强迫障碍患者父母教养方式的分析
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摘要
目的
强迫障碍是一种常见的终生致残性疾病,严重影响患者认知功能和社会功能。本研究拟探寻强迫障碍患者父母教养方式的特点并与正常人对照研究,探索强迫障碍患者与正常人父母教养方式的差异,探讨强迫障碍与强迫障碍患者父母教养方式的相关性。为强迫障碍的诊断、治疗、预防提供借鉴。
对象与方法
患者组：选择符合ICD-10强迫障碍诊断标准的患者(n=28),发放父母教养方式评价量表(EMBU)给患者并指导其填写,根据该量表中各因子得分对强迫障碍患者的父母教养方式进行评估,分析其特点及对患者的影响。
正常对照组(n=26)：选择年龄及文化程度与患者组匹配,无精神疾病病史及家族史,亦无精神活性物质依赖史,排除有严重的躯体疾病或依从性差者。发放父母教养方式评价量表给对照者并指导其填写。并建立数据库。最后将患者组与正常对照者的EMBU各项因子分数各项测试结果进行对照研究,分析其中的差异并讨论其意义。采用SPSS13.0进行统计分析,主要统计方法为X2检验和t检验。
结果
强迫症患者在父母惩罚及拒绝因子上评分均较高,父亲的情感温暖因子评分较低,同正常对照组比较,母亲惩罚过度有显著性意义(P<0.05外)。患者父亲与母亲(均各28例)的教养方式存在差异,父亲的惩罚严厉得分高于母亲,差异有显著性(P<0.05)；而母亲的拒绝、否认得分高于父亲,差异有非常显著性差异(P<0.01)。
结论
1、强迫症患者父母的教养方式与正常对照组存在差异。
2、强迫症患者的父亲和母亲的教养方式存在差异。
Obsessive-compulsive disorder is a common life-long disabling diseases, Serious impact on cognitive function and social function。This study was to explore the characteristics of parental rearing styles in patients with normal-control study, Explore parental rearing styles in patients with obsessive-compulsive disorder and normal differences of parental education on the impact of patients with obsessive-compulsive disorder。For obsessive-compulsive disorder diagnosis, treatment, prevention to provide reference。
Methods
PAT:Choose in line with ICD-10 diagnostic criteria for obsessive-compulsive disorder patients(n=28), Parenting payment methods rating scale (EMBU) to patients and guide them to fill out, According to the scale of each factor score in patients with obsessive-compulsive disorder to assess parental rearing styles, Analysis of their characteristics and the impact on patients; Normal controls(n=26):Choose age and educational level matched with patients with no history of mental illness and family history, no history of psychoactive substance dependence, excluding a serious physical illness or poor compliance were. And distributed EMBU to the controls and guide them to fill out. And the establishment of a database.
Finally, the patients and normal controls EMBU factor scores of the various control study of the test results, analysis of the differences and discuss its significance. Using SPSS 13.0 statistical analysis, the main statistical methods for theX2 test and t test.
Results
Patients with obsessive-compulsive disorder in the parents, the factors of punishment and rejection rates were high, the father's emotional warmth factor score low, Compared with the normal control group, the mother excessive punishment are significant (P<0.05)。Patients with father and mother (both of 28 cases) differences in rearing methods, the father's punishment severe scores than the mother, the difference was significant (P<0.05); while the mother refused, denying higher scores than fathers, the difference There was a significant (P<0.01).
Conclusion
1. In patients with obsessive-compulsive disorder parental rearing styles in patients with normal control group, there are differences.
2. In patients with obsessive-compulsive disorder in patients with a way of bringing the father and mother, there are differences.
