目的 比较精神分裂症患者与正常人群自尊水平的差异,探讨精神分裂症患者自尊水平与症状的关系.方法 采用Rosenberg自尊量表(Rosenberg Self-esteem Scale,RSES)及阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS),对90例精神分裂症患者及30例正常对照人群的自尊水平及症状进行评估.结果 精神分裂症患者与正常对照人群进行组间的比较,两组间在总分和正性因子得分比较,差异无统计学意义(总分P>0.05,正因子得分P>0.05),两组间在负性因子得分比较,差异有统计学意义(P<0.05);Rosenberg量表总分与精神分裂症的概念紊乱症状有显著相关性(P<0.05),正性因子分与概念紊乱、兴奋、夸大症状评分有显著相关性(P<0.05),负性因子分与兴奋及刻板思维症状评分有显著的相关性(P<0.05).结论 精神分裂症患者与正常人群的自尊总体水平差异无统计学意义,但是自尊成分与正常人群差异有统计学意义,体现在负性自尊水平高于正常人.精神分裂症患者自尊水平与概念紊乱症状有显著的相关性.

在经济飞速发展的新时代背景下,物质生活日益丰富的同时,也给人们精神生活带来一定的挑战.根据近期发表在《柳叶刀》精神病学子刊上的中国精神卫生调查,我国精神障碍患病率为9.32％.《中国国民心理健康发展报告(2019-2020)》指出,自新冠肺炎疫情暴发以来,随着心理健康知识的宣传普及,公众的心理健康意识进一步增强.然而即使在这样的背景下,人们对于精神障碍的病耻感依然显著存在.

This article describes the process of analytic treatment of Mary, unfolding through snippets that illustrate her feminine identity, her dreams, conflicts with her husband, and the countertransference of the therapist. Mary grew freer and even eloquent about her feelings (enhancement of verbalisation) and became more self-aware with a growing ability to think of herself and about others (enhancement of metalization). She gained an acceptance of her daughter's affection, of her own self, and a new ability to make judgements and decisions for herself and for her family (an enhancement of autonomy). As Mary became more present in the family and sought a more equal partnership, her marriage also arrived at a major finish line at the same time as did our analytic work.

PURPOSE:To examine the levels and associations of differentiation of self based on Bowen's theory and adult attachment in a sample with anxiety-related disorders.DESIGN AND METHODS:One hundred fourteen adults with anxiety-related disorders and 117 age- and gender-matched controls were recruited. Levels of differentiation of self, adult attachment, and trait and state anxiety were assessed.FINDINGS:Adults with anxiety-related disorders showed significantly lower global levels of differentiation of self after controlling for socio-demographic characteristics. Adults with anxiety-related disorders also displayed significantly higher levels of anxiety and avoidant attachment.PRACTICE IMPLICATIONS:These constructs may be appropriate targets for intervention research in the study of anxiety-related disorders.

近年来随着生活水平的提高和生活节奏的增快,人们感受到的精神压力增多,对精神生活的要求也在提高,使得心理咨询与心理治疗(下文中将统一用心理治疗的术语)[注]服务越来越被更多的人所接受. 总结过去这些年来在心理门诊工作和心理治疗之中的经验,想到应该为患者和家属提供一些来自于专业人员的忠告和相关的信息,有以下几个方面:

The present study aimed to examine the effects of attachment, social support and resilience on posttraumatic stress disorder (PTSD) symptoms in people living with HIV/AIDS. One hundred fifty-two HIV+ adults in China were investigated. The results suggested that attachment anxiety had a significant direct effect on PTSD symptoms and impacted PTSD symptoms indirectly though associations with social support and resilience. Attachment avoidance could also be considered a distal risk factor of PTSD symptoms via the mediation of social support and resilience. The findings highlight the importance of identifying trauma and PTSD symptoms in people affected by HIV/AIDS and suggest that people with attachment anxiety and low social support resources might be at high risk for PTSD.

