伴或不伴述情障碍抑郁症患者负性自动思维与应对方式研究

Negative automatic thinking and coping style in depression patients with or without alexithymia

目的:探讨伴或不伴述情障碍的抑郁症患者负性自动思维与应对方式的关系。方法:根据多伦多述情障碍量表(TAS-20)评分将80例抑郁症患者分为述情障碍组(TAS-20> 61分,n=40)和非述情障碍组(TAS-20 <51分,n=40);给予入组者汉密尔顿抑郁量表(HAMD)、自动思维问卷(ATQ)及应对方式问卷(CSQ)评估;分析两组间的差异及TAS-20与ATQ及CSQ评分的相关性。结果:述情障碍组ATQ评分显著高于非述情障碍组(P <0. 01);述情障碍组CSQ中求助、合理化、解决问题评分显著低于非述情障碍组(P均<0. 01);伴述情障碍的抑郁症患者TAS-20总分与ATQ总分呈正相关(r=0. 883,P <0. 01);与CSQ中求助、合理化、解决问题评分呈负相关(r=-0. 687,-0. 6796,-0. 712; P均<0. 01),与退避、幻想、自责评分呈正相关(r=0. 638,r=0. 583,r=0. 576; P均<0. 01)。结论:与不伴述情障碍的抑郁症患者相比,伴述情障碍的抑郁症患者负性自动思维程度更重,消极应对方式更明显,积极应对方式显著欠缺;负性自动思维与消极应对方式共同影响抑郁症的严重程度。

Objective:To explore the relationship between negative automatic thinking and coping style in depression patients with or without alexithymia.Method:According to the Toronto Alexithymia Scale(TAS-20)score,80 patients with depression were divided into alexithymia group(TAS-20 scores >61,n=40)and non alexithymia group(TAS-20 scores<51,n=40),evaluated by the Hamilton depression scale(HAMD),automatic thinking questionnaire(ATQ)and coping style questionnaire(CSQ).The differences between the two groups and the correlation among TAS-20,ATQ and CSQ scores were analyzed.Results:The ATQ score of alexithymia group was significantly higher than that in the non-alexithymia group,the difference was statistically significant(P<0.01).The projects of help seeking,rationalization,resolution in CSQ between the two groups had differences,the differences were statistically significant(P<0.01).The score of ATQ was positively correlated with the TAS-20 score(r=0.883,P<0.01),the scores of help seeking,rationalization and resolution of CSQ were negatively correlated with the TAS-20 score in the alexithymia group(r=-0.687,-0.6796,-0.712;all P<0.001).There was a positive correlation with the score of backoff,fantasy and self-reproach(r=0.638,r=0.583,r=0.576;all P<0.001).Conclusion:Compared with the depressive patients without alexithymia,depression patients with alexithymia have more negative automatic thinking and negative coping style while lack positive coping style.The automatic thinking and coping style affect the depression severity together.