摘要目的 探索强迫症患者强迫症状与认知融合、经验性回避的关系.方法 以认知融合问卷(cognitive fusion questionnaire,CFQ)、接纳与行动问卷第二版(acceptance and action questionnaire2nd edition,AAQ-Ⅱ)、耶鲁-布朗强迫症状维度量表(Yale-Brown scale for obsessive-compulsive symptoms,Y-BOCS)为研究工具,对100例强迫症被试,166例健康对照组进行测试,比较两组被试认知融合、经验性回避得分的差异,采用多元线性逐步回归分析强迫症状与认知融合、经验性回避的关系.结果 强迫症组在认知融合[(49.89±10.62)分,(33.88±11.44)分,t=-11.35,P＜0.01]与经验性回避[(29.75±9.53)分,(21.59±7.03)分,t=-7.99,P＜0.01]得分上均要显著高于健康对照组.强迫症组不同年龄的认知融合得分差异有统计学意义(F=8.63,P＜0.01).在AAQ-Ⅱ中,条目2(r=0.246,P＜0.05)、条目6(r=0.223,P＜0.05)及总分(r=0.240,P＜0.05)与Y-BOCS总分呈显著性正相关;条目2(r=0.311,P＜0.01)、条目3(r=0.286,P＜0.05)、条目6(r=0.248,P＜0.05)及总分(r=0.229,P＜0.05)与强迫思维得分呈显著正相关.在CFQ中,条目2(r=0.231,P＜0.05)、条目4(r=0.242,P＜0.05)、条目7(r=0.308,P＜0.05)、条目8(r=0.277,P＜0.05)及条目9(r=0.249,P＜0.05)与Y-BOCS总分呈显著正相关;条目8(r=0.261,P＜0.05)与强迫思维得分呈显著性正相关;条目7(r=0.237,P＜0.05)及条目9(r=0.238,P＜0.05)与强迫行为得分呈显著的正相关.多元线性逐步回归分析显示,在预测强迫总分时,仅有CFQ的条目7(B=1.827,P＜0.01)、条目3(B=-0.956,P＜0.05),及AAQ-Ⅱ的条目6(B=0.584,P＜0.05)进入了方程,其联合解释变异量为19.0％;在预测强迫思维得分时,仅有AAQ-Ⅱ的条目2(B=0.446,P＜0.01)进入了方程,解释变异量为9.7％;在预测强迫行为时,仅有CFQ的条目9(B=0.815,P＜0.05)进入了方程,其解释变异量为5.6％.结论 强迫症患者认知融合、经验性回避水平高可能是症状得以维持的重要因素.

abstractsObjective To compare the difference of cognitive fusion,empirical avoidance between patients with obsessive-compulsive disorder and healthy control group,and to explore the relationship between obsessive-compulsive score and cognitive fusion,empirical avoidance.Methods The cognitive fusion questionnaire(CFQ),acceptance and action questionnaire-2nd edition (AAQ-Ⅱ) and Yale-Brown scale for obsessive-compulsive symptoms (Y-BOCS) were used to investigate 100 subjects with obsessive-compulsive disorder (OCD) and 166 healthy controls.And the differences in cognitive fusion and empirical avoidance scores were compared between the two groups.The relationship of obsessive-compulsive symptoms and cognitive fusion,empirical avoidance was analyzed using multiple linear regression analysis.Results The scores of cognitive fusion ((49.89± 10.62) vs (33.88 ± 11.44),t =-11.345,P＜ 0.01) and empirical avoidance ((29.75±9.53) vs (21.59±7.03),t=-7.995,P＜0.01) in obsessive-compulsive disorder group were significantly higher than those in healthy control group.There were significant differences in cognitive fusion and empirical avoidance in age variables (F=8.63,P＜0.01).In AAQ-Ⅱ,item 2 (r=0.246,P＜ 0.05),item 6 (r=0.223,P＜0.05) and total score (r=0.240,P＜0.05) were positively correlated with the total score of Y-BOCS.Item 2 (r=0.311,P＜0.01),item 3 (r=0.286,P＜0.05),item 6 (r=0.248,P＜0.05) and total score (r=0.229,P＜0.05) were positively correlated with the scores of obsessive-thinking.In CFQ,item 2 (r=0.231,P＜0.0) 5),item 4 (r=0.242,P＜ 0.05),item 7 (r =0.308,P＜ 0.05),item 8 (r =0.277,P＜0.05) and item 9 (r=0.249,P＜0.05) were positively correlated with the total score of Y-BOCS.Item 8 (r=0.261,P＜0.05) was positively correlated with the scores of obsessive-thinking,item 7 (r=0.237,P＜0.05) and item 9 (r=0.238,P＜0.05) were positively correlated with scores of obsessive-compulsive behavior.When predicting total obsessive-compulsive scores,only CF item 7 of Q (B=1.827,P＜0.01),item 3 (B=0.956,P＜0.05),and item 6 of AAQ-Ⅱ (B=0.584,P＜0.05) entered the equation with a joint explanatory variation of 19％.When predicting the score of obsessive-thinking,only item 2 of AAQ-Ⅱ (B=0.446,P＜0.01) entered the equation,explaining the variance was 9.7％.In the prediction of obsessive-compulsive behavior,only item 9 (B=0.815,P＜0.05) of CFQ entered the equation,and the explanatory variation was 5.6％.Conclusion Cognitive fusion in the patients with obsessive-compulsive disorder and the high level of empirical avoidance may be an important factor for the maintenance of the symptoms.