青少年抑郁症患者述情障碍、孤独感、心理弹性与非自杀型自我伤害行为的关系

Relations between alexithymia, loneliness, resilience, and non-suicidal self-injurybehaviors in adolescents with depression

目的 探讨青少年抑郁症患者的述情障碍、孤独感、心理弹性与非自杀型自我伤害(nonsuicidal self-injury, NSSI)行为的关系及其作用机制。方法 采用自残功能评估量表、多伦多述情障碍量表、UCLA孤独感量表和心理弹性量表简化版对326名青少年抑郁症患者施测。分析各变量间的关系及其相关的中介效应及调节作用。结果 NSSI行为与述情障碍和孤独感呈显著正相关,与心理弹性呈显著负相关。与无NSSI行为的青少年抑郁症患者比较,有NSSI行为者的述情障碍总分及其情感识别困难、情感描述困难、外向性思维维度得分以及孤独感总分均较高,心理弹性总分较低,差异均有统计学意义(P<0.01)。述情障碍正向预测NSSI行为,心理弹性负向预测NSSI行为。述情障碍通过心理弹性的中介作用对NSSI产生影响,孤独感对中介模型的前半段路径具有调节作用。结论 青少年抑郁症患者的孤独感、心理弹性和述情障碍均与NSSI行为显著相关。述情障碍是NSSI行为发生的危险因素,心理弹性是减少NSSI行为发生的保护因素。心理弹性在述情障碍与NSSI行为的关系中起中介作用,孤独感在其中发挥调节作用。

Objective To explore the relations between a lexithymia,loneliness,resilience,and non-suicidal self-injury(NSSI)behaviors in adolescents with depression,and investigate the mechanism.Methods The functional assessment of self-mutilation(FASM),Toronto alexithymia scale(TAS),UCLA loneliness scale,and the Connor-Davidson resilience scale(CD-RS-10)were used to investigate 326 adolescents with depression.The relations among the variables and possible moderated mediating relationships were analyzed.Results Alexithymia and loneliness were significantly positively correlated with the NSSI behaviors,while resilience was significantly negatively associated with NSSI behaviors.Compared with non-NSSI group,total score of alexithymia,difficulties in emotion recognition and description,scores of extraversion thinking dimension,and total score of loneliness in the NSSI group were significantly higher,while the score of resilience was significantly lower(P<0.01).Alexithymia positively predicted the development of NSSI,while resilience negatively predicted the development of NSSI. Alexithymia influenced NSSI through the mediating role of resilience,and loneliness moderated the first half of this mediating model. Conclusion Loneliness, resilience, and alexithymia ofadolescents with depression are significantly correlated with NSSI behaviors. Alexithymia is a risk factor for the developmentof NSSI, while the resilience is a protective factor in reducing NSSI behaviors. Resilience plays a mediating role in therelationship between alexithymia and NSSI behavior, with loneliness playing a moderating role.