儿童期逆境与中学生抑郁和焦虑情绪的关系

刘玉林; 欧阳靖雯; 张华; 周春燕

doi:10.16835/j.cnki.1000-9817.2023.06.016

儿童期逆境与中学生抑郁和焦虑情绪的关系

doi: 10.16835/j.cnki.1000-9817.2023.06.016

中国地质大学(武汉)教育研究院心理学系/心理科学与健康研究中心，湖北 430074

基金项目:

国家社会科学基金项目 19BSH166

详细信息

作者简介:
刘玉林(1995-)，女，河南周口人，在读硕士，主要研究方向为青少年发展与教育

通讯作者:
周春燕，E-mail：mailzcy@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G444 R179 G78
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出版历程
- 收稿日期: 2022-10-25
- 修回日期: 2023-02-27
- 网络出版日期: 2023-06-28
- 刊出日期: 2023-06-25

Relationship between adverse childhood experiences and depression and anxiety among students in middle school

Department of Psychology, School of Education, China University of Geosciences/Research Center for Psychological and Health Sciences, Wuhan(430074) , China

摘要

摘要: 目的了解儿童期逆境与中学生抑郁和焦虑情绪的关系，为中学生抑郁和焦虑情绪的预防及干预提供依据。方法于2020年10—11月，采用方便抽样法选取湖北省的初中、普高、中职、职高共计12所学校4 861名中学生，调查人口学信息、儿童期逆境及抑郁焦虑状况，并采用χ²检验和多因素Logistic回归分析数据。结果中学生的抑郁、焦虑情绪检出率分别为39.0%和52.3%；单因素分析显示，儿童期逆境总分及儿童虐待忽视、家庭功能障碍、家庭缺失、家庭外暴力维度与抑郁和焦虑情绪有关联(χ²值分别为105.36, 147.12，43.69，46.61，196.48；100.06，132.28，26.53，24.32，169.94，P值均 < 0.01)；在调整年龄、是否独生子女、性别等控制变量后，Logistic回归分析结果显示，儿童虐待忽视、家庭功能障碍、家庭缺失和家庭外暴力与抑郁情绪均呈正相关(OR值分别为1.61，1.62，1.06，2.08，P值均 < 0.01)；儿童虐待忽视、家庭功能障碍、家庭外暴力与焦虑情绪均呈正相关(OR值分别为1.66，1.50，1.98，P值均 < 0.05)。结论中学生的抑郁与焦虑情绪和儿童期逆境有关联，其中在儿童期受到家庭外暴力和虐待忽视的中学生发生抑郁和焦虑情绪的风险更高。
- 生活变动事件 /
- 抑郁 /
- 焦虑 /
- 精神卫生 /
- 回归分析 /
- 学生
Abstract: Objective To investigate the relationship between adverse childhood experiences with depression and anxiety prevention and intervention among middle school students, so as to provide evidence for preventing and intervening in depression and anxiety among adolescents. Methods From October to November 2020, a total of 4 861 middle school students from 12 schools in a province in central China, including junior high schools, senior high schools, secondary vocational schools, and vocational high school selected by using convenient sampling method. Demographic information, adverse childhood experiences, depression and anxiety symptoms were collected. The Chi-square test and multivariate Logistic regression analysis were used to analyze the data. Results The detection rates of depression and anxiety of students in middle school were 39.0% and 52.3%, respectively. Univariate analysis showed that the total scores of adverse childhood experiences and dimensions of childhood maltreatment and neglect, family dysfunction, parent absence, and violence outside the home were significantly associated with depressive and anxiety symptoms (χ²=105.36, 147.12, 43.69, 46.61, 196.48; 100.06, 132.28, 26.53, 24.32, 169.94, P < 0.01). After controlling variables such as age, only child, sex and economic status of family, Logistic regression showed that childhood maltreatment and neglect, family dysfunction, family absence and violence outside the home were positively associated with depressive symptoms (OR=1.61, 1.62, 1.06, 2.08, P < 0.01) and anxiety symptoms (OR=1.66, 1.50, 1.98, P < 0.05). Conclusion Depressive and anxiety symptoms among middle school students are associated with adverse childhood experiences, and those who experienced childhood maltreatment and neglect and violence outside the home are at higher risk.
- Life change events /
- Depression /
- Anxiety /
- Mental health /
- Regression analysis /
- Students
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表 1 不同组别中学生抑郁焦虑情绪检出率比较

Table 1. Comparison of the detection rates of depression and anxiety among middle school students in different groups

