Horn Andrea B, Maercker Andreas
Psychopathologie und Klinische Intervention, Universität Zürich, Schweiz.
Psychother Psychosom Med Psychol. 2015 Aug;65(8):296-303. doi: 10.1055/s-0035-1545310. Epub 2015 Mar 30.
Maladaptive reactions on stressful experiences justifying a diagnosis of adjustment disorder have high prevalence. Little is known about the possible risk for clinically significant maladaptation that results from the social context. The literature on the effects of depression on communication and altered support conditions in couples is suggesting this. Aim of this study was to investigate whether clinically significant depression in the romantic partner is a risk factor for adjustment disorder following a concept of stress-response disorder. Furthermore, from a dimensional point of view a possible positive association between depressive symptoms in the partner and own adjustment symptom was studied. Thereby, own depressive symptoms were controlled for in order to exclude mere depressive contagion and isolate stress-related responses. In an online-couple-study N=294 participants (N=147 couples) reported whether or not they had experienced a stressful event that is still bothering them. N=152 participants reported such an event. N=28 of this group reached the threshold of a possible diagnosis with the screening questionnaire "Adjustment disorder New Module". N=14 romantic partners reported depressive symptoms above the cut-off of the CES-D. The risk for an adjustment disorder is elevated if the female partner reports a clinically significant level of depressive symptoms (OR 7.13). This was only true when female partners were depressed, the depression of male partners did not show any significant associations. Accordingly, dimensionally there is a positive association between depressive symptoms of the female partner and adjustment symptoms of preoccupation (stressor-related repetitive negative thoughts). Depression of the romantic partner seems to be a significant risk factor for maladaptive reactions on a stressful event. This was particularly true for male participants of the study. To sum up, results encourage taking up an interpersonal perspective in research and clinical interventions.
因应激经历而出现的适应不良反应若符合适应障碍的诊断标准，则其发生率较高。对于社会环境导致临床上显著适应不良的潜在风险，我们知之甚少。关于抑郁症对夫妻间沟通及支持条件改变的影响的文献表明了这一点。本研究的目的是，依据应激反应障碍的概念，调查浪漫伴侣中临床上显著的抑郁症是否是适应障碍的一个风险因素。此外，从维度的角度研究了伴侣的抑郁症状与自身适应症状之间可能存在的正相关关系。因此，对自身的抑郁症状进行了控制，以排除单纯的抑郁传染，并分离出与压力相关的反应。在一项在线夫妻研究中，N = 294名参与者（N = 147对夫妻）报告了他们是否经历过仍困扰着他们的应激事件。N = 152名参与者报告了此类事件。在这组参与者中，N = 28人通过“适应障碍新模块”筛查问卷达到了可能诊断的阈值。N = 14名浪漫伴侣报告的抑郁症状高于CES - D的临界值。如果女性伴侣报告临床上显著水平的抑郁症状，那么患适应障碍的风险会升高（比值比7.13）。仅当女性伴侣抑郁时才是如此，男性伴侣的抑郁未显示出任何显著关联。相应地，从维度上看，女性伴侣的抑郁症状与专注的适应症状（与应激源相关的重复性消极思维）之间存在正相关。浪漫伴侣的抑郁似乎是应激事件后适应不良反应的一个重要风险因素。在本研究的男性参与者中尤其如此。总之，研究结果鼓励在研究和临床干预中采用人际视角。
