童年期创伤和心理弹性与青少年非自杀性自伤关联性研究  

A study on the correlation between childhood trauma,resilience and non-suicidal self-injury in adolescents

作　　者：高媛媛[1] 王冉[1] 李娜[1] 王岚[1] 赵天宇 赵晓川[1] 卢文婷[1] 焦艳明 张聪敏[1] 李宁[1] 王金成 王学义[1] GAO Yuanyuan;WANG Ran;LI Na;WANG Lan;ZHAO Tianyu;ZHAO Xiaochuan;LU Wenting;JIAO Yanming;ZHANG Congmin;LI Ning;WANG Jincheng;WANG Xueyi(Department of Psychiatry,the First Hospital of Hebei Medical University,Hebei Institute of Mental Health,Shijiazhuang 050031,China)

机构地区：[1]河北医科大学精神卫生中心,河北省精神心理疾病临床医学研究中心,河北省精神卫生研究所,河北省精神心理健康评估与干预技术创新中心,石家庄050031

出　　处：《中国神经精神疾病杂志》2024年第8期483-488,共6页Chinese Journal of Nervous and Mental Diseases

基　　金：河北省省级科技计划资助(编号:21377711D);河北省引进外国智力项目(编号:YZ202306);河北省精神心理疾病临床医学研究中心项目(编号:199776245D);河北省医学科学研究课题(编号:20201141)。

摘　　要：目的探讨童年期创伤和心理弹性对青少年非自杀性自伤行为(non-suicidal self-injury,NSSI)的影响。方法纳入158例首发青少年心境障碍患者,根据有无NSSI行为,将其分为伴NSSI组(n=94)和不伴NSSI组(n=64)。采用汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、童年期创伤问卷(childhood trauma questionnaire,CTQ-SF)、心理弹性量表(Connor-Davidson resilience scale,CD-RISC)评估抑郁焦虑情绪、童年期创伤经历及心理弹性水平。结果伴NSSI组与不伴NSSI比较,发病年龄小[(16.17±1.67)岁vs.(16.73±1.37)岁],文化程度初中及以下(30.9%vs.15.6%)、留守经历(48.9%vs.29.7%)、学校欺凌(46.8%vs.25.0%)、自杀意念(85.1%vs.37.5%)、自杀未遂史(29.8%vs.6.3%)者更多,HAMD评分(27.99±5.94 vs.24.19±5.19)、HAMA评分(18.02±5.94 vs.15.45±4.99)、CTQ总分(48.43±15.40 vs.41.97±9.75)、情感虐待分值(12.77±6.06 vs.10.19±4.06)、情感忽视分值(11.40±5.34 vs.9.14±3.55)更高,两组差异有统计学意义(P<0.05)。不伴NSSI组心理弹性总分(39.83±10.27 vs.28.66±12.75)、坚韧性(19.59±4.92 vs.12.28±6.47)、力量性(12.03±3.98 vs.9.99±4.67)、乐观性(8.98±2.97 vs.6.47±3.73)评分高于伴NSSI组(P<0.05)。logistic回归分析显示,留守经历(OR=4.494,95%CI:1.192~16.940)、学校欺凌(OR=5.983,95%CI:1.329~26.945)、自杀意念(OR=13.225,95%CI:2.908~60.146)、自杀未遂史(OR=16.769,95%CI:1.845~152.379)、HAMD评分(OR=1.264,95%CI:1.046~1.626)、情感虐待(OR=1.327,95%CI:1.093~1.612)、坚韧性(OR=0.468,95%CI:0.266~0.823)与青少年心境障碍患者NSSI行为的关联有统计学意义(P<0.05)。结论留守经历、校园欺凌、自杀意念及自杀未遂、情感虐待、抑郁程度、心理弹性可能与青少年心境障碍患者NSSI行为相关联。Objective To explore association between childhood trauma,resilience and non-suicidal self-injury in adolescents.Methods One hundred and fifty-eight first-episode adolescent patients with mood disorders were selected and divided into NSSI group(n=94)and non-NSSI group(n=64)based on presence or absence of NSSI.The Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA),childhood trauma questionnaire(CTQ-SF)and Connor-Davidson resilience scale(CD-RISC)were used to evaluate the depression and anxiety symptoms,childhood trauma and resilience.Results There were more cases of younger age(16.17±1.67 vs.16.73±1.37),lower education level(30.9%vs.15.6%),left behind experience(48.9%vs.29.7%),school bullying(46.8%vs.25.0%),suicide ideation(85.1%vs.37.5%)and history of attempted suicide(29.8%vs.6.3%)in the group with NSSI compared to those without NSSI.The HAMD score(27.99±5.94 vs.24.19±5.19),HAMA score(18.02±5.94 vs.15.45±4.99),CTQ total score(48.43±15.40 vs.41.97±9.75),emotional abuse score(12.77±6.06 vs.10.19±4.06),and emotional neglect score(11.40±5.34 vs.9.14±3.55)were higher in the group with NSSI,and the differences between the two groups were significant(P<0.05).The total scores of psychological resilience(39.83±10.27 vs.28.66±12.75),resilience(19.59±4.92 vs.12.28±6.47),strength(12.03±3.98 vs.9.99±4.67),and optimism(8.98±2.97 vs.6.47±3.73)in the group without NSSI were higher than those in the group with NSSI(P<0.05).Logistic regression analysis showed that left behind experience(OR=4.494,95%CI:1.192-16.940),school bullying(OR=5.983,95%CI:1.329-26.945),suicidal ideation(OR=13.225,95%CI:2.908-60.146),history of attempted suicide(OR=16.769,95%CI:1.845-152.379),HAMD(OR=1.264,95%CI:1.046-1.626),emotional abuse(OR=1.327,95%CI:1.093-1.612),and resilience(OR=0.468,95%CI:0.266-0.823)were significantly associated with adolescent mood disorders with NSSI(P<0.05).Conclusion Left behind experience,campus bullying,suicidal ideation and attempted suicide,emotional abuse,degree of depression,and psychologica

关 键 词：青少年 心境障碍 非自杀性自伤 儿童期虐待 心理弹性 留守 欺凌 抑郁 自杀 

分 类 号：R749.4[医药卫生—神经病学与精神病学]