冠心病患者中D型人格与抑郁、焦虑心理结构的区辨效度

摘要

Objective: To investigate the rational use of 14-item Type D Scale (DS-14) in the study of cardiovascular disease and to prove Ihat type D personality is different from the unique psychological structure of depression and anxiety. Methods: Totally 78 angina and 69 myocardial infarction hospitalized patients were included. They were assessed with the DS-14, Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS). Principal component analysis and confirmatory factor analysis were used to explore the validity of DS-14 and its discriminant validity with depression and anxiety district Results: In this sample, 77 patients were type D personality while 70 patients were non-Type D Personality; the correlations of DS-NA and SDS and SAS were 0.40 and 0.46 (P < 0.01), while the correlation of DS-SI and SDS was 0.21 (P < 0.01). The patients with type D personality were more likely to feel the affection of depression and anxiety than the patients with non-type D personality (62.8% vs. 37.2%, 66. 1 % vs. 33.9%; Ps<0.01). Principal component analysis revealed 7 common factors; the Negative Affectivity factor contained all of the DS-NA projects and two SAS projects, the Social Inhibition only contained the full of DS-SI projects, and the two structures of DS-14 were clearly distinguished. Confirmatory factor analysis results showed that the discriminant validity of DS-14 with SDS and DS-14 with SAS also fit the model indices, respectively, and the results of exploratory factor analysis confirmed the results of principal component analysis. Conclusion: This study suggests that the application of the Type D personality scale in the study of Chinese patients with coronary artery disease is reasonable, and type D personality may be not the repeat of depression, but a different and special construct to depression.%目的:探讨中国心血管疾病研究中14个条目的D型人格量表(DS-14)使用的合理性,并证明D型人格是区别于抑郁和焦虑的独特心理结构.方法:选取某医院心内科78位心绞痛和69位心肌梗死住院患者,采用DS-14(包含消极情感NA和社交抑制SI两个分量表)测查患者的D型人格结构,采用抑郁自评量表(SDS)和焦虑自评量表(SAS)测查患者的抑郁、焦虑情绪状况.并对3个量表的共54个项目进行主成分分析和验证性因素分析,来探讨DS-14的结构合理性及与抑郁焦虑情绪的区辨效度.结果:D型人格患者77人,非D型人格患者70人.DS-NA得分与SDS、SAS得分正相关(r=0.40、0.46,P＜0.01)；DS-SI得分与SDS得分正相关(r=0.21,P＜0.01).D型人格患者的抑郁情绪和焦虑情绪的发生多于非D型人格患者(62.8％ vs.37.2％,66.1％ vs.33.9％；均P＜0.01).主成分分析结果显示出7个公共因子,消极情感因子包含DS-NA的7个项目和SAS的2个项目,社交抑制因子仅包含7个DS-SI项目；验证性因素分析显示DS-14与SDS的模型拟合指数为x2/df=1.29,CH =0.91,IFI =0.91,GH=0.83,RMSEA=0.04;DS-14与SAS的模型拟合指数为,x2=1.28,CFI=0.90,IFI =0.90,GFI =0.82,RMSEA =0.04.结论:本研究表明,在中国冠心病患者的研究中使用D型人格量表是合理的,中国冠心病患者的D型人格不是抑郁情绪的重复,而是不同于抑郁的特殊结构.