缓解期精神分裂症患者负性自动思维特点及影响因素分析  

The characteristic of automatic thoughts and related factors analysis of patients with schizophrenia in remission

作　　者：刘超[1] 钱丽菊[2] 刘利[2] 曹中昌[2] LIU Chao;QIAN Li-ju;Liu li;CAO Zhong-chang(Ji Ning medical college, fining 272051, China)

机构地区：[1]济宁医学院,272051 [2]山东省济宁市精神病防治院

出　　处：《临床精神医学杂志》2018年第2期107-109,共3页Journal of Clinical Psychiatry

摘　　要：目的:探讨缓解期精神分裂症患者的负性自动思维特点及从应激系统角度探讨影响负性自动思维的主要因素及作用机制。方法:对152例精神分裂症患者采用负性自动思维问卷、应付方式量表、领悟社会支持量表、90项症状自评量表(SCL-90)、艾森克人格量表(EPQ)评定,所有数据进行描述性统计、Pearson相关分析、多元逐步回归分析。结果:缓解期精神分裂症的自动思维以个体适应不良及对改变的渴求条目均分最高;负性自动思维与心身症状、自责、回避、幻想、神经质、精神质呈显著正相关(分别r=0.772,0.483,0.252,0.231,0.508,0.430),与解决问题、求助、家庭内社会支持、家庭外社会支持、社会支持总分、内外向、掩饰分呈显著负相关(分别r=-0.335,-0.188,-0.369,-0.245,-0.304,-0.275,-0.348);以自动思维总分为因变量,选取解决问题、自责、家庭内社会支持、神经质、焦虑、抑郁等为自变量进行多元逐步回归分析,结果依次进入回归方程的因素是:抑郁、神经质及解决问题,共可解释方程变化的67.6%,其中抑郁对负性自动思维量表总分的贡献是60.8%。结论:缓解期精神分裂症患者的自动思维以对现状的不满及希望改变为主,心身症状、应对方式、社会支持、个性等因素均可引起自动思维发生变化,抑郁对负性自动思维的预测显著,神经质个性、解决问题应对方法等变量对缓解期精神分裂症的自动思维作用明显,认知改变可通过多途径改变。Objective： To study the characteristic of automatic thoughts and examine the main factors and effect mechanism by stress-system theory. Method： One hundred and fifty-two patients with schizophrenia were recruited and assessed by negative automatic thoughts questionnaire,coping style scale,perceived social support scale,90 items symptom check list,Eysenck personality inventory. All data were performed descriptive statistics,Pearson correlation analysis and multivariate stepwise regression analysis（ α = 0. 05）. Results： The remitted schizophrenic patients showed highest score on the item individual maladjustment and thirst for changing; Automatic thoughts showed significantly positive correlation with psycho-somatic symptom,reproach,fantasy,avoidance,neuroticism and psychoticism（ r = 0. 772,0. 483,0. 252,0. 231,0. 508,0. 430,respectively）,and significantly negative correlation with problem-solving,searching for help,social support in and out the family,social support total score,introversion-extroversion,lie（ r =-0. 335,-0. 188,-0. 369,-0. 245,-0. 304,-0. 275,-0. 348,respectively）. Multiple stepwise regression analysis with automatic thoughts scores as the dependent variable and other variable as independent variable indicated that the factors entering the equators were by turn the depression,neuroticism,problem-solving,which accounted for 67. 6% of total variance and among which the contribution of depression to automatic thoughts was 60. 8% . Conclusion： Individual maladjustment and thirst for changing is the principal automatic thoughts of patients with schizophrenia. Psycho-somatic symptoms,coping styles,social support and personality factors play a vital role in automatic thinking. Psychosomatic symptoms significantly predict negative automatic thinking. Depression,neuroticism,problem-solving have an obvious effect on automatic thoughts of remission schizophrenia patients,so various ways can be used to change cognition content.

关 键 词：负性自动思维 应付方式 社会支持 人格 心身症状 

分 类 号：R749.3[医药卫生—神经病学与精神病学]