应激有关因素与缓解期精神分裂症患者应对方式的相关研究

Correlation between stress-related factors and coping styles in patients with schizophrenia in remission

目的探讨应激有关因素与缓解期精神分裂症患者应对方式的相关性。方法选取142例缓解期精神分裂症患者为研究组,85例正常人为对照组,采用应对方式问卷对研究组和对照组进行评定,对研究组患者单独评定症状自评量表(SCL-90)、领悟社会支持量表(PSSS)、自动思维问卷(ATQ)及艾森克人格问卷(EPQ)。结果研究组解决问题分低于对照组,自责、回避、合理化分高于对照组,成熟应对方式得分明显低于对照组,不成熟应对方式得分明显高于对照组(P<0.05)。研究组中,ATQ与应付方式问卷中除合理化外各因子均有相关性(P<0.05),PSSS量表中的家庭外社会支持和社会支持总分与解决问题、求助、成熟应对方式有相关性(P<0.05),SCL-90与所有应对方式因子均有相关性(P<0.05),EPQ中的内外向与解决问题、自责、求助、成熟应对方式有相关性(P<0.01),神经质与除解决问题外各因子均有相关性(P<0.01),精神质与除回避外各因子均有相关性(P<0.05),掩饰与所有因子均有相关性(P<0.05)。多元逐步回归分析结果显示,与成熟应对相关的因子包括内外向、家庭外支持、家庭内支持、精神质,与不成熟应对相关的有ATQ、掩饰因子,与混合型应对方式相关的有SCL-90总分。结论缓解期精神分裂症患者存在不成熟应对方式,其与应激因素相关。

Objective To study the relationship between stress-related factors and coping styles of patients with schizophrenia in remission stage. Methods 142 patients with schizophrenia in remission stage （ study group） were evaluated with Coping Style Questionnaire （CSQ）, Symptom Checklist-90 （SCL-90）, Perceived Social Support Scale （PSSS）, Automatic Thoughts Questionnaire （ATQ） and Eysenck Personality Questionnaire （EPQ）. 85 healthy controls （control group） were evaluated with CSQ. Results Factor score of problem solving in CSQ in study group was significantly lower than that in control group, while factor scores of self-blame, avoidance, rationalization in study group were significantly higher than those in control group. Compared with control group, score of mature coping style was significantly lower and score of immature coping style scores was significantly higher in study group （P 〈 0. 05 ）. In study group, score of ATQ was significantly correlated with all factors in CSQ except rationalization （P 〈 0.05 ）. Factor score of outside-family social support and total score of social support of PSSS were significantly correlated with factor scores of problem-solving, seeking help and mature coping style of CSQ （P 〈 0. 05 ）. Total score of SCL-90 was significantly correlated with all factors of coping styles （ P 〈 0.05 ）. Factor score of extroversion of EPQ was significantly correlated with problem-solving, self-blame, seeking help and mature coping style of CSQ （P 〈 0. O1 ）. Neuroticism was significantly correlated with all factors of CSQ except problem-solving （P 〈 0. O1 ）. Psychoticism was significantly correlated with all factors of CSQ except avoidance （ P 〈 0. 05 ） and factor score of Lie was significantly correlated with all factors of CSQ （ P 〈 0. 05）. Multiple stepwise regression analysis indicated that extraversion, outside-family social support, inside-family social support, psychoticism were related with mature coping style. Automatic thoughts and Lie factor were related with immature coping style. Total score of SCL-90 was related with mixed coping style. Conclusion Patients with schizophrenia in remission stage tend to use immature coping styles, which was related with stress events.