述情障碍对抑郁症患者严重程度的影响：认知情绪调节的中介作用

The Effect of Alexithymia on Depression Severity in Patients with Depression: The Mediating Role of Cognitive Emotion Regulation

摘要: 目的：探讨抑郁症患者抑郁情绪、述情障碍和认知情绪调节的关系。方法：采用汉密尔顿抑郁量表(HAMD-17)、述情障碍量表(TAS-26)和认知情绪调节问卷中文版(CERQ-C)对142名住院以及门诊患者进行调查。结果：述情障碍能显著正向预测非适应性认知情绪调节策略(β = 0.152, p < 0.05)，并显著负向预测适应性认知情绪调节策略(β = −0.212, p < 0.01)。在控制述情障碍后，非适应性认知情绪调节策略和适应性认知情绪调节策略均能显著预测抑郁情绪(β = 0.077, p < 0.05; β = −0.073, p < 0.05)。述情障碍对抑郁情绪的直接效应未达到统计学显著水平(β = 0.056, p = 0.062)，但总间接效应显著，效应值为0.027，95% CI [0.008, 0.054]。具体而言，通过非适应性认知情绪调节策略的间接效应为0.012，95% CI [0.000, 0.030]；通过适应性认知情绪策略的间接效应为0.016，95% CI [0.002, 0.036]。两条间接路径的效应量差异不显著(β = −0.004, 95% CI [−0.028, 0.018])。结论：非适应性认知情绪调节策略和适应性认知情绪调节策略在述情障碍与抑郁情绪之间起并行中介作用，述情障碍主要通过这两类策略的间接路径影响抑郁情绪。

Abstract: Objective: To explore the relationships among depressive mood, alexithymia, and cognitive emotion regulation in patients with depression. Methods: A total of 142 hospitalized and outpatient patients were assessed using the Hamilton Depression Scale (HAMD-17), the Toronto Alexithymia Scale (TAS-26), and the Chinese version of the Cognitive Emotion Regulation Questionnaire (CERQ-C). Results: Alexithymia significantly and positively predicted the use of maladaptive cognitive emotion regulation strategies (β = 0.152, p < 0.05) and significantly and negatively predicted the use of adaptive cognitive emotion regulation strategies (β = −0.212, p < 0.01). After controlling for alexithymia, both maladaptive and adaptive cognitive emotion regulation strategies significantly predicted depressive mood (β = 0.077, p < 0.05; β = −0.073, p < 0.05, respectively). The direct effect of alexithymia on depressive mood was not statistically significant (β = 0.056, p = 0.062), but the total indirect effect was significant, with an effect size of 0.027, 95% Bootstrap CI [0.008, 0.054]. Specifically, the indirect effect through maladaptive cognitive emotion regulation strategies was 0.012, 95% CI [0.000, 0.030], and the indirect effect through adaptive cognitive emotion regulation strategies was 0.016, 95% CI [0.002, 0.036]. The difference in effect sizes between the two indirect pathways was not significant (β = −0.004, 95% CI [−0.028, 0.018]). Conclusion: Both maladaptive and adaptive cognitive emotion regulation strategies serve as parallel mediators in the relationship between alexithymia and depressive mood, in the relationship between alexithymia and depressive mood, indicating that alexithymia primarily influences depressive mood through these indirect pathways.