中小学生注意偏向和焦虑抑郁情绪与创伤后应激障碍症状的关系

Relationship between attentional bias, anxiety, depression and post-traumatic stress disorder in primary and middle school students

目的 考察新冠肺炎疫情暴发后消极注意偏向与创伤后应激障碍(PTSD)症状在抑郁、焦虑负向情绪作用下的关系,为中小学校开展心理教育提供科学依据。方法 2021年3—4月,采用方便整群方法抽取北京、山西、湖南、山东、河北、湖北省的小学六年级至初三708名学生,采用事件冲击量表(儿童版)、中文版积极/消极注意偏向量表、抑郁-焦虑-压力量表进行问卷调查。结果 中小学生PTSD共检出242名,检出率为34.2%。男生在闯入、高唤醒维度上得分(7.92±5.33,8.60±5.41)低于女生(8.72±4.85,9.50±4.76),差异均有统计学意义(t值分别为-2.04,-2.32,P值均<0.05);不同年级中小学生在消极注意偏向、事件冲动量表总分及闯入、回避、高唤醒维度得分差异均有统计学意义(F值分别为3.57,5.99,4.45,4.60,7.40,P值均<0.05);消极注意偏向、焦虑、抑郁与PTSD症状之间均呈正相关(r=0.27~0.84,P值均<0.05)。Logistic回归分析显示,焦虑(OR=1.13,95%CI=1.06~1.20)和消极注意偏向(OR=1.10,95%CI=1.07~1.12)与中小学生的PTSD症状呈正相关(P值均<0.01)。结论 中小学生负向情绪中的焦虑、抑郁影响消极注意偏向,同时加重创伤后应激障碍症状。调整好学生的情绪有助于减轻创伤后应激反应。

Objective To investigate the relationship between negative attentional bias and post-traumatic stress disorder(PTSD) in the context of higher depression and anxiety symptoms after the outbreak of COVID-19, so as to provide scientific basis for mental health education in primary and secondary schools. Methods From March to April 2021, a total of 708 students from primary school and junior high school(grade 6 through grade 9) in Beijing, Shanxi, Hunan, Shandong, Hebei, Hubei of China were selected. The Children’s Revised Impact of Event Scale(CRIES), the Attention to Positive and Negative Information Scale(APNI)and Depression, Anxiety and Stress Scale-21(DASS-21) were used in a questionnaire survey. Results A total of 242 students were diagnosed with PTSD, and the detection rate was 34.2%.The scores of intrusion and high arousal of boys(7.92±5.33,8.60±5.41) were lower than those of girls(8.72±4.85,9.50±4.76),and the difference was statistically significant(t=-2.04,-2.32,P<0.05). There were statistically significant differences of negative attention bias, CRIES score, intrusion, debarb and high arousal among primary and middle school students of different grades(F=3.57,5.99,4.45,4.60,7.40, P<0.05). Negative attention bias, anxiety, depression and post-traumatic stress symptoms were significantly positively correlated(r=0.27-0.84, P<0.05). Logistic regression analysis showed that anxiety(OR=1.13, 95%CI=1.06-1.20) and negative attention bias(OR=1.10, 95%CI=1.07-1.12) were positively associated with PTSD symptoms in primary and middle school students(P<0.01). Conclusion Anxiety and depressive symptoms show impacts on negative attention bias and might exacerbate the symptoms of post-traumatic stress disorder. Therefore, emotional adjustments can help reduce the post-traumatic stress response in the post-epidemic period.