青少年强迫症与应激等的关系研究

目的：了解青少年强迫症发病与生活事件、应对方式和社会支持的关系.方法：对44例青少年强迫症患者和214名正常对照者进行一般社会人口学资料表、青少年生活事件量表（ASLEC）、特质应对方式问卷（TCSQ）和领悟社会支持量表（PSSS）的测评.结果：与对照组相比,强迫症组在人际关系、学习压力、受惩罚、健康适应、应激总量的得分上均显著较高（P＜0.05）;强迫症组患者较多采用消极应对方式,较少采取积极应对方式,获得较少社会支持,与正常对照者比较差异非常显著（P＜0.01）.结论：青少年强迫症的发病与负性生活事件、不良应对方式和缺乏社会支持有关.     

抑郁症患者的积极情绪状况及与应对方式和社会支持的关系

目的了解抑郁症患者的积极情绪、特质应对方式和社会支持状况。方法采用方便取样法对天津安定医院14例抑郁症住院患者和18例健康人分别进行正性负性情绪量表(PANAS)、特质应对方式问卷(TCSQ)和领悟社会支持(PSSS)的评估。结果抑郁组积极情绪、积极应对方式和领悟社会支持低于对照组,差异有统计学意义(t=-5.53,P0.01;t=-3.76,P0.01;t=-2.35,P0.05),抑郁组消极应对方式高于对照组,差异有统计学意义(t=1.15,P0.05)。抑郁患者的积极情绪和积极应对方式存在相关,有统计学意义(r=0.54,P0.05)。结论抑郁症患者的积极情绪和积极应对方式较少,感到较少的社会支持。抑郁症患者的积极情绪和积极应对方式相关。     

抑郁症残留症状及对疾病结局影响

目的：调查抑郁症残留症状及危险因素和其对疾病结局影响。方法：选择100例治疗12周以上抑郁症患者,评估人口社会学资料、抑郁症状、生活事件、应对方式、社会支持、生活质量和社会功能。结果：贝克抑郁自评问卷（BDI）≥5分和汉密顿抑郁量表17项（HAMD17）≥8分的患者比例分别为53％和49％;残留症状与负性生活事件（t=-4．90,P=0．00）、积极应对方式（t=8．22,P=0．00）、消极应对方式（t=-4．53,P=0．00）、社会支持（t=2．01,P=0．05）及家庭支持（t=1．97,P=0．05）明显有关;有残留症状者生活质量和社会功能显著差于无残留症状者（P〈0．01）。结论：抑郁症患者残留症状发牛率相当高．需要心弹社会干预。     

脑梗塞后抑郁与心理社会因素的关系探讨

目的　探讨脑梗塞后抑郁与病前生活事件、社会支持以及应对方式的关系。方法　采用Hamilton抑郁量表、生活事件量表、应付方式问卷、社会支持量表等工具评定 30例脑梗塞后伴明显抑郁症状的患者 ,并与 30例不伴明显抑郁症状的脑梗塞及 30名健康人进行对照。结果　负性生活事件刺激量和生活刺激总量 ,抑郁组高于非抑郁组 ,非抑郁组高于健康组 ,差异具有显著性 (P <0 .0 1)。抑郁组寻求帮助因子得分低于健康对照组 (P <0 .0 1) ;抑郁组的退避因子得分高于非抑郁组和健康对照组分 (P <0 .0 1) ;抑郁组的主观支持得分低于健康对照组 (P <0 .0 1)。结论　近期负性生活事件刺激量高、不适当的应对方式和缺乏社会支持是影响脑梗塞后抑郁症状的重要心理社会因素。     

老年抑郁症患者社会支持与应对方式特点研究

目的了解老年抑郁症患者的社会支持与应对方式特点。方法30例老年抑郁症患者为研究组，30例正常老年人为对照组。用社会支持评定量表和应对方式问卷分别进行测评。结果老年抑郁组的SSRS评分显著少于对照组（P〈0．01）。老年抑郁组的消极应对因子幻想及逃避评分显著高于对照组，而积极应对因子面对、淡化及探索评分显著低于对照组（P〈0．01～0．05）。结论老年抑郁症存在社会支持不足及应对方式不良，加强社会支持与应对方式指导可能对防治老年抑郁症起重要作用。     

有无自杀意念抑郁症患者抑郁情绪、认知应对策略及应激的比较研究

目的:探讨有无自杀意念抑郁症患者抑郁情绪、认知应对策略及应激性生活事件的差异。方法:对143例抑郁症患者进行自编一般情况问卷、Beck抑郁自评量表(BDI)、认知情绪调节问卷中文版(CERQ-C)评定。结果:有自杀意念抑郁症发作患者BDI总分、婚姻家庭应激及社会生活应激分及CERQ-C适应性策略与不适应性策略总分显著高于无自杀意念抑郁症患者(P<0.05或P<0.01)。有自杀意念抑郁症患者抑郁总分与工作学习应激、婚姻家庭应激、社会生活应激及CERQ-C不适应性策略分呈显著正相关(r=0.569,0.470,0.341,0.303,P<0.05或P<0.01);无自杀意念抑郁症患者抑郁总分仅与婚姻家庭应激呈显著正相关(r=0.361,P<0.01)。结论:有自杀意念较无自杀意念抑郁症患者经历更多的负性生活事件,存在更严重的抑郁情绪,较多地采用认知应对策略。     

