| Objective:Somatoform disorder is a relatively common refractory neurosis,which is more common in young people.The current etiology and pathogenesis are still unclear,and there is still no clear and effective cure in clinical practice.Studies in China have shown that there are also somatoform disorder in the college student,which seriously affects students' life and learning.At present,there are relatively few reports on the psychological intervention research on somatoform disorder of medical college students in China.Therefore,this study is the first to use Naikan Cognitive Therapy to intervene medical students of somatoform disorder,evaluate its intervention effect,and analyze the mechanism of the related psychosocial factors,aiming to improve the mental health problems of medical students,at the same time,providing a basis for reference for intervention of somatoform disorder.Methods:From March to April 2018,the somaticized self-rating scale(total score >36points)was screened in the undergraduate student group of Tianjin Medical University,and 66 college students who met the inclusion criteria and exclusion criteria were finally included.Randomized digital table method was used to randomly assign two groups,33 in the Naikan Cognitive Therapy group(NCT group)and 33 in the control group.The NCT group underwent a 7-day semi-centralized Naikan Cognitive Therapy intervention,and the control group conducted self-learning on mental health knowledge during the same time.All subjects(NCT group and control group)were evaluated at the time of enrollment and after intervention.The assessment tools included the Somatic Self-rating Scale(SSS),the Toronto Alexithymia Scale(TAS-20),the Irrational Belief Scale(IBS),the Self Consistency and Congruence Scale(SCCS),and the Simplified Coping Style Questionnaire(SCSQ).The intervention effect of NCT on somatoform disorder was investigated by comparing the scores of the NCT group and the control group before and after the intervention.Results:Due to the loss of 2 cases in the middle,the final results were 32 in the NCT group of 32(8 boys,24 girls),32 in the control group(10 boys,22 girls).Baseline assessment showed no significant difference between the two groups and the comparison between the evaluation indicators.(1)After intervention,the scores of SSS and the scores of the two groups were significantly lower than those of the control group,and the difference was statistically significant(P<0.01).Before and after intervention in the NCT group,the total scores of SSS and the scores of each factor were decreased,and the differences were statistically significant(P<0.01).There was no significant difference in the scores before and after the control group(P>0.05).The scores of SSS-S in the NCT group were significantly lower than those before the intervention,and the difference was statistically significant(P<0.01).(2)After the intervention,the total score of TAS-20 and the scores of the factors were significantly lower in the NCT group than in the control group,and the difference was statistically significant(P<0.01).Before and after the intervention in the NCT group,the TAS-20 total score and the scores of each factor were lower than the previous ones,and the difference was statistically significant(P<0.01).There was no significant difference in the scores before and after the control group(P>0.05).(3)After intervention,the total scores of IBS and the scores of the two groups were significantly lower than those of the control group,and the difference was statistically significant(P<0.01).Before and after intervention in the NCT group,the scores of IBS total scores and factors were lower than before,and the differences were statistically significant(P<0.01).There was no significant difference in the scores before and after the control group(P>0.05).(4)After intervention,the scores of SCCS and the scores of the two groups were significantly different between the two groups(P<0.01).Before and after the intervention in the NCT group,the SCCS total score,self-experience discord and self-stereotypic scores were reduced,and self-flexibility scores were increased,and the differences were statistically significant(P<0.01).There was no significant difference in the scores before and after the control group(P>0.05).(5)After the intervention,the scores of the SCSQ scales were compared between the two groups.The difference between the NCT group and thecontrol group was statistically significant(P<0.01).Compared with before and after intervention in the NCT group,the scores of positive coping styles increased earlier,and the scores of negative coping styles decreased compared with the previous ones,and the differences were statistically significant(P<0.01).There was no significant difference in the scores between the control group and the control group(P>0.05).(6)Correlation analysis: The total scores of SSS and the scores of each factor in the NCT group were positively correlated with the total scores and factor scores of some other scales;the difference between the SSS scores before and after the intervention in the NCT group and the total scores and factors of some other scales.The difference is positively correlated.(7)Analysis of mediating effects:NCT intervention can directly affect somatic symptoms.Affective disorder,irrational beliefs and self-harmony have multiple mediating effects between NCT intervention and somatic symptoms.The effects are 18.014%,17.730%,and 25.532%,respectively.Conclusions:(1)Naikan Cognitive Therapy can effectively improve the somatization symptoms of medical students with somatoform disorders and reduce the severity of somatization symptoms.(2)Naikan Cognitive Therapy can effectively improve the alexithymia of physical survival of somatoform disorders and help to improve their emotional and emotional expression.(3)Naikan Cognitive Therapy can effectively correct the irrational cognition of somatic disorder medical survival,making its concept ideas more objective and reasonable.(4)Naikan Cognitive Therapy can effectively promote the self-harmony of medical students with somatoform disorders,so that subjective and objective tend to be consistent.(5)Naikan Cognitive Therapy can enhance the positive coping style of medical students with somatoform disorders and reduce negative coping.(6)Factors influencing the intervention effect of Naikan Cognitive Therapy on physical form disorders: NCT has the problem of alexithymia,recognition and description of affective disorder,lack of fantasy,lack of rational cognition,face frustration and weakness,low self-harmony,The physical form of physical education,such as stereotypes,inflexibility,and negative attitudes,may be more effective.(7)Naikan Cognitive Therapy indirectly affects the somatic symptoms of medical students with somatoform disorders through individual alexithymia,irrational beliefs,and mediating effects of self-harmony.(8)Through the research of this subject,it is proved that Naikan Cognitive Therapy has significant effects in improving the somatization symptoms and adverse psychosocial factors of medical students with somatoform disorders,which is helpful to help college students to establish positive and healthy cognitive behaviors.Modes that regulate bad mood and promote healthy behavior.At the same time,the therapy can also be used as a reference for clinical intervention and prevention of somatoform disorders.In the future,it is necessary to expand the sample size,extend the follow-up time,and further observe the intervention effect of the endoscopic cognitive therapy on the somatoform disorders of different college students in different colleges and universities,as well as the long-term effect evaluation. |
PDF Full Text Request