病耻感与精神症状关系初步研究

目的 调查精神分裂症患者的病耻感状况,探讨病耻感与精神症状的关系.方法 取北京安定医院住院治疗的精神分裂症患者95例,北京东城区社区精神分裂症患者152例,采用贬低-歧视感知量表、阳性与阴性症状量表(PANSS)对患者进行评估和测查.结果 研究对象“贬低-歧视感知量表”平均得分为(2.38±0.33)分,显著低于量表中点2.50分(t=-5.507,P＜0.01);患者的贬低-歧视感知量表评分与阳性因子分(r=0.136,P＜0.05)、PANSS总分(r=-0.152,P＜0.05)、BPRS分(r=-0.185,P＜0.01)均呈负相关.结论 ①精神分裂症患者未强烈感知到他人的贬低和歧视态度:②精神分裂症患者的精神症状越明显,感知到的病耻感就越少.     

住院精神分裂症患者病耻感与抑郁的关系

目的探讨住院精神分裂症患者病耻感与抑郁的关系。方法采用精神病患者病耻感评估量表、卡尔加里精神分裂症抑郁量表对77例住院精神分裂症患者进行问卷调查。结果精神分裂症患者的抑郁发生率为25.97%;不同受教育程度患者的病耻感总分及能力因子得分差异显著(P0.05);与抑郁总分相关性具有显著意义的变量包括:病耻感总分能力因子(r=0.39,0.35;P0.01),治疗因子(r=0.28,P0.05)。与抑郁体验因子相关性具有显著意义的变量包括:病耻感总分社交因子,能力因子(r=0.34,0.30,0.32;P0.01);与自我评价因子相关性具有显著意义的变量包括:病耻感总分社交因子(r=0.34,0.40;P0.01)。结论住院精神分裂症患者抑郁较常见,且病耻感越强,住院精神分裂症患者抑郁症状越明显。     

精神分裂症住院患者与社区患者感知病耻感水平对比

目的 调查精神分裂症患者的感知病耻感状况,探讨精神分裂症住院患者与社区患者的感知病耻感水平对比.方法 选取北京安定医院住院治疗的95例精神分裂症患者,北京东城区社区152例精神分裂症患者,运用贬低—歧视感知量表对患者进行测查.结果 精神分裂症患者的贬低—歧视感知量表的平均得分为(2.38±0.33)分,显著低于量表中点2.50分(t=-5.507,P＜0.01),差异具有统计学意义;精神分裂症住院患者感知病耻感水平高于社区患者(Z=-3.230,P＜0.01).结论 ①北京的精神分裂症患者在某些方面未强烈感知到他人的贬低和歧视态度;②住院患者的感知病耻感高于社区患者.     

住院精神分裂症患者病耻感状况及其相关因素

目的:了解住院精神分裂症患者的病耻感状况及其相关因素,为制定有效的护理对策提供依据。方法:采用精神疾病患者病耻感量表中文版(SSMI-C)、罗森博格自尊量表(SES)、一般自我效能感量表(GSES)及社会支持评定量表(SSRS)作为评定工具对144名住院精神分裂症患者进行调查,分析病耻感状况及其影响因素。结果:不同住院时间患者在病情掩饰因子、病耻感总分上,差异具有统计学意义(t=-2.211,-2.371;P0.05);不同病程患者在歧视因子上,差异有统计学意义(F=3.256,P0.05);积极效应因子与效能得分呈正相关(r=0.205,P0.05);多元逐步回归分析显示,效能可以预测患者病耻感体验的强烈程度(β=1.302,P0.05)。结论:精神分裂症患者病耻感与一般自我效能密切相关,应重点关注病程25年以上和住院时间4年以上的患者。     

中老年慢性前列腺炎伴性功能减退患者的病耻感与其自尊、社会功能的关系

目的:观察分析中老年慢性前列腺炎伴性功能减退患者的心理护理对病耻感及其自尊、社会功能的影响。方法:随机选取2016年1-12月于我院就诊的慢性前列腺炎伴性功能减退中老年患者60例作为观察组,并选取同期于我院就诊的前列腺炎患者60例作为对照组,观察两组患者的病耻感对其自尊、社会功能的影响。结果:观察组患者的社会排斥评分(t=6.789)、经济歧视评分(t=8.688)、内在羞耻感评分(t=8.109)、社会隔离(t=8.137)、总分(t=7.138)均显著高于对照组,差异具有统计学意义(P0.01),观察组患者的自尊评分显著低于对照组(t=-3.890,P0.01);通过相关性分析得知,中老年慢性前列腺炎伴性功能减退患者的病耻感总分与自尊评分呈负相关(r=-0.383,P0.05),与社会功能评分成正相关(r=0.325,P0.05)。结论:中老年慢性前列腺炎伴性功能减退患者的病耻感与自尊与社会功能均呈负相关,病耻感越高,自尊水平与社会功能越低。     

