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Background: Mental health problems has become a major public health issue among medical students. Self-esteem and psychological flexibility were important associated factors for mental health, but their relations have not been discussed in medical students. The present study aimed to assess the status of mental health problems among medical students and identified whether psychological flexibility had a mediating role in the effects of self-esteem on the top three most common psychological symptoms. Methods: A total of 810 undergraduate students from 18 classes comprised in the sample. Nine dimensions of psychological symptoms was assessed by the Symptom Checklist-90-revised (SCL-90-R). Self-esteem was measured by the Self-esteem Scale (SES) and psychological flexibility was evaluated by the Acceptance and Action Questionnaire 2nd Edition (AAQ-II) and Cognitive Fusion Questionnaire (CFQ-F). Univariate analysis and logistic regression analysis were used to determine the relationship among the top three common psychological symptoms, self-esteem, psychological flexibility, and participants' characteristics. The mediating effect of psychological flexibility between self-esteem and psychological symptoms was detected by bootstrap method. Results: 57.8% of the medical undergraduate students reported positive at least one of the nine psychological symptom dimensions assessed by the SCL-90-R and 13.8% of students had moderate or more severe symptoms. The symptoms of obsessive-compulsiveness, interpersonal sensitivity, and depression were the three most common psychological symptoms among the medical students. Meanwhile, self-esteem and psychological flexibility were negatively associated to the symptoms of obsessive-compulsiveness, interpersonal sensitivity, and depression. And, almost 50% effects of self-esteem on these three symptoms in medical students exert indirect effects through psychological flexibility. Conclusions: Psychological distress was quite common in the Chinese medical students. The three most common psychological symptoms were successively obsessive-compulsiveness, interpersonal sensitivity, and depression. Low self-esteem and psychological inflexibility might be the risk factors for these top three symptoms, and psychological flexibility might play a mediating role in the effects of self-esteem on these psychological symptoms.
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Objective@#To compare the difference of cognitive fusion, empirical avoidance between patients with obsessive-compulsive disorder and healthy control group, and to explore the relationship between obsessive-compulsive score and cognitive fusion, empirical avoidance.@*Methods@#The cognitive fusion questionnaire(CFQ), acceptance and action questionnaire-2nd edition(AAQ-II) and Yale-Brown scale for obsessive-compulsive symptoms (Y-BOCS) were used to investigate 100 subjects with obsessive-compulsive disorder (OCD) and 166 healthy controls.And the differences in cognitive fusion and empirical avoidance scores were compared between the two groups.The relationship of obsessive-compulsive symptoms and cognitive fusion, empirical avoidance was analyzed using multiple linear regression analysis.@*Results@#The scores of cognitive fusion ((49.89±10.62) vs (33.88±11.44), t=-11.345, P<0.01)and empirical avoidance ((29.75±9.53) vs (21.59±7.03), t=-7.995, P<0.01) in obsessive-compulsive disorder group were significantly higher than those in healthy control group.There were significant differences in cognitive fusion and empirical avoidance in age variables (F=8.63, P<0.01). In AAQ-Ⅱ, item 2 (r=0.246, P<0.05), item 6 (r=0.223, P<0.05) and total score (r=0.240, P<0.05) were positively correlated with the total score of Y-BOCS.Item 2 (r=0.311, P<0.01), item 3 (r=0.286, P<0.05), item 6 (r=0.248, P<0.05) and total score (r=0.229, P<0.05) were positively correlated with the scores of obsessive-thinking.In CFQ, item 2 (r=0.231, P<0.0) 5), item 4 (r=0.242, P<0.05), item 7 (r=0.308, P<0.05), item 8 (r=0.277, P<0.05) and item 9 (r=0.249, P<0.05) were positively correlated with the total score of Y-BOCS.Item 8 (r=0.261, P<0.05) was positively correlated with the scores of obsessive-thinking, item 7 (r=0.237, P<0.05) and item 9 (r=0.238, P<0.05) were positively correlated with scores of obsessive-compulsive behavior.When predicting total obsessive-compulsive scores, only CF item 7 of Q (B=1.827, P<0.01), item 3 (B=0.956, P<0.05), and item 6 of AAQ-Ⅱ (B=0.584, P<0.05) entered the equation with a joint explanatory variation of 19%.When predicting the score of obsessive-thinking, only item 2 of AAQ-Ⅱ (B=0.446, P<0.01) entered the equation, explaining the variance was 9.7%.In the prediction of obsessive-compulsive behavior, only item 9 (B=0.815, P<0.05) of CFQ entered the equation, and the explanatory variation was 5.6%.@*Conclusion@#Cognitive fusion in the patients with obsessive-compulsive disorder and the high level of empirical avoidance may be an important factor for the maintenance of the symptoms.
