Chen Yadong, Jiang Zhicheng, Rong Fan, Jin Zhengge, Li Ruoyu, Li Shuqin, Wan Yuhui
School of Physical Education Science, Hefei Normal University, Hefei 230601, China.
School of Public Health, Anhui Medical University, Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei 230032, China.
Wei Sheng Yan Jiu. 2024 Sep;53(5):711-717. doi: 10.19813/j.cnki.weishengyanjiu.2024.05.005.
To analyze the influence of childhood abuse experience, recent life events and coping styles on depression symptoms of medical students based on the model of "vulnerability-stress-coping".
A longitudinal study design was adopted to select freshmen from Hefei City and Anqing City in Anhui province by cluster sampling. A total of 4211 questionnaires were collected at baseline from November to December 2019. Follow-up surveys were conducted in November to December 2020, and a total of 3662 medical students were finally included in this study. The childhood trauma questionnaire, adolescent self-rating life events checklist, coping style questionnaire and self-rating depression scale were used to evaluate childhood abuse experience, recent life events, coping styles and depression symptoms of medical students. The PROCESS software model 1(double interaction analysis) and model 3(triple interaction analysis) were used to investigate the independent and interactive effects of childhood abuse experience, recent life events, and different coping styles on depressive symptoms of medical students during follow-up.
Among the 3662 medical students, 976 were male and 2686 were female, with an average age of(19.2±1.0) years. Spearman correlation analysis showed that childhood abuse experience, recent life events, self-blame, fantasy, problem avoidance, and rationalization coping style were positively related to depressive symptoms(P<0.05). The coping style of problem solving and seeking help was negatively related to depressive symptoms(P<0.05). In model 1, both childhood abuse experience(β=0.097, 95%CI 0.065-0.129) and recent life events(β=0.102, 95%CI 0.073-0.132) had a positive predictive effect on depressive symptoms, and they also had positive interaction on depressive symptoms(β=0.030, 95%CI 0.025-0.004). In model 3, there was a negative interaction between childhood abuse, recent life events and seeking help(β=-0.034, 95%CI-0.061--0.007) or fantasy(β=-0.039, 95%CI-0.065--0.013) coping styles on depressive symptoms.
Childhood abuse experience and recent life events are the predisposition factors for depressive symptoms of medical students, and they can mutually promote depression, while seeking help and fantasy coping styles could weaken the promoting effects of both.
基于“易感性-应激-应对”模型，分析童年虐待经历、近期生活事件及应对方式对医学生抑郁症状的影响。
采用纵向研究设计，通过整群抽样选取安徽省合肥市和安庆市的大一新生。2019年11月至12月共收集基线问卷4211份。2020年11月至12月进行随访调查，最终纳入本研究的医学生共3662名。采用儿童创伤问卷、青少年自评生活事件量表、应对方式问卷和自评抑郁量表评估医学生的童年虐待经历、近期生活事件、应对方式和抑郁症状。使用PROCESS软件模型1（双因素交互分析）和模型3（三因素交互分析）探讨童年虐待经历、近期生活事件及不同应对方式对随访期间医学生抑郁症状的独立及交互作用。
3662名医学生中，男性976名，女性2686名，平均年龄（19.2±1.0）岁。Spearman相关分析显示，童年虐待经历、近期生活事件、自责、幻想、问题回避及合理化应对方式与抑郁症状呈正相关（P<0.05）。解决问题和寻求帮助的应对方式与抑郁症状呈负相关（P<0.05）。在模型1中，童年虐待经历（β=0.097，95%CI 0.065-0.129）和近期生活事件（β=0.102，95%CI 0.073-0.132）均对抑郁症状有正向预测作用，且二者对抑郁症状存在正向交互作用（β=0.030，95%CI 0.025-0.004）。在模型3中，童年虐待、近期生活事件与寻求帮助（β=-0.034，95%CI -0.061--0.007）或幻想（β=-0.039，95%CI -0.065--0.013）应对方式在抑郁症状上存在负向交互作用。
童年虐待经历和近期生活事件是医学生抑郁症状的易感因素，二者可相互促进抑郁，而寻求帮助和幻想应对方式可削弱二者的促进作用。
