淄博市青春期学生心理健康发展特点与性别差异

Developmental characters and gender difference of mental health in adolescent students in Zibo city

目的:采用SCL-90症状自评量表对淄博市青春期学生进行心理健康调查,以了解青春期学生心理发展的特点及是否存在性别差异。方法:2004-11随机选取山东省淄博市4所中学初一至初四的580名学生作为调查对象,选用SCL-90症状自评量表(共9组症状群,每一项均采取5级评分制。1分表示正常,2分表示存在轻度心理健康问题,3分表示存在中度的心理健康问题,≥4分表示存在较严重的心理健康问题)对青春期学生的心理健康问题进行检测,以SCL-90项目得分≥2分作为存在心理问题的划界分。数据采集时间为各年级第一学期开学后2个月内,以班为单位进行测查。通过班主任教师组织、由接受过培训的心理学教师做主试,测试中使用统一的指导语进行,当场收回问卷并进行整理,剔除测试内容不完整的问卷。结果:按实际处理分析,选取山东省淄博市4所中学初一至初四的580名学生作为调查对象,最终资料完整的569份问卷进入结果分析。①不同年级学生心理健康问题各个因子的检出率:初一学生各因子的检出率都较低;初二学生在强迫、人际关系紧张与敏感、敌对、偏执、焦虑方面的检出率明显提高,分别为33.7%,28.9%,26.8%、25.8%和20.0%;初三学生敌对、强迫、偏执因子的检出率较高,分别为26.4%、25.7%和22.1%;初四学生在强迫、人际关系紧张与敏感、偏执、敌对、焦虑、抑郁方面的检出率又明显提高,分别为48.2%,35.5%,33.6%,32.7%,30.0%,28.2%。②不同年级学生心理健康问题各个因子SCL-90症状自评量表得分的差异:初四学生的心理健康水平显著差于初一、初二、初三年级,初二学生的心理问题也较严重,心理问题大体上随年龄的增长而增多。③不同年级学生SCL-90症状自评量表得分在性别上的差异:初一学生在偏执、精神病性、附加项方面男生显著高于女生(P<0.05);初二学生在人际关系敏感、抑郁、焦虑、恐怖、偏执、精神病性、总分方面女生显著高于男生(P<0.05);初三学生只在偏执方面男生显著高于女生(P<0.05);初四学生各项分数上都没有表现出明显性别差异。结论:青春期学生存在较大比例的心理问题,大体上随年龄增长而逐渐增多,初二、初四是心理问题的高发期,性别差异存在年龄阶段性,应及时建立一个有效的青少年健康辅导计划。

AIM： To investigate the mental health OF adolescent students in Zibo city by means of symptom checklist-90 （SCL-90）, so as to understand the characteristics of the mental development in adolescent students and whether there is gender difference. METHODS： In November 2004, 580 students from Grade 1-4 in 4 mid- die schools in Zibo city of Shandong province were chosen. Their mental health problems were investigated with SCL-90 （included symptoms, each item was scored by 5-grades： 1 as normal, 2 as mild mental health problems, 3 as moderate mental health problems, ≥4 as severe mental health problems）, the item score ≥2 in SCL-90 was taken as the cut off score of having mental problem. The data were collected within 2 months of the first semester in each grade, one class was taken as a unit in the investigation. It was organized by the teacher in charge of the class, and tested by trained psychological teachers, the uniform instruction was used in the test, the questionnaires were recollected on the spot and sorted, and the incomplete questionnaires were deleted. RESULTS： According intention-to-treat analysis, totally 580 students from Grade 1-4 in 4 middle schools in Zibo city of Shandong province were investigated, and finally 569 questionnaires with complete data were involved in the analysis of results. ① The detection rate of the factors of mental health problems in students of different grades： The detection rates of all the factors were lower in students of Grade 1. In students of Grade 2, the detection rates of obsession-compulsion, interpersonal sensitivity, hostility, paranoid ideation and anxiety were obviously increased, which were 33.7%, 28.9%, 26.8%, 25.8% and 20.0%. In students of Grade 3, the detection rates of hostility, obsession-compulsion and paranoid ideation were obvious- ly increased, which were 26.4%, 25.7% and 22.1%. In students of Grade 4, the detection rates of obsession-compulsion, interpersonal sensitivity, paranoid ideation, hostility, anxiety and depression were also obviously increased, which were 48.2%, 35.5%, 33.6%, 32.7%, 30.0%, 28.2%. ② Differences of factor scores in SCL-90 among different grades： The mental health level was significantly worse in students of Grade 4 than in those of Grades 1-3, and the mental problems in students of Grade 2 were also severe, the mental problems were gradually increased with aging. ③ Gender difference of SCL-90 scores in different grades： In Grade 1, the scores of paranoid ideation, psychoticism and additional items were significantly higher in males than in females （P 〈 0.01）. In Grade 2, the scores of interpersonal sensitivity, depression, anxiety, phobic anxiety, paranoid ideation, psychoticism and total score were significantly higher in females than in males （P 〈 0.05）. In Grade 3, only the score of paranoid ideation was remarkably higher in males than in females （P 〈 0.05）. In Grade 4, there were no obvious gender differences in all the factor scores. CONCLUSION： Adolescent students have psychological problems on a high rate, which increase with aging. There are peaks in Grades 2 and 4. We should make up a valid mental health guidance project for youngsters.