夫妻沟通方式与抑郁症状的关系:一项基于临床样本的追踪研究

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	夫妻沟通方式与抑郁症状的关系:一项基于临床样本的追踪研究
其他题名	The Relationship between Communication Patterns and Depression Symptoms: A follow-up Study based on Clinical Samples
	李强
导师	周明洁
	2017-11
摘要	本研究尝试探索夫妻沟通方式与抑郁症状之间的关系，对400名一般己婚被试，以及148例夫妻关系问题患者为横向日会较研究对象，对173例夫妻关系问题患者纵向追踪，采用9条目患者健康问卷(The Patient Health Questionnaire-99PHQ-9、沟通模式问卷一简短版(The Communication Patterns Questionnaire-ShortForm9 CPQ-SF)为测量工具。研究发现，(1)临床组与一般组在抑郁(t=-14.22, p < 0.001),男要求女回避沟通(t=-2.26, p < 0.05 )、女要求男回避沟通(t=-3 .22 , p < 0. 01l )、双方都要求/回避沟通(t=-3.39, p < 0.01)和批评/防御沟通(t=-6.708, p < 0.001)上具有统计学差异;女要求男回避沟通、交替进行要求/回避沟通、双方都要求/回避沟通和批评/防御沟通均正向预测抑郁症状(B=0.15 , p<0.001; B=0.19 , p<0.001;B=0.21, p<0.001 > B=0.20, p<0.001; 8=0.21, p<0.001)，积极沟通负向预测抑郁症状(B=-0.22, p<0.001) ; ( 2 )调节效应分析显示，样本类型在男要求女回求女回避沟通对抑郁的影响更严重。样本类型在在积极沟通与抑郁之间有调节作用(8=-0.19, p < 0.001)，但对于临床组来说，积极沟通方式对抑郁的缓解更明显;C3)交叉滞后检验显示，Tl抑郁会显著正向预测T2的男要求女回避沟通、批评/防御沟通、双方都要求/回避沟通(8=0.319 p<0.0I ; B=0.23 y p<0.05 ; B=0.22 ,p<0.05 ) ; T2抑郁会显著正向预测T3的女要求男回避沟通(B=0.27, p<0.05 ),对T3批评/防御沟通和T3双方都要求/回避沟通的正向预测呈边缘显著性C B=0.22, p=0.075 ; B=0.18 , p=0.098 );其他交叉滞后关系均不显著。基于以上的结果得到的结论如下:m夫妻的沟通方式与抑郁之间存在显著的关联，减少男要求女回避这种负面的沟通方式不会大幅度减轻抑郁个体的抑郁水平，但会大幅度改善一般个体的抑郁水平;积极沟通方式的增多不会大幅度减轻一般个体的抑郁水平，但会大幅度改善抑郁个体的抑郁水平。(2)在临床样本中，夫妻的沟通方式不能够预测其抑郁状况，但是，抑郁症状能够预测夫妻沟通方式。针对抑郁群体，尤其是对重度抑郁障碍患者来说，通过改善沟通方式带来的症状缓解并不明显，首先要改善的是患者的抑郁情绪，而当抑郁症状改善之后，其沟通方式也会随之改善。本研究的意义与价值正是在于，解释了一般群体与临床群体各变量之间的关系模式可能是不一样的。目前，大多数关于心理健康的研究都是基于一般样本得出来的，我们的研究结果显示，基于一般样本得出的结论推广到临床群体的时候，应该更加谨慎。有必要开展更多的临床样本的对照研究，以确认各因素对心理健康影响的模式和范畴。并且，在针对伴有抑郁症状的夫妻关系问题群体进行临床心理干预时，需要考虑这是一个特殊群体，对抑郁患者，尤其是重度抑郁障碍患者，采取先减轻抑郁症状，待症状基本缓解后，再进行沟通方式的改善的干预顺序更为合理。
其他摘要	This study aims to explore the relationship between husband and wife's communication patterns and depressive symptoms. 400 common subjects and 148 cases of married couples with affection problems were included in the cross-sectional study, and 173 cases of married couples with affection problems were included in the longitudinal study. Patient Health Questionnaire with 9 items (The Patient Health Questionnaire-9, PHQ-9), and Communication Patterns Questionnaire-Short Form, CPQ-SF were used as the measurement tool. The results show that (1) there were statistically significant differences between clinical group and common group in depression (t=-14.22, P<0.001), male demand/female withdraw (t=-2.26, P<0.05), female demand/male withdraw (t=-3.22, P<0.01), total demand/withdraw (t=-3.39, P<0.01) and critical/defend (t=-6.708, P<0.001). Female demand/male withdraw, alternative demand/withdraw, both demand/withdraw and critical/defend could positively predict depressive symptoms depression (B=-0.13, P<0.01). The impact of male demand/female withdraw on depression is severer for common group. Sample type also played a moderation role in the relationship between active communication and depression (B=-0.19, P<0.001). The mitigation effect of active communication on depression is more obviousin clinical group. (3) Tl results showed that pretest depression could significantly predict T2 male demand/female withdraw, criticize/defend, both demand/withdraw (B=0.31, p<0.01; B=0.23, p<0.05; B=0.22, p<0.05). The T2 depression could positively predict T3 female demand/male withdraw (B=0.27, p<0.05), and marginally positively significantly predicted T3 criticize/defend and both demand/withdraw. (B=0.22, p=0.075; B=0.18, p=0.098).