【作者】 张俊红；

【导师】 刘铁桥；

【作者基本信息】 中南大学 ， 临床医学（专业学位）， 2022， 硕士

【摘要】 目的:验证改编的中文版问题性社交媒体使用量表是否适用于我国的心境障碍患者;验证Caplan提出的认知-行为理论模型在心境障碍患者中的适用性;探索心境障碍患者的问题性社交媒体使用与抑郁、焦虑、社交媒体使用动机及社会人口学变量的相关性。方法:1.在湘雅二医院精神科病房对符合入组标准和不符合排除标准的心境障碍住院患者进行问卷调查。使用改编的中文版问题性社交媒体使用量表（problematic use of social media scale,PUSMS）评估患者的问题性社交媒体使用（problematic use of social media,PUSM）情况,对改编的量表进行验证性因素分析,使用结构方程模型对Caplan的认知-行为理论进行验证。2.使用自制人口学问卷收集患者的人口学资料,分别使用抑郁自评量表（Self-Rating Depression Scale,SDS）、焦虑自评量表（Self-Rating Anxiety Scale,SAS）评估患者的抑郁、焦虑症状,采用社交网站使用动机量表评估患者使用社交网站的动机,探索心境障碍患者的PUSM与这些变量的关系。结果:共收集有效问卷400份,包括抑郁症患者222人,双相障碍患者178人。1.条目分析结果表明改编量表的条目得分在高、低分组上均有显著的统计学差异,且各条目与总量表得分都显著相关。信度分析结果表明总量表的克朗巴赫α系数为0.879,负面后果分量表的系数为0.698,其他分量表的系数均大于0.800。效度分析结果表明模型拟合良好,且各维度之间及维度与总量表均有显著相关性（r在0.104至0.703之间,p<0.01）。验证性分析结果表明整体模型拟合良好:自由度（Degree of Freedom,DF）=82,x²_（82）=287.76;RMSEA=0.079;SRMR=0.049;CFI=0.993;TLI=0.991。结构方程模型分析的结果表明整体模型拟合良好:x²_（84）=297.23;RMSEA=0.080;SRMR=0.051;CFI=0.992;TLI=0.991。结构模型标准化的回归系数在0.10至0.95之间,只有偏爱在线社交互动（Preference for Online Social Interaction,POSI）和缺乏自我调节能力之间未标准化的回归系数没有显著的统计学意义,其他回归系数均具有显著的统计学意义。POSI能够直接预测情绪调节,但不能直接预测缺乏自我调节能力,情绪调节能够直接预测缺乏自我调节能力,缺乏自我调节能力能够直接预测负面后果;POSI能够通过情绪调节间接预测缺乏自我调节能力,情绪调节能够通过缺乏自我调节能力间接预测负面后果,POSI不能通过缺乏自我调节能力间接预测负面后果。2.心境障碍患者的PUSM在性别、年龄、职业等社会人口学变量上都没有显著的统计学差异（p>0.05）;双变量相关性分析结果表明患者的PUSM与抑郁（r=0.213,p<0.01）、焦虑（r=0.246,p<0.01）、打发时间动机（r=0.362,p<0.01）、获取信息动机（r=0.175,p<0.01）、娱乐放松动机（r=0.412,p<0.01）、自我表现动机（r=0.324,p<0.01）、逃避动机（r=0.421,p<0.01）均呈显著的正相关。3.多因素线性回归结果表明心境障碍患者的焦虑症状（b=0.236,p<0.01）和打发时间动机（b=0.874,p<0.01）、娱乐动机（b=1.813,p<0.01）、自我表现动机（b=0.478,p<0.05）、逃避动机（b=0.813,p<0.01）能够正向预测PUSM,获取信息动机（b=-0.493,p<0.05）能够负向预测PUSM。结论:1.本研究初步表明改编的问题性社交媒体使用量表在中国青少年及青年心境障碍人群中具有良好的信效度,可以用于该群体问题性社交媒体使用的认知、行为和负面后果的测量。2.Caplan提出的认知行为理论模型可能不完全适用于中国青少年及青年心境障碍患者。对于共病PUSM的心境障碍患者而言,提高情绪调节能力可能是预防和干预PUSM的主要目标。3.心境障碍患者的PUSM与性别、年龄、职业等社会人口学变量无显著相关性,PUSM与焦虑症状和打发时间动机、娱乐动机、自我表现动机、逃避动机均呈显著正相关。4.心境障碍患者的焦虑症状和打发时间动机、娱乐动机、自我表现动机、逃避动机能够正向预测PUSM,获取信息动机能够负向预测PUSM。图3幅,表8个,参考文献111篇更多还原

