摘要
目的 探讨有自伤行为青少年的心理健康状态及可能的相关因素。方法 在苏州市某城区设立的全部18所中学展开问卷普查,筛选出1 482名有自伤行为的青少年,采用广泛性焦虑量表(GAD-7)、患者健康问卷(PHQ-9)、匹兹堡睡眠质量指数(PSQI)、简明国际神经精神访谈(MINI)自杀筛选问卷来评估心理健康状态,一般自我效能感量表(GSES)、特质应对方式问卷(TCSQ)评估个性特征,自制人口学问卷来评估家庭相关因素。结果 有自伤行为青少年中42.5%存在睡眠质量问题,58.9%存在自杀意念,23.3%有自杀行为。低龄层(≤15岁)自杀行为的报告率较高(P<0.05)。而不同性别GSES、TCSQ积极和消极应对方式评分比较差异均具有统计学意义(P<0.01)。其中,有自伤行为的男生GSES稍高,但低于同一水平的健康青少年男生GSES常模(P<0.01)。与同一水平的健康青少年群体TCSQ常模相比,有自伤行为的青少年消极应对方式评分增加(P<0.01),且女生往往采用更为消极的应对方式处理生活事件。有自伤行为青少年不同户口、不同居住条件、不同父母受教育水平GSES评分比较差异均有统计学意义(P<0.05);是否为独生子女TCSQ消极应对方式评分比较差异有统计学意义(P<0.05);不同父母关系GAD-7、PHQ-9、PSQI、SR、GSES、TCSQ积极应对方式评分比较差异均有统计学意义(P<0.05)。中介模型检验结果显示父母关系可以预测有自伤行为青少年的自杀风险,其中,不同性别的个性特征在父母关系与自杀风险间中介作用不同。结论 有自伤行为青少年有中等程度的抑郁焦虑情绪,广泛存在睡眠质量问题及自杀意念,一般自我效能感降低,负性应对方式明显增加,推测不同性别的这部分青少年,改善其父母关系可以通过不同的途径降低其自杀风险。
Objective To explore the mental health status and possible related factors in adolescents with self-harm behaviors. Methods A total of 1 482 adolescents with self-harm behaviors were screened from all 18 middle schools in one district of Suzhou city and assessed with general information questionnaire, 7-item Generalized Anxiety Disorder(GAD-7), 9-item Patient Health Questionnaire(PHQ-9), Pittsburgh Sleep Quality Index(PSQI), Suicidal Risk(SR) section of Mini-International Neuropsychiatric Interview(MINI), General Self-Efficacy Scale(GSES) and Trait Coping Style Questionnaire(TCSQ). Results There were 42.5%, 58.9%, and 23.3% adolescents with self-harm behaviors reporting sleep quality problems, suicidal ideations and suicidal behaviors respectively. And the younger group(≤15 years old) showed higher incidence rates of suicidal behaviors(P<0.05). There existed significant differences in GSES scores and positive and negative coping style scores of TCSQ between adolescents with different genders(P<0.01). The total score of GSES in boys with self-harm behaviors was higher than that in girls, but lower than the norm(P<0.01). The negative coping style score of TCSQ in adolescents with self-harm behaviors was significantly higher than the norm(P<0.01), and the girls tended to deal with life events through more negative coping styles. There existed significant differences in the total scores of GSES among adolescents with different registered residences, different living conditions and parents’ different educational levels(P<0.05). The only child adolescents showed different negative coping style score of TCSQ from the non-only child adolescents(P<0.05). There existed significant differences in the total scores of GAD-7, PHQ-9, PSQI, SR, GSES and positive coping style score of TCSQ among adolescents with different parental relationships(P<0.05). Mediation model test results showed that parental relationship could predict the suicide risk of adolescents with self-harm behaviors, with different genders having different mediating roles. Conclusion The adolescents with self-harm behaviors possess moderate anxiety, depression and poor sleep quality, as well as suicidal ideations. They have lower self-efficacy, and more negative coping styles. It is speculated that the improvement of parental relationship among these adolescents of different genders could reduce their suicide risks in different ways.
出处
《精神医学杂志》
2022年第2期139-145,共7页
Journal of Psychiatry
基金
江苏省青年医学人才项目(编号:QNRC2016229)
苏州市卫生青年骨干人才“全国导师制”培训项目(编号:Qngg2021027)
苏州市姑苏卫生人才计划(编号:GSWS2020096)。
关键词
横断面调查
自伤
青少年
心理健康
个性特征
家庭
中介
Cross-sectional survey
Self-harm
Adolescents
Mental health
Individual characteristics
Family
Mediating effect
