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。
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),threatonly(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.
作者
侯皓
罗丹
康丽君
马思梦
刘忠纯
杨冰香
HOU Hao;LUO Dan;KANG Lijun;MA Simeng;LIU Zhongchun;YANG Bingxiang(Department of Psychiatry,Renmin Hospital of Wuhan University,Wuhan 430064,China)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2024年第6期349-354,共6页
Chinese Journal of Nervous and Mental Diseases
基金
国家自然科学基金项目(编号:72174152)
国家重点研发计划(编号: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(编号:2042022kf1218,2042022kf1037)。
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
Major depressive episode
Depression
Childhood trauma
Dysfunctional attitude
Cognitive distortion
Emotional abuse
Physical abuse
