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ENGLISH ABSTRACT
加强反刍思维在不同精神障碍中作用的理解
张倩倩
曾伶思
马墨涵
秦雪梅
欧雯雯
吕冠仪
王汨
廖梅
张丽
鞠玉朦
刘帮杉
柳进
张燕
作者及单位信息
·
DOI： 10.3760/cma.j.cn113661-20240112-00026
To enhance understanding of the role of rumination in different mental disorders
Zhang Qianqian
Zeng Lingsi
Ma Mohan
Qin Xuemei
Ou Wenwen
Lyu Guanyi
Wang Mi
Liao Mei
Zhang Li
Ju Yumeng
Liu Bangshan
Liu Jin
Zhang Yan
Authors Info & Affiliations
Zhang Qianqian
Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Hunan, Changsha 410011, China
Zeng Lingsi
Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Hunan, Changsha 410011, China
Ma Mohan
Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Hunan, Changsha 410011, China
Qin Xuemei
Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Hunan, Changsha 410011, China
Ou Wenwen
Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Hunan, Changsha 410011, China
Lyu Guanyi
Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Hunan, Changsha 410011, China
Wang Mi
Department of Clinical Psychology Center, Xiangya Hospital, Central South University, Changsha 410008, China
Liao Mei
Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Hunan, Changsha 410011, China
Zhang Li
Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Hunan, Changsha 410011, China
Ju Yumeng
Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Hunan, Changsha 410011, China
Liu Bangshan
Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Hunan, Changsha 410011, China
Liu Jin
Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Hunan, Changsha 410011, China
Zhang Yan
Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Hunan, Changsha 410011, China
·
DOI： 10.3760/cma.j.cn113661-20240112-00026
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摘要

反刍思维是一种在多种精神障碍中常见的病理性的习惯性思维模式，与抑郁、焦虑、创伤后应激和强迫障碍等精神障碍的症状严重程度、治疗结局和社会功能结局密切相关。近年来反刍思维成为了精神障碍临床诊疗关注的热点，但反刍思维的研究仍面临挑战，主要包括概念模糊、缺乏一致的评估工具、病理机制不明确以及缺乏有效的干预方法等。为增强对不同精神障碍反刍思维的理解，本文通过回顾国内外相关文献，概述介绍反刍思维的概念、评估、病理机制和干预手段，以期为反刍思维的临床诊疗提供借鉴和参考。

精神障碍;反刍思维;临床表征;量化工具;评估;机制;干预
ABSTRACT

Rumination is a pathological habitual thinking pattern commonly observed in various mental disorders. It is closely associated with the severity of symptoms, treatment outcomes, and social functioning outcomes in conditions such as depression, anxiety, post-traumatic stress disorder, and obsessive-compulsive disorder. In recent years, rumination has become a focal point in the clinical diagnosis and treatment of mental disorders. However, research on rumination still faces challenges, including conceptual ambiguity, lack of consistent assessment tools, unclear pathological mechanisms, and a shortage of effective intervention methods. This paper conducts a comprehensive review by examining relevant domestic and international literature to enhance our understanding of rumination across different mental disorders. The review encompasses the concepts, assessments, pathological mechanisms, and intervention methods of rumination, aiming to provide insights and references for the clinical diagnosis and treatment of rumination.

Mental disorders;Rumination;Clinical phenotype;Quantitative tools;Assessments;Pathological mechanisms;Intervention measures
Zhang Yan, Email: nc.defudabe.uscgnahz.nay
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引用本文

张倩倩,曾伶思,马墨涵,等. 加强反刍思维在不同精神障碍中作用的理解[J]. 中华精神科杂志,2024,57(08)：465-472.

DOI:10.3760/cma.j.cn113661-20240112-00026

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在临床实践中，经常观察到精神障碍患者不断地、难以自控地反复回想自己的失败、遗憾或对未来的担忧。这种持续且难以控制的思维模式被称为“反刍思维”或“思维反刍” ［ 1 ］ 。通常，反刍思维涉及对个人过去的经历、问题或情感进行反复思考，特别是对负面事件的持续回忆 ［ 2 ］ 。然而，值得注意的是，尽管反刍思维在很大程度上影响着精神障碍的发生和病程转归，但在临床实践中，往往忽视了对这类症状的充分评估。
研究表明，反刍思维是多种精神障碍共同的临床表征，影响疾病的发生、发展和治疗结局 ［ 3 ］ 。在抑郁症中，反刍思维通过加剧负面情绪、延长压力响应时间，以及妨碍有效问题解决能力，加重了精神病理状态 ［ 4 ］ 。同时，反刍思维独立于抑郁症状预测青少年发生自伤、自杀的风险 ［ 5 ］ 。在焦虑谱系障碍中，对潜在威胁和担忧的关注会增加焦虑症状的严重程度，从而加重易感人群的症状 ［ 6 ］ 。同样，容易出现反刍思维的人更有可能采取一些行为，如暴饮暴食或强迫性行为，以转移自己对反刍内容的注意力 ［ 3 ］ 。一些研究认为反刍思维和强迫思维是自发思维的不同表现形式，反刍思维的存在进一步加剧了强迫障碍患者的认知情感偏差和注意力分配困难，从而使强迫障碍的临床诊疗更加复杂 ［ 7 ］ 。
总的来说，反刍思维不仅是多种精神障碍共有的表征 ［ 1 ， 3 ］ ，也是这些精神障碍发展和治疗过程中的关键干预点。理解并应对反刍思维，对于提高多种精神障碍治疗效果、预防复发及减轻疾病负担至关重要 ［ 3 ］ 。然而，由于涉及的理论模型和评估工具存在多样性，临床实践中有效识别和干预反刍思维仍面临挑战。本文旨在回顾国内外相关文献，探讨反刍思维的概念、评估方法、潜在病理机制以及干预策略，以提供初步了解这一临床表征的基础，并为未来深入研究和临床实践提供参考。
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备注信息
A
张燕，Email： nc.defudabe.uscgnahz.nay
B
张倩倩, 曾伶思, 马墨涵, 等. 加强反刍思维在不同精神障碍中作用的理解[J]. 中华精神科杂志, 2024, 57(8): 465-472. DOI: 10.3760/cma.j.cn113661-20240112-00026.
C
所有作者声明无利益冲突
D
科技创新2030 (2021ZD0202000)
国家自然科学基金区域创新发展联合基金 (U23A20434)
国家自然科学基金 (82301738)
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