强迫障碍是一种常见的终生致残性疾病,严重影响患者认知功能和社会功能。本研究拟探寻强迫障碍患者父母教养方式的特点并与正常人对照研究,探索强迫障碍患者与正常人父母教养方式的差异,探讨强迫障碍与强迫障碍患者父母教养方式的相关性。为强迫障碍的诊断、治疗、预防提供借鉴。
对象与方法
患者组：选择符合ICD-10强迫障碍诊断标准的患者(n=28),发放父母教养方式评价量表(EMBU)给患者并指导其填写,根据该量表中各因子得分对强迫障碍患者的父母教养方式进行评估,分析其特点及对患者的影响。
正常对照组(n=26)：选择年龄及文化程度与患者组匹配,无精神疾病病史及家族史,亦无精神活性物质依赖史,排除有严重的躯体疾病或依从性差者。发放父母教养方式评价量表给对照者并指导其填写。并建立数据库。最后将患者组与正常对照者的EMBU各项因子分数各项测试结果进行对照研究,分析其中的差异并讨论其意义。采用SPSS13.0进行统计分析,主要统计方法为X2检验和t检验。
结果
强迫症患者在父母惩罚及拒绝因子上评分均较高,父亲的情感温暖因子评分较低,同正常对照组比较,母亲惩罚过度有显著性意义(P<0.05外)。患者父亲与母亲(均各28例)的教养方式存在差异,父亲的惩罚严厉得分高于母亲,差异有显著性(P<0.05)；而母亲的拒绝、否认得分高于父亲,差异有非常显著性差异(P<0.01)。
结论
1、强迫症患者父母的教养方式与正常对照组存在差异。
2、强迫症患者的父亲和母亲的教养方式存在差异。
Obsessive-compulsive disorder is a common life-long disabling diseases, Serious impact on cognitive function and social function。This study was to explore the characteristics of parental rearing styles in patients with normal-control study, Explore parental rearing styles in patients with obsessive-compulsive disorder and normal differences of parental education on the impact of patients with obsessive-compulsive disorder。For obsessive-compulsive disorder diagnosis, treatment, prevention to provide reference。
Methods
PAT:Choose in line with ICD-10 diagnostic criteria for obsessive-compulsive disorder patients(n=28), Parenting payment methods rating scale (EMBU) to patients and guide them to fill out, According to the scale of each factor score in patients with obsessive-compulsive disorder to assess parental rearing styles, Analysis of their characteristics and the impact on patients; Normal controls(n=26):Choose age and educational level matched with patients with no history of mental illness and family history, no history of psychoactive substance dependence, excluding a serious physical illness or poor compliance were. And distributed EMBU to the controls and guide them to fill out. And the establishment of a database.
Finally, the patients and normal controls EMBU factor scores of the various control study of the test results, analysis of the differences and discuss its significance. Using SPSS 13.0 statistical analysis, the main statistical methods for theX2 test and t test.
Results
Patients with obsessive-compulsive disorder in the parents, the factors of punishment and rejection rates were high, the father's emotional warmth factor score low, Compared with the normal control group, the mother excessive punishment are significant (P<0.05)。Patients with father and mother (both of 28 cases) differences in rearing methods, the father's punishment severe scores than the mother, the difference was significant (P<0.05); while the mother refused, denying higher scores than fathers, the difference There was a significant (P<0.01).
Conclusion
1. In patients with obsessive-compulsive disorder parental rearing styles in patients with normal control group, there are differences.
2. In patients with obsessive-compulsive disorder in patients with a way of bringing the father and mother, there are differences.
引文
1 沈渔邮.精神病学(第四版)[M].北京：人民卫牛出版社,2003,4：465.
2 Doron GKyriosM. Obsessive compulsive disorder:a review of possible
3 specificinternal representations within a broader cognitive theory. J Clin Psychol Rev 2005; 25(4):415_432.
4 Weissman MM, Bland RC, Canino GJ, et al. The cross-national epidemiology of obsessive-compulsive disorder. J Clin Psychiatry 1994; 55(Snppl 3):5-10.
5 Karno M, Golding JM, Sorenson SB, et ai. The epidemiology of obsessive-compulsive disorder in five US communities. J Arch Gen Psychiatry 1988; 45:1094-1099.
6邓冰,罗忆等.贵阳地区儿童青少年行为问题与家庭背景研究[J].中国心理卫生杂志,2000,14(4)： 217
7杨彦春,刘协和.强迫症的家系遗传研究.中华医学遗传学杂志,1998,15(5)：303.306
8吴志远.强迫症的功能影像学研究进展阴.国外医学临床放射学分册,2005 July,28(4)：214-217
9满常红,陈微.强迫症的研究进展.国外医学精神病学分册,2001,24(3)：144—148
10 Purcell K Maruff P, Kyrios M, et al. Neuropsychological deficits in obsessive-compulsivedis-order:a comparation with unipolar depression, panic disorderandnormal controls[J], ArchGenPsychiatry,1998,55:415-423
11 Lenane MC, Swedos E, Lenoard HL, et al. Psychiatric disorders in first degree relmives of children and adolescents with obsessive-compulsivedisorder. JAmAcad. ChildAdolescence Psychiatry.1990; 29(3):407.
12岳冬梅,李鸣嗥,金魁和等。父母教养方式：EMBU的初步修订及其在神经症患者的应用[J].中国心理卫生杂志,1993。7(2)：97-101.
