初中生抑郁症状在同伴欺凌与自杀意念间的中介作用

陈珊珊; 何阳; 袁梦园; 李泳汉; 常俊杰; 汪耿夫; 苏普玉

doi:10.16835/j.cnki.1000-9817.2022.10.004

初中生抑郁症状在同伴欺凌与自杀意念间的中介作用

doi: 10.16835/j.cnki.1000-9817.2022.10.004

安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/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, 合肥 230032

基金项目:

国家自然科学基金面上项目 81874268

国家自然科学基金面上项目 82173539

详细信息

作者简介:
陈珊珊(1996-), 女, 安徽明光人, 在读硕士, 主要研究方向为儿童青少年发育与行为医学

通讯作者:
苏普玉, E-mail: supuyu@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: B844.2 G627.8 G444
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- 文章访问数: 675
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- 被引次数: 0
出版历程
- 收稿日期: 2022-03-30
- 修回日期: 2022-06-01
- 网络出版日期: 2022-10-28
- 刊出日期: 2022-10-25

Mediating role of depression symptom in the association among peer bullying and suicidal ideation in junior high school students

Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University/ Key Laboratory Population Health Across Life Cycle, Ministry of Education of the People's Republic of China/Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei (230032), China

摘要

摘要: 目的探讨初中生抑郁症状在同伴欺凌模式与自杀意念间的中介作用, 为同伴欺凌防治和青少年自杀预防提供参考依据。方法采用整群抽样方法, 于2019年9月(T1)在安徽省濉溪县1所普通中学全体初一学生中建立随访队列, 2020年9月(T2)进行第一次随访, 共1 687名初中生参与。采用自编同伴欺凌问卷、中文版流调中心抑郁量表-儿童版(CES-DC)和自杀相关心理行为问卷对初中生进行问卷调查。结果初中生近1年自杀意念、被欺凌、欺凌他人的报告率分别为28.3%, 27.0%, 24.4%。同伴欺凌潜在类别分析分为低被欺凌-欺凌他人组(71.4%), 高被欺凌-欺凌他人组(3.3%), 高言语和关系被欺凌-欺凌他人组(25.3%)3组。以低被欺凌-欺凌他人组为参照组, T1抑郁症状在高被欺凌-欺凌他人组(中介效应值为0.43, P < 0.05)及高言语和关系被欺凌-欺凌他人组(中介效应值为0.29, P < 0.05)致T2自杀意念中起中介作用。结论抑郁症状在同伴欺凌致青少年自杀意念中起中介作用。为预防同伴欺凌及青少年自杀相关心理行为, 教育工作者在制定相应措施时应重视青少年的心理健康。
- 抑郁 /
- 暴力 /
- 精神卫生 /
- 自杀 /
- 青少年
Abstract: Objective To explore the mediating effect of depressive symptom on the relationship between peer bullying patterns and suicidal ideation, and to provide suggestions for school bullying and suicide prevention for adolescents. Methods A follow-up cohort was established in a junior middle school in Suixi County, Anhui Province in September 2019 (T1). The first follow-up was conducted in September 2020 (T2). A total of 1 687 junior high school students participated in this study. Self-designed peer bullying questionnaire, center for Epidemiological Studies Depression Scale for children, and questions regarding suicide-related behaviors were administered. Results Prevalence of suicidal ideation, victimization and bullying were 28.3%, 27.0% and 24.4%, respectively. The latent class analysis(LCA) identified three heterogeneous peer bullying classes: low aggressive-victims(71.4%), high aggressive-victims(3.3%), high verbal and relational aggressive-victims(25.3%). The low aggressive-victims class was used as the reference group, T1 depressive symptom mediated the association between high aggressive-victims(mediating effect=0.43, P < 0.05), high verbal and relational aggressive-victims class (mediating effect=0.29, P < 0.05) and T2 suicidal ideation. Conclusion Depressive symptom plays a mediating role in the relationship between peer bullying and suicidal ideation. In order to prevent peer bullying and suicide-related psychological behaviors of adolescents, educators should pay attention to adolescents' mental health when formulating corresponding measures.
- Depression /
- Violence /
- Mental health /
- Suicide /
- 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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图 1 初中生同伴欺凌3个潜在类别的条件概率分布

Figure 1. Conditional probability distribution of 3 latent classes on peer bullying in junior high school students

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表 1 不同人口统计学特征初中生同伴欺凌和自杀意念报告率比较

Table 1. Comparison of peer bullying and suicidal ideation reporting rates among junior high school students with different demographic characteristics

