关于抑郁的认知理论中自我图式的实验研究

关于抑郁的认知理论中自我图式的实验研究一、引言抑郁的认知理论认为，抑郁患者具有消极看待自我、消极看待周围环境、消极看待未来的认知特点。并将此特点归结为一种与正常人不同的消极认知图式所致（Ｂｅｃｋ，１９６７）。图式（Ｓｃｈｅｍａｔａ）通常被认为是影响信...     

Beck抑郁量表构想效度的验证性因素分析

以２８４名不同专业不同年级的男、女大学生为样本，施测了Ｂｅｃｋ抑郁量表（ＢＤＩ）。验证性因素分析表明该量表的构想效度并不理想。     

老年住院患者孤独及其与抑郁、焦虑情绪的相关研究

采用UCLA孤独量表和18项简明症状问卷（BSI-18）对487名老年住院患者的孤独、焦虑、抑郁情绪进行调查分析。结果显示,（1）老年住院患者存在不同程度的孤独感、抑郁和焦虑情绪,男性患者的躯体症状、抑郁情绪和焦虑情绪重于女性患者。高学历患者躯体症状、抑郁情绪和焦虑情绪轻于低学历患者,有配偶患者孤独感低于无配偶的老年患者。（2）老年住院患者的孤独感与躯体症状、抑郁、焦虑呈正相关,且焦虑和抑郁能显著预测老年住院患者的孤独感。     

青少年重度抑郁患者自伤行为及危险因素研究

为探讨重度抑郁青少年非自杀性自伤(non-suicidial self-injury,NSSI)行为发生的风险因素,采用贝克自杀意念量表、焦虑自评量表、Barratt冲动量表、认知情绪调节量表、青少年生活事件量表、家庭亲密度及适应性量表对160例抑郁障碍青少年患者进行调查。结果发现,青少年重度抑郁发作患者中NSSI行为发生率较高,性别差异不显著。伴NSSI组患者的冲动性、自杀危险、焦虑、自我责难、灾难化及人际关系得分显著高于不伴NSSI组(P0.05);计划、积极重新评价,家庭实际适应性得分显著低于不伴NSSI组(P0.05)。二分类Logistic回归分析显示,自杀危险得分、冲动性总分、人际关系、自我责难是NSSI的危险因素。     

Beck对抑郁的认知研究

Ｂｅｃｋ对抑郁的认知研究重庆医科大学（６３００４６）肖丰抑郁（Ｄｅｐｒｅｓｓｉｏｎ）是以消极性情感障碍为核心问题的一种较常见的心身疾病。在每个人的一生中,几乎都会经历由于失望或者失败所带来的抑郁情绪。所幸的是,多数人很快从这种不愉快感中解脱出来。但仍...     

上海市某区社区卫生服务中心医务人员抑郁焦虑情 绪调查

目的:调查社区卫生服务中心医务人员抑郁焦虑情绪现状及其影响因素,为预防其发生提供科学依据。方法:对上海市某区8家社区卫生服务中心医务人员整群抽样,使用抑郁自评量表(SDS)和焦虑自评量表(SAS)调查抑郁、焦虑症状检出率,并分析相关的人口社会学因素。结果:发放问卷720份,收回有效问卷692份。在接受调查的医务人员中,...     

难治性与非难治性抑郁症患者自动思维的比较

目的难治性抑郁症与非难治性抑郁症病人自动思维特点之间的差异,以及自动思维与抑郁、焦虑严重程度的关系。方法采用自动思维问卷(ATQ)、汉密尔顿抑郁17项量表(HAMD)和汉密尔顿焦虑量表(HAMA)对830例抑郁症患者进行测查。结果 1常模、难治性与非难治性抑郁症患者自动思维差异具有显著性(F=658.57,p0.01)。2负性自动思维与抑郁、焦虑症状存在正相关性,与HAMD总分相关系数r=0.251(p0.01),与HAMA总分相关系数r=0.200(p0.01)3抑郁症患者负性自动思维在年龄维度上差异具有显著性(t=-3.336,p0.01)。结论1难治性与非难治性抑郁症患者自动思维均显著高于常模;难治性抑郁症与非难治性抑郁症病人自动思维差异不具有显著性。2负性自动思维与抑郁、焦虑症状存在正相关关系。3抑郁症患者负性自动思维在年龄维度上青年人自动思维出现的频度显著高于中年人。     

慢性失眠伴焦虑抑郁患者血清炎症相关标志物研究进展

慢性失眠是临床上常见的睡眠障碍,慢性失眠患者多伴有焦虑抑郁,慢性失眠是导致焦虑抑郁的重要危险因素,同时焦虑抑郁又会加重患者的慢性失眠,两者关系密切,相互影响,最终有可能进一步引发大脑认知功能损伤。慢性失眠和焦虑抑郁的发病机制目前尚不十分明确,最新研究提示慢性失眠伴焦虑抑郁可以导致机体内免疫机能及炎症反应的变化,现就慢性失眠伴焦虑抑郁患者血清炎症相关标志物研究进展进行综述。     

