摘要
目的:探讨反刍思维和述情障碍在老年抑郁障碍患者抑郁症状与自我效能感之间的链式中介效应。方法:选取某院2022年3月-2024年2月106例老年抑郁障碍患者,使用汉密尔顿抑郁量表(HAMD)评估抑郁症状,根据评分结果将8~17分、18~24分、>24分者分别纳入轻度抑郁组、中度抑郁组、重度抑郁组,所有患者均接受一般自我效能感问卷(GSES)、反刍思维量表(RRS)、多伦多述情障碍量表(TAS-20)评估,对比不同抑郁程度患者自我效能感、反刍思维、述情障碍差异,经Pearson相关性分析各量表评分的关系,通过多重线性回归检验反刍思维、述情障碍在老年抑郁障碍患者抑郁症状与自我效能感之间的链式中介效应。结果:106例老年抑郁障碍患者HAMD量表评分21.56±4.53分,其中轻度抑郁35例,中度抑郁42例,重度抑郁29例;重度抑郁组自我效能感GSES评分低于中度抑郁组,中度抑郁组低于轻度抑郁组,重度抑郁组反刍性思维RRS评分、述情障碍TAS-20评分高于中度抑郁组,中度抑郁组高于轻度抑郁组(P<0.05);老年抑郁障碍患者抑郁症状与自我效能感呈现负相关,与反刍思维、述情障碍呈现正相关(r=-0.723,0.635,0.594;P<0.05);自我效能感与反刍思维、述情障碍呈现负相关(r=-0.523,-0.491;P<0.05);反刍思维与述情障碍呈现正相关(r=0.408,P<0.05);回归方程加入反刍思维/述情障碍变量后,自我效能感对抑郁症状的回归系数均显著,在自我效能感影响抑郁症状之间,患者反刍思维/述情障碍均具有部分中介作用,反刍思维、述情障碍在自我效能感与抑郁症状之间的中介效应分别占总效应的23.48%(总效应量:0.724:中介效应量:0.170)、18.09%(总效应量:0.724:中介效应量:0.131)。结论:老年抑郁障碍患者反刍思维、述情障碍在自我效能感与抑郁症状间具有部分中介作用。
Objective:To investigate the chain mediation effect of rumination and alexithymia between depressive symptoms and self-efficacy in elderly patients with depressive disorder.Methods:A total of 106 elderly patients with depressive disorder from our hospital were selected between March 2022 and February 2024.The Hamilton Depression Scale(HAMD)was used to assess depressive symptoms.Based on the scores,patients scoring 8~17,18~24,and>24 were classified into mild,moderate,and severe depression groups,respectively.All patients were assessed using the General Self-Efficacy Scale(GSES),Ruminative Response Scale(RRS),and Toronto Alexithymia Scale(TAS-20).Differences in self-efficacy,rumination,and alexithymia among patients with varying degrees of depression were compared.Pearson correlation analysis was conducted to examine the relationships between the scale scores.Multiple linear regression was used to test the chain mediation effect of rumination and alexithymia between depressive symptoms and self-efficacy in elderly patients with depressive disorder.Results:The HAMD scores of 106 elderly patients with depressive disorder were(21.56±4.53).There were 35 cases of mild depression,42 cases of moderate depression,and 29 cases of severe depression.The GSES score for self-efficacy was lower in the severe depression group compared to the moderate depression group,and lower in the moderate depression group compared to the mild depression group.The RRS score for rumination and TAS-20 score for alexithymia were higher in the severe depression group compared to the moderate depression group,and higher in the moderate depression group compared to the mild depression group(P<0.05).Depressive symptoms in elderly patients with depressive disorder were negatively correlated with self-efficacy and positively correlated with rumination and alexithymia(r=-0.723,0.635,0.594;P<0.05).Self-efficacy was negatively correlated with rumination and alexithymia(r=-0.523,-0.491;P<0.05).Rumination was positively correlated with alexithymia(r=0.408,P<0.05).When rumination and alexithymia variables were added to the regression equation,the regression coefficients of self-efficacy on depressive symptoms were significant.Both rumination and alexithymia partially mediated the effect of self-efficacy on depressive symptoms,accounting for 23.48%(total effect:0.724;mediation effect:0.170)and 18.09%(total effect:0.724;mediation effect:0.131)of the total effect,respectively.Conclusion:In elderly patients with depressive disorder,rumination and alexithymia have a partial mediating effect between self-efficacy and depressive symptoms.
作者
蓝素敏
夏乐宏
LAN Sumin;XIA Lehong(Department of Psychiatry,Suichang Branch,Lishui Second People's Hospital,Lishui 323300,China)
出处
《中国健康心理学杂志》
2024年第11期1615-1620,共6页
China Journal of Health Psychology
基金
丽水市科技计划项目(编号:2022GYX47)。
