儿童抑郁症状应激—认知易感模型的追踪研究
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摘要
目的：(1)探寻儿童抑郁症状的年龄和性别特征；(2)在国内儿童样本中检验Beck抑郁理论及抑郁绝望理论应激-认知易感假设的调节模式；(3)在国内儿童样本中检验Beck抑郁理论及抑郁绝望理论应激-认知易感假设的中介模式；(4)在国内儿童样本中探寻Beck抑郁理论与抑郁绝望理论认知易感因素整合对应激事件水平和抑郁症状关系的影响机制。
方法：采用儿童抑郁量表(CDI)、儿童应激事件量表(CHAS)、儿童归因方式问卷(CASQ)、儿童认知方式问卷(CCSQ)、儿童不良态度问卷(CDAS)对三年级318名学生和七年级324名学生进行调查,初测后每间隔2个月对所有学生追踪测量所有量表,三年级学生共追踪3次,七年级学生共追踪4次。应用多层线性模型(HLM)检验抑郁应激-认知易感性模型的调节模式——考察Beck抑郁认知理论和抑郁绝望理论在我国儿童中的适用性；使用多层结构方程模型(MSEM)检验抑郁应激-认知易感性模型的中介模式在我国儿童中的适用性。
结果：(1)三年级儿童,第二次和第三次追踪测量的儿童抑郁症状有显著的性别差异(t(267)=2.77,p<0.01；t(271)=2.79,p<0.01),而七年级儿童抑郁症状各次测量结果都没有显著的性别差异；(2)三年级儿童应激事件水平初测和第一次追踪测量结果存在显著性别差异(t(303)=2.48,p<0.01；t(313)=2.00,p<0.05),七年级儿童应激事件水平第三次追踪测量的结果也存在显著的性别差异(t(312)=-2.60,p<0.05)；(3)三年级儿童抑郁症状水平和应激事件水平显著低于七年级儿童(t(611)=-6.10,p<0.001；t(617)=-2.14,p<0.05)；(4)三年级儿童不良态度×应激事件水平的交互作用不能显著预测抑郁症状的变化(β=-0.001,SE=0.018,F(1,564)=0.00,p>0.05)；七年级儿童不良态度×应激事件水平的交互作用也不能显著预测抑郁症状的变化(β=0.023,SE=0.022,F(1,812)=1.07,p>0.05)。(5)三年级儿童绝望理论最弱联结×应激水平的交互作用对抑郁症状变化的预测不显著(β=-0.005,SE=0.018,F(1,564)=0.09,p>0.05)；七年级儿童绝望理论最弱联结×应激水平的交互作用对抑郁症状变化的预测也不显著(》=0.006,SE=0.020,F(1,883)=0.10,p>0.05)。(6)三年级儿童中Beck抑郁理论和绝望理论认知因素的最弱联结×应激水平的交互作用对抑郁症状变化的预测不显著(β=-0.002,SE=0.018,F(1,564)=0.01,p>0.05)；七年级儿童中Beck抑郁理论和绝望理论认知因素的最弱联结×应激水平的交互作用对抑郁症状变化的预测同样不显著(β=0.019,SE=0.020,F(1,883)=0.93,p>0.05)。(7)三年级儿童不良态度在应激事件与抑郁症状关系中的中介效应不显著(ββ=0.006,SE=0.004,p=0.139)；但七年级男儿童不良态度在应激事件与抑郁症状关系中存在显著的中介效应(ββ=0.005,SE=0.002,p<0.05),女儿童则没有显著中介效应(ββ=0.006,SE=0.004,p=0.139)。(8)三年级儿童绝望理论认知易感因素最弱联结在应激事件与抑郁症状关系中的中介效应不显著(β=0.001,SE=0.001,p=0.261)；但七年级儿童绝望理论认知易感因素最弱联结在应激事件与抑郁症状关系中具有显著的中介效应(β=0.007,SE=0.003,p<0.01)。(9)三年级儿童Beck抑郁理论和绝望理论认知因素的最弱联结在应激事件与抑郁症状关系中的中介效应不显著(β=0.001,SE=0.001,p=0.407)；而七年级儿童Beck抑郁理论和绝望理论认知因素的最弱联结在应激事件与抑郁症状关系中具有显著的中介效应(β=0.008,SE=0.003,p<0.01)。
