Hultman C M, Wieselgren I M, Ohman A
Department of Clinical Psychology, University of Uppsala, Sweden.
Scand J Psychol. 1997 Mar;38(1):3-13. doi: 10.1111/1467-9450.00002.
The vulnerability-stress model for schizophrenia posits that relapses are at least partly determined by interacting triggering and protecting psychosocial factors. This study examined social support and general coping style in 42 consecutively admitted DSM:III schizophrenic patients, who were followed prospectively for up to four years. In a second part of the study, a subgroup of the patients were interviewed using the Life Event and Difficulty Schedule 9 months after discharge or at relapse. Patients contented with low social integration had a higher relapse rate over four years than patients lacking of social provisions, but wanting more. We found an excess of life events three weeks before relapse compared to events reported in the non-relapsing group. Suggesting a buffering effect of social factors, time between life event and relapse was significantly extended among patients with a high availability of attachment and a coping strategy characterised of active support seeking.
精神分裂症的易感性-应激模型假定，复发至少部分地由相互作用的触发和保护性社会心理因素所决定。本研究对42例连续入院的DSM-III精神分裂症患者的社会支持和一般应对方式进行了调查，并对他们进行了长达四年的前瞻性随访。在研究的第二部分，对一部分患者在出院9个月后或复发时使用生活事件和困难量表进行访谈。社会融入度低但感到满意的患者在四年内的复发率高于缺乏社会支持但希望获得更多支持的患者。我们发现，与未复发组报告的事件相比，复发前三周的生活事件过多。这表明社会因素具有缓冲作用，在具有高依恋性和以积极寻求支持为特征的应对策略的患者中，生活事件与复发之间的时间显著延长。