应对方式及社会家庭支持对焦虑症患者影响的相关研究

目的调查心理咨询门诊中焦虑症患者应激事件中的应对方式及社会家庭支持,并探讨应对模式及心理支持对焦虑症患者的影响。方法采用病例对照的研究方法,对焦虑症组及正常对照组采用特质应对方式问卷,家庭亲密度与适应性量表,社会支持量表评估。运用非参数t检验Spearman相关分析。结果消极应对方式与焦虑症呈显著正相关（P〈0．01）;积极应对与焦虑症呈显著负相关。正常人群与焦虑症的社会,家庭支持异同（P〈0．05）。男性与女性焦虑症患者应对方式有显著差异（P〈0．01）。社会支持中男性患者与女性患者有显著差异（P〈0．01）。应对方式,社会支持及家庭亲密度适应性三者明显相关。结论应对模式,社会支持及家庭亲密度适应性对于个体的心理健康及心理应激至关重要。     

抑郁症患者生活事件、特质应对方式、父母养育方式及社会支持情况研究

目的了解抑郁症患者生活事件、特质应对方式、父母养育方式及社会支持状况及其性别差异。方法选取符合《国际疾病分类(第10版)》(ICD-10)抑郁症诊断标准的天津市精神卫生中心2013年3月-2014年2月门诊和住院患者104例,在社区中选取与所调查抑郁症患者社会人口学特征较为接近且汉密尔顿抑郁量表(HAMD-24)评分8分的健康人106例作为对照组;对两组进行生活事件(LES)、特质应对方式(TCSQ)、父母教养方式(EMBU)及社会支持(SSRS)量表测评。结果抑郁症患者负性刺激量、积极应对方式、父亲处罚严厉、母亲处罚严厉、母亲拒绝否认因子评分与对照组比较[(29.96±11.81)vs.(15.00±9.81),(29.31±5.39)vs.(25.36±5.00),(14.69±4.11)vs.(18.41±10.29),(10.23±2.69)vs.(12.34±4.39),(10.02±2.29)vs.(12.64±4.13)],差异有统计学意义(t=-5.699~9.976,P均0.01)。男性抑郁症患者的积极、消极应对方式及社会支持的总得分均高于女性(P0.05)。结论 1抑郁症患者经历更多的负性生活事件并多采用积极应对方式;2父母亲的教育方式均表现为低处罚严厉、低拒绝否认,母亲还表现为低过度保护;3抑郁症患者的客观社会支持较多、主观社会支持较少;4男性比女性抑郁症患者采用更多的积极应对方式和消极应对方式,并有更多的社会支持。     

青少年抑郁障碍患者心理社会学特征

目的探讨青少年抑郁障碍患者的心理社会学特点。方法收集符合《国际疾病分类(第10版)》(ICD-10)抑郁障碍诊断标准的96例青少年抑郁症患者。所有患者均未经治疗,且均为首次就诊。正常对照组按性别、年龄等一般特征与病例组进行1∶1匹配。采用自编一般资料调查表、艾森克人格问卷(EPQ)、家庭环境量表中文版(FES-CV)、父母教养方式评价量表(EMBU)、青少年生活事件量表(ASLEC)和抑郁自评量表(SDS)进行测评。结果病例组EPQ的神经质(N)维度评分高于对照组,内外向(E)维度评分低于对照组(P0.01);病例组中独立性、亲密度、知识性、娱乐性、情感表达、成功性评分均较对照组低,差异均有统计学意义(P均0.01);父母情感温暖与理解因子评分低于对照组,差异有统计学意义(P0.01)。结论青少年抑郁障碍可能与其成长环境、父母因素、人格、应激生活事件、社会支持、同伴关系等有关。     

首发青少年抑郁症与父母养育方式和自我接纳的关系研究

目的了解父母养育方式和自我接纳与首次发病青少年抑郁症的关系。方法对52例首次抑郁发作的青少年患者和214例正常对照者进行一般社会人口学资料表、父母养育方式评价量表(EMBU)和自我接纳问卷(SAQ)测评。结果与正常对照组相比,青少年抑郁症患者的父母更少情感温暖、理解(P<0.01),母亲有更多的拒绝、否认和更少偏爱被试(P<0.05);逐步判别分析显示,母亲的温暖、理解具有统计学判别意义(P<0.01);抑郁症青少年的自我接纳和自我评价显著低于正常青少年(P<0.01)。结论父母养育方式和自我接纳程度低与青少年抑郁发病相关;母亲的情感温暖、理解对青少年抑郁症的影响最大。     

