养老机构老年人抑郁与情绪调节策略的病例对照研究
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摘要
目的探讨银川市养老机构老年人抑郁的影响因素及其与情绪调节策略的关系。方法采用整群抽样的方法,选择银川市5所养老机构505名老年人为研究对象,老年人抑郁调查采用老年抑郁量表(GDS),按照1∶4匹配病例对照研究的方法,将筛选出的中度抑郁老年人(GDS≥21分)47例为病例组,病例组GDS平均得分为(23.5±2.2)分;按性别、年龄±4岁选择同期调查的无抑郁老年人(GDS≤10分)188例为对照组,对照组GDS平均得分为(5.1±2.3)分。采用Cross情绪调节问卷(ERQ)和反刍思维量表(RRS)调查老年人情绪调节策略。结果组间均衡性检验显示,病例组和对照组在年龄、性别、民族、文化程度、既往职业和婚姻状况差异无统计学意义(P均>0.05)。单因素Logistic回归分析显示,兴趣爱好(OR=0.332,95%CI:0.168~0.655)、体育锻炼(OR=0.418,95%CI:0.195~0.896)、家庭支持(OR=0.205,95%CI:0.066~0.648)、负性生活事件(OR=14.063,95%CI:5.797~34.118)、慢性病数量(OR=1.916,95%CI:1.450~2.531)、认知重评(OR=0.874,95%CI:0.831~0.919)和反刍思维(OR=1.250,95%CI:1.138~1.373)是银川市养老机构老年人抑郁的影响因素。多因素Logistic回归分析显示,银川市养老机构老年人抑郁与认知重评情绪调节策略(OR=0.857,95%CI:0.752~0.976)、反刍思维情绪调节策略(OR=1.223,95%CI:1.093~1.368)以及负性生活事件(OR=6.617,95%CI:1.386~36.601)有关。结论多使用认知重评策略是银川市养老机构老年人抑郁的保护因素,多使用反刍思维策略和过去一年经历过负性生活事件是其危险因素。
Objective To explore the influencing factors of depression in the elderly and their relationship with mood regulation strategies. Methods Using the cluster sampling method,the 505 elderly people from 5 Pension institution in Yinchuan were selected as the research object,The geriatric depression scale(GDS)was used as a measurement tool. According to the 1∶ 4 matched case-control study,47 cases with moderate-to-severe depression(GDS≥21 points)were selected as the case group,and the average score of GDS in the case group was(23.5±2.2)points. According to sex,age±4 years old to choose the same period of investigation of the elderly without depression(GDS≤10 points),188 cases as the control group. The emotional adjustment questionnaire(ERQ) and the rumination thought scale(RRS) were used to investigate the emotional regulation of the elderly. Results Inter-group balance tests showed there were no significant differences in age,sex,ethnicity,educational level,previous occupation and marital status between case group and control group(all P>0.05).Univariate conditional logistic regression analysis showed that,Interests(OR=0.332,95% CI: 0.168-0.655),Physical exercise(OR=0.418,95% CI:0.195-0.896),Family support(OR=0.205,95% CI:0.066-0.648),Negative life events(OR=14.063,95% CI: 5.797-34.118),The number of chronic diseases(OR=1.916,95% CI:1.450-2.531),cognitive reappraisal(OR=0.874,95% CI:0.831-0.919)and Rumination(OR=1.250,95% CI :1.138-1.373). Multivariate conditional logistic regression analysis showed that depression in elderly was associated with cognitive reappraisal(OR=0.857,95% CI:0.752-0.976),negative life events(OR=6.617,95% CI:1.386-36.601),rumination(OR=1.223,95% CI:1.093-1.368). Conclusion Cognitive reappraisal is a protective factor for depression in the elderly. Rumination and negative life events are the risk factors of depression in the elderly.
