高中生认知性情绪调节策略的性别差异

目的: 探讨高中生在认知性情绪调节策略的使用以及其对抑郁症状预测作用的性别差异.方法: 采用横断面研究设计,在湖南2所普通中学高中部的一年级和二年级各随机抽取5个班级,获得有效样本505人,其中女生262人,男生243人,完成认知性情绪调节问卷和流调中心用抑郁量表.结果: 女生认知性情绪调节问卷的自我责难、沉思、灾难化分量表分均高于男生[(12.1±2.2)vs.(11.4±3.1),(12.2±3.3)vs.(11.3±3.6),(8.4±3.0)vs.(7.7±3.0); P=0.002,0.004,0.012],而积极重新关注、理性分析分量表分均低于男生[(11.2±3.0)vs.(12.0±3.4),(13.7±2.5)vs.(14.4±2.7);P=0.005,0.003].多元回归分析的结果提示,在女性样本中,9个认知性情绪调节策略总的解释方差值为39%(R2=0.39),高水平的自我责难、沉思、灾难化可以显著增加抑郁发生的可能性.而在男性样本中,9个认知性情绪调节策略总的解释方差值为27%(R2=0.27),高水平的自我责难、沉思、灾难化以及低水平的积极重新关注和理性分析可以显著增加抑郁发生的可能性.与女生相比,男生的积极重新关注(β=-0.15)和理性分析(β=-0.18)均可以显著减少抑郁症状的发生.结论: 高中生认知性情绪调节策略的使用以及其对抑郁症状的预测具有显著的性别差异.     

认知情绪调节问卷中文版在抑郁性障碍患者中的应用

目的:评估认知情绪调节问卷(CERQ)中文版在抑郁性障碍患者中的信度、效度。方法:299例抑郁性障碍患者完成认知情绪调节问卷和流调中心用抑郁自评量表。结果:CERQ全量表的α系数为0.858,9个分量表的α系数在0.622～0.869之间;全量表条目间平均相关系数为0.144,9个分量表的条目间平均相关系数在0.291～0.623之间;全量表的分半信度系数为0.747,9个分量表的分半信度系数为0.613～0.856。验证性因子分析结果显示TLI为0.890,CFI为0.904,IFI为0.905,RMSEA为0.053。依据CES-D得分将被试分为抑郁低分组、抑郁高分组,两组患者在CERQ自我责备、沉思、积极重新评价、理性分析和灾难化等因子上的得分差异显著(P<0.05)。结论:CERQ的信度与效度达到了心理测量学要求,可用于测查抑郁性障碍患者的认知情绪调节方式。     

大学生情绪调节的认知策略、外显自尊、人格特质与社交焦虑的关系

目的探讨大学生在社交焦虑中高、低分组间的性格、自尊、认知性情绪调节策略选择的差异,以及不同的自尊水平、性格和认知性情绪调节策略对社交焦虑的预测作用。方法 540名大学生,完成自我意识量表-社交焦虑分量表、艾森克个性问卷、自尊量表及认知性情绪调节问卷。结果被试社交焦虑得分在性别上没有显著差异,在性格的内外向、稳定程度及部分认知性情绪调节策略因子上存在显著差异。高、低社交焦虑组大学生在自尊、性格特征两维度的差异有统计学意义(P<0.01);在认知性情绪调节策略上,自我责难、沉思、重新关注计划、积极重新评价、理性分析、灾难化、责怪他人等策略上存在显著性差异(P<0.05)。相关分析发现,大学生的社交焦虑与自尊、人格特征内外向维度呈显著的负相关(r=-0.34、-0.46,P<0.001),而与性格特征情绪稳定性维度呈显著的正相关(r=0.38,P<0.001)。多元回归分析显示,内外向、情绪稳定性、自我责难策略及重新关注计划策略进入方程的预测变量中。结论不同性别的社交焦虑表现并无明显差异,而高社交焦虑人群表现出内向不稳定的性格特征且低自尊,倾向于选择理性分析的积极策略,沉思、自我责难、灾难化及责怪他人的消极策略。内向不稳定的性格特征、对自我责难和重新关注计划的认知性情绪调节策略的选择倾向,可以显著增加社交焦虑发生的可能性。     

