情绪劳动与抑郁及焦虑的关系：情绪耗竭的中介作用

本研究探讨情绪劳动与抑郁、焦虑的关系,着力考察情绪耗竭在二者之间的中介作用。采用情绪劳动量表、情绪耗竭量表和SCL-90对328名零售业员工进行调查。结果表明：表面行为与情绪耗竭、抑郁及焦虑没有显著相关;深度行为对情绪耗竭、抑郁及焦虑有显著的负预测作用;情绪耗竭在情绪劳动与抑郁及焦虑之间起完全中介作用。     

The validity of personal disturbance scale (DSSI/sAD) in people with diabetes mellitus,using longitudinal data

Despite being used since 1976, Delusions-Symptoms-States-Inventory/states of Anxiety and Depression (DSSI/sAD) has not yet been validated for use among people with diabetes. The aim of this study was to examine the validity of the personal disturbance scale (DSSI/sAD) among women with diabetes using Mater-University of Queensland Study of Pregnancy (MUSP) cohort data. The DSSI subscales were compared against DSM-IV disorders, the Mental Component Score of the Short Form 36 (SF-36 MCS), and Center for Epidemiologic Studies Depression Scale (CES-D). Factor analyses, odds ratios, receiver operating characteristic (ROC) analyses and diagnostic efficiency tests were used to report findings. Exploratory factor analysis and fit indices confirmed the hypothesized two-factor model of DSSI/sAD. We found significant variations in the DSSI/sAD domain scores that could be explained by CES-D (DSSI-Anxiety: 55%, DSSI-Depression: 46%) and SF-36 MCS (DSSI-Anxiety: 66%, DSSI-Depression: 56%). The DSSI subscales predicted DSM-IV diagnosed depression and anxiety disorders. The ROC analyses show that although the DSSI symptoms and DSM-IV disorders were measured concurrently the estimates of concordance remained only moderate. The findings demonstrate that the DSSI/sAD items have similar relationships to one another in both the diabetes and non-diabetes data sets which therefore suggest that they have similar interpretations.     

Construction and evaluation of a self rating scale for stress‐induced Exhaustion Disorder,the Karolinska Exhaustion Disorder Scale

Prolonged stress (≥ six months) may cause a condition which has been named exhaustion disorder (ED) with ICD‐10 code F43.8. ED is characterised by exhaustion, cognitive problems, poor sleep and reduced tolerance to further stress. ED can cause long term disability and depressive symptoms may develop. The aim was to construct and evaluate a self‐rating scale, the Karolinska Exhaustion Disorder Scale (KEDS), for the assessment of ED symptoms. A second aim was to examine the relationship between self‐rated symptoms of ED, depression, and anxiety using KEDS and the Hospital Anxiety and Depression Scale (HAD). Items were selected based on their correspondence to criteria for ED as formulated by the Swedish National Board of Health and Welfare (NBHW), with seven response alternatives in a Likert‐format. Self‐ratings performed by 317 clinically assessed participants were used to analyse the scale's psychometric properties. KEDS consists of nine items with a scale range of 0–54. Receiver operating characteristics analysis demonstrated that a cut‐off score of 19 was accompanied by high sensitivity and specificity (each above 95%) in the discrimination between healthy subjects and patients with ED. Reliability was satisfactory and confirmatory factor analysis revealed that ED, depression and anxiety are best regarded as different phenomena. KEDS may be a useful tool in the assessment of symptoms of Exhaustion Disorder in clinical as well as research settings. There is evidence that the symptom clusters of ED, anxiety and depression, respectively, reflect three different underlying dimensions.     

冠状动脉旁路移植术后患者抑郁焦虑状况及对生存质量的影响

研究选取2008年至2010年在我院接受冠状动脉旁路移植术（CABG）并完整填写术后半年、1年、2年抑郁焦虑自评量表（SDS 、SAS）及 SF-36问卷的患者,得出 CABG 术后2年内抑郁的发生率为32．4％,术后半年、1年、2年分别为29．4％、27．7％、23．6％。 CABG 术后2年内焦虑的发生率为18．2％,术后半年、1年、2年分别为14．7％、16．9％、7．9％。在术后生存质量的比较中,得出术后半年、1年、2年情感障碍组患者的生存质量要明显比非情感障碍组差。抑郁焦虑症状的高发生率,及其明显地降低了 CABG 术后患者的生存质量,提示临床医生须对冠心病及 CABG 术后患者的心理健康予以足够的重视。     

