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焦虑敏感性在童年学习经历与青年期疑病观念增强之间的关系中起中介作用。

Anxiety sensitivity mediates the relationships between childhood learning experiences and elevated hypochondriacal concerns in young adulthood.

作者信息

Watt M C, Stewart S H

机构信息

Department of Psychology, Dalhousie University, 1355 Oxford Street, B3H 4JI, Halifax, Nova Scotia, Canada.

出版信息

J Psychosom Res. 2000 Aug;49(2):107-18. doi: 10.1016/s0022-3999(00)00097-0.

Abstract

OBJECTIVE

the present study investigated childhood learning experiences potentially associated with the development of elevated hypochondriacal concerns in a non-clinical young adult sample, and examined the possible mediating roles of anxiety sensitivity (i.e., fear of anxiety-related symptoms) and trait anxiety (i.e., frequency of anxiety symptoms) in explaining these relationships.

METHOD

197 university students participated in a retrospective assessment of their childhood instrumental (i.e., parental reinforcement) and vicarious (i.e., parental modeling) learning experiences with respect to arousal-reactive (e.g., dizziness) and arousal-non-reactive (e.g., lumps) bodily symptoms, respectively. Childhood learning experiences were assessed using a revised version of the Learning History Questionnaire (LHQ), anxiety sensitivity levels with the Anxiety Sensitivity Index (ASI), trait anxiety levels with the State-Trait Anxiety Inventory-Trait (STAI-T) scale, and degree of hypochondriacal concerns with the Illness Attitudes Scale (IAS)-Total score.

RESULTS

consistent with earlier findings [Watt MC, Stewart SH, Cox BJ. A retrospective study of the learning history origins of anxiety sensitivity. Behav Res Ther 1998; 36: 505-525.], elevated anxiety sensitivity levels were associated with increased instrumental and vicarious learning experiences related to both arousal-reactive and arousal-non-reactive bodily symptoms. Similarly, individuals with elevated hypochondriacal concerns also reported both more instrumental and vicarious learning experiences around bodily symptoms than did students with lower levels of such concerns. However, contrary to the hypothesis, the childhood learning experiences related to hypochondriacal concerns were not specific to arousal-non-reactive symptoms, but instead involved parental reinforcement and modeling of bodily symptoms in general (arousal-reactive and -non-reactive symptoms alike). Anxiety sensitivity, but not trait anxiety, partially mediated the relationships between childhood learning experiences and elevated hypochondriacal concerns in young adulthood.

CONCLUSIONS

elevated anxiety sensitivity appears to be a risk factor for the development of hypochondriasis when learning experiences have involved both arousal-reactive and arousal-non-reactive bodily symptoms.

摘要

目的

本研究调查了在非临床青年成人样本中,可能与疑病观念增强发展相关的童年学习经历,并检验了焦虑敏感性(即对焦虑相关症状的恐惧)和特质焦虑(即焦虑症状的频率)在解释这些关系中可能的中介作用。

方法

197名大学生分别参与了一项回顾性评估,内容涉及他们童年时期在与唤醒反应性(如头晕)和唤醒非反应性(如肿块)身体症状相关的工具性(即父母强化)和替代性(即父母示范)学习经历。童年学习经历使用修订版的学习史问卷(LHQ)进行评估,焦虑敏感性水平使用焦虑敏感性指数(ASI)评估,特质焦虑水平使用状态-特质焦虑量表-特质(STAI-T)评估,疑病观念程度使用疾病态度量表(IAS)总分评估。

结果

与早期研究结果一致[瓦特·MC、斯图尔特·SH、考克斯·BJ。焦虑敏感性学习史起源的回顾性研究。行为研究与治疗1998年;36:505-525。],焦虑敏感性水平升高与与唤醒反应性和唤醒非反应性身体症状相关的工具性和替代性学习经历增加有关。同样,疑病观念增强的个体在身体症状周围报告的工具性和替代性学习经历也比疑病观念较低的学生更多。然而,与假设相反,与疑病观念相关的童年学习经历并非特定于唤醒非反应性症状,而是普遍涉及父母对身体症状的强化和示范(唤醒反应性和非反应性症状均有)。焦虑敏感性而非特质焦虑部分中介了童年学习经历与青年期疑病观念增强之间的关系。

结论

当学习经历涉及唤醒反应性和唤醒非反应性身体症状时,焦虑敏感性升高似乎是疑病症发展的一个危险因素。

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