父母婚姻状况对中学生消极情绪和非自杀性自伤行为的影响:一项多中心横断面研究

Effects of Parental Marital Status on Negative Emotions and Nonsuicidal Self-injury Behaviors in Middle School Students:a Multicenter Cross-sectional Study

背景父母婚姻状况对青少年负性心理及非自杀性自伤行为(NSSI)影响的研究报道较少,且现有的研究样本量较小。目的探究父母婚姻状况与中学生消极情绪和NSSI的关联,为中学生NSSI的防控提供参考。方法2020年3—4月,采用分层随机抽样法对南充市及周边20个乡镇、67所中学的学生进行问卷调查。调查人员将问卷输入问卷星平台生成二维码,学校发放二维码给家长或学生监护人。问卷包括一般信息问卷、渥太华自残量表(OSI)和中文版抑郁焦虑压力量表-21(DASS-21)。统计中学生NSSI、抑郁、焦虑、压力检出率,并分析影响中学生NSSI、抑郁、焦虑和压力的相关因素。结果本调查共对23所中学的8785名学生发放问卷,最终获得有效问卷8606份,有效回收率98.0%。8606名中学生中男4540名(52.8%)、女4066名(47.2%);初中5937名(69.0%),高中1028名(11.9%),职业高中1641名(19.1%);双亲家庭7274名(84.5%),父母离异单亲787名(9.1%),父母离异再婚545名(6.4%)。本次调查的中学生NSSI检出率为5.6%(486/8606),抑郁检出率为21.9%(1884/8606),焦虑检出率为26.8%(2305/8606),压力检出率为12.3%(1060/8606)。多因素Logistic回归分析结果显示,在所有中学生中,与男生相比,女生发生NSSI、焦虑的风险较大(OR=2.363,95%CI=1.946~2.868;OR=1.195,95%CI=1.086~1.315);与初中生相比,职业高中生发生NSSI、抑郁、焦虑、压力的风险较大(OR=1.847,95%CI=1.494~2.284;OR=1.886,95%CI=1.667~2.134;OR=1.857,95%CI=1.141~1.532;OR=1.527,95%CI=1.309~1.781);与双亲家庭的中学生相比,离异单亲、离异再婚家庭的中学生NSSI、抑郁、焦虑、压力的风险较大(离异单亲:OR=2.194,95%CI=1.699~2.834;OR=1.563,95%CI=1.326~1.843;OR=1.573,95%CI=1.346~1.839;OR=1.417,95%CI=1.153~1.741;离异再婚:OR=2.207,95%CI=1.638~2.975;OR=1.863,95%CI=1.543~2.249;OR=1.796,95%CI=1.499~2.153;OR=1.821,95%CI=1.453~2.282);与长期由双亲照顾的中学生相比,长期由父亲单独照顾、母亲单独照顾、祖父母照顾发生NSSI、抑郁、焦虑的风险较大(父亲单独照顾:OR=2.045,95%CI=1.366~3.062;OR=1.633,95%CI=1.289~2.145;OR=1.373,95%CI=1.069~1.762;母亲单独照顾:OR=1.772,95%CI=1.141~2.751;OR=1.435,95%CI=1.095~1.882;OR=1.513,95%CI=1.174~1.951;祖父母照顾:OR=2.465,95%CI=1.918~3.168;OR=1.783,95%CI=1.513~2.100;OR=1.843,95%CI=1.577~2.154),由母亲单独照顾、祖父母照顾发生压力的风险较大(OR=1.604,95%CI=1.166~2.207;OR=1.678,95%CI=1.375~2.049)(P<0.05)。结论中学生的NSSI、抑郁、焦虑、压力与父母离异及照顾者有关,因此,需要对处于这些情况的中学生给予特别关注和干预。

Background Effects of parental marital status on nonsuicidal self-injury(NSSI)behaviors and negative emotions in adolescents have been rarely reported,and the existing research sample size is relatively small.Objective To explore the association of parental marital status with negative emotions and NSSI in middle school students,to provide a reference for the prevention and control of NSSI in them.Methods A stratified random sampling method was used to conduct the questionnaire survey on students from 20 townships and 67 middle schools in Nanchong City and its surrounding areas from March to April 2020.The investigators input the questionnaire into the WJX.cn to generate QR codes,which were distributed to parents or student guardians by schools.The questionnaire,consisting of the General Information Questionnaire,Ottawa Self-injury Inventory(OSI)and the Chinese version of the Depression Anxiety Stress Scale-21(DASS-21),was used to calculate the detection rates of NSSI,depression,anxiety and stress in middle school students to analyze the relevant factors affecting NSSI,depression,anxiety and stress in middle school students.Results A total of 8785 students from 23 middle schools were surveyed,and 8606 valid questionnaires were finally obtained,with a valid recovery rate of 98.0%.Among the 8606 middle school students,there were 4540(52.8%)males,4066(47.2%)females;5937(69.0%)junior high school students,1028(11.9%)senior high school students and 1641(19.1%)vocational high school students;7274(84.5%)students in two-parent families,787(9.1%)students in divorced single-parent families,and 545(6.4%)students in families with divorced and remarried parents.The detection rates of NSSI,depression,anxiety and stress in middle school students were 5.6%(486/8606),21.9%(1884/8606),26.8%(2305/8606)and 12.3%(1060/8606),respectively.The results of multivariate Logistic regression analysis showed that among all middle school students,compared with boys,girls had a higher risk of NSSI(OR=2.363,95%CI=1.946-2.868)and anxiety(OR=1.195,95%CI=1.086-1.315);compared with junior high school students,vocational high school students had a higher risk of NSSI(OR=1.847,95%CI=1.494-2.284),depression(OR=1.886,95%CI=1.667-2.134),anxiety(OR=1.857,95%CI=1.141-1.532)and stress(OR=1.527,95%CI=1.309-1.781);compared with middle school students in two-parent family,students in divorced single-parent family had a higher risk of NSSI(OR=2.194,95%CI=1.669-2.834),depression(OR=1.563,95%CI=1.326-1.843),anxiety(OR=1.573,95%CI=1.346-1.839)and stress(OR=1.417,95%CI=1.153-1.741),students in families with divorced and remarried parents also had a higher risk of NSSI(OR=2.207,95%CI=1.638-2.975),depression(OR=1.863,95%CI=1.543-2.249),anxiety(OR=1.796,95%CI=1.499-2.153)and stress(OR=1.821,95%CI=1.453-2.282);compared to middle school students who are taken care of by their parents for a long time,those who are taken care of by their father alone,mother alone or grandparents alone for a long time had a higher risk of NSSI,depression and anxiety(by father alone:OR=2.045,95%CI=1.366-3.062;OR=1.633,95%CI=1.289-2.145;OR=1.373,95%CI=1.069-1.762;by mother alone:OR=1.772,95%CI=1.141-2.751;OR=1.435,95%CI=1.095-1.882;OR=1.513,95%CI=1.174-1.951;by grandparents alone:OR=2.465,95%CI=1.918-3.168;OR=1.783,95%CI=1.513-2.100;OR=1.843,95%CI=1.577-2.154),students who were taken care of by mother alone or by grandparents alone had a higher risk of stress(OR=1.604,95%CI=1.166-2.207;OR=1.678,95%CI=1.375-2.049)(P<0.05).Conclusion The NSSI,depression,anxiety and stress of middle school students are related to parental divorce and caregivers.Therefore,special attention and intervention should be given to middle school students in these situations.