【摘要】：目的：了解大學(xué)生抑郁癥狀的流行特征及其與歸因風(fēng)格、應(yīng)對(duì)方式和功能失調(diào)性態(tài)度等認(rèn)知特征的關(guān)系；分析大學(xué)生認(rèn)知特征及其對(duì)抑郁癥狀發(fā)生的影響，探索導(dǎo)致抑郁癥狀發(fā)生的認(rèn)知易感性因素。 方法：以安徽省合肥市某醫(yī)科大學(xué)為研究現(xiàn)場(chǎng)，以該校臨床專業(yè)1-4年級(jí)1498名在校大學(xué)生為研究對(duì)象，采用流調(diào)用抑郁量表、歸因風(fēng)格問卷、應(yīng)對(duì)方式問卷、功能失調(diào)性態(tài)度問卷對(duì)大學(xué)生進(jìn)行橫斷面調(diào)查，了解大學(xué)生抑郁癥狀的流行狀況及其與歸因風(fēng)格、應(yīng)對(duì)方式和功能失調(diào)性態(tài)度的關(guān)系。 以無明顯抑郁癥狀的一年級(jí)臨床醫(yī)學(xué)專業(yè)大學(xué)生為研究對(duì)象建立研究隊(duì)列，采用流調(diào)用抑郁量表、歸因風(fēng)格問卷、應(yīng)對(duì)方式問卷、功能失調(diào)性態(tài)度問卷、生活事件量表和社會(huì)支持量表先后進(jìn)行2次隨訪調(diào)查，觀察認(rèn)知特征的變化及其對(duì)抑郁癥狀發(fā)生的影響；將隨訪對(duì)象認(rèn)知特征分為正常組和異常組，比較正常組與異常組及異常組中具備不同認(rèn)知特征的大學(xué)生抑郁癥狀的發(fā)生率，探討抑郁癥狀發(fā)生的認(rèn)知易感性因素。 結(jié)果：橫斷面調(diào)查結(jié)果顯示，大學(xué)生抑郁癥狀檢出率為28.2%，女生低于男生（χ~2=7.925，P0.01），農(nóng)村生源學(xué)生高于城市生源學(xué)生（χ~2=10.269，P0.01），大一年級(jí)至大四年級(jí)學(xué)生抑郁癥狀的檢出率分別為22.5%、31.3%、31.4%和26.1%（χ~2=10.306，，P0.05）；調(diào)查對(duì)象抑郁總分、不同性別及各年級(jí)學(xué)生的抑郁癥狀評(píng)分與其歸因風(fēng)格中的消極外歸因評(píng)分之間存在正相關(guān)（γ=0.202~0.275，P0.01）；調(diào)查對(duì)象抑郁總分、不同性別及大一、大二和大三年級(jí)的學(xué)生的抑郁癥狀評(píng)分與其歸因風(fēng)格中的積極外歸因評(píng)分之間呈現(xiàn)負(fù)相關(guān)（γ=-0.088~-0.179，P0.05）；調(diào)查對(duì)象抑郁總分、男生及大二年級(jí)學(xué)生的抑郁癥狀評(píng)分與其歸因風(fēng)格中的消極內(nèi)歸因評(píng)分之間呈現(xiàn)負(fù)相關(guān)（γ=-0.088~-0.129，P0.05）；大一學(xué)生的抑郁癥狀評(píng)分與歸因風(fēng)格中的積極內(nèi)歸因評(píng)分之間呈正相關(guān)（P0.01）；大學(xué)生抑郁癥狀評(píng)分與應(yīng)對(duì)方式中的問題解決和求助兩個(gè)維度評(píng)分之間呈現(xiàn)負(fù)相關(guān)（γ=-0.417~-0.230，P0.01），而與應(yīng)對(duì)方式中的自責(zé)、幻想、退避和合理化四個(gè)維度評(píng)分之間呈現(xiàn)正相關(guān)（γ=0.216~0.466，P0.01）；大學(xué)生抑郁癥狀總分、不同性別及各年級(jí)學(xué)生的抑郁癥狀評(píng)分與功能失調(diào)性態(tài)度評(píng)分之間呈現(xiàn)正相關(guān)（γ=0.460~0.526，P0.01）。 以上述大學(xué)一年級(jí)經(jīng)評(píng)定沒有抑郁學(xué)生為對(duì)象建立研究隊(duì)列，研究隊(duì)列半年和一年隨訪率分別為85.2%和93.3%。隊(duì)列隨訪調(diào)查結(jié)果顯示，功能失調(diào)性態(tài)度評(píng)分正常組學(xué)生在半年隨訪時(shí)有76.7%的學(xué)生維持正常狀態(tài)，23.3%的學(xué)生轉(zhuǎn)變?yōu)楫惓＃δ苁д{(diào)性態(tài)度評(píng)分異常組學(xué)生中有68.2%的學(xué)生保持不變，31.8%的學(xué)生轉(zhuǎn)為正常（P0.01）；功能失調(diào)性態(tài)度評(píng)分正常組學(xué)生在一年隨訪時(shí)，出現(xiàn)異常的比例為12.4%，保持正常的比例為87.6%，功能失調(diào)性態(tài)度評(píng)分異常組學(xué)生在一年隨訪時(shí)，轉(zhuǎn)為正常和仍為異常的學(xué)生比例分別為65.4%和34.6%（P0.01）。半年隨訪調(diào)查研究顯示，三項(xiàng)認(rèn)知特征均正常者和至少有一項(xiàng)異常的大學(xué)生半年隨訪的抑郁癥狀發(fā)生率分別為5.6%和15.8%，正常組顯著低于異常組（χ~2=6.383，P0.05）；一年隨訪的抑郁癥狀發(fā)生率分別為13.2%和29.3%，正常組顯著低于異常組（χ~2=10.192，P0.01）。半年隨訪調(diào)查結(jié)果發(fā)現(xiàn)，采取樂觀和悲觀歸因風(fēng)格的隨訪對(duì)象抑郁癥狀發(fā)生率分別為7.9%和15.8%（χ~2=3.909，P0.05）；采用積極和消極應(yīng)對(duì)方式的隨訪對(duì)象抑郁癥狀發(fā)生率分別為8.9%和21.6%（χ~2=6.502，P0.05）；功能失調(diào)性態(tài)度評(píng)分正常組學(xué)生抑郁癥狀發(fā)生率為9.5%，異常組抑郁癥狀發(fā)生率為20.5%（χ~2=4.298，P0.05）；一年的隨訪調(diào)查結(jié)果表明，采用消極應(yīng)對(duì)方式的隨訪對(duì)象抑郁癥狀的發(fā)生率顯著高于積極應(yīng)對(duì)方式者，抑郁癥狀發(fā)生率分別為42.3%和17.7%（χ~2=14.774，P0.01）；功能失調(diào)性態(tài)度評(píng)分異常組的隨訪對(duì)象抑郁癥狀發(fā)生率顯著高于正常組，抑郁癥狀發(fā)生率分別為48.1%和16.4%（χ~2=24.523，P0.01）。半年隨訪調(diào)查結(jié)果顯示，有三項(xiàng)認(rèn)知評(píng)定異常的隨訪對(duì)象抑郁癥狀發(fā)生率最高36.4%，有兩項(xiàng)認(rèn)知評(píng)定異常和一項(xiàng)認(rèn)知評(píng)定異常的學(xué)生抑郁癥狀發(fā)生率分別為17.1%和12.8%（χ~2=10.639，P0.01）；一年隨訪調(diào)查結(jié)果表明，有三項(xiàng)認(rèn)知評(píng)定異常者抑郁癥狀發(fā)生率最高（70.0%），有兩項(xiàng)認(rèn)知評(píng)定異常者次之（36.4%），有一項(xiàng)認(rèn)知評(píng)定異常者最低（22.3%）（χ~2=21.252，P0.01）。Cox回歸分析表明，采取消極應(yīng)對(duì)和功能失調(diào)性態(tài)度異常者均為抑郁癥狀發(fā)生的危險(xiǎn)因素（RR=1.79,95%CI：1.01~3.17和RR=2.39，95%CI：1.40~4.08）。 結(jié)論：有抑郁癥狀大學(xué)生比例較高，抑郁癥狀與歸因風(fēng)格、應(yīng)對(duì)方式和功能失調(diào)性態(tài)度間密切關(guān)聯(lián)；悲觀歸因、消極應(yīng)對(duì)方式和功能失調(diào)性態(tài)度異常是導(dǎo)致抑郁癥狀發(fā)生的高危因素，三者對(duì)抑郁癥狀的產(chǎn)生可能存在聯(lián)合作用，消極應(yīng)對(duì)方式和功能失調(diào)性態(tài)度異常對(duì)抑郁的發(fā)生具有預(yù)測(cè)作用。
