以依恋和人格为中心的个体特征对抑郁症治疗影响的研究——基于潜在剖面分析

A Study on the Impact of Individual Characteristics Centered on Attachment and Personality in the Treatment of Depression—Based on Latent Profile Analysis

摘要: 本研究基于依恋与人格理论，探讨抑郁症患者的个体心理特征分类及其对治疗缓解过程的影响。以139例住院抑郁症患者为研究对象，采用潜在剖面分析(LPA)整合成人依恋、人格特质(艾森克问卷)、应对方式、心理弹性及人际交往能力等多维指标，识别出三类异质性亚组：高风险组(42.4%)、中风险组(44.6%)和低风险组(13.0%)。结果显示，高风险组以高神经质、精神质及消极应对为特征，治疗依从性较低；中风险组以依恋焦虑和低心理弹性为核心，治疗中期症状改善滞后；低风险组因高外倾性、心理弹性及人际能力优势，症状缓解最快。重复测量方差分析表明，低风险组在治疗末期汉密尔顿抑郁量表(HAMD)得分显著低于高风险组(p < 0.05)。研究提示，整合依恋、人格及心理社会功能的分类模型可优化抑郁症精准干预策略，如针对高风险组强化情绪调节与团体治疗，对中风险组引入依恋聚焦疗法。未来需结合纵向数据与跨文化样本验证分类稳定性，并探索其神经机制。

Abstract: This study, based on attachment and personality theories, explores the classification of individual psychological characteristics of patients with depression and their impact on the treatment remission process. A total of 139 inpatients with depression were recruited as research subjects. Latent profile analysis (LPA) was employed to integrate multidimensional indicators, including adult attachment, personality traits (Eysenck Personality Questionnaire), coping styles, psychological resilience, and interpersonal skills, to identify three heterogeneous subgroups: high-risk group (42.4%), moderate-risk group (44.6%), and low-risk group (13.0%). The results showed that the high-risk group was characterized by high neuroticism, psychoticism, and negative coping, with lower treatment adherence; the moderate-risk group was marked by attachment anxiety and low psychological resilience, with delayed symptom improvement in the middle of treatment; the low-risk group, due to its high extraversion, psychological resilience, and interpersonal strengths, achieved the fastest symptom relief. Repeated-measures analysis of variance indicated that the low-risk group had significantly lower scores on the Hamilton Depression Rating Scale (HAMD) at the end of treatment compared to the high-risk group (p < 0.05). The study suggests that a classification model integrating attachment, personality, and psychosocial functioning can optimize precision intervention strategies for depression, such as strengthening emotion regulation and group therapy for the high-risk group, and introducing attachment-based therapy for the moderate-risk group. Future research needs to verify the stability of the classification using longitudinal data and cross-cultural samples and explore its neurobiological mechanisms.