儿童期虐待对青少年抑郁障碍患者非自杀性自伤行为的影响:心理弹性和抑郁情绪的链式中介作用  

Influence of childhood abuse on non-suicidal self-injury in adolescents with depressive disorder:the chain mediation roles of psychological resilience and depression

作　　者：段登艾 张志雄 王维[1] 张勇辉[1] 张轶杰[1] 谷樟林 DUAN Deng′ai;ZHANG Zhixiong;WANG Wei;ZHANG Yonghui;ZHANG Yijie;GU Zhanglin(Department of Psychiatry,Yunnan Provincial Psychiatric Hospital,Kunming 650224;Department of Cardiovascular Medicine,Yunnan Third People′s Hospital,Kunming 650011)

机构地区：[1]云南省精神病医院精神科,昆明650224 [2]云南省第三人民医院心血管内科,昆明650011

出　　处：《郑州大学学报（医学版）》2024年第1期95-99,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：昆明市卫生健康委员会卫生科研课题项目(2022-03-09-018);云南省精神病医院项目(2022-09)。

摘　　要：目的:探讨青少年抑郁障碍患者儿童期虐待与非自杀性自伤行为(NSSI)的关系。方法:采用汉密尔顿抑郁量表24项评分、青少年非自杀性自伤行为问卷、心理弹性量表和儿童期虐待问卷对云南省精神病医院住院治疗的213例青少年抑郁障碍患者进行调查。结果:儿童期虐待对NSSI行为具有正向预测作用[β(95%CI)=0.112(0.076~0.148),P<0.001],儿童期虐待对心理弹性存在负向预测作用[β(95%CI)=-0.459(-0.629~-0.289),P<0.001],对抑郁情绪存在正向预测作用[β(95%CI)=0.100(0.027~0.172),P<0.001];儿童期虐待、心理弹性、抑郁情绪同时对NSSI行为存在预测作用[β(95%CI)=0.047(0.012~0.082),-0.064(-0.093~-0.034)和0.201(0.127~0.275),P<0.001]。心理弹性在儿童期虐待与NSSI行为之间的中介效应值(95%CI)为0.029(0.015~0.051),占总效应的25.89%;抑郁情绪在儿童期虐待与NSSI行为之间的中介效应值(95%CI)为0.020(0.006~0.040),占总效应的17.86%;心理弹性和抑郁情绪在儿童期虐待与NSSI行为之间的链式中介效应值(95%CI)为0.016(0.009~0.028),占总效应的14.29%。结论:心理弹性和抑郁情绪在青少年抑郁障碍患者儿童期虐待对NSSI的影响中起到链式中介作用。Aim:To explore the relationship between childhood abuse and non-suicidal self-injury(NSSI)in adolescents with depressive disorder.Methods:A total of 213 adolescents with depressive disorder were investigated by Hamilton Depression Scale-24,Non-Suicidal Self-Injury Questionnaire,the Connor-Davidson Resilience Scale and Childhood Trauma Questionnaire in Yunnan Psychiatric Hospital.Results:Childhood abuse had positive predictive effect on NSSI behavior[β(95%CI)=0.112(0.076-0.148),P<0.001],negative predictive effect on resilience[β(95%CI)=-0.459(-0.629--0.289),P<0.001]and positive predictive effect on depression[β(95%CI)=0.100(0.027-0.172),P<0.001];childhood abuse,resilience and depression had predictive effect on NSSI behavior[β(95%CI)=0.047(0.012-0.082),P=0.010;β(95%CI)=-0.064(-0.093--0.034),P<0.001;β(95%CI)=0.201(0.127-0.275),P<0.001].The mediating effect value of resilience between childhood abuse and NSSI behavior was 0.029(95%CI:0.015-0.051),accounting for 25.89%of the total effect;the mediating effect value of depression between childhood abuse and NSSI behavior was 0.020(95%CI:0.006-0.040),accounting for 17.86%of the total effect;the chain mediating effect value of resilience and depression between childhood abuse and NSSI behavior was 0.016(95%CI:0.009-0.028),accounting for 14.29%of the total effect.Conclusion:Resilience and depression play a chain mediating role in the effect of childhood abuse on NSSI in adolescents with depressive disorder.

关 键 词：儿童期虐待 非自杀性自伤行为 心理弹性 抑郁障碍 

分 类 号：R749[医药卫生—神经病学与精神病学]