Associations of parenting style and depressive symptoms with nightmare disorder in adolescents
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摘要:
目的 探究噩梦障碍青少年的父母教养方式及抑郁情绪之间的关系,为制定有效的家庭干预措施和心理辅导提供科学依据。 方法 2023年1月—2024年8月,纳入杭州市各城区医院/社区或初高中招募的176名健康志愿者及杭州市第七人民医院收治的90名青少年噩梦障碍患者作为研究对象,采用噩梦经历问卷(NEQ)、家庭关系问卷(FRQ)、抑郁自评量表(PVP)对其进行测评。组间量表得分及定性资料比较采用t检验和χ2检验,采用Pearson相关和多元线性回归(逐步法)探究PVP与NEQ或FRQ之间的相关性,采用Process模型验证探究NEQ/FRQ/PVP之间的中介效应。 结果 噩梦障碍组在噩梦频率、NEQ 4个因子(生理影响、负性情绪、意义解释、恐怖刺激)和PVP得分(24.86±18.89,10.12±3.67,19.01±3.51,17.02±3.31,15.14±3.26,14.02±4.38)均高于健康对照组(2.34±1.04,6.49±2.18,17.63±4.76,13.91±4.24,12.40±4.49,9.39±3.28)(t值分别为15.79,10.11,2.43,6.09,5.14,27.46,P值均 < 0.05)。噩梦障碍组一般依恋、母亲鼓励得分均低于健康对照组(7.22±2.81,16.39±3.28)(t值分别为-5.53,-4.95);母亲虐待、母亲控制、父亲自由释放和父亲控制得分(8.23±1.80,13.11±3.73,18.36±3.37,12.04±3.29)均高于健康对照组(6.07±1.85,8.48±3.80,15.15±2.51,9.47±3.03)(t值分别为6.70,8.96,5.90,7.04)(P值均 < 0.01)。Pearson相关分析结果显示,噩梦障碍组PVP得分与负性情绪、噩梦频率、母亲虐待和母亲控制得分均呈正相关(r值分别为0.14,0.63,0.26,0.51,P值均 < 0.05)。多元线性回归分析结果显示,用FRQ得分预测NEQ得分,噩梦障碍组中调整R2=0.01~0.59,母亲虐待可以预测生理影响(β=0.33),母亲控制可以预测负性情绪、恐怖刺激和噩梦频率(β值分别为0.29,0.30,0.79);父亲自由释放可以预测负性情绪(β=0.26),父亲控制可以预测负性情绪和噩梦频率(β值分别为0.22,0.45)(P值均 < 0.05)。中介效应分析显示,在噩梦障碍组中,PVP得分是FRQ母亲控制与NEQ负性情绪间的中介变量。 结论 虐待、控制和忽视等不良家庭教养方式以及抑郁情绪可能是诱发青少年噩梦障碍的关键因素。 Abstract:Objective To explore the relationship between parenting styles and depressive symptoms in adolescents with nightmare disorder, so as to provide a scientific basis for formulating effective family intervention measures and psychological counseling. Methods From January 2023 to August 2024, 90 adolescents diagnosed with nightmare disorder and admitted to Hangzhou Seventh People's Hospital, along with 176 healthy controls from the urban areas of Hangzhou, were recruited as participants in the study. All participants were assessed using the Nightmare Experience Questionnaire (NEQ), Family Relationship Questionnaire (FRQ), and Plutchik-van Praag Self-report Depression Scale (PVP). The t-test and Chi-square test were conducted to compare two groups. Pearson correlation and stepwise multiple linear regression were employed to explore the correlations between PVP and NEQ or FRQ. The Process model was used to testing the mediating effects among NEQ/FRQ/PVP. Results The nightmare disorder group had higher scores in nightmare frequency, the four factors of NEQ (physical effect, negative emotion, meaning interpretation, horrible stimulation), and PVP than the healthy control group (24.86±18.89, 10.12±3.67, 19.01±3.51, 17.02±3.31, 15.14±3.26, 14.02±4.38; 2.34±1.04, 6.49±2.18, 17.63±4.76, 13.91±4.24, 12.40±4.49, 9.39±3.28)(t=15.79, 10.11, 2.43, 6.09, 5.14, 27.46, P < 0.05). The nightmare disorder group reported significantly lower scores in FRQ general attachment and maternal encouragement than the healthy control group (7.22±2.81, 16.39±3.28) (t=-5.53, -4.95). In contrast, they exhibited significantly higher scores in maternal abuse, maternal dominance, paternal freedom release, and paternal dominance than the healthy control group (8.23±1.80, 13.11±3.73, 18.36±3.37, 12.04±3.29; 6.07±1.85, 8.48±3.80, 15.15±2.51, 9.47±3.03) (t=6.70, 8.96, 5.90, 7.04, P < 0.01). The results of Pearson correlation analysis showed that, in the nightmare disorder group, the PVP score was positively correlated with negative emotion, nightmare frequency, maternal abuse, and maternal dominance score (r=0.14, 0.63, 0.26, 0.51, P < 0.05). The results of multiple linear regression analysis showed that when using FRQ score to predict NEQ score, the adjusted R2 in the nightmare disorder group was 0.01-0.59. Mother abuse could prediced physical effect (β=0.33); maternal dominance significantly predicted negative emotion, horrible stimulation, and nightmare frequency (β=0.29, 0.30, 0.79); paternal freedom release could predict negative emotion (β=0.26), paternal dominance predicted both negative emotion and nightmare frequency (β=0.22, 0.45) (P < 0.05). Mediation analysis further revealed that, in the nightmare disorder group, PVP scores served as a mediating variable between FRQ and NEQ. Conclusion Abusive, controlling, and neglectful family upbringing styles as well as depression maybe are key factors that may contribute to the development of nightmare disorder among adolescents. -
Key words:
- Legal guardians /
- Education /
- Depression /
- Nightmare disorder /
- Mental health /
- Adolescent
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 噩梦障碍组与健康对照组NEQ、FRQ和PVP得分比较($\bar{x}$±s)
Table 1. Comparison of NEQ, FRQ, and PVP scores between nightmare disorder group and healthy control group($\bar{x}$ ±s)
组别 人数 NEQ FRQ PVP 生理影响 负性情绪 意义解释 恐怖刺激 一般依恋 母亲鼓励 母亲虐待 母亲自由释放 母亲控制 父亲鼓励 父亲虐待 父亲自由释放 父亲控制 噩梦障碍组 90 10.12±3.67 19.01±3.51 17.02±3.31 15.14±3.26 14.72±4.52 14.02±4.38 8.23±1.80 18.22±2.24 13.11±3.73 12.30±2.67 8.30±2.18 18.36±3.37 12.04±3.29 14.02±4.38 健康对照组 176 6.49±2.18 17.63±4.76 13.91±4.24 12.40±4.49 17.22±2.81 16.39±3.28 6.07±1.85 17.06±2.54 8.48±3.80 13.17±4.45 7.91±1.43 15.15±2.51 9.47±3.03 9.39±3.28 t值 10.11 2.43 6.09 5.14 -5.53 -4.95 6.70 1.96 8.96 -1.71 2.22 5.90 7.04 27.46 P值 < 0.01 0.02 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 0.26 < 0.01 0.09 0.35 < 0.01 < 0.01 < 0.01 -
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