青少年失眠与自伤行为的关系:情绪调节困难和抑郁症状的中介作用

Relationship between insomniaandnon-suicidal self-injury:A multiple mediation model

目的:探讨情绪调节困难和抑郁症状在青少年失眠与自伤行为间的链式中介作用。方法:采用整群抽样的方法,选取河北省两所中学的432名学生进行班级团体施测。问卷调查的内容包括失眠症状、情绪调节困难、抑郁症状和自伤行为。结果:①有31.5%的青少年在过去一年中至少有过1次自伤行为,女性显著高于男性(χ^(2)=10.96,P<0.001)。②相关分析显示,青少年的失眠症状与情绪调节困难、抑郁症状和自伤行为之间呈显著正相关(r=0.44,0.59,0.28;P<0.001),情绪调节困难与抑郁症状和自伤行为之间呈显著正相关(r=0.70,0.37;P<0.001),抑郁症状和自伤行为之间呈显著正相关(r=0.39,P<0.001)。③路径分析表明,在控制性别和年级后,失眠通过情绪调节困难,抑郁症状及其链式关系影响自伤行为的中介路径有统计学意义(效应值分别为0.08,0.08,0.05),其95%置信区间不包含0。结论:失眠主要通过影响情绪调节困难和抑郁症状间接影响青少年的自伤行为。因此,睡眠卫生教育和失眠的认知干预治疗可适当减少自伤行为的发生。

Objective:To explore the chain mediating effects of insomnia and non-suicidal self-injury in Chinese adolescents.Methods:By using the method of random cluster sampling,432 adolescents in Hebei Province were selected as the research objects.The contents of the questionnaire included insomnia symptoms,emotional regulation difficulties,depressive symptoms and non-suicidal self-injury.Results:①The prevalence rates of suicidality in adolescents were 31.5%,and women were significantly higher than men(χ^(2)=10.96,P<0.001).②Correlation analysis showed that insomnia symptoms were positively correlated with emotional regulation difficulties,depressive symptoms and non-suicidal self-injury(r=0.44,0.59,0.28;P<0.001);Emotional regulation difficulties were positively correlated with depressive symptoms and non-suicidal self-injury(r=0.70,0.37;P<0.001);Depressive symptoms were positively correlated with non-suicidal self-injury(r=0.39,P<0.001).③The mediating path of insomnia affecting non-suicidal self-injury through emotion regulation difficulty,depressive symptoms and their chain relationship was statistically significant(effect values were 0.08,0.08,0.05,respectively),and its 95%confidence interval did not include 0.Conclusion:The mediating path of insomnia affecting non-suicidal self-injury is through emotion regulation difficulty and depressive symptoms.Sleep hygiene education and cognitive behavior therapy for insomnia can reduce the occurrence of non-suicidal self-injury behaviors.