The SF-36 Among Cambodian and Vietnamese Refugees: An Examination of Psychometric Properties

Among traumatized Cambodian (N=90) and Vietnamese (N=94) refugees attending a psychiatric clinic, the study examined the validity and psychometric properties of the Short Form-36 Health Survey (SF-36), a measure of self-perceived mental and physical health. In both patient samples, all eight SF-36 scales displayed excellent internal consistency (item-scale correlations and Cronbach's α). But, similar to other studies of Asian samples, (a) the Vitality (VT) scale did not separate from the Mental Health (MH) and General Health (GH) scales, as evidenced by item-scale and interscale correlations, and (b) the VT scale loaded as strongly (Vietnamese sample) or more strongly (Cambodian sample) than the MH scale on the so-called Mental Factor in a two-factor solution of the eight scales (with the GH scale also loading heavily on the same factor).     

Measuring QoL with SF-36 in Older Americans with TBI

This study demonstrated reliability and factor structure of the Medical Outcomes Study Short-Form Health Survey (SF-36) among older Americans with Traumatic brain injury (TBI), and evaluated effects of injury severity and race on SF-36's items and latent domains. A representative sample of 654 older, racially diverse patients with TBI was selected from the South Carolina Traumatic Brain Injury Follow-up Registry. Reliability and factor structure of SF-36 were evaluated using Cronbach’s alpha and confirmatory factor analysis (CFA). Multiple-indicator multiple-causes (MIMIC) models were used to study effects of injury severity and race on items (differential item functioning, DIF) and latent domains (population heterogeneity) of SF-36. SF-36 was reliable and its current eightfactor structure was confirmed. While TBI severity did not impact latent domain scores of SF-36, race did. Blacks had higher vitality and lower role-emotional scores than whites. The measurement model was invariant to injury severity and race (free of DIF), and DIF did not contribute to the differences of vitality and role-emotional between black and white older TBI patients. SF-36 was valid to measure quality of life (OoL) after TBI in racially diverse elderly population. Blacks tend to assert to strong coping behaviors in the presence of physical stress while admitting low performance due to emotional stress. In QoL research where the primary outcomes are usually composite scores from instruments, MIMIC models have advantages over conventional multivariable regression models in testing the validity of the instruments and assessing covariate effects on latent traits of instruments while controlling for DIF effects.     

测量大学生的心理问题:GHQ-20的结构及其信度和效度

本研究对GHQ-20进行了结构分析并检验其对中国大学生被试的可信性和有效性。被试取自北京市两所高校的一至三年级大学生,共1142人。包括两个分研究,研究一(354名被试 )和研究二(788名被试)。研究一的因素分析提取出三个因子,它们被分别命名为三个不同的分量表:GHQ-自我肯定,GHQ-忧郁和GHQ-焦虑。两个研究结果均发现,GHQ-20的内部一致性满意,其三个分量表的内部一致性或者满意或者可接受。效度检验结果表明,GHQ-20及三个分量表均具有良好效度。基于上述结果,GHQ-20可以作为测量中国大学生心理问题的一个较为满意的工具,其分量表亦可作为测量中国大学生不同心理问题的较满意或至少是可用工具。     

Anxiety,depression, and health-related quality of life in aging people living with HIV compared to diabetes patients and patients with minor health conditions: a longitudinal study

HIV infection has evolved from a fatal to a treatable condition, leading to an increase in the rate of elderly People Living with HIV (PLWH). However, little is known about the psychosocial burden of elderly PLWH. Thus, the aim of this longitudinal multi-center cohort study was to investigate whether elderly PLWH experience more anxiety and depression and reduced health related quality of life (HRQOL) compared to elderly patients with other chronic conditions. PLWH were compared to diabetes patients (DM) and patients with minor health conditions (MHC), e.g. patients with hypertension or allergic conditions. All patients were over 50 years old. Anxiety and depression (HADS) as well as HRQOL (SF-36) were assessed at baseline and after 12 months. 218 PLWH, 249 DM and 254 MHC were included. At baseline, the study groups did not differ in anxiety, depression, and physical HRQOL. However, PLWH indicated lower mental HRQOL than DM and MHC patients (p = 0.001). We did not obtain any moderating effects showing a differential effect of patient characteristics on anxiety, depression, and HRQOL in the three patient groups. At follow-up, the level of anxiety, depression, and HRQOL did not change significantly. The prevalence of anxiety ranged between 27 and 35%, and that of depression between 17 and 28%. Thus, the results of our investigation tentatively suggest that the psychosocial adaptation to HIV among elderly PLWH resembles those of other chronic diseases. There may be some subtle impairments, though, as PLWH experienced lower mental HRQOL.     

