广泛性焦虑障碍患者的述情障碍与状态焦虑、特质焦虑的关系

目的探讨广泛性焦虑障碍患者的述情障碍与焦虑特质的相关性。方法采用自制的一般情况调查表、多伦多述情障碍量表(TAS-20)、状态-特质焦虑问卷(STAI)对46例广泛性焦虑障碍患者(焦虑组)及50例健康志愿者(对照组)进行评估,并分析述情障碍与状态焦虑、特质焦虑的关系。结果 1焦虑组的TAS总分、因子1、因子2、因子3显著高于对照组(P0.05);2焦虑组患者状态焦虑分、特质焦虑分显著高于对照组,差异有统计学意义(P0.05);3焦虑患者的TAS-20总分与状态焦虑和特质焦虑的评分呈显著正相关(P0.05或P0.01);TAS因子2与状态焦虑分显著正相关,而与特质焦虑分无显著相关(P0.05);TAS因子3与特质焦虑分呈显著正相关(P0.05),与状态焦虑无显著相关(P0.05);TAS因子1与状态焦虑、特质焦虑分均无明显相关(P0.05)。结论广泛性焦虑障碍的患者存在述情障碍,缺乏情感描述能力与状态焦虑关系较为密切,外向性思维缺乏与特质焦虑更为密切。     

神经症患者述情障碍及其特征的探讨

目的：了解神经症患者的述情障碍状况；了解不同类型的神经症患者述情障碍的差异及其主要的特点，为神经症的病因学研究及治疗和预防提供一些信息和证据。方法：神经症组：符合CCMD—Ⅲ神经症诊断标准的病人258人；符合DSM—Ⅳ分类与诊断标准中抑郁障碍的患者73人，焦虑障碍54人，抑郁与焦虑同时存在的(共病)65人，其它类型的神经症患者66人。对照组：无神经症及其它精神疾病健康人，共150人。使用本课题组修订的20个条目的多仑多述情量表(TAS-20)中文版作为评定工具，对所有样本进行述情障碍评定。结果：两组在总分及各因子分上的差异显著，神经症患者的述情障碍明显高于正常对照组；抑郁性障碍、焦虑性障碍、抑郁与焦虑共存(共病)三组在外向性思维因子分和量表总分上有明显的组间差异，抑郁性障碍组和共病组在外向思维因子分及量表总分上均显著高于焦虑性障碍组；不同性别的述情障碍比较结果表明正常对照组内没有明显的性别差异，而在神经症组内男性患者的述情量表总分和外向思维因子分明显低于女性病人。结论：神经症患者存在明显的述情障碍，且女性更严重；不同类型的神经症患者述情障碍的严重程度存在差异，抑郁性障碍和共病患者的述情障碍比焦虑性障碍严重，主要表现在外向思维方面。     

综合性医院门诊就诊患者述情障碍与情绪状态

目的探讨综合性医院门诊就诊患者述情障碍与情绪状态的相关关系。方法采用述情障碍量表和中国心身健康量表中的焦虑和抑郁因子,以382例门诊就诊患者作为研究组和462名健康人群作为对照组进行问卷调查,数据应用t检验、描述统计、Pearson相关分析、回归分析。结果①综合性医院门诊就诊患者述情障碍总分及各因子分均高于对照组(t=1.746~7.419,P0.05,除情感体验缺失因子);②已婚患者的述情障碍状况较未婚患者好(F=2.662~3.160,P0.05)、高文化患者的述情障碍较低文化患者好(F=0.773~6.253,P0.01,除情感体验缺失因子);③门诊就诊患者述情障碍与焦虑、抑郁呈正相关(r=0.067~0.281,P0.05),与其一般情况无显著相关(P0.05);④影响综合性医院门诊就诊患者述情障碍的主要原因是焦虑(P0.01)。结论综合性医院门诊就诊患者的述情障碍相对较严重;已婚和高文化患者的述情障碍状况较好;焦虑、抑郁症状越严重,患者的述情障碍越差,其中影响述情障碍的主要因素是焦虑因子。     