人口统计学指标	选项	人数	被欺凌			欺凌他人			自杀意念
人口统计学指标	选项	人数	报告人数	χ²值	P值	报告人数	χ²值	P值	报告人数	χ²值	P值
性别	男	1 019	315(30.9)	20.30	＜0.01	314(30.8)	56.97	＜0.01	236(23.2)	33.93	＜0.01
	女	668	140(21.0)			98(14.7)			242(36.2)
家庭结构	核心家庭	773	193(25.0)	5.33	0.15	169(21.9)	6.10	0.11	199(25.7)	6.11	0.11
	单亲家庭	271	82(30.3)			78(28.8)			78(28.8)
	大家庭	621	171(27.5)			159(25.6)			196(31.6)
	孤儿	22	9(40.9)			6(27.3)			5(22.7)
母亲受教育程度	小学及以下	432	142(32.9)	11.80	＜0.01	117(27.1)	2.97	0.23	115(26.6)	1.67	0.43
	初中	843	201(23.8)			192(22.8)			237(28.1)
	高中及以上	412	112(27.2)			103(25.0)			126(30.6)
父亲受教育程度	小学及以下	265	85(32.1)	5.80	0.06	75(28.3)	2.61	0.27	71(26.8)	0.80	0.67
	初中	893	222(24.9)			210(23.5)			261(29.2)
	高中及以上	529	148(28.0)			127(24.0)			146(27.6)
与母亲关系	一般及以下	311	129(41.5)	45.58	＜0.01	87(28.0)	18.35	＜0.01	129(41.5)	34.23	＜0.01
	亲密	713	187(26.2)			200(28.1)			192(26.9)
	非常亲密	663	139(21.0)			125(18.9)			157(23.7)
与父亲关系	一般及以下	504	184(36.5)	33.26	＜0.01	152(30.2)	16.77	＜0.01	202(40.1)	48.99	＜0.01
	亲密	694	161(23.2)			167(24.1)			165(23.8)
	非常亲密	489	110(22.5)			93(19.0)			111(22.7)
合计		1 687	455(27.0)			412(24.4)			478(28.3)
注：()内数字为报告率/%。

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表 2 初中生同伴欺凌潜在类别分析拟合信息(n=1 687)

Table 2. Fit information of latent class models on peer bullying in junior high school students(n=1 687)

类别	k	Log	AIC值	BIC值	aBIC值	Entropy值	LMR值	BLRT值
1	8	-3 976.794	7 969.588	8 013.033	7 987.618	-	-	-
2	17	-3 478.149	6 990.299	7 082.621	7 028.614	0.803	＜0.01	＜0.01
3	26	-3 417.539	6 887.077	7 028.276	6 945.677	0.762	＜0.01	＜0.01
4	35	-3 399.848	6 869.696	7 059.771	6 948.581	0.798	0.09	＜0.01
5	44	-3 385.874	6 859.748	7 098.699	6 958.916	0.770	0.07	＜0.01
6	53	-3 371.269	6 848.538	7 136.365	6 967.991	0.752	0.01	0.03
注：k为自由估计的参数数目。

下载: 导出CSV

参考文献(39)

