【摘要】：目的調(diào)查抑郁障礙患者的心理彈性水平,采用資源取向的心理治療策略,研究焦點解決短期心理療法(SFBT)對抑郁障礙的心理彈性的影響,為抑郁障礙患者臨床路徑探索更為有效的臨床心理治療方法。方法1.前測調(diào)查研究:選用方便抽樣的方式,對80名抑郁障礙住院患者進(jìn)行問卷調(diào)查。使用一般調(diào)查問卷、漢密爾頓抑郁量表(HAMD)、心理彈性量表(CD-RISC)進(jìn)行調(diào)查。同時以患者家屬和醫(yī)護(hù)人員為正常對照共計70人對其進(jìn)行問卷調(diào)查,采用簡版一般調(diào)查問卷、心理彈性量表(CD-RISC)。2.心理治療研究:治療方法主要為焦點解決短期心理療法(SFBT),治療周期2-3周,共6-8次完成;研究對像為80名抑郁障礙患者,單次治療時間為80分鐘。治療結(jié)束時也即患者出院時進(jìn)行后測評估(短期評估)。3.隨訪研究:對結(jié)束心理治療滿一年的39名抑郁障礙患者進(jìn)行電話隨訪。評估患者一年后的服藥情況和心理狀況,包括生活適應(yīng)程度、社會功能恢復(fù)程度、是否出現(xiàn)過復(fù)發(fā)以及治療依從性等,并使用漢密爾頓抑郁量表(HAMD)、心理彈性量表(CDRISC)對其問卷評估。結(jié)果1.調(diào)查研究結(jié)果:(1)抑郁障礙患者心理彈性的得分明顯低于健康對照組,差異具有統(tǒng)計學(xué)意義(P0.001),其中抑郁障礙患者樂觀性、堅韌性、力量性的得分都顯著低于健康對照組,差異具備統(tǒng)計學(xué)意義(P0.001)。(2)不同既往史的抑郁障礙患者在心理彈性的樂觀性維度上的得分差異具有統(tǒng)計學(xué)意義(P0.05),人口社會學(xué)資料上其余維度均無明顯差異(P0.05)。(3)多元回歸分析顯示,心理彈性中的樂觀性對抑郁情緒影響顯著(β=-0.374,P0.05,R2=4.6%)。樂觀性可以解釋抑郁情緒程度的4.6%。2.心理治療研究結(jié)果:(1)HAMD前后測顯示,臨床路徑下心理治療后,抑郁障礙患者的抑郁情緒顯著下降(P0.01)。(2)CD-RISC前后測顯示,臨床路徑下心理治療后,抑郁障礙患者的心理彈性總分與各維度(樂觀性、堅韌性、力量性)得分都顯著提升(P0.01)。3.隨訪研究結(jié)果(1)39名接受隨訪的患者,一年內(nèi)復(fù)發(fā)的有4位,復(fù)發(fā)率為10.3%。(2)回收的34份抑郁障礙患者隨訪問卷中,一年后其抑郁情緒隨訪得分較之于后測顯著下降(P0.01)。心理彈性得分顯著提高,其中心理彈性的堅韌性(P0.01)、樂觀性(P0.05)的得分顯著提升。結(jié)論1.抑郁障礙患者的心理彈性顯著低于正常人。2.抑郁障礙患者的心理彈性中的樂觀性與抑郁情緒顯著負(fù)相關(guān),樂觀性能夠預(yù)測患者的抑郁程度,是抑郁障礙患者的重要保護(hù)因子。3.抑郁障礙臨床路徑下聯(lián)合SFBT能顯著提升抑郁障礙患者的心理彈性,降低抑郁水平。4.隨訪研究證實,抑郁障礙臨床路徑急性期聯(lián)合SFBT對抑郁障礙患者的心理彈性的遠(yuǎn)期療效顯著,且能降低復(fù)發(fā)率。
[Abstract]:Objective to investigate the level of psychological elasticity in patients with depressive disorder and to study the effect of short-term psychotherapy (SFBT) on the mental resilience of depressive disorder by using a resource-oriented psychotherapy strategy. To explore a more effective clinical psychotherapy for patients with depression. Method 1. Pretest investigation: 80 inpatients with depressive disorder were investigated by convenient sampling. The Hamilton Depression scale (HAMD),) and the Hamilton Depression scale (CD-RISC) were used. At the same time, a total of 70 patients with family members of patients and medical staff as normal control were investigated by using a brief version of the general questionnaire, CD-RISC. 2. Psychotherapy study: the main treatment method was focus solution short term psychotherapy (SFBT),) for 2-3 weeks, complete 6-8 times, and 80 patients with depressive disorder were studied for a single time of 80 minutes. At the end of the treatment, that is, the patient discharged from the hospital for a post-test assessment (short-term assessment). 3. Follow-up study: 39 patients with depressive disorder who had completed psychotherapy for one year were followed up by telephone. To assess the patient's medication and psychological status after one year, including life adaptation, social function recovery, recurrence and treatment compliance, etc. Hamilton Depression scale (HAMD),) was used to evaluate the questionnaire with (CDRISC). Result 1. The results were as follows: (1) the scores of psychological elasticity in patients with depressive disorder were significantly lower than those in the healthy control group (P0.001), and the scores of optimism, tenacity and strength of the patients with depressive disorder were significantly lower than those of the healthy control group. The difference was statistically significant (P0. 001). (2). The scores of depression patients with different history of depression had significant difference in the optimistic dimension of psychological elasticity (P0.05), but there was no significant difference in the other dimensions of demographic and sociological data (P0.05). (3). Optimism in resilience had a significant effect on depression (尾 -0.374N P0.05R24.6%). Optimism explains the degree of depression by 4. 6. 2. The results of psychotherapy were as follows: (1) after HAMD, the depressive mood of the patients with depressive disorder decreased significantly (P0.01). (2) before and after CD-RISC, and after the psychotherapy under the clinical pathway, the depression mood of the patients with depressive disorder decreased significantly (P0.01). (2). The total score of mental elasticity and the scores of each dimension (optimism, tenacity, strength) in patients with depression increased significantly (P0.01) .3. Results: (1) in 39 patients with depression, 4 patients recurred within one year, the recurrence rate was 10.33.2.In 34 patients with depression, the scores of depression were significantly lower after one year (P0.01). The scores of resilience (P0.01) and optimism (P0.05) increased significantly. Conclusion 1. The psychological elasticity of depressive disorder patients was significantly lower than that of normal persons. There is a significant negative correlation between optimism and depression mood in depression disorder patients. Optimism can predict the degree of depression, and it is an important protective factor of depression disorder. Combined with SFBT in the clinical pathway of depression disorder can significantly improve the psychological resilience of patients with depression disorder, reduce the level of depression. 4. Follow-up studies confirmed that the long-term effect of SFBT combined with clinical pathway on depression disorder patients was significant and could reduce the recurrence rate.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R749.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 吳歌;;短程焦點解決輔助團(tuán)體療法對青少年焦慮、抑郁情緒的改善作用[J];重慶醫(yī)學(xué);2016年06期

