混合性焦虑抑郁障碍青少年同伴关系对孤独感的影响:睡眠质量和心理弹性的链式中介效应分析  

The effect of peer relationship on loneliness in adolescents with mixed anxiety and depressive disorder:a chain mediating effect analysis of sleep quality and psychological resilience

作　　者：贺云铃 王冬雪 张耀文 廖容[2] 任凯 张慧 He Yunling;Wang Dongxue;Zhang Yaowen;Liao Rong;Ren Kai;Zhang Hui(School of Nursing,Harbin Medical University,Harbin 150081,China;Department of Cardiology(South Bank),Second People's Hospital of Yibin,Yibin Hospital of West China Hospital,Sichuan University,Yibin 644000,China;Department of Nutrition,Second People's Hospital of Yibin,Yibin Hospital of West China Hospital,Sichuan University,Yibin 644000,China;Unit of Child and Adolescent Psychology,the Third Hospital of Daqing,Daqing 163712,China)

机构地区：[1]哈尔滨医科大学护理学院,哈尔滨150081 [2]宜宾市第二人民医院、四川大学华西医院宜宾医院心血管内科南区,644000 [3]宜宾市第二人民医院、四川大学华西医院宜宾医院营养科,644000 [4]大庆市第三医院儿童青少年心理单元,163712

出　　处：《神经疾病与精神卫生》2023年第7期497-503,共7页Journal of Neuroscience and Mental Health

摘　　要：目的 探讨睡眠质量和心理弹性在混合性焦虑抑郁障碍(MADD)青少年同伴关系与孤独感中的作用。方法 采用方便抽样法,选取2020年9月至2021年6月在大庆市第三医院青少年心理门诊就诊或住院的265例MADD青少年为研究对象。采用儿童青少年同伴关系量表、美国加州大学洛杉矶分校(UCLA)孤独感量表、青少年心理韧性量表(RSCA)、匹兹堡睡眠质量指数(PSQI)进行调查。采用Pearson相关分析MADD青少年同伴关系、孤独感、睡眠质量、心理弹性之间的相关性。采用SPSS PROCESS宏程序中的模型6进行中介效应检验。本研究共发放问卷280份,回收有效问卷265份,有效回收率为93.00%。结果 MADD青少年的儿童青少年同伴关系量表得分为(59.69±12.93)分,UCLA孤独感量表得分为(56.49±10.83)分,RSCA得分为(67.68±15.72)分,PSQI得分为(10.31±3.92)分。MADD青少年中睡眠质量与同伴关系、睡眠质量与孤独感、同伴关系与孤独感呈正相关(r=0.49、0.50、0.76;P<0.01),心理弹性与同伴关系、孤独感、睡眠质量呈负相关(r=-0.65、-0.69、-0.47;P<0.01)。心理弹性在MADD青少年同伴关系与孤独感间起部分中介作用,中介效应包含同伴关系-睡眠质量-孤独感、同伴关系-心理弹性-孤独感、同伴关系-睡眠质量-心理弹性-孤独感共3条路径,各路径的效应值分别占总效应值的6.94%、21.73%和3.93%,总间接效应占总效应的32.59%。结论 同伴关系除直接影响MADD青少年的孤独感外,还分别通过睡眠质量与心理弹性的中介作用、睡眠质量和心理弹性的链式中介作用产生间接影响。Objective To examine the effects of sleep quality and psychological resilience on the relationship between peer relationship and loneliness in adolescents with mixed anxiety and depressive disorder(MADD).Methods A total of 265 adolescents diagnosed with MADD,who visited or were hospitalized in the Unit of Child and Adolescent Psychology of Daqing Third Hospital from September 2020 to June 2021,were selected as the research subjects by convenience sampling method.Adolescent Peer Relationship Scale,University of California,Los Angeles(UCLA)Loneliness Scale,Resilience Scale for Children and Adolescent(RSCA),Pittsburgh Sleep Quality Index(PSQI)were used to investigate.Pearson correlation was used to analyze the correlation among peer relationship,loneliness,sleep quality and psychological resilience of MADD adolescents.The model 6 in SPSS PROCESS macro program was a used to test the mediating effect.A total of 280 questionnaires were distributed in this study,and 265 valid questionnaires were collected,with an effective response rate of 93.00%.Results The score of the Adolescent Peer Relationship Scale in MADD adolescents was(59.69±12.93),the score of the UCLA Loneliness Scale was(56.49±10.83),the RSCA score was(67.68±15.72),and the PSQI score was(10.31±3.92).In MADD adolescents,sleep quality was positively correlated with peer relationship,sleep quality with loneliness,and peer relationship with loneliness(r=0.49,0.50,0.76;P<0.01),while psychological resilience was negatively correlated with peer relationship,loneliness,and sleep quality(r=-0.65,-0.69,-0.47;P<0.01).Psychological resilience played a partial mediating role in the relationship between peer relationship and loneliness in adolescents with MADD.The mediating effect consisted of three pathways:peer relationship-sleep quality-loneliness;peer relationshipresilience-loneliness;peer relationship-sleep quality-resilience-loneliness.The effect value of these three pathways accounted for 6.94%,21.73%and 3.93% of the total effect,respectively.The total indirec

关 键 词：混合性焦虑抑郁障碍 同伴关系 孤独感 睡眠质量 心理弹性 链式中介效应 

分 类 号：R749[医药卫生—神经病学与精神病学]