重性抑郁发作患者威胁型和剥夺型儿童期创伤与功能失调性态度的关联性分析
Analysis of the association between threat and deprivation childhood traumas and dysfunctional attitudes in patients with major depressive episode
侯皓 1罗丹 2康丽君 3马思梦 3刘忠纯 3杨冰香1
作者信息
- 1. 武汉大学人民医院 精神科(武汉 430064);武汉大学 护理学院 精神心理与智慧护理研究中心
- 2. 武汉大学 护理学院 精神心理与智慧护理研究中心
- 3. 武汉大学人民医院 精神科(武汉 430064)
- 折叠
摘要
目的 基于逆境和精神病理维度模型(dimensional model of adversity and psychopathology,DMAP)探索重性抑郁发作患者的威胁型和剥夺型儿童期创伤与功能失调性态度的关联.方法 收集970例重性抑郁发作患者资料,根据简版儿童期创伤问卷(childhood trauma questionnaire,CTQ-SF)评分将患者分为无创伤组(426例)、仅威胁组(86例)、仅剥夺组(210例)、混合组(248例),采用功能失调性态度量表(dysfunctional attitudes scale,DAS)评估患者的认知歪曲情况,DAS得分大于所有受试者得分的上四分位数定义为高认知歪曲.采用多因素logistic回归分析探究患者威胁型和剥夺型创伤与功能失调性态度的关联.结果 无创伤组、仅威胁组、仅剥夺组、混合组整体高认知歪曲者比例存在统计学差异(19.25%vs.30.23%vs.20.00%vs.35.89%,P<0.001),且各维度高认知歪曲比例均存在统计学差异(P≤0.001).多因素logistic回归分析显示,威胁型创伤与整体高认知歪曲呈正关联(OR=2.031,P<0.001),且威胁型创伤与DAS中脆弱性(OR=1.709,P<0.001)、吸引与排斥(OR=2.088,P<0.001)、完美化(OR=2.321,P<0.001)、强制性(OR=1.765,P=0.001)、寻求赞许(OR=1.837,P<0.001)、依赖性(OR=1.554,P=0.006)、自主性态度(OR=1.864,P<0.001)等7个维度高认知歪曲呈正关联,剥夺型创伤仅与认知哲学维度高认知歪曲呈正关联(OR=1.495,P=0.015).结论 重性抑郁发作患者的儿童期创伤与功能失调性态度紧密相关,威胁型创伤与整体及除认知哲学外的维度高认知歪曲正相关,而剥夺型创伤仅与认知哲学维度高认知歪曲正相关.
Abstract
Objective This study aims to explore the associations between threat and deprivation childhood traumas and dysfunctional attitudes among patients with major depressive episode,based on the dimensional model of adversity and psychopathology(DMAP).Methods Data from 970 patients with major depressive episode were collected and categorized based on the childhood trauma questionnaire-short form(CTQ-SF)scores into no trauma(426),threat-only(86),deprivation-only(210),and mixed groups(248).Cognitive distortions were assessed using the dysfunctional attitudes scale(DAS),with scores above the upper quartile indicating significant distortions.Multifactorial logistic regression analysis was employed to examine the association between threat and deprivation and dysfunctional attitudes.Results There were significant differences in the proportion of cognitive distortions among the no trauma,threat-only,deprivation-only,and mixed groups(19.25% vs.30.23% vs.20.00% vs.35.89%,P<0.001),with differences across all dimensions(P≤0.001).Multifactorial logistic regression revealed a positive correlation between threat and overall cognitive distortions(OR=2.031,P<0.001),and specific positive correlations with dimensions such as vulnerability(OR=1.709,P<0.001),appeal and repulsion(OR=2.088,P<0.001),perfectionism(OR=2.321,P<0.001),compulsivity(OR=1.765,P=0.001),approval seeking(OR=1.837,P<0.001),dependency(OR=1.554,P=0.006),and autonomous attitudes(OR=1.864,P<0.001).In contrast,deprivation was only positively correlated with the cognitive philosophy dimension(OR=1.495,P=0.015).Conclusion Childhood trauma is closely associated with dysfunctional attitudes in patients with major depressive episode.Threat correlates positively with cognitive distortions in all dimensions except cognitive philosophy,whereas deprivation correlates only with the cognitive philosophy dimension.
关键词
重性抑郁发作/抑郁情绪/儿童期创伤/功能失调性态度/认知歪曲/情感虐待/躯体虐待Key words
Major depressive episode/Depression/Childhood trauma/Dysfunctional attitude/Cognitive distor-tion/Emotional abuse/Physical abuse引用本文复制引用
基金项目
国家自然科学基金项目(72174152)
国家重点研发计划(2018YFC1314600)
湖北省青年拔尖人才培养计划()
中央高校基本科研业务费专项资金(2042022kf1218)
中央高校基本科研业务费专项资金(2042022kf1037)
出版年
2024
NETL
NSTL
万方数据