结论：(1)三年级男童的应激事件水平能显著影响其抑郁症状的变化,而女童应激事件水平对其抑郁症状变化的影响不显著；七年级儿童应激事件水平能显著影响抑郁症状的变化,且该影响没有性别的显著差异；(2)不良态度的抑郁认知易感因素在三年级和七年级儿童中都不能显著调节应激事件水平与抑郁症状间的关系,可能说明在国内儿童群体中Beck的抑郁理论不适用；(3)在三年级和七年级儿童中,抑郁绝望理论的认知因素最弱联结结果不能显著调节应激事件水平和抑郁症状间的关系,可能说明以最弱联结假设为认知依据的抑郁绝望理论在国内儿童中也不成立；(4)在三年级和七年级儿童中,通过最弱联结方法得到的Beck理论和抑郁绝望理论的认知整合不能显著调节应激事件和抑郁症状之间的关系,可能表明在国内儿童群体中,Beck抑郁理论和抑郁绝望理论的最弱联结整合形式的调节模式同样不适用；(5)Beck抑郁理论的不良态度认知,抑郁绝望理论中认知易感因素的最弱联结在三年级儿童中均没有对应激事件水平与抑郁症状关系的显著中介作用,但在七年级儿童中存在显著的中介效应；(6)通过最弱联结方法得到的Beck理论和抑郁绝望理论的认知整合在三年级儿童中对应激事件和抑郁症状之间的关系的中介效应不显著,但在七年级儿童中存在显著的中介效应；(7)在儿童群体中,对于较小年龄的儿童可能抑郁认知易感因素还不能对应激事件水平与抑郁症状间的关系产生显著影响；而在较大年龄的儿童中,抑郁应激-认知易感模型的中介模式可能较之调节模式更为符合儿童的实际情况,即在较大年龄的儿童群体中,抑郁的认知易感因素对应激事件水平和抑郁症状间的关系起中介作用。
Objective:(1) to explore the age and gender developmental characteristics of children's depression symptoms; (2) to examine the moderating modes of Beck's depression theory and Hopelessness Theory in Chinese children samples respectively; (3) to examine the mediating modes of Beck's depression theory and Hopelessness Theory in Chinese children samples respectively; (4) to explore the influencing mechanism of intergration of Beck's depression theory and hopelessness theory on the relationship of stress events and depression symptoms.
Method:In the longitudinal study,318 third grade and 324 seventh grade students completed Children's Depression Inventory(CDI), Children's Hassles Scale(CHAS), Children's Attributional Style Questionnaire(CASQ), Children's Cognitive Style Questionnaire(CCSQ), and Children's Dysfunctional Attitude Scale Revised(CDAS-R) in the initial test and follow-up tests with an interval of 2 month. Third grade students were carried out 4 times Investigation, seventh grade students Investigation 5 times. The moderating modes of cognitive diathesis-strees model (including Beck's depression theory(BT) and Hopelessness Theory (HT))were tested by hierarchical linear model (HLM); and the mediating modes of cognitive diathesis-strees model were tested by multilevel structural equation model (MSEM).