焦虑障碍者的个性倾向、特质焦虑和自我效能感

目的:通过对焦虑障碍患者个性倾向、自我效能感、特质焦虑等影响因素的相关研究,探讨焦虑障碍可能的病理心理学机制。方法:采用病例对照研究,对144例焦虑障碍患者和144名健康人利用中国人个性量表-情感量表(CPAI2-E)、状态-特质焦虑问卷(STAI)、自我效能感量表(GSES)评定。结果:①患者组情感量表的诸因子得分显著高于对照组(P<0.01);②患者组特质焦虑得分显著高于对照组,而自我效能感得分对照组高于患者组(P<0.01);③状态焦虑与情感量表各因子、特质焦虑呈正相关(r=0.459～0.781,P<0.01),与自我效能感量呈负相关(r=-0.332,P<0.01)。④多元逐步回归分析发现,特质焦虑和焦虑紧张因子与焦虑情绪的关系更为密切。结论:特质焦虑、抑郁、焦虑紧张、躯体症状、躯体化、性适应不良及自卑倾向等诸多因素间的交互作用可能是焦虑障碍发生的病理心理学基础,特质焦虑与焦虑情绪的关系更为密切。     

抑郁症患者的述情障碍与焦虑、抑郁的相关性研究

目的 探讨抑郁症患者的述情障碍以及与焦虑、抑郁的关系.方法 采用多伦多述情障碍量表(Toronto Alexithymia Scale, TAS)、Hamilton焦虑量表(Hamilton Anxiety Scale,HAMA)及Hamilton抑郁量表(Hamilton Depression Scale,HAMD)对100例抑郁症患者和100例正常自愿者进行测评,并对述情障碍与焦虑、抑郁作相关分析.结果 抑郁症组TAS评分显著高于正常对照组0=6.86,P＜0.01);其述情障碍的发生率为43%,亦显著高于对照组的11%(x2=25.98,P＜0.01).抑郁症患者的TAS总分及因子Ⅰ、Ⅱ、Ⅳ评分与HAMA及HAMD评分均呈显著性正相关.结论 抑郁症患者存在着明显的述情障碍,并与焦虑、抑郁有关.     

述情障碍和无聊倾向性在神经质与焦虑、抑郁之间的中介效应

目的:考察新兵人格特征与心理健康的关系及述情障碍和无聊倾向性在人格特征与心理健康的中介作用.方法:通过使用艾森克人格问卷简式量表中国版、自评抑郁量表、状态和特质焦虑量表、述情障碍量表和无聊倾向性量表对314名新兵进行调查.结果:神经质、述情障碍、无聊倾向性与抑郁、状态焦虑、特质焦虑均呈正相关(r=0.38～0.52,Ps<0.01).述情障碍在神经质对抑郁、状态焦虑和特质焦虑的预测中介效应分别为0.375、0.467、0.377(Ps<0.01).无聊倾向性在神经质对抑郁、状态焦虑和特质焦虑的中介作用分别为0.359、0.546、0.565(Ps<0.01).结论:述情障碍和无聊倾向性是影响神经质类型人格心理健康水平的重要因素,士兵的心理健康防治工作可以从这两个方面开展.     

消化性溃疡患者述情障碍调查分析

为评定消化性溃疡患者有无述情障碍,用多伦多述情障碍量表(TAS)对60例住院患者进行评定,并与60例正常健康者对照,结果发现,消化性溃疡患者TAS总分及4个因子分均显著高于对照组,说明在消化性溃疡患者中存在述情障碍。     

焦虑障碍患者心理健康状况与个性特征的调查

目的：了解焦虑障碍患者的心理健康状况与个性特征的现状。方法采用病例对照研究，对101例焦虑障碍患者和101例健康人选用症状自评量表(SCL-90)，中国人个性量表-情感量表(CPAI2-E)，焦虑自评量表(SAS)，汉密尔顿焦虑量表(HAMA)评定。结果①焦虑障碍患者SCL-90评分总分、总均分、阳性项目数和各因子均高于健康对照组(P<0.05)；②焦虑障碍患者CPAI2-E总分、因子分高于健康对照组(<0.01)；③不同文化程度焦虑障碍患者躯体症状因子和躯体化因子得分存在显著差异(<0.05)，文化程度较低者得分较高。结论①焦虑障碍患者心理健康水平偏低，消极情感倾向和敏感，躯体症状倾向突出，自然效能感更低；②低文化程度患者较多存在躯体症状和躯体化倾向。     

