心境障碍患者童年虐待在情绪反应与自杀风险关系中的调节作用
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Moderating effect of childhood abuse on the relationship between emotion reactivity and suicide risk in patients with mood disorders
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    摘要:

    目的 探讨心境障碍患者童年虐待在情绪反应和自杀风险关系间的调节作用,为针对心 境障碍患者的自杀预防和干预提供科学的指导。方法 连续纳入首都医科大学附属北京安定医院和北 京回龙观医院住院的心境障碍患者323 例[平均年龄(30.01±11.85)岁],采用情绪反应性量表(ERS,包 括情绪敏感性、情绪强度和情绪持续性3 个分量表)、童年不良经历国际版问卷(ACE-IQ)中的虐待和忽 视维度、自杀行为问卷-修订版(SBQ-R)进行调查。对心境障碍患者情绪反应与自杀风险的相关性采 用Spearman 相关分析,再进一步采用多元线性回归分析,模型中变量筛选采用进入和后退的逐步回归 法。采用中介变量为类别变量的中介模型对童年虐待在情绪反应与自杀风险之间的中介效应进行检测, 并采用分层回归分析方法对童年虐待在情绪反应和自杀风险关系中的调节作用进行检验。结果 伴 与不伴童年虐待的心境障碍患者在情绪敏感性、情绪强度、情绪持续性得分和SBQ-R 得分上的差异均 具有统计学意义[分别为13(9,16)分比5(4,6)分、10(7,12)分比4(3,5)、5(2,8)分比3(1,4)、(11.33±3.91)分 比(4.18±1.43)分,均P < 0.01];SBQ-R得分与情绪敏感性、情绪强度和情绪持续性得分均呈正相关 (r=0.714~0.917,均P< 0.01);回归分析显示,情绪敏感性、情绪强度和情绪持续性与自杀风险密切相关 (β=0.107~0.650,均P < 0.01),童年虐待调节了情绪敏感性(β=0.097,P < 0.001)、情绪持续性(β=0.068, P< 0.05)与自杀风险之间的关系。结论 心境障碍患者情绪反应水平越高,自杀风险越大,童年虐待 在心境障碍患者情绪敏感性、情绪持续性与自杀风险关系中起调节作用。

    Abstract:

    Objective To explore the moderating effect of childhood abuse on the relationship between emotion reactivity and suicide risk in patients with mood disorders, and to provide scientific guidance for suicide prevention and intervention in patients with mood disorders. Methods A total of 323 patients with mood disorders[ mean age( 30.01±11.85) years] enrolled in Beijing Anding Hospital Capital Medical University and Beijing Huilongguan Hospital were investigated by the Emotion Reactivity Scale( ERS, including emotional sensitivity, emotional intensity, emotional persistence), the abuse & neglect subscale of the Adverse Childhood Experiences-International Questionnaire( ACE-IQ), and the Suicide Behaviors Questionnaire-Revised( SBQ-R). Spearman correlation analysis was used to analyze the correlation between emotion reactivity and suicide risk in patients with mood disorder, and then multiple linear regression analysis was used. Stepwise regression method was used to screen variables in the model. The mediating effect of childhood abuse on emotion reactivity and suicide risk was tested by using a mediating model with mediating variables as categorical variables. Hierarchical regression analysis was used to test the moderating role of childhood abuse in the relationship between emotion reactivity and suicide risk. Results The differences in scores of emotional sensitivity, emotional intensity, emotional persistence and scores of SBQ-R between patients with and without childhood abuse were statistically significant[ 13(9,16) vs. 5(4,6), 10(7,12) vs. 4(3,5), 5(2,8) vs. 3(1,4),( 11.33±3.91) vs.( 4.18±1.43), all P< 0.01)]; The score of SBQ-R was positively correlated with the scores of emotional sensitivity, emotional intensity and emotional persistence( r=0.714-0.917, all P<0.01). Regression analysis showed that emotional sensitivity, emotional intensity and emotional persistence were closely related to suicide risk( β=0.107-0.650, all P<0.01). Childhood abuse moderated the relationship between emotional sensitivity( β=0.097, P<0.001), emotional persistence( β=0.068,P < 0.05) and suicidal risk. Conclusions Patients who have higher level of emotion reactivity tend to have higher suicide risk. Childhood abuse may have moderating effect on the relationship between emotional sensitivity, emotional persistence, and suicidal risk.

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王路 刘君 屈燕花 邹海欧.心境障碍患者童年虐待在情绪反应与自杀风险关系中的调节作用[J].神经疾病与精神卫生,2020,20(9):
DOI :10.3969/j. issn.1009-6574.2020.09.004.

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  • 在线发布日期: 2020-12-21