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[应对方式能否改善情绪调适?一项针对支气管癌患者的纵向研究结果]

[Does coping improve emotional adjustment? Results of a longitudinal study with bronchial carcinoma patients].

作者信息

Faller H, Schilling S, Lang H

机构信息

Institut für Psychotherapie und Medizinische Psychologie, Universität Würzburg.

出版信息

Psychother Psychosom Med Psychol. 1994 Sep-Oct;44(9-10):355-64.

PMID:7972654
Abstract

Coping research has been able to identify some maladaptive coping behaviours, but only little is known about favorable modes of adaptation. These findings have raised the issue of circularity, i.e. the question as to whether depressive ways of coping are actually the cause or rather the effect of emotional distress, whether those correlations reflect different aspects of psychological distress, or, even worse, confounded measures. Cross-sectional correlations are unable to solve this problem. The present study applies cross-lagged multiple regression analysis within a panel design. N = 120 newly diagnosed lung cancer patients who were admitted to a large tumor centre are included in the sample. Patients are assessed by self-reports and interviewer-ratings on measures of psychological adjustment (distress, hope) and coping (active confrontation, arguing with one's fate, consolation, distancing) at three times: Time 1 pre-treatment, Time 2 post-treatment, Time 3 recurrence. Results pertaining to the course of the measures of adjustment and coping are presented. Systematic deteriorating effects can be reveiled only at time 3. Stability coefficients prove to be lower than expected, especially with respect to the longer time interval. The cross-lagged pane 1 design allows testing alternative causal models. The time 1- time 2 results show, that arguing with one's fate may lead to future emotional distress, whereas hope is connected with reduced future arguing with one's fate. These short term findings are confirmed in the prediction of the time 3-data. In addition, consolation seems to have a negative impact on hope in the long term.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

应对研究已能够识别出一些适应不良的应对行为,但对于有利的适应方式却知之甚少。这些发现引发了循环论证的问题,即抑郁的应对方式究竟是情绪困扰的原因还是结果,这些相关性是否反映了心理困扰的不同方面,或者更糟糕的是,是否存在混淆的测量方法。横断面相关性无法解决这个问题。本研究在面板设计中应用交叉滞后多元回归分析。样本包括120名新确诊的肺癌患者,他们被收治于一家大型肿瘤中心。通过自我报告和访谈者评分,在三个时间点对患者的心理调适(困扰、希望)和应对方式(积极对抗、与命运抗争、安慰、疏离)进行评估:时间1为治疗前,时间2为治疗后,时间3为复发时。呈现了调适和应对方式测量指标的变化过程结果。仅在时间3发现了系统性的恶化效应。稳定性系数低于预期,尤其是在较长时间间隔方面。交叉滞后面板设计允许检验替代因果模型。时间1至时间2的结果表明,与命运抗争可能导致未来的情绪困扰,而希望则与未来较少与命运抗争相关。这些短期结果在时间3数据的预测中得到了证实。此外,从长期来看,安慰似乎对希望有负面影响。(摘要截断于250字)

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