多导心理-生理数据辅助焦虑性神经症咨询案例

A Consulting Case of Psychological-physiological Polysomnography Data for Auxiliary Diagnosis of Anxiety Neurosis

目的通过介绍1例从事科技工作的焦虑性神经症求助者的咨询案例,探讨焦虑性神经症的个性化治疗方法及Superlab多导生理-心理数据对焦虑性神经症的辅助诊断作用。方法咨询师根据求助者的症状、汉密尔顿焦虑量表及症状自评量表(SCL-90)的检测结果,再结合Superlab多导生理仪器检测得到的各项生理指标,综合分析求助者的表现属于焦虑性神经症。咨询师针对求助者具有丰富的医学背景、性格内敛以及非常强的自我控制力等特点,采用符合求助者个性的儒家自省、积极情绪和眼动放松治疗方法,关注缓和家庭矛盾与眼动调节反馈作用,从认知、情绪、行为上对求助者进行干预和心理咨询。结果求助者咨询前后症状除容易惊醒无明显改变外,其余症状均消失。进一步了解得知,求助者父亲每日起夜4次,为防止父亲摔倒,求助者晚上要在父亲起夜时起床帮助,因此无法熟睡。但汉密尔顿焦虑量表减分率为88.23%,属于痊愈。求助者咨询前后SCL-90检测结果总分从161分降为111分(常模为160分),阳性项目从52项(常模少于43项)减为24项,焦虑项目分值下降明显,从25分减为13分,回归常模,敌对分也从14分下降为7分。求助者咨询前后呼吸、脉搏、心电波幅等改变不明显,但皮电下降明显。咨询前求助者心电静息状态下低频/高频(LF/HF)为1.300。咨询后,下降为0.274。结论个性化的反省结合眼动治疗可以有效、快速地缓解高知人群的焦虑性神经症,且Superlab多导生理-心理数据可对焦虑性神经症的治疗起到辅助诊断作用。

Objective To explore the individualized treatment of anxiety neurosis and Superlab psychologicalphysiological polysomnography data for auxiliary diagnosis of anxiety neurosis through a consulting case of a scientific and technological worker（the help seeker）with anxiety neurosis.Methods According to test results of the help seeker′s Symptom Hamilton Anxiety Scale and the Symptom Checklist-90（SCL-90）,the consultant combined them with the physiological indicators detected by Superlab polysomnography equipment to obtain a comprehensive analysis that the help seeker had anxiety neurosis.Because the help seeker had rich medical background,introverted personality and quite strong self-control,the consultant adopted a therapy of Confucian introspection,positive emotions and eye movement relaxation,and paid attention to easing family conflicts and the feedback of eye movement regulation so as to intervene and have psychological counseling from the perspectives of cognition,emotion and behavior of the help seeker.Results After consultation,the symptom of easily being waken up did not change significantly but the other symptoms of the help seeker disappeared.The reason was that the father of the help seeker had to urinate 4times during the evening and the help seeker had to help him to get up in order to prevent him from falling down,thus the help seeker could not fall asleep.But the reduction rate of Hamilton Anxiety Scale was 88.23%,which indicated the help seeker was healed.After consultation,the total scores of SCL-90 dropped from 161 to 111（the norm is 160）,positive items decreased significantly from 52 to 24（the norm 〈43）,scores of anxiety items reduced sharply from 25to13,returning to the norm,and scores of hostile dropped from 14 to 7.The changes of breathing,pulse and electrocardiogram wave amplitude of the help seeker were not obvious,but transcutaneous electricity decreased significantly.Before consultation,under resting electrocardiogram low frequency to high frequency（LF/HF）was 1.300,and it decreased to 0.274 after consultation.Conclusion Individualized introspection combined with eye movement therapy can effectively and quickly relieve anxiety neurosis of highly educated people,and Superlab psychological-physiological polysomnography data plays a role in auxiliary diagnosis of treating anxiety neurosis.