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精神分裂症谱系障碍患者、其兄弟姐妹及对照组中自我报告的自我干扰现象与个人康复之间的关联

The Association between Self-Reported Self-Disturbance Phenomena and Personal Recovery in Patients with a Schizophrenia Spectrum Disorder, Siblings and Controls.

作者信息

Jelsma Auke, Dijkstra Stéphanie, Wiemer Sietske, Vellinga Astrid, de Koning Mariken, Cahn Wiepke, Simons Claudia, van der Pluijm Marieke, de Haan Lieuwe

出版信息

Psychopathology. 2025 May 28:1-22. doi: 10.1159/000546557.

Abstract

INTRODUCTION

Self-disturbance phenomena are increasingly recognized as fundamental and debilitating features for patients with a schizophrenia spectrum disorder (SSD). The concept of personal recovery describes the process of building a meaningful and satisfying life despite persistent symptoms or challenges related to mental illness. No previous study has investigated the association between self-disturbance phenomena and personal recovery in patients with SSD. Understanding the impact of self-disturbance could strengthen the therapeutic alliance with patients and contribute to the development of treatment strategies supporting their recovery.

AIM

To investigate whether severity of self-reported self-disturbance phenomena is associated with the level of self-reported personal recovery in patients with SSD, their unaffected siblings and healthy controls.

METHODS

In a cross-sectional design with 522 patients with SSD, 608 unaffected siblings and 369 healthy controls, the frequency and distress of self-disturbance phenomena was measured with the Self-Experience Lifetime Frequency Scale (SELF). Personal recovery was assessed with the Recovery Assessment Scale (RAS-24). Spearman's rank correlation coefficients between both scales were examined. Subsequent multiple hierarchical regression analyses were conducted to assess additional explained variance in personal recovery by severity of self-disturbance phenomena, adjusting for positive, negative and general symptomatology.

RESULTS

Significant correlations were reported between higher SELF and lower RAS-24 scores for patients (ρ = -0.20, p < 0.001), siblings (ρ = -0.24, p < 0.001) and controls (ρ = -0.16, p < 0.005). The severity of self-disturbance phenomena significantly albeit modestly predicted total personal recovery score after adjusting for positive, negative and general symptoms for patients (R2 Change = 0.035, β = -0.19, p < 0.001).

CONCLUSION

Current findings suggest that self-reported self-disturbance phenomena are relevant for the personal recovery of patients with SSD. Healthcare practitioners are urged for attention to patients' first-person perspectives, including experiences of self-disturbance.

摘要

引言

自我干扰现象日益被视为精神分裂症谱系障碍(SSD)患者的基本且使人衰弱的特征。个人康复的概念描述了尽管存在与精神疾病相关的持续症状或挑战,但仍构建有意义且令人满意生活的过程。此前尚无研究调查SSD患者的自我干扰现象与个人康复之间的关联。了解自我干扰的影响有助于加强与患者的治疗联盟,并有助于制定支持其康复的治疗策略。

目的

调查自我报告的自我干扰现象的严重程度是否与SSD患者、其未受影响的兄弟姐妹及健康对照者自我报告的个人康复水平相关。

方法

采用横断面设计,纳入522例SSD患者、608例未受影响的兄弟姐妹和369例健康对照者,使用自我体验终生频率量表(SELF)测量自我干扰现象的频率和困扰程度。使用康复评估量表(RAS - 24)评估个人康复情况。检验两个量表之间的斯皮尔曼等级相关系数。随后进行多重分层回归分析,以评估自我干扰现象严重程度对个人康复额外的解释方差,同时对阳性、阴性和一般症状进行校正。

结果

患者(ρ = -0.20,p < 0.001)、兄弟姐妹(ρ = -0.24,p < 0.001)和对照者(ρ = -0.16,p < 0.005)的SELF得分越高与RAS - 24得分越低之间存在显著相关性。在对患者的阳性、阴性和一般症状进行校正后,自我干扰现象的严重程度虽适度但显著预测了个人康复总分(R2变化 = 0.035,β = -0.19,p < 0.001)。

结论

目前的研究结果表明,自我报告的自我干扰现象与SSD患者的个人康复相关。敦促医疗从业者关注患者的第一人称视角,包括自我干扰的经历。

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