创伤经历者的认知改变对社会支持与创伤负性后果关系的中介作用  

The Mediating Role of Cognitive Change in Relationship between Social Support and Negative Outcomes of Trauma Event

作　　者：徐慰[1] 尉玮[1] 何丽[1] 谢秋媛 王建平[1,2] 

机构地区：[1]北京师范大学心理学院,北京100875 [2]首都医科大学,北京100088

出　　处：《中国临床心理学杂志》2014年第3期433-436,441,共5页Chinese Journal of Clinical Psychology

基　　金：首都医科大学精神疾病诊断与治疗北京市重点实验室开放课题(2014JSJB02)

摘　　要：目的:构建创伤经历者的社会支持影响创伤负性后果的理论模型,考察认知改变在该模型中的中介作用。方法:网络招募具有创伤经历的个体173名。采用受害者/幸存者社会认可度问卷(SAQ)测评社会支持,采用创伤后认知改变问卷(PCC)测量个体认知改变,采用创伤后压力诊断量表(PDS)、症状自评量表—抑郁分量表(SCLD)和社会功能损害问卷(SFI)测评创伤负性后果。结果:SAQ、PCC、PDS、SCL-D、SFI各量表之间存在显著相关关系。结构方程模型分析表明,假设模型拟合度良好(χ2/df=2.052,GFI=0.982,TLI=0.974,CFI=0.989,NFI=0.980,RMSEA=0.078)。认知改变在模型中起到的间接作用比率为60.4%。进一步通过中介分析发现,认知改变对社会支持与抑郁之间的关系起部分中介作用(解释率55.8%),对社会支持与社会功能损害之间的关系也起部分中介作用(解释率45.7%),对社会支持与创伤后应激症状之间的关系起完全中介作用(解释率79.0%)。结论:认知改变是社会支持影响创伤恢复的重要因素,未来研究应采用大样本的纵向设计构建更为完善的创伤后应激症状的理论模型。Objective To construct a cognitive model to explain the relationship between social support and negativeoutcomes of trauma event. In this model, mediation effect was tested to explore the role of cognitive change in the correla-tion between social support and negative outcomes of trauma event. Methods： A total of 173 participants who experiencedtrauma event were recruited to complete a series of questionnaires. The social support was assessed by the Social Acknowl-edgement as a Victim or Survivor Questionnaire（SAQ）. The cognitive change was assessed by the Posttraumatic CognitiveChanges（PCC）. And the negative outcome of trauma event was assessed by Posttraumatic Diagnostic Scale（PDS）, SymptomChecklist 90- Depression（SCL- D） and Social Functioning Impairment（SFI）. Results： There were significant correlationsamong the scores of SAQ, PCC, PDS, SCL-D and SFI. Structural equation modeling showed that the model fitted the datawell（χ2/df=2.052, GFI=0.982, TLI=0.974, CFI=0.989, NFI=0.980, RMSEA=0.078）. The indirect effect of cognitive changeaccounted for 60.4% of the total effect in the model. Further mediation analyses found that cognitive change acted as a partial mediator in the correlation between the social support and depression（accounted for 55.8% variances）, and functioningimpairment（accounted for 45.7% variances）, and as total mediator in the correlation between social support and PTSD symptoms（accounted for 79.0% variances）. Conclusion： Cognitive change is an important factor influencing the effects of socialsupport on the PTSD. And the longitudinal design with large sample is warranted to test this model in the future researches.

关 键 词：社会支持 认知改变 创伤后应激症状 功能损害 抑郁 中介分析 

分 类 号：R395.2[哲学宗教—心理学]