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[精神分裂症中的应对方式:作为应激应对策略决定因素的临床和功能变量研究]

[Coping styles in schizophrenia: study of clinical and functional variables as determinants of strategies to cope with stress].

作者信息

Zappia Serena, Montemagni Cristiana, Macrì Antonio, Sandei Luisa, Sigaudo Monica, Rocca Paola

机构信息

Dipartimento di Neuroscienze, Sezione di Psichiatria, Università di Torino.

出版信息

Riv Psichiatr. 2012 May-Jun;47(3):238-45. doi: 10.1708/1128.12447.

DOI:10.1708/1128.12447
PMID:22825440
Abstract

AIM

The purpose of this study was to analyze the relation between coping styles, and both clinical and functional variables in a sample of patients with stable schizophrenia.

METHODS

Forty-seven consecutive outpatients were enrolled in a cross-sectional study. A clinical assessment was performed and included: the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), the Scale for the Assessment of Unawareness of Mental Disorder (SUMD), the Rosenberg Self-Esteem Scale (RSES), the Quality of Life Scale (QLS) and the questionnaire Short Form Health Survey 36 (SF-36). Coping strategies were assessed with the Coping Inventory for Stressful Situations (CISS), identifying three main coping styles: task-, emotion- and avoidance-oriented. Three different multiple regression models with backward elimination were performed in order to discover contributing factors to coping styles.

RESULTS

From the results of multiple regression, depressive symptoms and objective quality of life were contributing factors to task-oriented coping style, explaining about 32% of variance. Negative symptoms, subjective quality of life, self-esteem, awareness of symptomatology and attribution of symptoms to illness resulted to be contributing factors to emotion-oriented coping strategies, explaining about 60% of variance.

DISCUSSION

These results suggested the role of some clinical and functional variables as contributing factors to coping styles. In this context, supportive and rehabilitative interventions and cognitive-behavioral therapy focused to manage psychotic symptoms and to decrease distress could help patients to employ more adaptive coping strategies and improve their outcomes.

摘要

目的

本研究旨在分析稳定型精神分裂症患者样本中应对方式与临床及功能变量之间的关系。

方法

47名连续的门诊患者参与了一项横断面研究。进行了临床评估,包括:阳性和阴性症状量表(PANSS)、精神分裂症卡尔加里抑郁量表(CDSS)、精神障碍自知力评估量表(SUMD)、罗森伯格自尊量表(RSES)、生活质量量表(QLS)以及简短健康调查问卷36(SF - 36)。使用应激情境应对量表(CISS)评估应对策略,确定三种主要应对方式:任务导向型、情绪导向型和回避导向型。进行了三种不同的逐步回归多元回归模型,以发现应对方式的影响因素。

结果

多元回归结果显示,抑郁症状和客观生活质量是任务导向型应对方式的影响因素,解释了约32%的方差。阴性症状、主观生活质量、自尊、症状自知力以及将症状归因于疾病是情绪导向型应对策略的影响因素,解释了约60%的方差。

讨论

这些结果表明一些临床和功能变量作为应对方式的影响因素所起的作用。在此背景下,旨在管理精神病性症状和减轻痛苦的支持性、康复性干预措施以及认知行为疗法可能有助于患者采用更具适应性的应对策略并改善其预后。

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