小学生情绪状态与焦虑障碍发生的剂量反应关系

Dose-response relationship between emotional state and anxiety disorder among primary students

目的探究小学生情绪体验持续时间与焦虑障碍发生关联强度的剂量-反应关系,为研究不同情绪状态水平对应的焦虑障碍发生风险提供参考。方法采用方便整群抽样方法,抽取上海市闵行区16所公办小学三至五年级的7 152名学生作为调查对象,采用儿童焦虑障碍自评量表及积极情感-消极情感量表进行问卷调查。结果小学生焦虑障碍总检出率为19.91%,其中男、女生焦虑障碍患病率分别为19.41%和20.43%。调整了性别、年级、户籍、是否为独生子女、父母婚姻状况、父母职业、父母文化程度、家庭经济水平、担任班干部、接受过体育和艺术专项培训或辅导情况及被欺凌情况后,积极情绪持续天数为7~16 d组、17~24 d组和>24 d组与焦虑障碍患病风险的发生呈负相关(OR值分别为0.53,0.36,0.37,P值均<0.05);消极情绪持续天数为0.27~0.93 d组、0.94~2 d组和>2 d组与焦虑障碍患病风险的发生呈正相关(OR值分别为1.27,3.73,7.66,P值均<0.05)。限制性立方样条分析显示,情绪状态的持续天数与焦虑障碍患病关联强度呈明显的非线性剂量-反应关系(P<0.01),即随着小学生积极情绪持续天数的增长,患焦虑障碍的风险持续降低;随着小学生消极情绪持续天数的增长,患焦虑障碍的风险持续增高。结论小学生情绪状态持续天数与焦虑障碍发生呈显著剂量-反应关系,促进小学生获得和维持积极情绪可作为改善小学生心理健康的重要切入点。

Objective To explore the dose-response relationship between duration of emotional experience of primary school students and the intensity of anxiety disorders, and to understand the risk of anxiety disorders corresponding to different emotional state levels. Methods A total of 7 152 primary students from grade 3 to 5 were investigated with questionnaire survey from 16 public primary schools, by using the Screen for Child Anxiety Related Emotional Disorder(SCARED) and Positive Affect and Negative Affect Scale. Results The prevalence of anxiety disorders was 19.91%, among which the prevalence rates of anxiety disorders in boys and girls were 19.41% and 20.43%, respectively. After adjusting for gender, grade, household register, the only child, parental marital status, parental occupation, parental educational level, family financial level, serving as a class leader, receiving special training or counseling in sports and art, and being bullied, the risk of anxiety disorder in children with positive emotions lasting for 7-16 days, 17-24 days and >24 days was lower compared to those with positive emotions lasting for less than 6 days(P<0.05);the risk of anxiety disorder in children with negative emotions lasting for 0.27-0.93 day, 0.94-2 days and >2 days was higher compared to those with negative emotions lasting less than 0.26 day(P<0.05). Restricted cubic spline analysis showed that the duration of emotional state and anxiety disorder showed a significant non-linear dose-response relationship(non-linear test, P<0.01), that is, as the number of days of positive emotions increases, the risk of anxiety disorder continues to decrease, and as the number of days of negative emotions increases, the risk of anxiety disorder continues to increase. Conclusion There is a significant dose-response relationship between the duration of the emotional state of primary school students and the prevalence of anxiety disorders. Acquirement and maintain positive emotions m be an important entry point for mental health promotion among primary school students.