抑郁症患者应对方式与童年受虐经历的关系

摘要

目的：探讨抑郁症患者应对方式与童年受虐经历之间的关系。方法采用病例对照研究，对80例成年抑郁症患者及80例配比健康对照进行回顾性问卷调查。包括自设一般情况问卷了解其人口学资料、童年期创伤性经历问卷（CTQ‐SF）评估童年受虐情况和特质应对方式量表（TCSQ）评估应对方式，运用 t检验、非参数Mann‐Whitney U检验、Spearman相关分析和多元线性逐步回归分析抑郁症患者应对方式的特点及其与童年受虐经历的相关性。结果（1）抑郁症病例组的消极应对方式分值显著高于健康对照组（t＝9．13，P＜0．01），而其积极应对方式分值显著低于健康对照组（t＝－12．01，P＜0．01）；有受虐经历的抑郁症病例组消极应对分显著高于有受虐经历的健康对照组（ Z＝－6．134，P＜0．01 ），而其积极应对方式分显著低于健康对照组（Z＝－5．452，P＜0．01）；抑郁症组中有受虐经历的患者消极应对分显著高于无受虐经历患者（Z＝－2．159，P＜0．05），积极应对分值两者之间无明显差异。（2）抑郁症患者童年受虐经历与其消极应对方式呈显著正相关，与其积极应对方式呈显著负相关（r＝0．562，P＜0．01；r＝－0．333，P＜0．05）。（3）抑郁症患者消极应对水平能够被童年受虐待总分和躯体因子共同解释占34．4％（P＜0．01）。结论童年受虐经历明显影响抑郁症患者的应对方式，且虐待程度越重，尤其有躯体虐待，其消极应对越明显。%Objective To explore the relationship between coping styles and childhood abuse in adult patients with depression . Methods A case‐control study was conducted between 80 adult patients with depression and 80 health controls .In general ques‐tionnaire was designed to collect the demo‐graphic information ,Childhood Trauma Questionnaire‐28 Item Short Form (CTQ‐SF) was used to assess childhood trauma and Trait Coping Styles Questionnaire (TCSQ) was assigned to evaluate coping styles .T test , Mann‐Whitney U test ,Spearman Bivariate correlations and Multiple linear regression were employed to explore the characteristics of the major depressive patients′coping styles and the association between childhood abuse .Results (1) The patients with depres‐sion had both statistically significantly higher scores on negative coping style (t=9 .13 ,P<0 .01) and lower scores on positive cop‐ing style (t= -12 .01 ,P<0 .01)than the controls with childhood abuse .The patients with childhood abuse had both statistically significantly higher scores on negative coping style(Z= -6 .134 ,P<0 .01) and lower scores on positive coping style(Z= -5 .452 , P<0 .01) than the controls with childhood abuse .Inside the group of patients with depression ,the patients who had childhood a‐buse gained significantly higher scores in negative coping style than the others who had no early trauma (Z= -2 .159 ,P<0 .05) , however ,no conspicuous differences were found on the positive coping style scores .(2)The childhood abuse was both significantly positive correlated with the passive coping and negative related to the active coping (r=0 .562 ,P<0 .01;r= -0 .333 ,P<0 .05)a‐mong the patients of depression .(3)The total degree of abuse and physical abuse had significant prediction function of 34 .4% (P<0 .01)on the patients′ negative coping .Conclusion The coping styles of patients with depression were prone to be influenced by childhood abuse remarkably ,more severe abuse ,especially with the physical abuse ,more negative the coping styles were .