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哮喘中的惊恐——恐惧。症状学作为信号焦虑的指标,人格作为自我资源的指标。

Panic-fear in asthma. Symptomatology as an index of signal anxiety and personality as an index of ego resources.

作者信息

Dirks J F, Kinsman R A, Staudenmayer H, Kleiger J H

出版信息

J Nerv Ment Dis. 1979 Oct;167(10):615-9.

PMID:490148
Abstract

Clinical observations and studies of asthmatic patients have often concluded that therre is a strong relationship between the degree of the patient's anxiety and the medical intractability of his illness. However, psychotherapeutic interventions designed to alleviate patient anxiety have been noticeably inconsistent in achieving meaningful alleviation of the patient's asthma. The present paper addresses this apparent paradox by positing the existence of two types of anxiety: a) asthma-specific anxiety, as indexed by Panic-Fear symptomatology scores of the Asthma Symptom Checklist; and b) characterological and pervasive anxiety, as indexed by Panic-Fear personality scores of the Minnesota Multiphasic Personality Inventory. In this study, long term medical outcome was found to be influenced by the combination of these types of anxiety. Wehn high asthma-specific anxiety coexisted with high characterological anxiety, medical outcome following intensive long term medical treatment was exceptionally poor. In contrast, when high asthma-specific anxiety coexisted with average levels of characterological anxiety, medical outcome was exceptionally good. These results are discussed relative to the theoretical distinctions between signal anxiety and anxiety concomitant with a lack of basic ego resources.

摘要

对哮喘患者的临床观察和研究常常得出结论,患者的焦虑程度与疾病的医学难治性之间存在密切关系。然而,旨在减轻患者焦虑的心理治疗干预措施在显著减轻患者哮喘方面一直明显不一致。本文通过假定存在两种类型的焦虑来解决这一明显的矛盾:a)哮喘特异性焦虑,以哮喘症状清单的惊恐-恐惧症状评分来衡量;b)性格性和广泛性焦虑,以明尼苏达多相人格调查表的惊恐-恐惧人格评分来衡量。在这项研究中,发现长期医疗结果受到这些类型焦虑组合的影响。当高哮喘特异性焦虑与高性格性焦虑共存时,强化长期医疗后的医疗结果异常糟糕。相比之下,当高哮喘特异性焦虑与平均水平的性格性焦虑共存时,医疗结果则异常良好。本文将结合信号焦虑和与缺乏基本自我资源相伴的焦虑之间的理论区别来讨论这些结果。

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