心理韧性在童年不良经历与青少年抑郁症状间的作用:基于网络分析的探索性研究  

The Role of Psychological Resilience in the Relationship between Adverse Childhood Experiences and Adolescent Depressive Symptoms:An Exploratory Study Based on Network Analysis

作　　者：白玉 舒畅[1,2] 王高华[1,2] BAI Yu;SHU Chang;WANG Gaohua(Mental Health Center,Renmin Hospital ofWuhan University,Wuhan 430060,China;Institute of Neuropsychiatry,Renmin Hospital ofWuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院精神卫生中心,武汉430060 [2]武汉大学人民医院神经精神病研究所,武汉430060

出　　处：《神经损伤与功能重建》2025年第2期73-78,共6页Neural Injury and Functional Reconstruction

基　　金：中国光华科技基金会项目(脑-肠轴在童年虐待影响青少年及成年早期抑郁发病和临床结局中的中介效应,No.GHKJJJ20220703)。

摘　　要：目的:探究青少年群体中不同童年不良经历亚型、心理韧性与不同抑郁症状的关系。方法:选取武汉大学人民医院精神科132名青少年抑郁症患者和38名健康青少年,采用童年不良经历问卷(ACE-IQ)评估青少年的童年不良经历暴露情况,采用Connor-Davidson韧性量表(CD-RISC)评估青少年心理韧性水平,采用17项汉密尔顿抑郁量表(HAMD-17)及斯奈思-汉密尔顿快感缺失量表(SHAPS)评估青少年抑郁症状及其严重程度;使用基于图论的网络分析方法探索青少年群体间童年不良经历、心理韧性、抑郁症状间的关联。结果:①3种童年不良经历暴露程度与6种抑郁症状严重程度均成正相关,心理韧性得分与3种童年不良经历暴露程度及6种抑郁症状严重程度均成负相关。②在童年不良经历-心理韧性-抑郁症状网络中,抑郁症状中的“迟缓”显示出最大的强度中心性,是最重要的抑郁症状;“虐待和忽视”在3种童年不良经历模式中显示出最大的强度中心性,是最重要的童年不良经历模式;“心理韧性”显示出最大桥接强度,是连接不同节点的“桥梁”。③网络稳定性及准确性检验结果显示强度中心性与桥强度均具有足够的稳定性。结论:心理韧性是心理健康的重要支持性因素,应积极提升心理韧性水平,防治童年不良经历带来的不良后果。Objective:To explore the relationships between different subtypes of adverse childhood experiences(ACEs),psychological resilience,and various depressive symptoms in adolescents.Methods:A total of 170 adolescent patients,including 132 adolescents with depression and 38 healthy adolescents,were selected from the psychiatry outpatient clinic of Wuhan University Renmin Hospital.The Adverse Childhood Experiences International Questionnaire(ACES-IQ)was used to assess the exposure to ACEs in adolescents,the Connor-Davidson Resilience Scale(CD-RISC)was employed to evaluate the level of psychological resilience,and the 17-item Hamilton Depression Rating Scale(HAMD-17)as well as the Snaith-Hamilton Exuberance Scale(SHAPS)were utilized to assess depressive symptoms and their severity in adolescents.Graph theory-based network analysis was conducted to explore the associations among ACEs,psychological resilience,and depressive symptoms within the adolescent population.Results:(1)The exposure levels of all three types of ACEs were positively correlated with the severity of all six types of depressive symptoms,while the scores of psychological resilience were negatively correlated with the exposure levels of the three types of ACEs and the severity of the six types of depressive symptoms.(2)In the ACEs-psychological resilience-depressive symptoms network,“psychomotor retardation”among the depressive symptoms showed the highest degree centrality and was the most important depressive symptom;“abuse and neglect”among the three types of ACEs patterns exhibited the highest degree centrality and was the most significant ACEs pattern;“psychological resilience”demonstrated the greatest bridge strength,acting as the“bridge”connecting different nodes.(3)The results of network stability and accuracy tests indicated that both degree centrality and bridge strength had sufficient stability.Conclusion:Psychological resilience is an important supportive factor for mental health,and efforts should be made to enhance the level of

关 键 词：童年不良经历 心理韧性 青少年 抑郁 网络分析 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.02[医药卫生—临床医学] R749