The Empirical Study Of Negative Cognitive Bias Model-poor Prognosis Of Pancreatic Cancer

Part Ⅰ The application of Negative emotions and negative screening test of cognitive bias search tool in pancreatic cancer patientsObjective:The aim of the present study was to study the applicability of negative emotions and negative screening test of cognitive bias tool in the patients with pancreatic cancer and to compare the pancreatic cancer patients with community control group in the emotional and negative cognitive features.Methods:This study included1029patients and472normative subjects. All of the subjects completed the Chinese version of the Mood and Anxiety Symptom Questionnaire-Short Form,(MASQ-SF); Dysfunctional Attitude Scale,(DAS) and Cognitive Style Questionnaire (CSQ). We calculated the mean inter-item correlations for the total Scale and for each of the subscales. Cronbach’s alpha coefficients to analyze the inter-correlations and reliability. We utilized confirmatory factor analysis to do measurement model A one-way multivariate analysis of variance (MANOVA) was computed to examine the effects of gender.Results:(1) Scale scores:negative emotion scores in patients with pancreatic cancer group and the community control group were significantly different in all factors and pancreatic cancer patients have more negative dysfunctional attitudes. Negative emotion score in Male and female patients and factor scores were not significantly different, but the negative cognitive bias the pancreatic cancer patients in factor score of the subjects had significant gender differences.(2) Reliability:The pancreatic cancer group:(1) the total scale’s internal consistency coefficient of mood and anxiety symptoms questionnaire is0.88, and all subscales between0.79to0.93.(2) Dysfunctional attitude questionnaire: internal consistency coefficient (a=0.75);(3) internal consistency coefficient for cognitive style questionnaire is0.79. Community control group:(1) total scale internal consistency coefficient for mood and anxiety symptoms questionnaire is0.88,(2) internal consistency coefficient of Dysfunctional attitude questionnaire is0.79,(3) The internal consistency coefficient for Cognitive Style Questionnaire is0.80(2) The average correlation coefficient between items:pancreatic cancer group:mood and anxiety symptom questionnaire entries in the table between the total amount of the average correlation coefficient is0.29, the average correlation for the total scale of dysfunctional attitudes questionnaire was0.33and the total amount of the average correlation coefficient for the cognition Style Questionnaire was0.33. The community control group:the total amount of the correlation coefficient for the mood and anxiety symptom questionnaire is0.31, while the Dysfunctional Attitude average correlation between the total table entries0.31, while the cognitive style questionnaire table entry total average correlation coefficient is0.29.(3) Construct validity:confirmatory factor analysis showed that samples of pancreatic cancer patients and the community in the control group sample have a good model fit index of mood and anxiety symptoms questionnaire. The convergent and discriminant validity:The correlation between subscales and total scale of mood and anxiety symptom questionnaire and the cognitive style questionnaire ient between the correlation coefficients between subscales were significant.Conclusion:Negative emotions-and negative cognitive bias screening tool assessment tool in pancreatic cancer patients, showed good reliability and validity, can assist in evaluating the emotional problems of patients with pancreatic cancer and negative cognitive bias problem, to provide new ideas in pancreatic cancer patients Treatment and care. Part I The use of the Cognitive Emotion Regulation Questionnaire Chinese Version (CERQ-C) in a hypertensive subjectObjective:The aim of the present study was to develop a Chinese version of the Cognitive Emotion Regulation Questionnaire (CERQ-C) and to examine its psychometric properties in both hypertensive and normative subjects.Methods:This study included434hypertensive patients and462normative subjects. All of the subjects completed the Chinese version of the Cognitive Emotion Regulation Questionnaire,(CERQ); Dysfunctional Attitude Scale,(DAS); Mood and Anxiety Symptom Questionnaire Short Form,(MASQ-SF); Center for Epidemiologic Studies Depression Scale,(CES-D). We calculated the mean inter-item correlations for the total CERQ-C and for each of the subscales. Cronbach’s alpha coefficients to analyze the inter-correlations and reliability. When examining the nine-factor model, we utilized confirmatory factor analysis. The measurement model consisted of nine first-order factors (self-blame, acceptance, rumination, positive refocus, refocus on planning, positive reappraisal, putting into perspective, catastrophizing, and blaming others). A one-way multivariate analysis of variance (MANOVA) was computed to examine the effects of gender. Results:(1) The Cognitive Emotion Regulation strategies hypertension patients and normative sample most frequently used were positive reappraisal. Hypertensive group reported significantly higher scores than normative sample on Rumination (12.19±2.51/11.51±2.60,p<0.001) and catastrophizing (8.82±2.19/8.11±2.70, p<0.001), blaming others (10.76±2.11/9.88±2.48, p<0.001) and significantly lower scores than normative sample on positive reappraisal (13.80±3.55/14.71±4.11,p<0.001)(2)reliability:In hypertension group the Cronbach’s alpha for the Total CERQ-C was0.80, and the Cronbach’s alpha coefficient for the nine subscale ranged from0.71(Self-blame) to0.90(Rumination). And in normative group the Cronbach’s alpha for the Total CERQ-C was0.79, and the Cronbach’s alpha coefficient for the nine subscale ranged from0.71(Positive Reappraisal) to0.90(Rumination). The mean inter-item correlation coefficient for the nine subscale ranged from0.21-0.42(hypertension group)/0.19-0.32(normative group). In hypertension group, the test-retest reliability of the total scale was0.82, the test-retest reliability of nine subscales ranged from0.73to0.92; And in normative group, the test-retest reliability of the total scale was0.79, the test-retest reliability of nine subscales ranged from0.71to0.88.