积极成长经历对青少年心理健康风险的缓冲效应

  目的  探讨积极成长经历对青少年心理健康风险的缓冲效应，为后续开展有效的支持和干预措施提供科学依据。  方法  采用方便抽样方法，于2019年10月新冠肺炎疫情前在安徽省池州市2个县中小学校招募1 322名四至九年级学生，开展学生问卷调查，收集学生一般人口统计学信息、积极成长经历、抑郁症状、焦虑症状、自伤行为、自杀意念情况等信息，并于2020年5月新冠肺炎疫情学校复课后进行随访。以疫情前和复课后青少年的心理健康状况作为观测指标，采用多元Logistic回归分析检验积极成长经历与青少年心理健康变化间的相关性。  结果  复课后学生抑郁症状、焦虑症状、自伤行为、自杀意念的检出率(22.6%，16.0%，40.0%，29.9%)高于疫情前(16.5%，13.5%，31.1%，22.6%)。积极成长经历高分组青少年抑郁症状、焦虑症状、自伤行为、自杀意念在疫情前与复课后检出率差异均无统计学意义(Z值分别为-0.05，0.27，0.84，1.84，P值均>0.05)。多元Logistic回归分析显示，积极成长经历低分组复课后抑郁症状风险是疫情前的1.39倍(95%CI=1.05~1.84，P＜0.05)，自伤行为风险是疫情前的1.31倍(95%CI=1.05~1.62，P＜0.05)。积极成长经历高分组中，疫情前后学生的心理健康状况差异均无统计学意义(P值均＞0.05)。  结论  新冠肺炎疫情暴发背景下，积极成长经历与青少年抑郁、焦虑、自伤行为和自杀意念风险降低相关。应从家庭、学校和同伴角度给予更多的支持和帮助，减轻公共卫生突发事件对青少年心理健康的不利影响。

Buffering effect of positive childhood experiences on mental health risks among adolescents

  Objective  To explore the buffering effect of positive childhood experiences (PCEs) on mental health risks among adolescents before and after COVID-19 epidemic.  Methods  In October 2019 (before the outbreak of COVID-19), 1 322 students from grades 4 to 9 were recruited from primary and secondary schools in two counties of Chizhou city, Anhui Province. A questionnaire survey was conducted to collect general demographic information, PCEs, depressive symptoms, anxiety symptoms, self-harm behavior, suicidal ideation. Follow-up survey was conducted after school re-opening (May 2020). Mental health status before and after the COVID-19 epidemic was compared among students with different PCEs by multiple logistic regression analyses.  Results  The detection rates of depressive symptoms, anxiety symptoms, self-harm behavior and suicidal ideation (22.6%, 16.0%, 40.0%, 29.9%) of the respondents after school re-opening were significantly higher compared that before the epidemic (16.5%, 13.5%, 31.1%, 22.6%). There were no significant differences in the detection rates of depressive symptoms, anxiety symptoms, self-harm behavior and suicidal ideation between high PCEs group before and after the epidemic (Z=-0.05, 0.27, 0.84, 1.84, P>0.05). Multivariate Logistic regression analysis showed that the risk of depressive symptoms and self-harm behavior in the low PCEs group after school re-opening was 1.39 times higher than that before the epidemic (95%CI=1.05-1.84, P < 0.05). The risk of non-suicidal self-injury behavior in the low PCEs group after school re-opening was 1.31 times higher than that before the epidemic (95%CI=1.05-1.62, P < 0.05). There were no significant differences in mental health detection rates in high PCEs group before and after the epidemic (P>0.05).  Conclusion  During the time of COVID-19 epidemic, PCEs is associated with lower rates of depressive symptoms, anxiety symptoms, self-harm behavior and suicide ideation in adolescents. The findings suggest that more support and help should be given to adolescents from the perspectives of family, school and peers, so as to reduce the adverse effects of public health emergencies on adolescents' mental health.