广泛性焦虑障碍患者的述情障碍及其特征

目的探讨广泛性焦虑障碍患者的述情障碍及其影响因素。方法采用自制的一般情况调查表、多伦多述情障碍量表(TAS-20)对伴有或不伴有惊恐发作的46例广泛性焦虑障碍患者(焦虑组)及50例健康志愿者(对照组)进行评估。结果 1焦虑组的TAS总分与对照组相比较差异有统计学意义(t=3.41,P0.01);2男性焦虑患者的TAS因子3显著高于女性焦虑患者,差异有统计学意义(t=2.76,P0.05);3焦虑患者的TAS总分及各因子分与受教育水平显著负相关(P0.05);4伴有惊恐发作的焦虑患者的TAS总分显著高于不伴有惊恐发作的广泛性焦虑患者,差异有统计学意义(t=3.43,P0.01)。结论广泛性焦虑障碍的患者存在述情障碍,且男性、低文化水平更为严重;伴有惊恐发作的焦虑患者的述情障碍较不伴有惊恐发作的患者严重。     

广泛性焦虑障碍患者的述情障碍与焦虑症状的相关分析

目的探讨广泛性焦虑障碍患者的述情障碍与焦虑的相关性。方法采用自制的一般情况调查表、多伦多述情障碍量表(TAS-20)、汉密尔顿焦虑量表(HAMA)对伴有或不伴有惊恐发作的46例广泛性焦虑障碍患者(焦虑组)及50例健康志愿者(对照组)进行评估,并分析述情障碍与焦虑的相关性。结果 1焦虑组的TAS总分、因子1、因子2、因子3显著高于对照组(t=3.41,P0.05);2焦虑患者的TAS总分与HAMA总分及躯体评分呈显著正相关(t=17.27,P0.01),与精神焦虑分无相关性(t分别=-0.13,0.16,P0.05);TAS因子1、因子3与HAMA总分、精神焦虑分、躯体焦虑分无显著相关性(r=0.50,P0.05);因子2与HAMA总分、躯体焦虑分呈显著正相关(P0.05)。结论广泛性焦虑障碍的患者存在述情障碍,且述情障碍与焦虑症状存在正相关,缺乏情感描述能力者躯体焦虑更为显著。     

Alexithymia in obsessive-compulsive disorder - results from a family study

BACKGROUND: Previous studies have suggested an association between alexithymia and obsessive-compulsive disorder (OCD). However, it is unclear to which extent alexithymic traits in OCD patients reflect familial deficits in cognitively processing and communicating feelings that are also present in their first-degree relatives. This study investigates the hypotheses of an elevated level of alexithymia in subjects with OCD and their first-degree relatives compared to controls and their first-degree relatives. METHODS: 82 cases with OCD and 169 first-degree relatives were compared to 76 controls and 144 first-degree relatives from a German family study on OCD (GENOS). All subjects completed the 20-item Toronto Alexithymia Scale (TAS-20). Direct or family informant interviews were carried out with the German version of the Schedule for Affective Disorders and Schizophrenia - lifetime version for anxiety disorders (DSM-IV). RESULTS: OCD was associated with significantly higher scores of alexithymia. However, first-degree relatives of OCD cases and of controls did not differ in TAS-20 scores. In linear regression analyses, the TAS-20 total score showed significant intrafamilial associations within the families of control subjects but not within families of OCD cases. CONCLUSION: OCD is a severe mental disorder that is associated independently from other current comorbid axis I disorders with deficits in identifying and expressing feelings. However, alexithymia does not represent a familial risk factor for OCD.     

