消极父母教养方式与青少年抑郁症状的关系：多重作用路径的结构方程模型

Relationship between negative parenting styles and adolescent depressive symptoms： a structural equation modeling approach to multiple mediation pathways

中文关键词:  教养方式  社会支持  心理弹性  抑郁  青少年

英文关键词:Parenting styles  Social support  Psychological resilience  Depression  Adolescents

中文摘要:

      背景 青少年抑郁症状高发，且对其身心发展存在深远影响，亟需有效的针对青少年抑郁症状的干预措施。既往研究多聚焦单一风险因素，尚未建立整合性模型分析父母教养方式、学习倦怠、童年创伤与青少年抑郁症状之间的多层次交互作用，社会支持与心理弹性在其中可能发挥的保护性效应尚不清楚。目的 构建多重作用路径的结构方程模型，探索消极父母教养方式、童年创伤、学习倦怠、心理弹性、社会支持对青少年抑郁症状的综合作用机制，为制定针对青少年抑郁症状的干预策略提供参考。方法 于2022年3月—5月，采用分层抽样法选取四川省成都市12所中学的5 865名学生为研究对象。采用简式父母教养方式问卷（s-EMBU）、童年创伤量表简版（CTQ-SF）、青少年学习倦怠量表、患者健康问卷抑郁量表（PHQ-9）、社会支持评定量表（SSRS）以及心理弹性量表（CD-RISC）进行评定。采用偏最小二乘结构方程模型（PLS-SEM）构建模型，探讨消极父母教养方式、童年创伤、学习倦怠、心理弹性及社会支持影响青少年抑郁症状的多重作用路径网络。结果 青少年PHQ-9评分与s-EMBU过度保护维度、s-EMBU拒绝维度、CTQ-SF以及青少年学习倦怠量表评分均呈正相关（r=0.272、0.368、0.288、0.587，P均<0.01），PHQ-9评分与SSRS和CD-RISC评分均呈负相关（r=-0.532、-0.418，P均<0.01）。消极父母教养方式（β=0.113，95% CI：0.087~0.138）和学习倦怠（β=0.339，95% CI：0.315~0.364）可以正向预测抑郁症状。童年创伤是消极父母教养方式与抑郁症状之间的作用路径，效应值为0.018（95% CI：0.013~0.024）。社会支持是消极父母教养方式与抑郁症状（β=0.080，95% CI：0.069~0.092）、消极父母教养方式与童年创伤（β=0.041，95% CI：0.032~0.050）之间的作用路径，亦是学习倦怠与抑郁症状（β=0.092，95% CI：0.081~0.104）、学习倦怠与童年创伤（β=0.048，95% CI：0.037~0.058）之间的作用路径。心理弹性是消极父母教养方式与抑郁症状（β=0.004，95% CI：0.002~0.007）、学习倦怠与抑郁症状（β=0.037，95% CI：0.023~0.052）、童年创伤与抑郁症状（β=0.003，95% CI：0.001~0.006）之间的作用路径。结论 学习倦怠可直接影响青少年抑郁症状，消极父母教养方式既可以直接影响抑郁症状，也可通过童年创伤影响抑郁症状。此外，社会支持及心理弹性在消极教养方式、学习倦怠与抑郁症状之间起中介作用。

英文摘要:

      Background The distressingly high prevalence of depressive symptoms among adolescents exerts profound impacts on their physical and psychological development， urgently necessitating effective preventive interventions. Existing studies， however， have predominantly focused on isolated risk factors， neglecting to construct an integrated model that systematically disentangles the intricate relationships linking parenting styles， learning burnout， and childhood trauma to adolescent depressive symptoms. Moreover， the potential protective roles of social support and psychological resilience in this context remain insufficiently elucidated.Objective To construct a structural equation model encompassing multiple pathways to unravel the comprehensive mechanisms through which negative parenting styles， childhood trauma， learning burnout， psychological resilience， and social support collectively influence adolescent depressive symptoms， thereby providing evidence-based intervention strategies.Methods A stratified sampling technique was utilized to recruit 5 865 students from 12 middle schools in Chengdu City， Sichuan Province from March to May 2022. Participants were assessed using the following validated instruments： the Short-form Egna Minnen av Barndoms Uppfostran （s-EMBU）， the Childhood Trauma Questionnaire-Short Form （CTQ-SF）， the Adolescent Student Burnout Inventory， the Patients' Health Questionnaire Depression Scale-9 item （PHQ-9）， the Social Support Rating Scale （SSRS），and the Connor-Davidson Resilience Scale （CD-RISC）. A partial least squares structural equation modeling （PLS-SEM） approach was employed to construct a predictive framework examining the complex network of pathways through which negative parenting styles， childhood trauma， learning burnout， psychological resilience，and social support collectively influence depressive symptoms in adolescents.Results The PHQ-9 scores demonstrated significant positive correlations with the scores on s-EMBU overprotection subscale （r=0.272， P<0.01）， s-EMBU rejection subscale （r=0.368， P<0.01）， CTQ-SF （r=0.288， P<0.01） and Adolescent Student Burnout Inventory （r=0.587， P<0.01）. Conversely， significant negative correlations were observed between PHQ-9 scores and both SSRS （r=-0.532， P<0.01） and CD-RISC scores （r=-0.418， P<0.01）. Negative parenting styles （β=0.113， 95% CI： 0.087-0.138） and learning burnout （β=0.339， 95% CI： 0.315-0.364） emerged as significant positive predictors of depressive symptoms， with childhood trauma mediating the relationship between negative parenting styles and depressive symptoms （effect size=0.018， 95% CI： 0.013-0.024）. Social support servesed as a mediating pathway between negative parenting styles and depressive symptoms （β=0.080， 95% CI： 0.069-0.092）， as well as between negative parenting styles and childhood trauma （β=0.041， 95% CI： 0.032-0.050）. It also functioned as an intermediary pathway linking learning burnout to depressive symptoms （β=0.092， 95% CI： 0.081-0.104） and connecting learning burnout with childhood trauma （β=0.048， 95% CI： 0.037-0.058）. Additionally， psychological resilience serveed as a mediating pathway between negative parenting styles and depressive symptoms （β=0.004， 95% CI： 0.002-0.007）， between learning burnout and depressive symptoms （β=0.037， 95% CI： 0.023-0.052）， and between childhood trauma and depressive symptoms （β=0.003， 95% CI： 0.001-0.006）.Conclusion Learning burnout exerts a direct effect on adolescent depressive symptoms. Negative parenting styles influence depressive symptoms both directly and indirectly through childhood trauma. Furthermore， social support and psychological resilience serve as mediator linking negative parenting styles and learning burnout to depressive symptoms in adolescents. ［Funded by Science and Technology Project of the Health Commission of Sichuan Province （number， 24LCYJPT18）］