Results:(1) For third grade children, the gender significant differences of depressive symptoms were found in second and third follow-up investigations (t(267)=2.77,p<0.01; t(271)=2.79,p<0.01); But for seventh grade children, there were no gender significant difference in all investigations; (2) the significant gender differences of stress events were found in the initial and first follow-up investigations in third grade children (t(303)=2.48, p＜0.01; t(313)=2.00,p<0.05), the significant gender difference existed in third follow-up investigation in seventh grade children; (3) The degree of depression symptoms and stress events in third grade children was significantly less than that in seventh grade children (t(611)=-6.10,p<0.001;t(617)=-2.14, p<0.05); (4) The interaction of dysfunctional attitude and stress events couldn't predict the depressive symptoms in third and seventh grade children significantly (β=-0.001, SE=0.018, F(1,564)=0.00, p>0.05;β=0.023, SE=0.022, F(1,812)=1.07, p>0.05); (5) The interaction of HT's weakest link and strss events couldn't predict depressive symptoms in third and seventh grade children (β=-0.005, SE=0.018, F(1,564)=0.09, p> 0.05;β= 0.006, SE=0.020, F(1,883)=0.10, p>0.05); (6) The weakest link of BT and HT×stress events couldn't predict the depressive symptoms in third and seventh grade children (β=-0.002, SE=0.018, F(1,564)=0.01, p> 0.05;β=0.019, SE=0.020, F(1,883)=0.93, p>0.05); (7) The dysfunctional attitude couldn't mediate the relationship of stress events and depressive symptoms in third grade children (β=0.006, SE=0.004, p=0.139); However, the dysfunctional attitude mediated the relationship of stress events and depressive symptoms in seventh grade male children (β=0.005, SE=0.002, p＜0.05), not in female children (β=0.001, SE=0.001,β=0.261); (8) The HT weakest link couldn't mediate the relationship of stress events and depressive symptoms in third grade children (β=0.001, SE=0.001,p=0.261); The HT weakest link mediated the relationship of stress events and depressive symptoms in third grade children (β=0.007, SE=0.003, p<0.01); (9) The HT and BT weakest link couldn't mediate the relationship between stress events and depressive symptoms in third grade children (β=0.001, SE=0.001, p=0.407); The HT and BT weakest link mediated the relationship between stress events and depressive symptoms in third grade children (β=0.008, SE=0.003,p＜0.01).
Conclusion:(1) The stress events predicted depressive symptoms in third grade male children but not in female children; the stress events predicted depressive symptoms in seventh grade children, and there was no gender difference in this grade; (2) The Beck's depression theory might not be applied to Chinese children; (3) The Hopelessness Theory based on weakest link hypothesis also might not be applied to Chinese children; (4) The intergration of Beck's depression theory and Hopelessness theory based on weakest link might not be applied to Chinese children; (5) In third grade children, the dysfunctional attitude and weakest link of HT couldn't mediate the relationship of stress events and depression symptoms, however in seventh grade children, there were mediating effects; (6) The intergration of BT and HT based on weakest link