大学生自我缺陷感与述情障碍的相关性

目的:探索大学生自我缺陷感与述情障碍的关系,为大学生述情障碍提供预防依据。方法:通过整群抽样方法抽取河北省某高校的426名本科生作为调查对象,采用缺陷感量表和多伦多述情障碍量表,调查在校大学生心理健康状况,并分析缺陷感与述情障碍的关系。结果:1426名大学生的述情障碍量表测查结果总分为(69.99±9.43)分,高于常模(65.70±7.98)分,差异具有统计学意义(t=9.383,P0.01)。大学生缺陷感与述情障碍年级差异无显著性(t=0.256,0.608;P0.05),大学生述情障碍在性别上差异也无显著性(t=-1.058,P0.05),而大学生自我缺陷感总分,自尊,社交自信,外貌,体能在性别上存在显著差异(t=3.920,P0.01;t=2.209,3.069;P0.05;t=4.198,4.032;P0.01),在学习能力方面不存在显著差异(t=1.471,P0.05);2大学生自我缺陷感得分及其各因子与述情障碍总分及其描述情感的能力,认识和区分情感和躯体感受的能力,外向性思维呈显著负相关(P0.05),与述情障碍中缺乏幻想呈显著正相关(P0.05);3多元逐步回归分析显示,缺陷感量表中自尊和学习能力依次进入回归方程,对述情障碍有显著的负向预测作用,两者联合能解释抑郁方差变异的12.6%。结论:大学生述情障碍特征明显,大学生自我缺陷感对述情障碍有直接影响,自我缺陷感越强的学生越容易产生述情障碍,尤其缺陷感中的自尊和学习能力对大学生述情障碍作用明显。     

述情障碍对冠心病合并2型糖尿病患者应对方式及生活质量的影响

目的:探讨述情障碍对冠心病合并2型糖尿病患者应对方式及生活质量的影响。方法:对符合世界卫生组织冠心病、2型糖尿病诊断标准的70例患者,依据多伦多述情障碍量表(TAS-20)评分分为2组,总分60分为述情障碍组,50分为非述情障碍组,50~60分不做研究。述情障碍组41例,无述情障碍组29例。尔后分别进行医学应对问卷(MCMQ)、生活质量综合评定问卷(GQLI)测评,并进行比较分析。结果:述情障碍组MCMQ面对因子评分显著低于非述情障碍组(t=-8.23,P0.01),而回避、屈从因子评分则显著高于非述情障碍组(t=5.21,4.27;P0.01)。非述情障碍组GQLI总分及躯体健康、心理健康、社会功能因子分均显著高于述情障碍组,差异有统计学意义(t=3.66,3.82,3.66,2.37;P0.01);物质生活维度评分差异无统计学意义(P0.05)。患者TAS-20评分与MCMQ的面对因子评分呈显著负相关(r=-0.34,P0.01),而与MCMQ回避、屈从因子评分呈显著正相关(r=0.32,0.34;P0.01);与GQLI总分、躯体健康、心理健康及社会功能因子分呈显著负相关(r=-0.31,-0.33,-0.30;P0.01),与物质生活维度评分无相关性。结论 :冠心病合并2型糖尿病述情障碍患者多采用回避和屈服的消极应对方式,而较少采用积极应对方式;其生活质量较非述情障碍患者差。     

特殊环境下不同程度述情障碍军人的应对方式

目的:探讨特殊环境下军人述情障碍的程度及其与应对方式的关系。方法:使用多伦多述情障碍量表(TAS-20)、简易应对方式问卷(CSQ)对地处偏远山区、作业环境封闭的3935名官兵进行测定,对述情障碍高、中、低分组的应对方式进行单因素方差分析,对多伦多述情障碍量表(TAS)得分与简易应对方式问卷(CSQ)得分进行相关分析。结果:特殊环境下述情障碍高、中、低分组的军人所占的比例分别为20.13%、66.45%与13.42%;不同述情障碍组之间积极应对方式得分、消极应对方式得分均存在显著差异(F=45.676,91.715;P均0.01),述情障碍总分及情感描述困难、外向性思维两因子得分与积极应对方式得分呈显著负相关(r=-0.115,-0.100,-0.185;P均0.01),述情障碍总分及3个因子分与消极应对方式得分均呈显著正相关(r=0.212,0.182,0.187,0.104;P均0.01)。结论:地处偏远山区的军人述情障碍程度与应对方式具有相关性,高述情障碍的军人倾向于采用消极应对方式。     

