精神分裂症非理性信念和应对方式与社会功能的相关性

Correlation among Irrational Beliefs,Coping Style and Social Function in Schizophrenia Patients

目的探讨精神分裂症患者非理性信念和应对方式与社会功能的关系。方法对89例精神分裂症患者在心理治疗前和结束后60周进行测评,测评工具包括阳性与阴性症状量表(PANSS)、非理性信念量表(IBS)、应对方式问卷(CSQ)及个人和社会功能量表(PSP)。结果①与治疗前相比,治疗结束后60周IBS中的低挫折耐受、概括化评论和绝对化要求评分降低,差异均有统计学意义(P<0.01);CSQ中的问题解决评分升高,自责、幻想、退避与合理化评分降低,差异均有统计学意义(P<0.01);PSP评分升高,差异有统计学意义(P<0.01);②Pearson相关分析表明,概括化评论、绝对化要求和幻想评分与社会功能评分之间呈显著负相关(r=-0.226,-0.211,-0.218;P<0.05),问题解决评分与社会功能评分之间呈显著正相关(r=0.247,P=0.020);③路径分析表明,问题解决、幻想、概括化评论对社会功能的路径系数分别为0.268,-0.214,-0.226(P<0.05),概括化评论对问题解决的路径系数为-0.371(P<0.01),绝对化要求对幻想的路径系数为0.411(P<0.01)。结论非理性信念、应对方式与精神分裂症患者的社会功能相关;问题解决、幻想和概括化评论对社会功能产生直接作用;概括化评论与绝对化要求分别通过问题解决和幻想对社会功能产生间接作用。

Objective To explore the correlation among irrational beliefs, coping styles and social function in schizophrenia patients. Methods A cohort of 89 schizophrenia patients were assessed with Positive and Negative Syndrome Scale for Schizophrenia, Irrational Beliefs Scale, Coping Style Questionnaire and Personal and Social Performance Scale at baseline and week 84. Results （1） Compared to baseline,there were significant declines on scores of low frustration, generalization comments and demandingness of IBS, a significant in- creaseon problem solving and significant declines on self accusation, fancy, withdrawal and rationalization of CSQ at week 84 （P 〈 0.01 ）. The score of PSP was significantly higher than that at baseline（P 〈 0.01 ）. （2） Pearson correlation analysis showed that the scores of gen- eralization comments（ r = -0. 226, P 〈 0.05 ）, demandingness （ r = -0. 211, P 〈 0. 05 ） and fancy （ r = -0. 218, P 〈 0.05 ） were negatively correlated with the score of PSP; The score of problem solving was positively correlated with the score of PSP （ r = 0. 247, P 〈 0. 020）. （3） Path analysis showed that problem solving,fancy and generalization comments had direct effects on patients＇social function and path coefficients were 0.268,-0. 214,-0. 226 （P 〈 0.05 ） ;Generalization comments had a direct effect on problem solving and path coefficients was-0. 371 （ P 〈 0.01 ）. Demandingness had a direct effect on fancy and path coefficient was 0.411 （ P 〈 0. 01 ）. Conclusion Irrational beliefs and coping styles are correlated with schizophrenia patients ＇social function. Problem solving, fancy and generalization comments have direct effects on patients＇social function. Generalization comments also has an indirect effect on patients＇oeial function via problem solving. Demandingness has an indirect effect on patients＇social function via fancy.