家庭结构对青少年抑郁和焦虑症状的影响：情感忽视的中介作用

The influence of family structure on depression and anxiety symptoms in adolescents: the mediating role of emotional neglect

摘要:

目的 探索家庭结构对青少年抑郁、焦虑症状的影响及其作用机制。方法 采用整群抽样法于2021年4—5月对上海市7所中学的学生进行线上问卷调查。问卷包括自编一般情况调查表、儿童期创伤问卷、儿童抑郁量表和儿童焦虑性情绪障碍筛查表。采用单因素方差分析、卡方检验、二元logistic回归、中介效应分析等方法探讨不同家庭结构青少年的抑郁和焦虑症状发生情况、儿童期创伤的差异及其中介作用。结果 与核心家庭青少年相比，三代直系家庭的青少年出现抑郁症状的风险较低（OR=0.794，95%CI：0.649~0.972，P<0.05），寄宿家庭的青少年出现抑郁症状的风险较高（OR=4.548，95%CI：1.113~18.580，P<0.05）；隔代家庭和寄宿家庭的青少年在儿童期创伤问卷中情感忽视维度的得分更高（P<0.05）。情感忽视在隔代家庭和寄宿家庭对青少年抑郁症状的影响中起中介作用。结论 父母和祖辈在家庭结构中具有一定的积极影响。与父母分离会使青少年感知到更多的情感忽视，进而增加抑郁症状的发生。

Abstract:

Objective To study the influence of family structure on depression and anxiety symptoms in adolescents and its mechanism.Methods The cluster sampling method was used to select the students from seven middle schools in Shanghai, China. An online questionnaire survey was conducted using a self-made general status questionnaire, Childhood Trauma Questionnaire, Children's Depression Inventory, and Screen for Child Anxiety Related Emotional Disorders. The methods including one-way analysis of variance, chi-square test, binary logistic regression analysis, and mediating effect analysis were used to evaluate depression and anxiety symptoms in adolescents and the difference in childhood trauma and its mediating effect.Results Compared with the adolescents from nuclear families, the adolescents from three-generation lineal families had a lower risk of depression symptoms (OR=0.794, 95%CI: 0.649-0.972, P<0.05), while those from host families had a higher risk of depression symptoms (OR=4.548, 95%CI: 1.113-18.580, P<0.05). The adolescents from inter-generational families and host families had a significantly higher score on the Childhood Trauma Questionnaire subscale of emotional neglect (P<0.05). Emotional neglect played a mediating role in the influence of inter-generational families and host families on depression symptoms in adolescents.Conclusions Parents and grandparents have a certain positive effect in family structures. Separation from parents may make adolescents perceive more emotional neglect, which may increase the occurrence of depression symptoms.