医学生人格 心理弹性与自杀意念的关系

Relationship among personality,resilience and suicidal ideation of medical students

目的 探讨医学生人格、心理弹性与自杀意念的关系及其影响机制,为制订降低其自杀意念的干预措施提供依据。方法 2021年6月6日~10日从东北地区3所医学院校抽取了1 510名医学生,采用大五人格中文版简化量表(NEO-FFI)、心理弹性量表(CD-RISC)与自杀意念自评量表(SIOSS)进行医学生人格、心理弹性与自杀意念调查,观察各变量平均得分、相关系数(含积差相关与等级相关)、回归系数与中介效应等指标。结果 医学生人格各维度得分均处于典型高分与典型低分之间;心理弹性、自杀意念得分分别为(88.04±16.72)分、(5.11±4.41)分,其中140名(9.27%)医学生具有自杀意念。神经质与心理弹性各维度及总分之间呈负相关(r=-0.341、-0.361、-0.290、-0.356,P均<0.01),与自杀意念各维度及总分之间呈正相关(r=0.544、 0.378、 0.385、 0.628,P均<0.01);人格的其他4个维度与心理弹性各维度及总分之间呈正相关(r=0.570、 0.554、 0.511、 0.582,P均<0.01),与自杀意念各维度及总分之间呈负相关(r=-0.438、-0.373、-0.280、-0.504,P均<0.01)。神经质、开放性正向预测自杀意念(Beta=0.450、0.082,t=19.266、3.648,P<0.01),心理弹性、外向性负向预测自杀意念(Beta=-0.192、-0.172,t=-7.541、-6.370,P均<0.01),并能解释自杀意念41.3%的方差比例通过结构方程模型检验,心理弹性在神经质、外向性与自杀意念之间的中介效应有统计学意义(χ^(2)/df=4.517、4.781,良适性适配指数=0.907、0.889,调整后适配度指数=0.926、0.903,规准适配指数=0.876、0.917,比较适配指数=0.928、0.913,增值适配指数=0.902、0.879,近似误差均方根0.075、0.079)。结论 医学生人格、心理弹性发展正常,近十分之一的医学生有自杀意念;人格、心理弹性与医学生自杀意念之间均一定程度相关;同时,心理弹性在神经质、外向性与自杀意念之间具有中介效应。

Objective To explore the relationship among personality,resilience and suicidal ideation of medical students and its affecting mechanisms,so as to provide a basis for the design of interventions to reduce their suicidal ideation.Methods From June 6-10,2021,1 510 medical students were selected from three medical colleges in Northeast China.The personality,resilience and suicidal ideation of medical students were investigated by using NEO-FFI,CD-RISCandSIOSS.The average score,correlation coefficient(including Pearson and Spearman Correlation),regression coefficient and intermediary effect of each variable were observed.Results The scores of medical students’ personality dimensions were between typical high scores and typical low ones.The scores for resilience and suicidal ideation were(88.04±16.72),(5.11±4.41),and 9.27% of medical students had suicidal ideation.A significant negative correlation was found between neuroticism and resilience(r=-0.341,-0.361,-0.290,-0.356,all P<0.01),and there was positive correlations between neuroticism and of suicidal ideation(r=0.544,0.378,0.385,0.628,all P<0.01).Significant positive correlations were found between the other four dimensions of personality and resilience(r=0.570,0.554,0.511,0.582,et al.,all P<0.01),and there was negative correlation between suicidal ideationand them(r=-0.438,-0.373,-0.280,-0.504,et al.,all P<0.01).Neuroticism and Openness positively predictedsuicidal ideation(Beta=0.450,0.082,t=19.266,3.648,both P<0.01),and extraversion and resilience negatively predicted suicidal ideation(Beta=-0.192,-0.172,t=-7.541,-6.370,both P<0.01)and theycould explain 41.3% of the variance ratio in suicidal ideation.Based on structural equation model test,the mediating effects of resilience between neuroticism,extraversion and suicidal ideation were statistically significant(χ^(2)/df=4.517,4.781,GFI=0.907,0.889,AGFI=0.926,0.903,NFI=0.876,0.917,CFI=0.928,0.913,IFI=0.902,0.879,RMSEA=0.075,0.079).Conclusions Medical students have normal personality and resilience development,and nearly one tenth of medical students have suicidal ideation.Personality,resilience and suicidal ideation of medical students are correlated to some extent.Resilience has a mediating effect between neuroticism,extraversion and suicidal ideation.