Childhood Trauma,Attachment Status,Family Environment And EMDR Intervention In Depressive Patients With Social Anxiety Comorbidities

ObjectiveTo investigate the effects of childhood trauma,attachment style and family environment on patients with social anxiety disorder comorbidity depression,to explore the influencing factors of social anxiety disorder comorbidity depression,and to provide theoretical basis for preventing the occurrence of social anxiety disorder comorbidity depression.On the basis of this study,the effect of eye movement desensitization and reprocessing therapy(EMDR)focusing on psychological trauma treatment on social anxiety disorder comorbidities depression patients was discussed.Methods1.Patients with social anxiety comorbidity and depression disorder(n=231)who were admitted to the clinical psychology department of a third-class A hospital from June 2021 to December 2022 were conveniently selected as research objects.The Liebowitz Social Anxiety Scale(LSAS),Beck Depression Scale(BDI),Childhood Trauma Scale(CTQ-SF),Attachment Style Questionnaire(ASQ)and the Chinese version of Family Environment Scale(FES-CV)were used for questionnaire survey.According to LSAS scores,the patients were divided into three groups: mild,moderate and severe.Chi-square test and variance analysis were used to compare the differences in childhood trauma,family environment and attachment style among the three groups.Pearson correlation analysis and multiple linear regression were used to explore the relationship between childhood trauma,attachment style,family environment and social anxiety and depression.2.Thirty-four patients with social anxiety comorbid depression were selected and paired case control method was adopted.According to the severity of social anxiety,patients were paired one by one.The EMDR group received EMDR+ drug treatment,and the TAU group received drug treatment.LSAS,BDI and SCL-90 were evaluated before and after treatment in the two groups.Independent sample T-testand paired sample T-test were used to evaluate the evaluation results,and the therapeutic effects of the two groups of patients were compared.Results1.The questionnaire results showed that:(1)85.7% of the patients with social anxiety comorbity depression had childhood trauma experience.The positive rate of childhood trauma in the moderate group was higher than that in the severe group and the mild group,and the positive rate of emotional abuse in the severe group was higher than that in the moderate group and the mild group,and there was a statistical difference between the groups.(2)Social anxiety comorbidity depression patients with childhood trauma experience,attachment style,family environment are correlated.The LSAS and BDI scores of patients were positively correlated with the emotional and physical abuse dimensions of CTQ.It was positively correlated with avoidant attachment and anxious attachment,and negatively correlated with secure attachment.Patients’ LSAS and BDI scores were positively correlated with the contradiction dimension in FES-CV,and negatively correlated with the intimacy,recreation and organization dimension.Patients’ BDI scores were positively correlated with sexual abuse and physical neglect,and negatively correlated with EE.(3)Patients’ attachment style was correlated with childhood trauma experience and family environment: secure attachment was negatively correlated with emotional abuse and physical abuse in childhood trauma.Avoidant attachment and anxious attachment were positively correlated with emotional abuse,physical abuse and physical neglect of childhood trauma.Secure attachment is positively correlated with intimacy,emotional expression,entertainment and organization in family environment,but negatively correlated with contradiction dimension.Avoidant attachment and anxious attachment were negatively correlated with intimacy,entertainment and organization in the family environment.Avoidant attachment was also negatively correlated with emotional expression in the family environment,and anxious attachment was positively correlated with control in the family environment.The results showed that the less emotional abuse and physical abuse,the more likely the patients with family intimacy,emotional expression,entertainment,organization and contradiction were to form secure attachment.The more emotional abuse,physical abuse and physical neglect patients with poor intimacy,entertainment and organization with family environment,the more likely to form avoidant and anxious attachment.(4)Regression analysis showed that childhood trauma,attachment style and family environment had predictive effects on social anxiety comorbidity depression,while childhood trauma experience and family environmenthad predictive effects on attachment style.Emotional abuse in childhood trauma,avoidant attachment and anxious attachment can positively predict social anxiety,emotional abuse and anxious attachment can positively predict depression,and secure attachment and affective expression can negatively predict depression.2.EMDR intervention results show: There were no statistically significant differences in LSAS,BDI and SCL-90 scores between EMDR group and TAU group before intervention(P>0.05),but there were statistically significant differences in BDI scale scores,SCL-90 scale compulsion,depression,interpersonal relationship,psychosis and total score between the two groups after intervention(P < 0.05).Paired sample T-test results showed that the reduction rates of LSAS,BDI and SCL90 before and after intervention in EMDR group were statistically significant(P < 0.05).There was a statistically significant difference in the reduction rate of SCL-90 in TAU group before and after intervention,but no statistically significant difference in the reduction rate of LSAS and BDI scales.Conclusions1.Social anxiety comorbidity depression patients had a high incidence of childhood traumatic experience,and 85.7% experienced more than one traumatic experience.2.Childhood trauma,attachment style and family environment are correlated with social anxiety comorbidity depression,suggesting that doctors should consider the relationship between these three factors comprehensively to develop effective intervention measures for patients.3.The application of EMDR therapy in patients with social anxiety disorder comorbidities depression is effective.This study further enriched the theory of EMDR therapy in the treatment of other mental diseases except post-traumatic stress disorder,and provided a basis for the psychological treatment of patients with clinical social anxiety disorder comorbidities depression.