青少年认知情绪调节策略与抑郁的关系

目的探讨青少年在应对负性生活事件时使用认知情绪调节策略的特点,以及与抑郁的关系。方法对全国10个城市的7110名青少年进行认知情绪调节策略问卷(CERQ)和流调中心抑郁用量表(CES-D)的评定。结果①青少年使用适应性策略多于使用非适应性策略;②男生的抑郁分数显著低于女生(t=-5.79,P<0.001),初中生的抑郁分数显著低于高中生(t=-13.89,P<0.001);③抑郁与非适应性策略的使用有中等强度的正相关,与适应性策略有弱的负相关;④灾难化、沉思、理性分析、重新关注计划、积极重新评价和责难他人对抑郁均有显著性的预测作用(F=373.62,P<0.001)。结论认知情绪调节策略可以预测青少年的抑郁症状。     

中学生认知情绪调节策略对焦虑的预测作用

目的探讨中学生焦虑的总体状况,以及认知情绪调节策略对中学生焦虑的预测作用。方法对来自全国10个城市的8031名中学生进行了认知情绪调节策略问卷中文版(CERQ-C)和儿童多维焦虑量表中文版(MASC-C)评定。结果①中学生使用认知情绪调节策略按得分由高到低依次为:理性分析,积极重新关注,接受,积极重新评价,重新关注计划,沉思,责难自己,责难他人,灾难化;②使用适应性策略多于非适应性策略;男生的焦虑分数显著低于女生(t=-17.94,P<0.001),初中生的焦虑分数显著低于高中生(t=-20.27,P<0.001);③多元回归分析表明,责难自己、灾难化、责难他人、沉思、积极重新关注、积极重新评价、理性分析、接受对焦虑均有显著的预测作用(F=453.27,P<0.001)。结论中学生认知情绪调节策略具有预测焦虑的作用,为进一步研究和预防中学生的焦虑情绪提供了新的途径。     

认知情绪调节和领悟社会支持在大学生情绪表达冲突与抑郁间的作用

目的:探讨认知情绪调节和领悟社会支持在大学生情绪表达冲突与抑郁之间的中介作用。方法:采用情绪表达冲突问卷(AEQ)、认知情绪调节问卷(CERQ)、领悟社会支持量表(PSSS)和简版流调中心抑郁量表(CES-D-13)测量了428名大学生,用结构方程模型分析各变量之间的关系。结果:(1)情绪表达冲突与消极认知情绪调节、抑郁得分之间呈显著正相关(r=0.44、0.35,P0.001);领悟社会支持与情绪表达冲突、消极认知情绪调节和抑郁得分之间呈显著负相关(r=-0.11,P0.05;r=-0.16,P0.01;r=-0.38,P0.001),消极认知情绪调节和抑郁得分之间呈显著正相关(r=0.42,P0.001);(2)消极认知情绪调节和领悟社会支持在情绪表达冲突与抑郁之间起部分中介作用,其中介效应分别占总效应的55.3%和10.6%。结论:情绪表达冲突通过消极认知情绪调节和领悟社会支持的部分中介作用影响个体的抑郁水平。     

特战队员核心自我评价与抑郁的关系:情绪调节方式的中介作用

目的:调查特战队员抑郁现状,探究特战队员情绪调节方式在核心自我评价与抑郁之间的中介作用。方法:采用核心自我评价量表、流调中心用抑郁量表和军人情绪调节方式量表对560名特战队员进行调查。结果:(1)特战队员抑郁的检出率为13.2%,其中中重度抑郁占9.6%。情绪调节方式使用的频率依次为式自我安慰、情感求助、行为抑制和认知重视,核心自我评价得分高于理论中值;(2)不同抑郁程度特战队员在核心自我评价和情绪调节方式上有显著差异;(3)抑郁与核心自我评价(r=-0.660,P0.001)和情感求助(r=-0.289,P0.01)、自我安慰(r=-0.467,P0.01)呈显著负相关,与认知重视(r=0.568,P0.01)呈显著正相关,与行为抑制相关不显著;(4)核心自我评价(β=-0.371,P0.001)和自我安慰(β=-0.275,P0.001)可负向预测抑郁程度,认知重视(β=0.395,P0.001)可正向预测抑郁程度;(5)中介效应模型显示,认知重视和自我安慰在核心自我评价对抑郁的影响中起部分中介作用。结论:特战队员中重度抑郁发生率较高,核心自我评价影响个体抑郁水平,且这种影响被认知重视和自我安慰部分中介。     

