自动思维在首发女性抑郁症患者发病中的交互作用

The interaction of automatic thinking in female patients with first-episode depressive disorders

目的探讨首发女性抑郁症患者自动思维与抑郁症相关的应激因素之间存在交互作用。方法选取住院的60例首发女性抑郁症患者,经过自动思维问卷、功能失调性态度问卷、社会支持量表、应付方式问卷及YG性人格测验测评,用Spearman相关分析及路径分析方法,分析自动思维与抑郁症相关的应激因素在首发女性抑郁症患者发病过程中的相互作用。结果 1自动思维总分与抑郁/焦虑总分、功能失调性认知总分、脆弱性、吸引和排斥、完美化和自主性态度等因子分呈正相关(P<0.05或P<0.01)。2自动思维总分与十二种性格中的自卑感、神经质、缺乏客观性和非合作性因子分呈正相关,与支配性、社会内外向性因子分呈负相关(P<0.05或P<0.01)。3自动思维和自责、合理化呈正相关,自动思维和社会支持总分、主观支持呈负相关(P<0.05或P<0.01)。4路径分析表明:自动思维对抑郁有直接预测作用;神经质、完美化、自责、焦虑通过自动思维对抑郁有间接预测作用;主观支持对自动思维有负向预测作用,且通过自动思维对抑郁有间接预测作用(P<0.05或P<0.01)。结论自动思维与抑郁症相关的应激因素之间存在交互作用,在开展抑郁症的心理治疗时需要综合考虑这些因素。

Objective To investigate the interaciton of automatic thoughts and stress factors related depression in fe-male patients with first-episode depressive disorder. Methods The 60 female patients with first-episode depression were enrolled and assessed by Hamilton Depression Rating Scale（HAMD）,Hamilton anxiety scale（HAMA）,Automatic thought questionnaire （ATQ）, Dysfunctional attitude scale （DAS）,ways of coping, the social support scale and Y-G Personality Questionnaire. Spearman correlation analysis and path analysis were used to analyse the interaciton of auto-matic thoughts and stress factors related depression. Results ①Automatic thoughts, depression,anxiety and dysfunc-tional cognition were positively correlated each other. Automatic thoughts and vulnerability, attraction and repulsion ,perfection and autonomy attitude were positively correlated （P〈0.05 or P〈0.01）. ②Automatic thinking and feeling of inferiority, nervosity, lack of objectivity and non cooperative were positively correlated,while dominant, social in-side and outside were negatively correlated. The differences were statistically significant（P〈0.05 or P〈 0.01）. ③Au-tomatic thoughts and blame, rationalization were positively correlated, while automatic thoughts, total score of social support and subjective support were negatively correlated. ④Path analysis showed that automatic thoughts predicted depression directly; nervosity, the perfection, blame, anxiety predicted depression indirectly through the automatic thoughts; subjective support acted on automatic thinking as negatively predicator, and predicted depression indirectly through the automatic thoughts （P〈0.05 or P〈0.01）. Conclusion Interaction existed among automatic thoughts and stress factors of depression related. When making the psychological treatment of depression,we should be considered these factors.