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将特定情境下的功能失调性期望和倾向性乐观融入抑郁的认知模型 - 一种路径分析方法。

Integrating situation-specific dysfunctional expectations and dispositional optimism into the cognitive model of depression - A path-analytic approach.

机构信息

Philipps-University of Marburg, Department of Clinical Psychology and Psychotherapy, Gutenbergstraße 18, D-35032 Marburg, Germany.

Philipps-University of Marburg, Department of Clinical Psychology and Psychotherapy, Gutenbergstraße 18, D-35032 Marburg, Germany.

出版信息

J Affect Disord. 2018 Mar 15;229:199-205. doi: 10.1016/j.jad.2017.12.082. Epub 2018 Jan 3.

Abstract

BACKGROUND

Dysfunctional expectations are considered to be core features of mental disorders and, in particular, major depression. The aim of the present study was to integrate two important types of expectations into the cognitive model of depression: situation-specific dysfunctional expectations (SDE) and dispositional optimism (DO). It was hypothesized that the influence of both DO and intermediate beliefs (IB) on depressive symptoms would be mediated via SDE.

METHODS

We examined 95 individuals (age M = 40.7, 68.1% female) with a diagnosed major depressive disorder from two inpatient clinics and one outpatient clinic. Measurements used in the study included the Depressive Expectations Scale, Dysfunctional Attitudes Scale, Life Orientation Test Revised, and Beck's Depression Inventory-II. Relationships between the constructs were analyzed using path-analytic models with bias-corrected bootstrapping confidence intervals.

RESULTS

Results indicate that the effect of IB on depressive symptoms was fully mediated via SDE, while the effect of DO on depressive symptoms was partly mediated via SDE. IB and DO moderately correlated with each other.

LIMITATIONS

Due to the cross-sectional design of the study, it is not possible to draw unambiguous conclusions regarding the causality of the suggested relationships.

CONCLUSIONS

The present study stresses the crucial role of dysfunctional expectations for major depression. Moreover, it reveals that SDEs as expectations with a high level of situational specificity may pose an important link between global cognitions and depressive symptoms. Given this situational specificity, SDEs are amenable to disconfirmation through behavioral experiments and may therefore be a promising target for cognitive-behavioral interventions.

摘要

背景

功能失调的期望被认为是精神障碍的核心特征,尤其是重度抑郁症。本研究的目的是将两种重要的期望类型整合到抑郁的认知模型中:情境特异性功能失调期望(SDE)和倾向性乐观(DO)。假设 DO 和中间信念(IB)对抑郁症状的影响均通过 SDE 进行介导。

方法

我们研究了来自两个住院诊所和一个门诊诊所的 95 名患有诊断为重度抑郁症的个体(年龄 M = 40.7,68.1%为女性)。研究中使用的测量包括抑郁期望量表、功能失调态度量表、生活取向测验修订版和贝克抑郁量表-第二版。使用具有偏置校正引导置信区间的路径分析模型分析结构之间的关系。

结果

结果表明,IB 对抑郁症状的影响完全通过 SDE 进行介导,而 DO 对抑郁症状的影响部分通过 SDE 进行介导。IB 和 DO 中度相关。

局限性

由于研究的横断面设计,不可能就所提出的关系的因果关系得出明确的结论。

结论

本研究强调了功能失调的期望对重度抑郁症的重要作用。此外,它揭示了 SDE 作为具有高度情境特异性的期望,可能在全局认知和抑郁症状之间构成重要联系。鉴于这种情境特异性,SDE 可以通过行为实验来验证,因此可能是认知行为干预的一个有前途的目标。

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