[Abstract]:Objective: to understand the prevalence of depressive symptoms in college students and their relationship with cognitive characteristics such as attribution style, coping style and dysfunctional attitude, and to analyze the cognitive characteristics of college students and their influence on the occurrence of depressive symptoms, and to explore the cognitive susceptibility to depressive symptoms.
Methods: taking a Medical University in Hefei of Anhui as the research site and taking 1498 college students in grade 1-4 of the school as the research object, the flow call depression scale, attribution style questionnaire, coping style questionnaire and dysfunctional attitude questionnaire were used to investigate the prevalence of College Students' depressive symptoms. And its relationship with attribution style, coping style and dysfunctional attitudes.
The first grade clinical medical students who had no obvious symptoms of depression set up a study cohort for the study, using the flow call depression scale, attributable style questionnaire, coping style questionnaire, dysfunctional attitude questionnaire, life event scale and social support scale, and observed the changes of cognitive characteristics and their inhibition in 2 cases. The effect of the symptoms of depression; the cognitive characteristics of the follow-up subjects were divided into normal group and abnormal group, and the incidence of depressive symptoms in college students with different cognitive characteristics in normal group and abnormal group and abnormal group was compared, and the cognitive susceptibility factors of depressive symptoms were discussed.
Results: the cross-sectional survey showed that the prevalence rate of depressive symptoms in college students was 28.2%, girls were lower than boys (~2=7.925, P0.01), and rural students were higher than urban students (x ~2=10.269, P0.01). The detection rates of depressive symptoms from freshmen to fourth grade were 22.5%, 31.3%, 31.4% and 26.1% (x ~2=10.306, P0.05). There was a positive correlation between the scores of depressive symptoms and the negative attribution scores in the attribution style of the students of different sexes and grades (gamma =0.202~0.275, P0.01); the depression score of the subjects, the scores of depression and the positive attribution in the attribution style of the students of different sexes and freshmen, sophomores and sophomores There was a negative correlation between the scores (gamma =-0.088~-0.179, P0.05); the total score of depression in the subjects, the scores of depressive symptoms in boys and sophomores and the negative internal attribution scores in the attribution style were negatively correlated (gamma =-0.088~-0.129, P0.05); the depression score of the freshmen and the positive internal attribution score in the attribution style were between the scores of the students and the attribution style. There was a positive correlation (P0.01); there was a negative correlation between the scores of College Students' depression symptoms and the two dimensions of problem solving and help seeking in coping styles (gamma =-0.417~-0.230, P0.01), but there was a positive correlation between the scores of four dimensions of self reproach, fantasy, retreat and rationalization in coping styles (gamma =0.216~0.466, P0.01); and the total depression symptoms of college students were total. There was a positive correlation between the scores of depressive symptoms and dysfunctional attitudes among different sexes and grades (gamma =0.460~0.526, P0.01).
