躯体形式障碍患者的述情障碍

目的：探讨躯体形式障碍患者的心理健康状况,以及与述情障碍的关系.方法：采用症状自评量表（SCL-90）及多伦多述情障碍量表（TAS）对60例躯体形式障碍患者（患者组）和60名健康自愿者（对照组）进行测评,并对躯体形式障碍患者的心理健康状况与述情障碍作相关分析.结果：患者组SCL-90总分及躯体化、人际关系敏感、抑郁、焦虑、偏执、精神病性6个因子评分均显著高于对照组（P＜0.05或P＜0.01）;其TAS总分及因子Ⅰ、Ⅱ、Ⅳ评分亦均显著高于对照组（P＜0.05或P＜0.01）,而因子Ⅲ评分两组间比较,差别则无统计学意义.躯体形式障碍患者的SCL-90总分与TAS总分及因子Ⅰ、Ⅱ、Ⅳ评分均呈显著性正相关;而与因子Ⅲ评分则无显著性相关.结论：躯体形式障碍患者的心理健康状况较差,并与述情障碍有关.     

军人失眠症患者的述情障碍与心理健康状况的相关研究

目的探讨军人失眠症患者的述情障碍与心理健康状况及两者的关系。方法采用多伦多述情障碍量表(TAS-20)和症状自评量表(SCL-90)对48例军人失眠症患者进行评估,并随机抽取某部50名官兵作为对照组。结果①与对照组和军人常模比较,军人失眠症患者存有明显的述情障碍和多心理症状(P<0.05或0.01);②军人失眠症患者多伦多述情障碍量表总分、因子Ⅰ、Ⅱ与SCL-90各因子分呈正相关,因子Ⅲ与SCL-90各因子评分呈负相关(P<0.05或0.01)。结论军人失眠症患者的心理健康状况明显低于对照组官兵,述情障碍是影响军人失眠症患者心理健康水平的重要因素。     

医学生述情障碍与心理健康及人格特征的关系研究

目的探讨医学院学生述情障碍与心理健康状况及人格特征的关系。方法对医学院在校大学生310人进行多伦多述情障碍量表(TAS)、症状自评量表(SCL-90)、修订艾森克个性问卷(EPQ,其中205名学生完成)的测量,并进行相关和回归分析。结果TAS与SCL-90各因子相关均有统计学意义(P均=0.000),相关值在0.185-0.396,与强迫因子的相关系数最高;TAS各因子与EPQ中的内外向(E)、神经质维度(N)的相关具有统计学意义;回归分析发现强迫因子、E对TAS影响较强。结论医学生述情障碍与心理健康状况及人格特征中的部分量表存在有统计学意义的中度相关,其中与强迫因子、E相关较强。     

舰艇军人述情障碍与应对方式的关系

目的 探讨舰艇军人述情障碍程度与所采用应对方式的关系.方法 采用多伦多述情障碍20个条目量表(TAS-20)、应付方式问卷(CSQ)时489例舰艇军人的述情障碍情况及应对方式进行评定.以 TAS得分≥(x)+1s作为述障碍高分组,TAS得分≤(x)-1s作为述情障碍低分组,(x)-1s＜TAS得分＜(x)+1s作为述情障碍中分组,对三组的应付方式各分量表得分进行比较;将489例舰艇军人的应付方式分量表得分与TAS得分进行相关分析.结果 述情障碍高、低、中分组的应付方式6个分量表得分差异均具有统计学意义(P＜0.01),两两比较中高分组在不成熟型或混合型应对方式自责、幻想、退避和合理化因子得分上显著高于述情障碍低、中分组(P＜0.01);在成熟型应对方式解决问题和求助因子得分上显著低于低、中分组(P＜0.01).相关分析显示,应付方式量表中解决问题,求助分量表得分与TAS总分及各因子分呈显著负相关(r=-0.184～-0.386,P＜ 0.01).自责、幻想、退避、合理化各分量表得分与TAS总分及各因子分呈显著正相关(r=0.139～0.444,P＜0.01).结论 舰艇军人的应对方式与述情障碍程度有关,高述情障碍者倾向于采用不成熟应对方式.     

