积极成长经历对青少年心理健康风险的缓冲效应

周艺; 吴霈霈; 王世红; 方姣; 徐玉祥; 孙莹

doi:10.16835/j.cnki.1000-9817.2022.05.009

积极成长经历对青少年心理健康风险的缓冲效应

doi: 10.16835/j.cnki.1000-9817.2022.05.009

周艺¹,
吴霈霈¹,
王世红¹,
方姣¹,
徐玉祥¹,
孙莹^{1, 2, ,}

1.
安徽医科大学公共卫生学院儿少卫生与妇幼保健学系，合肥 230032
2.
出生人口健康教育部重点实验室/人口健康与优生安徽省重点实验室

基金项目:

国家自然科学基金项目 82173537

国家自然科学基金项目 81872638

安徽省自然科学基金杰青项目 1908085J26

详细信息

作者简介:
周艺(1994-)，女，江苏盐城人，在读硕士，主要研究方向为儿童青少年卫生

通讯作者:
孙莹，E-mail：yingsun@ahmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G478 G444 R179
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出版历程
- 收稿日期: 2021-10-27
- 修回日期: 2021-12-23
- 网络出版日期: 2022-05-20
- 刊出日期: 2022-05-25

Buffering effect of positive childhood experiences on mental health risks among adolescents

1.
Department of Maternal, Child & Adolescent, School of Public Health, Anhui Medical University, Hefei (230032), China

摘要

摘要: 目的探讨积极成长经历对青少年心理健康风险的缓冲效应，为后续开展有效的支持和干预措施提供科学依据。方法采用方便抽样方法，于2019年10月新冠肺炎疫情前在安徽省池州市2个县中小学校招募1 322名四至九年级学生，开展学生问卷调查，收集学生一般人口统计学信息、积极成长经历、抑郁症状、焦虑症状、自伤行为、自杀意念情况等信息，并于2020年5月新冠肺炎疫情学校复课后进行随访。以疫情前和复课后青少年的心理健康状况作为观测指标，采用多元Logistic回归分析检验积极成长经历与青少年心理健康变化间的相关性。结果复课后学生抑郁症状、焦虑症状、自伤行为、自杀意念的检出率(22.6%，16.0%，40.0%，29.9%)高于疫情前(16.5%，13.5%，31.1%，22.6%)。积极成长经历高分组青少年抑郁症状、焦虑症状、自伤行为、自杀意念在疫情前与复课后检出率差异均无统计学意义(Z值分别为-0.05，0.27，0.84，1.84，P值均>0.05)。多元Logistic回归分析显示，积极成长经历低分组复课后抑郁症状风险是疫情前的1.39倍(95%CI=1.05~1.84，P＜0.05)，自伤行为风险是疫情前的1.31倍(95%CI=1.05~1.62，P＜0.05)。积极成长经历高分组中，疫情前后学生的心理健康状况差异均无统计学意义(P值均＞0.05)。结论新冠肺炎疫情暴发背景下，积极成长经历与青少年抑郁、焦虑、自伤行为和自杀意念风险降低相关。应从家庭、学校和同伴角度给予更多的支持和帮助，减轻公共卫生突发事件对青少年心理健康的不利影响。
- 冠状病毒属 /
- 精神卫生 /
- 抑郁 /
- 焦虑 /
- 回归分析 /
- 青少年
Abstract: Objective To explore the buffering effect of positive childhood experiences (PCEs) on mental health risks among adolescents before and after COVID-19 epidemic. Methods In October 2019 (before the outbreak of COVID-19), 1 322 students from grades 4 to 9 were recruited from primary and secondary schools in two counties of Chizhou city, Anhui Province. A questionnaire survey was conducted to collect general demographic information, PCEs, depressive symptoms, anxiety symptoms, self-harm behavior, suicidal ideation. Follow-up survey was conducted after school re-opening (May 2020). Mental health status before and after the COVID-19 epidemic was compared among students with different PCEs by multiple logistic regression analyses. Results The detection rates of depressive symptoms, anxiety symptoms, self-harm behavior and suicidal ideation (22.6%, 16.0%, 40.0%, 29.9%) of the respondents after school re-opening were significantly higher compared that before the epidemic (16.5%, 13.5%, 31.1%, 22.6%). There were no significant differences in the detection rates of depressive symptoms, anxiety symptoms, self-harm behavior and suicidal ideation between high PCEs group before and after the epidemic (Z=-0.05, 0.27, 0.84, 1.84, P>0.05). Multivariate Logistic regression analysis showed that the risk of depressive symptoms and self-harm behavior in the low PCEs group after school re-opening was 1.39 times higher than that before the epidemic (95%CI=1.05-1.84, P < 0.05). The risk of non-suicidal self-injury behavior in the low PCEs group after school re-opening was 1.31 times higher than that before the epidemic (95%CI=1.05-1.62, P < 0.05). There were no significant differences in mental health detection rates in high PCEs group before and after the epidemic (P>0.05). Conclusion During the time of COVID-19 epidemic, PCEs is associated with lower rates of depressive symptoms, anxiety symptoms, self-harm behavior and suicide ideation in adolescents. The findings suggest that more support and help should be given to adolescents from the perspectives of family, school and peers, so as to reduce the adverse effects of public health emergencies on adolescents' mental health.
- Coronavirus /
- Mental health /
- Depression /
- Anxiety /
- Regression analysis /
- Adolescent
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 不同成长经历青少年疫情前与复课后心理健康问题检出率比较