老年人抑郁症状与情绪调节策略的横断面研究

目的:考察老年人抑郁症状与情绪调节策略的关系及老年人抑郁症状的相关因素,为老年人抑郁症状的干预提供理论指导。方法:选取北京市某社区60~80岁老年人335名,用流调中心用抑郁量表(CES-D,得分≥16分为"有抑郁症状")来评估老年人抑郁症状,用Gross情绪调节问卷(ERQ,包括认知重评和表达抑制两个分量表)来评估老年人认知重评和表达抑制策略的使用情况,用沉思量表(RRS)来测量老年人沉思策略的使用情况,并用logistic回归分析方法对老年人抑郁症状的相关因素进行分析。结果:有抑郁症状的老年人的比例为19.9%(61/306)。CES-D总分与ERQ的认知重评得分呈负相关(r=-0.21,P<0.01),与ERQ的表达抑制得分的相关无统计学意义(r=0.08,P>0.05),与RRS总分呈正相关(r=0.58,P<0.01)。Logistic回归分析表明,男性(OR=0.42,P<0.05)、健康状况好(OR=0.29,P<0.001)、生活方式好(OR=0.09,P<0.01)、经济状况好(OR=0.05~0.23,P<0.01)和ERQ认知重评得分较高(OR=0.93,P<0.05)的老年人,CES-D得分较低;而高龄(OR=1.04,P<0.05)和RRS总分较高(OR=1.19,P<0.01)的老年人,CES-D得分较高。结论:女性、高龄、经济状况差、健康水平低、无子女或子女在外地或国外、越多使用沉思策略和越少使用认知重评策略的老年人,越可能出现抑郁症状。     

青少年的抑郁情绪和认知情绪调节策略方式

目的:探讨青少年抑郁情绪和认知情绪调节策略的方式及二者的关系。方法:以班级为单位进行抽样问卷调查,对日照市四所中学的1231例中学生用Kutcher青少年抑郁量表(11项)(KADS-11)进行抑郁情绪、认知情绪调节问卷(CERQ-C)进行认知调节策略的测评,并对抑郁情绪与认知调节策略特点之间的关联进行探索性分析。结果:女性KADS-11焦躁不安因子得分高于男性,女性CERQ-C量表得分在以下条目均高于男性:自我责难、接受、沉思、积极重新关注、积极重新计划、积极重新评价以及积极认知情绪调节。15～18岁年龄组CERQ-C量表得分在以下条目高于11～14岁年龄组积极重新关注、理性分析及积极认知情绪调节。以KADS-11评分9分为分界值为抑郁分类(有或无抑郁情绪)作为因变量、以CERQ-C量表的9个分条目为自变量进行logistic回归分析,结果显示自我责难(OR=1. 095,95%CI:1. 032～1. 161)、沉思(OR=1. 077,95%CI:1. 021～1. 135)与抑郁为正向关联。结论:有抑郁情绪的青少年更倾向使用自我责难和沉思的认知调节方式。     

综合医院抑郁障碍的临床特征与识别

目的 探讨在综合医院就诊的抑郁障碍患者的临床症状特征,为临床医生的识别与诊断提供参考.方法 127例抑郁障碍患者分为青少年组和成年组,采用汉密尔顿抑郁量表(HAMD24)和自制抑郁症状调查表进行临床特征的对照研究.结果 ①青少年组HAMD24中认知障碍(t=2.856,P=0.007)、阻滞(t=4.762,P=0.001)、绝望感(t=3.188,P=0.002)因子得分与成人组比较差异显著；②就诊前出现的常见症状有:各种躯体症状、睡眠障碍、疲乏/倦怠、抑郁/沮丧/心境低落、职业兴趣下降、学习(工作)效率/成绩下降、认知功能下降、家庭冲突增多；③青少年组的学习(工作)效率/成绩下降(x2=41.571,P=0.0001)、厌学与逃学(旷工)(x2=7.788,P=0.005)、认知功能下降(x2=5.005,P=0.025)、家庭冲突增多(x2=11.998,P=0.001)、哭闹/易激惹(x2=4.915,P=0.027)、自杀企图与行为(x2=23.993,P=0.046)等症状出现的频率明显高于成人组.结论 ①综合医院抑郁障碍患者多以躯体症状、睡眠障碍、疲乏倦怠为主要表现；②青少年抑郁障碍除了具有情感低落和躯体症状外,常表现出与学习和人际交往等社会功能减退症状.     

