青少年抑郁情绪与心理弹性、家庭环境因素的关联
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摘要
目的探讨青少年抑郁情绪与家庭环境因素、心理弹性之间的关系。方法采用整群抽样法,选取2014年12月～2016年7月河南省新乡市3230名初高中生进行一般社会资料问卷、Kutcher青少年抑郁量表(11项)、家庭环境量表中文版(FES-CV)、中文版心理弹性量表(CD-RISC)评估。测评后,比较不同性别、年龄等的抑郁情绪差异;比较有抑郁情绪组与无抑郁情绪组CD-RISC评分、心理弹性的差异;对差异有统计学意义的因子进一步采用二分类Logistic回归分析研究心理弹性、家庭环境因素与青少年抑郁的关联。结果有效问卷为2960份,有抑郁情绪者659名(22.7%),其中男221名(20.0%),女483名(24.3%);母亲外出工作的家庭中有107名青少年(28.3%)有抑郁情绪,明显高于父亲外出的家庭(24.2%)。有抑郁情绪组与无抑郁情绪组的心理弹性(Z=-12.032)、忍受消极情感(Z=-9.677)、面对困难的能力(Z=-12.860)、接受变化(Z=-11.025)和控制方面(Z=-11.514)比较,差异均有统计学意义(P <0.05),且有抑郁情绪组明显低于无抑郁情绪组(P <0.05)。心理弹性(OR:0.967,95%CI:0.961～0.973)、控制力(OR:0.671,95%CI:0.604～0.745)、接受变化能力(OR:0.725,95%CI:0.659～0.796)、面对困难的能力(OR:0.720,95%CI:0.667～0.778)、忍受消极情绪(OR:0.804,95%CI:0.734～0.880)分值低,会增加抑郁症的危险。控制年龄和性别因素后,情感表达(OR:0.928,95%CI:0.869～0.990)、组织性(OR:0.886,95%CI:0.833～0.942)、娱乐性(OR:0.932,95%CI:0.887～0.980)、亲密度(OR:0.839,95%CI:0.788～0.839)越低,抑郁情绪明显;独立性(OR:1.075, 95%CI:1.010～1.114)和控制性分值(OR:1.143,95%CI:1.081～1.208)越高,抑郁情绪越明显。结论青少年抑郁情绪与心理弹性如忍受消极情绪和接受变化低有明显关联。情感表达低,家庭亲密度低是青少年抑郁的风险因素。控制性增高增加了抑郁情绪风险。
Objective To explore the relationship between adolescent depressive and family environment factors and mental resilience. Methods A cluster sampling method was used to select 3230 junior high school students from Xinxiang City, He′nan Province from December 2014 to July 2016 for general social data questionnaire, Kutcher Adolescent Depression Scale(11 items), and Family Environment Scale Chinese version(FES-CV), Chinese version of the Mental Resilience Scale(CD-RISC) assessment. After the evaluation, the differences in depression and emotions of different genders and ages were compared. The differences of CD-RISC scores and psychological elasticity between the depression group and the non-depression group were compared. Factors with statistically significant differerces were further analyzed by binary Logistic regression to study the relationship between resilient family environment factors and adolescent depression. Results There were 2 960 valid questionnaires, 659(22.7%) with depression, including 221 males(20.0%) and 483 females(24.3%). 107 adolescents(28.3%) with mothers working out had depression, which was significantly higher than those with fathers(24.2%). There were significant differences in resilience(Z = 12.032), tolerance of negative emotions(Z = 9.677), ability to face difficulties(Z = 12.860), acceptance of changes(Z = 11.025) and control(Z = 11.514) between the depressive group and the non-depressive group(P < 0.05), and the depressive group was significantly lower than the non-depressive group(P <0.05). Low scores of resilience(OR: 0.967, 95%CI: 0.961-0.973), control(OR: 0.671, 95%CI: 0.604-0.745), acceptance of change(OR: 0.725, 95%CI: 0.659-0.796),ability to face difficulties(OR: 0.720, 95%CI: 0.667-0.778), tolerance of negative emotions(OR: 0.804, 95%CI: 0.734-0.880) increase the risk of depression. After controlling for age and gender factors, the lower the emotional expression(OR: 0.928, 95%CI: 0.869-0.990), organization(OR: 0.886, 95%CI: 0.833-0.942), and entertainment(OR: 0.932, 95%CI: 0.887-0.980), intimacy(OR: 0.839, 95%CI: 0.788-0.839), the depression was more obvious; the higher the scores of independence(OR: 1.075, 95%CI: 1.010-1.114) and control(OR: 1.143, 95%CI: 1.081-1.208), the more obvious depression. Conclusion There is a significant correlation between adolescent depression and resilience, such as low tolerance of negative emotions and low acceptance changes. Low emotional expression and family intimacy are risk factors for depression in adolescents. Controlled increases increase increases the risk of depression.
