我国产后抑郁评估与诊断方法应用现状分析

早期评估与诊断是产后抑郁预防干预的第一步,通过分析国内产后抑郁评估与诊断方法的应用现状.为提高评估与诊断结果的科学性提供依据.发现爱丁堡产后抑郁量表为筛查首选量表,分析显示采用同一种量表和不同量表进行评估的检出率均有较大差异.因此,应根据研究特点选择适宜的筛查量表以提高不同研究结果的可比性,同时,需加强量表分界值本土化的研究.     

我国产后抑郁研究现状分析

本文通过系统分析产后抑郁领域的国内研究现状,为研制针对性的干预策略奠定基础。研究遵循循证医学的理念,运用文献计量分析方法,对国内1998年～2007年间发表的111篇产后抑郁领域的研究文献进行分析。可见研究文献数量呈现逐年上升趋势,但研究范围主要局限于医学中心及区域范畴,研究内容主要涉及产后抑郁的评估与诊断、危险因素研究和预防干预方法的探索,但总体研究设计存在较大缺陷。可见亟需加强社区层面研究,提高研究设计的科学性,并将预防干预方法研究作为重点。     

我国产后抑郁研究现状分析

本文通过系统分析产后抑郁领域的国内研究现状.为研制针对性的干预策略奠定基础.研究遵循循证医学的理念,运用文献计量分析方法,时国内1998年～2007年阃发表的111篇产后抑郁领域的研究文献进行分析.可见研究文献数量呈现逐年上升趋势,但研究范围主要局限于医学中心及区域范畴,研究内容主要涉及产后抑郁的评估与诊断,危险因素研究和预防干预方法的探索,但总体研究设计存在较大缺陷.可见亟需加强社区层面研究,提高研究设计的科学性,并将预防干预方法研究作为重点.     

产后抑郁预防干预方法现状分析

本文通过分析现有产后抑郁预防干预方法,为探索产后抑郁预防干预模式提供依据。研究中提及的产后抑郁预防干预方法众多,但缺乏效果评价,总体干预思路是以早发现为前哨,疏导为重点,建立社会支持系统为支撑,调整生活习惯为保障。集体心理干预值得推广,应加强实施效果评估,并将产后抑郁干预融入孕产妇保健体系。     

产后抑郁预防干预方法现状分析

本文通过分析现有产后抑郁预防干预方法,为探索产后抑郁预防干预模式提供依据.研究中提及的产后抑郁预防干预方法众多,但缺乏效果评价,总体干预思路是以早发现为前哨,疏导为重点,建立社会支持系统为支撑,调整生活习惯为保障.集体心理干预值得推广,应加强实施效果评估,并将产后押郁干预融入孕产妇保健体系.     

一例严重心理咨询的案例报告

赵某，女，20岁，大二学生，因身体出现问题而产生抑郁情绪。经心理测验SCL-90的抑郁因子分明显较高，SDS标准分76分。精神检查：意识清晰，思维正常，有明显的抑郁情绪。心理评估：情绪抑郁，认知存在偏差。经诊断为严重心理问题采用贝克认知疗法与求助者中心疗法，经过10次心理咨询后抑郁情绪缓解，认知能力得到改善。SDS简易量表测评结果为54。对咨询效果进行了回访、跟踪与评估，属成功咨询案例。     

剖宫产产后抑郁的发生与社会支持、应对方式及防御方式的相关性

了解剖宫产产后抑郁的发生与社会支持、应对方式及防御方式的相关性,对剖宫产患者进行抑郁状况的调查,并对其影响因素进行分析。对抑郁组与非抑郁组的一般情况构成比比较,并采用抑郁自评量表（SDS）、应付方式评定量表（YFFS）、社会支持问卷（ISSI）、防御方式问卷（DSQ）进行测评。社会支持、应对方式及防御方式对产后抑郁的发生均产生一定作用。应付方式、社会支持及防御方式是影响剖宫产患者产后抑郁的重要因素。     

成人学习不良的筛查与诊断

西方（以美国为代表）逐步形成了一套符合自身特点的成人学习不良筛查与诊断模式。文章讨论了筛查与诊断的关系,介绍了成人学习不良筛查与诊断的基本环节,以及筛查与诊断工具的选择与评估标准,并在对西方成人学习不良筛查与诊断模式特点的分析基础上,对建立我国成人学习不良测评体系提出了建议。     

