社会支持与精神分裂症残疾:自尊与心理韧性的链式中介作用
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摘要
目的:探究自尊与心理韧性在社会支持与精神分裂症残疾之间的中介作用。方法:采用世界卫生组织残疾评定量表、心理韧性量表、自尊量表及社会支持量表对503名精神分裂症患者进行测查。结果:(1)相关分析显示,社会支持与自尊、心理韧性均呈显著正相关,与精神分裂症残疾呈显著负相关;(2)结构方程模型分析表明,社会支持水平对精神分裂症残疾的直接效应显著,自尊及心理韧性在社会支持与精神分裂症残疾之间的中介作用均显著,且自尊-心理韧性的链式中介作用也显著。结论:社会支持既可直接预测精神分裂症残疾,又可分别通过自尊、心理韧性的中介作用,以及自尊-心理韧性的链式中介作用间接预测精神分裂症残疾。
Objective: To explore the mediating effects of self esteem and resilience on the relationship between social support and schizophrenia disability. Methods: WHO-DAS Ⅱ, Connor-Davidson Resilience Scale, Rosenberg Self-esteem Scale, Social Support Rating Scale were applied to 503 schizophrenia disabled patients. Results: Correlation analysis showed that social support was positively correlated with self-esteem and resilience, and negatively correlated with disability of schizophrenia disability. The structural equation model analysis showed that the direct effect of social support on schizophrenia disability was significant, and the mediating effects of self-esteem and resilience on social support and schizophrenia disability were significant, and the chain-mediated effect of self-esteem and psychological resilience was also significant. Conclusion: Social support not only influences schizophrenia disability through the direct path, but also through the indirect path of self-esteem and resilience, as well as the chain mediating path between those two variables.
Objective: To explore the mediating effects of self esteem and resilience on the relationship between social support and schizophrenia disability. Methods: WHO-DAS Ⅱ, Connor-Davidson Resilience Scale, Rosenberg Self-esteem Scale, Social Support Rating Scale were applied to 503 schizophrenia disabled patients. Results: Correlation analysis showed that social support was positively correlated with self-esteem and resilience, and negatively correlated with disability of schizophrenia disability. The structural equation model analysis showed that the direct effect of social support on schizophrenia disability was significant, and the mediating effects of self-esteem and resilience on social support and schizophrenia disability were significant, and the chain-mediated effect of self-esteem and psychological resilience was also significant. Conclusion: Social support not only influences schizophrenia disability through the direct path, but also through the indirect path of self-esteem and resilience, as well as the chain mediating path between those two variables.
引文
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2第二次全国残疾人抽样调查办公室.第二次全国残疾人抽样调查主要数据手册.华夏出版社,2007
3 Alptekin K,Erko?S,G?gü??A K,et al.Disability in schizophrenia:clinical correlates and prediction over 1-year follow-up.Psychiatry Research,2005,135(2):103-111
4付力牧,纪丽萍,沈渔邨.中国七个地区精神残疾、智力残疾流行病学调查.中华精神科杂志,1998,31(2):81-83
5刘冬梅,王志青,杨永和,等.宜宾地区居民精神分裂症流行病学调查.中国公共卫生,2013,29(12):1755-1757
6周志坚,张星,金冬,等.深圳社区精神分裂症患者症状、生存质量与残疾程度.中国健康心理学杂志,2018,26(3):325-327
7 Francis T Cullen.Social support as an organizing concept for criminology:Presidential address to the academy of criminal justice sciences.Justice Quarterly,1994,11(4):527-559
8 Shumaker SA,Brownell A.Toward a Theory of Social Support:Closing Conceptual Gaps.Journal of Social Issues,1984,40(4):11-36
9陈琼妮,刘莉,张丹,等.社会支持对精神分裂症患者生活质量和康复的影响.中国临床心理学杂志,2016,24(1):185-187
10 Thoits PA.Conceptual,methodological,and theoretical problems in studying social support as a buffer against life stress.J Health Soc Behav,1982,23(2):145-159