hypothesis couldn't mediate the relationship between stress events and depression symptoms in third grade children, however there was a significant mediating effect in seventh grade children; (7) There might not be significant influence of cognitive diathesis factors on the relationship between stress events and depression symptoms in young age children; However, in elder age children, there were significant mediating effects of cognitive diathesis factors on the relationship between stress events and depression symptoms.
方法：采用儿童抑郁量表(CDI)、儿童应激事件量表(CHAS)、儿童归因方式问卷(CASQ)、儿童认知方式问卷(CCSQ)、儿童不良态度问卷(CDAS)对三年级318名学生和七年级324名学生进行调查,初测后每间隔2个月对所有学生追踪测量所有量表,三年级学生共追踪3次,七年级学生共追踪4次。应用多层线性模型(HLM)检验抑郁应激-认知易感性模型的调节模式——考察Beck抑郁认知理论和抑郁绝望理论在我国儿童中的适用性；使用多层结构方程模型(MSEM)检验抑郁应激-认知易感性模型的中介模式在我国儿童中的适用性。
结果：(1)三年级儿童,第二次和第三次追踪测量的儿童抑郁症状有显著的性别差异(t(267)=2.77,p<0.01；t(271)=2.79,p<0.01),而七年级儿童抑郁症状各次测量结果都没有显著的性别差异；(2)三年级儿童应激事件水平初测和第一次追踪测量结果存在显著性别差异(t(303)=2.48,p<0.01；t(313)=2.00,p<0.05),七年级儿童应激事件水平第三次追踪测量的结果也存在显著的性别差异(t(312)=-2.60,p<0.05)；(3)三年级儿童抑郁症状水平和应激事件水平显著低于七年级儿童(t(611)=-6.10,p<0.001；t(617)=-2.14,p<0.05)；(4)三年级儿童不良态度×应激事件水平的交互作用不能显著预测抑郁症状的变化(β=-0.001,SE=0.018,F(1,564)=0.00,p>0.05)；七年级儿童不良态度×应激事件水平的交互作用也不能显著预测抑郁症状的变化(β=0.023,SE=0.022,F(1,812)=1.07,p>0.05)。(5)三年级儿童绝望理论最弱联结×应激水平的交互作用对抑郁症状变化的预测不显著(β=-0.005,SE=0.018,F(1,564)=0.09,p>0.05)；七年级儿童绝望理论最弱联结×应激水平的交互作用对抑郁症状变化的预测也不显著(》=0.006,SE=0.020,F(1,883)=0.10,p>0.05)。(6)三年级儿童中Beck抑郁理论和绝望理论认知因素的最弱联结×应激水平的交互作用对抑郁症状变化的预测不显著(β=-0.002,SE=0.018,F(1,564)=0.01,p>0.05)；七年级儿童中Beck抑郁理论和绝望理论认知因素的最弱联结×应激水平的交互作用对抑郁症状变化的预测同样不显著(β=0.019,SE=0.020,F(1,883)=0.93,p>0.05)。(7)三年级儿童不良态度在应激事件与抑郁症状关系中的中介效应不显著(ββ=0.006,SE=0.004,p=0.139)；但七年级男儿童不良态度在应激事件与抑郁症状关系中存在显著的中介效应(ββ=0.005,SE=0.002,p<0.05),女儿童则没有显著中介效应(ββ=0.006,SE=0.004,p=0.139)。(8)三年级儿童绝望理论认知易感因素最弱联结在应激事件与抑郁症状关系中的中介效应不显著(β=0.001,SE=0.001,p=0.261)；但七年级儿童绝望理论认知易感因素最弱联结在应激事件与抑郁症状关系中具有显著的中介效应(β=0.007,SE=0.003,p<0.01)。(9)三年级儿童Beck抑郁理论和绝望理论认知因素的最弱联结在应激事件与抑郁症状关系中的中介效应不显著(β=0.001,SE=0.001,p=0.407)；而七年级儿童Beck抑郁理论和绝望理论认知因素的最弱联结在应激事件与抑郁症状关系中具有显著的中介效应(β=0.008,SE=0.003,p<0.01)。
结论：(1)三年级男童的应激事件水平能显著影响其抑郁症状的变化,而女童应激事件水平对其抑郁症状变化的影响不显著；七年级儿童应激事件水平能显著影响抑郁症状的变化,且该影响没有性别的显著差异；(2)不良态度的抑郁认知易感因素在三年级和七年级儿童中都不能显著调节应激事件水平与抑郁症状间的关系,可能说明在国内儿童群体中Beck的抑郁理论不适用；(3)在三年级和七年级儿童中,抑郁绝望理论的认知因素最弱联结结果不能显著调节应激事件水平和抑郁症状间的关系,可能说明以最弱联结假设为认知依据的抑郁绝望理论在国内儿童中也不成立；(4)在三年级和七年级儿童中,通过最弱联结方法得到的Beck理论和抑郁绝望理论的认知整合不能显著调节应激事件和抑郁症状之间的关系,可能表明在国内儿童群体中,Beck抑郁理论和抑郁绝望理论的最弱联结整合形式的调节模式同样不适用；(5)Beck抑郁理论的不良态度认知,抑郁绝望理论中认知易感因素的最弱联结在三年级儿童中均没有对应激事件水平与抑郁症状关系的显著中介作用,但在七年级儿童中存在显著的中介效应；(6)通过最弱联结方法得到的Beck理论和抑郁绝望理论的认知整合在三年级儿童中对应激事件和抑郁症状之间的关系的中介效应不显著,但在七年级儿童中存在显著的中介效应；(7)在儿童群体中,对于较小年龄的儿童可能抑郁认知易感因素还不能对应激事件水平与抑郁症状间的关系产生显著影响；而在较大年龄的儿童中,抑郁应激-认知易感模型的中介模式可能较之调节模式更为符合儿童的实际情况,即在较大年龄的儿童群体中,抑郁的认知易感因素对应激事件水平和抑郁症状间的关系起中介作用。
Objective:(1) to explore the age and gender developmental characteristics of children's depression symptoms; (2) to examine the moderating modes of Beck's depression theory and Hopelessness Theory in Chinese children samples respectively; (3) to examine the mediating modes of Beck's depression theory and Hopelessness Theory in Chinese children samples respectively; (4) to explore the influencing mechanism of intergration of Beck's depression theory and hopelessness theory on the relationship of stress events and depression symptoms.
