社交恐惧症患者与正常对照的生活事件、社会支持和防御机制的比较(英文)

Comparison of the life events,social support and defense mechanisms between patients with social phobia and normal controls in China

背景生活事件、社会支持网络和心理防御机制的相互作用如何减轻或加重了社交恐惧症患者的社会功能,目前尚不清楚。目的比较社交恐惧症患者和正常对照之间的应激状态、社会支持与防御机制的关系。方法 对2009年10月-2010年8月南通市紫琅医院诊断的38例社交恐惧症患者,采用生活事件量表、社会支持评定量表和防御方式问卷进行测查,并与38名正常对照的测查结果进行比较。结果两组患者的正性与负性生活事件数的差异无统计学意义,但是社交恐惧症患者心理状况受负性事件和正性事件的影响程度比对照组严重。根据社会支持评定量表的评定结果,社交恐惧症组的平均(标准差)客观支持分、主观支持分、社会支持总分、支持利用度分均显著低于对照组。防御方式问卷的结果显示,与对照组相比,社交恐惧症组不成熟防御机制的得分明显较高(也就是说,他们更可能报告使用了这样的防御),成熟防御机制的得分明显降低。社交恐惧症组更可能报告使用了神经症型防御机制,如潜抑、回避、情感隔离、社会倾向增加,但较不可能报告使用了反向形成、否认和期望的防御机制。结论区别生活事件的类型似乎对社交恐惧症的病因不那么重要。与正常对照相比,社交恐惧症患者的社会支持网络较差,较少运用社会支持,更可能使用不成熟的防御机制。

Background： It is uncertain how stressful life events, social support networks and psychological defense mecha- nisms interact with each other to ameliorate or exacerbate the impairment in social functioning experienced by pa- tients with a diagnosis of social phobia.Objective： Compare the relationship of stress, social support and defense mechanisms between patients with social phobia and normal control subjects.Methods： 38 newly diagnosed patients with social phobia seen at the Zi Lang Hospital in Nantong between October 2009 and August 2010 were administered a Life Event Scale, the Social Support Rating Scale and the Defense Style Questionnaire. The results were compared with those for 38 normal controls.Results： There were no differences in the in the numbers of positive and negative life events between the two groups but the psychological impact of both positive and negative life events on the social phobia group were significantly greater than on the control group. Based on the results of the Social Support Rating Scale the mean （SD） scores of objective support, subjective support, total support and utilization of social support in the social phobia group were all significantly lower than those in the control group. Results of the Defense Style Questionnaire showed that compared to the control group the total score for immature defenses was significantly higher （ i. e., respondents were more likely to report using these defenses） and the total score for the mature defenses was significantly lower in the social phobia group. The social phobia group was significantly more likely to report using the neurotic defenses of repression, avoidance, isolation, and increased social association but significantly less likely to report using the neurotic defenses of reaction formation, denial, and anticipation.Conclusion： Differential patterns of life events do not appear to be important in the etiology of social phobia. Compared to normal control subjects, patients with social phobia have a less developed social support network, are less likely to use available social support and are.more likely to employ immature defense mechanisms.