精神分裂症病人敌意归因偏向及其影响因素分析

目的 探讨精神分裂症病人的敌意归因偏向及其影响因素.方法 选取2018年8月至2019年8月合肥市第四人民医院住院精神分裂症病人90例为观察组,选取同期本医院所在社区精神正常者80例为健康对照组,采用中文版模棱两可、目的和敌意问卷(AIHQ-C)对两组作敌意归因偏向评估,同时作偏执量表(Pa)、多伦多述情障碍量表(TAS-20)、自动思维量表(ATQ)、威斯康星卡片分类(WCST)及阳性和阴性症状量表(PANSS)等评估,分析精神分裂症病人敌意归因偏向相关影响因素.结果 观察组的AIHQ-C、Pa(17.02±4.99)分比(11.08±3.35)分]、TAS-20、ATQ(65.32±23.03)分比(49.68±19.04)分]等各项评分显著高于健康对照组(P<0.01),观察组WCST的完成分类数显著低于健康对照组(3.49±2.13)分比(5.44±1.21)分,P<0.01],持续性错误数显著高于健康对照组(27.19±15.80)分比(14.45±8.37)分,P<0.01];Pearson相关分析显示:观察组的AI-HQ-C各项评分与Pa、TAS-20、ATQ评分、PANSS总分、阳性症状分及WCST的持续性错误数呈正相关(P<0.05或P<0.01).以AIHQ-C的责备偏向分为因变量多元回归提示,自变量中Pa评分与PANSS阳性症状分、WCST持续性错误数被纳入方程,标准化系数分别为0.260(P<0.05)、0.286(P<0.01)、0.257(P<0.01).结论 精神分裂症病人存在明显的敌意归因偏向及述情障碍,认知灵活性低,偏执、阳性症状及认知灵活性对病人的敌意归因偏向有预测作用.

Analysis of hostile attribution bias and its influencing factors in patients with schizophrenia

Objective To investigate the hostile attribution bias and its influencing factors in schizophrenic patients. Methods Ninety patients with schizophrenia in Hefei Fourth People''s Hospital form August 2018 to August 2019 were selected as the observation group, and 80 patients with normal mentality in the community of hospital during the same period were selected as the healthy control group.The Chinese version of ambiguous intentions hostility questionnaire (AIHQ-C) was used to evaluate the hostile attribution bias. At the same time, paranoia scale (Pa), toronto alexithymia scale (TAS-20), the automatic thoughts questionnaire (ATQ), wisconsincard classification (WCST) and positive and negative symptoms scale (PANSS) were also evaluated to analyze the influencing factors ofhostile attribution bias in schizophrenia.Results The scores of AIHQ-C, Pa (17.02±4.99) scores vs. (11.08±3.35) scores], TAS-20 and ATQ (65.32±23.03) scores vs. (49.68±19.04) scores] in the patient group were significantly higher than those in the normal control group (P<0.01), the number of categories completed on WCST in the patient group was significantly lower than that in the normal control group (3.49±2.13) scores vs. (5.44±1.21) scores, P<0.01], and the number of perseverative errors was significantly higher than that in the normal control group (27.19±15.80) scores vs. (14.45±8.37) scores, P<0.01]. Pearson correlation analysis showed that AIHQ-C score in the patient group was positively correlated with Pa, TAS-20, ATQ score, PANSS total score, positive symptom score and Perseverative Errors number of WCST (P<0.05 or P<0.01). The multiple regression with the blame bias of AIHQ-C as dependent variablesshowed that Pa score and PANSS positive symptom score and WCST perseverative errors were included in the equation, and the standardized coefficients were 0.260 (P<0.05), 0.286 (P<0.01), and 0.257 (P<0.01), respectively.Conclusion The schizophrenic patientsshow hostile attribution bias and alexithymia, and the cognitive flexibility is lower. Paranoia, positive symptoms and the cognitive flexibility have a predictive effect on the hostile attribution bias of patients.