健康与遗传心理学研究室知识库

 
脑血管病已成为我国城乡人口死亡和致残的第一位原因，其中缺血性脑血管病占70%，且发病有上升趋势。研究者发现，脑卒中患者神经功能缺损程度越重，卒中后发生抑郁的可能性越大。该疾病情感障碍的出现对神经功能缺损的恢复或生活质量的改善极为不利，需进行积极心理治疗。心理灵活性概念正式形成的几十年来，心理灵活性研究还处于初步发展和假设验证阶段。心理灵活性是接纳与承诺疗法的核心，也是评估心理健康的重要指标。一般来讲，心理灵活性高的群体善于情绪调节和控制，能够有效地应对负性情绪，且一般具有全身心性的投入和接受当下的能力，建立一种积极、享受当下态度。西方已有研究发现心理灵活性是和它的成分（如接纳、认知融合）在改变心理病理症状如焦虑、抑郁中，发挥着中介或部分中介的作用。国内也有相关实证研究表明心理灵活性是焦虑抑郁负性情绪的影响因素，但是关于缺血性脑血管病患者这一群体的心理灵活性研究尚处于起步阶段。 本研究采用文献分析和问卷调查方法，选取宣武医院神经外科住院患者进行问卷调查，资料收集工作由病房护理工作人员一对一完成，通过描述性统计分析、假设检验、相关回归分析，先后探索了缺血性脑血管病患者中不同程度的焦虑、抑郁状态下心理灵活性情况，考察了两者之间存在的关系；验证了心理灵活性对焦虑、抑郁的影响。主要结论如下： 第一，证实缺血性脑血管病患者存在焦虑、抑郁等不良情绪，也反映出缺血性脑血管病患者存在心理功能的僵化或者不灵活性。 第二，缺血性脑血管患者中存在焦虑抑郁情绪的经验性回避、认知融合水平显著高于正常情绪的患者；且不同程度焦虑、抑郁的缺血性脑血管病患者间的经验性回避、认知融合水平差异有统计学意义。 第三，经验性回避、认知融合水平分别与焦虑、抑郁程度呈正相关，即经验性回避程度越高，陷入认知融合越深，其焦虑抑郁情绪越严重。 第四，分别以焦虑、抑郁为因变量，经验性回避、认知融合为自变量，通过多元线性回归分析，表明心理灵活性是焦虑抑郁的影响因子。 本研究对于缺血性脑血管病患者疾病管理的启示意义在于，心理灵活性作为接纳与承诺疗法的核心，在对患者心理健康产生作用的过程中，可以通过多种方法加以干预，通过提高患者的心理灵活性，从而有效的减少灾难化思维，重新建立积极的生活目标。

Cerebrovascular disease has become the first reason of death and disability in china , 70% of Cerebrovascular disease is the ischemic cerebrovascular disease , and the trends of incidence is increasing. The researchers found that the heavier the degree of nerve function defect, The greater the chance of post-stroke depression. Negative emotions for the recovery of neural function defect or the improvement of life quality, positive psychotherapy is therefore required. While the concept of psychological flexibility came into being more than decades ago, study in this field has still been creeping in the phase of initial development, hypothesis and verification. Psychological flexibility is not only the core of the Acceptance and Commitment Therapy, but is also an important indicator of psychological health. Generally speaking, the group of high psychological flexibility is good at adjusting and controlling their sentiments, and able to effectively response to negative sentiments. They are generally capable of devoting themselves to a goal and accepting the current reality. They can also establish the attitude to accepting the current reality. Results of study projects in the West have already found that it was the psychological flexibility and its ingredients (such as acceptance and cognitive fusion) that act as the intermediary or part of the intermediary in the process of changing the symptom of psychological diseases (such as anxiety and depression). Related empirical study projects conducted in mainland China have also found that psychological flexibility is the factor that influences sentiments of anxiety and depression. However, the study in the psychological flexibility of ischemic cerebrovascular patients has still in the starting-up stage. The present project adopted literature analysis and questionnaires and interviewed inpatients at the Neurosurgery Department of Xuanwu Hospital. Inpatient medicare staff collected and sorted out the data. The data went through descriptive statistical analysis, hypothetical inspection, and correlation regression analysis. This project explored the psychological flexibility under the anxiety and depression at different degrees among ischemic cerebrovascular patients, and explored the co-relationship between the two psychological statuses. This project also verified the influence of psychological flexibility on anxiety and depression. Here are the conclusions as below. I. Unhealthy sentiments -- such as anxiety and depression -- were found in ischemic cerebrovascular patients, which also showed the rigidness or inflexibility of these patients; II. Ischemic cerebrovascular patients showed experimental avoidance and cognitive fusion for anxiety and depression, much higher than those found in patients in normal mood. The difference of the level of this avoidance and fusion and the degree of anxiety and depression in these patients is significant in statistics. III. The level of experiential avoidance and cognitive fusion is in positive correlation with the degree of anxiety and depression, i.e. the higher the degree of experimental avoidance is, the deeper the cognitive fusion will be and the anxiety and depression will be more serious. IV. The anxiety and depression were dependent variables while the experiential avoidance and cognitive fusion were independent variable in the multiple linear regression analysis. This analysis showed that psychological flexibility is the Impact Factor for anxiety and depression. The inspiration of this project for ischemic cerebrovascular is that psychological flexibility -- as the core of the Acceptance and Commitment Therapy -- can be intervened in various ways in the course of influencing the psychological health of the patients. This intervene will improve the psychological flexibility of the patients so as to effectively reduce disastrous thinking and help them re-establish their living goals.