社交恐惧症的神经生物学研究进展

本文从疾病模型、临床神经生物学、遗传学、药物等方面综述了社交恐惧症的神经生物学研究进展     

童年期虐待和忽视与心身疾病的关联

童年期虐待和忽视可能是青少年或成年期罹患心身疾病的危险因素，推测可能与心理创伤所致的免疫功能失调、非稳态负荷、大脑结构和功能改变等因素有关。现就童年期虐待和忽视与心身疾病的关联进行综述。     

帕罗西汀治疗社交恐惧症的双盲对照研究

目的　比较帕罗西汀与阿普唑仑治疗社交恐惧症的疗效及安全性。方法　将 78例社交恐惧症患者按住院先后顺序分层随机法分为帕罗西汀组 4 0例及阿普唑仑组 38例 ,疗程均为 6周。疗效评定采用PRCA 2 4、CGI SI及临床四级疗效评定。安全性评价应用TESS、实验室检查及体检。结果　帕罗西汀组与阿普唑仑组疗效相当。帕罗西汀常见不良反应为恶心、头痛、口干、出汗、厌食等 ,不良反应程度均较轻 ,患者依从性好。结论　帕罗西汀治疗社交恐惧症安全、有效 ,患者对药物的耐受性及依从性均较好     

儿童期虐待对新兵社会支持及应对方式的影响

目的研究儿童期虐待对新兵社会支持及应对方式的影响。方法对505名入伍新兵进行儿童受虐问卷（CTQ-SF）、简易应对方式问卷（SCSQ）、青少年社会支持量表评定。结果遭受儿童期虐待的新兵在应付方式选择及社会支持上显著低于无虐待组（P〈0．05）。简单相关分析显示儿童期情感虐待、情感忽视、躯体忽视及总虐待分均与积极应对呈负相关（P〈0．01）;儿童期经历过情感虐待、情感忽视、性虐待、躯体虐待、躯体忽视及虐待总分均与消极应对呈正相关（P〈0．05,P〈0．01）。儿童期情感虐待、躯体虐待、情感忽视、躯体忽视及总虐待分均与社会支持总分、客观支持、支持利用度呈负相关（P〈0．01）;儿童期经历过情感虐待、情感忽视、性虐待、躯体虐待、躯体忽视及虐待总分均与主观支持成负相关（P〈0．05,P〈0．01）。情感忽视、躯体忽视与积极应对方式呈负相关（P=0．000,P=0．003）;虐待总分、情感虐待与消极应对方式呈正相关（P=0．032,P=0．026）,与社会支持总分呈负相关（P=0．000,P=0．011）。结论儿童期遭受虐待的新兵在应对方式上往往采取消极应对,且社会支持不良。     

社交恐惧症患者的16PF测试及父母教养方式调查分析

目的 了解社交恐惧症患者的人格特征,探讨其父母教养方式的特异性因素,为临床心理工作提供依据.方法 使用卡特尔十六种人格因素测试量表(16PF),对57名社交恐惧症患者进行个性测定,用父母教养方式问卷(EMBU)的中文版,对其进行调查,并分别与57名正常对照组进行比较.结果 发现社交恐惧症患者的人格特征16PF中A、C、H、Q2粗分低于正常对照组,I、L、O、Q4粗分高于对照组(各因子t≥3.42,P<0.01).与正常对照组相比,社交恐惧症患者评价其父母对他们惩罚、拒绝否认较多,对他们过分干涉,而缺乏情感温暖(各因子t≥3.85,P<0.01).结论 社交恐惧症的发生有其个性基础,其父母的不良教养方式在社交恐惧症的发生发展中起着重要的作用.     

青少年自尊发展研究

从郑州市两所中学选取初一至高二五个年级的280名学生,采用自卑感量表(FIS)探讨青少年自尊发展的现状。结果发现,青少年外貌自尊、体能自尊性别主效应显著;青少年外貌自尊、自敬、体能自尊和整体自尊年级主效应显著。     

暴力精神分裂症患者监护人自尊与社交自尊的特征及相关性

目的 研究暴力精神分裂症患者监护人自尊和社交自尊的特征及相关性.方法 纳入2014年1月至2016年12月在重庆市精神卫生中心就诊的精神分裂症患者监护人966例,其中487例暴力精神分裂症患者监护人作为研究组,479例非暴力精神分裂症患者监护人作为对照组,应用自尊量表(SES)、德克萨斯社交行为问卷(TSBI)对研究对...     