Objective To explore the relationship between adolescent depressive and family environment factors and mental resilience. Methods A cluster sampling method was used to select 3230 junior high school students from Xinxiang City, He′nan Province from December 2014 to July 2016 for general social data questionnaire, Kutcher Adolescent Depression Scale(11 items), and Family Environment Scale Chinese version(FES-CV), Chinese version of the Mental Resilience Scale(CD-RISC) assessment. After the evaluation, the differences in depression and emotions of different genders and ages were compared. The differences of CD-RISC scores and psychological elasticity between the depression group and the non-depression group were compared. Factors with statistically significant differerces were further analyzed by binary Logistic regression to study the relationship between resilient family environment factors and adolescent depression. Results There were 2 960 valid questionnaires, 659(22.7%) with depression, including 221 males(20.0%) and 483 females(24.3%). 107 adolescents(28.3%) with mothers working out had depression, which was significantly higher than those with fathers(24.2%). There were significant differences in resilience(Z = 12.032), tolerance of negative emotions(Z = 9.677), ability to face difficulties(Z = 12.860), acceptance of changes(Z = 11.025) and control(Z = 11.514) between the depressive group and the non-depressive group(P < 0.05), and the depressive group was significantly lower than the non-depressive group(P <0.05). Low scores of resilience(OR: 0.967, 95%CI: 0.961-0.973), control(OR: 0.671, 95%CI: 0.604-0.745), acceptance of change(OR: 0.725, 95%CI: 0.659-0.796),ability to face difficulties(OR: 0.720, 95%CI: 0.667-0.778), tolerance of negative emotions(OR: 0.804, 95%CI: 0.734-0.880) increase the risk of depression. After controlling for age and gender factors, the lower the emotional expression(OR: 0.928, 95%CI: 0.869-0.990), organization(OR: 0.886, 95%CI: 0.833-0.942), and entertainment(OR: 0.932, 95%CI: 0.887-0.980), intimacy(OR: 0.839, 95%CI: 0.788-0.839), the depression was more obvious; the higher the scores of independence(OR: 1.075, 95%CI: 1.010-1.114) and control(OR: 1.143, 95%CI: 1.081-1.208), the more obvious depression. Conclusion There is a significant correlation between adolescent depression and resilience, such as low tolerance of negative emotions and low acceptance changes. Low emotional expression and family intimacy are risk factors for depression in adolescents. Controlled increases increase increases the risk of depression.
引文
[1]Xu DD,Rao WW,Cao XL,et al. Prevalence of major depressive disorder in children and adolescents in china:A systematic review and meta-analysis[J]. J Affect Disord,2018,241:592-598.
[2]Whitney DG,Shapiro DN,Warschausky SA,et al. The contribution of neurologic disorders to the national prevalence of depression and anxiety problems among children and adolescents[J]. Ann Epidemiol,2018,29:81-84.
[3]Kostev K,Teichgraber F,Konrad M,et al. Association between chronic somatic conditions and depression in children and adolescents:A retrospective study of 13 326 patients[J]. J Affect Disord,2018,245:697-701.
[4]Tang X,Tang S,Ren Z,et al. Prevalence of depressive symptoms among adolescents in secondary school in mainland china:A systematic review and meta-analysis[J]. J Affect Disord,2018,245:498-507.
[5]Li ZZ,Li YM,Lei XY,et al. Prevalence of suicidal ideation in chinese college students:A meta-analysis[J]. PLoS One,2014,9(10):e104368.
[6]Boden JM,Foulds JA. Major depression and alcohol use disorder in adolescence:Does comorbidity lead to poorer outcomes of depression?[J]J Affect Disord,2016,206:287-293.
[7]McCabe BE,Lai BS,Gonzalez-Guarda RM,et al. Childhood abuse and adulthood ipv,depression,and high-risk drinking in latinas[J]. Issues Ment Health Nurs,2018:39(12):1004-1009.
[8]Fincham DS,Altes LK,Stein DJ,et al. Posttraumatic stress disorder symptoms in adolescents:Risk factors versus resilience moderation[J]. Compr Psychiatry,2009,50(3):193-199.
[9]Davydov DM,Stewart R,Ritchie K,et al. Resilience and mental health[J]. Clin Psychol Rev,2010,30(5):479-495.
[10]朱清,范方,郑裕鸿,等.心理弹性在负性生活事件和抑郁症状之间的中介和调节:以汶川地震后的青少年为例[J].中国临床心理学杂志,2012,20(4):514-517.