抑郁症患者的病耻感与应对方式的相关研究

目的探讨抑郁症患者病耻感水平与应对方式的关系。方法采用精神病患者病耻感评估量表、简易应对方式量表(SCSQ)对300名抑郁症患者进行调查。结果①不同年龄阶段的抑郁症患者的病耻感总分及社交、治疗因子存在显著性差异(t=3.907,4.532,3.847;P<0.05);②积极应对方式与病耻感存在显著负相关(r=-0.176,P<0.01),而消极应对方式与病耻感呈显著正相关(r=0.179,P<0.01)。结论抑郁症患者应对方式越积极,病耻感越低。     

精神分裂症患者病耻感影响因素分析

目的 探讨精神分裂症患者的病耻感体验及其影响因素.方法 采用精神疾病患者病耻感量表(SSMI)对342例精神分裂症患者进行调查,同时做人格、自尊、自我效能、应对方式、社会支持和精神症状评估.结果 单因素分析显示,与SSMI-C总分的相关性具有显著性意义的变量包括:病程(r=0.12,P＜0.05),PANSS抑郁因子分(r=0.18,P＜0.01),SES评分(r=-0.40,P＜0.01),GSES评分(r=-0.22,P＜0.01),EPQ的P分(r=0.22,P＜0.01)、E分(r=-0.22,P＜0.01)、N分(r=0.42,P＜0.01)和L分(r=-0.25,P＜0.01),SCSQ的积极应对方式评分(r=-0.14,P＜0.05)和消极应对方式评分(r=0.19,P＜0.01),SSRS的客观支持评分r=-0.25,P＜0.01),主观支持评分(r=-0.18,P＜0.01)和支持利用度评分(r=-0.25,P＜0.01).回归分析结果 :EPQ的P分、SES评分、SSRS的客观支持评分和PANSS抑郁因子分进入回归模型,标准化系数分别为0.30、-0.23、-0.19、0.13.结论 精神分裂症患者病耻感与多个因素有关,其中神经质人格特征、自尊水平、社会客观支持和抑郁情绪对患者的病耻感体验水平有着预测作用.     

精神分裂症患者病耻感与人格特征的相关性

目的了解康复期精神分裂症患者病耻感体验水平,考察人格特征与病耻感的关系。方法采用自编一般情况调查表、Link病耻感量表和艾森克成人人格问卷对175名具有自知力的精神分裂症患者进行问卷测试。结果 1患者"贬低-歧视感知"维度的平均得分为(2.5794±0.5511);应对方式中"保密"、"退缩"维度的平均得分为(2.5804±0.4363)和(2.5103±0.3979),但"教育"、"挑战"、"分离"3个维度平均得分都低于量表中点2.5分;在情感体验方面,"误解"和"不同/羞耻"两个维度平均得分都高于量表中点2.5分;2EPQ-E分与退缩、教育、挑战、误解分别呈显著负相关(r=-0.274,-0.374,-0.354,-0.209;P0.01),EPQ-N分与病耻感的3个维度贬低-歧视感知、病耻感应对、病耻感情感体验都呈现显著正相关(r=0.517,0.415,0.294;P0.01),而EPQ-P分与病耻感的3个维度也呈现显著正相关(P0.01)。结论精神分裂症患者普遍感知到较高水平的病耻感,认为自己不能被理解,感到与他人不同,通常采取保密、退缩的应对方式,且人格特征是影响精神分裂症患者病耻感的重要因素。     

