童年期虐待忽视与初中女生身心健康的关联

谢钱茹; 黄晓曼; 文雪; 汪耿夫

doi:10.16835/j.cnki.1000-9817.2024296

童年期虐待忽视与初中女生身心健康的关联

doi: 10.16835/j.cnki.1000-9817.2024296

1.
合肥市妇女儿童保健中心妇女保健部，安徽 230041
2.
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

基金项目:

国家自然科学基金项目 82204071

详细信息

作者简介:
谢钱茹(1980-)，女，安徽定远人，硕士，副主任医师，主要从事妇女保健方面工作

通讯作者:
汪耿夫，E-mail: wanggenfu@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: R179 B845.67 G444 R339.5⁺⁵
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出版历程
- 收稿日期: 2024-07-30
- 修回日期: 2024-08-08
- 网络出版日期: 2024-12-10
- 刊出日期: 2024-11-15

Association of childhood maltreatment with physical and mental health among junior high school girls

1.
Department of Maternal Health Care, Hefei Maternal and Child Health Care Institute, Hefei (230041), Anhui Province, China

摘要

摘要: 目的探究初中女生遭受童年期虐待忽视与身心健康之间的关联，为预防青少年身心健康提供基础数据。方法 2023年4—6月，采用分层随机整群抽样方法抽取安徽省6座城市共5 083名初中女生，使用中文版儿童创伤问卷简表、躯体症状量表-8、7条目广泛性焦虑障碍量表和9条目患者健康问卷开展调查。采用χ²检验进行组间比较，采用Logistic回归分析和χ²趋势检验探讨童年期虐待忽视与初中女生身心健康的关联。结果 34.3%的初中女生报告在小学及以前遭受过至少1种童年期虐待忽视，躯体虐待、情感虐待、性虐待、躯体忽视和情感忽视的报告率分别为13.9%, 27.1%, 7.3%, 7.0%和12.5%。不同类型童年期虐待忽视与初中女生焦虑症状、抑郁症状、躯体症状检出率均呈正相关(OR=2.53~6.90，P值均 < 0.01)；且随着童年期虐待忽视数量的增加，女生焦虑症状、抑郁症状、躯体症状检出的可能性均增加(χ_趋势²值分别为446.42，679.10，396.36；1种虐待忽视OR值分别为2.20，3.17，2.72；≥4种虐待忽视OR值分别为7.10，15.60，8.47，P值均 < 0.01)。结论童年期虐待忽视与初中女生身心健康密切相关，加强童年期虐待忽视预防控制，有助于缓解初中女生的负面身心健康状况。
- 虐待儿童 /
- 精神卫生 /
- 青春期发育 /
- 回归分析 /
- 学生 /
- 女(雌)性
Abstract: Objective To explore the association of childhood maltreatment with physical and mental health in junior high school girls, so as to provide a basic data for the prevention of adolescent physical and mental health. Methods From April to June 2023, a total of 5 083 junior high school girls in six cities in Anhui Province were selected by a stratified cluster random sampling method and surveyed by Childhood Trauma Questionnaire-Short Form, Somatic Symptom Scale-8, 7-tiem Generalized Anxiety Disorder Scale and Patient Health Questionnaire-9. Chi-quare test was used for inter group comparison, and Logistic regression analysis and Chi-quare trend test were used to explore the association of childhood maltreatment with physical and mental health of junior high school girls. Results About 34.3% of junior high school girls experienced at least one type of childhood maltreatment in elementary school and before, and the reporting rates of physical abuse, emotional abuse, sexual abuse, physical neglect and emotional neglect were 13.9%, 27.1%, 7.3%, 7.0% and 12.5%, respectively. Different types of childhood maltreatment were positively correlated with the detection of anxiety symptoms, depressive symptoms and somatic symptoms (OR=2.53-6.90, P < 0.01). And as the number of childhood maltreatment increased, the detection possibilty of anxiety symptoms, depressive symptoms and somatic symptoms in girls also increased (χ_trend²=446.42, 679.10, 396.36;1 type of childhood maltreatment: OR=2.20, 3.17, 2.72; more than 4 types of childhood maltreatment: OR=7.10, 15.60, 8.47, P < 0.01). Conclusion Childhood maltreatment is closely related to the physical and mental health of junior high school girls, and strengthening the prevention and control of childhood maltreatment can help alleviate the negative physical and mental health impacts on junior high school girls.
- Child abuse /
- Mental health /
- Adolescent development /
- Regression analysis /
- Students /
- Female
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 不同人口统计学特征初中女生身心健康症状检出率比较