(3) Confirmatory factor analysis:The results of our CFA suggest that the nine first-order factors data fit the both two sample well.(X2/(df)=2.28, p<0.001,CFI=0.91, IFI=0.92, RMSEA=0.05, TLI=0.944)/(x2/(df)=2.34, p<0.001,CFI=0.91, IFI=0.91, RMSEA= 0.08, TLI=0.90).(4):Convergent and discriminate validity:In hypertensive group Self-blame(y=0.14, p<0.01), catastrophizing (y=0.55, p<0.001), blaming others (γ=0.47,p<0.001) were positively correlated with the total scores of Dysfunctional Attitude Scale. And Positive Refocusing (t=-0.21, p<0.01), Putting into Perspective (y=-0.27,p<0.01) were negatively correlated with the total scores of Dysfunctional Attitude Scale. In normal group, Self-blame(y=0.37, p<0.001), Rumination (t=0.61, p<0.001), catastrophizing (γ=0.67, p<0.001), blaming others (γ=0.49, p<0.001) were positively correlated with the total scores of Dysfunctional Attitude Scale. Refocus on Planning (y=-0.27,p<0.001), Putting into Perspective (t=-0.33,p<0.001) were negatively correlated with the total scores of dysfunctional Attitude Scale.Conclusion:The properties of CERQ-C met the psychometrics standard indicated that it is a reliable and valid assessment of cognitive emotion regulation strategies, and can be considered as an appropriate tool for assessing Part2Study on the Cognitive Emotion Regulation strategies of the hypertension patients with depressionObjective:We study on the cognitive emotion regulation strategies and dysfunctional attitudes of the hypertension patients with or with not depression. Following a psychosocial perspective to study in the onset of depression.Methods:Recruiting1400hypertensive patients with depression from those patients recorded in the "Family Home of Hypertensive patients" and the out-patients with essential hypertension. Screening hypertension sufferers with the Hospital Anxiety and Depression Scale (HAD), the subjects with positive results (HAD>9) were evaluated with HAMA and HAMD.250patients enter the hypertension with depression group from263patients with positive screened result (HAMD>20, HAMA<14). And250hypertension patients with no depression as member of hypertension with no depression group.462normative subjects as member of normative group. All of the them completed the Hospital Anxiety and Depression Scale,(HAD), Cognitive Emotion Regulation Questionnaire,(CERQ), Dysfunctional Attitude Scale,(DAS)、Hamilton Anxiety Scale,(HAMA), Hamilton Depression Scale,(HAMD).Results:Significant differences were found in the use of Cognitive Emotion Regulation strategies between the three group (Wilks’ Lambda=0.79, P=0.001, Hotelling’s Trace=0.04, P=0.001).On the Self-blame, Positive Reappraisal, normative group reported significantly highest scores, hypertension with no depression group ranked second, and hypertension with depression group reported significantly lowest score. On Acceptance, Refocus on Planning factors, lower in hypertension with depression group than normative group and higher than hypertension with no depression group. On Rumination and Catastrophizing factors, lower in normative group than hypertension with depression group and higher than hypertension with no depression group. On Positive Refocusing, lower in normative group than hypertension with no depression group and higher than hypertension with depression group. On Putting into Perspective, lower in hypertension with depression group than hypertension with no depression group and higher than normative group. On the Blaming Others factor, lower in hypertension with no depression group than hypertension with depression group and higher than normative group. Significant differences were also found in the dysfunctional attitude between the three group.(Wilks’ Lambda=0.67, P=0.001, Hotelling’s Trace=0.05, P=0.001)A comparison among the two competitive models using SEM showed that the model-2was the optimal model, with better fit indexes than the others (X2/df (1.882), RMSEA (0.063), CFI (0.932), IFI (0.911), GFI (0.921)), and with the most parsimonious path(p<0.01).Conclusion:Patients of hypertension with depression more use Rumination, Catastrophizing and blame others et al negative Cognitive Emotion Regulation strategies and exists dysfunctional attitudes. Part3The effect of Antidepressant and Psychological Intervention on the Quality of Life and Blood Pressure of Hypertensive Patients with DepressionObjective:The effects of antidepressant and psychological intervention on the blood pressure and quality of life in hypertension patients with depression were investigatedMethods:After evaluating1400patients with essential hypertension by Hospital Anxiety and Depression Scale (HAD), patients with HAD positive result were evaluated with Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA). The subjects with positive results with HAMD were randomly divided into antidepressant and psychological intervention group (n=30, routine treatment, mental state intervention and the usage of antidepressant(seroxat)) and control group (n=30, only routine treatment).The effect of blood pressure control, the quality of life and the level of depression were compared between2groups.Results The depression symptoms were significantly improved in antidepressant and psychological intervention group compared to control group. The HAMD score fell from30.03±1.83at time of entrance to17.43±1.96at time of the study end; The blood pressure control were more effective with antidepressant and psychological intervention, The mean SBP and DBP decreased by26.17mmHg and13.63mmHg in antidepressant and psychological intervention group, while there were only14.32mmHg and7.18mmHg decrease in SBP and DBP respectively in control group; And the antidepressant and psychological intervention group have higher score quality of life. The total score of GQOLI-74has risen from65.97±4.68before treatment to71.20±5.13after treatment.Conclusion:The treatment of psychological intervention and usage of antidepressant could improve the control of blood pressure and quality of life in hypertensive patients.