中国临床心理学杂志

小学生躯体化症状及其与述情障碍、心理虐待和忽视的关系

作者：罗爱民¹ 邓云龙¹ 唐秋萍¹ 魏吉槐²

单位：1 中南大学湘雅三医院心身健康研究所长沙 410013
2 湖南益阳医学高等专科学校益阳 413000

分类号：R395.2

出版年,卷(期):页码：2013,21(2):236-239

摘要：

目的:了解小学生躯体化症状及其与述情障碍、心理虐待和忽视的关系。方法:采用儿童躯体化症状量表、多伦多述情障碍量表以及儿童心理虐待和忽视量表对长沙两所小学三至六年级的学生进行调查,收回有效问卷940份。结果:①儿童躯体化症状量表的平均得分为7.40±7.07,27.3%的儿童至少有一个经常出现或程度明显的症状,不同性别和不同年级儿童的躯体化症状检出率有显著差异;②述情障碍总分与躯体化总分的相关系数为0.32(P<0.01);③述情障碍对儿童躯体化症状的直接效应为0.39,心理虐待和忽视对儿童躯体化症状的间接效应分别为0.09和0.13。结论:①儿童躯体化症状的检出率为27.3%,其中疼痛/虚弱症状表现最为常见;②述情障碍与儿童躯体化症状之间存在低至中度相关;③述情障碍在心理虐待和忽视与儿童躯体化症状之间起完全中介作用。

Objective: To investigate the prevalence of children' s somatization symptoms and the relationship with alexithymia、psychological meltreatment and neglect, and to build relation model of this four. Methods: 940 primary school students were assessed with a series of questionnaires including Children' s Somatization symptoms Inventory Scale(CSI)、 the 20-item Toronto Alexithymia Scale(TAS-20) and Child Psychological Maltreatment and Neglect Scale. Results: ①The average score of children' s somatization symptoms inventory is 7.40 (M=7.40, SD=7.07), 27.3% of the children reported at least one serious somatization symptoms, There are significant differences in somatization symptoms from different gender and different grades; ②The correlation coefficients of the TAS-20 and CSI is 0.32 (P<0.01); ③The direct effect of alexithymia to children' s somatization symptoms is 0.39, and the indirect effect of child psychological meltreatment and neglect to somatization symptoms are 0.09 and 0.13. Conclusion: ①The detection rate of children's somatization symptoms in this sample is 27.3%, the pain/weak symptoms is the most common symptoms; ②There is low to moderate correlation between alexithymia and children somatization symptoms; ③ Alexithymia mediates the relationship between somatization symptoms and psychological meltreatment and neglect.

基金项目：

国家科技基础性工作专项:中国儿童青少年心理发育特征调查——儿童青少年发展障碍的临床研究子课题(2006FY110400);高等学校博士学科点专项科研基金(20070533025)

作者简介：

参考文献：

1 Lipowski ZJ. Somatization: the concept and its clinical application. Am J Psychiatry, 1988, 145(11): 1358-1368 2 Garralda ME. Practitioner review: Assessment and management of somatisation in childhood and adolescence: A practical perspective. J Child Psychol Psychial, 1999, 40 (8):1159-1167
3 张付全, 唐秋萍, 刘破资. 述情障碍与躯体化. 国际精神病学杂志, 2005, 32(3): 184-186
4 Waldinger RJ, Schulz MS, Barsky AJ, et al. Mapping theroad from childhood trauma to adult somatization: The roleof attachment. Psychosom Med, 2006, 68(1): 129-135
5 孟宪璋. 躯体化障碍和童年期的创伤. 中国临床心理学杂志, 2002, 10(3): 183-188
6 丁宗一. 儿童虐待与忽视研究的相关问题. 国外医学妇幼保健分册, 2003, 14(4): 248-249
7 Haugaard JJ. Recognizing and treating uncommon behavioral and emotional disorders in children and adolescents whohave been severely maltreated: Somatization and other somatoform disorders. Child Maltreat, 2004, 9(2): 169-176
8 常宪鲁,王华云.儿童期心理虐待和忽视与成人心理健康. 中国健康心理学杂志, 2008, 16(11): 1239-1240
9 Martin RD. The somatoform conundrum: A question of nosological values. General Hospital Psychiatry, 1999, 21 (3):177-186
10 De Gucht V, Heiser W. Alexithymia and somatisation Aquantitative review of the literature. J Psychosom Res, 2003,54(5): 425-434
11 Rieffe C, Oosterveld P, Terwogt MM, et al. Relationship between alexithymia, mood and internalizing symptoms inchildren and young adolescents: Evidence from an Iraniansample. Pers Individ Differ, 2010, 48(4): 425-430
12 任芳.儿童躯体化量表的应用.上海:上海交通大学,2006. 13-18
13 凌宇,蚁金瑶,杨娟,等.TAS-20中文版在1260名青少年中的信效度检验.中国临床心理学杂志,2009, 17(4):437-439
14 邓云龙, 潘辰, 唐秋萍, 等. 儿童心理虐待与忽视量表的初步编制. 中国行为医学科学, 2007, 16(2): 175-177
15 Meesters C, Muris P, Ghys A, et al. The children' s somatization inventory: further evidence for its reliability and validity in a pediatric and a community sample of Dutch children and adolescents. J Pediatr Psychol, 2003, 28(6): 413-422
16 凌宇,蚁金瑤,姚树桥,等.少儿述情障碍问卷中文版的信、效度. 儿童少年心理卫生, 2009, 23(4): 294-298
17 Pollak SJ, Freeman JE. Alexithymia among orthodox jews:The role of objection relations, family emotional expressiveness, and the presence of a disabled sibling. DisabilityStudies Quarterly, 2008, 28(2): 142-157
18 Taylor GJ, Bagby M, Parker JD. The alexithymia construct.A potential paradigm for psychosomatic medicine. Psychosomatic, 1991, 32(2): 153-164
19 姚树桥, 蚁金瑶, 钟明天, 等. 述情障碍者的情绪认知与认知性调节特征. 中国心理卫生杂志, 2009, 23(2): 118-122

服务与反馈：

【文章下载】【加入收藏】