中学生焦虑抑郁症状与智能手机成瘾关联的随访研究

嵇明霞; 杨洁; 贾取; 董莹; 王道森; 李祝敏; 温翔; 陈绮菲; 李秀红

doi:10.16835/j.cnki.1000-9817.2025223

中学生焦虑抑郁症状与智能手机成瘾关联的随访研究

doi: 10.16835/j.cnki.1000-9817.2025223

嵇明霞¹,
杨洁¹,
贾取¹,
董莹²,
王道森³,
李祝敏⁴,
温翔⁵,
陈绮菲³,
李秀红^3, ,

1.
深圳市光明区教育科学研究院，广东 518000
2.
南方科技大学附属光明凤凰学校
3.
中山大学公共卫生学院(深圳)
4.
中山大学深圳附属学校
5.
深圳市光明区高级中学

基金项目:

广东省教育科学规划专项资助课题项目 2021YQJK580

广东省教育科学规划中小学德育专项课题项目 2023ZXDY028

详细信息

作者简介:
嵇明霞(1983-)，女，江苏淮安人，博士，教研员，主要研究方向为儿童青少年心理健康

通讯作者:
李秀红，E-mail: lixh@mail.sysy.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G444 TN916.9 TN711
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- 文章访问数: 4
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- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2025-03-19
- 修回日期: 2025-05-01
- 网络出版日期: 2025-10-10
- 刊出日期: 2025-09-25

Follow-up study on the association of anxiety and depressive symptoms with smartphone addiction among middle school students

1.
Institute of Educational Science of Guangming Branch, Shenzhen 518000, Guangdong Province, China

摘要

摘要: 目的探讨中学生焦虑、抑郁症状与智能手机成瘾关联的变化趋势，为预防中学生智能手机成瘾提供科学依据。方法 2022—2023年，采用方便抽样与整群抽样相结合的方法从深圳市某区选取27所初中和3所高中8 923名中学生，分别于2022年9月(基线，T1)和2023年9月(随访，T2)进行调查。采用简版智能手机成瘾量表(SAS-SV)、患者健康问卷(PHQ-9)和广泛性焦虑量表(GAD-7)评估中学生智能手机成瘾及焦虑抑郁症状，使用混合效应模型分析中学生焦虑、抑郁症状和智能手机成瘾的关联性。结果 2022年9月—2023年9月，中学生智能手机成瘾报告率从24.22%升至25.25%(χ²=45.71)，智能手机成瘾得分[24.00(16.00, 32.00)，25.00(16.00, 33.00)分]、焦虑症状得分[2.00(0.00, 7.00)，3.00(0.00, 7.00)分]和抑郁症状得分[3.00(0.00, 8.00)，5.00(0.00, 9.00)分]均升高(Z值分别为-17.43，-42.38，-41.57)(P值均 < 0.05)。中学生焦虑、抑郁症状等级分布在2022和2023年差异均有统计学意义(χ²值分别为85.15，106.85，P值均 < 0.05)。混合效应模型结果显示，在调整年龄、性别、家庭背景等协变量后，中学生焦虑和抑郁症状与智能手机成瘾存在剂量—反应关联，轻度焦虑症状(OR=3.22)、中重度焦虑症状(OR=5.36)及轻度抑郁症状(OR=3.32)、中重度抑郁症状(OR=6.13)中学生的智能手机成瘾风险均升高；交互效应分析发现，焦虑抑郁症状共存时的中学生智能手机成瘾风险增加至无焦虑抑郁症状组的5.60倍(OR=5.60)，32%的联合风险归因于焦虑和抑郁症状协同作用(S=1.64，AP=0.32)(P值均 < 0.05)。结论焦虑、抑郁症状与中学生智能手机成瘾均存在关联，两者对智能手机成瘾存在协同作用。应提高对中学生情绪问题和智能手机成瘾的关注。
- 焦虑 /
- 抑郁 /
- 便携式电话 /
- 行为，成瘾 /
- 学生
Abstract: Objective To investigate the changing trends for associations of anxiety and depressive symptoms with smartphone addiction among middle school students, so as to provide a scientific basis for preventing smartphone addiction in middle school students. Methods From 2022 to 2023, a method of combining convenient sampling with cluster sampling was used to select 8 923 middle school students from 27 junior high schools and 3 senior high schools in a district of Shenzhen City between September 2022 (baseline, T1) and September 2023 (follow-up, T2). The Smartphone Addiction Scale-Short Version (SAS-SV), Patients Health Questionnaire-9 Item (PHQ-9), and Generalized Anxiety Disorder 7-item Scale (GAD-7) were administered to assess smartphone addiction, anxiety and depressive symptoms. Mixed-effects models were used to analyze the association of anxiety and depressive symptoms with smartphone addiction among middle school students. Results From September 2022 to September 2023, the reported prevalence of smartphone addiction increased from 24.22% to 25.25% (χ²=45.71); and smartphone addiction scores [24.00(16.00, 32.00), 25.00(16.00, 33.00)], anxiety symptom scores [2.00(0.00, 7.00), 3.00(0.00, 7.00)] and depressive symptom scores[3.00(0.00, 8.00), 5.00(0.00, 9.00)] all significantly increased (Z=-17.43, -42.38, -41.57) (all P < 0.05). There were statistically significant difference in the distribution of anxiety and depression symptom levels among middle school students in 2022 and 2023 (χ²=85.15, 106.85, both P < 0.05). After adjusting for covariates such as age, gender and family background, mixed-effects models revealed dose-response associations of anxiety and depressive symptoms with smartphone addiction among middle school students: mild anxiety symptom(OR=3.22), moderate-to-severe anxiety symptom (OR=5.36), mild depressive symptom (OR=3.32) and moderate-to-severe depressive symptom (OR=6.13) were significantly associated with higher risks of smartphone addiction (all P < 0.05). Interaction effect analysis found that co-existing anxiety and depressive symptoms synergistically increased addiction risk by 5.60 times (OR=5.60) compared to the asymptomatic group, with 32% of the combined risk attributable to their interaction (S=1.64, AP=0.32)(both P < 0.05). Conclusions Anxiety and depressive symptoms are significantly associated with smartphone addiction, exhibiting a synergistic effect. Attention should be paid to emotional issues and smartphone addiction among middle school students.
- Anxiety /
- Depression /
- Cellular phone /
- Behavior, addictive /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 中学生焦虑、抑郁症状与SA之间的混合效应模型分析[β值(95%CI)，n=8 923]