The study cohort was set up for the students who were not depressed in the first year of the University. The results of the half year and one year follow-up rate of the study cohort were 85.2% and 93.3%., respectively. The results showed that 76.7% of the students in the dysfunctional attitude score group were in the normal state and 23.3% of the students were abnormal. 68.2% of the students in the dysfunctional attitude score group remained unchanged, and 31.8% of the students turned to normal (P0.01). The abnormal proportion of the students in the dysfunctional attitude score group was 12.4% at one year's follow-up, and the normal proportion was 87.6%. The students in the dysfunctional attitude score group turned to the correct one year follow-up. The proportion of normal and still abnormal students was 65.4% and 34.6% (P0.01). A half year follow-up study showed that the incidence of depressive symptoms in three students with normal cognitive characteristics and at least one abnormality was 5.6% and 15.8% respectively. The normal group was significantly lower than the abnormal group (x ~2=6.383, P0.05), and the one year follow-up of depression like hair. The rate of birth was 13.2% and 29.3% respectively, and the normal group was significantly lower than that of the abnormal group (x ~2=10.192, P0.01). The results of the follow-up survey for half a year found that the incidence of depressive symptoms was 7.9% and 15.8% (x ~2=3.909, P0.05) in the follow-up subjects with optimistic and pessimistic attribution style, and the incidence of depressive symptoms was respectively in the follow-up subjects with positive and depolarization coping styles, respectively 8.9% and 21.6% (x ~2=6.502, P0.05); the incidence of depressive symptoms in students with dysfunctional attitude score was 9.5%, and the incidence of depressive symptoms in abnormal group was 20.5% (x ~2=4.298, P0.05). The results of one year follow-up survey showed that the incidence of depression symptoms in the follow-up subjects with negative coping style was significantly higher than those of the positive coping style. The incidence of depression was 42.3% and 17.7% (x ~2=14.774, P0.01), and the incidence of depressive symptoms in the patients with dysfunctional attitude score group was significantly higher than that in the normal group, and the incidence of depressive symptoms was 48.1% and 16.4% respectively (x ~2=24.523, P0.01). The highest incidence of symptoms was 36.4%. The incidence of depressive symptoms in two cognitive and cognitive abnormality was 17.1% and 12.8% respectively (x ~2=10.639, P0.01). One year follow-up survey showed that there were three cases of cognitive assessment with the highest incidence of depressive symptoms (70%), and two cognitive assessment abnormality (36.4%). The lowest (22.3%) (22.3%) (chi, P0.01).Cox regression analysis showed that negative coping and dysfunctional attitudes were all risk factors for depressive symptoms (RR=1.79,95%CI:1.01~3.17 and RR=2.39,95%CI:1.40~4.08).
Conclusion: the proportion of college students with depressive symptoms is higher, the depression symptoms and attribution style, the coping style and the dysfunctional attitude are closely related, pessimistic attribution, negative coping style and dysfunctional attitude are the high risk factors that lead to depressive symptoms, the three may have joint effect on depressive symptoms and negative coping. Abnormal attitude and dysfunctional attitude predict the occurrence of depression.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R749.4