Underlying correlation structures of parental stress, general health and anxiety

A partial least square regression (PLSR) was performed on the Swedish Parenthood Stress Questionnaire (SPSQ) sum score and subscales on incompetence, role restriction, social isolation, spouse relationship and health problems, using 42 items from the General Health Questionnaire (GHQ) and 20 items from the State Anxiety Inventory (STAI-X1). The dataset contained 227 fathers and 301 mothers of children aged 1.0-6.6 years from a population-based study on parental psychological distress in the general Norwegian population, and all items correlated positively with SPSQ. Subscales on spouse relationship, incompetence, social isolation and role restriction related to items on state anxiety and depression. The SPSQ subscale on health problems related to GHQ items on somatic symptoms and social dysfunction. The STAI-X1 item "not feeling rested" had a particularly important effect on parental stress. Underlying correlation structures between parental stress and items from STAI-X1 and GHQ were explored, but only the SPSQ sum score could be acceptably predicted. PLSR as a statistical methodology was found useful for health and psychometric data.     

Development and psychometric evaluation of a post exercise exhaustion scale utilising the Rasch measurement model

ObjectivesThe objective of this study to report on the development and psychometric analysis of a scale to measure post exercise exhaustion.DesignThis study utilised the Rasch measurement model for the psychometric analysis of a new scale aimed at measuring acute onset exhaustion in athletes.MethodAn extensive literature review, feedback from athletes and an expert panel from educators in psychology, sports science and exercise physiology provided feedback on the scale, providing evidence of content validity. A final survey, consisting of the 25 items and completed by three hundred and seventy-nine athletes (Sport: 187 tri-athletes and 192 cyclists; gender: 211 males, and 168 females; age: 18–25 [31], 26–35 [114], 36–45 [120], and 46+ [114]), was submitted to Rasch analysis.ResultsAfter amendments a final 14 item scale provided internally consistent and reliable measures of exhaustion for participants. The items of the final scale have good fit, and the scale has high PSI providing statistical evidence of reliability. The scale could benefit from items dealing with mid-range levels of exhaustion. The correlational association between the new scale and a similar scale was positive and significant correlation adding to the evidence of the validity of the new scale.ConclusionsThe scale appears to be a valuable tool for the assessment of exercise-induced acute onset exhaustion and may be an attractive option for researchers, clinicians, and coaches seeking to measure the levels of exhaustion in individuals. In addition to its valid theoretical structure and sound psychometric properties, the scale has advantages over other exhaustion or fatigue scales as it is not disease-specific.     

Attention Deficit/Hyperactivity Disorder in Adults with Sleep Apnea

AAttention deficit hyperactivity disorder (ADHD) is a common childhood illness. In some patients, this illness may persist into adulthood and an association between ADHD and Obstructive Sleep Apnea (OSA) has been found in childhood. However, it is unclear how OSA and ADHD coincide in adulthood. Therefore, to explore the relationship between OSA and adult ADHD the current investigation utilized a clinically-based cross-sectional survey. Subjects consisted of 81 treatment-naïve OSA patients and 32 controls. Measures included each patient completed a questionnaire regarding sleep, Adult ADHD scale. Clinical information, body mass index, 36-item Short Form Health Survey (SF-36), Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale, and polysomnography.The subjects with Apnea-Hypopnea Index (AHI) ≥ 5 events/h were defined as patients with OSA. The control group was accepted as individuals with AHI > 0 events/h. The prevalence of adult ADHD was not different between the patients with OSA and the control group [(7.4 % (6/75) vs. 6.3 % (2/30), p = 0.8, respectively]. OSA patients with ADHD, as compared with those without, had higher anxiety scores and poorer physical component scores of quality of life and higher ESS scores. ADHD scores in patients with OSA were associated with anxiety and depression scores and SF36 physical and mental component scores in bivariate analyses. Thus, in our sample ADHD was not a frequent illness in adult patients with OSA. However, in patients with OSA and ADHD higher levels of anxiety and daytime sleepiness and poorer quality of life was found.     