海洛因依赖者述情障碍研究

目的:了解海洛因依赖者(PHD)述情障碍特征及与负性情绪的关系. 方法:对194例男性PHD(PHD组),采用自编一般情况问卷、多伦多述情障碍量表(TAS)、抑郁自评量表(SDS)及焦虑自评量表(SAS)进行心理评估;107名健康男性作为对照,采用TAS进行述情障碍测评. 结果:PHD组TAS总分及各因子分、SDS及SAS评分均显著高于对照组(P<0.05或P<0.01);TAS总分及因子Ⅰ、因子Ⅱ、因子Ⅳ与SDS、SAS总分均呈显著正相关(r=0.178～0.294,P均<0.05或P<0.01);TAS因子Ⅲ与SAS总分均呈显著负相关(r=-0.147,P<0.05). 结论:男性PHD存在明显述情障碍,并与负性情绪密切相关.     

神经症和抑郁障碍患者的述情障碍及相关因素研究

目的探讨神经症和抑郁障碍患者的述情障碍及影响因素。方法对57例神经症和抑郁障碍患者运用多伦多述情障碍量表(TAS)进行评定，并与常模进行比较。结果神经症和抑郁障碍患者存在明显的述情障碍，TAS总分及各因子分明显高于常模，男女之间无显著性差异，多元回归分析进入方程的是SCL-90躯体化因子和焦虑因子。结论正确评定神经症和郁郁障碍患者的述情障碍及影响因素，具有重要的临床现实意义，对采用适当的心理治疗提供依据。     

驻舰艇军人心理状况与人格特征的相关研究

目的:探讨驻舰艇军人心理健康状态及相关因素。方法:采用症状自评量表(SCL-90)、艾森克人格问卷(EPQ)评估海军某水面舰艇200名驻舰航行(长航)前后的心理健康状况。结果:长航前,除人际关系因子外,驻舰军人SCL-90总分及其他因子分均较男性军人常模显著低(P<0.01)。长航后SCL-90总分及各因子分均有所提高,其中总分、躯体化、焦虑、恐惧及精神病性因子分变化有统计学意义(P<0.05或P<0.01)。驻舰军人EPQ各分量表得分与男性常模比较差异均无显著性(P均>0.05)。SCL-90各因子分与EPQ精神质、神经质呈显著正相关(P<0.01),与掩饰性呈显著负相关(P<0.01);而人际关系、抑郁、恐惧因子分与内外向呈负相关(P<0.05或P<0.01)。结论:驻舰军人心理健康水平较好。人格特征与应激状态下心理健康水平关系密切。     

躯体化症状为主抑郁症患者的述情障碍

目的:探讨以躯体化症状为主抑郁症患者和以情绪症状为主抑郁症患者述情障碍的差异。方法:50例以躯体化症状为主抑郁症患者(躯体症状组)、50例以情绪症状为主抑郁症患者(情绪症状组)和50名正常健康者(正常对照组)参加研究,采用90项症状自评量表(SCL-90)、汉密尔顿抑郁量表(HAMD)和多伦多述情障碍量表进行评定。结果:躯体症状组SCL-90总分、躯体化、焦虑、人际敏感、恐怖、偏执因子分及HAMD的焦虑/躯体化因子评分均高于情绪症状组(P<0.01或P<0.05),情绪症状组在强迫、抑郁因子评分及HAMD的认知障碍、阻滞、日夜变化、睡眠障碍及绝望因子分高于躯体症状组(P<0.05或P<0.01)。躯体症状组与情绪症状组仅在述情障碍因子II评分差异有统计学意义(P<0.05),而在述情障碍总分及因子分上均高于正常对照组(P<0.05或P<0.001)。结论:以躯体化症状为主和以情绪症状为主抑郁症患者均存在述情障碍,以前者更缺乏识别情绪和躯体感受能力。     