不同阶段心理特征护理对肺癌患者病耻感的康复效果及社会功能的影响

目的:探讨针对不同阶段心理特征的护理模式对肺癌患者病耻感及社会功能的影响。方法:选择我院2016年1-12月期间收治的肺癌患者80例,根据随机数字表法分为两组,对照组40例,给予常规的护理干预;观察组40例,在常规护理干预的基础上给予针对性心理护理。两组患者的疗程均为3个月。采用日常生活能力(ADL)量表评估患者的生活能力,健康状况调查问卷(SF-36)评估生存质量,中文版肺癌患者病耻感量表(Cataldo LungCancer Stigma Scale)评价病耻感康复效果,社会功能缺陷筛选量表(SDSS)评价社会功能。结果:两组患者干预前社会功能、羞耻感评分、生活质量评分无统计学差异(P0.05)。干预后,观察组患者耻辱(t=-2.019)、歧视(t=-2.142)、吸烟(t=-2.639)、社会孤立感(t=-2.376)等病耻感评分低于对照组;社会功能缺陷评分(t=-3.019)低于对照组;日常生活能力(U=2.869)明显优于对照组;总体生活质量(t=9.003)优于对照组,以上差异均有统计学意义(P0.05)。结论:对肺癌患者实施针对性心理特征护理,可更好地提高患者的病耻感康复效果、日常生活能力、社会功能,对患者生存质量的改善具有重要的临床意义。     

个体化家属教育对社区康复精神分裂症家属病耻感的影响

目的了解个体化家属教育对社区康复精神分裂症家属病耻感、自我隐瞒、应对方式与社会支持的影响。方法选取参加个体化家属教育的社区康复精神分裂症家属100例为研究组,选取未参加个体化家属教育的社区康复精神分裂症家属100例为对照组,采用病耻感感受问卷、自我隐瞒量表、应对方式问卷及社会支持量表进行调查,收集两组共200例的调查资料,建立数据库,以SPSS19.0进行统计检验分析。结果参加个体化家属教育的社区精神分裂症家属与未参加的家属在病耻感(研究组1.914±0.254,对照组2.304±0.367;t=-8.73,P0.01)、自我隐瞒(研究组17.25±5.200,对照组31.44±7.452;t=-15.61,P0.01)、应对方式(研究组0.790±0.177,对照组0.633±0.226;t=5.50,P0.01)、社会支持(研究组40.41±7.28,对照组33.34±7.24;t=6.89,P0.01)有统计学差异。结论个体化家属教育有利于降低家属病耻感,提高家属的应对方式,降低患者复发率。     

大学生人际交往障碍的相关研究

目的　了解大学生人际交往障碍的状况。方法　采用自编的大学生人际交往障碍量表对 45 6名大学生进行测查。结果　社交孤独感在南北方、独生子女、年级得分有显著差异 ;社交焦虑感在南北方、独生子女、城乡、是否学生干部得分有显著差异 ;社交无能感在南北方、独生子女有显著差异 ;交往障碍在南北方、独生子女、学生干部得分有显著差异。是否学生干部、城乡在社交孤独感、交往障碍量表存在相关。结论　在进行人际交往训练时要认真分析学生的个人情况。     

Social relationships and risk of dementia: A systematic review and meta-analysis of longitudinal cohort studies

It is unclear to what extent poor social relationships are related to the development of dementia. A comprehensive systematic literature search identified 19 longitudinal cohort studies investigating the association between various social relationship factors and incident dementia in the general population. Relative risks (RRs) with 95% confidence intervals (CIs) were pooled using random-effects meta-analysis. Low social participation (RR: 1.41 (95% CI: 1.13–1.75)), less frequent social contact (RR: 1.57 (95% CI: 1.32–1.85)), and more loneliness (RR: 1.58 (95% CI: 1.19–2.09)) were statistically significant associated with incident dementia. The results of the association between social network size and dementia were inconsistent. No statistically significant association was found for low satisfaction with social network and the onset of dementia (RR: 1.25 (95% CI: 0.96–1.62). We conclude that social relationship factors that represent a lack of social interaction are associated with incident dementia. The strength of the associations between poor social interaction and incident dementia is comparable with other well-established risk factors for dementia, including low education attainment, physical inactivity, and late-life depression.     

