West Patrick, Sweeting Helen
MRC Social & Public Health Sciences Unit, Glasgow, Scotland.
J Child Psychol Psychiatry. 2003 Mar;44(3):399-411. doi: 10.1111/1469-7610.00130.
Despite a widespread view that the mental health of young people has deteriorated, the evidence base is limited by the lack of comparable datasets over time, and their capacity to test specific hypotheses about the causes of such change, in this case those particularly affecting young females.
Two cohorts of 15-year-olds in the West of Scotland, surveyed in 1987 and 1999, were compared, using the 12-item version of the General Health Questionnaire to measure psychological distress (GHQ caseness, cut-off 2/3), together with items and indices of personal and performance worries.
Between 1987 and 1999, GHQ caseness increased significantly for females (from 19% to 33%), but not males (13% to 15%), a change particularly experienced by females from non-manual and skilled manual backgrounds. With one notable exception (unemployment), most worries also increased for both sexes, a gender gap emerging in respect of worries about school performance, females worrying more. While the effect of personal worries (e.g., looks and weight) on GHQ caseness persisted over time in both sexes, that of performance worries only emerged for females in 1999. Using survey date as an indicator, a relationship between proximity to exams and GHQ caseness was also only found among females in 1999.
The increase in levels of psychological distress among young females over this period may be explained by an increase in educational expectations, which together with more traditional concerns about personal identity, appear to have elevated levels of stress, with adverse consequences for mental health.
尽管人们普遍认为年轻人的心理健康状况已经恶化,但由于缺乏长期可比的数据集,以及缺乏检验此类变化原因(在本案例中是那些对年轻女性有特别影响的原因)的具体假设的能力,相关证据基础受到限制。
对1987年和1999年在苏格兰西部调查的两组15岁青少年进行比较,使用12项版本的一般健康问卷来测量心理困扰(一般健康问卷病例,临界值为2/3),同时使用个人和学业担忧的项目及指标。
1987年至1999年期间,女性的一般健康问卷病例显著增加(从19%增至33%),而男性未增加(从13%增至15%),非体力劳动和熟练体力劳动背景的女性变化尤为明显。除一个显著例外(失业)外,大多数担忧在两性中也有所增加,在学业表现担忧方面出现了性别差距,女性担忧更多。虽然个人担忧(如外貌和体重)对一般健康问卷病例的影响在两性中都随时间持续存在,但学业担忧的影响直到1999年才在女性中显现。以调查日期为指标,1999年也仅在女性中发现临近考试与一般健康问卷病例之间存在关联。
这一时期年轻女性心理困扰水平的增加可能是由于教育期望的提高,这与对个人身份的更传统担忧一起,似乎提高了压力水平,对心理健康产生了不利影响。