恶劣心境患者述情障碍与自主神经功能的相关研究

目的:探讨恶劣心境患者的人格特质、述情障碍与自主神经功能心理生理反应的相关机制。方法:采用多伦多述情障碍量表中文版(TAS-20-C)及心理健康测查表(PHI)对42例恶劣心境患者组(DD组)、33例重性抑郁症患者组(MD组)及30例健康对照组(NC组)进行述情障碍和心理健康水平和人格特质测定,并分析短时(5min)心率变异性(HRV),评定自主神经功能。结果:DD组TAS-20-C各因子得分及总分显著高于NC组(P<0.01),因子Ⅰ、因子Ⅱ及总分均明显高于MD组(P<0.01或P<0.05);DD组PHI量表躯体化、焦虑、病态人格及疑心因子分明显高于MD组(P<0.01或P<0.05);DD组HRV频谱指标中SDNN、PNN50及HF较MD及NC组均显著下降(P<0.01或P<0.05),LF∕HF较MD及NC组均明显升高(P<0.05);TAS-20-C总分及因子Ⅰ与躯体化、焦虑、病态人格、疑心均相关(︱r︱=0.25～0.38,0.40～0.44,0.47～0.59,0.43～0.42,P<0.01或P<0.05),因子Ⅱ与焦虑及变态人格相关(︱r︱=0.31,0.31,P<0.05);躯体化及焦虑与SDNN、VLF及LF均相关(︱r︱=0.26～0.27,0.39～0.27;︱r︱=0.36～0.28,P<0.05或P<0.01)。结论:恶劣心境患者存在明显的述情障碍,其人格特质可能导致患者焦虑程度更高,伴自主神经功能紊乱。     

新入监服刑人员心理健康和自尊状况关系研究

目的探讨新入监服刑人员的心理健康状况及其与自尊水平之间的关系。方法使用症状自评量表(SCL-90)和Rosenberg自尊量表(RSES)对100名新入监服刑人员的心理健康状况及自尊水平进行调查,并分析其相关性。结果新入监服刑人员的SCL-90总分、总均分、阳性项目数及躯体化、强迫、抑郁、焦虑、恐怖、偏执、精神病性因子分的得分上均显著高于全国常模(P<0.05或P<0.01),主要心理问题表现为抑郁、强迫、焦虑等方面,而且性别、年龄、犯罪类型、刑期对心理健康状况有影响。RSES总分与SCL-90总分及强迫、人际关系敏感、抑郁、焦虑、敌对、恐怖因子分均呈显著负相关,自尊是SCL-90总分和多个因子分的显著预测变量(P<0.05或P<0.01)。结论新入监服刑人员的心理健康状况存在明显的异常,自尊水平越低的人员心理健康状况越差,自尊对心理健康状况具有显著负向预测作用。在对新入监服刑人员进行心理干预时,需要重视自尊因素。     

大学生述情障碍与自杀倾向的相关性

目的 了解在校大学生述情障碍与自杀倾向的相关性.方法 采用多伦多述情障碍量表(TAS-20)、贝克绝望量表(BHS)以及自编的一般资料问卷对在校大学生进行现场调查.结果 男生在因子3分上显著性高于女生(P＜0.05),不同年级、学习成绩、家庭来源的大学生在TAS总分及3个因子分上均存在显著性差异(P＜0.05),独生子女的TAS总分、因子1、因子3得分高于非独生子女,差异有显著性(P＜0.01);有自杀倾向大学生TAS总分、因子1、因子3得分均高于无自杀倾向者,差异有显著性(P＜0.05);BHS总分与TAS总分及因子1、因子2、因子3都显著正相关(P＜0.01,r=0.08～0.33);通过Logistic多元回归分析,BHS总分、年级、动机丧失、成绩、独生子女5个变量依次进入回归方程.结论 在校大学生述情障碍和自杀倾向密切相关.     

The relationship between alexithymia and salivary cortisol levels in somatoform disorders

The purpose of this study was to investigate cortisol levels as a function of the hypothalamic-pituitary-adrenal axis (HPA) in relation to alexithymia in patients with somatoform disorders (SFD). Diurnal salivary cortisol was sampled in 32 patients with SFD who also underwent a psychiatric examination and filled in questionnaires (Toronto Alexithymia Scale, TAS scale; Screening for Somatoform Symptoms, SOMS scale; Hamilton Depression Scale, HAMD). The mean TAS total score in the sample was 55.6+/-9.6, 32% of patients being classified as alexithymic on the basis of their TAS scores. Depression scores were moderate (HAMD=13.2, Beck Depression Inventory, BDI=16.5). The patients' alexithymia scores (TAS scale "Difficulty identifying feelings") correlated significantly positively with their somatization scale scores (Symptom Checklist-90 Revised, SCL-90-R); r=0.3438 (P<0.05) and their scores on the Global Severity Index (GSI) on the SCL-90-R; r=0.781 (P<0.01). Regression analysis was performed with cortisol variables as the dependent variables. Cortisol levels [measured by the area under the curve-ground (AUC-G), area under the curve-increase (AUC-I) and morning cortisol (MCS)] were best predicted in a multiple linear regression model by lower depressive scores (HAMD) and more psychopathological symptoms (SCL-90-R). No significant correlations were found between the patients' alexithymia scores (TAS) and cortisol levels. The healthy control group (n=25) demonstrated significantly higher cortisol levels than did the patients with SFD; in both tests P<0.001 for AUC-G and AUC-I. However, the two groups did not differ in terms of their mean morning cortisol levels (P>0.05). The results suggest that pre-existing hypocortisolism might possibly be associated with SFD.     

