中国科学院心理健康重点实验室知识库

目的探讨焦虑抑郁情绪和元认知在妇科肿瘤患者躯体症状与恐惧疾病进展间的链式中介作用。方法采用一般人口学资料、恐惧疾病进展简化量表(fear of progression questionnaire-short form, FoP-Q-SF)、医院焦虑抑郁量表(hospital anxiety and depression scale, HADS)、元认知问卷(metacognition questionnaire, MCQ)、躯体症状量表(somatic symptom scale, SSS)对208名妇科肿瘤患者进行调查。采用SPSS 25.0进行Pearson相关分析。采用SPSS PROCESS宏程序偏差校正的非参数百分位Bootstrap方法进行中介效应检验。结果妇科肿瘤患者恐惧疾病进展得分(32.41±10.43)分、抑郁得分(6.43±4.17)分、焦虑得分(7.51±4.10)分、元认知得分(68.44±16.04)分、躯体症状得分(20.58±15.70)分, 48.56%的患者存在功能失调的恐惧疾病进展。相关分析显示, 恐惧疾病进展与躯体症状(r=0.394, P<0.01)、焦虑(r=0.640, P<0.01)、抑郁(r=0.533, P<0.01)、元认知(r=0.489, P<0.01)均呈正相关。中介效应检验显示, 焦虑抑郁情绪和元认知在妇科肿瘤患者躯体症状和恐惧疾病进展之间起完全链式中介作用。躯体症状对恐惧疾病进展的总效应为0.320;躯体症状通过影响焦虑情绪, 进而影响元认知, 间接影响恐惧疾病进展, 中介效应值为0.242;躯体症状通过影响抑郁情绪, 进而影响元认知, 间接影响恐惧疾病进展, 中介效应值为0.212。结论妇科肿瘤患者的躯体症状可以通过焦虑/抑郁和元认知的链式中介作用间接影响恐惧疾病进展。

Objective

To explore the chain mediating effects of anxiety/depression and metacognition between somatic symptoms and fear of disease progression (FoP) in gynecological tumor patients.

Methods

A total of 208 gynecological tumor patients were investigated by general demographic data, fear of progression questionnaire-short form(FoP-Q-SF), hospital anxiety and depression scale(HADS), metacognition questionnaire(MCQ) and somatic symptom scale(SSS). SPSS 25.0 was used for Pearson correlation analysis. The significance of mediating effect was tested by deviation corrected nonparametric percentile Bootstrap method using SPSS macro program PROCESS.

Results

The scores of FoP-Q-SF, depression, anxiety, MCQ and SSS were (32.41±10.43), (6.43±4.17), (7.51±4.10), (68.44±16.04), (20.58±15.70) respectively. 48.56% of gynecological tumor patients had dysfunctional fear of disease progression. Correlation analysis showed that FoP was significantly positively correlated with somatic symptoms (r=0.394, P<0.01), anxiety (r=0.640, P<0.01), depression (r=0.533, P<0.01) and metacognition (r=0.489, P<0.01). Mediating effect test showed that anxiety, depression and metacognition played a complete chain mediating role between somatic symptoms and FoP in gynecological tumor patients.The total effect of somatic symptoms on FoP was 0.320. Somatic symptoms indirectly affected FoP by influencing anxiety and metacognition, and the intermediary effect value was 0.242. Somatic symptoms indirectly affected FoP by influencing depression and metacognition, and the intermediary effect value was 0.212.

Conclusion

Somatic symptoms can indirectly affect FoP through the chain mediation of anxiety/depression and metacognition.