行为抑制/激活系统与初中生非自杀性自伤的关系:抑郁的中介效应

Correlation between behavioral inhibition/activation systems and adolescent non-suicidal self-injury:mediating effect of depression

目的 探讨初中生非自杀性自伤(NSSI)、抑郁情况,分析抑郁在行为抑制/激活系统(BIS/BAS)与NSSI之间的中介作用。方法 采用整群抽样法,于2022年6月选取山东省济宁市泗水县3所中学2 900名初中生为研究对象,采用青少年自伤行为问卷、BIS/BAS量表和抑郁自评量表(SDS)进行问卷调查。采用Pearson相关分析各变量之间的相关性。采用SPSS Amos 24.0软件构建结构方程模型并进行中介效应检验。本研究共发放问卷2 900份,回收有效问卷2 429份,有效回收率为83.76%。结果 2 429名初中生的NSSI年发生率为37.55%(912/2 429),抑郁发生率为32.73%(795/2 429)。根据是否有过NSSI行为分为有NSSI组(n=912)和无NSSI组(n=1 517)。有NSSI组初中生的青少年自伤行为问卷得分为(33.01±21.24)分。有NSSI组初中生的BIS、BAS-愉悦追求、SDS得分分别为(11.08±2.93)、(7.15±2.58)、(53.17±10.67)分,高于无NSSI组的(10.16±3.15)、(6.52±2.55)、(43.16±9.77)分,差异有统计学意义(t=-7.312、-5.838、-23.098;P<0.001);有NSSI组初中生的BAS-奖赏反应得分为(11.64±2.53)分,低于无NSSI组的(12.16±2.24)分,差异有统计学意义(t=5.084,P<0.001)。相关分析显示,有NSSI初中生的抑郁程度与NSSI严重程度、BIS敏感性、BAS-愉悦追求敏感性呈正相关(r=0.484、0.184、0.128;P<0.01);BAS-奖赏反应敏感性与NSSI严重程度、抑郁程度呈负相关(r=-0.203、-0.239;P<0.01)。回归分析显示,抑郁对NSSI有正向影响(β=0.461,P<0.001),而BAS-奖赏反应对NSSI有负向影响(β=-0.093,P<0.01)。结构方程模型结果显示,抑郁在BIS、BAS-愉悦追求与NSSI之间起完全中介作用,完全中介效应分别为0.121和0.104,占总效应的86.4%、72.7%;在BAS-奖赏反应与NSSI之间起部分中介作用,部分中介效应为-0.199,占总效应的58.2%。结论 初中生NSSI发生率较高,抑郁在BIS和BAS-愉悦追求与NSSI间起完全中介作用,在BAS-奖赏反应与NSSI之间起部分中介作用。

Objective To explore the situation of non-suicide self-injury(NSSI) and depression among junior high school students in Shandong Province,and analyze the intermediary role of depression between behavior inhibition/activation system(BIS/BAS) and NSSI.Methods In June 2022,a total of 2 900 students from 3 middle schools in Sishui County,Jining City,Shandong Province were recruited by cluster sampling method.Adolescent Self-Harm Behaviors Questionnaire,Behavioral Inhibition/Activation Systems Scales(BIS/BAS scales),and Self-Rating Depression Scale(SDS) were used for investigation.Pearson correlation was used to analyze the correlation between variables.SPSS Amos 24.0 software was used to construct the structural equation model and carry out the intermediary effect test.A total of 2 900 questionnaires were distributed in this study,and 2 429 valid questionnaires were recovered,with an effective recovery rate of 83.76%.Results The annual incidence of NSSI in 2 429 junior high school students was 37.55%(912/2 429),and the incidence of depression was 32.73%(795/2 429).All the students were divided into NSSI group(n=912) and non-NSSI group(n=1 517) according to whether there was NSSI behavior.The score of Adolescent Self-Harm Behaviors Questionnaire in NSSI group was(33.01±21.24).The score of BIS,BAS-Fun Seeking,and SDS in NSSI group was(11.08±2.93),(7.15±2.58) and(53.17±10.67),all higher than those in non-NSSI group(10.16±3.15),(6.52±2.55) and(43.16±9.77),respectively,and the differences were statistically significant(t=-7.312,-5.838,-23.098;P < 0.001).The score of BAS-Reward Responsiveness in NSSI group was(11.64±2.53),lower than that in non-NSSI group(12.16±2.24),and the difference was statistically significant(t=5.084,P<0.001).Pearson correlation analysis showed that the degree of depression of junior high school students with NSSI was positively correlated with the severity of NSSI,BIS Sensitivity and BAS-Drive Sensitivity(r=0.484,0.184,0.128;P<0.01);BAS-Reward Responsiveness sensitivity is negatively correlated with the severity of NSSI and the degree of depression(r=-0.203,-0.239;P<0.01).Regression analysis showed that depression had a positive impact on NSSI(β=0.461,P<0.001),while behavioral activation system-reward response had a negative impact on NSSI(β=-0.093,P<0.01).Results of the structural equation model showed that depression played a completely mediating role between BIS as well as BAS-Fun Seeking and NSSI,and the estimates of complete mediating effects were 0.121 and 0.204 respectively,accounting for 86.4% and 72.7% of the total effect.Depression played a partially mediating role between BAS-Reward Responsiveness and NSSI,and the estimate of the partial mediating effect was-0.199,accounting for 58.2% of the total effect.Conclusions The incidence of adolescent NSSI is relatively high.Depression plays a complete mediating role between BIS,BASFun Seeking and NSSI,and plays a partial mediating role between BAS-Reward Responsiveness and NSSI.