【作者】 黄晶菁； 邹欣妍； 徐鑫； 唐任之慧； 焦克媛； 钱文丽； 申新兰； 王建平；

【Author】 Jingjing Huang;Xinyan Zou;Xin Xu;Renzhihui Tang;Keyuan Jiao;Wenli Qian;Xinlan Shen;Jianping Wang;Faculty of Psychology,Beijing Normal University;Department of Social Work and Social Administration,The University of Hong Kong;

【机构】 北京师范大学心理学部； 香港大学社会工作及社会行政学系；

【摘要】 背景:哀伤的认知行为概念化模型及大量实证研究均表明,特定于丧亲事件的非适应性应对方式——抑郁回避和焦虑回避,在丧亲者的丧亲后适应中发挥着重要作用。以往关于丧亲者抑郁和焦虑回避的研究基本采用以变量为中心的方法,发现两者均会阻碍丧亲后适应。然而,个体层面两种回避使用情况是否存在差异仍然难以确定。因此,本研究采用以个体为中心的潜在剖面分析,探究中国成年丧亲者中的回避行为的不同模式,并进一步考察人口学及丧亲相关变量对潜在剖面的预测作用,以及不同回避应对的潜在剖面对丧亲后适应的影响。方法:采用延长哀伤中的抑郁焦虑回避量表（DAAPGQ）、病人健康问卷-9（PHQ-9）、复杂性哀伤量表（ICG）、创伤后应激障碍症状核查表（PCL-5）对丧亲时长一年内(M_month=3.98,SD=2.49)的263名成年丧亲者(M_age=34.50,SD=11.99,男性77人)进行调查,并收集其人口统计学（年龄、性别、受教育程度、有无宗教信仰）及丧亲相关信息（丧亲时长、是否自然死亡、有无心理预期）。结果:潜在剖面分析确定了丧亲者回避应对的四个亚组,分别为低回避组（C1;23.2%）,较低抑郁伴中等焦虑回避组（C2;27.6%）,较高抑郁伴中等焦虑回避组（C3;35.1%）和高回避组（C4;14.1%）。四个亚组的抑郁回避水平:C1<C2<C3<C4;焦虑回避水平:C1<C2≈C3<C4。回归混合模型发现:有无宗教信仰、丧亲时长、是否自然死亡、有无心理预期对不同亚组有预测作用,但是性别、年龄、受教育程度对不同亚组没有预测作用。四个亚组的丧亲后适应均存在显著差异,抑郁回避程度越高的亚组,抑郁、延长哀伤障碍症状和创伤后应激障碍症状越严重。结论:丧亲者的回避应对存在不同特征的亚组,提示应针对丧亲者回避应对的不同类型制定针对性的干预策略。更多还原

【Abstract】 Background:The cognitive-behavioral conceptualization of complicated grief and a large number of empirical studies have shown that maladaptive coping styles specific to bereavement events-depressive avoidance and anxious avoidance play an important role in bereaved people’s adaptation to bereavement.Previous studies on depressive and anxious avoidance of bereaved people have almost exclusively adopted variable-centered approaches,the results of which indicated that types of avoidance would hinder adaptation to bereavement.However,it was still to be examined whether there is a difference between the use of the two types of avoidance at the individual level.Therefore,this study adopted used an individual centered potential profile analysis to explore different patterns of avoidance behavior among Chinese bereaved adults,and further investigate the predictive effect of demographics and bereavement related variables on the potential profiles,as well as the impact of different potential profiles of avoidance coping on adaptation to bereavement.Method:263 bereaved adults(M_age=34.50,SD=11.99,77 males) with a bereavement duration within one year(M_month=3.98,SD=2.49) were assessed by using Depressive and Anxious Avoidance in Prolonged Grief Questionnaire（DAAPGQ）,Patient Health Questionnaire-9（PHQ-9）,Inventory of Complicated Grief（ICG）,and Post Traumatic Stress Disorder Checklist for DSM-5（PCL-5）.Their demographics（age,gender,education level,dichotomized religious belief） and bereavement related information（bereavement duration,dichotomized natural death,dichotomized expectedness） were also examined.Results:The latent profile analysis identified four subgroups of avoidance coping of bereaved adults including the lowest avoidance group（C1;23.2%）,lower depression with moderate anxiety avoidance group（C2;27.6%）,higher depression with moderate anxiety avoidance group（C3;35.1%） and the highest avoidance group（C4;14.1%）.The depressive avoidance level of the four subgroups were C1<C2<C3<C4;and anxious avoidance level of the four subgroups were C1<C2≈C3<C4.The regression mixed model indicated that dichotomized religious belief,bereavement duration,dichotomized natural death,and dichotomized expectedness had predictive effects on different subgroups,but gender,age,and education level had no predictive effects on different subgroups.There were significant differences in adaptation to bereavement among the four subgroups.The higher the level of depressive avoidance there was,the more serious the symptoms of depression,prolonged grief disorder and post-traumatic stress disorder were incurred.Conclusion:There are subgroups with different features in the avoidance coping of bereaved adults,suggesting that targeted intervention strategies should be developed according to the different types of avoidance coping of bereaved adults.更多还原