Table 1. Comparison of the detection rate of mental health problems between adolescents with different childhood experience before the epidemic and after school re-opening

组别	时间	统计值	抑郁症状	焦虑症状	自伤行为	自杀意念
高分组 (n=282)	疫情前		32(11.2)	25(8.9)	56(20.0)	36(12.6)
	复课后		31(11.1)	27(9.6)	65(23.0)	52(18.4)
		Z值	-0.05	0.27	0.84	1.84
		P值	0.96	0.78	0.40	0.07
低分组 (n=1 040)	疫情前		186(17.9)	154(14.8)	354(34.0)	275(25.4)
	复课后		266(25.6)	184(17.7)	463(44.5)	343(33.0)
		Z值	4.04	1.76	4.77	3.73
		P值	< 0.01	0.08	< 0.01	< 0.01
注：( )内数字为检出率/%。

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表 2 不同成长经历青少年心理健康问题在随访前后变化的多元Logistic回归模型[OR值(OR值95%CI)]

Table 2. Multivariate Logistic regression model of mental health problems of adolescents with different childhood experiences before and after follow-up [OR(OR 95%CI)]

组别	时间	抑郁症状	焦虑症状	自伤行为	自杀意念
高分组 (n=282)	疫情前	1.00	1.00	1.00	1.00
高分组 (n=282)	复课后	1.07(0.53~2.14)	0.81(0.39~1.69)	0.96(0.58~1.60)	1.48(0.80~2.74)
低分组 (n=1 040)	疫情前	1.00	1.00	1.00	1.00
	复课后	1.39 (1.05~1.84)^*	1.13(0.84~1.52)	1.31(1.05~1.62)^*	1.23(0.98~1.56)
	注： *P＜0.05。

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参考文献(18)