11 Baumeister RF,Campbell JD,Krueger JI,et al.Does high self-esteem cause better performance,interpersonal success,happiness,or healthier lifestyles?Psychological Science in the Public Interest,2003,4(1):1-44
12何厚建,胡茂荣,王敬,等.童年创伤经历对精神分裂症患者自尊水平的影响:社会支持的中介作用.现代预防医学,2017,44(11):92-95
13 Chen R,Liou TH,Chang KH,et al.Assessment of functioning and disability in patients with schizophrenia using the WHO Disability Assessment Schedule 2.0 in a large-scale database.European Archives of Psychiatry&Clinical Neuroscience,2017,2:1-11
14 Herrman H,Stewart DE,Diazgranados N,et al.What is resilience?Canadian Journal of Psychiatry,2011,56(5):258-265
15 Gooding PA,Littlewood D,Owen R,et al.Psychological resilience in people experiencing schizophrenia and suicidal thoughts and behaviours.Journal of Mental Health,2017.1-7
16史靖宇,赵旭东.精神分裂症患者心理弹性研究.医学与哲学,2016,37(10):78-81
17 Hofer A,Mizuno Y,Frajo-Apor B,et al.Resilience,internalized stigma,self-esteem,and hopelessness among people with schizophrenia:Cultural comparison in Austria and Japan.Schizophrenia Research,2016,171(1-3):86-91
18 Dumont M,Provost MA.Resilience in Adolescents:Protective Role of Social Support,Coping Strategies,Self-Esteem,and Social Activities on Experience of Stress and Depression.Journal of Youth&Adolescence,1999,28(3):343-363
19üstün TB,Kostanjsek N,Chatterji S,et al.Measuring health and disability:manual for WHO Disability Assessment Schedule(WHODAS 2.0).Geneva:World Health Organization,2010
20王莲娥,周洁,金欢.世界卫生组织残疾评定量表第2版中文版在精神残疾评定中的信效度检验.中国心理卫生杂志,2013,27(2):121-125
21 Kathryn MCMD,Jonathan RTDMD.Development of a new resilience scale:The Connor-Davidson Resilience Scale(CD-RISC).Depression&Anxiety,2003,18(2):76-82
22 Yu X,Zhang J.Factor analysis and psychometric evaluation of the Connor-Davidson Resilience Scale(CD-RISC)with Chinese people.Social Behavior&Personality An International Journal,2007,35(1):19-30
23汪向东.心理卫生评定量表手册.增刊.中国心理卫生杂志,1993.250-252
24肖水源,杨德森.社会支持对身心健康的影响.中国心理卫生杂志,1987,4:183-187
25熊红星,张璟,叶宝娟,等.共同方法变异的影响及其统计控制途径的模型分析.心理科学进展,2012,20(5):757-769
26 Vrbova K,Prasko J,Holubova M,et al.Positive and negative symptoms in schizophrenia and their relation to depression,anxiety,hope,self-stigma and personality traits-a crosssectional study.Neuro Endocrinol Lett,2018,39(1):9-18
27 Granholm E,Ben-Zeev D,Link PC.Social disinterest attitudes and group cognitive-behavioral social skills training for functional disability in schizophrenia.Schizophrenia Bulletin,2009,35(5):874-883
28 Lundberg B,Hansson L,Wentz E,et al.Sociodemographic and clinical factors related to devaluation/discrimination and rejection experiences among users of mental health services.Social Psychiatry&Psychiatric Epidemiology,2007,42(4):295
29 Pietrzak RH,Johnson DC,Goldstein MB,et al.Psychological resilience and postdeployment social support protect against traumatic stress and depressive symptoms in soldiers returning from Operations Enduring Freedom and Iraqi Freedom.Depression&Anxiety,2009,26(8):745-751
2第二次全国残疾人抽样调查办公室.第二次全国残疾人抽样调查主要数据手册.华夏出版社,2007
3 Alptekin K,Erko?S,G?gü??A K,et al.Disability in schizophrenia:clinical correlates and prediction over 1-year follow-up.Psychiatry Research,2005,135(2):103-111
4付力牧,纪丽萍,沈渔邨.中国七个地区精神残疾、智力残疾流行病学调查.中华精神科杂志,1998,31(2):81-83
5刘冬梅,王志青,杨永和,等.宜宾地区居民精神分裂症流行病学调查.中国公共卫生,2013,29(12):1755-1757
6周志坚,张星,金冬,等.深圳社区精神分裂症患者症状、生存质量与残疾程度.中国健康心理学杂志,2018,26(3):325-327
