强迫症患者强迫症状与认知融合、经验性回避的关系  

Relationship between cognitive fusion,empirical avoidance and obsessive-compulsive symptoms in patients with obsessive-compulsive disorder

作　　者：邱丽芳 刘健门 唐文新[3] 杨翠茹 朱丞[3] 赵侠 朱文静[3] Qiu Ltfang;Liu Jian;Tang Wenxin;Yang Cuiru;Zhu Cheng;Zhao Xia;Zhu Wenjing(Anhui Psychiatric Center,Anhui Medical University,Hefei 230032,China;Department of Science and Education,Hangzhou Seventh People's Hospital,Hangzhou 310013,China;Department of Psychiatry,Hangzhou Seventh People's Hospital,Hangzhou 310013,China)

机构地区：[1]安徽医科大学安徽省精神医学中心,合肥230032 [2]杭州市第七人民医院科教科310013 [3]杭州市第七人民医院精神科,310013

出　　处：《中华行为医学与脑科学杂志》2019年第11期999-1004,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：浙江省公益技术研究计戈iJ(LGF19H090015);杭州市市科委基金项目(20180533B83)。

摘　　要：目的探索强迫症患者强迫症状与认知融合、经验性回避的关系。方法以认知融合问卷(cognitive fusion questionnaire,CFQ)、接纳与行动问卷第二版(acceptance and action questionnaire-2nd edition,AAQ-11)、耶鲁-布朗强迫症状维度量表(Yale-Brown scale for obsessive-compulsive symptoms,Y-BOCS)为研究工具,对100例强迫症被试,166例健康对照组进行测试,比较两组被试认知融合、经验性回避得分的差异,采用多元线性逐步回归分析强迫症状与认知融合、经验性回避的关系。结果强迫症组在认知融合[(49.89±10,62)分,(33.88±11.44)分j=-ll.35,P<0.01]与经验性回避[(29.75±9.53)分,(21.59±7.03)分,t=-7.99,P<0.01]得分上均要显著高于健康对照组。强迫症组不同年龄的认知融合得分差异有统计学意义(F=&63,P<0.01)。在AAQ-II中,条目2(r=0.246,P<0.05)、条目6(r=0.223,P<0.05)及总分(r=0.240,P<0.05)与Y-BOCS总分呈显著性正相关;条目2(r=0.311,P<0.01),条目3(r=0.286,P<0.05)、条目6(r=0.248,P<0.05)及总分(r=0.229,P<0.05)与强迫思维得分呈显著正相关。在CFQ中,条目2(r=0.231,P<0.05)、条目4(r=0.242,P<0.05)、条目7(r=0.308,P<0.05)、条目8(r=0.277,P<0.05)及条目9(r=0.249,P<0.05)与Y-BOCS总分呈显著正相关;条目8(r=0.261,P<0.05)与强迫思维得分呈显著性正相关;条目7(r=0.237,P<0.05)及条目9(r=0.238,P<0.05)与强迫行为得分呈显著的正相关。多元线性逐步回归分析显示,在预测强迫总分时,仅有CFQ的条目7(B=1.827,P<0.01)、条目3(B=-0.956,P<0.05),及AAQ-口的条目6(B=0.584,P<0.05)进入了方程,其联合解释变异量为19.0%;在预测强迫思维得分时,仅有AAQ-H的条目2(B=0.446,P<0.01)进入了方程,解释变异量为9.7%;在预测强迫行为时,仅有CFQ的条目9(B=0.815,P<0.05)进入了方程,其解释变异量为5.6%。结论强迫症患者认知融合、经验性回避水平高可能是症状得以维持的重要因素。Objective To compare the difference of cognitive fusion,empirical avoidance between patients with obsessive-compulsive disorder and healthy control group,and to explore the relationship between obsessive-compulsive score and cognitive fusion,empirical avoidance.Methods The cognitive fusion questionnaire(CFQ),acceptance and action questionnaire-2nd edition(AAQ-II)and Yale-Brown scale for obsessive-compulsive symptoms(Y-BOCS)were used to investigate 100 subjects with obsessive-compulsive disorder(OCD)and 166 healthy controls.And the differences in cognitive fusion and empirical avoidance scores were compared between the two groups.The relationship of obsessive-compulsive symptoms and cogni tive fusion,empirical avoidance was analyzed using multiple linear regression analysis.Results The scores of cognitive fusion((49.89±10.62)vs(33.88±11.44),/=-11.345,P<0.01)and empirical avoidance((29.75±9.53)vs(21.59±7.03),t--7.995,P<0.01)in obsessive-compulsive disorder group were significantly higher than those in healthy control group.There were significant differences in cognitive fusion and empirical avoidance in age variables(F-8.63,PvO.01).In AAQ-U,item 2(r-0.246,P<0.05),item 6(r=0.223,P<0.05)and total score(r=0.240,Pv0.05)were positively correlated with the total score of Y-BOCS.Item 2(r=0.311,P<0.01),item 3(r=0.286,P<0.05),item 6(r=0.248,P<0.05)and total score(r=0.229,P<0.05)were positively correlated with the scores of obsessive-thinking.In CFQ,item 2(r=0.231,P<0.0)5),item 4(r=0.242,P<0.05),item 7(r=0.308,P<0.05),item 8(r=0.277,Pv 0.05)and item 9(r=0.249,P<0.05)were positively correlated with the total score of Y-BOCS.Item 8(r=0.261,P<0.05)was positively correlated with the scores of obsessive-thinking,item 7(r=0.237,P<0.05)and item 9(r=0.238,P<0.05)were positively correlated with scores of obsessive-compulsive behavior.When predicting total obsessive-compulsive scores,only CF item 7 of Q(=1.827,P<0.01),item 3(B=0.956,PvO.05),and item 6 of AAQ-U(B=0.584,P<0.05)entered the equation with a joint explan・atory variati

关 键 词：强迫性障碍 认知融合 经验性回避 接纳承诺治疗 

分 类 号：R74[医药卫生—神经病学与精神病学]