Associations between educational burden and depression and anxiety symptoms among middle school students in Taizhou City
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摘要:
目的 了解台州市中学生抑郁和焦虑症状及其与学业负担的关系，为制定更有针对性的心理干预措施提供理论依据。 方法 于2022年9—11月，运用多阶段整群抽样方法，从台州市5个区县的30所中学抽取初一到高三学生共8 128名完成问卷星平台的在线调查。采用青少年学习压力量表(ESSA)测量中学生学习压力情况，儿童抑郁量表(CDI)和广泛性焦虑量表(GAD-7)分别用于筛查抑郁和焦虑症状。采用Logistic回归模型对中学生学业负担与抑郁和焦虑症状之间的关系进行分析。 结果 台州市中学生抑郁和焦虑症状检出率分别为19.3%和11.1%。中学生学习压力量表平均得分为(52.8±11.5)分；课外辅导班和兴趣班门数平均 < 1门，课外班每天平均时长 < 1 h；人均每天用3.6 h写学校老师布置的作业，写家长、补习班布置作业 < 1 h；30.0%的学生学习日可自由支配时间≤0.5 h，28.5%的学生周末可自由支配时间≤2 h，30.8%的学生认为自己成绩较差。二元Logistic回归分析结果显示，在控制一般人口学变量后，学习压力量表得分更高、参与更多课外辅导班和兴趣班、学习日和周末写学校老师布置作业的时间更长、学习日和周末写家长和补习班布置作业的时间更长、学习日和周末上与课业有关的校外辅导班的时间更长、学习日和周末上与课业无关的兴趣班的时间更长、学习日可自由支配的时长≤0.5 h、周末可自由支配的时长≤2 h、成绩状况较差的中学生，存在抑郁和焦虑症状的风险更高(OR值分别为1.09，1.07，1.08，1.05，1.04，1.08，1.08，1.08，1.06，1.09，1.07，1.47，1.34，2.84；1.08，1.06，1.08，1.04，1.03，1.05，1.05，1.05，1.05，1.07，1.06，1.48，1.23，1.75，P值均 < 0.05)；成绩状况一般的中学生仅存在抑郁症状的风险更高(OR=1.34，P < 0.01)。 结论 学业负担对台州中学生的抑郁和焦虑症状存在负面影响。应减轻中学生的学业负担，改善其心理健康状况。 Abstract:Objective To investigate the prevalence of depression and anxiety symptoms among middle school students in Taizhou, Zhejiang Province, and its associations with their educational burden, so as to provide a theoretical reference for making more targeted psychological interventional measures. Methods A cross-sectional study was conducted by multi-stage cluster sampling from September to November 2022 from 30 schools in five districts and counties of Taizhou, with a final sample of 8 128 junior and senior high school students completing the online surveys on the Questionnaire Star platform. The Educational Stress Scale for Adolescents (ESSA) was used to measure academic stress; the Child Depression Inventory (CDI) and the Generalized Anxiety Disorder Scale (GAD-7) were used to screen students' depression and anxiety, respectively. The relationships between educational burden and depression and anxiety symptoms were analyzed by Logistic regression models. Results The prevalence of depression and anxiety were 19.3% and 11.1%, respectively. The average score of middle school students' study pressure was (52.8±11.5). The number of extracurricular classes was < 1, the time length of extracurricular courses was < 1 hour per day, and students averagely spend 3.6 hours per day on homework assigned by school teachers. Nearly 30.0% students had ≤0.5 of discretionary time school days and 28.5% students had ≤2 on weekends. About 30.8% students though they do worse in their academic performance. According to the results of binary Logistic regression analysis, after controlling the demographic variables, the score in Study Pressure Scale, the number of extracurricular classes, the volume of homework and the time length of extracurricular courses were positively associated with depression and anxiety (OR=1.09, 1.07, 1.08, 1.05, 1.04, 1.08, 1.08, 1.08, 1.06, 1.09, 1.07, 1.47, 1.34, 2.84; 1.08, 1.06, 1.08, 1.04, 1.03, 1.05, 1.05, 1.05, 1.05, 1.07, 1.06, 1.48, 1.23, 1.75, P < 0.05). Students with overage grades had a higher risk of depression symptoms (OR=1.34, P < 0.05). Conclusions Academic burden has negative effects on depression and anxiety of students in Taizhou. It is advisable to alleviate academic stress, so as to improve the mental health of students. -