Depression and Social Anxiety in Children: Differential Links with Coping Strategies

Strategies that children use for coping with stressors are known to be related to emotional adjustment, but not enough is understood about specific links with social anxiety and depression. The present investigation tested differentiated associations of social anxiety and depression with specific types of coping strategies, and evaluated the direction of these associations over time. In Study 1, 404 children aged 8–13 years completed a coping scale modified from Kochendefer-Ladd and Skinner (Developmental Psychology 38:267-278, 2002) in order to evaluate factor structure and subscale internal consistency. In Study 2, 270 8–11-year-old children completed depression and social anxiety scales, a sociometric survey, and the coping scale from Study 1, with a follow-up timepoint 9 months later. In Study 1, factor analysis revealed six internally consistent coping subscales. In Study 2, social anxiety and depression were found to have distinctive longitudinal associations with subsequent coping strategies. Decreased problem-solving, social support-seeking, and distraction were uniquely predicted by depression but not by social anxiety. Internalising coping was a stronger outcome of social anxiety, and increased externalising was uniquely predicted by depression. There was also some evidence for a moderating role of peer relations. However, none of the coping strategies predicted changes in depression or social anxiety over the two timepoints. These results highlight the impact that emotional adjustment may have on children’s coping strategies, and clarify important distinctions between social anxiety and depression in relation to coping.     

社会支持与大学生抑郁的关系:一个有调节的中介模型

为考察社会支持、社交焦虑、一般自我效能感和抑郁之间的关系,采用社会支持评定量表、社交焦虑量表、一般自我效能感量表以及抑郁自评量表对640名大学生进行调查。研究显示:(1)社交焦虑在社会支持与大学生抑郁之间起部分中介作用;(2)一般自我效能感在社会支持—社交焦虑—抑郁这一中介过程中的后半路径起调节作用。     

Psychometric properties of a Spanish version of the Beck Anxiety Inventory (BAI) in general population

This is the first study that provides normative, reliability, factor validity and discriminant validity data of the Beck Anxiety Inventory (BAI; Beck, Epstein, Brown, & Steer, 1988) in the Spanish general population, Sanz and Navarro's (2003) Spanish version of the BAI was administered to 249 adults. Factor analyses suggested that the BAI taps a general anxiety dimension comprising two related factors (somatic and affective-cognitive symptoms), but these factors hardly explained any additional variance and, therefore, little information is lost in considering only full-scale scores. Internal consistency estimate for the BAI was high (alpha = .93). The BAI was correlated .63 with the BDI-II and .32 with the Trait-Anger scale of the STAXI 2, but a factor analysis of their items revealed three factors, suggesting that the correlations between the instruments may be better accounted for by relationships between anxiety, depression, and anger, than by problems of discriminant validity. The mean BAI total score and the distribution of BAI scores were similar to those found in other countries. BAI norm scores for the community sample were provided from the total sample and from the male and female subsamples, as females scored higher than males. The utility of these scores for assessing clinical significance of treatment outcomes for anxiety is discussed.     

Construction of new scales for the Multiple Affect Adjective Check List

Factor analyses were used to develop new scales for the Multiple Affect Adjective Check List (MAACL) measuring anxiety, depression, hostility, positive, and sensation-seeking affects. Anxiety, depression, and hostility scales were moderately intercorrelated and a combined score called “dysphoria” was formed from their addition. Positive and sensation-seeking affects were also correlated and combined in a summary score (PASS). The dysphoric and PASS scores were not highly correlated. The number of items checked correlated highly with the positive affect scale, moderately with sensation seeking, and relatively low with the negative affect scales. Internal reliabilities were high and retest reliabilities were low, in conformance with the model for state scales. The anxiety score increased and the positive affect score and number of items checked decreased just prior to a classroom examination. Further plans for scale development are discussed.     

Stress and Health in Spanish Women1

This study examines the relationship between stress and health in a sample of 1,566 women aged between 18 and 65 years. Multiple regression analyses were conducted using the scaled version of the General Health Questionnaire (GHQ‐28) scales as the dependent variables, and 21 personal and social variables as predictors. The women with more severe depression, anxiety, and somatic and social dysfunction symptoms were those who had a more emotional coping style and greater work role dissatisfaction. Moreover, depression, anxiety, and social dysfunction symptoms were predicted by low self‐esteem, while depression, anxiety, and somatic symptoms were predicted by chronic stress. The women with more symptoms of anxiety and depression were those who have experienced more life events and have low perceived social support. Women with Type‐A behavior patterns were found to suffer more anxiety and somatic symptoms. Women who exercise more hours per week had fewer somatic symptoms, and those with a more rational coping style suffered less social dysfunction.     

