| 刘丽萍,张敏,陈滢伊,许冰岚,杜蕾,徐昭媛.青少年抑郁障碍患者校园欺凌与非自杀性自伤行为的关系：自尊和述情障碍的作用路径[J].四川精神卫生杂志,2025,(4):327-332.Liu Liping,Zhang Min,Chen Yingyi,Xu Binglan,Du Lei,Xu Zhaoyuan,Relationship between school bullying and non-suicidal self-injury behaviors in adolescents with depressive disorders： the pathways of self-esteem and alexithymia[J].SICHUAN MENTAL HEALTH,2025,(4):327-332 |
| 青少年抑郁障碍患者校园欺凌与非自杀性自伤行为的关系：自尊和述情障碍的作用路径 |
| Relationship between school bullying and non-suicidal self-injury behaviors in adolescents with depressive disorders： the pathways of self-esteem and alexithymia |
| 投稿时间：2024-11-19 |
| DOI：10.11886/scjsws20241119002 |
| 中文关键词: 青少年 校园欺凌 非自杀性自伤行为 述情障碍 自尊 |
| 英文关键词:Adolescents School bullying Non-suicidal self-injury Alexithymia Self-esteem |
| 基金项目:黑龙江省卫生健康委科研项目（项目名称：青少年非自杀性自伤风险预测模型构建及CBT干预研究，项目编号：20230303090154） |
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| 中文摘要: |
| 背景 青少年抑郁障碍患者非自杀性自伤（NSSI）行为的发生率较高，校园欺凌被认为是其重要的风险因素之一。既往研究表明，自尊和述情障碍与校园欺凌和NSSI行为密切相关，但自尊和述情障碍在校园欺凌与NSSI行为之间的作用路径尚不清楚。目的 探讨述情障碍和自尊在校园欺凌与青少年抑郁障碍患者NSSI行为之间的作用路径，以期为青少年抑郁障碍患者NSSI行为的干预提供参考。方法 选取2023年7月—2024年10月于哈尔滨市第一专科医院就诊的青少年抑郁障碍患者335例。采用自编问卷、青少年非自杀性自伤行为评定问卷中的行为问卷（ANSAQ-B）、特拉华欺负受害量表（学生卷）（DBVS-S）中文版、Rosenberg自尊量表（RSES）、多伦多述情障碍量表（TAS-26）进行评定。采用Pearson相关分析检验各量表评分之间的相关性。在控制性别、抑郁症状首发年龄后，采用R 4.4.2中的“mediation”包分析述情障碍和自尊在校园欺凌与青少年抑郁障碍患者NSSI行为之间的作用路径。结果 青少年抑郁障碍患者DBVS-S评分、TAS-26评分与ANSAQ-B评分均呈正相关（r=0.408、0.417，P均<0.01）；RSES评分与ANSAQ-B评分呈负相关（r=-0.300，P<0.01）。回归分析结果显示，校园欺凌、述情障碍可以正向预测青少年抑郁障碍患者NSSI行为（B=0.212、0.333，P均<0.01），自尊可以负向预测NSSI行为（B=-0.368，P<0.01）。述情障碍是校园欺凌与NSSI行为之间的作用路径，间接效应值为0.040（95% CI：0.018~0.069），效应量为17.17%。校园欺凌通过自尊对NSSI行为的间接效应无统计学意义（95% CI：-0.004~0.039）。结论 校园欺凌可以直接影响抑郁障碍青少年的NSSI行为，也可以通过述情障碍间接影响NSSI行为。 |
| 英文摘要: |
| Background Non-suicidal self-injury （NSSI） behaviors are common among adolescents with depressive disorders， and school bullying is recognized as a major risk factor. Previous research has shown that self-esteem and alexithymia are closely associated with both school bullying and NSSI. However， the mediating roles of self-esteem and alexithymia in the link between school bullying and NSSI are unclear.Objective To explore the mediating roles of alexithymia and self-esteem in the relationship between school bullying and NSSI behaviors in adolescents with depressive disorders， in order to inform intervention strategies targeting NSSI in this population.Methods A total of 335 adolescents diagnosed with depressive disorders and treated at the First Psychiatric Hospital of Harbin from July 2023 to October 2024 were enrolled. Assessments included a self-developed demographic questionnaire， Adolescent Non-suicidal Self-injury Assessment Questionnaire-Behavior （ANSAQ-B）， Delaware Bullying Victimization Scale-Student （DBVS-S）， Rosenberg Self-Esteem Scale （RSES）， and 26-item Toronto Alexithymia Scale （TAS-26）. Pearson correlation analysis was used to examine the relationship among variables. Controlling for gender and age at onset of depressive symptoms， mediation analysis was performed using the “mediation” package in R 4.4.2.Results Scores on DBVS-S and TAS-26 were positively correlated with ANSAQ-B score （r=0.408， 0.417， P<0.01）， while RSES scores were negatively correlated（r=-0.300， P<0.01）. Regression analysis showed that school bullying and alexithymia significantly positively predicted NSSI behaviors （B=0.212， 0.333， P<0.01）， while self-esteem negatively predicted NSSI behaviors （B=-0.368， P<0.01）. Alexithymia was found to mediate the relationship between school bullying and NSSI behaviors， with an indirect effect of 0.040 （95% CI： 0.018~0.069） ，account for 17.17% of the total effect. The indirect effect through self-esteem was not statistically significant （95% CI： -0.004~0.069）.Conclusion Exposure to school bullying and high levels of alexithymia are important predictors of NSSI behavior in adolescents with depressive disorders， and school bullying may indirectly influence NSSI behavior through alexithymia. ［Funded by Scientific Research Project of Health Commition of Heilongjiang Province，（number， 20230303090154］ |
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