组别	选项	人数	抑郁情绪			焦虑情绪
组别	选项	人数	检出人数	χ²值	P值	检出人数	χ²值	P值
性别	男	2 419	899(37.2)	6.55	0.01	1 283(53.0)	1.07	0.30
	女	2 442	995(40.7)			1 259(51.6)
长期居住地	城市	1 601	488(30.5)	97.16	< 0.01	745(46.5)	39.41	< 0.01
	乡镇	1 964	779(39.7)			1 044(53.2)
	农村	1 296	627(48.4)			753(58.1)
独生子女	是	1 407	472(33.5)	24.43	< 0.01	728(51.7)	0.24	0.62
	否	3 454	1 422(41.1)			1 814(52.5)
学校类型	初中	1 845	479(26.0)	64.58	< 0.01	803(43.5)	91.75	< 0.01
	普高	1 033	428(41.4)			593(57.4)
	中职	1 181	577(48.9)			681(57.7)
	职高	802	410(51.1)			465(58.0)
儿童虐待忽视	是	2 310	1 106(47.9)	147.12	< 0.01	1 408(61.0)	132.28	< 0.01
	否	2 551	788(30.9)			1 134(44.5)
家庭功能障碍	是	167	106(63.5)	43.69	< 0.01	120(71.9)	26.53	< 0.01
	否	4 694	1 788(38.1)			2 422(51.6)
家庭缺失	是	2 221	981(44.2)	46.61	< 0.01	1 247(56.1)	24.32	< 0.01
	否	2 640	913(34.6)			1 295(49.1)
家庭外暴力	是	1 229	686(55.8)	196.48	< 0.01	840(68.3)	169.94	< 0.01
	否	3 632	1 208(33.3)			1 702(46.9)
儿童期逆境(总)	是	3 423	1 493(43.6)	105.36	< 0.01	1 949(56.9)	100.06	< 0.01
	否	1 438	401(27.9)			593(41.2)
注：()内数字为检出率/%。

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表 2 中学生抑郁和焦虑情绪与儿童期逆境的Logistic回归分析

Table 2. Logistic regression analysis of depression and anxiety and childhood adversity

自变量	模型1		模型2
自变量	抑郁情绪	焦虑情绪	抑郁情绪	焦虑情绪
儿童虐待忽视	1.69(1.49~1.91)^**	1.66(1.47~1.87)^**	1.61(1.42~1.83)^**	1.66(1.47~1.87)^**
家庭缺失	1.19(1.05~1.34)^**	1.07(0.95~1.21)	1.06(0.93~1.20)^**	1.05(0.93~1.18)
家庭功能障碍	1.71(1.22~2.39)^**	1.50(1.05~2.14)^*	1.62(1.15~2.29)^**	1.50(1.05~2.14)^*
家庭外暴力	2.08(1.81~2.39)^**	2.07(1.80~2.39)^**	2.08(1.80~2.40)^**	1.98(1.72~2.29)^**
注：P < 0.05，*P < 0.01；模型1未调整变量，模型2调整年龄、性别、是否独生子女和家庭经济状况；各自变量均以“无”为参照。

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参考文献(23)