目的 调查男男性行为者(MSM)中艾滋病病毒(HIM)感染者的依恋情况,分析其影响因素,并希望能够将依恋理论用于指导HIV感染者的心理干预之中,促进艾滋病(AIDS)的防治工作.方法 用方便抽样的方法选取157名HIV阳性MSM为试验组,50名医院职工和其公司职员为对照组.采用关系评定问卷(RSQ)测量两组的依恋类型分布.采用SPSS 18.0对数据资料进行录入、整理、编码,采用描述统计、f检验、方差分析等方法进行数据处理.结果 试验组依恋类型分布:安全型13.38％,不安全型86.62％,其中拒绝型40.13％,关注型40.13％,恐惧型6.37％.对照组依恋类型分布:安全型47.76％,不安全型52.24％,其中拒绝型14.93％,关注型23.37％,恐惧型11.94％.两组在安全型、拒绝型、恐惧型上的得分差异具有统计学意义.结论 HIV阳性MSM的依恋类型以拒绝型和关注型为主,不安全依恋比例高于正常群体,提示可以将依恋理论应用于HIV感染的预防和干预.

目的 考察关系评定问卷(RSQ)中文版应用于具有一定代表性的艾滋病病毒(HIV)感染者群体的信效度,以期找出适合评定HIV感染者成人依恋类型的测评工具.方法 用方便抽样的方法抽取HIV感染者有效样本213例,设立正常对照组27例,接受RSQ中文版、亲密关系体验问卷修订版(ECR-R)测评.采用SPSS 13.0对数据资料进行录入、整理、编码,并使用AMOS 5.0进行验证性因素分析,采用Pearson相关分析、克伦巴赫(Cron-bach,s)α系数、组内相关(ICC)、卡方检验、t检验、方差分析等方法进行数据处理.结果 RSQ中文版量表整体的Cronbach's α为0.8157;4个分量表的Crombach'a系数:安全型0.5574,恐惧型0.7274,拒绝型0.6757,关注型0.5925.重测信度ICC为0.7269;分半信度为0.7786;条目分与分量表分的相关系数为0.303～0.720;均达到统计学显著差异水平.探索性因素分析表明,在此研究的HIV感染者样本中,成人依恋类型可以区分为四个类型:安全型、恐惧型、关注型、拒绝型.验证性因素分析表明,原作者的四因素理论结构对于所研究的样本拟合较为良好,其中三项拟合优度指数RMSEA 0.062、GFI 0.952、AGFI 0.920,达到理想值.结论 RSQ中文版是测量HIV感染者成人依恋类型的较为理想的工具,四分类成人依恋模型适合于HIV感染者群体.

目的:本研究考察我国艾滋病感染者中创伤后应激障碍的发病率及其症状结构.方法:样本1为云南省HIV感染者91名,样本2为该省和北京HIV感染者366名,施测白编创伤事件问卷及创伤后应激障碍检查表(PCL-C),用DSM-Ⅳ轴Ⅰ障碍定式临床检查病人版(SCID-Ⅰ)访谈对样本1被试进行诊断评估,确定PCL-C区分PTSD的分界点;用验证性因素分析比较PTSD症状结构的3个竞争模型.结果:①再体验-回避-麻木-警觉一阶四因子模型拟合最优;②PCL-C区分HIV感染者罹患PrSD的最佳分界点为44分,对应敏感度0.842,特异度0.906,诊断效能0.94,样本1中PTSD发病率为41.80％.结论:PTSD在HIV感染者人群中发病率高,PCL-C在该人群中呈一阶四因子一阶相关结构,提示该种症状分类具有跨样本一致性.

Objective: To study the trait of the adult attachment styles of the outpatients with anxiety disorders.Methods: Anxiety disorders of 123 outpatients meeting the Mini-International Neuropsychiatric Interview(MINI) were assessed by Experience of Close Relationship-Revised Version(ECR-R),State-trait Anxiety Inventory(STAI).Results: ①Compared with control group,social anxiety disorders group had higher rate of insecure adult attachment styles,higher scores in ECR-R anxiety and avoidance and the STAI.②Insecure style had 4.88 times of the risk of the anxiety disorders,fearful style had the highest risk(15.02 times),preoccupied style had 4.38 times and dismissing style had 3.76 times.③There were significant difference of STAI on the adult attachment within case group,fearful style with the highest level of anxiety.The score of STAI was higher of the participant with secure style in case group than control group.Conclusion: Insecure adult attachment styls are majority among anxiety disorder patients and it is the important risk factor of the anxity disorder,especially fearful style has the most signif icant inf luence.