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4 劉京徽;我國(guó)20%兒童出現(xiàn)抑郁癥狀 專家說父母影響是主要原因[N];中國(guó)婦女報(bào);2004年

5 張獻(xiàn)懷;抑郁影響每個(gè)人[N];中國(guó)醫(yī)藥報(bào);2007年

6 ;家有“抑郁癥” 你該怎么辦？[N];哈爾濱日?qǐng)?bào);2005年

7 梁月竹;兒童也會(huì)患抑郁癥[N];健康報(bào);2006年

8 王冠瑛;抑郁癥困擾多少“正常人”[N];衛(wèi)生與生活報(bào);2006年

9 北京友誼醫(yī)院主任醫(yī)師 王潤(rùn)華;消化道疾病常與抑郁癥為伍[N];光明日?qǐng)?bào);2008年

10 法律學(xué)者 羽戈;官員抑郁何來[N];中國(guó)經(jīng)營(yíng)報(bào);2010年

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2 胡華;抑郁癥動(dòng)物模型與腦血管因素相關(guān)研究[D];復(fù)旦大學(xué);2010年

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6 劉宇;2型糖尿病伴抑郁癥狀患者中西醫(yī)結(jié)合社區(qū)干預(yù)效果研究[D];中南大學(xué);2010年

7 馮正直;中學(xué)生抑郁癥狀的社會(huì)信息加工方式研究[D];西南師范大學(xué);2002年

8 吳輝;遼寧省醫(yī)護(hù)人員中職業(yè)緊張反應(yīng)、職業(yè)緊張?jiān)醇耙钟舭Y狀關(guān)系的研究[D];中國(guó)醫(yī)科大學(xué);2010年

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10 吳文峰;兒童抑郁癥狀應(yīng)激—認(rèn)知易感模型的追蹤研究[D];中南大學(xué);2011年

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5 郭敏;冠狀動(dòng)脈介入術(shù)后患者抑郁癥及其和預(yù)后的關(guān)系[D];延邊大學(xué);2010年

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9 吳節(jié)祥;當(dāng)事人訴訟歸因及其效果研究[D];華東政法學(xué)院;2003年

10 歐陽佩儀;小學(xué)兒童的自尊感與歸因模式的關(guān)系及相關(guān)影響因素的探討[D];華南師范大學(xué);2005年

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