【摘要】 目的:探讨团体认知行为治疗对社区精神分裂症患者自我效能感、应对方式的影响及与社会功能改善的相关性。方法:69例精神分裂症患者分为5个团体小组,在药物维持治疗基础上施行团体认知行为治疗,1次/周,每次约1.5 h,疗程6个月。于治疗前、治疗后12和24周,分别采用一般自我效能感量表(GSES)、应对方式问卷(CSQ)和社会功能缺陷筛选量表(SDSS)进行评估,并比较治疗前后的变化及各评分之间的相关性。结果:治疗后SDSS总分、CSQ的自责、幻想、退避、合理化得分显著下降;GSES总分、CSQ的解决问题、求助得分显著增高,治疗前后差异有统计学意义(F=30.789~3113.245,P<0.01或P<0.001);GSES评分显著增高(P<0.01)。相关分析显示,SDSS与GSES呈负相关(r=-0.334,P<0.01),与CSQ的自责、幻想、退避、合理化的应对方式呈正相关(r=0.079~0.388,P<0.01);GSES与CSQ的幻想、退避的应对方式呈负相关(r=-0.154~-0.161,P<0.05)。结论:团体认知行为训练可提高患者的自我效能感、改变应对方式,从而有效地改善患者的社会功能。更多还原

【Abstract】 Objective: To explore the effects of group cognitive-behavioral therapy( GCBT) on the self-efficacy and coping styles,and the relations between GCBT and the improvement of the social functions of schizophrenics in communities. Method: Sixty-nine cases of schizophrenics were divided into five groups. They were given GCBT( 1. 5 hours once a week) together with drug treatment in 6 months. Evaluation was conducted before treatment,12 weeks and 24 weeks after treatment respectively by virtue of general self-efficacy scale( GSES),coping styles questionnaire( CSQ) and social disability screening scale( SDSS). The comparison between the changes before and after treatment was also made,and meanwhile their correlations between different scores of GSES,CSQ and SDSS were also analyzed. Results: After treatment the total score of SDSS and the score for self blame,illusion,avoidance and rationalization in CSQ decreased greatly as opposed to the fact that the total score of GSES and the score for problem-solving and seeking help increased obviously. The differences before and after treatment were statistically significant( F = 30. 789-113. 245; P < 0. 01 or P < 0. 001). The total score of GSES went up significantly( P < 0. 01). The correlation analysis showed that SDSS was negatively correlated with GSES( r =- 0. 334,P < 0. 01),and at the same time positively correlated with self blame,illusion,avoidance and rationalization in CSQ( r = 0. 079-0. 388; P < 0. 01). GSES was negatively correlated with illusion and avoidance in CSQ( r =- 0. 154-- 0. 161; P < 0. 05). Conclusion: GCBT training has the benefit of increasing schizophrenics’ self-efficacy and can lead to the change of the coping styles,which in the end effectively improves the social functions.更多还原