13答会明.父母教养方式与孩子的自信、自尊、自我效能及心理健康水平的相关研究[J].中国健康教育,2002,18(8)：483—486.
14刘金同,张敬悬,翟静.父母教养方式对个性的影响[J]中国临床心理学杂志,1995,3(2)：96.97
15 Waters TL, Barrett PM. The role of the family in childhood obsessive-compulsive disorder [J]. Clin Child Fam Psycho Rev,2000Sep,3(3):173-184.
16易进.心理咨询及心理治疗中的家庭理论[J].心理学动态,1997,6(1)：37-42.
17高成阁,纪术茂,苏掌权等.强迫症患者的临床特征及人格类型研究J.中国临床心理学杂志,2001,9(1)：24.27
18 Fullana MA, Mataix-Cols D, Trujillo JL, et al. Personality characteristics in obsessive-compulsive disorder and individuals with subclinical. J Br J ClinPsychol,2004 Nov,43(Pt 4):387-98.
19 Wu KD, Clark LA, Wagon D. Relations between Obsessive—Compulsive Disorder and personality:Beyond Axis I-Axis Ⅱ comorbidity. J Anxiety Disord.2005Nov 30.
20 Joyee Akse, William W. Hale III, et al. Personality,perceived parental rejectionand problems behavior in adolescenceJ. Soe Psychiatry PsychiatrEpidemiol,2004,39:980—988.
21 Michael H. Ebert,d al. Current Diagnosis&Treatment in Psychiatry. M International Edition 2000.
22李焰,王极盛.焦虑理论研究的回归与展望叨.健康心理学杂志,1999,7(2)：127.128.
23 Salkovskis P, Shafran R,Rachman S, et al. Multiple pathways to inflated responsibility beliefs in obsessional proble ms:possible origins and implications for therapy and research. J Behavior Research and Therapy,1999,37,1055—1072.
24许东.父母教养方式与子女焦虑水平的相关因素分析明冲国心理卫生杂志,2002,16(9)：631-632.
25刘秀芬,黄悦勤,李立明,等.父母养育方式与人格障碍关系的研究.中国心理卫生杂志,2001,15：208.209.
1 沈渔邮.精神病学(第四版)[M].北京：人民卫生出版社,2003,4：46.
2十二地区精神疾病流行学调查协作组.十二地区神经症流行学调查.中华神经精神杂志,1992；6：167-170.
3 Rasmussen SA, Eisen JL. The epidemiology and clinical features of obsessive compulsive disorder [J]. Psychiatr Clin North Am,1992,15(4):743-758.
4 Jack W. Mahreatment and trauma:toward a comprehensive model of abused children from developmental psychology. Child and Adolescent Social Work Joumal,2005.22:3-4.
5 Geffken GR; Storch EA; Duke DC, et al. Hope and coping in family members of patients with obsessive-compulsive disorder. Journal of Anxiety Disorders,2006; 20 (50:614-629.
6 Billet EA, Richter MA, Kennedy JL. Genetics of obsessive compulsive disorder[M]//R. P. Swinson, M. M. Antony, S. Rachman,& M. A. Richter (Eds), Obsessive compulsive disorder: Ther res treat. New York:Guilford,1998:120-140.
7 Riddle MA, Scahill L, King R, et al. Obsessive compulsive disorder in children and adolescents:Phenomenology and family history[J]. J Am Acad Child Adole Psychiatry,1990,29 (5):766-772.
8 王宇中,冯丽云,王志铭,等.医学生神经症病因的多因素分析.中国心理卫生杂志,2001,15(3)：232.
9 Stengler-Wenzke K, Trosbach J, Dietrich S, et al. Angermeyer Coping strategies used by the relatives of people with obsessive compulsive disorder. Journal of Advanced Nursing,2004; 48(1):35-42.
10陈仲庚.变态心理学.北京：人民卫生出版社,1985.25
11 Hibbs E, Hamburger S, Lenane M, et al. Determinants of expressed emotion if families of disturbed and normal children. J Child Psychol Psychiatry,1991; 32:757-770.
12 VaillantGE.Theoretical hierarchy of adaptive egomechanisms:a 30-year follow-up of 30 men selected for psychological health.Arch Gen Psychiatry,1971,24(2):107-118.