Table 1. Mixed-effects model analysis of anxiety and depressive symptoms with smartphone addiction among middle school students[β(95%CI), n=8 923]

自变量	选项	SA得分		是否SA
自变量	选项	粗模型	调整模型	粗模型	调整模型
量表得分	焦虑症状	0.88(0.85~0.91)	0.84(0.81~0.87)	1.15(1.14~1.16)	1.14(1.14~1.15)
	抑郁症状	0.77(0.75~0.80)	0.74(0.71~0.76)	1.13(1.13~1.14)	1.13(1.12~1.14)
焦虑症状等级	轻度	7.36(7.02~7.69)	7.14(6.80~7.47)	3.36(3.11~3.64)	3.22(2.97~3.49)
	中重度	10.13(9.68~10.58)	9.86(9.40~10.31)	5.55(5.03~6.13)	5.36(4.84~5.92)
抑郁症状等级	轻度	7.17(6.84~7.49)	7.00(6.67~7.33)	3.46(3.18~3.76)	3.32(3.05~3.62)
	中重度	10.62(10.22~11.02)	10.39(9.98~10.79)	6.36(5.79~6.98)	6.13(5.57~6.74)
注： P值均 < 0.05。

下载: 导出CSV

表 2 中学生焦虑与抑郁症状对SA的联合影响[OR值(95%CI)，n=8 923]

Table 2. Joint effect of anxiety and depressive symptoms on smartphone addiction among middle school students[OR(95%CI), n=8 923]

自变量	粗模型	调整模型
无焦虑症状+无抑郁症状	1.00	1.00
有焦虑症状+无抑郁症状	2.21(1.86~2.61)	2.16(1.82~2.56)
无焦虑症状+有抑郁症状	2.71(2.42~3.05)	2.64(2.35~2.97)
有焦虑症状+有抑郁症状	5.78(5.13~6.28)	5.60(5.13~6.11)
RERI值(95%CI)	1.86(1.34~2.38)	1.80(1.28~2.31)
AP值(95%CI)	0.32(0.24~0.40)	0.32(0.24~0.40)
S值(95%CI)	1.64(1.39~1.92)	1.64(1.39~1.94)
注：P值均 < 0.05。

下载: 导出CSV

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