[1]	KALMAKIS K A, CHANDLER G E. Adverse childhood experiences: towards a clear conceptual meaning[J]. J Adv Nurs, 2014, 70(7): 1489-1501. doi: 10.1111/jan.12329
[2]	HUGHES K, BELLIS M A, HARDCASTLE K A, et al. The effect of multiple adverse childhood experiences on health: a systematic review and Meta-analysis[J]. Lancet Public Health, 2017, 2(8): e356-e366. doi: 10.1016/S2468-2667(17)30118-4
[3]	EILAND L, ROMEO R D. Stress and the developing adolescent brain[J]. Neuroscience, 2013, 249: 162-171. doi: 10.1016/j.neuroscience.2012.10.048
[4]	ANITA T, COLLISHAW S, DANIEL S P, et al. Depression in adolescence[J]. Lancet, 2012, 379(9820): 1056-1067. doi: 10.1016/S0140-6736(11)60871-4
[5]	COSTELLO E J, EGGER H L, ANGOLD A. The developmental epidemiology of anxiety disorders: phenomenology, prevalence, and comorbidity[J]. Child Adolesc Psychiatr Clin N Am, 2005, 14(4): 631-648. doi: 10.1016/j.chc.2005.06.003
[6]	OLLENDICK T H, HIRSHFELD-BECKER D R. The developmental psychopathology of social anxiety disorder[J]. Biol Psychiatry, 2002, 51(1): 44-58. doi: 10.1016/S0006-3223(01)01305-1
[7]	马金凤, 戴江红, 茹建国, 等. 医学生心理健康状况与儿童期不良经历的关系探讨[J]. 中华疾病控制杂志, 2013, 17(3): 218-221. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201303008.htm MA J F, DAI J H, RU J G, et al. Study on the relationship between adult mental health status and adverse childhood experiences among medical college students[J]. Chin J Dis Control Prev, 2013, 17(3): 218-221. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201303008.htm
[8]	HUH H J, KIM K H, LEE H, et al. The relationship between childhood trauma and the severity of adulthood depression and anxiety symptoms in a clinical sample: the mediating role of cognitive emotion regulation strategies[J]. J Affect Disord, 2017, 213: 44-50. doi: 10.1016/j.jad.2017.02.009
[9]	DIERKHISING C B, FORD J D, BRANSON C, et al. Developmental timing of polyvictimization: continuity, change, and association with adverse outcomes in adolescence[J]. Child Abuse Negl, 2019, 87: 40-50. doi: 10.1016/j.chiabu.2018.07.022
[10]	周春燕, 宋炜玲, 李林, 等. 儿童期逆境国际问卷在中学生群体中的信效度分析[J]. 中国临床心理学杂志, 2022, 30(6): 1329-1333. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY202206012.htm ZHOU C Y, SONG W L, LI L, et. al. Reliability and validity of the revised Adverse Childhood Experiences-International Questionnaire (ACE-IQ) among the Chinese middle school students[J]. Chin J Clin Psychol, 2022, 30(6): 1329-1333. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY202206012.htm
[11]	BIRLESON P. The validity of depressive disorder in childhood and the development of a self-rating scale: a research report[J]. J Child Psychol Psychiatry, 1981, 22(1): 73-88. doi: 10.1111/j.1469-7610.1981.tb00533.x
[12]	苏林雁, 王凯, 朱炎, 等. 儿童抑郁障碍自评量表的中国城市常模[J]. 中国心理卫生杂志, 2003(8): 547-549. doi: 10.3321/j.issn:1000-6729.2003.08.011 SU L Y, WANG K, ZHU Y, et al. Norm of the Depression Self-Rating Scale for children in Chinese urban children[J]. Chin Ment Health J, 2003, 17(8): 547-549. (in Chinese) doi: 10.3321/j.issn:1000-6729.2003.08.011
[13]	赵品良, 史占彪, 张金凤. 儿童焦虑敏感性指数的效度研究[J]. 中国临床心理学杂志, 2013, 21(3): 393-397. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201303013.htm ZHAO P L, SHI Z B, ZHANG J F. Psychometric properties of the childhood anxiety sensitivity index in children and adolescents[J]. Chin J Clin Psychol, 2013, 21(3): 393-397. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201303013.htm
[14]	任芳, 张劲松. 儿童焦虑敏感性指数量表的临床应用[J]. 中国儿童保健杂志, 2012, 20(4): 330-332. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201204016.htm REN F, ZHANG J S. Application of childhood anxiety sensitivity index[J]. Chin J Child Health Care, 2012, 20(4): 330-332. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201204016.htm
[15]	邢超, 屠春雨, 谈荣梅, 等. 青少年应对方式与抑郁焦虑情绪的关联[J]. 中国学校卫生, 2011, 32(12): 1449-1451. https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS201112018.htm XING C, TU C Y, TAN R M, et al. Association of coping styles with depression and anxiety among adolescents[J]. Chin J Sch Health, 2011, 32(12): 1449-1451. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS201112018.htm
[16]	程芳, 胡珍玉, 张文武. 宁波市2123名中学生焦虑情绪及其影响因素调查研究[J]. 中国现代医生, 2016, 54(7): 122-126. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS201607039.htm CHENG F, HU Z Y, ZHANG W W. Investigation and research on anxiety and its influencing factors for 2123 middle school students in Ningbo[J]. Chin Mod Doct, 2016, 54(7): 122-126. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS201607039.htm
[17]	刘小群, 杨孟思, 彭畅, 等. 校园欺凌中不同角色中学生的焦虑抑郁情绪[J]. 中国心理卫生杂志, 2021, 35(6): 475-481. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS202106010.htm LIU X Q, YANG M S, PENG C, et al. Anxiety emotion and depressive mood of middle school students with different roles in school bullying[J]. Chin Ment Health J, 2021, 35(6): 475-481. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS202106010.htm
[18]	于增艳, 赵阿勐, 刘爱书. 儿童期受虐经历与抑郁的元分析[J]. 心理学报, 2017, 49(1): 40-49. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXB201701004.htm YU Z Y, ZHAO A M, LIU A S. Childhood maltreatment and depression: a Meta-analysis [J]. Acta Psychol Sinica, 2017, 49(1): 40-49. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XLXB201701004.htm
[19]	CHEN X, WANG L, CAO R. Shyness-sensitivity and unsociability in rural Chinese children: relations with social, school, and psychological adjustment[J]. Child Dev, 2011, 82(5): 1531-1543.
[20]	FINKELHOR D, SHATTUCK A, TURNER H, et al. A revised inventory of adverse childhood experiences[J]. Child Abuse Negl, 2015, 48: 13-21.
[21]	张慧会, 张亮. 早期应激对情绪调节的影响及其神经机制[J]. 心理科学进展, 2018, 26(7): 1193-120. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXD201807006.htm ZHANG H H, ZHANG L. The effects of early life stress on emotion regulation and the underlying mechanisms[J]. Adv Psychol Sci, 2018, 26(7): 1193-1203. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XLXD201807006.htm
[22]	李潇晓, 刘越, 周东洋, 等. 留守初中生亲子互动与心理健康的性别差异[J]. 中国学校卫生, 2021, 42(6): 876-878. doi: 10.16835/j.cnki.1000-9817.2021.06.018 LI X X, LIU Y, ZHOU D Y, et al. Gender difference in parent-child interaction and mental health of left-behind adolescents in junior high school[J]. Chin J Sch Health, 2021, 42(6): 876-878. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.06.018
[23]	KONG J, LIU Y, GOLDBERD J, et al. Adverse childhood experiences amplify the longitudinal associations of adult daily stress and health[J]. Child Abuse Negl, 2021, 122: 105337.