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生活事件与青少年/青年期身心症状的关系:结构方程模型方法。

Relationship between life events and psychosomatic complaints during adolescence/youth: a structural equation model approach.

机构信息

CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.

出版信息

J Adolesc Health. 2011 Aug;49(2):199-205. doi: 10.1016/j.jadohealth.2010.11.260. Epub 2011 Feb 11.

Abstract

PURPOSE

To assess the contribution of life events (LEs) on psychosomatic complaints in adolescents/youths taking into account a set of socioeconomic variables.

METHODS

We tested a conceptual model implemented with structural equation modeling on longitudinal data from a representative sample of adolescents/youths and parents. Psychosomatic complaints were measured by the Health Behaviour in School-aged Children scale and hypothesized to be affected by: (a) contextual factors at distal level: financial resources, home life and social support (KIDSCREEN), and parent baseline mental health (SF-12); (b) triggering factors: LEs (Coddington Life Events Scales, with two typologies: desirability and familiarity); (c) intermediate factors: same as distal level but measured at follow-up; (d) immediate cause: mental health at proximal level (Strengths and Difficulties Questionnaire at baseline and follow-up); and (e) gender.

RESULTS

The structural model yielded a good fit (Comparative Fit Index = .95, Tucker-Lewis Index = .93, Root Mean Square Error = .04). Boys showed more psychosomatic complaints than girls (β = .40, p < .05). Girls reported experiencing more LEs (p < .05). Only undesirable LEs showed a significant direct negative effect on psychosomatic complaints, which became nonsignificant when mediated by home life and mental health. Undesirable LEs had a remaining indirect effects on psychosomatic complaints (βindirect = -.10, p < .05) via Home Life and Mental health, which were protective factors (β = .41 and β = -.15, p < .05).

CONCLUSIONS

The experience of undesirable LEs increases the probability of psychosomatic complaints, but the final effect would be determined by previous levels of home life and mental health stability.

摘要

目的

评估生活事件(LEs)对青少年/青年身心症状的影响,同时考虑一系列社会经济变量。

方法

我们使用结构方程模型对具有代表性的青少年/青年及其父母的纵向数据进行了概念模型测试。身心症状通过《儿童健康行为问卷》进行测量,并假设其受到以下因素的影响:(a)远端背景因素:经济资源、家庭生活和社会支持(KIDSCREEN),以及父母基线心理健康(SF-12);(b)触发因素:LEs(Coddington 生活事件量表,具有两种类型:期望性和熟悉性);(c)中间因素:与远端因素相同,但在随访时进行测量;(d)直接原因:近端心理健康(基线和随访时的《长处和困难问卷》);和(e)性别。

结果

结构模型拟合良好(比较拟合指数=.95,Tucker-Lewis 指数=.93,均方根误差=.04)。男孩比女孩表现出更多的身心症状(β=.40,p<.05)。女孩报告经历了更多的 LEs(p<.05)。只有不期望的 LEs 对身心症状有显著的直接负向影响,而通过家庭生活和心理健康的中介作用后,其影响变得不显著。不期望的 LEs 通过家庭生活和心理健康对身心症状仍具有间接影响(β间接= -.10,p<.05),这两者是保护因素(β=.41 和 β= -.15,p<.05)。

结论

不期望的 LEs 的经历增加了身心症状的可能性,但最终的影响将取决于家庭生活和心理健康的先前水平。

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