The relationship between alexithymia and salivary cortisol levels in somatoform disorders

The purpose of this study was to investigate cortisol levels as a function of the hypothalamic–pituitary–adrenal axis (HPA) in relation to alexithymia in patients with somatoform disorders (SFD). Diurnal salivary cortisol was sampled in 32 patients with SFD who also underwent a psychiatric examination and filled in questionnaires (Toronto Alexithymia Scale, TAS scale; Screening for Somatoform Symptoms, SOMS scale; Hamilton Depression Scale, HAMD). The mean TAS total score in the sample was 55.6±9.6, 32% of patients being classified as alexithymic on the basis of their TAS scores. Depression scores were moderate (HAMD=13.2, Beck Depression Inventory, BDI=16.5). The patients’ alexithymia scores (TAS scale “Difficulty identifying feelings”) correlated significantly positively with their somatization scale scores (Symptom Checklist-90 Revised, SCL-90-R); r=0.3438 (P<0.05) and their scores on the Global Severity Index (GSI) on the SCL-90-R; r=0.781 (P<0.01). Regression analysis was performed with cortisol variables as the dependent variables. Cortisol levels [measured by the area under the curve–ground (AUC-G), area under the curve–increase (AUC-I) and morning cortisol (MCS)] were best predicted in a multiple linear regression model by lower depressive scores (HAMD) and more psychopathological symptoms (SCL-90-R). No significant correlations were found between the patients’ alexithymia scores (TAS) and cortisol levels. The healthy control group (n=25) demonstrated significantly higher cortisol levels than did the patients with SFD; in both tests P<0.001 for AUC-G and AUC-I. However, the two groups did not differ in terms of their mean morning cortisol levels (P>0.05). The results suggest that pre-existing hypocortisolism might possibly be associated with SFD.     

Effects of inpatient psychotherapy on the stability of alexithymia characteristics

Background

Although alexithymia is associated with several psychiatric disorders, there has been little research into the effects of psychodynamic psychotherapies on this condition. Here, the influence of inpatient multimodal psychodynamic psychotherapy on alexithymia and symptom load was evaluated in a large sample of patients.

Methods

Alexithymia [measured with the Toronto Alexithymia Scale (TAS)-26] and psychological stress and depression [measured with the Symptom Checklist 90 Revised (SCL-90-R)] were evaluated at admission and after inpatient multimodal psychotherapy in patients with various psychosomatic and psychiatric disorders admitted to this unit between 2002 and 2005. Patients undergoing both short-term (up to 4 weeks) and long-term treatment (8-12 weeks) were studied. Analyses of covariance were used to analyse the data on depression (SCL-90-R) and psychological stress (SCL-90-R), and correlations between admission and discharge scores for the TAS-26 were computed to evaluate mean and relative stability of alexithymia.

Results

Data on 397 of the 568 patients admitted were analysed. Psychological stress and depression (SCL-90-R) decreased significantly during the study across all diagnostic groups. The TAS-26 total score also decreased significantly, showing that there was no mean stability of alexithymic characteristics. However, the significance of decrease was lost when psychological stress and depression were controlled for. Highly significant correlations between TAS-26 sores before and after treatment reflected high relative stability of alexithymia.

Conclusions

During inpatient multimodal psychodynamic treatment, the symptom load and alexithymia in our patients decreased. The high relative stability of alexithymia shown supports the view that alexithymia is a relative stable personality trait.     