Objective:To study relationship between attachment Styles and differentiation of self in patients with Obsessive Compulsive Disorder(OCD).Methods:84 outpatients with OCD and 100 normal controls(NC) were assessed by Experi ence of Close Relationship-Revised Version(ECR-R), Differentiation of Self Inventory Revised edition(DSI-R) and StateTrait Anxiety Inventory(STAI).Results:The patients with OCD had significantly higher rate of insecure adult attachment styles than NC group. The patients were higher in ECR-R anxiety and avoidance scores, but lower in STAI and DSI-R total score, and emotional reactivity(ER), I position(IP), emotional cutoff(EC) scores. Compared with the patients with secure at tachment and the NC with secure and insecure attachment, the patients with insecure attachment in OCD group had least scores in DSI-R total and ER and highest scores of STAI. In patients, the scores in DSI-R total and four subscales were negatively associated with the scores in ECR-R anxiety, while both the scores of EC and IP were negatively correlated with ECR-R avoidance score. The scores of EC、ER and IP could predict 71% of the scores of ECR-R anxiety, while the scores of EC and IP could predict 76% of the scores of ECR-R avoidance.Conclusion:Patients with OCD tend to have insecure attachment styles and lower differentiation of self. The patients with insecure attachment had lower differentiation of self.The attachment styles were associated with the differentiation of self in the patients with OCD.

Objective To study the level of differentiation of self and to explore its relationship with trait anxiety in outpatients with anxiety disorders. Methods 123 outpatients with anxiety disorder diagnosed with Mini-International Neuropsychiatric Interview( MINI) and 123 healthy controls were assessed with Differentiation of Self Inventory-Revised edition( DSI-R) and State-trait Anxiety Inventory( STAI). Results( 1) Total score of DSI-R,factor scores of emotional reactivity( ER) and I position( IP) in anxiety group were significantly lower than those in healthy control group( P < 0. 01). There was no significant difference in factor scores of emotional cutoff( EC) and fusion of others( FO) between the two groups.( 2) In anxiety group,age was positively correlated with total score of DSI-R,factor score of ER,IP and EC( P < 0. 05,or P < 0. 01). There was no significant correlation between age and factor score of IP. Factor score of ER in male patients with anxiety disorder was significantly higher than that in females( P < 0. 05).In healthy control group,age was positively correlated with factor score of IP( P < 0. 01). Total score of DSI-R and factor score of ER in singles were significantly higher than those in married subjects( P < 0. 01).( 3) Step-by-step regression analyses showed that factor scores of ER and IP were key predictors for trait anxiety,the contribution was27. 2% and 39. 9% in anxiety group and control group respectively. Conclusion Patients with anxiety disorder have lower differentiation of self than healthy subjects. Differentiation of self can predict the trait anxiety of individuals.

The primary purposes of this study were to (1) compare the characteristics of childhood experiences of parental rearing patterns in China reported by patients with borderline personality disorder (BPD), patients with other personality disorders and patients without personality disorders; (2) identify the reported parental rearing patterns associated with BPD in China; and (3) determine whether these patterns differ for males and females. One hundred and fifty-two patients with BPD, 79 patients with other personality disorders and 55 patients without Axis II diagnoses were administered the Chinese version of the McLean Screening Instrument for BPD and completed the Egna Minnen av Barndoms Uppfostran (EMBU), a self-report measure of childhood parental rearing patterns. Parental rearing patterns reported by the BPD group were characterized by less emotional warmth, and greater punishment, rejection and control than patterns reported by the other two groups. Within the BPD group, males were more likely than females to report parental punishment, rejection and control. Paternal punishment, low maternal emotional warmth and female gender predicted BPD diagnosis. Negative parental rearing patterns appear to contribute to the development of BPD in China and vary with the gender of the child. Maternal emotional warmth may be a protective factor against BPD.

目的 调查修订后的创伤后应激障碍自评量表(PCL-C)在癌症患者中的信效度,确定其分界点.方法采用修订后的PCL-C量表、DSM临床结构轴I半定式访谈(SCID-I)、一般资料调查表,对抽取的100例住院癌症患者进行调查.结果①PCL-C量表在癌症患者中有良好的信度和效度,量表整体的Cronbach's α系数为0.940(P<0.05),2w后的重测信度为0.804(P<0.01);②因素分析得到三因子结构,三个因子可解释总方差的67.349%;③以SCID-I作为效标,发现以38分作为癌症患者PCL-C的分界点时,该量表的敏感性和特异性分别为95%和86.25%,正确诊断指数为81.25%.结论 PCL-C量表在癌症患者中有良好的信效度和较高的正确诊断指数,可用于筛查癌症患者创伤后应激障碍的共病.