[11]屈坚定,高伟娜,余星池.中国青少年自杀意念[J].青年研究,2002(6):44-49.
[12]费立鹏,沈其杰,郑延平,等.“家庭亲密度和适应性量表”和“家庭环境量表”的初步评价——正常家庭与精神分裂症家庭成员对照研究[J].中国心理卫生杂志,1991(5):198-202.
[13]周慧鸣,郝楠,杜亚松,等.中文版kutcher青少年抑郁量表测评青少年样本的效度与信度[J].中国心理卫生杂志,2015,29(6):413-418.
[14]Connor KM,Davidson JR. Development of a new resilience scale:The connor-davidson resilience scale(cdrisc)[J]. Depress Anxiety,2003,18(2):76-82.
[15]Wu L,Tan Y,Liu Y. Factor structure and psychometric evaluation of the connor-davidson resilience scale in a new employee population of China[J]. BMC Psychiatry,2017,17(1):49.
[16]Hankin BL,Abramson LY. Development of gender differences in depression:An elaborated cognitive vulnerability-transactional stress theory[J]. Psychol Bull,2001,127(6):773-796.
[17]Salk RH,Hyde JS,Abramson LY. Gender differences in depression in representative national samples:Metaanalyses of diagnoses and symptoms[J]. Psychol Bull,2017,143(8):783-822.
[18]Skrove M,Romundstad P,Indredavik MS. Resilience,lifestyle and symptoms of anxiety and depression in adolescence:The young-hunt study[J]. Soc Psychiatry Psychiatr Epidemiol,2013,48(3):407-416.
[19]Anyan F,Hjemdal O. Adolescent stress and symptoms of anxiety and depression:Resilience explains and differentiates the relationships[J]. J Affect Disord,2016,203:213-220.
[20]胡潇林,李晓燕,郭海英,等.流动儿童心理弹性潜在类别及内外化问题比较[J].中国临床心理学杂志,2017,25(3):507-511.
[21]宋丽萍,白雪姣,王梦娇,等.成年早期抑郁障碍患者心理弹性与情绪智力和自动思维的关系[J].中国健康心理学杂志,2017,25(2):188-191.
[22]孙莉,谢红涛,王琦,等.青少年抑郁情绪与健康危险行为、家庭功能的相关性分析[J].临床心身疾病杂志,2014(z1):138-139.
[23]吕婧,曹建琴,才运江,等.家庭环境及应对方式对大一新生焦虑、抑郁情绪的影响[J].神经疾病与精神卫生,2018,18(9):632-636.
[24]Dittrich K,Fuchs A,Bermpohl F,et al. Effects of maternal history of depression and early life maltreatment on children′s health-related quality of life[J]. J Affect Disord,2018,225:280-288.
[25]Yap MB,Jorm AF. Parental factors associated with childhood anxiety,depression,and internalizing problems:A systematic review and meta-analysis[J]. J Affect Disord,2015,175:424-440.
[26]孙丽萍,鞠佳雯,蒋柳青,等.父母心理控制与青少年焦虑的关系:一项交叉滞后研究[J].心理发展与教育,2018,34(6):758-768.
[27]孙丽萍,田微微,边玉芳.父母心理控制的发展趋势及青少年抑郁、焦虑的影响:一项三年追踪研究[J].中国临床心理学杂志,2018,26(4):730-735.
[28]Cummings EM,Koss KJ,Davies PT. Prospective relations between family conflict and adolescent maladjustment:Security in the family system as a mediating process[J].J Abnorm Child Psychol,2015,43(3):503-515.
[29]Peltonen K,Kangaslampi S. Treating children and adolescents with multiple traumas:A randomized clinical trial of narrative exposure therapy[J]. Eur J Psychotraumatol,2019,10(1):1558708.
[2]Whitney DG,Shapiro DN,Warschausky SA,et al. The contribution of neurologic disorders to the national prevalence of depression and anxiety problems among children and adolescents[J]. Ann Epidemiol,2018,29:81-84.
[3]Kostev K,Teichgraber F,Konrad M,et al. Association between chronic somatic conditions and depression in children and adolescents:A retrospective study of 13 326 patients[J]. J Affect Disord,2018,245:697-701.
[4]Tang X,Tang S,Ren Z,et al. Prevalence of depressive symptoms among adolescents in secondary school in mainland china:A systematic review and meta-analysis[J]. J Affect Disord,2018,245:498-507.
[5]Li ZZ,Li YM,Lei XY,et al. Prevalence of suicidal ideation in chinese college students:A meta-analysis[J]. PLoS One,2014,9(10):e104368.
