留守中学生创伤后应激障碍的流行特征及影响因素  

Prevalence of post-traumatic stress disorder and analysis of influencing factors among left-behind middle school students

作　　者：王姜雪 吴纤 曾小朵 向兵[1,2] 杨梅[1,2] 周峰[1,2] 谢新艳 曾婧[1,2] WANG Jiangxue;WU Xian;ZENG Xiaoduo;XIANG Bing;YANG Mei;ZHOU Feng;XIE Xinyan;ZENG Jing(Research Center for Health Promotion in Women,Youth and Children,Hubei Province Key Laboratory of Occupational Hazard Identification and Control,School of Public Health,Wuhan University of Science and Technology,Wuhan 430065,China;Key Research Base of Humanities and Social Sciences in Hubei Colleges and Universities of"Healthy Hubei building and social development",Wuhan University of Science and Technology,Wuhan 430065,China)

机构地区：[1]武汉科技大学公共卫生学院妇女儿童健康促进中心,职业危害识别与控制湖北省重点实验室,武汉430065 [2]武汉科技大学“健康湖北建设和社会发展”湖北省高校人文社科重点研究基地,武汉430065

出　　处：《中华疾病控制杂志》2025年第2期164-170,223,共8页Chinese Journal of Disease Control & Prevention

基　　金：国家社会科学基金(20BSH066)。

摘　　要：目的 了解留守中学生创伤后应激障碍(post-traumatic stress disorder, PTSD)的流行情况及其影响因素,为保护留守中学生心理健康状况提供科学依据。方法 2021年9月―2023年6月采用多阶段整群抽样的方法,选取留守儿童较多的6个省份中10~18岁留守中学生作为研究对象。通过问卷调查收集一般情况、创伤性事件和PTSD发生情况。采用χ^(2)检验、t检验分析不同特征留守中学生PTSD的发生情况,采用logistic回归分析模型分析PTSD的影响因素。结果 8 878名留守中学生中,4 496人(50.6%)有过创伤经历,965人有PTSD症状,PTSD总体发生率为10.9%,创伤群体发生率为21.5%。在创伤群体中,经历过在外面被暴打、被骂或者被伤害事件的PTSD发生率最高(42.6%),从创伤类型来看,经历其他类型的PTSD发生率最高(18.1%);从创伤数量来看,经历数量越多,PTSD的发生率越高。多因素分析结果显示,女性(OR=1.49, 95%CI:1.28~1.73)、家庭氛围一般(OR=1.33, 95%CI:1.09~1.62)或差(OR=2.77, 95%CI:2.04~3.75)、看护人不固定(OR=1.26, 95%CI:1.05~1.52)、主要教养方式为责骂(OR=1.51, 95%CI:1.23~1.86)、溺爱(OR=1.30, 95%CI:1.01~1.66)、体罚(OR=1.52, 95%CI:1.10~2.19)或不管不问(OR=2.56, 95%CI:1.66~3.94)是PTSD的危险因素。与看护人关系一般或亲近、经济条件中等、学校附近治安好是PTSD的保护因素(均P<0.05)。相较于经历1件创伤性事件,经历≥7件创伤性事件的PTSD风险增加8.72倍(OR=8.72, 95%CI:5.52~13.80)。相较于只经历事故/伤害类型的创伤性事件,只经历其他或多种类型创伤性事件的PTSD风险都会增加。结论 留守中学生群体发生PTSD风险较大,尤其是有创伤经历的群体,其心理健康状况亟待关注,应及时采取针对性的措施进行预防和干预。Objective This study examines the prevalence of Post-Traumatic Stress Disorder(PTSD)and its influencing factors among left-behind middle school students,providing a scientific basis for mental health interventions.Methods From September 2021 to June 2023,a multi-stage cluster sampling method was used to select left-behind middle school students aged 10-18 from six provinces with a significant population of left-behind children for mental health interventions.A questionnaire collected data on demographics,traumatic experiences,and PTSD.The prevalence of PTSD was analyzed using chi-square tests and t-tests,while logistic regression identified the influencing factors.Results Among the 8878 left-behind middle school students,4496(50.6%)reported experiencing trauma,and 965 exhibited PTSD symptoms,resulting in an overall PTSD prevalence rate of 10.9%and a prevalence rate of 21.5%among those who had experienced trauma.The highest PTSD prevalence(42.6%)was found in students who reported being physically assaulted,threatened,or severely harmed in their town.Students who experienced"other"types of trauma had the highest PTSD prevalence at 18.1%.The prevalence of PTSD increased with the number of traumatic events experienced.Multivariate analysis identified several risk factors for PTSD,including female gender(OR=1.49,95%CI:1.28-1.73),moderate(OR=1.33,95%CI:1.09-1.62)or poor family environments(OR=2.77,95%CI:2.04-3.75),unstable caregivers(OR=1.26,95%CI:1.05-1.52),and certain parenting styles such as reprimanding(OR=1.51,95%CI:1.23-1.86),spoiling(OR=1.30,95%CI:1.01-1.66),corporal punishment(OR=1.52,95%CI:1.10-2.19),or neglect(OR=2.56,95%CI:1.66-3.94).Protective factors included having a close or average relationship with caregivers,moderate economic conditions,and good security near the school(all P<0.05).Additionally,the risk of PTSD was 8.72 times higher for those who experienced more than 7 traumatic events compared to those who experienced only one.Students who experienced trauma categorized as"other"or multiple types ha

关 键 词：创伤后应激障碍 留守中学生 流行特征 

分 类 号：R181[医药卫生—流行病学]