(B=0.15, p<0.001;8=0.19, p<0.001;8=0.21，p<0.001;B p<0.001; -0.20, }=0.21。p<0.001), active communication negatively predicted depressive symptoms (B=-0.22,p<0.001). (2) Moderation effect analysis showed that the samples type played a moderation role in the relationship bet Based on the results aboard, we could draw the following conclusions:(1) The is a significant correlation between couples' communication patterns and depression.Neither less negative communication pattern like male demand/female withdraw nor more active communication pattern will not reduce the depression level of depressed individuals, but can significantly improve mental health of common individuals. (2) In clinical samples, couples'communication patterns could not predict their depression level, but on the contrast, depression symptoms could significantly predict the communication patterns between couples. For patients with depression, especially those with severe depressive disorder, the improvement of con}znun.ication patterns could not mitigate depressive symptoms. When the depressive symptoms were mitigated, the communication patterns would improvere . The significance and value of this study is that it explains the pattern of the relationship among variables may be different between connnon group and clinical group. At present, most studies on mental health are based on common samples. And our results indicate that the generalized conclusion based on conunon samples should be cautiously extended to clinical groups since it might not be the case. It is necessary to can -y out comparative studies on clinical and common samples to confirm the patterns and categories of the effects of various factors on mental health. Also, in the clinical psychological intervention for couples with depressive symptatns, we need to consider it as a special group of patients, especially on patients with severe depressive disorder. It is more rational to alleviate the symptoms of depression firstly, and then help improve the communication pattern after the symptoms are mitigated.
学科领域	健康心理学
关键词	夫妻沟通方式抑郁追踪研究
学位类型	硕士
语种	中文
学位名称	理学硕士
学位专业	健康心理学
学位授予单位	中国科学院大学;中国科学院心理研究所
学位授予地点	北京
统计方法	描述性统计;相关检验;差异检验;回归统计;结构方程模型;交叉滞后模型
测验名称	自编人口学变量问卷;9条目患者健康问卷 PHQ-9;沟通模式问卷-简短版
取样对象	人类
性别	男;女
年龄组	青年（18岁-29岁） ; 三十多岁（30岁-39岁） ; 中年（40岁-64岁） ; 老年（65岁以上）
病症	抑郁症
被试数量	实验一：548;实验二：173
国家或地区	中国
统计软件	SPSS 22.0;AMOS 21.0
测验题目数量	20
文献类型	学位论文
条目标识符	http://ir.psych.ac.cn/handle/311026/28449
专题	健康与遗传心理学研究室
作者单位	1.中国科学院大学; 2.中国科学院心理研究所
推荐引用方式 GB/T 7714	李强. 夫妻沟通方式与抑郁症状的关系:一项基于临床样本的追踪研究[D]. 北京. 中国科学院大学;中国科学院心理研究所,2017.

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