表达性艺术治疗对精神分裂症住院患者自我意识的影响
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摘要
目的探讨表达性艺术治疗对精神分裂症住院患者自我意识的干预效果。方法 2015年4—12月,选择上海市闵行区精神卫生中心120例慢性精神分裂症住院患者随机分为观察组和对照组各60例,对照组给予药物治疗,观察组在此基础上结合表达性艺术治疗,采用自我意识量表评价两组患者在入组时、治疗7周末及14周末的得分情况。结果组内分析显示,在自我意识评分上,观察组治疗7周末评分显著高于入组时(P<0.01),治疗14周末评分显著高于治疗7周末(P<0.01);对照组治疗7周末评分显著低于入组时(P<0.01)。在私我意识评分上,观察组治疗14周末评分显著高于治疗7周末(P<0.01);对照组治疗7周末评分显著低于入组时(P<0.01)。在公我意识评分上,观察组治疗7周末评分显著高于入组时(P<0.01),治疗14周末评分显著高于治疗7周末(P<0.01)。治疗14周后,两组患者的自我意识总分及各维度得分差异均有统计学意义(P<0.01)。结论表达性艺术治疗能够改善慢性精神分裂症住院患者的自我意识状态,提升其私我意识及公我意识,促进患者康复。
Objective To investigate the effect of expressive arts therapy on self-consciousness of the inpatients with schizophrenia. Methods A total of 120 patients with chronic schizophrenia were chosen from Minhang District Mental Health Center, Shanghai during April and December 2015. They were randomly divided into the study group and control group, with 60 cases in each group. The control group was given drug therapy, and the study group was given additional expressive arts therapy. The Self-Consciousness Scale(SCS) was used at baseline, 7-week and 14-week after therapy. Results In terms of self-consciousness score, it was higher at 7-week post-therapy than at baseline(P<0.01), and higher at 14-week post-therapy than at 7-week post-therapy(P<0.01) in the study group. In the control group the score was lower at 7-week post-therapy than at baseline(P<0.01). In terms of private self-consciousness score, it was higher at 14-week post-therapy than at 7-week post-therapy(P<0.01) in the study group, and was lower at 7-week post-therapy than at baseline in the control(P<0.01). In terms of public self-consciousness score, it was higher at 7-week post-therapy than at baseline(P<0.01), and higher at 14-week post-therapy than at 7-week post-therapy(P<0.01) in the study group.There were significant differences in the scores of Self-Consciousness Scale and its subscales between the two groups(P<0.01). Conclusion Expressive arts therapy can improve the self-consciousness status in the inpatients with chronic schizophrenia, enhance their private self-consciousness and public self-consciousness, and promote rehabilitation.
Objective To investigate the effect of expressive arts therapy on self-consciousness of the inpatients with schizophrenia. Methods A total of 120 patients with chronic schizophrenia were chosen from Minhang District Mental Health Center, Shanghai during April and December 2015. They were randomly divided into the study group and control group, with 60 cases in each group. The control group was given drug therapy, and the study group was given additional expressive arts therapy. The Self-Consciousness Scale(SCS) was used at baseline, 7-week and 14-week after therapy. Results In terms of self-consciousness score, it was higher at 7-week post-therapy than at baseline(P<0.01), and higher at 14-week post-therapy than at 7-week post-therapy(P<0.01) in the study group. In the control group the score was lower at 7-week post-therapy than at baseline(P<0.01). In terms of private self-consciousness score, it was higher at 14-week post-therapy than at 7-week post-therapy(P<0.01) in the study group, and was lower at 7-week post-therapy than at baseline in the control(P<0.01). In terms of public self-consciousness score, it was higher at 7-week post-therapy than at baseline(P<0.01), and higher at 14-week post-therapy than at 7-week post-therapy(P<0.01) in the study group.There were significant differences in the scores of Self-Consciousness Scale and its subscales between the two groups(P<0.01). Conclusion Expressive arts therapy can improve the self-consciousness status in the inpatients with chronic schizophrenia, enhance their private self-consciousness and public self-consciousness, and promote rehabilitation.
引文
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[14]曹韵佶,陆佳瑞.多元化艺术治疗在精神分裂症患者康复中的应用[J].齐鲁护理杂志,2016,22(9):12-14.
[15]YALOM I D,LESZCZ M.团体心理治疗:理论与实践[M].5版.李敏,李鸣,译.北京:中国轻工业出版社,2010:48.
[16]0STER G D,GOULD P,原著.绘画评估与治疗[M].吕俊宏.刘静女,译.台北:心理出版社,2002:18.