Objective To develop a short Chinese version of the center for epidemiological studies depression scale(CES-D).Method A stratified random nationwide sample with 30801 normal people and a mentally ill sample with 415 patients were tested.Items in the short version were chosen according to both the result of independent t-test in current study and the result of reliance and validity.Cut-off scores were offered to check up depressions.Result The internal consistency reliability of the 9-item Chinese version CES-D ranged from 0.85 to 0.88.The test-retest reliability was 0.49(P＜0.001).All item-total correlations were higher than 0.5.The correlation between sumscores of the original scale and sunscores of the Chinese short version ranged from 0.94 to 0.96 (P＜ 0.001) in all the samples.The sum scores of initial diagnosis depression sample were significantly higher than that of treated depression sample and common sample.A two-dimension structure was testified.The cut-off scores of the short version were 10 and 17.Conclusion The 9-item Chinese version of CES-D can be used in various samples with reliable and valid effect.

Objective: To explore the relationship between meta mood and depression in depressive disorder patients.Methods: 84 depressive disorder patients meeting DSM-IV criteria of depressive disorders were assessed by Mini-International Neuropsychiatric Interview,the Trait Meta Mood Scale and the Beck Depression Inventory.Results:(1) Compared with the control group,the depressive disorder group had higher scores in mood clarity and mood repair.The man of the depressive disorder group had higher scores in mood repair compared with women.(2) The score of mood clarity and mood repair were both negatively correlate with the score of BDI.(3) The mood repair was protective factor.Conclusion: The people who have lower scoreofmoodrepairaremorelikelytobedepression.

Objective: To explore the attachment styles and stress perception of Obsessive-Compulsive Disorder,and their relationship.Methods: 75 OCD patients(including 46 males and 29 females) and 75 healthy people were administered the Relationgship Scales Questionnaire(RSQ) and Chinese Perceived Stress Scale(CPSS).Results: The proportion of unsecure attachment styles(84%) in OCD group was higher than that in normal control group(45.3%),in which the proportion of preoccupied attachent style was 38.7%,dismissing-avoidant attachment style was 33.3%,fearful-avoidant attachment stlyle was 12.0%.The total score of CPSS in OCD(47.24±8.83) was higher than that in normal group(37.99±7.89),the difference in tension of CPSS between OCD group and normal group was statistically significant(P0.01).The tension of life stress was significantly different between two groups(P0.01).Secure attachment style in OCD had a negative relationship with a loss of control of CPSS.Unsesure attachment style had a positive relationship with the two aspects of CPSS(except for dismissing-avoidant attachment style),self-dimension of unsesure attachment style in OCD had a negative relationship with the two aspects of CPSS.Conclusion: The proportion of unsecure attachment styles in OCD group is higher than that in normal control group.Adult attachment styles may have a significant impact on the awareness of life pressure.

Objective:To explore the relationships between adult attachment and depression in depressive disorder patients.Methods: 84 depressive disorder patients meeting DSM-IV criteria of depressive disorders were assessed by MiniInternational Neuropsychiatric Interview,the Experiences in Close Relationships-Revised Questionnaire and the Beck Depression Inventory.Results: ①The attachment style distribution of the patients with depressive disorder was as follows: Securely(44%),Preoccupied 31%,Dismissing 17.9%,and Fearful 7.1%.Compared with the control group,the depressive disorder group had higher scores in ECR-R anxiety and avoidance.Compared with the anxiety disorder group,the depressive disorder group had higher scores in ECR-R anxiety,but no difference in avoidance.②Insecure style patients had 3.909 more times of the risk of having depressive disorders than the secure ones,fearful style had the highest risk(6.486 more times than the secure ones),preoccupied style had 5.622 more times and dismissing style had 2.317 more times.③ There were significant difference of BDI in adult attachment between case groups.The score of BDI was higher in the participants with insecure style than those with the secure style group.Conclusion: Insecure adult attachment styls are the majority among depressive disorder patients and it is the important risk factor of the depressive disorder,especially the fearful style has the most risk.