抑郁症患者防御方式在早期适应不良图式与心理健康状况间的中介作用

Mediating effects of defense styles on the relationship between early maladaptive schemas and mental health in patients with depression

目的:探讨抑郁症患者早期适应不良图式、防御方式与心理健康状况的关系,并检验防御方式在早期适应不良图式与心理健康状况之间的中介作用。方法:选取门诊抑郁症患者87名,采用Young图式问卷-短版2(Young schema questionnaire-short form,YSQ-SF2)、防御方式问卷(defense style questionnaire,DSQ)、症状自评量表(symptom checklist-90,SCL-90)及贝克抑郁问卷(Beck depression inventory,BDI)进行测评。运用SPSS Process程序结合Bootstrap方法分析防御方式的中介作用。结果:女性遗弃/不稳定图式得分高于男性[2.00(0.50,4.00)分,0(0,1.25)分,Z=-2.963,P=0.003],差异具有统计学意义;男性情感压抑图式得分高于女性[1.00(0,3.00)分,0(0,2.00)分,Z=-2.318,P=0.02]。脆弱/对伤害或疾病的易感性、情感剥夺显著正向预测SCL-90总分,可解释的变异率为27.7%。社交孤立/疏离、遗弃/不稳定显著正向预测SCL-90阳性项目数,可解释的变异率为19.3%。不成熟防御方式在社交孤立/疏离与心理健康状况之间以及在遗弃/不稳定与心理健康状况之间均起完全中介作用。结论:抑郁症患者的社交孤立/疏离与遗弃/不稳定图式通过不成熟防御方式的中介作用影响心理健康。

Objective:To explore the relationship between early maladaptive schemas,defense styles and mental health in patients with depression,and to investigate the mediating effects of defense styles between early maladaptive schemas and mental health.Methods:A total of 87 outpatients with depression were assessed with the Young schema questionnaire-short form 2(YSQ-SF2),defense style questionnaire(DSQ),symptom checklist-90(SCL-90)and Beck depression inventory(BDI).SPSS Process program and Bootstrap method were used to explore the mediating effect of defense styles.Results:The scores of abandonment/instability were higher in females than those in males(2(0.5,4),0(0,1.25),Z=-2.963,P=0.003)while the score of emotional inhibition was higher in males than in females(1(0,3),0(0,2),Z=-2.318,P=0.02).The total score of SCL-90 was positively predicted by vulnerability to harm or illness and emotional deprivation,with an explanatory variation rate of 27.7%.The number of SCL-90 positive items was positively predicted by social isolation/alienation and abandonment/instability,with an explanatory variation rate of 19.3%.Immature defense styles fully mediate the relationship between social isolation/alienation and mental health,as well as between abandonment/instability and mental health.Conclusion:Social isolation/alienation and abandonment/instability affect the mental health of patients with depression by the mediating effect of immature defense styles.