中国成人心理健康维护方法研究
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摘要
维护心理健康是当代中国成人实现心理和谐与幸福的重要内容。改革开放30多年来,中国在经济、政治、社会和文化方面发生了巨大的变化。在社会的发展变革中,中国成人无疑经历着诸多压力和考验,也面临着社会变迁等带来的心理问题。为了使人民生活得更加幸福,国家高度重视改善民生,促进社会和谐。在改善民生的同时,如何使人民的心理感受到幸祸,是一个值得研究的重要问题。本研究的目的就是从中国广大民众创造的心理健康维护方法中,寻找那些能够有效促进幸福感的方法,为全面建设小康社会服务。
     通过文献综述,本研究将心理健康界定为一种幸福进取的良好状态。把心理健康维护方法界定为个人在生活中为了促使自己达到一种幸福进取的良好状态而采取的方法。通过10个分研究,较完整地考察了日常生活中有益于我国正常成人维护心理健康的方法,并分析了影响这些方法的因素。
     研究1采用深度访谈法搜集了76名成人报告的心理健康维护方法,并对访谈结果进行内容分析以初步检验心理健康维护方法的类型。研究2在研究1的基础上,通过两次预测编制了《心理健康维护方法问卷》。正式施测采取分层整群抽样的方法,对云南、重庆、陕西、湖北、北京、广东等六个地区的20岁至60岁以上的2250名成人进行调查。共回收有效问卷2021份,问卷有效率为89.92%。正式施测结果表明该问卷有较好的信效度。为了深入研究影响心理健康维护方法的因素,研究3提出了心理健康信念的概念,采用深度访谈和开放式问卷调查初步探讨了心理健康信念包含的因素。研究4在研究3的基础之上,通过两次预测编制了《心理健康信念问卷》,正式施测结果说明该问卷有较好的信效度。为了评估心理健康维护方法与心理健康的关系,研究5修订了美国心理学家Keyes的心理健康连续简表(MHC-SF)。信度分析与验证性因素分析结果说明,MHC-SF中文版可以适用于评估中国成人的心理健康状况。研究6考察了中国成人的性别、年龄、地域、所属单位、收入、受教育程度等人口学变量与心理健康维护方法的关系;研究7考察了心理健康信念与心理健康维护方法的关系;研究8根据Keyes对心理健康状况的分类标准,将MHC-SF得分不同的成人分为振作向上者、中等心理健康水平者和颓废萎靡者三类,考察了这三类成人在心理健康维护方法上存在的差异。研究9依据社会心理学关于信念与行为关系的理论,不限定心理健康维护方法与心理健康信念之间的因果关系,采用将心理健康维护方法作为自变量,信念作为中介变量,或将心理健康信念作为自变量,方法作为中介变量的方式,建立了6个假设模型以较全面地考察心理健康维护方法、心理健康信念与心理健康状况/抑郁状况的关系。研究10在黄希庭提出的“幸福进取者”概念的基础上,以进一步检验研究9获得的结论为目的,在前期的深度访谈对象中,选择报告了丰富信息的5名幸福进取者与3名不幸者。通过对比性个案研究,对幸福进取者与不幸者两类个案报告的心理健康维护方法、心理健康信念、心理健康状况/负面情绪状况的关系进行了分析。
     10个分研究的结果表明:
     (1)中国成人的心理健康维护方法主要有建立压力应对资源、自立自强和调节心态的方法三类。这三类方法义分为九种子方法,其中,建立压力应对资源的方法包括建立身体资源、家人资源、朋友资源、动力资源的方法;自立自强的方法包括成就个人、贡献社会的方法;调节心态的方法包括调节对情绪的心态、调节对困难的心态、调节对能力的心态的方法。
     (2)中国成人整体使用心理健康维护方法的频率稍高,介于有时使用与经常使用之间。三类方法中,使用最多的是调节心态的方法。九种子方法中,使用最多的是建立家人资源的方法,其次是成就个人的方法,使用最少的是建立身体资源的方法。
     (3)中国成人的心理健康信念水平影响其心理健康维护方法的使用频率,心理健康信念越积极的成人,使用各种心理健康维护方法的频率越高。九种子方法都受到心理健康信念的较大影响。其中,受影响最大的是“调节对能力的心态的方法”,其次是“成就个人的方法’而“建立朋友资源的方法”受影响程度排在最后。
     (4)中国成人心理健康状况越佳者,越多的使用各类心理健康维护方法。振作向上者经常使用这些方法、中等心理健康者有时使用这些方法,而颓废萎靡者很少使用这些方法。
     (5)中国成人所使用的心理健康维护方法对他们的心理健康不仅有直接回归效应,同时还通过心理健康信念的部分中介作用影响心理健康。而心理健康维护方法对抑郁的影响是完全中介效应,中国成人所使用的心理健康维护方法需要通过心理健康信念才能发挥降低抑郁的作用。
     (6)幸福进取者表现出高水平的心理健康信念,最常用“建立动力资源”、“建立朋友资源”、“成就个人”、“贡献社会”等方法促进心理健康。幸福进取者使用的心理健康维护方法对其心理健康有着重要的直接影响,而对其负面情绪的影响主要是通过心理健康信念这一中介变量发挥作用的。不幸者表现出低水平的心理健康信念,采取向他人提要求、幻想、哭、封闭自我、忍让等方法解决心理困扰问题;基本上缺乏促进心理健康的方法。
     本研究在理论和方法上有所创新。在理论方面,认为个人对心理健康的维护并不是一个暂时性的、被动应对压力的过程,而是一个长期的、主动的、重在改善的过程,尝试采取不同于压力应对研究的思路来研究成人的心理健康维护问题。提出心理健康维护方法的概念,提出并验证了由建立压力应对资源的方法、自立自强的方法和调节心态的方法这三类方法所构成的心理健康维护方法具有增进成人心理健康的作用;界定了心理健康信念的定义,提出并验证了心理健康维护方法、心理健康信念与心理健康状况/抑郁状况之间存在多种关系等。在方法上,本研究重视理论研究与实证研究的结合,重视质性研究与量化研究的结合。10个分研究采用质性研究与量化研究的混合研究设计,从质性研究到量化研究、再到质性研究,力图达到全面、系统、深入地研究中国成人心理健康维护方法的目的。另外,本研究引入效果量指标检验变量的统计显著性差异是否具有实际意义;采用结构方程模型考察心理健康维护方法与心理健康信念、心理健康状况之间的关系,这些都为本研究的科学性和严谨性提供了一定的保证。
     在应用价值方面,本研究为心理健康教育提供了一些有益的理论和实证支持,可用于指导成人的心理健康教育,也能应用于成人心理健康的自我维护。
     心理健康维护方法是一个系统,对它的研究应该是多角度的。本研究主要从个人实现幸福进取这一角度探讨了维护心理健康的方法,今后需要从其它角度开展研究,以掌握更多种类的心理健康维护方法。此外,影响心理健康维护方法的因素很多,本研究主要考察了心理健康信念、性别、年龄等人口学变量对心理健康维护方法的影响。未来的研究可以考虑引入其他变量,比如人格、生活事件、人际交往等,以更好的考察影响成人使用心理健康维护方法的因素,并探讨这些因素与心理健康维护方法对心理健康的作用路径。
Mental health maintenance is an important issue for Chinese adults on psychological harmony and well-being. After implementing the reform and opening-up policy over 30 years, China has great changes on economy, politics, society, culture and other fields. During the whole innovation, it is undoubtedly that Chinese adults have undergone lots of pressures and challenges. In order to getting people into a happier life, the government attaches great importance to improving people's livelihood and promoting social harmony. It is deserved to study on how to make people feel happy due to the happy feeling not necessarily accompanied by their livelihood improving. Chinese people create lots of mental health maintenance methods in their daily life, and some of them could help people to promote their mental well being effectively. The purpose of this study is explore these effectively approaches which could promote people's mental well being to serve for China to bring out moderate prosperity in all-round way.