[17]杨甫德,崔勇.精神康复--艺术治疗实操手册[M].北京:人民卫生出版社,2016:106.
[18]崔吉俊,吴任钢,董春,等.自我意识及其在心理卫生保健中的应用[J].山东精神医学,2003,16(2):126-128.
[19]LIEBMANN M.艺术治疗与团体工作实例与活动[M].赖念华译.4版.台北:张老师文化事业股份有限公司,2016:36-39.
[20]牛卫青,曹艺苧,陆志德,等.表达性心理治疗对慢性精神分裂症住院患者自卑和孤独感的作用[J].中华行为医学与脑科学杂志,2017,26(8):710-712.
[21]周爱霞,曲琳莉.综合性心理治疗对康复期精神分裂症患者焦虑和抑郁的影响观察[J].中国民康医学,2011,23(10):1199,1260.
[22]王玉春.动机性访谈对恢复期精神分裂症患者负性情绪的影响[J].中国实用医药,2015,10(10):262-263.
[23]杨祥英,蒙华庆,胡华.绘画在团体心理治疗中的应用[J].临床精神医学杂志,2013,23(1):64-66.
[2]珀文.人格科学[M].周榕,陈红,杨炳钧,等译.上海:华东师范大学出版社,2001:266-298.
[3]洪炜.医学心理学[M].北京:北京医科大学、中国协和医科大学联合出版社,1996:10-14.
[4]王井云.自我意识对惧怕否定评价的影响[J].中国健康心理学杂志,2011,19(10):1264-1265.
[5]FENIGSTEIN A,SCHEIER M F,BUSS A H.Public and private self‐consciousness:Assessment and theory[J].J Consult Clin Psychol,1975,37:75-86.
[6]常荷.精神分裂症患者自我面孔识别能力及其与失言识别和执行功能的相关性研究[D].合肥:安徽医科大学,2012:6.
[7]王善澄,冯永林,郑锡基,等.慢性精神分裂症的自我意识障碍[J].中国神经精神疾病杂志,1988,14(5):283-284.
[8]LIERSCH-SUMSKIS S,MOXHAM L,CURTIS J.Choosing to use compared to taking medication:the meaning of medication as described by people who experience schizophrenia[J].Perspect Psychiatr Care,2015,51(2):114-120.
[9]李遵清,韩鹏,仇爱玫.积极心理学理论在精神分裂症康复护理中的应用效果[J].中华护理杂志,2013,48(12):1098-1101.
[10]邱鸿钟.艺术心理治疗的理论与实践[M].广州:暨南大学出版社,2010:3.
[11]张明园.精神科评定量表手册[M].长沙:湖南科学技术出版社,1998:35-42,218-223.
[12]蒋灿.自我意识量表的初步修订及相关研究[D].重庆:西南大学,2007.
[13]GAJIéc G M.Group art therapy as adjunct therapy for the treatment of schizophrenic patients in day hospital[J].Vojnosanit Pregl,2013,70(11):1065-1069.
[14]曹韵佶,陆佳瑞.多元化艺术治疗在精神分裂症患者康复中的应用[J].齐鲁护理杂志,2016,22(9):12-14.
[15]YALOM I D,LESZCZ M.团体心理治疗:理论与实践[M].5版.李敏,李鸣,译.北京:中国轻工业出版社,2010:48.
[16]0STER G D,GOULD P,原著.绘画评估与治疗[M].吕俊宏.刘静女,译.台北:心理出版社,2002:18.
[17]杨甫德,崔勇.精神康复--艺术治疗实操手册[M].北京:人民卫生出版社,2016:106.
[18]崔吉俊,吴任钢,董春,等.自我意识及其在心理卫生保健中的应用[J].山东精神医学,2003,16(2):126-128.
[19]LIEBMANN M.艺术治疗与团体工作实例与活动[M].赖念华译.4版.台北:张老师文化事业股份有限公司,2016:36-39.
[20]牛卫青,曹艺苧,陆志德,等.表达性心理治疗对慢性精神分裂症住院患者自卑和孤独感的作用[J].中华行为医学与脑科学杂志,2017,26(8):710-712.
[21]周爱霞,曲琳莉.综合性心理治疗对康复期精神分裂症患者焦虑和抑郁的影响观察[J].中国民康医学,2011,23(10):1199,1260.
[22]王玉春.动机性访谈对恢复期精神分裂症患者负性情绪的影响[J].中国实用医药,2015,10(10):262-263.
[23]杨祥英,蒙华庆,胡华.绘画在团体心理治疗中的应用[J].临床精神医学杂志,2013,23(1):64-66.
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