【摘要】：目的：探索焦慮障礙患者的成人依戀類型、自我分化水平以及兩者的關(guān)系。為探索焦慮障礙的病理心理學(xué)機制以及心理治療模式提供研究依據(jù)。 方法：采取病例對照研究，對符合簡要國際神經(jīng)精神科訪談工具（MINI）中文版診斷的123名門診焦慮障礙患者和120名健康對給予問卷調(diào)查：①采用親密關(guān)系體驗問卷中文版修訂版（ECR-R）評定依戀的焦慮和回避兩個維度，然后再將其轉(zhuǎn)換成依戀類型；②采用自我分化量表修訂版的中文版(DSI-R)，評定區(qū)分理智和情感的能力以及在親密關(guān)系中即體驗親密又保持自我獨立性的能力；③采用狀態(tài)-特質(zhì)焦慮量表(STAI)評定焦慮情緒狀態(tài)和人格特質(zhì)性焦慮傾向。 結(jié)果：①焦慮障礙組患者的ECR-R焦慮維度、回避維度及STAI分值顯著高于正常對照組，，DSI-R總分、情緒反應(yīng)性、自我位置維度分值顯著低于正常對照組。②焦慮障礙組不安全依戀類型占多數(shù)（57%），其中迷戀型占18.4%，淡漠型占24.6%，恐懼型占14%。不安全依戀類型者罹患焦慮障礙的風(fēng)險是安全型的4.88倍，其中恐懼型風(fēng)險最大，是安全型的15.02倍，迷戀型者是4.38倍,淡漠型是3.76倍。③在病例組，迷戀型和恐懼型患者的DSI-R總分和情緒反應(yīng)性維度分值低于安全型和淡漠型,迷戀型患者的情感斷絕維度分值最低，恐懼型患者的特質(zhì)焦慮分值最高。④對照組安全型被試與病例組安全型被試相比，DSI-R總分和情緒反應(yīng)性維度分值高，STAI分值低。病例組安全型被試和病例組不安全型被試相比，DSI-R總分、情緒反應(yīng)性和情感斷絕維度分值高而STAI分值低。⑤患者組的ECR-R焦慮維度分值與DSI-R總分及各維度分值呈負相關(guān)⑥患者組的DSI-R總分和情感斷絕維度分值分別與ECR-R焦慮維度分值有線性回歸關(guān)系，后者能預(yù)測前者的41%、29%，DSI-R情緒反應(yīng)性維度分值與ECR-R焦慮維度和回避維度分值有線性回歸關(guān)系，后者可聯(lián)合預(yù)測前者的36%。 結(jié)論：焦慮障礙患者相對于健康對照組不安全依戀類型占多數(shù)，自我分化水平低，狀態(tài)和特質(zhì)焦慮水平高；迷戀型和恐懼型患者相對于安全型和淡漠型患者的自我分化水平低而焦慮水平高；病例組安全型被試的自我分化水平低于對照組安全型而高于病例組不安全型，其焦慮水平也在兩者之間；焦慮障礙患者的成人依戀焦慮維度與自我分化呈顯著負相關(guān)。
[Abstract]:Objective: to explore the types of adult attachment, self-differentiation and the relationship between them in patients with anxiety disorder. To explore the pathophysiological mechanism and psychotherapy model of anxiety disorder. Methods: a case-control study was conducted. 123 outpatients with anxiety disorder and 120 healthy subjects who were diagnosed with the Chinese version of the brief International Neuropsychiatric interview tool (mini) were investigated by using the Chinese version of the revised Chinese version of the intimate relationship experience questionnaire (ECR-R) to assess attachment. Two dimensions of worry and avoidance, Then it was transformed into attachment type. The Chinese version of the revised version of Self-differentiation scale (DSI-R) was used to evaluate the ability to distinguish between reason and emotion, as well as the ability to experience intimacy and maintain self-independence in intimate relationships. 3. State-trait anxiety scale (STAI) was used to assess anxiety state and personality trait anxiety tendency. Results the ECR-R anxiety dimension, avoidance dimension and STAI score in the anxiety disorder group were significantly higher than those in the normal control group. The score of self-position dimension was significantly lower than that of the normal control group (57%), including infatuation type (18.4%), indifferent type (24.6%) and fear type (14%). The risk of anxiety disorder was 4.88 times that of safety type, and the risk of fear type was 15.02 times that of safety type, that of infatuation type was 4.38 times, and that of indifferent type was 3.76 times. The total score of DSI-R and the score of emotional reactivity in infatuation and fear type patients were lower than those in safety type and apathy type, and the score of affective severance dimension in infatuation type was the lowest. The score of trait anxiety was highest in the fear type group. 4 the total score of DSI-R and the score of emotional reactivity dimension were higher and the score of STAI was lower in the safety type subjects in the control group than in the safety type subjects in the case group. The total score of DSI-R was compared between the safety type subjects of the case group and the unsafe type subjects of the case group. ECR-R anxiety dimension score was negatively correlated with DSI-R total score and each dimension score of patients with lower STAI score, DSI-R total score and affective severance dimension score were negatively correlated with ECR-R anxiety in patients with lower STAI score. The dimension scores have linear regression relation, The latter can predict that there is a linear regression relationship between the scores of DSI-R emotional reactivity dimension and ECR-R anxiety dimension and avoidance dimension of the former, and the latter can jointly predict the 36th dimension of the former. Conclusion: compared with the healthy control group, the patients with anxiety disorder have the majority of unsafe attachment types, low self-differentiation level and high level of state and trait anxiety. The self-differentiation level of infatuation type and fear type was lower than that of safety type and apathy type, and the self-differentiation level of safety type subjects in case group was lower than that of control group, but higher than that of unsafe type in case group. There was a significant negative correlation between the dimension of adult attachment anxiety and self-differentiation in patients with anxiety disorder.
【學(xué)位授予單位】：首都醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R749.72

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