青少年心理病理症状及应对方式与童年期反复躯体和情感虐待经历的相关性研究

Correlation between psychopathological symptoms,coping style in adolescent and childhood repeated physical,emotional maltreatment

目的分析青少年心理问题、应对方式与童年期反复严重躯体虐待、中度躯体虐待及情感虐待经历的关联强度。方法 5141名中学生以自愿、无记名方式填写调查表的形式调查童年期经历父母或其他监护人的严重和中度躯体虐待及情感虐待情况。以在小学年龄阶段,3类共24项虐待行为中至少1项平均1年发生3次以上,界定为有该项童年期反复虐待经历。用症状自评量表(SCL-90)评定总心理问题、心理病理症状阳性项目数和9种心理病理症状,运用特质性应对方式问卷评定青少年积极和消极应对方式。结果青少年总心理问题检出率为9.1%,其中躯体化、强迫、人际关系敏感、抑郁、焦虑、敌对、恐惧、偏执、精神病性症状检出率分别为1.3%、3.6%、3.6%、2.8%、2.2%、4.0%、2.1%、2.8%、1.6%。总心理问题检出率、9种心理病理症状检出率和阳性项目数与3类童年期反复虐待经历的数量呈剂量-反应趋势。有童年期反复虐待经历的青少年,消极应对评分高于无童年期反复虐待经历者,且消极评分越高,其总心理问题检出率和阳性项目数增加。以青少年和父母的人口统计学变量为协变量,多项式 Logistic 回归分析表明,积极应对评分不影响3类童年期反复虐待经历与总心理问题的比值比(OR),但消极应对降低童年期反复虐待经历与总心理问题及9种心理病理症状的 OR 值。结论不同种类和数量的童年期反复躯体虐待、情感虐待经历对青少年心理健康产生负面影响,消极应对方式可能参与调节了童年期虐待经历与青少年心理问题的联系。

Objective To study possible relationship between psychopathological symptoms, positive and negative coping styles in adolescents who experienced repeated serious childhood physical abuse （CPA） , moderate CPA, and childhood emotional abuse （CEA）. Methods A total of 5453 students were recruited as subjects from 9 middle schools at grades 7, 8, 10, and 11. They provided informed consent and participated in the self-administered anonymous survey on their frequencies of serious or moderate physical abuse and emotional abuse by his/her parents or other caregivers about average times of experiencing maltreatment every year during primary school. The Symptoms Checklist 90 （SCL-90） was used to rate general mental problem and 9 special psychopathological symptoms. The trait positive and negative coping styles were assessed with the Trait Coping Style Questionnaire （TCSQ） . Totally 5141 respondents substantially completed surveys. It was defined as repeating childhood maltreatment that the adolescent reported he/she had suffered 3 or more episodes of one or more forms of serious CPA, moderate CPA, and CEA. Muhinomial logistic regression model was used to analyze the effect of the types and quantities of repeating childhood experiences on mental health when the positive, negative coping styles, and both of them entered the statistics model, taking the demographic variables as covariates. Results Of respondents, 9. 1 percent were rated as having general mental health problem. The rates of somatization, obsession, interpersonal susceptivity, depression, anxiety, phobia, paranoia, and psychotic symptoms were 1.3%, 3.6%, 3.6%, 2. 8%, 2. 2%, 4. 0%, 2. 1%, 2.8% and 1.6%, respectively. Dose-response trend existed between the number of items of repeating serious CPA, moderate CPA, CEA, and rates of general mental problems, 9 kinds of psychopathological symptoms, number of positive items of psychopathological symptoms. Compared with the respondents without serious CPA, moderate CPA or CEA, those with repeating childhood maltreatment had higher scores of negative coping styles. In the respondents with repeating childhood maltreatments, the prevalence of general mental problems and number of positive psychopathological symptoms increased with the rising of scores of negative coping styles. The results from multinomial logistic regression analysis showed that negative coping style decreased the odds ratio （OR） of repeating serious CPA, moderate CPA, and CEA with general mental health problems, but positive coping style did not. Conclusions The experiences of repeating childhood physical or emotional maltreatment are associated with a wide variety of psychopathological symptoms and general mental health problems. Negative coping strategies may moderate the links of childhood abusive experiences and mental problems.