Social support and social negativity findings in depression: perceived responsiveness to basic psychological needs

Social relationships can influence the well-being of depressed individuals, both positively and negatively. However, processes underlying these diverse effects are not clear. Drawing from self-determination theory (Deci & Ryan, 2000), we propose that the extent to which social relationship partners are perceived to fulfill or undermine basic psychological needs serves to explain both the positive and negative effects that social relationships have on the well-being of depressed individuals. This proposal forms a major tenet of a model that integrates previous models of social support mechanisms, namely, the buffering hypothesis and the main effects hypothesis. This model thus explains both the positive and negative effects that social relationships have on the well-being of depressed individuals. Presentation of this model is followed by a discussion of the possible effects of two characteristics of depressed individuals (i.e., stress generation and negative cognitive style) on their perceptions of relationship partners' responsiveness to basic psychological needs. We conclude with suggestions for future research and possible clinical applications.     

不同社会支持类型的大学生社会适应状况的研究

目的探讨大学生的社会支持同社会适应之间的关系。方法采用社会生活适应性问卷和领悟社会支持量表对257名大学生进行测查。结果 1大学生感受到的社会支持水平和他们的社会适应水平呈正相关(r=0.358,P0.01);2不同支持型学生社会适应水平的高低依次是:朋友支持(3.8182±0.4127)、家庭支持(1.6804±0.4036)和其他支持(1.2000±0.4011);3家庭支持和大学生的学习相关最高(r=0.2473,P0.01),朋友支持和大学生的交往活动相关最高(r=0.2631,P0.01)。结论大学生感受到的社会支持水平越高,他们的社会适应水平就越好。     

Social networks and social support: living with chronic renal disease.

Individuals with chronic renal disease who receive dialysis treatment are continually faced with major adjustments. These may include dealing with changes in work and economic status, social roles, activity levels, self-image, health status, and normal routines, as well as learning to live with uncertainty and loss. The individual's social network plays a key role as the individual experiences and moves through various stages of adjustment. Networks with certain characteristics (e.g. provision of affective support, reciprocal ties) may be more effective than others lacking these characteristics in meeting the individual's changing needs during the process of adjusting to chronic renal disease. This paper examines this relationship between the characteristics of an individual's social network and adjustment to chronic renal illness. The discussion focuses on the impact of chronic renal disease on the individual, the composition and characteristics of the social network, and on the relationships between network members. How the social network affects a person's adjustment to stages of adaptation to chronic renal disease is also addressed. Finally, suggestions are presented for how health care professionals can intervene at the individual, network, and organizational level to strengthen and enlarge social networks in order to enhance social support.     

苏北地区失地农民心理异常与社会保障多因素研究

目的了解失地农民心理健康状况、社会支持和社会保障现状,分析当前形势下,失地农民的身心健康状况、社会关系状况和对社会关怀的需求状况。为维护社会稳定、缓解社会矛盾提供决策依据。方法采用整群抽样的方法抽取徐州市两社区失地农民开展问卷调查,收回有效问卷1070份。结果失地农民心理健康问题严重,有近一半的失地农民心理异常。超过一半的农民认为自己身体状况一般或差。超过60%的人没有职业,超过65%的人没有医疗保险,超过80%的人没有养老保险,超过90%的没有失业保险。年龄低、无职业、健康状况差、无经济帮助、无社会保障措施成为心理异常的独立危险因素。结论失地农民心理健康问题严重,有近一半的失地农民心理异常。应尽快完善社会保障制度、医疗保险制度,开展社区医疗服务、心理咨询服务,加强失地的农民的社会支持。     

潜艇官兵社交回避及苦恼的心理社会因素研究

目的探讨导致潜艇官兵社交回避及苦恼的心理社会因素。方法对568名潜艇官兵进行量表测评,包括社交回避及苦恼量表、卡特尔16种人格因素问卷、生活事件量表、特质应对问卷、领悟社会支持量表、症状自评量表。数据采用SPSS15.0软件包进行统计分析。结果潜艇官兵社交回避(SA)和社交苦恼(SD)分值均显著低于国内大学生常模(SA:t=-3.28,P<0.01;SD:t=-2.24,P<0.05);不同衔级(SA:F=13.02,P<0.01;SD:F=5.58,P<0.01)、文化程度(SA:F=3.94,P<0.05;SD:F=3.77,P<0.05)、婚姻状况(SA:t=-5.22,P<0.01;SD:t=-2.63,P<0.01)潜艇官兵的社交焦虑状况比较存在显著差异;潜艇官兵社交回避及苦恼与个性、生活事件、特质应对、社会支持、心理健康水平有显著相关性;多元回归分析显示,人际关系敏感、敢为性、消极应对方式和兴奋性对社交回避行为的影响较大(标准回归系数依次为-0.274-、0.246、0.230-、0.227);敢为性、强迫症状、积极应对方式和敌对对社交苦恼情感的影响较大(标准回归系数依次为-0.332-、0.305-、0.300-、0.258)。结论个性、生活事件、特质应对、社会支持和心理健康水平等心理社会因素影响潜艇官兵社交回避及苦恼。     