108名优秀毕业生抑郁、焦虑、自尊水平的比较研究

目的调查与探讨某高校优秀毕业生的心理健康状况,并与普通毕业生进行比较,为高校更有效地开展毕业生教育工作提供科学的依据。方法:随机选取某高校各类优秀毕业生108人,并对照普通毕业生80人,采用自评抑郁量表、自评焦虑量表、自尊量表对其进行调查分析。结果:1.优秀毕业生的抑郁、焦虑水平显著低于普通毕业生,自尊水平显著高于普通毕业生;2.优秀毕业生的抑郁、焦虑、自尊水平之间呈显著相关,且不同自尊水平的优秀毕业生,其抑郁和焦虑水平也存在显著差异。建议:高校应采取多种途径加强毕业生的心理健康教育工作,提高毕业生的心理素质。     

家庭韧性对抑郁的影响：个体心理韧性的部分中介作用

为考察家庭韧性和个体心理韧性对个体抑郁的影响以及二者的关系，本研究运用家庭韧性量表、个体心理韧性量表和流调中心用抑郁量表对301名被试进行问卷调查。结果发现家庭韧性与个体心理韧性显著正相关，二者与抑郁均存在显著负相关。多元逐步回归分析发现家庭韧性及个体心理韧性均对抑郁有显著预测力，共同解释了变异量的28.6%。以抑郁为结果变量，构建以家庭韧性和个体心理韧性为预测变量的中介模型，检测结果显示中介模型拟合良好，个体心理韧性在家庭韧性与抑郁之间起到部分中介作用。因此，家庭韧性既可以直接负向预测抑郁，也可以通过提升个体心理韧性负向预测抑郁。     

Crying as a Form of Parent–Infant Communication in the Context of Maternal Depression

In cases of maternal depression certain complex factors interfere with communication with the child. The present study sought to investigate forms of parent–infant communication in families in which the mother was experiencing postpartum depression. Particular emphasis was placed on analysis of crying patterns and on methods employed by parents to soothe the child. The study sample comprised 15 families in which the mother had a diagnosis of postpartum depression. Semi-structured interviews were performed, followed by qualitative content analysis. Results showed that depressed mothers—and, at times, their husbands—reported difficulties in communication with their child, particularly in distinguishing different types of cries and in ways of soothing the infant. Postpartum depression is discussed as a specific diagnosis, beyond its relational aspect, which affects the family as a whole.     

Controlled prospective study of postpartum mood disorders: psychological, environmental, and hormonal variables

Demographic, psychiatric, social, cognitive, and life stress variables were used to determine the etiology of depression in childbearing (CB; n = 182) and nonchildbearing (NCB; n = 179) women. Hormonal variables in postpartum depression were also evaluated. In the CB group predictors of depression diagnosis were previous depression, depression during pregnancy, and a Vulnerability (V) x Life Stress (LS) interaction; predictors of depressive symptomatology were previous depression, depressive symptoms during pregnancy, life events, and V x LS. Only estradiol was associated with postpartum depression diagnosis. In the NCB group V X LS was the only predictor of depression diagnosis; depressive symptoms during pregnancy and life events were predictors of depressive symptomatology. Previous findings about depression vulnerability were replicated. The significant V x LS interactions support the vulnerability-stress model of postpartum depression.     

Unemployment, coping and psychological distress

This study addressed the role of coping sytle in anxiety and depression of unemployed people. Two-hundred thirty-three people checking in at unemployment services participated. They filled in Carver, Scheier and Weintraub's (1989) coping measure (COPE), the Hospital Anxiety and Depression scale (HAD), gave information as to age, duration of unemployment and their appraisal of their situation. Four secondary dimensions of COPE were used in data analyses. Multiple regression analyses were undertaken with anxiety/depression as dependent and the coping variables as independent variables, with background/appraisal variables entered first. Coping variables added to the prediction of anxiety and depression over and above background/appraisal variables. For women Focus on Emotion coping as well as Avoidance was related to higher anxiety/depression scores ( p <0.01), whereas Reappraisal was related to lower anxiety/depression ( p <0.05). For men only Avoidance was related to anxiety/depression ( p <0.01). More Avoidance co-occurred with higher levels of anxiety as well as depression. The results are discussed with respect to possible intervention.     