[1]	World Health Organization. Suicide in the world: global health estimates[M]. Geneva: World Health Organization, 2019.
[2]	PATTON G C, COFFEY C, SAWYER S M, et al. Global patterns of mortality in young people: a systematic analysis of population health data[J]. Lancet, 2009, 374(9693): 881-892. doi: 10.1016/S0140-6736(09)60741-8
[3]	陶芳标, 武丽杰, 马军, 等. 儿童少年卫生学[M]. 8版. 北京: 人民卫生出版社, 2017. TAO F B. Child and adolescent health[M]. 8th. Beijing: People's Medical Publishing Press, 2017. (in Chinese)
[4]	NOCK M K, BORGES G, BROMET E J, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts[J]. Br J Psychiatry, 2008, 192(2): 98-105. doi: 10.1192/bjp.bp.107.040113
[5]	朱琦, 夏庆华, 喻彦, 等. 上海市长宁区初中生自杀意念流行现状及影响因素分析[J]. 中国学校卫生, 2017, 38(11): 1637-1640. doi: 10.16835/j.cnki.1000-9817.2017.11.011 ZHU Q, XIA Q H, YU Y, et al. Analysis on prevalence of suicide ideation and its related factors among junior school students[J]. Chin J Sch Health, 2017, 38(11): 1637-1640. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2017.11.011
[6]	申俊贤, 王煜. 2009—2018年中国大陆中学生自杀意念者自杀尝试发生率的Meta分析[J]. 现代预防医学, 2020, 47(12): 2206-2210. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202012029.htm SHEN J X, WANG Y. Suicide attempts in Chinese mainland middle school students with suicidal ideation: a Meta-analysis between 2009 and 2018[J]. Mod Prev Med, 2020, 47(12): 2206-2210. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202012029.htm
[7]	SOHN M, OH H, LEE S K, et al. Suicidal ideation and related factors among Korean high school students: a focus on cyber addiction and school bullying[J]. J Sch Nurs, 2018, 34(4): 310-318. doi: 10.1177/1059840517734290
[8]	BENATOV J, BRUNSTEIN K A, CHEN-GAL S. Bullying perpetration and victimization associations to suicide behavior: a longitudinal study[J]. Eur Child Adolesc Psychiatry, 2021. DOI: 10.1007/s00787-021-01776-9.
[9]	BRUNSTEIN K A, BARZILAY S, APTER A, et al. Bi-directional longitudinal associations between different types of bullying victimization, suicide ideation/attempts, and depression among a large sample of European adolescents[J]. J Child Psychol Psychiatry, 2019, 60(2): 209-215. doi: 10.1111/jcpp.12951
[10]	陈秀珍, 贾珍荣, 杨晓娟. 生活事件、自尊和抑郁对大学生自杀意念的影响[J]. 中国健康心理学杂志, 2020, 28(10): 1557-1561. doi: 10.13342/j.cnki.cjhp.2020.10.027 CHEN X Z, JIA Z R, YANG X J. Effects of life events, self-esteem and depression on suicidal ideation of college students[J]. Chin J Health Psychol, 2020, 28(10): 1557-1561. (in Chinese) doi: 10.13342/j.cnki.cjhp.2020.10.027
[11]	于士伟, 武春雷, 王博, 等. 中小学生网络受欺凌与自杀意念: 有调节的中介模型[J]. 中华疾病控制杂志, 2021, 25(2): 227-230. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ202102021.htm YU S W, WU C L, WANG B, et al. Cyberbullying and suicidal ideas among primary and middle school students: a moderated mediation model[J]. Chin J Dis Control Prev, 2021, 25(2): 227-230. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ202102021.htm
[12]	WANG G F, JIANG L, WANG L H, et al. Examining childhood maltreatment and school bullying among adolescents: a cross-sectional study from Anhui Province in China[J]. J Interpers Viol, 2019, 34(5): 980-999. doi: 10.1177/0886260516647000
[13]	SOLBERG M E, OLWEUS D. Prevalence estimation of school bullying with the Olweus Bully/Victim Questionnaire[J]. Aggress Behav, 2003, 29(3): 239-268. doi: 10.1002/ab.10047
[14]	MUTISO V N, MUSYMI C W, KROLINSKI P, et al. Relationship between bullying, substance use, psychiatric disorders, and social problems in asample of Kenyan secondary schools[J]. Prev Sci, 2019, 20(4): 544-554. doi: 10.1007/s11121-019-01014-4
[15]	THOMA H J, CONNOR J P, LAWRENCE D M, et al. Prevalence and correlates of bullying victimisation and perpetration in a nationally representative sample of Australian youth[J]. Aust N Z J Psychiatry, 2017, 51(9): 909-920. doi: 10.1177/0004867417707819
[16]	BABARRO I, ANDIARENA A, FANO E, et al. Risk and protective factors for bullying at 11 years of age in a Spanish Birth Cohort Study[J]. Int J Environ Res Public Health, 2020, 17(12): 4428. doi: 10.3390/ijerph17124428
[17]	CYNTHIA M H, CAROLYN S L, ERICA K A, et al. A psychometric comparison of two self-report measures of bullying and victimization: differences by sex and grade[J]. Sch Ment Health, 2011, 3(1): 44-57. doi: 10.1007/s12310-010-9046-1
[18]	KALTIALA H R, FROJD S. Correlation between bullying and clinical depression in adolescent patients[J]. Adolesc Health Med Ther, 2011, 2: 37-44.
[19]	FENDRICH M, WEISSMAN M M, WARNER V. Screening for depressive disorder in children and adolescents: validating the Center for Epidemiologic Studies Depression Scale for Children[J]. Am J Epidemiol, 1990, 131(3): 538-551. doi: 10.1093/oxfordjournals.aje.a115529