13 Hoover CF, Insel TR. Families of origin in obsessivecompulsive disorder[J]. J Nerv Ment Dis, 1984,172(4):207-215.
14 Barrett PM, Healy LJ, March JS. Cognitive-behavioural family treatment for childhood obsessive-compulsive disorder:a controllestrial. J Am Acad Child Adolesc Psychiatry,2004; 43:46-62.
15 Valleni-Basile LA, Garrison CZ; Jackson KL, et al. Family and psychosocial predictors of obsessive compulsive disorder in a community sample of young adolescents. Journal of Child and Family Studies,1995; 4:193-206.
16 岳冬梅,李鸣杲,金魁和,等.父母教养方式：EMBU的初步修订及其在神经症患者的应用.中 国心理卫生杂志,1993,7(2)：97101.
17宫翠凤,李涛,薛秀梅.等.青少年心理疾病与家庭养育方式的关系.中国临床心理学杂志.2002,10(2)：152-153
18 曾昭祥,刘琳.强迫症患者的防御方式及其家庭因素研究.四川精神卫生杂志,2006,19：193.196.
19 Barrett P, Shortt A, Healy L. Do parent and child behaviours differentiate families whose children have obsessive-compulsive disorder from other clinic and non-clinic families? Journal of Chilil Psychology and Psychiatry,2002; 43 (5):597-607.
20 Salkovskis P, Shafran R, Rachman S, et al. Multiple pathways to inflated responsibility beliefs in obsessional problems:Possible origins and implications for therapy and research..JBehav Res Ther,1999,37:1055-1072.
2 Doron GKyriosM. Obsessive compulsive disorder:a review of possible
3 specificinternal representations within a broader cognitive theory. J Clin Psychol Rev 2005; 25(4):415_432.
4 Weissman MM, Bland RC, Canino GJ, et al. The cross-national epidemiology of obsessive-compulsive disorder. J Clin Psychiatry 1994; 55(Snppl 3):5-10.
5 Karno M, Golding JM, Sorenson SB, et ai. The epidemiology of obsessive-compulsive disorder in five US communities. J Arch Gen Psychiatry 1988; 45:1094-1099.
6邓冰,罗忆等.贵阳地区儿童青少年行为问题与家庭背景研究[J].中国心理卫生杂志,2000,14(4)： 217
7杨彦春,刘协和.强迫症的家系遗传研究.中华医学遗传学杂志,1998,15(5)：303.306
8吴志远.强迫症的功能影像学研究进展阴.国外医学临床放射学分册,2005 July,28(4)：214-217
9满常红,陈微.强迫症的研究进展.国外医学精神病学分册,2001,24(3)：144—148
10 Purcell K Maruff P, Kyrios M, et al. Neuropsychological deficits in obsessive-compulsivedis-order:a comparation with unipolar depression, panic disorderandnormal controls[J], ArchGenPsychiatry,1998,55:415-423
11 Lenane MC, Swedos E, Lenoard HL, et al. Psychiatric disorders in first degree relmives of children and adolescents with obsessive-compulsivedisorder. JAmAcad. ChildAdolescence Psychiatry.1990; 29(3):407.
12岳冬梅,李鸣嗥,金魁和等。父母教养方式：EMBU的初步修订及其在神经症患者的应用[J].中国心理卫生杂志,1993。7(2)：97-101.
13答会明.父母教养方式与孩子的自信、自尊、自我效能及心理健康水平的相关研究[J].中国健康教育,2002,18(8)：483—486.
14刘金同,张敬悬,翟静.父母教养方式对个性的影响[J]中国临床心理学杂志,1995,3(2)：96.97
15 Waters TL, Barrett PM. The role of the family in childhood obsessive-compulsive disorder [J]. Clin Child Fam Psycho Rev,2000Sep,3(3):173-184.
16易进.心理咨询及心理治疗中的家庭理论[J].心理学动态,1997,6(1)：37-42.
17高成阁,纪术茂,苏掌权等.强迫症患者的临床特征及人格类型研究J.中国临床心理学杂志,2001,9(1)：24.27
18 Fullana MA, Mataix-Cols D, Trujillo JL, et al. Personality characteristics in obsessive-compulsive disorder and individuals with subclinical. J Br J ClinPsychol,2004 Nov,43(Pt 4):387-98.
19 Wu KD, Clark LA, Wagon D. Relations between Obsessive—Compulsive Disorder and personality:Beyond Axis I-Axis Ⅱ comorbidity. J Anxiety Disord.2005Nov 30.
20 Joyee Akse, William W. Hale III, et al. Personality,perceived parental rejectionand problems behavior in adolescenceJ. Soe Psychiatry PsychiatrEpidemiol,2004,39:980—988.