正念减压疗法对脑卒中后抑郁的影响

目的探讨正念减压疗法(MBSR)对脑卒中后抑郁(PSD)患者的影响。方法将某三级甲等医院神经内科一年内确诊的68名PSD患者按确诊时间排序,并按最小不平衡指数法分为研究组和对照组各34名,两组均进行常规健康教育与治疗,研究组在此基础上进行每周1次、共8次的正念减压训练。治疗前后采用汉密尔顿抑郁量表24项版(HAMD-24)对患者进行测评,评估治疗效果。结果研究组经MBSR治疗后HAMD-24评分较治疗前低,差异有统计学意义[(16.20±2.04)vs.(21.32±1.86),P0.01],对照组治疗前后HAMD-24评分差异无统计学意义(P0.05),治疗后研究组HAMD-24评分低于对照组,差异有统计学意义(P0.01)。结论正念减压疗法对脑卒中后抑郁可能有效。     

创伤后应激障碍的认知行为治疗

创伤后应激障碍(PTSD)是个体经历或目睹严重的创伤性事件后表现出的持续性严重的精神疾病。认知行为治疗(CBT)是PTSD的一线治疗方法,能有效改善PTSD临床症状。本文对PTSD的CBT理论基础、方法技术和临床应用等进行介绍和评价。     

Oxidative stress in schizophrenia - focusing on the main markers

Oxidative stress is the condition arising from imbalance between toxic reactive oxygen species and antioxidant systems. It is believed that increased oxidative stress may be relevant to the pathophysiology of schizophrenia. In this way, the main markers of the lipid peroxidation processes include 4-hydroxynonenal and malondialdehyde. On the other side, the potential toxicity of free radicals is counteracted by a number of cytoprotective antioxidant enzymes that limit the damage, such as superoxide dismutase and glutathione peroxidase. However, the reports regarding the status of oxidative stress markers schizophrenia are very inconsistent, with various authors stating both increased and decreased activities of the main antioxidant enzymes, while others did not observe any significant modifications, as compared to control groups. Similar aspects were also reported in the case of the lipid peroxidation markers, although in here the contradictions are much more reduced than in the case of the antioxidant defences. It is generally believed that the equivocal results mentioned above may be due to different tissues studies, different species or the administrated treatment and the duration of the disease/treatment. In this context, in the present paper we were interested to review some studies regarding the oxidative stress status in patients and animal models of schizophrenia, by referring mainly to antioxidant enzymes and lipid peroxidation markers.     

Neuro-cognitive foundations of word stress processing - evidence from fMRI

Background

To date, the neural correlates of phonological word stress processing are largely unknown.

Methods

In the present study, we investigated the processing of word stress and vowel quality using an identity matching task with pseudowords.

Results

In line with previous studies, a bilateral fronto-temporal network comprising the superior temporal gyri extending into the sulci as well as the inferior frontal gyri was observed for word stress processing. Moreover, we found differences in the superior temporal gyrus and the superior temporal sulcus, bilaterally, for the processing of different stress patterns. For vowel quality processing, our data reveal a substantial contribution of the left intraparietal cortex. All activations were modulated by task demands, yielding different patterns for same and different pairs of stimuli.

Conclusions

Our results suggest that the left superior temporal gyrus represents a basic system underlying stress processing to which additional structures including the homologous cortex site are recruited with increasing difficulty.     

Moderate versus severe early life stress: associations with stress reactivity and regulation in 10-12-year-old children

Early life stress (ELS) is expected to increase reactivity of the hypothalamic-pituitary-adrenocortical (HPA) axis; however, several recent studies have shown diminished cortisol reactivity among adults and children with ELS exposure. The goal of this study was to examine cortisol activity in 10-12-year-old internationally adopted children to determine if moderate and severe ELS have different impacts on the HPA axis. Salivary cortisol and two measures of autonomic activity were collected in response to the Trier Social Stress Test for Children (TSST-C). Three groups reflecting moderate, severe, and little ELS were studied: early adopted children who came predominantly from foster care overseas (early adopted/foster care (EA/FC), n=44), later adopted children cared for predominantly in orphanages overseas (late adopted/post-institutionalized (LA/PI), n=42) and non-adopted (NA) children reared continuously by their middle- to upper-income parents in the United States (n=38). Diminished cortisol activity was noted for the EA/FC group (moderate ELS), while the LA/PI group (severe ELS) did not differ from the NA group. Overall, few children showed cortisol elevations to the TSST-C in any group. The presence/absence of severe growth delay at adoption proved to be a critical predictive factor in cortisol activity. Regardless of growth delay, however, LA/PI children exhibited higher sympathetic tone than did NA children. These results suggest that moderate ELS is associated with diminished cortisol activity; however, marked individual differences in cortisol activity among the LA/PI children suggest that child factors modify the impact of severe ELS. Lack of effects of severe ELS even for growth delayed children may reflect the restorative effects of adoption or the generally low responsiveness of this age group to the TSST-C.