青少年抑郁症患者及其主要照料者的应对方式与家庭韧性关系的主客体互倚模型  

The analysis of the relationship of the coping styles of depressed adolescents and their primary caregivers with family resilience based on an actor-partner interdependence model

作　　者：王素红[1] 朱雪丽[1] 于洋洋[1] 张俊蕾[2] 严芳[3] WANG Suhong;ZHU Xueli;YU Yangyang;ZHANG Junlei;YAN Fang(Department of Psychiatry,the Second Affiliated Hospital of Xinxiang Medical University,Xinxiang 453002,Henan Province,China;Department of Children and Adolescents,the Second Affiliated Hospital of Xinxiang Medical University,Xinxiang 453002,Henan Province,China;Department of Nursing,the Second Affiliated Hospital of Xinxiang Medical University,Xinxiang 453002,Henan Province,China)

机构地区：[1]新乡医学院第二附属医院精神六科,河南新乡453002 [2]新乡医学院第二附属医院儿童少年科,河南新乡453002 [3]新乡医学院第二附属医院护理部,河南新乡453002

出　　处：《新乡医学院学报》2025年第3期236-241,共6页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关计划项目(编号:RKX202202038);新乡医学院第二附属医院精神神经开放课题(编号:XYEFYJSSJ-2023-01)。

摘　　要：目的以主客体互倚模型(APIM)为基础,评估青少年抑郁症患者及其主要照料者应对方式对家庭韧性关系的影响。方法选择2021年5月至2024年6月新乡医学院第二附属医院收治的126例青少年抑郁症患者及其主要照料者(126名)为观察对象。分析青少年抑郁症患者及主要照料者一般资料,并采用简易应对方式问卷(SCSQ)、中文版家庭韧性量表(FHI)进行调查。比较青少年抑郁症患者与主要照料者的SCSQ及FHI得分,分析青少年抑郁症患者及其主要照料者各变量间的相关性,并应用APIM分析二者应对方式对于家庭韧性关系的主客体效应。结果青少年抑郁症患者的SCSQ评分中积极应对方式得分显著低于主要照料者,消极应对方式得分显著高于主要照料者(P<0.05);青少年抑郁症患者FHI评分中责任、控制、挑战维度得分及总分均显著低于主要照料者(P<0.05)。Pearson相关性分析结果显示,青少年抑郁症患者的积极应对与其主要照料者的积极应对、患者家庭韧性均呈正相关(r=0.401、0.295,P<0.05),与主要照料者消极应对、患者消极应对呈负相关(r=-0.239、-0.382,P<0.05);青少年抑郁症患者消极应对与主要照料者积极应对呈负相关(r=-0.259,P<0.05);主要照料者积极应对与其家庭韧性呈正相关(r=0.409,P<0.05)。APIM模型结果显示,主体效应方面,青少年抑郁症患者积极应对方式、主要照料者积极应对方式对青少年抑郁患者及主要照料者家庭韧性均有正向促进作用(β=0.653、0.751,P<0.05);客体效应方面,青少年抑郁症患者积极应对方式亦可促进主要照料者家庭韧性发展(β=0.526,P<0.05),但主要照料者积极应对对青少年抑郁症患者的家庭韧性几乎无影响(β=0.086,P>0.05)。结论青少年抑郁症患者及其主要照料者的应对方式与家庭韧性程度存在一定交互关系,整体表现为应对方式越积极、家庭韧性水平相应越好,提示工作人员可以Objective To assess the impact of the coping styles of depressed adolescents and their primary caregivers on family resilience based on an actor-partner interdependence model(APIM).Methods The general information of 126 adolescent patients with depression admitted to the Second Affiliated Hospital of Xinxiang Medical University from May 2021 to June 2024 and 126 main caregivers were analyzed.The simplified coping style questionnaire(SCSQ)and the Chinese version of family hardiness index(FHI)were used for investigation.SCSQ and FHI scores of patients and their primary caregivers were compared,and the correlation between variables of patients and their primary caregivers was analyzed.Moreover,the APIM was used to analyze the effects of the coping styles of patients and their primary caregivers on family resilience.Results The comparison of SCSQ scores revealed that depressed adolescents scored lower in positive coping and higher in negative coping than primary caregivers(P<0.05).The comparison of FHI scores showed that depressed adolescents had lower scores in dimensions of responsibility,control,and challenge and a lower total score than primary caregivers(P<0.05).Pearson correlation analysis showed that the positive coping of depressed adolescents was correlated positively with the positive coping of main caregivers and the family resilience of the patients(r=0.401,0.295;P<0.05),and negatively with the negative coping of main caregivers and the patients(r=-0.239,-0.382;P<0.05).The positive coping of primary caregivers was correlated negatively with the negative coping of depressed patients(r=-0.259,P<0.05),and positively with the family resilience of primary caregivers(r=0.409,P<0.05).The APIM results showed that in terms of the actor effect,the positive coping styles of depressed patients and main caregivers improved the family resilience of patients and main caregivers,respectively(β=0.653,0.751;P<0.05).In terms of the partner effect,the positive coping style of depressed adolescents promoted the development o

关 键 词：抑郁 应对方式 青少年 主要照料者 家庭韧性 主客体互倚模型 

分 类 号：R749.4[医药卫生—神经病学与精神病学]