Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
Mental Health America, United States of America.
J Affect Disord. 2024 Nov 15;365:437-442. doi: 10.1016/j.jad.2024.08.090. Epub 2024 Aug 17.
This study aimed to examine acute and chronic stressors, and perceived lack social support, and their associations with depression and suicidal ideation in adolescents during the COVID-19 pandemic.
Deidentified data from (N = 270,153) U.S. adolescents aged 11 to 17 who completed the Patient Health Questionnaire 9-item tool (PHQ-9) in the years 2020 and 2021 were sourced from a collection of online screening tools that are free, confidential, anonymous, and scientifically validated. In addition to depression, the survey included questions about suicidality, past/chronic stressful events, and contributors to mental health problems and sociodemographic variables. SPSS software version 28 for descriptive analyses, and Mplus version 7.31 for confirmatory factor analysis (CFA) and structural equation modeling (SEM), were respectively used.
Participants were predominantly female, White, and heterosexual, and exhibited a high prevalence of severe depression and a significant frequency of suicidal thoughts. Significant associations were found between past/chronic stressful events, and lack of social support, with suicidality and depression. Mental health stress due to the COVID-19 pandemic itself presented no significant associations with depression and suicidality and was weakly and negatively associated with lack of social support and past/chronic stressors.
These findings reinforce the notion that prior traumatic events can create vulnerabilities in the face of acute stressors, while social support can enhance resilience in adolescents. Factors that increase resilience, such as preventing traumatic events, reducing social stressors, and increasing social support, can serve as valuable guidelines for clinical and public health interventions.
本研究旨在探讨青少年在 COVID-19 大流行期间急性和慢性应激源、感知缺乏社会支持与抑郁和自杀意念的关系。
从 2020 年和 2021 年期间完成患者健康问卷 9 项工具（PHQ-9）的 270153 名美国 11 至 17 岁青少年的匿名数据中提取。这些数据来源于一系列免费、保密、匿名和经过科学验证的在线筛查工具。除了抑郁，该调查还包括关于自杀倾向、过去/慢性应激事件以及心理健康问题和社会人口学变量的原因的问题。SPSS 软件版本 28 用于描述性分析，Mplus 版本 7.31 用于验证性因素分析（CFA）和结构方程建模（SEM）。
参与者主要为女性、白人、异性恋，表现出严重抑郁的高发率和显著的自杀意念频率。过去/慢性应激源与缺乏社会支持，与自杀倾向和抑郁显著相关。COVID-19 大流行本身对心理健康的压力与抑郁和自杀倾向无显著关联，与缺乏社会支持和过去/慢性应激源呈弱负相关。
这些发现进一步证明了这样一种观点，即先前的创伤性事件会使个体在面对急性应激源时变得脆弱，而社会支持可以增强青少年的适应能力。增加适应能力的因素，如预防创伤性事件、减少社会应激源和增加社会支持，可以作为临床和公共卫生干预的有价值的指导方针。