青少年抑郁综合认知模型及其性别差异

Beck抑郁认知理论认为功能失调性态度和自动思维对抑郁的形成和发展有着重要的影响, 但是不同水平的认知因素在青少年抑郁中起什么样的作用还有待于进一步的研究。根据Oei和Kwon (2007)综合认知模型(ICM), 我们假设在青少年负性生活事件和抑郁症状间功能失调性态度是调节变量, 而自动思维是中介变量。研究采用开学初和临近期末间隔近四个月两个时间点的纵向数据搜集方式, 对613名初中生施以青少年生活事件量表(ASLEC)、功能失调性态度问卷(DAS)、自动思维问卷(ATQ)以及流调中心用抑郁量表(CES-D), 然后通过路径分析对模型进行了拟合度和性别差异检验, 结果表明：(1)各变量显著相关(p<0.01), 且各变量间隔四个月两个时间点的分数差异显著(p<0.01); (2)修正后的青少年抑郁综合认知模型较好地拟了数据, 且功能失调性态度与负性生活事件的交互作用对自动思维的影响上女生的路径系数显著大于男生。结论：功能失调性态度在负性生活事件和青少年抑郁症状间起调节作用, 而自动思维从中起到了认知中介的作用, 且该模型性别差异显著。     

女性冠心病患者并发焦虑和抑郁的个性化干预效果评价及影响因素

评价女性冠心病患者伴焦虑抑郁的个性化干预效果并探讨影响因素.试验组进行个性化干预,对照组不做任何特殊处理.干预后试验组的焦虑自评量表和抑郁自评量表分数明显低于试验前(P＜0.01),而对照组无显著变化(P＞0.05);试验组的平均住院时间为11.36天,低于对照组的15.42天(P＜0.01);文化程度、公费比例、疾病认知和病程影响焦虑的干预效果,疾病认知和单身年限会影响抑郁的干预效果.采取个性化干预的综合治疗效果显著.     

Cognitive specificity and positive-negative affectivity: complementary or contradictory views on anxiety and depression?

A principal factor analysis, conducted on a mixed psychiatric outpatient sample (N = 470), identified both common and specific dimensions underlying anxiety and depression. Although an initial single-factor extraction accounted for a significant proportion of variance in cognitive and symptom measures of anxiety and depression, a two-factor solution, in which anxiety and depression formed separate dimensions, proved to be the better solution. MANOVAS performed on pure depressed, pure anxious, and mixed anxious/depressed subgroups provided evidence of a specific cognitive profile for anxiety and depression. The mixed subsample evidenced greater severity, a mixed cognitive and symptom profile, and character traits that may indicate increased vulnerability to psychological disturbance. Results are discussed in terms of Beck's (1976) cognitive content-specificity hypothesis and the positive-negative affect model (Watson & Tellegen, 1985).     

Threat interpretation bias as a vulnerability factor in childhood anxiety disorders

The present study examined threat interpretation biases in children 7-12 years of age with separation, social and generalised anxiety disorders (N=15), non-anxious offspring at risk due to parental anxiety (N=16) and non-anxious controls of non-anxious parents (N=14). Children provided interpretations of ambiguous situations to assess cognitive, emotional and behavioural responses. In comparison with non-anxious control children and at-risk children who did not differ from each other, anxious children reported stronger negative emotion and less ability to influence ambiguous situations. These results suggest that threat interpretation bias may be a cognitive factor associated with ongoing childhood anxiety but not a vulnerability factor associated with parental anxiety.     

Dysfunctional Cognitions in Children with Social Phobia, Separation Anxiety Disorder, and Generalized Anxiety Disorder

According to cognitive theories of anxiety, anxious adults interpret ambiguous situations in a negative way: They overestimate danger and underestimate their abilities to cope with danger. The present study investigated whether children with social phobia, separation anxiety disorder, and generalized anxiety disorder have such a bias, compared to a clinical and a normal control group. Children were exposed to stories in which ambiguous situations were described, and asked to give their interpretations, using open and closed responses. Results showed that anxious children reported more negative cognitions than control children. However, anxious children did not overestimate danger on the free responses, but they did judge the situations as more dangerous on the closed responses. Anxious children had lower estimations of their own competency to cope with danger than the control groups on both open and closed responses. The results indicate that children with anxiety disorders have dysfunctional cognitions about ambiguous situations.     

