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家庭动力学特征和负性生活事件与青少年抑郁症状的相关性分析

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目的 探讨家庭动力学特征与青少年抑郁症状的相关性,以及负性生活事件在二者之间的中介作用。方法 收集2021年9月-2023年2月在同济大学附属东方医院临床心理科就诊,且符合国际疾病分类(ICD)-10诊断标准的124例青少年抑郁症患者进行横断面研究。使用系统家庭动力量表(SSFD)第2版、儿童抑郁量表(CDI)及青少年生活事件量表(ASLEC)对患者的家庭动力学特征、抑郁症状及负性生活事件进行评估。采用典型相关分析探索系统家庭动力学4个维度[家庭气氛(FA)、系统逻辑(SL)、个性化(IN)、疾病观念(IC)]与CDI 5个因子(低自尊、负面情绪、快感缺乏、效能低下、人际问题)之间的相关性,通过中介效应分析(Bootstrap检验)建立模型检验负性生活事件在家庭动力学特征与青少年抑郁症状之间的中介作用。结果 SSFD 4个维度中的FA、SL、IN得分与CDI总分呈负相关(r=-0。359、-0。256、-0。291,P<0。01),与ASLEC总分呈负相关(r=-0。318、-0。371、-0。406,P<0。01);ASLEC总分与CDI总分呈正相关(r=0。633,P<0。01)。SSFD 4个维度与CDI 5个因子的典型相关分析得到1对有统计学意义的典型变量(U1、V1),典型相关系数为0。483(P<0。05),反映SSFD的典型变量U1主要受FA的影响,反映CDI的典型变量V1主要受低自尊和人际问题的影响。负性生活事件对家庭动力学特征与抑郁症状的中介作用的分析结果显示,FA、IN、SL得分影响CDI总分的总效应均较弱(效应值分别为-0。147、-0。117、-0。102),但均有统计学意义(P<0。05);其中,IN、SL得分对CDI总分的直接效应无统计学意义(P>0。05),而FA得分对CDI总分的直接效应有统计学意义(效应值为-0。076,P<0。05),而FA、IN、SL得分通过ASLEC总分影响CDI总分的中介效应均有统计学意义(效应值分别为-0。071、-0。095、-0。087,P<0。05)。结论 青少年抑郁症状可能受家庭动力学特征及负性生活事件的影响,负性生活事件在FA、IN、SL等家庭动力学特征对抑郁症状的影响中发挥中介作用;家庭动力学特征中的IC与青少年抑郁症状不相关。
Correlation between family dynamics characteristics and negative life events with adolescent depressive symptoms
Objective To explore the correlation between systemic family dynamics characteristics and adolescent depressive symptoms,and the mediating role of negative life events between them.Methods A cross-sectional study was conducted on 124 adolescent patients diagnosed with depressive disorder according to the international classification of diseases(ICD)-10 criteria at the Psychosomatic Medicine Department of Shanghai East Hospital Affiliated to Tongji University from September 2021 to February 2023.The second edition of the Scale of Systematic Family Dynamics(SSFD),Children's Depression Inventory(CDI),and Adolescent Self-Rating Life Events Checklist(ASLEC)were utilized to evaluate the family dynamics characteristics,depressive symptoms,and negative life events.Canonical correlation analysis was performed to explore the relationships between 4 dimensions of SSFD[family atmosphere(FA),individuation(IN),system logic(SL),illness concept(IC)]and 5 factors of CDI(low self-esteem,negative emotion,anhedonia,inefficiency,interpersonal problem).A mediation effect analysis using Bootstrap test was conducted to analyze the mediating role of negative life events between family dynamics and adolescent depressive symptoms.Results The scores for FA,SL,and IN in SSFD were negatively correlated with the total score of CDI(r=-0.359,-0.256,-0.291,P<0.01),and negatively correlated with the total score of ASLEC too(r=-0.318,-0.371,-0.406,P<0.01).However,a positive correlation was observed between the total scores of ASLEC and CDI(r=0.633,P<0.01).Canonical correlation analysis between the 4 dimensions of SSFD and the 5 factors of CDI revealed one pair of statistically significant canonical variables(U1,V1)with a canonical correlation coefficient of 0.483(P<0.05).This indicates that the canonical variable U1 of SSFD was primarily influenced by FA,while the canonical variable V1 of CDI was mainly affected by low self-esteem and interpersonal problems.The mediating analysis showed that the effects of FA,IN,and SL scores on CDI total score were all weak(-0.147,-0.117,-0.102,respectively)but statistically significant(P<0.05).The direct effect of IN and SL scores on CDI total score was not statistically significant(P>0.05),while the direct effect of FA score on CDI total score was statistically significant(-0.076,P<0.05).Additionally,the mediating effect of ASLEC between the scores of FA,IN,SL and CDI total score were all significant(-0.071,-0.095,-0.087,respectively)(P<0.05).Conclusions Adolescent depressive symptoms may be influenced by systemic family dynamics characteristics and negative life events.Negative life events mediate the influence of FA,IN,and SL on depressive symptoms.However,the IC is not related to depressive symptoms in adolescents.

adolescenthealthdepressionfamily relationsnegative life eventmediation

周惠至、杨舒然、韩冬、陈诗、冯强、王璐、康传媛

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同济大学附属东方医院临床心理科,上海 200120

解放军联勤保障部队第920医院精神心理科,云南昆明 650100

青少年 健康 抑郁 家庭关系 负性生活事件 中介

2024

解放军医学杂志
人民军医出版社

解放军医学杂志

CSTPCD北大核心
影响因子:1.644
ISSN:0577-7402
年,卷(期):2024.49(12)