     At first, the study determined a definition for mental health and the process of mental health maintenance by reviewing related literatures. Mental health is defined as an enterprising states of well-being in which individual promote positive emotional feeling initiatively, improve quality of life constantly, and work effectively. The process of mental health maintenance refers the methods which individuals employ to bring out such enterprising states. The study investigates the process of mental health maintenance in normal Chinese adults and analyzes the factors which have influence on maintaining mental health with ten studies.
     In-depth interviews was used on interviewing 76 adults to get the mental health maintenance process, and analysis the results of in-depth interview to test the types of mental health maintenance process preliminarily in study 1. Based on the research on study 1, we compiled the scale of mental health maintenance process by two pretests in study 2. Stratified cluster sampling was taken to investigate adults from 20 years old to upwards 60 years old from Yunnan, Chongqing, Shanxi, Hubei, Being and Guangdong, and retake valid questionnaires 2021 in formal test, in which the effective rate of questionnaires is 89.92%. The results from formal test show that the scale of mental health maintenance process works good in internality reliability and validity. In order to intensive study the impact factors of mental health maintenance process, in study 3 a definition was made to determine what mental health belief is, in-depth interview and open questionnaire were taken to discuss the factors which are involved in the definition of mental health belief. In study 4 we compiled scale on mental health belief with two pretests according to the result from study 3. The result of formal test shows that the scale of mental health belief is good in internality reliability and validity. For the purpose of analyzing the relationship between process of mental health maintenance and mental health, we revised the mental health continuum short form (NHC-SF), which compiled by Keyes, a US psychologist in study 5. MCH-SF was translated to Chinese and applied to a sample of 1981 adults. Factor analysis revealed that MHC-SF replicated the three-factor structure of emotional, psychological and social well-being found in US samples, and the MHC-SF Scale is good in internal reliability. MHC-SF China is applicable to estimate mental health state of Chinese adults. It was discussed that the relationship between mental health maintenance process and demographic variables such as gender, age, area, work unit, income and schooling in study 6. The relationship between mental health belief with mental health maintenance process was discussed in study 7. According to diagnostic condition of MCH-SF, in study 81981 adults were classified to three groups:flourishing, moderately mentally healthy, and languishing, and the difference on the process of mental health maintenance among three groups were discussed. Depending on the social psychological theory on the relationship between belief and behavior, in study 9 without the limitation of causality between mental health maintenance process and mental belief, six hypothesis models were built to explore the relationship of mental health maintenance process and mental health belief to mental health state / depress state by taking mental health maintenance process as independent variable and mental health belief as mediating variable or in turn the position of two factors. We checked the results from study 9 by running intensive test in study 10 based on the concept happy enterprising individual which proposed by Xiting Huang, and five happy enterprising individuals,3 unhappy individuals from in-depth interviewees of study 1 were chosen in study 10. The informant about the relationship between happy and unhappy enterprising individuals on mental health maintenance process, mental health belief and state of mental health/states of negative emotion was analyzed by comparative case study.