男性服刑人员冲动性与心理健康的相关性研究

目的:探讨男性服刑人员的冲动性水平、心理健康状况及其相关性。方法:采用Barratt冲动性量表第11版(BIS-11)、症状自评量表(SCL-90)对456名男性服刑人员(研究组)及年龄及受教育程度匹配的178名健康男性(对照组)进行评估。结果:研究组BIS-11总分、运动冲动性及无计划冲动性评分明显高于对照组(P0.05或P0.01);SCL-90总分及各因子分明显高于对照组(P0.05或P0.01)。研究组SCL-90总分及各因子分与BIS-11总分及因子分呈正相关(P均0.01);回归分析显示注意力冲动性对SCL-90总分(b=0.295,P=0.000)有较好的预测作用。结论:男性服刑人员具有冲动性人格特质,心理健康状况较差;冲动性尤其注意力冲动性对其心理健康有明显的影响。     

Nightmares and alexithymia in traumatized North Korean refugees

BackgroundThe present study examined the association between nightmare distress and alexithymia in traumatized North Korean (NK) refugees resettled in South Korea and the effects of clinical or subclinical psychiatric symptoms on this association.MethodsThirty-eight NK refugees living in South Korea who had traumatic experiences (15 males, 23 females; 29.50 ± 13.11 years of age) were recruited. The Structured Clinical Interview for DSM-IV and the Clinician-Administered Post-Traumatic Stress Disorder (PTSD) Scale were conducted. All participants completed a series of questionnaires on the history of their previous traumatic experiences, the Beck Depression Inventory, the Nightmare Distress Questionnaire (NDQ), the Toronto Alexithymia Scale (TAS), and the Impact of Event Scale. In total, 18 refugees were classified as having nightmare distress based on NDQ scores, and 20 refugees were not.ResultsRefugees with nightmares reported significantly higher TAS total scores and Difficulty Identifying Feelings (DIF; a subscale of TAS) scores compared to those without nightmares. In addition, NDQ scores were positively correlated with TAS total scores (r = 0.43, p < 0.01) and DIF scores (r = 0.49, p < 0.01). These correlations remained significant after excluding refugees with current axis I psychiatric disorders or clinical or subclinical depressive symptoms. However, there was no significant correlation between nightmares and alexithymia after excluding refugees with clinical or subclinical trauma-related symptoms.ConclusionsNightmares in traumatized refugees were associated with alexithymia even in the absence of current psychiatric disorders or depressive symptoms. Trauma-related symptoms might be a mediating factor between nightmares and alexithymia in traumatized refugees.     

Distribution of alexithymia as a personality-trait in psychosomatically ill in-patients--measured with TAS 20 and LEAS

Preliminary findings of an ongoing study of the distribution of alexithymia in different diagnostic-groups of psychosomatically ill in-patients (n = 240, will be increased to n = 400) are reported. Alexithymiea is measured simultaneousely by the Levels of Emotional Awareness Scale (LEAS, a performance-test) and the 20-item Toronto Alexithymia Scale (TAS 20, a self-report-scale). Measured by the LEAS and compared with other diagnostic groups (affective, anxiety and compulsive-obsessive disorders; adjustment disorders; eating disorders), patients with somatoform disorders showed a decreased ability to be aware of and to communicate their emotional states. This finding which meets theoretical considerations about the origin of alexithymia could not be found with the TAS 20. The TAS 20 did not differentiate between the diagnostic groups, but showed - in accordance with two other self-report-scales (STAI for self reported anxiety as a personality trait and SCL-90-R for self reported somatic und psychic complaints) - higher mean scores at the onset than at the end of treatment. Methodical implications of the different findings of the two alexithymia scales are discussed.     

失眠症患者心理社会因素分析

目的:探讨失眠症患者的应付方式,心理健康状况和社会支持状况.方法:采用应付方式问卷(CSQ)、症状自评量表(SCL-90)和社会支持量表(SSS)对失眠症患者和正常对照者各88例进行测评.结果:失眠症组自责、幻想和退避分量表的得分显著高于对照组,求助分量表的得分显著低于对照组(P＜0.01);失眠症组SCL-90总分及躯体化、抑郁、焦虑、睡眠障碍各因子分与对照组比较,有显著差异(P＜0.01).失眠症组社会支持总分、客观支持和对社会支持的利用度评分显著低于正常对照组(P＜0.05).失眠症组自责与躯体化症状、焦虑、抑郁等因子及总分呈显著正相关,而求助与焦虑、抑郁、偏执和总分呈显著负相关(P＜0.05).结论:失眠症患者多采用不成熟的应付方式,且有较多的心身症状,应付方式和身心健康有相关性.失眠症患者缺乏社会支持.