[6]Boden JM,Foulds JA. Major depression and alcohol use disorder in adolescence:Does comorbidity lead to poorer outcomes of depression?[J]J Affect Disord,2016,206:287-293.
[7]McCabe BE,Lai BS,Gonzalez-Guarda RM,et al. Childhood abuse and adulthood ipv,depression,and high-risk drinking in latinas[J]. Issues Ment Health Nurs,2018:39(12):1004-1009.
[8]Fincham DS,Altes LK,Stein DJ,et al. Posttraumatic stress disorder symptoms in adolescents:Risk factors versus resilience moderation[J]. Compr Psychiatry,2009,50(3):193-199.
[9]Davydov DM,Stewart R,Ritchie K,et al. Resilience and mental health[J]. Clin Psychol Rev,2010,30(5):479-495.
[10]朱清,范方,郑裕鸿,等.心理弹性在负性生活事件和抑郁症状之间的中介和调节:以汶川地震后的青少年为例[J].中国临床心理学杂志,2012,20(4):514-517.
[11]屈坚定,高伟娜,余星池.中国青少年自杀意念[J].青年研究,2002(6):44-49.
[12]费立鹏,沈其杰,郑延平,等.“家庭亲密度和适应性量表”和“家庭环境量表”的初步评价——正常家庭与精神分裂症家庭成员对照研究[J].中国心理卫生杂志,1991(5):198-202.
[13]周慧鸣,郝楠,杜亚松,等.中文版kutcher青少年抑郁量表测评青少年样本的效度与信度[J].中国心理卫生杂志,2015,29(6):413-418.
[14]Connor KM,Davidson JR. Development of a new resilience scale:The connor-davidson resilience scale(cdrisc)[J]. Depress Anxiety,2003,18(2):76-82.
[15]Wu L,Tan Y,Liu Y. Factor structure and psychometric evaluation of the connor-davidson resilience scale in a new employee population of China[J]. BMC Psychiatry,2017,17(1):49.
[16]Hankin BL,Abramson LY. Development of gender differences in depression:An elaborated cognitive vulnerability-transactional stress theory[J]. Psychol Bull,2001,127(6):773-796.
[17]Salk RH,Hyde JS,Abramson LY. Gender differences in depression in representative national samples:Metaanalyses of diagnoses and symptoms[J]. Psychol Bull,2017,143(8):783-822.
[18]Skrove M,Romundstad P,Indredavik MS. Resilience,lifestyle and symptoms of anxiety and depression in adolescence:The young-hunt study[J]. Soc Psychiatry Psychiatr Epidemiol,2013,48(3):407-416.
[19]Anyan F,Hjemdal O. Adolescent stress and symptoms of anxiety and depression:Resilience explains and differentiates the relationships[J]. J Affect Disord,2016,203:213-220.
[20]胡潇林,李晓燕,郭海英,等.流动儿童心理弹性潜在类别及内外化问题比较[J].中国临床心理学杂志,2017,25(3):507-511.
[21]宋丽萍,白雪姣,王梦娇,等.成年早期抑郁障碍患者心理弹性与情绪智力和自动思维的关系[J].中国健康心理学杂志,2017,25(2):188-191.
[22]孙莉,谢红涛,王琦,等.青少年抑郁情绪与健康危险行为、家庭功能的相关性分析[J].临床心身疾病杂志,2014(z1):138-139.
[23]吕婧,曹建琴,才运江,等.家庭环境及应对方式对大一新生焦虑、抑郁情绪的影响[J].神经疾病与精神卫生,2018,18(9):632-636.
[24]Dittrich K,Fuchs A,Bermpohl F,et al. Effects of maternal history of depression and early life maltreatment on children′s health-related quality of life[J]. J Affect Disord,2018,225:280-288.
[25]Yap MB,Jorm AF. Parental factors associated with childhood anxiety,depression,and internalizing problems:A systematic review and meta-analysis[J]. J Affect Disord,2015,175:424-440.
[26]孙丽萍,鞠佳雯,蒋柳青,等.父母心理控制与青少年焦虑的关系:一项交叉滞后研究[J].心理发展与教育,2018,34(6):758-768.
[27]孙丽萍,田微微,边玉芳.父母心理控制的发展趋势及青少年抑郁、焦虑的影响:一项三年追踪研究[J].中国临床心理学杂志,2018,26(4):730-735.
[28]Cummings EM,Koss KJ,Davies PT. Prospective relations between family conflict and adolescent maladjustment:Security in the family system as a mediating process[J].J Abnorm Child Psychol,2015,43(3):503-515.
[29]Peltonen K,Kangaslampi S. Treating children and adolescents with multiple traumas:A randomized clinical trial of narrative exposure therapy[J]. Eur J Psychotraumatol,2019,10(1):1558708.