍儿童家庭动力学和父母养育方式改变的影响。方法采用方便取样,选取符合中国精神障碍分类与诊断标准第3版(CCMD-3)童年情绪障碍诊断标准,在南京医科大学附属脑科医院确诊的情绪障碍儿童21例,对患儿及父母实施叙事治疗,采用系统家庭动力学自评问卷(SSFD)和父母养育方式量表(EMBU)比较治疗前后家庭动力学、父母养育方式的变化。结果治疗后EMBU在父亲情感温暖、偏爱被试和母亲情感温暖、偏爱被试上高于治疗前,差异有统计学意义(t=-3.60、-2.56、-3.25、-2.60,P<0.05),在母亲拒绝否认、惩罚严厉上低于治疗前,差异有统计学意义(t=2.74、2.55,P<0.05)。治疗后SSFD家庭气氛、个性化评分低于治疗前,差异有统计学意义(t=2.29、3.83,P<0.05)。相关分析显示,治疗前后母亲情感温暖、偏爱被试因子差值同治疗前后家庭气氛差值、个性化差值呈正相关(r=0.52、0.45、0.45、0.50,P<0.05)。结论叙事治疗可以使情绪障碍儿童家庭动力学和父母养育方式产生良性改变。Objective To explore the effect of narrative therapy on family dynamics and parental rearing patterns in adolescents with emotional disorder. Methods A total of 21 adolescents with emotional disorder and their parents from Affiliated Brain Hospital of Nanjing Medical University were enrolled and then treated with narrative therapy. All subjects were assessed with self-rating Scale of Systemic Family Dynamics （SSFD） and Egma Minnen av Bardndosnauppforstran （EMBu） at baseline and at the end of the therapy to evaluate the family dynamics and parental rearing patterns. Results Sores of paternal emotional warmth and favoritism, maternal emotional warmth and favoritism of EMBU at the end of the therapy were significantly higher than those at baseline （t = - 3.60, 2. 56, - 3. 25, - 2. 60 ; P 〈 0.05 ）. Scores of maternal rejection and punishment of EMBU at the end of the therapy were significantly lower than those at baseline （t = 2. 74, 2.55 ; P 〈 0.05 ）. As for family atmosphere and individuation of SSFD, the post-therapy scores were significantly lower than pre-therapy scores （ t = 2. 29, 3.83 ; P 〈 0.05 ）. Correlation analysis indicated that the pre-and post-therapy difference value of maternal emotional warmth and favoritism of EMBU were positively correlated with the pre-and post-therapy difference value of family atmosphere and individuation of SSFD （r = 0. 52, 0. 45, 0. 45, 0. 50 ; P 〈 O. 05 ）. Conclusion Narrative therapy can effectively improve the family dynamics and parental rearing patterns in adolescents with emotional disorder.

关 键 词：儿童 情绪障碍 叙事治疗 家庭动力学 父母养育方式 

分 类 号：R749.7[医药卫生—神经病学与精神病学]