强迫症患者的成人依恋与自我分化相关研究

Study on the Relationship between Attachment Styles and Differentiation of Self in Patients with Obsessive Compulsive Disorder

目的:探索强迫症患者的成人依恋类型、自我分化水平以及两者的关系。方法:对82名强迫症(OCD)患者和100名正常对照(NC)予以亲密关系体验问卷中文版(ECR-R)、自我分化量表修订版的中文版(DIS-R)、状态-特质焦虑量表(STAI)问卷调查。结果:OCD组中不安全依恋类型显著高于NC组。OCD患者的ECR-R焦虑、回避维度、STAI分值高于NC组,DSI-R总分、情绪反应性(ER)、自我位置(IP)、情感断绝(EC)维度分值低于NC组。相对于安全依恋型的OCD患者和安全型及不安全型的NC组被试,不安全型OCD患者的DSI-R总分、ER维度分值最低,而SAI、TAI分值最高。OCD患者的ECR-R焦虑维度与DSI-R总分及四个维度均相关,ECR-R回避维度与DSI-R的IP、EC维度相关。OCD组ER、EC、IP维度分值可以联合预测ECR-R焦虑分值的71%,而EC、IP维度分值可以联合预测ECR-R回避分值的76%。结论:OCD患者中不安全依恋类型占多数,自我分化水平较低,不安全依恋类型的OCD患者自我分化水平更低,成人依恋与自我分化相关。

Objective： To study relationship between attachment Styles and differentiation of self in patients with Obses- sive Compulsive Disorder（OCD）. Methods： 84 outpatients with OCD and 100 normal controls（NC） were assessed by Experi- ence of Close Relationship-Revised Version（ECR-R）, Differentiation of Self Inventory Revised edition（DSI-R） and State- Trait Anxiety Inventory（STAI）. Results： The patients with OCD had significantly higher rate of insecure adult attachment styles than NC group. The patients were higher in ECR-R anxiety and avoidance scores, but lower in STAI and DSI-R total score, and emotional reactivity（ER）, I position（IP）, emotional cutoff（EC） scores. Compared with the patients with secure at- tachment and the NC with secure and insecure attachment, the patients with insecure attachment in OCD group had least scores in DSI-R total and ER and highest scores of STAI. In patients, the scores in DSI-R total and four subscales were negatively associated with the scores in ECR-R anxiety, while both the scores of EC and IP were negatively correlated with ECR-R avoidance score. The scores of EC ,ER and IP could predict 71% of the scores of ECR-R anxiety, while the scores of EC and IP could predict 76% of the scores of ECR-R avoidance. Conclusion： Patients with OCD tend to have insecure attachment styles and lower differentiation of self. The patients with insecure attachment had lower differentiation of self. The attachment styles were associated with the differentiation of self in the patients with OCD.