Sex-specific difference in social support--a study in female guinea pigs

In challenging situations, the male guinea pig's hormonal stress responses can be ameliorated by the presence of his female bonding partner. Such social support cannot be provided, however, by a female with whom the male is familiar but has no social ties. In this study, we investigated whether the same phenomenon also accounts for female guinea pigs. First, the spontaneous behaviour of 14 females was recorded in their home colonies to determine their male bonding partners. Then, a so-called challenge test was conducted with 22 females: they were placed into an unknown enclosure for 4 h either alone (n=8), or together with their bonding partner (n=7) or with a familiar male from the same colony, who was not their bonding partner (n=7). Immediately before as well as 1, 2 and 4 h after the beginning of the challenge test, blood samples were taken to determine cortisol levels (CORT). Further on, the behaviour was recorded during the first 2 h of the challenge test. Placing a female guinea pig into an unknown enclosure led to significantly increased CORT independently of whether she was tested alone or with a social partner. However, females that were tested together with their bonding partner showed significantly lower CORT than females tested alone. In females who were tested with a familiar male CORT was in between. The behaviour during the challenge tests reflected the magnitude of the stress response. Thus, also in female guinea pigs social support can be provided by social partners. In contrast to males, however, not only the bonding partner is able to reduce the female's stress responses, but also a familiar conspecific, though in a less effective way.     

社会网络、社会支持对离退休老年病人生存质量的影响

目的:探讨社会支持、社会网络、社会交往等因素对离退休老年病人生存质量的影响。方法:对351名离退休老年病人进行生存质量量表、期望性支持和获得性支持量表和社会网络数量、社会交往的频率、疾病诊断的数量等评定。结果:多元逐步线性回归分析显示,社会网络的数量和社会交往的频率对老年病人的生存质量各领域因子分均没有显示明显的影响,没有进入回归方程;情感支持对生存质量心理领域、社会关系领域、精神支柱/宗教/个人信仰等领域影响较为明显,所解释的变异分别为17.0%、29.9%、14.2%;期望性支持对总的生活质量及健康状况有明显影响,所解释的变异为12.9%,并对生存质量心理领域、社会关系领域也有一定的影响;有形支持分仅对生存质量环境领域影响较为明显,所解释的变异为22.5%,对生存质量其他领域影响不明显。疾病诊断的数量对生存质量的多个领域都显示有负面的影响,影响程度比年龄更为明显,除对生存质量生理领域较为明显外(可解释总分变异的25.3%),还对心理领域、独立领域、社会关系领域、总的生活质量及健康状况都有一定的影响。结论:社会支持对老年病人生存质量的影响主要不是取决于其社会交往和社会网络的数量,而是取决于社会支持的质量。情感性、感受性支持较有形的社会支持或工具性支持对老年病人生存质量的影响更为明显。疾病对生存质量的影响不仅仅表现身体的痛苦上,还对患者的心理社会功能造成明显的影响。     

The effect of self-imagery on symptoms and processes in social anxiety: A systematic review

Background

Cognitive models of Social Anxiety Disorder suggest that negative self-images maintain social fears despite repeated exposure to benign social situations. An accumulating body of evidence supports this notion, and preliminary data indicate that modifying self-imagery can potentially reduce fears of negative evaluation in socially anxious individuals. This systematic review aims to evaluate the existing research on the effect of self-imagery on symptoms and processes in social anxiety.

Methods

The following databases were searched: PsycInfo, Medline, PubMed, and Cochrane Central Register of Controlled Trials. Articles were limited to adult samples and English language papers that examined the effect of self-imagery on at least one measure related to social anxiety. Risk of bias and study results were reviewed for each study.

Results

In the 17 studies that were identified, negative self-imagery had a consistently adverse effect on anxiety, self and observer-rated performance appraisals, and negative thoughts for both socially anxious and non-clinical participants. Effects of negative self-imagery were generally not significantly greater for socially anxious participants.

Conclusions

Further research is warranted to determine the precise role of different types of self-imagery for both clinical and non-clinical individuals.