四川农村中学生焦虑抑郁在社会支持与自杀意念间的作用

目的探讨农村中学生社会支持、抑郁、焦虑及自杀意念的关系,为促进中学生心理健康、降低自杀意念提供科学依据。方法采用典型抽样和整群随机抽样相结合的方法对四川省资中县山区的2所乡镇中学共2 217名初一和高一全部学生展开为期3年的追踪调查。使用社会支持评定量表(Social Support Rating Scale,SSRS)、抑郁自评量表(Self-rating Depression Scale, SDS)、焦虑自评量表(Self-rating Anxiety Scale, SAS)、自编自杀意念的条目进行调查,通过构建一般及群组分析的结构方程模型探讨变量间的关系。结果中学生抑郁得分为(13.51±12.57)分,女生抑郁得分为(14.61±12.67)分,男生为(12.24±12.34)分;初中生社会支持得分为(35.49±5.88)分,高中生为(34.70±5.43)分,差异均有统计学意义(t值分别为4.46,2.67,P值均<0.05)。抑郁、焦虑直接影响自杀意念,标准化效应分别为0.11(95%CI=0.06~0.16)、0.09(95%CI=0.05~0.14)。抑郁、焦虑是社会支持与自杀意念关系中的中介变量,中介效应值分别为-0.46(95%CI=-0.51^-0.41)、-0.21(95%CI=-0.27^-0.16)。学段在社会支持通过焦虑对自杀意念的间接关系中具有调节作用。结论农村中学生焦虑、抑郁在社会支持与自杀意念关系中有中介效应,焦虑和抑郁干预是在低社会支持者中降低自杀意念的重要措施。

Mediating effects of anxiety and depression on social support and suicidal ideation among rural middle school students in Sichuan

Objective To explore the relationships among social support, depression, anxiety and suicide ideation among middle school students in rural areas of south Sichuan Province so as to provide a scientific basis for promoting middle school students’ mental health and reducing suicide ideation. Methods A sum of 2 217 students of grade 7 and 10 from 2 township middle schools in mountainous areas of Zizhong County, Sichuan Province, were investigated by means of typical sampling and cluster random sampling. Social Support Rating Scale(SSRS), Self-rating Scale for Depression(SDS), Self-rating Anxiety Scale(SAS) and Self-compiled adolescent health questionnaire were used to measure suicidal ideation, and structural equation model was used for statistical analysis. Results The depression score of middle school students was(13.51±12.57), and the self-rating scale for Depression score of girls was(14.61±12.67), higher than that of boys(12.24±12.34). The SSRS score of Social Support Rating Scale of junior high school students was(35.49±5.88), which was higher than that of senior high school students(34.70±5.43), and the differences were of statistical significance(t=4.46, 2.67, P<0.05). The results of structural equation model showed that depression and anxiety directly affected suicidal ideation, and the standardized effects were respectively 0.11(95%CI=0.06-0.16) and 0.09(95%CI=0.05-0.14). Depression and anxiety were the intermediate variables in the relationship between social support and suicidal ideation, and the mediating effects were respectively-0.46(95%CI=-0.51--0.41) and-0.21(95%CI=-0.27--0.16). Studying period could play a mediating role in the indirect effect made by social support on suicide ideation through anxiety. Conclusion Anxiety and depression have significant mediating effect on the relationship between social support and suicidal ideation among middle school students in rural areas of south Sichuan province. Anxiety and depression intervention are important measures to reduce suicide ideation among low social supporters.