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夫妻中特定障碍的情绪共同调节模式:强迫症与神经性厌食症的比较。

Disorder-specific patterns of emotion coregulation in couples: Comparing obsessive compulsive disorder and anorexia nervosa.

作者信息

Fischer Melanie S, Baucom Donald H, Baucom Brian R, Abramowitz Jonathan S, Kirby Jennifer S, Bulik Cynthia M

机构信息

Department of Psychology and Neuroscience, University of North Carolina.

Department of Psychology, University of Utah.

出版信息

J Fam Psychol. 2017 Apr;31(3):304-315. doi: 10.1037/fam0000251. Epub 2016 Oct 17.

Abstract

Impaired emotion regulation and maladaptive strategies to manage distress are central to psychopathology, including obsessive-compulsive disorder (OCD) and anorexia nervosa (AN). Emotion regulation can be fostered or thwarted by romantic partners, and the tendency to rely on interpersonally oriented emotion regulation may vary by disorder. This study examined coregulation as a form of interpersonal emotion regulation in OCD and AN. We hypothesized that OCD is associated with exaggerated and AN with diminished coregulation, and that OCD patients have greater overall levels of emotional arousal than AN patients. Greater symptom severity was expected to exacerbate these opposing tendencies. Vocally encoded emotional arousal was measured during couple conversations in 34 AN patients, 18 OCD patients, and their partners. Two indicators of coregulation (covariation and coupling) were analyzed using cross-lagged actor-partner interdependence and coupled linear oscillator models. As hypothesized, OCD was associated with greater overall emotional arousal than AN. Symptom severity was not associated with emotional arousal or coregulation. Covariation differed in the opposite direction of the hypothesis; there was no difference in coupling. AN patients exhibited consistent coregulation, indicating high reactivity to partners' emotional arousal which may contribute to interpersonal avoidance. OCD couples showed limited predictability of patients' arousal over time, while partners were affected by the patients' emotional arousal; thus, symptom accommodation may in part be partners' attempts at managing their own distress along with the patients'. A better understanding of interpersonal emotion regulation in OCD and AN can inform treatment by targeting interaction patterns that may maintain symptoms. (PsycINFO Database Record

摘要

情绪调节受损以及应对痛苦的适应不良策略是包括强迫症(OCD)和神经性厌食症(AN)在内的精神病理学的核心。浪漫伴侣可能促进或阻碍情绪调节,而且依赖人际导向型情绪调节的倾向可能因疾病而异。本研究考察了共同调节作为强迫症和神经性厌食症中人际情绪调节的一种形式。我们假设强迫症与过度的共同调节相关,而神经性厌食症与减弱的共同调节相关,并且强迫症患者的情绪唤醒总体水平高于神经性厌食症患者。预计症状严重程度会加剧这些相反的倾向。在34名神经性厌食症患者、18名强迫症患者及其伴侣的夫妻对话中测量了语音编码的情绪唤醒。使用交叉滞后的行为者-伴侣相互依赖模型和耦合线性振荡器模型分析了共同调节的两个指标(协变和耦合)。如假设的那样,与神经性厌食症相比,强迫症与更高的总体情绪唤醒相关。症状严重程度与情绪唤醒或共同调节无关。协变与假设的方向相反;耦合方面没有差异。神经性厌食症患者表现出一致的共同调节,表明对伴侣的情绪唤醒有高反应性,这可能导致人际回避。强迫症夫妻中,患者情绪唤醒随时间的可预测性有限,而伴侣会受到患者情绪唤醒的影响;因此,症状适应可能部分是伴侣试图与患者一起应对自身痛苦的尝试。更好地理解强迫症和神经性厌食症中的人际情绪调节可以通过针对可能维持症状的互动模式来为治疗提供信息。(PsycINFO数据库记录

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