Objective To explore the influencing factors of depression in the elderly and their relationship with mood regulation strategies. Methods Using the cluster sampling method,the 505 elderly people from 5 Pension institution in Yinchuan were selected as the research object,The geriatric depression scale(GDS)was used as a measurement tool. According to the 1∶ 4 matched case-control study,47 cases with moderate-to-severe depression(GDS≥21 points)were selected as the case group,and the average score of GDS in the case group was(23.5±2.2)points. According to sex,age±4 years old to choose the same period of investigation of the elderly without depression(GDS≤10 points),188 cases as the control group. The emotional adjustment questionnaire(ERQ) and the rumination thought scale(RRS) were used to investigate the emotional regulation of the elderly. Results Inter-group balance tests showed there were no significant differences in age,sex,ethnicity,educational level,previous occupation and marital status between case group and control group(all P>0.05).Univariate conditional logistic regression analysis showed that,Interests(OR=0.332,95% CI: 0.168-0.655),Physical exercise(OR=0.418,95% CI:0.195-0.896),Family support(OR=0.205,95% CI:0.066-0.648),Negative life events(OR=14.063,95% CI: 5.797-34.118),The number of chronic diseases(OR=1.916,95% CI:1.450-2.531),cognitive reappraisal(OR=0.874,95% CI:0.831-0.919)and Rumination(OR=1.250,95% CI :1.138-1.373). Multivariate conditional logistic regression analysis showed that depression in elderly was associated with cognitive reappraisal(OR=0.857,95% CI:0.752-0.976),negative life events(OR=6.617,95% CI:1.386-36.601),rumination(OR=1.223,95% CI:1.093-1.368). Conclusion Cognitive reappraisal is a protective factor for depression in the elderly. Rumination and negative life events are the risk factors of depression in the elderly.
引文
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[13]吕永良,吴爱勤,李鸣,等.老年抑郁症的心理社会因素研究[J].中国心理卫生杂志,2004,18(4):254-256,261.
[14]张柏芳,曾爱琼.生活事件与老年抑郁症发病的相关研究[J].实用老年医学,2008,22(5):386-387.
[2]张玲,徐勇,聂宏伟.2000~2010年中国老年人抑郁患病率的Meta分析[J].中国老年学杂志,2011,31(17):3349-3352.
[3]王春梅.抑郁症患者负性情绪调节的认知重评策略:ERP研究[D].天津师范大学,2012.
[4]Gross JJ,John OP.Individual differences in two emotion regulation processes:implications for affect,relationships,and well-being[J].J Pers Soc Psychol,2003,85(2):348-362.
[5]Aker M,Harmer C,Landr覬NI.More rumination and less effective emotion regulation in previously depressed women with preserved executive functions[J].BMC Psychiatry,2014,14(1):334.
[6]Nolen-Hoeksema S,Morrow J.A prospective study of depression and posttraumatic stress symptoms after a natural disaster:the 1989 Loma Prieta Earthquake[J].J Pers Soc Psychol,1991,61(1):115-121.
[7]王敬欣,王春梅,谢芳,等.负性情绪调节中认知重评和分心策略的作用:ERPs研究[J].心理科学,2015,38(5):1039-1044.
[8]王振宏.国外教师效能研究述评[J].心理科学进展,2001,9(2):146-150.
[9]王妍.反刍思维:类型、理论解释与展望[J].社会心理科学,2015(10):45-47.
[10]宁志军,聂衍刚,吴少波.青少年自我差异对抑郁的影响:沉思反应的中介作用[J].中国健康心理学杂志,2015,23(5):735-739.
[11]戴必兵,彭义升,李娟.老年人抑郁症状与情绪调节策略的横断面研究[J].中国心理卫生杂志,2014,28(3):192-196.
[12]赵鑫,周仁来.情绪调节测量:工具、应用及问题[J].西北师大学报(社会科学版),2014,51(5):119-123.
[13]吕永良,吴爱勤,李鸣,等.老年抑郁症的心理社会因素研究[J].中国心理卫生杂志,2004,18(4):254-256,261.
[14]张柏芳,曾爱琼.生活事件与老年抑郁症发病的相关研究[J].实用老年医学,2008,22(5):386-387.