产后抑郁相关危险因素分析

本文通过分析引发产后抑郁的相关危险因素及其对健康的影响,为探索干预措施提供依据。危险因素重要性的分析显示“夫妻关系不佳”位居危险因素之首;产妇的性格特征和孕期心理状态是产后抑郁发生的重要心理影响因素。因此,丈夫角色不容忽视,社会支持系统的建立意义重大,干预效果显著的因素应作为研究重点。     

Examination of the Hamilton Scales in Assessment of Anxious Older Adults: A Replication and Extension

This study examined the original and reconstructed Hamilton scales in the assessment of anxiety and depression in a sample of older adults diagnosed with GAD (n = 82). Internal consistency of all scales appeared adequate. Results indicated improved construct validity with the reconstructed scales, which demonstrated reduced shared variance. However, construct validity examined through intercorrelations of the Hamilton scales with self-report measures of anxiety and depression was generally poor. Discriminant function analysis indicated that the reconstructed scales might have some clinical utility in differentiation of patients with and without coexistent depressive diagnosis (67% correct classification). In addition, two items from the Hamilton rating scale for depression (Work and Activities; Hopelessness) correctly classified patients with and without depression at a similar level as the Hamilton scale total scores (64–65% correct classification). These results suggest that the Work and Activities, and Hopelessness items may provide clinicians with useful screening questions for depression in anxious older adults.     

UNDERSTANDING THE CONNECTION BETWEEN ATTACHMENT TRAUMA AND MATERNAL SELF‐EFFICACY IN DEPRESSED MOTHERS

Maternal self‐efficacy predicts sensitive and responsive caregiving. Low maternal self‐efficacy is associated with a higher incidence of postpartum depression. Maternal self‐efficacy and postpartum depression can both be buffered by social support. Maternal self‐efficacy and postpartum depression have both been linked independently, albeit in separate studies, to the experience of violent trauma, childhood maltreatment, and spousal abuse. This study proposed a model in which postpartum depression mediates the relation between attachment trauma and maternal self‐efficacy, with emotional support as a moderator. Participants were 278 first‐time mothers of infants under 14 months. Cross‐sectional data were collected online. Mothers completed questionnaires on attachment trauma, maternal self‐efficacy, postpartum depression, and emotional support. A moderated mediation model was tested in a structural equation modeling framework using Mplus’ estimate of indirect effects. Postpartum depression fully mediated the relation between trauma and maternal self‐efficacy. Emotional support moderated only the pathway between postpartum depression and maternal self‐efficacy. Attachment trauma's implications for maternal self‐efficacy should be understood in the context of overall mental health. Mothers at the greatest risk for low maternal self‐efficacy related to attachment trauma also are those suffering from postpartum depression. Emotional support buffered mothers from postpartum depression, though, which has implications for intervention and future research.     

新冠肺炎疫情下的评估、应对与抑郁和焦虑的关系：多元多重中介模型

作为全球性公共卫生事件,新型冠状病毒肺炎疫情成为潜在心理应激事件。本研究以线上问卷调研形式在疫情爆发上升期考察了民众对此疫情的可控性评估及应对方式对抑郁焦虑的影响。结果表明：（1）自控性显著负向预测抑郁焦虑,他控性对抑郁焦虑无显著预测作用;（2）前行应对显著负向预测抑郁焦虑,创伤应对显著正向预测抑郁焦虑;（3）前行应对在自控性与抑郁焦虑之间起中介作用,即自控性通过正向预测前行应对进而负向预测抑郁焦虑;（4）前行应对在他控性与抑郁焦虑之间起中介作用,即他控性通过正向预测前行应对进而对抑郁焦虑产生积极影响;（5）然而,创伤应对也在他控性与抑郁焦虑之间起中介作用,即他控性通过正向预测创伤应对对抑郁焦虑产生消极影响。本研究对可控性评估和应对方式对抑郁焦虑的影响以及应对方式的中介作用进行了探究与讨论。