情绪调控策略与创伤后应激障碍症状关系的性别差异

目的研究情绪调控在预测创伤后应激障碍(PTSD)症状中的性别差异。方法本研究利用认知情绪调控问卷调查了265名大学生的积极评估与沉思默想两种策略与PTSD症状之间的关系,分析了情绪调控策略与PTSD症状之间的性别差异,并利用相关及多元回归分析了生活应激经历与情绪调控策略对PTSD症状的影响。结果女生比男生会更多地采用积极评估策略来应对应激(t=-1.91,P=0.058),并且积极评估策略与女生的PTSD症状之间存在显著的负相关(回避:r=-0.26,P0.01;记忆闯入:r=-0.19,P0.01;高唤醒:r=-0.19,P0.01)。但积极评估与PTSD症状的关系存在显著的性别差异,积极评估策略的使用与男生的PTSD症状之间存在显著的正相关(记忆闯入:r=0.28,P0.05;高唤醒:r=0.26,P0.05)。沉思默想与PTSD症状之间的关系并不存在男女差异,无论对于男女,沉思默想与PTSD症状之间均存在显著的正相关(r=0.37~0.46,P0.01)。研究还发现,情绪调控比生活应激经历本身更能决定PTSD症状的严重性。结论应激后陷入沉思默想不但会对个体的心理健康带来不良影响,还可能会破坏男性利用积极评估策略应对应激的能力。     

4～6年级发展性阅读障碍儿童生活事件与情绪调节策略的关系

目的:了解发展性阅读障碍儿童所遭遇的负性生活事件及常用的情绪调节策略,为提高其情绪调控能力提供依据。方法:采用标准化量表对浙南地区595名4~6年级儿童的生活事件、情绪调节策略进行了调查;语文老师或班主任对语文成绩排名后10%的儿童进行汉语阅读障碍评估,结合智力测验结果筛查发展性阅读障碍儿童。采用方差分析,探索正常儿童与阅读障碍儿童在生活事件、情绪调节方面的差异;采用相关分析,探索阅读障碍儿童生活事件与情绪调节策略之间的相关性。结果:1从总样本来看,除理性分析外,儿童生活事件、情绪调节总分及各维度在性别和年级方面均不存在显著差异(P0.05);2发展性阅读障碍儿童发生率为6.55%。与正常儿童相比,他们更容易遭遇受惩罚和学习压力两种负性生活事件(F=11.18,19.30;P0.001);较多采用表达抑制(F=5.28,P0.05)、自我责备(F=12.70,P0.001)、沉思(F=4.71,P0.05)、灾难化(F=15.72,P0.001)、责备他人(F=15.95,P0.001)等消极情绪调节策略,较少采用接纳(F=4.10,P0.05)、重新关注计划(F=6.10,P0.05)、积极重新评价(F=17.99,P0.001)等积极情绪调节策略;3相关分析结果表明,阅读障碍儿童的生活事件与自我责备、消极认知情绪调节显著相关(r=0.320,0.630;P0.05)。结论:发展性阅读障碍儿童容易遭遇负性生活事件,更倾向于采用消极情绪调节策略。     

Cognitive emotion regulation strategies and neuroticism in relation to depressive symptoms following burn injury: a longitudinal study with a 2-year follow-up

Sustaining burns is considered a stressful life event that has the power to elicit depressive symptoms. This study aimed to identify predictors of depressive symptoms by investigating the role of demographic variables, the number of operations (burn severity), neuroticism, and cognitive emotion regulation styles as possible influencing factors. Data from 242 patients with burns were analyzed employing latent growth modeling. The level of depressive symptoms across the 2-year interval was associated with burn severity, higher levels of neuroticism and rumination, and lower levels of positive refocusing. Notably, rumination partly mediated the effect of neuroticism on the course of depressive symptoms. Correlational analysis suggested a specific effect of burn severity on rumination. The results indicate that screening for symptoms of depression, rumination, and neuroticism in burn patients is useful. Early interventions focusing on cognitive restructuring could assist in improving the cognitive emotional adaptation process following a burn event.     

