门诊焦虑障碍患者的自我分化水平研究

Study on the differentiation of self in outpatients with anxiety disorder

目的探讨精神科门诊焦虑障碍患者的自我分化水平及其与焦虑特质的关系。方法对符合简明国际神经精神访谈(MINI)中文版诊断的123名焦虑障碍患者和120名健康对照予以自我分化量表修订版的中文版(DSI-R)、状态-特质焦虑量表(STAI)问卷调查。结果 (1)焦虑障碍组DSI-R总分、情绪反应性(ER)维度和自我位置(IP)维度分值低于健康对照组,差异有显著性(P<0.01),而情感断绝(EC)维度和与他人融合(FO)维度分值两组差异无显著性;(2)焦虑障碍组年龄与DSI-R总分、ER、IP、EC维度呈正相关(P<0.05或P<0.01),与FO维度无相关关系。男性焦虑障碍患者的ER维度分值高于女性焦虑障碍患者(P<0.05),健康对照组年龄与IP维度正相关(P<0.01),未婚者的DSI-R总分及ER维度分值高于已婚者(P<0.01);(3)逐步回归分析表明,情绪反应性(ER)和自我位置(IP)是特质焦虑的重要预测因素,能联合预测特质焦虑的27.2%(焦虑障碍组)、39.9%(健康对照组)的变异量。结论焦虑障碍患者自我分化水平较健康对照组低,自我分化能预测个体的焦虑特质。

Objective To study the level of differentiation of self and to explore its relationship with trait anxiety in outpatients with anxiety disorders. Methods 123 outpatients with anxiety disorder diagnosed with Mini-International Neuropsychiatric Interview（MINI） and 123 healthy controls were assessed with Differentiation of Self Inventory-Revised edition （DSI-R） and State-trait Anxiety Inventory （STAI）. Results （1） Total score of DSI-R, factor scores of emotional reactivity （ER） and I position （IP） in anxiety group were significantly lower than those in healthy control group （P 〈 0.01 ）. There was no significant difference in factor scores of emotional cutoff （EC） and fusion of others （FO） between the two groups. （2） In anxiety group, age was positively correlated with total score of DSI-R, factor score of ER, IP and EC （P 〈 0.05, or P 〈 0.01 ）. There was no significant correlation between age and factor score of IP. Factor score of ER in male patients with anxiety disorder was significantly higher than that in females （ P 〈 0.05 ）. In healthy control group, age was positively correlated with factor score of IP （P 〈 0.01 ）. Total score of DSI-R and factor score of ER in singles were significantly higher than those in married subjects （ P 〈 0.01 ）. （ 3 ） Step-by-step regression analyses showed that factor scores of ER and IP were key predictors for trait anxiety, the contribution was 27.2% and 39.9% in anxiety group and control group respectively. Conclusion Patients with anxiety disorder have lower differentiation of self than healthy subjects. Differentiation of self can predict the trait anxiety of individuals.