养育方式对青少年心理门诊患者应对方式的影响

目的:了解青少年心理门诊患者的应对方式与父母养育方式的关系. 方法:对107例青少年心理门诊患者(研究组)和104名正常青少年(对照组)进行应对方式和父母养育方式的测评,比较两组之间的差异,并对应对方式和父母养育方式作相关分析. 结果:研究组解决问题、求助的应对方式的评分显著低于对照组,而自责、退避、幻想的方式的评分显著高于对照组;研究组父母养育方式中,父母情感温暖因子评分显著低于对照组,而父母惩罚严厉、拒绝否认因子评分显著高于对照组(P<0.05或P<0.01).相关分析中,积极的应对方式与父母正性的情感因子呈正相关(P<0.05或P<0.01),而消极的应对方式则与父母负性的情感因子呈正相关(P<0.05或P<0.01). 结论:青少年心理门诊患者多采用消极的应对方式,且明显受到父母养育方式的影响.     

儿童青少年学校恐惧症的相关因素及心理治疗特点

<正>1概述儿童青少年因害怕学习和学校而拒绝上学,俗称厌学。Johnson于1941年首先提出学校恐惧症(school phobia)一词[1],特指那些对学校环境产生异常恐惧,强烈拒绝上学的儿童,认为其是儿童情绪障碍的一种类型。20世纪50年代,一些教育界学者发现,由于心理因素造成的拒绝上学行为,其背景是由于儿童与母亲的分离焦虑而导致对学校的恐惧,与逃学有本质区别,后者往往伴有品行问题和反     

Causal links between stressful events, coping style, and adolescent symptomatology

In a longitudinal study, the causal links between different types of stressors, coping styles and adolescent symptomatology were investigated. A total of 94 adolescents and their mothers participated in three annual assessments of critical life events, daily stressors and coping styles. The longitudinal associations between life events, everyday stressors, a dysfunctional coping style and symptomatology were analyzed via a path-analytic model. Critical life events and daily stressors were found to be strongly related over time; however, the type of stressor was not consistently linked with adolescent symptomatology. In contrast, withdrawal, a form of avoidant coping, emerged as a significant predictor of adolescent symptomatology across all times. Further, emotional and behavioral problems led to a time-lagged increase in withdrawal, creating a vicious circle. The results are discussed with reference to the coping-skill deficit model.     

History of childhood abuse in panic disorder,social phobia,and generalized anxiety disorder

The authors examined the prevalence of self-reported childhood physical or sexual abuse in a sample of adult patients presenting for treatment of panic disorder, social phobia, or generalized anxiety disorder. Regardless of the presence of comorbid anxiety disorders or comorbid depression, patients with panic disorder had significantly higher rates of past childhood physical or sexual abuse than patients with social phobia. Patients with generalized anxiety disorder had intermediate rates of past physical or sexual abuse that were not significantly different from the other two diagnostic groups. Anxiety disorder patients with a history of childhood abuse were also more likely to have comorbid major depression than those without. These findings are discussed in terms of biological and behavioral factors that may influence the development of anxiety disorders after the experience of a traumatic event.     

Characterizing the association between parenting and adolescent social phobia

ObjectivesFor characterizing the association between parenting and offspring social phobia (SP), contrasting maternal vs. paternal contributions, putative predictors of unfavorable parenting behaviors and its specificity for SP are warranted to delineate targeted prevention and intervention strategies.MethodsA population-based sample of 1053 adolescents was followed-up using the M-CIDI. Parenting was assessed via questionnaire in offspring passing the high risk period for SP-onset. Natal complications and childhood serious health problems as assessed by maternal reports were hypothesized to relate to unfavorable parenting.ResultsThe pattern of maternal overprotection, paternal rejection and lower emotional warmth was associated with SP, but not with other offspring anxiety disorders. Natal complications were related to overprotection and lower emotional warmth; trend-level associations emerged for serious health problems and unfavorable parenting.ConclusionsPaternal behavior appears particularly relevant for SP. The pattern of maternal overprotection, paternal rejection and lower emotional warmth was observed in SP only, suggesting that its detailed assessment provides a promising opportunity for targeted prevention and intervention in SP.     

