Psychopathology and autobiographical memory in stroke and non-stroke hospitalized patients
Psychopathology and autobiographical memory in stroke and non-stroke hospitalized patients
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DOI：
10.1002/gps.763
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发表时间：
2003-01-01
影响因子：
4
通讯作者：
Sembi, S
中科院分区：
文献类型：
--
作者：
Sampson, MJ;Kinderman, P;Sembi, S
研究背景：对一组脑卒中和非脑卒中住院患者进行精神病理和自传体记忆的调查。这两个群体都被认为具有高水平的精神病理学（Katon and Sullivan 1990; burville et al., 1995）。回忆特定的自传式记忆（过度记忆）的困难已被确定为抑郁症的重要心理变量和预后预测因子（Williams and Scott 1988; Brittlebank et al., 1993）。在抑郁女性（Kuyken and Brewin, 1995）和抑郁癌症患者（Brewin et al., 1998a）中，侵入性自传式记忆也被发现与抑郁和过度记忆有关。这项研究观察了中风和非中风住院患者的精神病理学和自传式记忆水平。方法筛选417例患者，176例符合条件的患者中103例同意参与研究（脑卒中54例，非脑卒中49例）。通过自传式记忆测试和事件影响量表对参与者的记忆侵入性进行评估。还评估了ptsd样症状（PCL-S）、情绪（HADS、GHQ-28）和认知能力（MMSE、语言流畅性、数字广度和估计的病前智商）。结果脑卒中患者与非脑卒中患者在抑郁、焦虑、ptsd样症状严重程度及自传式记忆方面均无显著差异。对合并数据（卒中和非卒中）的反向多元回归分析表明，过度记忆回忆、过去事件的侵入性记忆和疾病的侵入性记忆是抑郁症（HADS）的显著独立预测因子。对侵入性记忆的回避和童年痛苦的报告并不是泛泛记忆回忆的预测因子。总体记忆回忆的显著预测因子是；性别，抗抑郁药物和估计的智商。结论该队列中存在显著的精神病理水平。然而，卒中和非卒中住院患者在抑郁、焦虑、创伤后应激障碍症状和自传体记忆水平上没有显著差异。特别令人感兴趣的是，发现类似创伤后应激障碍的症状似乎不受患者疾病性质的影响。在综合数据（中风和非中风）中，自传式记忆（疾病的侵入性图像，其他事件的侵入性记忆和一般记忆回忆变量）是该队列中抑郁症的重要预测因素。这表明记忆过程的心理干预可能是这些群体抑郁症心理干预的一个有价值的目标。性别、认知障碍、抗抑郁药物和估计的智商是过度记忆回忆的重要预测因素，对这些发现的有效性的进一步调查是有必要的。最后讨论了进一步研究的建议和研究的局限性。版权所有:John Wiley Sons, Ltd。
Background Psychopathology and autobiographical memory were investigated in a cohort of stroke and non-stroke hospitalized patients. Both these cohorts have been identified as having high levels of psychopathology (Katon and Sullivan 1990; Burvill et al., 1995). Difficulties recalling specific autobiographical memories (overgeneral memory) have been identified as important psychological variables in depression and predictors of outcome (Williams and Scott 1988; Brittlebank et al., 1993). Intrusive autobiographical memories have also been found to be associated with depression and overgeneral memory in depressed women (Kuyken and Brewin, 1995) and depressed cancer patients (Brewin et al., 1998a). This study looked at levels of psychopathology and autobiographical memories in stroke and non-stroke hospital patients.Method 417 patients were screened, of the 176 eligible 103 agreed to participate (54 stroke and 49 non-stroke). Participants were assessed for overgenerality using the Autobiographical Memory Test and intrusiveness of memories using the Impact of Events Scale. Also assessed were PTSD-like symptoms (PCL-S), mood (HADS, GHQ-28) and cognitive ability (MMSE, verbal fluency, digit span and estimated pre-morbid IQ).Results No significant differences were found between stroke and non-stroke patients on severity of depression, anxiety, severity of PTSD-like symptoms or autobiographical memories. Backward multivariate regression analyses for combined data (stroke and non-stroke) indicated that overgeneral memory recall, intrusive memories of past events and intrusive memories of illness were significant independent predictors of depression (HADS). Avoidance of intrusive memories and reported childhood distress were not predictors of overgeneral memory recall. Significant predictors of overgeneral memory recall were; Gender, antidepressant medication, and estimated IQ.Conclusion Significant levels of psychopathology were identified in this cohort. However, there were no significant differences in the levels of depression, anxiety, PTSD symptoms and autobiographical memory between stroke and non-stroke hospitalized patients. Of particular interest was the finding that PTSD-like symptoms did not appear to be influenced by the nature of the person's illness. In combined data (stroke and non-stroke) autobiographical memories (intrusive images of their illness, intrusive memories of other events and overgeneral memory recall variables) were significant predictors of depression in this cohort. This suggests that psychological intervention of memory processes may be a worthwhile target in psychological intervention for depression in these cohorts. Gender, cognitive impairment, antidepressant medication, and estimated IQ were significant predictors of overgeneral memory recall and further investigation into the validity of these findings are warranted. Suggestions for further research and limitations of the study are also discussed. Copyright (C) 2002 John Wiley Sons, Ltd.