[1]	BAHN G H. Coronavirus disease 2019, school closures, and childr-en's mental health[J]. Soa Chongsonyon Chongsin Uihak, 2020, 31(2): 74-79. https://pubmed.ncbi.nlm.nih.gov/32595345/
[2]	ORBEN A, TOMOVA L, BLAKEMORE S J. The effects of social deprivation on adolescent development and mental health[J]. Lancet Child Adolesc, 2020, 4(8): 634-640. doi: 10.1016/S2352-4642(20)30186-3
[3]	LOADES M E, CHATBURN E, HIGSON-SWEENEY N, et al. Rapid systematic review: the impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19[J]. J Am Acad Child Psy, 2020, 59(11): 1218-1239. doi: 10.1016/j.jaac.2020.05.009
[4]	MAGSON N R, FREEMAN J Y A, RAPEE R M, et al. Risk and protective factors for prospective changes in adolescent mental health during the COVID-19 pandemic[J]. J Youth Adolesc, 2021, 50(1): 44-57. doi: 10.1007/s10964-020-01332-9
[5]	CRUSH E, ARSENEAULT L, JAFFEE S R, et al. Protective factors for psychotic symptoms among poly-victimized children[J]. Schizophr Bull, 2018, 44(3): 691-700. doi: 10.1093/schbul/sbx111
[6]	BETHELL C, JONES J, GOMBOJAV N, et al. Positive childhood experiences and adult mental and relational health in a statewide sample: associations across adverse childhood experiences levels[J]. JAMA Pediatr, 2019, 173(11): e193007. doi: 10.1001/jamapediatrics.2019.3007
[7]	RAUDINO A, WOODWARD L J, FERGUSSON D M, et al. Childhood conduct problems are associated with increased partnership and parenting difficulties in adulthood[J]. J Abn Child Psychol, 2012, 40(2): 251-263. doi: 10.1007/s10802-011-9565-8
[8]	SLOPEN N, CHEN Y, GUIDA J L, et al. Positive childhood experiences and ideal cardiovascular health in midlife: associations and mediators[J]. Prev Med, 2017, 97: 72-79. doi: 10.1016/j.ypmed.2017.01.002
[9]	SHEIKH M A. The potential protective effect of friendship on the association between childhood adversity and psychological distress in adulthood: a retrospective, preliminary, three-wave population-based study[J]. J Affect Disord, 2017, 226: 21-27.
[10]	CAO F L, SU L Y, CHENG P X. Reliability and validity of the mood and feelings questionnaire in Chinese adolescents[J]. Chin J Clin Psy, 2009, 17(4): 440-442.
[11]	COSTELLO E J, ANGOLD A. Scales to assess child and adolescent depression: checklists, screens, and nets[J]. J Am Acad Child Psy, 1988, 27(6): 726-737. doi: 10.1097/00004583-198811000-00011
[12]	BOYCE W T, ESSEX M J, WOODWARD H R, et al. The confluence of mental, physical, social, and academic difficulties in middle childhood. Ⅰ: exploring the "Headwaters" of early life morbidities[J]. J Am Acad Child Psy, 2002, 41(5): 580-587. doi: 10.1097/00004583-200205000-00016
[13]	WAN Y, JING C, YING S, et al. Impact of childhood abuse on the risk of non-suicidal self-injury in mainland Chinese adolescents[J]. PLoS One, 2015, 10(6): e0131239. doi: 10.1371/journal.pone.0131239
[14]	CDC. Adolescent and school health: YRBSS Questionnaire 2013[EB/OL].(2020-11-17)[2021-08-11].https://www.cdc.gov/healthyyouth/data/yrbs/questionnaires.htm.
[15]	WAN Y H, CHEN R L, MA S S, et al. Associations of adverse childhood experiences and social support with self-injurious behaviour and suicidality in adolescents[J]. Br J Psychiat, 2019, 214(3): 146-152. doi: 10.1192/bjp.2018.263
[16]	RACINE N, MCARTHUR B A, COOKE J E, et al. Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: a Meta-analysis[J]. JAMA Pediatr, 2021, 32(4): 381398. https://jamanetwork.com/journals/jamapediatrics/fullarticle/2782796
[17]	CAUCHEMEZ S, KERKHOVE V M D, ARCHER B N, et al. School closures during the 2009 influenza pandemic: national and local experiences[J]. BMC Infect Dis, 2014, 14(1): 207. doi: 10.1186/1471-2334-14-207
[18]	ZHANG L, FANG J, ZHANG D, et al. Poly-victimization and psychopathological symptoms in adolescence: examining the potential buffering effect of positive childhood experiences[J]. J Affect Disord, 2021, 282: 1308-1314. doi: 10.1016/j.jad.2021.01.011