Table 1. Comparison of the detection rates of physical and mental health symptoms among junior high school girls with different demographic characteristics

人口统计学指标		人数	统计值	焦虑症状	抑郁症状	躯体症状
地区	皖南	1 719		966(56.2)	916(53.3)	1 082(62.9)
	皖中	1 595		867(54.4)	827(51.8)	988(61.9)
	皖北	1 769		1 072(60.6)	1 042(58.9)	1 192(67.4)
			χ²值	14.31	19.22	12.51
			P值	< 0.01	< 0.01	< 0.01
年级	七	1 737		875(50.4)	839(48.3)	971(55.9)
	八	1 654		963(58.2)	922(55.7)	1 112(67.2)
	九	1 692		1 067(63.1)	1 024(60.5)	1 179(69.7)
			χ²值	57.49	52.56	80.75
			P值	< 0.01	< 0.01	< 0.01
是否独生	是	1 090		599(55.0)	559(51.3)	652(59.8)
子女	否	3 993		2 306(57.8)	2 226(55.7)	2 610(65.4)
			χ²值	2.74	6.89	11.46
			P值	0.11	< 0.01	< 0.01
户籍	城市	2 253		1 264(56.1)	1 167(51.8)	1 400(62.1)
	农村	2 830		1 641(58.0)	1 618(57.2)	1 862(65.8)
			χ²值	1.82	14.63	7.29
			P值	0.18	< 0.01	< 0.01
家庭类型	核心家庭	2 849		1 634(57.4)	1 526(53.6)	1 802(63.3)
	单亲家庭	481		278(57.8)	270(56.1)	313(65.1)
	大家庭	1 279		697(54.5)	696(54.4)	826(64.6)
	其他	474		296(62.4)	293(61.8)	321(67.7)
			χ²值	9.24	11.60	3.91
			P值	0.03	< 0.01	0.27
与母亲	一般及以下	1 753		1 190(67.9)	1 240(70.7)	1 282(73.1)
关系	亲密	2 256		1 235(54.7)	1 112(49.3)	1 404(62.2)
	非常亲密	1 074		480(44.7)	433(40.3)	576(53.6)
			χ²值	155.87	298.32	116.80
			P值	< 0.01	< 0.01	< 0.01
与父亲	一般及以下	2 702		1 774(65.7)	1 759(65.1)	1 899(70.3)
关系	亲密	1 830		924(50.5)	840(45.9)	1 099(60.1)
	非常亲密	551		207(37.6)	186(33.8)	264(47.9)
			χ²值	199.22	272.72	120.72
			P值	< 0.01	< 0.01	< 0.01
自评学习	中等以下	2 283		1 359(59.5)	1 350(59.1)	1 489(65.2)
成绩	中等	1 961		1 097(55.9)	1 042(53.1)	1 264(64.5)
	中等以上	839		449(53.5)	393(46.8)	509(60.7)
			χ²值	10.96	40.95	5.64
			P值	< 0.01	< 0.01	0.06
与老师	一般及以下	3 300		2 030(61.5)	2 023(61.3)	2 232(67.6)
关系	较好	1 504		766(50.9)	675(44.9)	895(59.5)
	非常好	279		109(39.1)	87(31.2)	135(48.4)
			χ²值	86.68	178.91	61.69
			P值	< 0.01	< 0.01	< 0.01
与同学	一般及以下	1 906		1 225(64.3)	1 256(65.9)	1 335(70.0)
关系	较好	2 508		1 374(54.8)	1 258(50.2)	1 564(62.4)
	非常好	669		306(45.7)	271(40.5)	363(54.3)
			χ²值	80.76	171.73	60.73
			P值	< 0.01	< 0.01	< 0.01
注： ()内数字为检出率/%。

