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童年期创伤对患有重性抑郁障碍的青少年非自杀性自伤和抑郁严重程度的影响:积极和消极应对方式的不同中介作用。

The effects of childhood trauma on nonsuicidal self-injury and depressive severity among adolescents with major depressive disorder: The different mediating roles of positive and negative coping styles.

机构信息

Chongqing Mental Health Center, No. 102 Jinzi Mountain, Chongqing 401147, PR China.

The Second People's Hospital of Jiangning District, Nanjing 211103, PR China.

出版信息

J Affect Disord. 2024 Sep 15;361:508-514. doi: 10.1016/j.jad.2024.06.037. Epub 2024 Jun 22.

Abstract

OBJECTIVE

We aimed to examine whether positive and negative coping styles mediated the influences of childhood trauma on NSSI or depressive severity in adolescents with major depressive disorder (MDD).

METHODS

The Children's Depression Inventory (CDI), the Ottawa Self-Injury Inventory Chinese Revised Edition (OSIC), the short-form Childhood Trauma Questionnaire (CTQ-SF), and the Simplified Coping Style Questionnaire (SCSQ) were evaluated in 313 adolescents with MDD.

RESULTS

MDD adolescents with NSSI had higher CTQ-SF total score, emotional and sexual abuse subscale scores, but lower CDI total and subscale scores compared to the patients without NSSI. The multiple linear regression analysis revealed that emotional abuse (β = 0.075, 95 % CI: 0.042-0.107) and ineffectiveness (β = -0.084, 95 % CI: -0.160 ∼ -0.009) were significantly associated with the frequency of NSSI in adolescents with MDD, but emotional abuse (β = 0.884, 95 % CI: 0.570-1.197), sexual abuse (β = 0.825, 95 % CI: 0.527-1.124) and negative coping style (β = 0.370, 95 % CI: 0.036-0.704) were independently associated with the depressive severity in these adolescents. Furthermore, the mediation analysis demonstrated that positive coping style partially mediates the effect of childhood trauma on NSSI (Indirect effect = 0.002, 95 % bootCI: 0.001-0.004), while the negative coping style partially mediates the relationship between childhood trauma and depressive severity (Indirect effect = 0.024, 95 % bootCI: 0.005-0.051) in adolescents with MDD.

LIMITATIONS

A cross-sectional design, the retrospective self-reported data, the small sample size.

CONCLUSION

Our findings suggest that coping styles may serve as mediators on the path from childhood trauma to NSSI or depressive severity in MDD adolescents.

摘要

目的

本研究旨在探讨积极应对和消极应对方式是否在童年创伤对患有重度抑郁症(MDD)青少年的自伤行为(NSSI)或抑郁严重程度的影响中起中介作用。

方法

对 313 名 MDD 青少年进行儿童抑郁量表(CDI)、修订后的中文渥太华自伤量表(OSIC)、简短版童年创伤问卷(CTQ-SF)和简易应对方式问卷(SCSQ)评估。

结果

与无 NSSI 的 MDD 患者相比,有 NSSI 的 MDD 青少年 CTQ-SF 总分、情感和性虐待分量表得分较高,CDI 总分和分量表得分较低。多元线性回归分析显示,情感虐待(β=0.075,95%CI:0.042-0.107)和无效应对(β=-0.084,95%CI:-0.160∼-0.009)与 MDD 青少年 NSSI 的频率显著相关,但情感虐待(β=0.884,95%CI:0.570-1.197)、性虐待(β=0.825,95%CI:0.527-1.124)和消极应对方式(β=0.370,95%CI:0.036-0.704)与这些青少年的抑郁严重程度独立相关。此外,中介分析表明,积极应对方式部分中介了童年创伤对 NSSI 的影响(间接效应=0.002,95%bootCI:0.001-0.004),而消极应对方式部分中介了童年创伤与 MDD 青少年抑郁严重程度的关系(间接效应=0.024,95%bootCI:0.005-0.051)。

局限性

横断面设计、回顾性自我报告数据、样本量小。

结论

我们的研究结果表明,应对方式可能是 MDD 青少年童年创伤与 NSSI 或抑郁严重程度之间的中介因素。

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