社区独居老人的抑郁状况与社会支持、应对方式和自我效能的相关性分析

目的:探讨社区独居老人社会支持、应对方式、自我效能与抑郁状况的关系。方法:随机抽取虹口区1个街道(广中街道),分别以老年抑郁量表、领悟社会支持量表、应对方式问卷和自我效能量表调查社区独居老人(n=1 033)的抑郁状况、社会支持、应对方式和自我效能。结果:不同年龄、性别、文化程度及抑郁状况的独居老人社会支持、应对方式与自我效能的差异有统计学意义(P0.05)。独居老人的抑郁和自我效能、问题解决应对方式、求助应对方式、朋友支持和其他支持呈负相关,与退避应对方式、自责应对方式和幻想应对方式呈正相关(P0.05)。结论:独居老人的抑郁状况和应对方式及自我效能密切相关。     

儿童情感虐待与青少年焦虑的关系

目的　探讨儿童期情感虐待对青少年期焦虑症的影响。方法　采用整群抽样法,对河南省新乡市493 名初中生进行一般社会资料问卷,焦虑自评量表(SAS)、儿童虐待史问卷(CECA.Q) 进行评估。结果　青少年焦虑与家中是否有兄弟姐妹、父母离异和父母接受教育的程度无明显关系;青少年焦虑和情感虐待有明显的关联;Logistic 回归结果发现,控制年龄、性别因素后,情感虐待与青少年焦虑呈正相关。父亲和母亲的忽视增加青少年焦虑的风险最明显,父母的憎恶对青少年焦虑症影响较小。结论　父母的忽视是青少年焦虑的重要风险因素。     

抑郁症患者抑郁症状与自我效能感、自我接纳、应付方式的关系

目的:探讨抑郁症患者抑郁症状与自我效能感、自我接纳及应付方式的关系。方法:对40例抑郁症患者(抑郁症组)进行贝克抑郁问卷(BDI)、一般自我效能感量表(GSES)、自我接纳问卷(SAQ)、应付方式问卷的评定,同时以40名正常人(正常对照组)作为对照进行GSES及SAQ的评定,两组进行比较及相关分析。结果:抑郁症组自我效能感、自我接纳因子、自我评价因子得分及SAQ总分均低于正常对照组(t=3.980,t=5.907,t=2.967,t=5.411;P均0.01)。相关分析显示,BDI得分与自我效能感、自我接纳总分均呈高度负相关(r=-0.602,r=-0.786;P均0.05);与应付方式中的情绪缓冲性应付总分、情绪加工因子、顺从回避因子呈正相关(r=0.433,r=0.425,r=0.372;P均0.05)。结论:抑郁症患者抑郁症状越严重,自我效能感、自我接纳程度越低,自我评价也越低。     

The association between social phobia, social anxiety cognitions and paranoid symptoms

Schutters SIJ, Dominguez M‐d‐G, Knappe S, Lieb R, van Os J, Schruers KRJ, Wittchen H‐U. The association between social phobia, social anxiety cognitions and paranoid symptoms. Objective: Previous research suggests high levels of comorbidity between social phobia and paranoid symptoms, although the nature of this association remains unclear. Method: Data were derived from the Early Developmental Stages of Psychopathology study, a 10‐year longitudinal study in a representative German community sample of 3021 participants aged 14–24 years at baseline. The Munich‐Composite International Diagnostic Interview was used to assess social phobia and paranoid symptoms, along with data on social phobia features. Cross‐sectional and longitudinal analyses were conducted. Differential associations with environmental risk factors and temperamental traits were investigated. Results: Lifetime social phobia and paranoid symptoms were associated with each other cross‐sectionally (OR = 1.80, 95% CI = 1.31–2.47). Lifetime paranoid symptoms were associated specifically with social anxiety cognitions. Lifetime cognitions of negative evaluation predicted later onset of paranoid symptoms, whereas onset of social phobia was predicted by cognitions of loss of control and fear/avoidance of social situations. Lifetime social phobia and paranoid symptoms shared temperamental traits of behavioural inhibition, but differed in environmental risks. Conclusions: The present study showed that paranoid symptoms and social phobia share similarities in cognitive profile and inhibited temperament. Avoidance appears to be important in the development of social phobia, whereas cannabis use and traumatic experiences may drive paranoid thinking in vulnerable individuals.     

Recent developments in child and adolescent social phobia

The following article discusses research trends in childhood and adolescent social phobia during the past year. Of particular importance are findings regarding prevalence rates, cognitive variables and social skills deficits, temperamental influences, and the use of selective serotonin reuptake inhibitors (SSRIs). Recent prevalence rates of social anxiety disorder in children and adolescents range from 0.5% to 4.0%. Findings regarding the role of cognitive processes and social skills deficits in childhood social phobia are supported. Recent longitudinal data investigating the stability of extremes of behavioral inhibition have found that it persists from childhood into adolescence. Initial data regarding the use of SSRIs suggest that they may be a promising treatment option.