童年期虐待、应对方式、自尊与青少年社交恐惧症的相关研究

摘要

Objective To investigate the correlation between childhood abuse, coping style, self esteem and adolescent social phobia, and to explore its relationship with onset age, course of disease and severity of adolescent social phobia. Methods A total of 110 adolescents with social phobia according with CCMD-3 diagnostic criteria and 142 healthy controls were assessed with Childhood Trauma Questionnaire-28 item Short Form (CTQ-SF) , Simplified Coping Style Questionnaire (SCSQ) and Self-Esteem Scale (SES). Moreover, the adolescents with social phobia were assessed with Social Avoidance and Distress Scale ( SAD) and their general clinical data were collected. Results Compared with healthy controls, adolescent social phobia group showed significantly higher total score and all dimensional scores of CTQ-SF ( P < 0. 05) , higher score of positive coping and negative coping of SCSQ ( P < 0. 05) , lower score of SES (P<0. 05). Correlation analysis indicated that score of SAD was significantly positively correlated with total score of CTQ-SF, dimensional scores of CTQ-SF and score of negative coping (P < 0. 01 ), while was significantly negatively correlated with score of positive coping and score of SES (P < 0. 01 ). Non-conditional Logistic regression analysis showed that the level of childhood abuse, emotional abuse (EA) , emotional neglect ( EN) , negative coping and self-esteem took effect on the onset of adolescent social phobia. The onset age was significantly negatively related with total score of CTQ-SF, EA score and EN score (P < 0. 01 ). The course of disease was significantly positively related with the severity of EA and EN (P < 0.05). Conclusion The adolescents with social phobia usually experience more childhood abuse. Risk factors of adolescent social phobia consist of childhood abuse, emotional abuse, emotional neglect, negative coping style and low self-esteem. While positive coping style is protection factor ofrnadolescent social phobia. And the more serious childhood abuse is, the smaller the onset age is. The more experience of EA and EN, the more severe the adolescent social phobia is and the longer the disease course is.%目的 探讨童年期虐待、应对方式、自尊与青少年社交恐惧症的相关性,并探讨其与青少年社交恐惧症的起病年龄、病程及严重程度的关系.方法 对符合CCMD-3诊断标准的110例青少年社交恐惧症患者(病例组)以及142例健康对照(对照组)进行童年期虐待问卷(Childhood Trauma Questionnaire-28 item Short Form,CTQ-SF)、简易应对方式量表(Simplified Coping Style Questionnaire,SCSQ)、自尊量表(Self-Esteem Scale,SES)评估,并对青少年社交恐惧症患者进行临床资料、社交回避及苦恼量表(Social Avoidance and Distress Scale,SAD)的评定.结果 相对于对照组,病例组CTQ-SF总分及其各维度分、积极应对和消极应对分更高(P＜0.05),SES 评分更低(P＜0.05).相关分析结果表明:青少年SAD分与CTQ-SF总分及其各维度分、消极应对分存在显著正相关(P＜0.01),与积极应对分、SES分呈显著负相关(P＜0.01).非条件Logistic回归分析发现,童年期虐待水平、情感虐待(EA)、情感忽视(EN)、消极应对、自尊为影响青少年社交恐惧症发病的因素,且CTQ-SF总分、EA分、EN分与青少年社交恐惧症患者的起病年龄成显著负相关(P＜0.01),EA、EN的严重程度与病程呈显著正相关(P＜0.05).结论 青少年社交恐惧症患者有更多的童年期虐待经历.童年期虐待水平、情感虐待、情感忽视、消极应对、自尊为影响青少年社交恐惧症发病的危险因素,积极应对是青少年社交恐惧症发病的保护因素,且童年期虐待经历越多,其起病年龄越早,经历的情感虐待、情感忽视越多,其病情越严重、病程越长.