Key words:
- Depression /
- Anxiety /
- Mental health /
- Regression analysis /
- Students
1) 利益冲突声明 所有作者声明无利益冲突。2) 王子瑶与陈潇潇为共同第一作者 -
表 1 不同组别中学生抑郁焦虑症状检出率比较
Table 1. Comparison of the detection rate of depression and anxiety symptoms among different groups of middle school students
组别 选项 人数 抑郁症状 焦虑症状 检出人数 χ2值 P值 检出人数 χ2值 P值 性别 男 4 318 811(18.8) 1.69 0.19 458(10.6) 2.71 0.10 女 3 810 759(19.9) 448(11.8) 学段 初中 4 092 657(16.1) 56.20 <0.01 369(9.0) 37.72 <0.01 高中 4 036 913(22.6) 537(13.3) 学校类型 公办 6 160 1 126(18.3) 17.55 <0.01 645(10.5) 11.73 <0.01 民办或私立 1 968 444(22.6) 261(13.3) 户籍 城市 2 663 479(18.0) 4.49 0.03 298(11.2) 0.01 0.93 农村 5 465 1 091(20.0) 608(11.1) 自评家庭经济状况 较好 1 304 178(13.7) 167.71 <0.01 126(9.7) 42.99 <0.01 一般 6 283 1 179(18.8) 674(10.7) 较差 541 213(39.4) 106(19.6) 与母亲的关系 良好 6 705 953(14.2) 679.08 <0.01 578(8.6) 305.76 <0.01 一般 1 171 485(41.4) 244(20.8) 较差 178 107(60.1) 71(39.9) 其他 74 25(33.8) 13(17.6) 与父亲的关系 良好 6 067 782(12.9) 733.31 <0.01 472(7.8) 348.62 <0.01 一般 1 679 585(34.8) 309(18.4) 较差 299 177(59.2) 106(35.5) 其他 83 26(31.3) 19(22.9) 父亲学历 小学及以下 1 073 282(26.3) 39.10 <0.01 138(12.9) 4.33 0.12 初中、高中或中专 5 673 1 046(18.4) 609(10.7) 大学及以上 1 382 242(17.5) 159(11.5) 母亲学历 小学及以下 1 299 314(24.2) 25.00 <0.01 173(13.3) 8.34 0.02 初中、高中或中专 5 428 1 015(18.7) 593(10.9) 大学及以上 1 401 241(17.2) 140(10.0) 最近3个月是否有应激事件 是 903 288(31.9) 103.12 <0.01 166(18.4) 53.71 <0.01 否 7 225 1 282(17.7) 740(10.2) 是否有躯体疾病 是 367 155(42.2) 132.58 <0.01 101(27.5) 114.08 <0.01 否 7 761 1 415(18.2) 805(10.4) 是否进行体育锻炼 是 4 727 691(14.6) 159.97 <0.01 437(9.2) 41.26 <0.01 否 3 401 879(25.8) 469(13.8) 注：( )内数字为检出率/%。 
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表 2 中学生学业负担与抑郁焦虑症状的二元Logistic回归分析[n=8 128, OR值(95%CI)]
Table 2. Binary Logistic regression analysis of factors related to depression and anxiety symptoms and educational burden among middle school students[n=8 128, OR(95%CI)]
自变量 抑郁症状 焦虑症状 模型1 模型2 模型1 模型2 学习压力量表得分 1.10(1.09~1.10)** 1.09(1.08~1.10)** 1.09(1.08~1.10)** 1.08(1.08~1.09)** 课外班门数 课外辅导班门数 1.06(1.03~1.10)** 1.07(1.03~1.11)** 1.07(1.03~1.11)** 1.06(1.01~1.10)** 兴趣班门数 1.06(1.02~1.10)** 1.08(1.03~1.12)** 1.09(1.04~1.13)** 1.08(1.04~1.14)** 每天学习及课外活动平均时长 学习日写学校老师布置的作业 1.08(1.07~1.10)** 1.05(1.03~1.08)** 1.08(1.05~1.10)** 1.04(1.02~1.07)** 周末写学校老师布置的作业 1.05(1.03~1.07)** 1.04(1.02~1.06)** 1.04(1.02~1.06)** 1.03(1.00~1.05)* 学习日写家长、补习班布置的作业 1.08(1.06~1.11)** 1.08(1.05~1.11)** 1.07(1.04~1.10)** 1.05(1.02~1.08)** 周末写家长、补习班布置的作业 1.07(1.05~1.09)** 1.08(1.05~1.10)** 1.06(1.03~1.08)** 1.05(1.02~1.07)** 学习日上与课业有关的校外辅导班 1.10(1.07~1.12)** 1.08(1.05~1.11)** 1.08(1.05~1.11)** 1.05(1.02~1.08)** 周末上与课业有关的校外辅导班 1.07(1.04~1.09)** 1.06(1.04~1.09)** 1.07(1.04~1.09)** 1.05(1.02~1.08)** 学习日上与课业无关的兴趣班 1.12(1.08~1.15)** 1.09(1.05~1.13)** 1.11(1.07, 1.14)** 1.07(1.03~1.11)** 周末上与课业无关的兴趣班 1.08(1.05~1.11)** 1.07(1.04~1.11)** 1.07(1.05~1.11)** 1.06(1.02~1.09)** 学习日可自由支配的时间 ≤0.5 h/d 1.67(1.49~1.88)** 1.47(1.29~1.67)** 1.70(1.47~1.96)** 1.48(1.27~1.72)** 学习日可自由支配的时间 ≤2 h/d 1.36(1.21~1.53)** 1.34(1.17~1.52)** 1.30(1.12~1.51)** 1.23(1.05~1.43)* 自评成绩状况 一般 1.50(1.29~1.76)** 1.34(1.14~1.59)** 1.27(1.05~1.53)* 1.17(0.96~1.42) 较差 3.50(3.02~4.05)** 2.84(2.42~3.33)** 2.16(1.80~2.58)** 1.75(1.45~2.11)** 注：*P<0.05，**P<0.01。
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