7 Francis T Cullen.Social support as an organizing concept for criminology:Presidential address to the academy of criminal justice sciences.Justice Quarterly,1994,11(4):527-559
8 Shumaker SA,Brownell A.Toward a Theory of Social Support:Closing Conceptual Gaps.Journal of Social Issues,1984,40(4):11-36
9陈琼妮,刘莉,张丹,等.社会支持对精神分裂症患者生活质量和康复的影响.中国临床心理学杂志,2016,24(1):185-187
10 Thoits PA.Conceptual,methodological,and theoretical problems in studying social support as a buffer against life stress.J Health Soc Behav,1982,23(2):145-159
11 Baumeister RF,Campbell JD,Krueger JI,et al.Does high self-esteem cause better performance,interpersonal success,happiness,or healthier lifestyles?Psychological Science in the Public Interest,2003,4(1):1-44
12何厚建,胡茂荣,王敬,等.童年创伤经历对精神分裂症患者自尊水平的影响:社会支持的中介作用.现代预防医学,2017,44(11):92-95
13 Chen R,Liou TH,Chang KH,et al.Assessment of functioning and disability in patients with schizophrenia using the WHO Disability Assessment Schedule 2.0 in a large-scale database.European Archives of Psychiatry&Clinical Neuroscience,2017,2:1-11
14 Herrman H,Stewart DE,Diazgranados N,et al.What is resilience?Canadian Journal of Psychiatry,2011,56(5):258-265
15 Gooding PA,Littlewood D,Owen R,et al.Psychological resilience in people experiencing schizophrenia and suicidal thoughts and behaviours.Journal of Mental Health,2017.1-7
16史靖宇,赵旭东.精神分裂症患者心理弹性研究.医学与哲学,2016,37(10):78-81
17 Hofer A,Mizuno Y,Frajo-Apor B,et al.Resilience,internalized stigma,self-esteem,and hopelessness among people with schizophrenia:Cultural comparison in Austria and Japan.Schizophrenia Research,2016,171(1-3):86-91
18 Dumont M,Provost MA.Resilience in Adolescents:Protective Role of Social Support,Coping Strategies,Self-Esteem,and Social Activities on Experience of Stress and Depression.Journal of Youth&Adolescence,1999,28(3):343-363
19üstün TB,Kostanjsek N,Chatterji S,et al.Measuring health and disability:manual for WHO Disability Assessment Schedule(WHODAS 2.0).Geneva:World Health Organization,2010
20王莲娥,周洁,金欢.世界卫生组织残疾评定量表第2版中文版在精神残疾评定中的信效度检验.中国心理卫生杂志,2013,27(2):121-125
21 Kathryn MCMD,Jonathan RTDMD.Development of a new resilience scale:The Connor-Davidson Resilience Scale(CD-RISC).Depression&Anxiety,2003,18(2):76-82
22 Yu X,Zhang J.Factor analysis and psychometric evaluation of the Connor-Davidson Resilience Scale(CD-RISC)with Chinese people.Social Behavior&Personality An International Journal,2007,35(1):19-30
23汪向东.心理卫生评定量表手册.增刊.中国心理卫生杂志,1993.250-252
24肖水源,杨德森.社会支持对身心健康的影响.中国心理卫生杂志,1987,4:183-187
25熊红星,张璟,叶宝娟,等.共同方法变异的影响及其统计控制途径的模型分析.心理科学进展,2012,20(5):757-769
26 Vrbova K,Prasko J,Holubova M,et al.Positive and negative symptoms in schizophrenia and their relation to depression,anxiety,hope,self-stigma and personality traits-a crosssectional study.Neuro Endocrinol Lett,2018,39(1):9-18
27 Granholm E,Ben-Zeev D,Link PC.Social disinterest attitudes and group cognitive-behavioral social skills training for functional disability in schizophrenia.Schizophrenia Bulletin,2009,35(5):874-883
28 Lundberg B,Hansson L,Wentz E,et al.Sociodemographic and clinical factors related to devaluation/discrimination and rejection experiences among users of mental health services.Social Psychiatry&Psychiatric Epidemiology,2007,42(4):295
29 Pietrzak RH,Johnson DC,Goldstein MB,et al.Psychological resilience and postdeployment social support protect against traumatic stress and depressive symptoms in soldiers returning from Operations Enduring Freedom and Iraqi Freedom.Depression&Anxiety,2009,26(8):745-751