[20]	WANG G F, HAN A Z, ZHANG G B, et al. Sensitive periods for the effect of bullying victimization on suicidal behaviors among university students in China: the roles of timing and chronicity[J]. J Affect Disord, 2020, 268: 12-19. doi: 10.1016/j.jad.2020.02.049
[21]	BLUM R W, LI M, NARANJO-RIVERA G. Measuring adverse child experiences among young adolescents globally: relationships with depressive symptoms and violence perpetration[J]. J Adolesc Health, 2019, 65(1): 86-93. doi: 10.1016/j.jadohealth.2019.01.020
[22]	MAGIDSON J, VERMUNT J K. Latent class models[M]//KAPLAN D. The Sage Handbook of Quantitative Methodology for the Social Sciences. Thousand Oaks: Sage Publications, 2004: 175-198.
[23]	MASYN K. Latent class analysis and finite mixture modeling[M]//LITTLE T. The Oxford handbook of quantitative methods: Vol. 2. statistical analysis. New York: Oxford University Press, 2013: 551-611.
[24]	MUTHEN L K, MUTNEN B. Mplus user's guide: statistical analysis with latent variables[M]. Los Angeles, CA: Muten & Muthn, 2017.
[25]	PENG Z, KLOMEK A B, LI L, et al. Associations between Chinese adolescents subjected to traditional and cyber bullying and suicidal ideation, self-harm and suicide attempts[J]. BMC Psychiatry, 2019, 19(1): 324. doi: 10.1186/s12888-019-2319-9
[26]	RIFFLE L N, KELLY K M, DEMARAY M L, et al. Associations among bullying role behaviors and academic performance over the course of an academic year for boys and girls[J]. J Sch Psychol, 2021, 86: 49-63. doi: 10.1016/j.jsp.2021.03.002
[27]	KOLAKOWSKY-HAYNER S A, GOLDIN Y, KINGSLEY K, et al. Psychosocial impacts of the COVID-19 quarantine: a study of gender differences in 59 countries[J]. Medicina (Kaunas), 2021, 57(8): 789. doi: 10.3390/medicina57080789
[28]	MILTON A, DAVENPORT A, IORFINO F, et al. Suicidal thoughts and behaviors and their associations with transitional life events in men and women: findings from an international web-based sample[J]. JMIR Ment Health, 2020, 7(9): e18383. doi: 10.2196/18383
[29]	BETTENCOURT A F, FARRELL A D. Individual and contextual factors associated with patterns of aggression and peer victimization during middle school[J]. J Youth Adolesc, 2013, 42(2): 285-302. doi: 10.1007/s10964-012-9854-8
[30]	WANG G F, JIANG L, WANG L H, et al. Examining childhood maltreatment and school bullying among adolescents: a cross-sectional study from Anhui Province in China[J]. J Interp Viol, 2016, 34(5): 980-999.
[31]	KOYANAGI A, OH H, CARVALHO A F, et al. Bullying victimization and suicide attempt among adolescents aged 12-15 years from 48 countries[J]. J Am Acad Child Adolesc Psychiatry, 2019, 58(9): 907-918. doi: 10.1016/j.jaac.2018.10.018
[32]	ZHANG S, GONG M, LI W, et al. Patterns of bullying victimization and associations with mental health problems in Chinese adolescents: a Latent Class Analysis[J]. Int J Environ Res Public Health, 2020, 17(3): 779. doi: 10.3390/ijerph17030779
[33]	RYOO J H, WANG C, SWEAR S M, et al. Longitudinal model building using latent transition analysis: an example using school bullying data[J]. Front Psychol, 2018, 9: 675. doi: 10.3389/fpsyg.2018.00675
[34]	金凤, 刁华, 蒲杨, 等. 重庆市中学生传统欺凌、网络欺凌与自杀相关心理行为关系[J]. 中国公共卫生, 2022, 38(1): 39-46. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW202201008.htm JIN F, DIAO H, PU Y, et al. Association of traditional bullying and cyberbullying victimization with suicide related psychological behaviors in high school students in Chongqing municipality[J]. Chin J Public Health, 2022, 38(1): 39-46. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW202201008.htm
[35]	SWEARER S M, HYMEL S. Understanding the psychology of bullying: moving toward a social-ecological diathesis-stress model[J]. Am Psychol, 2015, 70(4): 344-353. doi: 10.1037/a0038929
[36]	陈珊珊, 何阳, 张志华, 等. 肠道菌群对抑郁症的影响及其可能机制的研究进展[J]. 医学研究生学报, 2020, 33(10): 1093-1097. https://www.cnki.com.cn/Article/CJFDTOTAL-JLYB202010017.htm CHEN S S, HE Y, ZHANG Z H, et al. Advances in the effect of intestinal flora on depression and its possible mechanism[J]. J Med Postgrad, 2020, 33(10): 1093-1097. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JLYB202010017.htm
[37]	GESLAMU L, HA K. Attitudes towards suicide and risk factors for suicide attempts among university students in South Korea[J]. J Affect Disord, 2020, 272: 166-169. doi: 10.1016/j.jad.2020.03.135
[38]	RIBEIRO J D, HUANG X, FOX K R, et al. Depression and hopelessness as risk factors for suicide ideation, attempts and death: Meta-analysis of longitudinal studies[J]. Br J Psychiatry, 2018, 212(5): 279-286. doi: 10.1192/bjp.2018.27
[39]	DONG M, WANG S B, LI Y, et al. Prevalence of suicidal behaviors in patients with major depressive disorder in China: a comprehensive Meta-analysis[J]. J Affect Disord, 2018, 225: 32-39. doi: 10.1016/j.jad.2017.07.043