     The result from ten studies shows:
     (1) Mental health maintenance process of Chinese adults involves process of building coping resources, strengthening self, and adjusting attitude. Three processes consist of nine sub processes. Building coping resources process consists of building body power resources, building family resources, building friend resources, and building power resources. Strengthening self process consists of individual growing up and contributing to society. Adjusting attitude process consists of adjusting attitude to deal with emotion, adjusting attitude to handle difficulty, adjusting attitude to improve ability.
     (2) It is in slight higher frequency the whole process of mental health maintenance was employed by Chinese adults, and the frequency of employment is between'sometimes’and'often'. The most employed process is adjusting attitude process. For nine sub processes, the process of building family resource was employed most frequently and the second most employed processes was growing up individual process, however building body power resource was rarely employed.
     (3) Mental health belief has significant impact on mental health maintenance process, the more positive mental health belief adults hold, the more frequently they used mental health maintenance methods. Nine processes are subjected to great impact on mental health belief. The first two methods which were influenced by mental health belief is adjusting ability attitude and growth up individuals, and building friendship resource got least impact from mental health belief.
     (4) In population of Chinese adults, the better they are on mental health, the more frequently they employ mental health maintenance processes. Specially, these methods were most frequently employed by flourishing adults, mentally healthy adults employ these methods in moderately frequency, and languishing adults are those who rarely use these methods.
     (5) Mental health maintenance process not only has direct impacts on adults'mental health state, but also these impacts throw their shadow on mental health belief, which eventually has impact on mental health state. However, the influence of mental health maintenance process on depress is full mediator effects, in other words, mental health belief fully mediated the relationship between mental health maintenance process and depress.
     (6) Happy enterprising individuals who possess excellent mental health belief employed processes to promote mental health, such as building power resource, building friendship resource process, growing up individual, and contributing to society. The mental health maintenance process that used by happy enterprising individuals has great direct impact to improve their mental health, and its impact on negative emotion is shown by mental health belief. Unhappy individuals possess bad mental health belief, they always employ processed to cope with psychological distress, such as asking other to do something, bubbling, crying, tolerating, and closing self, they were in deficiency of promoting mental health methods.
     There are some innovations in the theory and methodology. In theory, the study refers mental health maintenance as an enduring and initiative course that improve individual's mental health, rather than a temporary and passive course for copying pressure. In this opinion, the study explored the issue about adults'mental health maintenance. Mental health maintenance process and its three type methods, such as building copying resource, strengthening self process, and adjusting attitude process, are identified and tested, and the positive impaction of three type methods on mental health are verified effectively. Moreover, the mental health belief was identified, and the multiple relations among mental health maintenance process, mental health belief, and mental health state/depress state were verified. In methodology, the study integrated theoretical researches with empirical studies, and integrates qualitative researches with quantitative researches. Ten studies were employed to explore the process of mental health maintenance on Chinese adults with the qualitative and quantitative mixed research designs, such as running study from qualitative research to quantitative research, and then going back to qualitative research, in order to work out this issue comprehensive, systematical, and in-depth. Furthermore, effect size index was employed in the study to test whether significant difference between variables in statistic is also significant in practice, and structural equation model was employed to test the relationship among mental health maintenance process, mental health belief and mental health state.
     In value of application, the present study provides some useful theoretical and empirical support for mental health education, which could be used to guide mental health education for adults, and also applied to mental health self-rotecting.
     Mental health maintenance process is a system, so it should be tested from various views in future study. In present study mental health maintenance process was mainly discussed on happy enterprising, it should be need to test it from different view in future, in order to take a look into any other types of it. Furthermore, in present study we tested the relationship among mental health maintenance process, mental health belief, demographic variables such as gender, age and so on. In future studies more influence factors such as personality, life event, and personal interaction should be introduced, and the relation of these factors with mental health should be involved into analysis.
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