中国临床心理学杂志

短程表达书写对实验室应激的干预研究

作者：柴明莉¹ 余慧慧¹ 刘媛¹ 吕倩² 潘芳¹

单位：1. 山东大学医学院济南 250012
2. 休斯敦大学心理系美国德克萨斯州休斯敦 77204

分类号：R395.5

出版年,卷(期):页码：2014,22(6):1128-1132

摘要：

目的:观察短程表达书写对实验室应激反应的干预效果。方法:64名4年级医学生随机分为干预组和对照组,采用医患冲突视频诱发心理应激,以状态焦虑量表、情绪评估表、唾液皮质醇水平和创伤后成长问卷作为应激反应的指标。干预组进行3次15分钟的书写干预,主题分别是披露感受与想法、情绪宣泄和资源审视,对照组进行相同时间的非卷入书写。结果:医患冲突视频诱发被试者明显的应激反应,两组被试者的状态焦虑得分、愤怒、焦虑、抑郁和恐惧评分显著高于基础水平(P<0.01)。两组被试者书写后,状态焦虑得分,愤怒、焦虑和恐惧评分显著降低(P<0.01),但抑郁评分无明显改变(P>0.05)。表达书写组的焦虑和愤怒情绪显著低于对照组(P<0.01;P<0.05)。书写表达对唾液皮质醇水平和创伤后成长无显著影响(P>0.05)。特质焦虑与应激后状态焦虑、焦虑、抑郁和恐惧呈显著正相关(P<0.001),与干预后状态焦虑和抑郁呈显著正相关(P<0.001)。性别(女性)与应激后状态焦虑、抑郁和恐惧呈显著正相关(P<0.001;P<0.005)。结论:短程表达书写对实验室应激性情绪反应具有明显干预效果。

Objective: To examine the effect of short term expression writing on stress response in laboratory condition. Methods: 64 4th grade clinical medical students were randomly divided into intervention group and control group. Stress responses were induced by videoes doctor-patient conflicts. After that, state anxiety, negative emotion(such as anger, anxiety, depression and fear), salivary cortisol and posttraumatic growth were assessed. 15 minutes expressive writings included feeling and ideas, express emotion and search for resources and support about stress event was used as the intervention method in writing group for 3 times. The subjects of control group took uninvolved writing. Results: The conflict video induced obvious stress response of subjects, the levels of state anxiety, anger, anxiety, depression and fear scores after video show were significantly higher than that at the baseline in both groups( P <0.01). Both expressive and uninvolved writing significantly decreased the levels of state anxiety, anger, anxiety and fear( P <0.01), but had no effects on depression scores( P > 0.05). Compared with control group, expressive writing group had lower levels of anxiety and anger( P <0.01; P <0.05). Expressive writing had no significant effect on salivary cortisol level and posttraumatic growth( P >0.05). Trait anxiety had positive correlation with state anxiety, anxiety, depression and fear( P <0.001) just after stress-induction, and had positive correlation with state anxiety and depression after intervention( P <0.001). Gender(female) had positive association with state anxiety, depression and fear after stress( P <0.001; P <0.005). Conclusion: Short term expressive writing significantly can decrease stress reactions effciently.

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