How do cancer patients manage unattainable personal goals and regulate their emotions/

Objectives This article addressed the role of goal adjustment (i.e. disengagement from unattainable goals and reengagement in alternative goals) and cognitive emotion‐regulation strategies (i.e. rumination, catastrophizing, positive refocusing) in cancer patients' psychological well‐being. We expected that patients who are better able to disengage from unattainable goals, identify alternative goals, and regulate their emotions by positive refocusing and not engaging in rumination and catastrophizing would experience less negative and more positive affect. Design In this cross‐sectional study, data were collected using a self‐report questionnaire. Methods Cancer patients (N = 108) were recruited on a psychoeducational meeting aimed to inform them about the illness and its consequences. To examine the relationships between goal adjustment, cognitive emotion‐regulation strategies, and affect, Pearson correlations were calculated and regression analyses were performed. Results Regression analyses showed that reengaging in meaningful goals and focusing on pleasant issues were significantly associated with more positive affect. Focusing on pleasant issues was also significantly associated with less negative affect, whereas rumination and catastrophizing were significantly associated with more negative affect. Conclusions Goal reengagement as well as cognitive emotion‐regulation strategies seems to play an important role in cancer patients' psychological well‐being. Health care professionals may assist patients in paying more attention to positive experiences in their daily life and in finding new meaningful goals. Techniques based on mindfulness may be used to assist cancer patients in decreasing the repetitive negative thinking about causes, meanings, and consequences of the illness and helping them to focus attention on the present moment.     

A longitudinal study of postpartum depressive symptoms: multilevel growth curve analyses of emotion regulation strategies, breastfeeding self-efficacy, and social support

Postpartum depression is a serious health issue affecting as many as 10-15 % of postpartum women. This longitudinal study aimed to explore how psychological variables such as cognitive emotion regulation strategies, breastfeeding self-efficacy (BSE), and dimensions of social support predicted postpartum depressive symptoms (Edinburgh Postnatal Depression Scale). The data were collected with web-based survey questionnaires between May 2008 and December 2009, in a sample of 737 new mothers. The same questionnaire was surveyed at three points in time: 6 weeks, 3 months, and 6 months postpartum. Data were analyzed using multilevel modeling (level 1, time points; level 2, person). Results showed that BSE, certain cognitive emotion regulation strategies, perceived available support, and need for support predicted the rate of postpartum depressive symptoms. Only breastfeeding self-efficacy predicted change in postpartum depressive symptoms. This study illustrates the importance of psychological variables with regard to postpartum depressive symptoms. Implications for preventative efforts are discussed.     

Prevalence and association of somatic symptoms in patients with Major Depressive Disorder

BACKGROUND: Painful and non-painful somatic symptoms are often reported in patients with depressive disorder. The proper identification of depression-relevant somatic symptoms is important for the accurate diagnosis of depression, development of treatment strategies and measurement of outcome. The objective of this study was to characterize the relationship between somatic symptoms and depression in patients diagnosed with Major Depressive Disorder (MDD), using data from randomized drug trials carried out by a pharmaceutical company. METHODS: Pooled 'blinded' data from 2191 patients enrolled in randomized, multicenter, double-blind placebo-controlled studies for the treatment of MDD were analyzed. Somatic symptoms were assessed using the Somatic Symptoms Inventory (SSI) and the Hamilton Depression Rating Scale (HAMD) was used to assess symptoms of depression. RESULTS: The most common somatic symptom reported by patients with MDD was 'feeling fatigued, weak, or tired all over', with 78% of patients reporting 'moderate' levels or above. This was followed by 'feeling that not in as good physical health as most of your friends' (59%), 'not feeling well most of the time in the past few years' (54%), and 'feeling weak in parts of body' (45%). 'Headache' was the most common pain-related symptom with 43% reporting 'moderate' or above. Pearson's product-moment correlations revealed that somatic symptoms generally increased as a function of overall depressive (r=0.43), with 'feeling fatigued, weak, or tired all over' (r=0.50), 'feeling that not in as good physical health as most of your friends' (r=0.42), 'feeling weak in parts of body' (r=0.41), 'heavy feeling in arms and legs' (r=0.34), 'not feeling well most of the time in the past few years' (r=0.32), and 'headache' (r=0.31) showing the strongest correlation with overall HAMD scores. Non-parametric item response analyses showed that many somatic symptoms demonstrate good relationship between item response and the overall severity of depression. In particular, 'feeling fatigued, weak, or tired all over' exhibited good discriminative properties across the full range of severity for depression. LIMITATIONS: The analysis utilized data from a 'restricted' patient population in drug trials sponsored by a pharmaceutical company. CONCLUSIONS: These results demonstrate a high prevalence and association of somatic symptoms in patients with MDD, including feelings of fatigue, physical malaise and pain-related symptoms, which could be potentially useful in the assessment of depression and in the evaluation of treatment strategies.     