【Abstract】 Objective:To examine the factorial validity of the adapted Chinese version of the Problematic Use of Social Media Scale(PUSMS),and to verify the applicability of Caplan’s cognitive-behavioral theoretical model in patients with mood disorders in China.To explore the correlation between problematic use of social media and depression,anxiety,motivation for social media use,and sociodemographic variables in mood disorders.Methods:1.In the psychiatric ward of the Second Xiangya Hospital,inpatients with mood disorders who met the inclusion criteria and did not meet the exclusion criteria were surveyed using questionnaires.Patients were assessed for problematic use of social media(PUSM)with Chinese version of PUSMS adapted from Caplan’s Generalized Problematic Internet Scale model.Confirmatory factor analysis was conducted to assess the factorial validity of the scale,and a structural equation model was used to verify Caplan’s cognitive-behavioral theory.2.The self-made demographic questionnaire was used to collect the demographic data of the patients,and the Self-Rating Depression Scale(SDS)and Self-Rating Anxiety Scale(SAS)were used to evaluate the symptoms of depression and anxiety in the patients.The motivation for using social media was evaluated by the motivation scale of social media and the relationships between PUSM and these variables in mood disorders were explored.Results:A total of 400 valid questionnaires were collected,including222 patients with depression and 178 patients with bipolar disorder.1.The results of item analysis showed that there were significant statistical differences between high and low item scores groups.The results of reliability analysis showed that the Cronbach’sαcoefficient of the total scale was 0.879,the Cronbach’sαcoefficient of the negative consequences subscale was 0.698,and the Cronbach’sαcoefficients of other subscales were all greater than 0.80.The result of validity analysis showed that the model fits well,and there were significant correlations between all dimensions as well as the total scale(r ranged from 0.104 to0.703,P<0.01).The results of confirmatory factor analysis showed that the model fits well:Degree of freedom(DF)=82,x~2(82)=287.76;RMSEA=0.079;SRMR=0.049;CFI=0.993;TLI=0.991.The results of structural equation modeling showed that the model fits well:x~2(84)=297.23;RMSEA=0.080;SRMR=0.051;CFI=0.992;TLI=0.991.The normalized regression coefficient of the structural model was between0.10 and 0.95.Only the unnormalized regression coefficient between Preference for Online Social Interaction(POSI)and deficient self-regulation had no significant statistical significance.Other regression coefficients had significant statistical significance.POSI can directly predict emotion regulation but not deficient self-regulation,emotion regulation can directly predict deficient self-regulation,and deficient self-regulation can directly predict negative outcomes.POSI can indirectly predict deficient self-regulation through emotion regulation,emotion regulation can indirectly predict negative outcomes through deficient self-regulation,and POSI cannot indirectly predict negative outcomes through deficient self-regulation.2.There were no significant differences in PUSM of mood disorders in gender,age,occupation,and other social demographic variables(P>0.05).Results of bivariate correlation analysis revealed that PUSM was positively correlated with depression(r=0.213,P<0.01),anxiety(r=0.246,P<0.01),motivation of killing time(r=0.362,P<0.01),motivation of recreation and relaxation(r=0.412,P<0.01),motivation of self-expression(r=0.324,P<0.01),and motivation of avoidance(r=0.421,P<0.01).3.Multivariate linear regression showed that anxiety symptoms(b=0.236,P<0.01),motivation of killing time(b=0.874,P<0.01),motivation of entertainment(b=1.813,p<0.01),motivation of self-expression(b=0.478,P<0.05),and motivation of avoidance(b=0.813,P<0.01)can positively predict PUSM in patients with mood disorders,and motivation of obtaining information(b=-0.493,P<0.05)can negatively predict PUSM.Conclusion:1.This study preliminarily demonstrated that the adapted PUSMS has good reliability and validity in teenagers and youths with mood disorders in China,and can be used to measure the cognitive,behavioral,and negative consequences of PUSM in this population.2.The cognitive behavioral theoretical model proposed by Caplan may not be completely applicable to teenagers and youths with mood disorders in China.For mood disorders comorbid with PUSM,improving the ability to regulate emotion may be the main target of prevention and intervention for PUSM.3.There were no significant correlations in PUSM of mood disorders with gender,age,occupation,and other social demographic variables.PUSM has significant positive correlation with anxiety symptoms and motivation of killing time,motivation of entertainment,motivation of self-expression,and motivation of avoidance.4.The anxiety symptoms,motivation of killing time,motivation of entertainment,motivation of self-expression,and motivation of avoidance of mood disorders can positively predict PUSM,and motivation of obtaining information can negatively predict PUSM.更多还原