The tell-tale heart: physiological reactivity during resolution of ambiguity in youth anxiety

In the past decade, cognitive biases and physiological arousal have each been proposed as mechanisms through which paediatric anxiety develops and is maintained over time. Preliminary studies have found associations between anxious interpretations of ambiguity, physiological arousal, and avoidance, supporting theories that link cognition, psychophysiology, and behaviour. However, little is known about the relationship between youths’ resolutions of ambiguity and physiological arousal during acute stress. Such information may have important clinical implications for use of verbal self-regulation strategies and cognitive restructuring during treatments for paediatric anxiety. In this brief report, we present findings suggesting that anxious, but not typically developing, youth select avoidant goals via non-threatening resolution of ambiguity during a stressor, and that this resolution of ambiguity is accompanied by physiological reactivity (heart rate, heart rate variability, and respiratory sinus arrhythmia). We propose future empirical research on the interplay between interpretation bias, psychophysiology, and child anxiety, as well as clinical implications.     

The impact of pre-sleep arousal state and strategy to control unwanted thoughts on sleep quality

Objective: It has been questioned whether elevated pre-sleep cognitive arousal contributes to poor sleep or whether it is the use of maladaptive thought control strategies, used to manage this cognitive arousal, that are responsible. The study aimed to examine how these factors – cognitive arousal (with and without anxiety) and maladaptive thought control strategies contribute to perceived sleep quality (SQ). Design: 129 “healthy adults” (46 males, 83 females) were exposed to picture-stimuli eliciting either anxious cognitive arousal or non-anxious cognitive arousal at bedtime. The groups were then randomly split and briefed to use either a cognitive distraction or cognitive suppression thought control strategy or no instructions were given (controls). Subjective SQ was measured immediately on waking. Results: Induced anxious cognitive arousal was associated with lower SQ compared to non-anxious cognitive arousal. Analyses revealed a significant interaction between arousal and the strategies used to control unwanted thoughts on SQ. When experiencing anxious cognitive arousal, the strategy of distraction was associated with poorer sleep outcomes. Conclusion: The findings suggest that the efficacy of differing thought control strategies vary depending upon whether cognitive arousal elicits anxiety or not. With that in mind, clinical implications in terms of augmenting the treatment of insomnia are discussed.     

Differentiating cognitive content between depressed and anxious outpatients

Quantitative research suggests that depressed and anxious patients can be differentiated based on their cognitive content. This study used qualitative research methods to separate the specific components of open-ended depressive and anxious thought content in 79 psychiatric outpatients. Patients with major depressive disorder (MDD; n = 36), generalized anxiety disorder (GAD; n = 10), and other psychiatric disorders (PC; n = 33) were instructed to (a) describe their most bothersome problem; (b) imagine the worst possible negative outcome followed by the best possible positive outcome; and (c) describe associated thoughts and emotions for each scenario. The content of patients' responses were coded to examine (a) the types and severity of problems; (b) the presence or absence of hopelessness, catastrophizing, hopefulness, and unrealistic positive expectations; and (c) the presence or absence of particular emotions associated with imagined worst and best outcomes. More GAD patients than MDD and PC patients indicated anticipated anxious emotions associated with imagined worst outcomes, and fewer MDD patients than GAD and PC patients indicated anticipated happiness associated with imagined best outcomes. No group differences emerged for the other variables considered. These findings suggest that depressed and anxious patients differ in their cognitive expectancies about future life events in terms of their own anticipated emotional reactions.     

Why worry? The cognitive function of anxiety

The phenomenon of worry is considered to arise from cognitive processes involved in anxiety, that serve to maintain high levels of vigilance for personal danger. Rather than rely on self-report alone, the research described here draws on information processing methodology, to investigate this hypothesized cognitive function. Evidence is summarized to show that anxious subjects selectively attend to threatening information, and interpret ambiguous events in a relatively threatening way. However, the evidence on memory suggests that although such information may be easily activated, it is not necessarily more accessible. The allocation of attentional priority to threatening information is seen as a characteristic of anxious (rather than depressed) mood, while the ease with which this processing mode is adopted may underlie trait anxiety and vulnerability to anxiety disorders.     

Investigating models of affect: relationships among EEG alpha asymmetry, depression, and anxiety

The approach-withdrawal and valence-arousal models both predict that depressive and anxious profiles will be associated with relatively reduced left frontal and increased right frontal activity respectively, while the valence-arousal model also proposes a dissociation by lower and higher right parietotemporal activity, respectively. Recent work further suggests that subtypes of anxiety disorders may be characterized by distinctive patterns of activity depending on their type of arousal (anxious arousal/apprehension). The aim of this study was to investigate the relationships among nonclinical depression/anxiety and lateralized frontal/parietotemporal activity by categorizing participants (N=428) on the basis of both negative mood and alpha EEG. Key findings include: (i) greater right frontal lateralization in anxious participants, symmetrical frontal activity in depressed/comorbid, and left frontal lateralization in healthy controls; (ii) right frontal lateralization in anxious arousal participants, left frontal and right parietotemporal lateralization in anxious apprehension; (iii) bilateral increase in frontal and increased right parietotemporal activity in depressed/comorbid participants. Findings support predictions for frontal but not posterior regions. Grouping on the basis of EEG may not be reciprocally predictive of negative mood groupings, suggesting involvement of additional factors.