21 Michael H. Ebert,d al. Current Diagnosis&Treatment in Psychiatry. M International Edition 2000.
22李焰,王极盛.焦虑理论研究的回归与展望叨.健康心理学杂志,1999,7(2)：127.128.
23 Salkovskis P, Shafran R,Rachman S, et al. Multiple pathways to inflated responsibility beliefs in obsessional proble ms:possible origins and implications for therapy and research. J Behavior Research and Therapy,1999,37,1055—1072.
24许东.父母教养方式与子女焦虑水平的相关因素分析明冲国心理卫生杂志,2002,16(9)：631-632.
25刘秀芬,黄悦勤,李立明,等.父母养育方式与人格障碍关系的研究.中国心理卫生杂志,2001,15：208.209.
1 沈渔邮.精神病学(第四版)[M].北京：人民卫生出版社,2003,4：46.
2十二地区精神疾病流行学调查协作组.十二地区神经症流行学调查.中华神经精神杂志,1992；6：167-170.
3 Rasmussen SA, Eisen JL. The epidemiology and clinical features of obsessive compulsive disorder [J]. Psychiatr Clin North Am,1992,15(4):743-758.
4 Jack W. Mahreatment and trauma:toward a comprehensive model of abused children from developmental psychology. Child and Adolescent Social Work Joumal,2005.22:3-4.
5 Geffken GR; Storch EA; Duke DC, et al. Hope and coping in family members of patients with obsessive-compulsive disorder. Journal of Anxiety Disorders,2006; 20 (50:614-629.
6 Billet EA, Richter MA, Kennedy JL. Genetics of obsessive compulsive disorder[M]//R. P. Swinson, M. M. Antony, S. Rachman,& M. A. Richter (Eds), Obsessive compulsive disorder: Ther res treat. New York:Guilford,1998:120-140.
7 Riddle MA, Scahill L, King R, et al. Obsessive compulsive disorder in children and adolescents:Phenomenology and family history[J]. J Am Acad Child Adole Psychiatry,1990,29 (5):766-772.
8 王宇中,冯丽云,王志铭,等.医学生神经症病因的多因素分析.中国心理卫生杂志,2001,15(3)：232.
9 Stengler-Wenzke K, Trosbach J, Dietrich S, et al. Angermeyer Coping strategies used by the relatives of people with obsessive compulsive disorder. Journal of Advanced Nursing,2004; 48(1):35-42.
10陈仲庚.变态心理学.北京：人民卫生出版社,1985.25
11 Hibbs E, Hamburger S, Lenane M, et al. Determinants of expressed emotion if families of disturbed and normal children. J Child Psychol Psychiatry,1991; 32:757-770.
12 VaillantGE.Theoretical hierarchy of adaptive egomechanisms:a 30-year follow-up of 30 men selected for psychological health.Arch Gen Psychiatry,1971,24(2):107-118.
13 Hoover CF, Insel TR. Families of origin in obsessivecompulsive disorder[J]. J Nerv Ment Dis, 1984,172(4):207-215.
14 Barrett PM, Healy LJ, March JS. Cognitive-behavioural family treatment for childhood obsessive-compulsive disorder:a controllestrial. J Am Acad Child Adolesc Psychiatry,2004; 43:46-62.
15 Valleni-Basile LA, Garrison CZ; Jackson KL, et al. Family and psychosocial predictors of obsessive compulsive disorder in a community sample of young adolescents. Journal of Child and Family Studies,1995; 4:193-206.
16 岳冬梅,李鸣杲,金魁和,等.父母教养方式：EMBU的初步修订及其在神经症患者的应用.中 国心理卫生杂志,1993,7(2)：97101.
17宫翠凤,李涛,薛秀梅.等.青少年心理疾病与家庭养育方式的关系.中国临床心理学杂志.2002,10(2)：152-153
18 曾昭祥,刘琳.强迫症患者的防御方式及其家庭因素研究.四川精神卫生杂志,2006,19：193.196.
19 Barrett P, Shortt A, Healy L. Do parent and child behaviours differentiate families whose children have obsessive-compulsive disorder from other clinic and non-clinic families? Journal of Chilil Psychology and Psychiatry,2002; 43 (5):597-607.
20 Salkovskis P, Shafran R, Rachman S, et al. Multiple pathways to inflated responsibility beliefs in obsessional problems:Possible origins and implications for therapy and research..JBehav Res Ther,1999,37:1055-1072.
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