中学生解离倾向的影响因素分析

Factors affecting dissociative tendency among middle school students

目的了解中学生解离倾向发生情况及其影响因素,为预防和早期干预青少年解离倾向提供依据。方法于2021年1月—2022年3月,采用多阶段分层整群抽样方法抽取杭州市3个县(市、区)9所中学的13~18岁在校学生为调查对象。采用自制问卷和标准化量表调查学生的社会人口学资料、社会环境、学校环境、家庭环境和心理因素等资料;采用青少年解离经验量表(A-DES)初步筛查解离倾向,再由3名精神科医生按《精神障碍诊断和统计手册第5版》进行诊断;采用多因素logistic回归模型分析中学生解离倾向的影响因素。结果调查3240人,有效应答2841人,应答率为87.69%。男生1389人,占48.89%;女生1452人,占51.11%;年龄为(15.69±1.58)岁。检出解离倾向683例,检出率为24.04%;男生解离倾向检出率为29.23%,高于女生的19.08%(χ^(2)=24.529,P<0.001)。多因素logistic回归分析结果显示:负向师生关系(OR=1.055,95%CI:1.010~1.103)、家庭情感表达(OR=0.872,95%CI:0.777~0.978)、家庭冲突性(OR=1.152,95%CI:1.045~1.271)、家庭组织性(OR=0.880,95%CI:0.780~0.992)和家庭亲密度(OR=0.871,95%CI:0.766~0.987)是男生解离倾向的影响因素;躯体化(OR=1.041,95%CI:1.002~1.082)、偏执(OR=1.094,95%CI:1.006~1.190)是女生解离倾向的影响因素。结论调查的中学生解离倾向检出率为24.04%;负向师生关系以及情感表达、冲突性、组织性和亲密度等家庭环境因素可能影响男生解离倾向;躯体化、偏执可能影响女生解离倾向。

Objective To investigate the prevalence of dissociative tendency and its influencing factors among middle school students,so as to provide insights into prevention and early interventions of adolescent dissociative tendency.Methods Students at ages of 13 to 18 years that studied in 9 high schools were sampled using a multistage,strati⁃fied,cluster sampling method from 3 counties(districts)of Hangzhou City from January,2021 and March,2022.Partici⁃pants'demographics and social,school,family environment and psychological factors were collected using self-designed questionnaires and standardized scales.The dissociative tendency was initially screened using the Adolescent Dissociative Experience Scale(A-DES),and the diagnosed by three psychiatrists according to Diagnostic and Statistical Manual of Mental Disorders(5th Edition).Factors affecting ADT were identified using a multivariable logistic regression model.Results Totally 3240 students were recruited,and 2841 students were qualified,with a response rate of 87.69%.The respondents included 1389 men(48.89%)and 1452 women(51.11%),and had a mean age of(15.69±1.58)years.The prevalence of dissociative tendency was 24.04%,and the detection of dissociative tendency was higher among men than among women(29.23%vs.19.08%;χ^(2)=24.529,P<0.001).Multivariable logistic regression analysis identified negative teacher-student relationship(OR=1.055,95%CI:1.010-1.103),family emotional expressiveness(OR=0.872,95%CI:0.777-0.978),family conflict(OR=1.152,95%CI:1.045-1.271),family organization(OR=0.880,95%CI:0.780-0.992)and family cohesion(OR=0.871,95%CI:0.766-0.987)as factors affecting dissociative tendency among men,and somatization(OR=1.041,95%CI:1.002-1.082)and paranoid ideation(OR=1.094,95%CI:1.006-1.190)as factors affect⁃ing dissociative tendency among women.Conclusions The prevalence of dissociative tendency was 24.04%among mid⁃dle school students.Negative teacher-student relationship,family emotional expressiveness,family conflict,family organi⁃zation,and family cohesion may affect dissociative tendency among men,while somatization and paranoid ideation may affect dissociative tendency among women.