Catastrophizing,Depression and Anxiety During Pregnancy: Relation Between Lumbopelvic Pain and Physical/Social Functioning

Catastrophizing, a cognitive behavioral aspect of pain, is defined as an excessively negative orientation against a noxious stimulus. The primary goal of the present study is to assess the association between catastrophizing and lumbopelvic pain intensity during the pregnancy period, the secondary goal is to explore the variation of pain catastrophizing, anxiety and depression, and the tertiary goal is to investigate the relationship between catastrophizing and quality of life. After approval, pregnant women with lumbopelvic pain were invited to join in the study. During admission, participants were asked to complete questionnaires including Pain Catastrophizing Scale, Beck Anxiety Inventory, Beck Depression Inventory-II, and Short Form-36. Age, gravida, parity, number of abortus, number of live-births and the pain intensity score were recorded. A total of 429 women were enrolled in the study. Pain catastrophizing scores showed a fluctuation during pregnancy, and were significantly correlated with the scores of Beck Anxiety Inventory, Beck Depression Inventory, Visual Analog Scale, and Short Form-36 sub-scales including social functioning, vitality, physical functioning and mental health. The present study demonstrated that catastrophizing level shows an alteration throughout the pregnancy period, and variation in catastrophizing shows an approximately similar course with pain intensity, depression and anxiety.     

Health-Related Quality of Life in College Undergraduates with Learning Disabilities: The Mediational Roles of Anxiety and Sadness

Little research has examined health-related quality of life (HRQoL) in adults with learning disabilities in post-secondary settings and the potential relationship between a learning disability and anxiety or sadness. This study examined HRQoL in 68 undergraduate students: 34 students who reported having been diagnosed with a “learning disability” were compared to 34 students who indicated they had not been diagnosed with a learning disability. Participants completed an online survey of anxiety, sadness, and HRQoL, including the SF-36. ANCOVAs on the Emotional Well-Being and Role Limitations Due to Emotional Problems scales from the SF-36 revealed that students reporting a diagnosis of a learning disability were significantly more impaired in Emotional Well-Being. Regression analyses suggested that impairment in Emotional Well-Being was mediated by separate ratings of both anxiety and sadness. Results indicated that those undergraduates reporting learning disabilities suffered from an impaired sense of well-being associated with anxious and sad feelings. A portion of these data were presented at the 2005 annual meetings of the Association for Behavioral and Cognitive Therapies (ABCT).     

Coping strategies and quality of life among liver transplantation candidates

The maintenance of self-reported quality of life (QL) among people on the liver transplantation waiting list is one of the priority objectives of transplantation teams. Although there are different determinant factors of QL, results are not conclusive. In our study, the goal was to evaluate both the influence of cirrhosis etiology (ethylic and non-ethylic) and the coping strategies used concerning QL. A sample of 93 patients was selected, divided into two groups: ethylic cirrhosis (EC) and non-ethylic cirrhosis (NEC). QL was evaluated through the SF-36 Health Survey, and coping strategies through the Medical Coping Modes Questionnaire (MCMQ). Our results indicated that subjects with EC obtained similar QL levels to subjects with NEC, on all the SF-36 and MCMQ subscales. Furthermore, negative correlations were found between avoidance and acceptance-resignation coping strategies with the SF-36 components. Consequently, the acceptance-resignation strategy was associated with a worse perception of physical functioning, general and mental health, and vitality and role-emotional. Overall, these results suggest that cirrhosis etiology is not a determinant factor of QL, whereas the acceptance-resignation coping strategy might lead to lower self-perception of QL.     

SLE患者焦虑抑郁影响因素调查分析

为了探讨SLE（systemic lupus erythematosus）即系统性红斑狼疮患者焦虑抑郁心理影响因素,应用Zung焦虑自评量袁（Self—rating anxiety scale,SAS）和抑郁自评量表（self—rating depression scale,SDS）,对36例系统性红斑狼疮患者进行检测,辅以自行设计因素调查表进行相关因素调查。结果显示,SDS和SAS均分为49．70±11．3和42．13±8．9,与国内常模比较,差异有统计学意义,P〈0．01。单因素分析显示：对疾病的恐惧感、对病情了解程度、治疗效果、药物副作用、家庭经济状况、家庭支持、婚姻关系、睡眠质量、担心事业受影响、躯体症状的反复出现、社交娱乐活动受限、担心医护不精心12项因素与SLE患者抑郁焦虑状态的发生显著相关,P〈0．01。证明SLE患者抑郁焦虑心理与对疾病的恐惧感、治疗效果、家庭经济状况、睡眠质量等因素相关,这为心理干预提供了依据。