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Objective To compare the difference of cognitive fusion,empirical avoidance between patients with obsessive-compulsive disorder and healthy control group,and to explore the relationship between obsessive-compulsive score and cognitive fusion,empirical avoidance.Methods The cognitive fusion questionnaire(CFQ),acceptance and action questionnaire-2nd edition (AAQ-Ⅱ) and Yale-Brown scale for obsessive-compulsive symptoms (Y-BOCS) were used to investigate 100 subjects with obsessive-compulsive disorder (OCD) and 166 healthy controls.And the differences in cognitive fusion and empirical avoidance scores were compared between the two groups.The relationship of obsessive-compulsive symptoms and cognitive fusion,empirical avoidance was analyzed using multiple linear regression analysis.Results The scores of cognitive fusion ((49.89± 10.62) vs (33.88 ± 11.44),t =-11.345,P＜ 0.01) and empirical avoidance ((29.75±9.53) vs (21.59±7.03),t=-7.995,P＜0.01) in obsessive-compulsive disorder group were significantly higher than those in healthy control group.There were significant differences in cognitive fusion and empirical avoidance in age variables (F=8.63,P＜0.01).In AAQ-Ⅱ,item 2 (r=0.246,P＜ 0.05),item 6 (r=0.223,P＜0.05) and total score (r=0.240,P＜0.05) were positively correlated with the total score of Y-BOCS.Item 2 (r=0.311,P＜0.01),item 3 (r=0.286,P＜0.05),item 6 (r=0.248,P＜0.05) and total score (r=0.229,P＜0.05) were positively correlated with the scores of obsessive-thinking.In CFQ,item 2 (r=0.231,P＜0.0) 5),item 4 (r=0.242,P＜ 0.05),item 7 (r =0.308,P＜ 0.05),item 8 (r =0.277,P＜0.05) and item 9 (r=0.249,P＜0.05) were positively correlated with the total score of Y-BOCS.Item 8 (r=0.261,P＜0.05) was positively correlated with the scores of obsessive-thinking,item 7 (r=0.237,P＜0.05) and item 9 (r=0.238,P＜0.05) were positively correlated with scores of obsessive-compulsive behavior.When predicting total obsessive-compulsive scores,only CF item 7 of Q (B=1.827,P＜0.01),item 3 (B=0.956,P＜0.05),and item 6 of AAQ-Ⅱ (B=0.584,P＜0.05) entered the equation with a joint explanatory variation of 19％.When predicting the score of obsessive-thinking,only item 2 of AAQ-Ⅱ (B=0.446,P＜0.01) entered the equation,explaining the variance was 9.7％.In the prediction of obsessive-compulsive behavior,only item 9 (B=0.815,P＜0.05) of CFQ entered the equation,and the explanatory variation was 5.6％.Conclusion Cognitive fusion in the patients with obsessive-compulsive disorder and the high level of empirical avoidance may be an important factor for the maintenance of the symptoms.
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Objective:To explore the difference of cognitive fusion and empirical avoidance level between depression patients and normal people and the relationship between cognitive fusion and empirical avoidance and depression level in all subjects.Methods:Totally 124 patients with depression were selected from outpatients and hospitalized depressive patients in a hospital, and 99 normal participants were recruited online at the same time.The second edition of the Action Questionnaire (AAQ-II), Cognitive Fusion Scale (CFQ), Depression Self-Assessment Scale (SDS) were used to investigate cognitive fusion, empirical avoidance and depression.Results:The average scores of CFQ, AAO-II and SDS were higher in patients with depression than in the normal group (Ps＜0.01).Cognitive fusion scores and empirical avoidance scores could positively predict depression scores (β=0.40, 0.25, Ps＜0.05).Conclusion:The cognitive fusion level and experiential avoidance level are higher in patients with depression than in normal people.Cognitive fusion and empirical avoidance are positively correlated with depression level.