Cognitive Coping and Goal Adjustment After First-Time Myocardial Infarction: Relationships With Symptoms of Depression

The authors studied the relationships among cognitive coping strategies, goal adjustment processes (disengagement and reengagement), and depressive symptomatology in a sample of 139 patients who had experienced a first-time acute myocardial infarction between 3 and 12 months before data assessment. They assessed cognitive coping strategies, goal adjustment, and depressive symptoms by the Cognitive Emotion Regulation Questionnaire, the Goal Obstruction Questionnaire, and the Hospital Anxiety and Depression Scale, respectively. Main statistical methods were Pearson correlations and multiple regression analyses. Results show significant associations among the cognitive coping strategies of rumination, catastrophizing, and higher depressive symptoms, as well as among positive refocusing, goal reengagement, and lower depressive symptoms. This suggests that cognitive coping and goal reengagement strategies may be useful targets for intervention.     

Emotion-regulation strategies across psychopathology: A meta-analytic review

We examined the relationships between six emotion-regulation strategies (acceptance, avoidance, problem solving, reappraisal, rumination, and suppression) and symptoms of four psychopathologies (anxiety, depression, eating, and substance-related disorders). We combined 241 effect sizes from 114 studies that examined the relationships between dispositional emotion regulation and psychopathology. We focused on dispositional emotion regulation in order to assess patterns of responding to emotion over time. First, we examined the relationship between each regulatory strategy and psychopathology across the four disorders. We found a large effect size for rumination, medium to large for avoidance, problem solving, and suppression, and small to medium for reappraisal and acceptance. These results are surprising, given the prominence of reappraisal and acceptance in treatment models, such as cognitive-behavioral therapy and acceptance-based treatments, respectively. Second, we examined the relationship between each regulatory strategy and each of the four psychopathology groups. We found that internalizing disorders were more consistently associated with regulatory strategies than externalizing disorders. Lastly, many of our analyses showed that whether the sample came from a clinical or normative population significantly moderated the relationships. This finding underscores the importance of adopting a multi-sample approach to the study of psychopathology.     

The relationship between depressive symptoms in outpatients with chronic illness and health care costs

PURPOSE: To evaluate the relationship between depressive symptoms and health care costs in outpatients with chronic medical illnesses in Korea, we screened for depressive symptoms in 1,118 patients with a chronic medical illness and compared the severity of somatic symptoms and health care costs. PATIENTS AND METHODS: Data were compared between outpatients with depressive symptoms and those without depressive symptoms. Depression and somatic symptoms were measured by Zung's Self-rating Depression Scale (SDS) and Patient Health Questionnaire (PHQ)-15, respectively. We also investigated additional data related to patients' health care costs (number of visited clinical departments, number of visits made per patients, and health care costs). A total of 468 patients (41.9%) met the criteria for depressive disorder. RESULTS: A high rate of severe depressive symptoms was found in elderly, female and less-educated patients. A positive association between the severity of somatic symptoms and depressive symptoms was also identified. The effects of depressive symptoms in patients with chronic illnesses on three measures of health services were assessed by controlling for the effects of demographic variables and the severity of somatic symptoms. We found that the effects of depressive symptoms on the number of visited departments and number of visits made per patients were mediated by the severity of somatic symptoms. However, for health care costs, depressive symptoms had a significant main effect. Furthermore, the effect of gender on health care costs is moderated by the degree of a patient's depressive symptoms. CONCLUSION: In summary, there is clearly a need for increased recognition and treatment of depressive symptoms in outpatients with chronic medical illnesses.