An evaluation of the absolute and relative stability of alexithymia in patients with major depression

BACKGROUND: Previous studies demonstrating an association between alexithymia and depression have led to the proposal that alexithymia may be a state-dependent phenomenon rather than a stable and enduring personality trait. Several longitudinal studies have provided support for a trait view of alexithymia, but most of these studies evaluated absolute stability only (i.e., the extent to which alexithymia scores change over time) and did not examine the relative stability of alexithymia (i.e., the extent to which relative differences among individuals remain the same over time) in the context of changes in illness symptomatology. The present study evaluated both absolute stability and relative stability of alexithymia in depressed patients who experienced a marked reduction in the severity of depressive symptoms. METHODS: Forty-six psychiatric outpatients with major depression were assessed for alexithymia and depression with the 20-item Toronto Alexithymia Scale and the Hamilton Rating Scale for Depression at the start of treatment (baseline) and after 14 weeks of treatment (follow-up) with antidepressant medication. Paired t tests and correlational analyses were performed to evaluate absolute stability and relative stability in alexithymia. Hierarchical regression analyses were then used to assess the degree to which the relative stability in alexithymia scores was related to the severity of depressive symptoms, and the degree to which changes in alexithymia scores could be attributed to changes in depression scores. RESULTS: Alexithymia scores changed significantly from baseline to follow-up, indicating a general lack of absolute stability. There was, however, strong evidence of relative stability, as alexithymia scores at baseline correlated significantly with alexithymia scores at follow-up and were also a significant predictor of follow-up alexithymia scores, after partialling the effects of depression severity. CONCLUSIONS: Although alexithymia scores may change in the presence of large changes in the severity of depressive symptoms, the finding of relative stability of alexithymia supports the view that this construct is a stable personality trait rather a state-dependent phenomenon.     

Relationship between alexithymia and panic disorder: a longitudinal study to answer an open question

BACKGROUND: In the present study, we evaluated whether patients with panic disorder (PD) in complete remission were more alexithymic than normal controls. METHODS: Fifty-two PD patients (both during the acute phase of the disorder and after at least 2 months of complete remission) and 52 age- and sex-matched normal subjects completed the Toronto Alexithymia Scale-20 and the Hamilton Rating Scales for Anxiety (Ham-A) and for Depression. RESULTS: A higher rate of alexithymia was found in PD patients than in controls (3.8%) both during the acute phase (44.2%; p < 0.001) and after remission of the disorder (21.2%; p = 0.008). During remission, PD patients showed: (1) Ham-A scores significantly higher than controls (p < 0.001); (2) only an elevation of the 'difficulty in identifying feeling' (DIF) dimension of alexithymia, and (3) a positive relationship between Ham-A scores and DIF levels (p < 0.001). CONCLUSION: After remission of panic attacks, phobic avoidance and anticipatory anxiety, PD patients are more alexithymic (even though the levels of alexithymia decreased after the resolution of the acute phase of PD) and anxious than controls. This finding might be explained by an overlap between cognitive aspects of PD and the DIF dimension of alexithymia, since alexithymic and anxious levels are positively related.     

The relationship of anger expression and alexithymia with coronary artery stenosis in patients with coronary artery diseases

This study examined the relationship between anger expression or alexithymia and coronary artery stenosis in patients with coronary artery diseases. 143 patients with coronary artery diseases (104 males and 39 females) were enrolled in this study. The severity of their coronary artery stenosis was measured by angiography. The Anger Expression Scale and the Toronto Alexithymia Scale were used to assess the level of anger expression and alexithymia. The more stenotic group (occluded by 75% or more) exhibited a significantly higher level of alexithymia than the less stenotic group (occluded by less than 25%). Multiple regression analysis on the extent of stenosis also revealed that regardless of gender and age, the coronary artery disease patients with higher alexithymia were likely to show a greater level of stenosis. However, no significant differences were found on either the anger-in or anger-out subscale scores between the two groups. These results suggest that alexithymia is associated with the severity of coronary artery stenosis in patients with coronary artery disease. However, both anger expression and anger suppression were not shown to be associated with the severity of coronary artery stenosis.