2 張英蘭;楊勝甫;;焦點解決短期心理咨詢對青光眼患者焦慮抑郁情緒及生存質(zhì)量的影響[J];臨床護(hù)理雜志;2015年06期

3 李國鵬;李杰;孔令華;胡曉婧;厲萍;;心理彈性在抑郁癥緩解期患者社會支持與心理困擾間的中介作用[J];護(hù)理學(xué)報;2015年23期

4 宮火良;許維素;;焦點解決短期療法應(yīng)用效果的分析[J];心理與行為研究;2015年06期

5 許維素;;蟄伏的蛻變:進(jìn)展停滯與復(fù)發(fā)的處理[J];心理技術(shù)與應(yīng)用;2015年10期

6 許維素;;滾雪球效應(yīng):改變的推進(jìn)[J];心理技術(shù)與應(yīng)用;2015年09期

7 許維素;陳宣融;;焦點解決短期治療在臺灣地區(qū)學(xué)校輔導(dǎo)中的應(yīng)用[J];心理研究;2015年04期

8 許維素;;畫龍點睛的晤談反饋[J];心理技術(shù)與應(yīng)用;2015年08期

9 蔣桂黎;;焦點解決短期心理咨詢技術(shù)的特色與局限性[J];科技展望;2015年14期

10 李榮娓;劉春霞;楚孔渠;;系統(tǒng)式家庭治療與抑郁癥復(fù)發(fā)的關(guān)聯(lián)研究[J];中外醫(yī)療;2015年15期

相關(guān)博士學(xué)位論文 前1條

1 薛云珍;認(rèn)知偏差與抑郁癥關(guān)系研究[D];天津師范大學(xué);2009年

，

本文編號：2160479