青少年抑郁综合认知模型及其性别差异

A Study of the Integrated Cognitive Model of Depression for Adolescents and Its Gender Difference

Beck抑郁认知理论认为功能失调性态度和自动思维对抑郁的形成和发展有着重要的影响,但是不同水平的认知因素在青少年抑郁中起什么样的作用还有待于进一步的研究。根据Oei和Kwon(2007)综合认知模型(ICM),我们假设在青少年负性生活事件和抑郁症状间功能失调性态度是调节变量,而自动思维是中介变量。研究采用开学初和临近期末间隔近四个月两个时间点的纵向数据搜集方式,对613名初中生施以青少年生活事件量表(ASLEC)、功能失调性态度问卷(DAS)、自动思维问卷(ATQ)以及流调中心用抑郁量表(CES-D),然后通过路径分析对模型进行了拟合度和性别差异检验,结果表明:(1)各变量显著相关(p<0.01),且各变量间隔四个月两个时间点的分数差异显著(p<0.01);(2)修正后的青少年抑郁综合认知模型较好地拟了数据,且功能失调性态度与负性生活事件的交互作用对自动思维的影响上女生的路径系数显著大于男生。结论:功能失调性态度在负性生活事件和青少年抑郁症状间起调节作用,而自动思维从中起到了认知中介的作用,且该模型性别差异显著。

Over the past 40 years Beck＇s cognitive theory of depression has emerged as one of the major cognitive theories to explain depressive phenomena （Oei ＆ Dingle, 2008）. It has been proposed that two levels of cognitions, that is, dysfunctional attitudes and automatic thoughts, contribute to the development and maintenance of depression. However, little empirical research has been carried out to specify and examine the differential roles of dysfunctional attitudes and automatic thoughts in the development of depression. In a comprehensive review Oei and Kwon （2007） creatively proposed the Integrated Cognitive model of depression （ICM） to test the differential roles of dysfunctional attitudes and automatic thoughts. Whereas ICM has been studied in western adult populations, the research examining this model in adolescents or non-western population lagged far behind. Longitudinal cross-cultural evidence are needed to evaluate the validity of the ICM in Chinese adolescents. With the two-wave panel data we hypothesized that in the relationship between adolescents＇ negative life events experienced between Timel and Time2 （ASLEC2） and changes in the severity of depressive symptoms （CES-D2-CES-D1） dysfunctional attitudes measured at Timel（DAS1） served as a cognitive moderator and the frequency of automatic thoughts between Timel and Time2 （ATQ2-ATQ1） as a cognitive mediator. That was dysfunctional attitudes was a mediated moderator. Additionally the model did not exclude the possibility that either negative life events or dysfunctional attitudes might have some direct influences on automatic thoughts and depressive symptoms and was called Integrated Cognitive Model of Depression for Adolescents （ICM-A）. As a contrast we also tested the integrated cognitive model （ICM） and the symptom model （SM）. Participants were 613 Chinese junior high school students. All participants completed the Adolescent Life Events Questionnaire （ASLEC）, Dysfunctional Attitudes Scale （DAS）, Automatic Thoughts Questionnaire （ATQ） and Center for Epidemiological Studies Depression Scale （CES-D） twice -about 4 months apart. The results of the path analysis indicated ： （1） The correlations among the measures were significant and repeated measures t-tests revealed that all the measures increased significantly from Timel to Time2; （2） The modified ICM-A best model fitted the Chinese adolescent data and there was a gender difference in the path estimate from the interaction between dysfunctional attitudes and negative life events to automatic thoughts. We concluded that at the increasing phase of adolescents＇ depressive symptoms dysfunctional attitudes could be a common cognitive moderator of depression, whereas automatic thoughts could be specific cognitive mediators of depression and there was a gender difference in the model. The findings support the moderating role of dysfunctional attitudes and the mediating role of automatic thoughts in the relationships between negative life events and depressive symptoms at the increasing phase of adolescents＇ depressive symptoms. This indicates the main cognitive constructs of Chinese adolescents, such as the roles of dysfunctional attitudes and automatic thoughts, may share similarities when compared to Western populations. This provides initial support that Western-based theories and treatments for depression may be suitable for use in some non-Western populations. Cognitive intervention will be effective in Chinese adolescents＇ depression prevention. And the current investigation provides preliminary evidence of the gender difference in the moderating role of dysfunctional attitudes.