Method:In the longitudinal study,318 third grade and 324 seventh grade students completed Children's Depression Inventory(CDI), Children's Hassles Scale(CHAS), Children's Attributional Style Questionnaire(CASQ), Children's Cognitive Style Questionnaire(CCSQ), and Children's Dysfunctional Attitude Scale Revised(CDAS-R) in the initial test and follow-up tests with an interval of 2 month. Third grade students were carried out 4 times Investigation, seventh grade students Investigation 5 times. The moderating modes of cognitive diathesis-strees model (including Beck's depression theory(BT) and Hopelessness Theory (HT))were tested by hierarchical linear model (HLM); and the mediating modes of cognitive diathesis-strees model were tested by multilevel structural equation model (MSEM).
Results:(1) For third grade children, the gender significant differences of depressive symptoms were found in second and third follow-up investigations (t(267)=2.77,p<0.01; t(271)=2.79,p<0.01); But for seventh grade children, there were no gender significant difference in all investigations; (2) the significant gender differences of stress events were found in the initial and first follow-up investigations in third grade children (t(303)=2.48, p＜0.01; t(313)=2.00,p<0.05), the significant gender difference existed in third follow-up investigation in seventh grade children; (3) The degree of depression symptoms and stress events in third grade children was significantly less than that in seventh grade children (t(611)=-6.10,p<0.001;t(617)=-2.14, p<0.05); (4) The interaction of dysfunctional attitude and stress events couldn't predict the depressive symptoms in third and seventh grade children significantly (β=-0.001, SE=0.018, F(1,564)=0.00, p>0.05;β=0.023, SE=0.022, F(1,812)=1.07, p>0.05); (5) The interaction of HT's weakest link and strss events couldn't predict depressive symptoms in third and seventh grade children (β=-0.005, SE=0.018, F(1,564)=0.09, p> 0.05;β= 0.006, SE=0.020, F(1,883)=0.10, p>0.05); (6) The weakest link of BT and HT×stress events couldn't predict the depressive symptoms in third and seventh grade children (β=-0.002, SE=0.018, F(1,564)=0.01, p> 0.05;β=0.019, SE=0.020, F(1,883)=0.93, p>0.05); (7) The dysfunctional attitude couldn't mediate the relationship of stress events and depressive symptoms in third grade children (β=0.006, SE=0.004, p=0.139); However, the dysfunctional attitude mediated the relationship of stress events and depressive symptoms in seventh grade male children (β=0.005, SE=0.002, p＜0.05), not in female children (β=0.001, SE=0.001,β=0.261); (8) The HT weakest link couldn't mediate the relationship of stress events and depressive symptoms in third grade children (β=0.001, SE=0.001,p=0.261); The HT weakest link mediated the relationship of stress events and depressive symptoms in third grade children (β=0.007, SE=0.003, p<0.01); (9) The HT and BT weakest link couldn't mediate the relationship between stress events and depressive symptoms in third grade children (β=0.001, SE=0.001, p=0.407); The HT and BT weakest link mediated the relationship between stress events and depressive symptoms in third grade children (β=0.008, SE=0.003,p＜0.01).
Conclusion:(1) The stress events predicted depressive symptoms in third grade male children but not in female children; the stress events predicted depressive symptoms in seventh grade children, and there was no gender difference in this grade; (2) The Beck's depression theory might not be applied to Chinese children; (3) The Hopelessness Theory based on weakest link hypothesis also might not be applied to Chinese children; (4) The intergration of Beck's depression theory and Hopelessness theory based on weakest link might not be applied to Chinese children; (5) In third grade children, the dysfunctional attitude and weakest link of HT couldn't mediate the relationship of stress events and depression symptoms, however in seventh grade children, there were mediating effects; (6) The intergration of BT and HT based on weakest link hypothesis couldn't mediate the relationship between stress events and depression symptoms in third grade children, however there was a significant mediating effect in seventh grade children; (7) There might not be significant influence of cognitive diathesis factors on the relationship between stress events and depression symptoms in young age children; However, in elder age children, there were significant mediating effects of cognitive diathesis factors on the relationship between stress events and depression symptoms.
引文
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