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表 2 有无童年期虐待忽视经历初中女生身心健康症状检出率比较

Table 2. Comparison of the detection rates of physical and mental health symptoms among junior high school girls with or without childhood maltreatment experiences

童年期虐待忽视类型	选项	人数	统计值	焦虑症状	抑郁症状	躯体症状
躯体虐待	无	4 377		2 356(53.8)	2 203(50.3)	2 657(60.7)
	有	706		549(77.8)	582(82.4)	605(85.7)
			χ²值	142.22	252.97	165.14
			P值	< 0.01	< 0.01	< 0.01
情感虐待	无	3 703		1 788(48.3)	1 626(43.9)	2 079(56.1)
	有	1 380		1 117(80.9)	1 159(84.0)	1 183(85.7)
			χ²值	437.82	651.82	382.63
			P值	< 0.01	< 0.01	< 0.01
性虐待	无	4 712		2 607(55.3)	2 484(52.7)	2 946(62.5)
	有	371		298(80.3)	301(81.1)	316(85.2)
			χ²值	87.75	112.11	76.77
			P值	< 0.01	< 0.01	< 0.01
躯体忽视	无	4 726		2 602(55.1)	2 467(52.2)	2 942(62.3)
	有	357		303(84.9)	318(89.1)	320(89.6)
			χ²值	120.50	182.21	108.27
			P值	< 0.01	< 0.01	< 0.01
情感忽视	无	4 448		2 359(53.0)	2 211(49.7)	2 704(60.8)
	有	635		546(86.0)	574(90.4)	558(87.9)
			χ²值	246.35	371.34	177.28
			P值	< 0.01	< 0.01	< 0.01
总体	无	3 342		1 556(46.6)	1 378(41.2)	1 807(54.1)
	有	1 741		1 349(77.5)	1 407(80.8)	1 455(83.6)
			χ²值	447.04	724.04	433.38
			P值	< 0.01	< 0.01	< 0.01
注： ()内数字为检出率/%。

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表 3 初中女生童年期虐待忽视经历与身心健康关系的Logistic回归分析[OR值(95%CI)，n=5 083]

Table 3. Logistic regression analysis of the relationship between childhood maltreatment experience and physical and mental health of junior high school girls[OR(95%CI), n=5 083]

自变量	焦虑症状	抑郁症状	躯体症状
躯体虐待	2.53(2.09~3.07)	3.83(3.10~4.72)	3.39(2.71~4.24)
情感虐待	3.93(3.36~4.59)	5.58(4.73~6.58)	4.22(3.56~5.01)
性虐待	2.83(2.17~3.70)	3.28(2.49~4.31)	3.04(2.26~4.09)
躯体忽视	3.75(2.77~5.06)	5.95(4.21~8.39)	4.46(3.14~6.33)
情感忽视	4.23(3.33~5.37)	6.90(5.23~9.11)	3.80(2.95~4.90)
童年期虐待忽视	3.39(2.95~3.89)	4.99(4.31~5.76)	3.91(3.36~4.55)
注： P值均 < 0.01。

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表 4 初中女生童年期虐待忽视数量与身心健康关系Logistic回归分析[OR值(95%CI)]

Table 4. Logistic regression analysis of the relationship between the number of childhood maltreatment experiences and physical and mental health of junior high school girls[OR(95%CI)]

虐待忽视数量/种	人数	焦虑症状	抑郁症状	躯体症状
1	772	2.20(1.86~2.62)	3.17(2.65~3.78)	2.72(2.25~3.28)
2	478	4.91(3.81~6.31)	7.10(5.43~9.27)	5.06(3.84~6.66)
3	293	5.44(3.89~7.61)	8.38(5.80~12.11)	5.98(4.11~8.71)
≥4	198	7.10(4.54~11.10)	15.60(8.79~27.67)	8.47(5.03~14.27)
注：自变量以无童年期虐待忽视为参照组，P值均 < 0.01。

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