青少年情绪障碍患者及其照顾者家庭关怀度与积极应对方式的关系

Relationship between family functioning and positive coping strategies in adolescents with emotional disorders and their caregivers

摘要

目的 基于主客体互倚模型探讨青少年情绪障碍患者及其照顾者家庭关怀度与积极应对方式的关系,为构建青少年情绪障碍患者家庭干预方案提供参考。方法 2023年12月—2024年9月,便利选取上海市某三级甲等精神科专科医院青少年情绪障碍患者及其主要照顾者303对作为研究对象,使用一般资料调查表、家庭关怀度指数问卷和简易应对方式问卷进行调查,采用主客体互倚模型和Pearson相关性分析,分析患者及其照顾者家庭关怀度和积极应对方式相互之间的路径关系。结果 患者和照顾者家庭关怀度得分分别为(5.32±3.25)、(5.87±2.61)分;积极应对方式均分分别为(1.56±0.65)、(2.20±0.49)分。在主客体互倚模型中发现,患者与照顾者家庭关怀度可正向预测自身的积极应对方式(β₁=0.338,β₂=0.338,P<0.001),主体效应显著;患者家庭关怀度可正向预测照顾者的积极应对方式(β=0.142,P<0.01),存在客体效应。结论 青少年情绪障碍患者的家庭关怀度与自身及其照顾者的应对方式密切相关,医护人员应将其视作一个整体进行干预。

Abstract

Objective To examine the relationship between family functioning and positive coping strategies in adolescents with emotional disorders and their caregivers using the actor-partner interdependence model (APIM),in order to provide a reference for the construction of family intervention programs for adolescent patients with emotional disorders. Methods From December 2023 to September 2024, a convenience sample of 303 adolescent-caregiver dyads was recruited from a tertiary psychiatric hospital in Shanghai.Participants completed the Family Adaption,Partnership,Growth,Affection,Resolve Index Questionnaire(APGAR), Simplified Coping Style Questionnaire(SCSQ), and a demographic survey.APIM and Pearson correlation analysis were employed to analyze the dyadic relationships between family functioning and positive coping strategies. Results The mean family APGAR scores were 5.32±3.25 for adolescents and 5.87±2.61 for caregivers; positive coping strategy scores were 1.56±0.65 and 2.20±0.49, respectively.The APIM revealed significant actor effects, with both adolescents′ and caregivers′ family functioning positively predicting their own positive coping strategies (β₁=0.338, β₂=0.338, P<0.001).A significant partner effect was observed, showing that adolescents′ family APGAR positively predicted caregivers′ positive coping strategies (β=0.142, P<0.01). Conclusions Family APGAR is closely associated with coping strategies in both adolescents with emotional disorders and their caregivers.Healthcare professionals should adopt a family-centered approach when implementing interventions.

关键词

情绪障碍 / 家庭关怀度 / 积极应对方式 / 主客体互倚模型 / 青少年

Key words

emotional disorder / family APGAR / positive coping styles / actor-partner interdependence model / adolescents

[1] 金宇.儿童青少年情绪障碍早期识别与治疗[J].中国儿童保健杂志,2023,31(12): 126-131.
Jin Y.Early identification and treatment of emotional disorders in children and adolescents[J].Chin J Child Health Care, 2023,31(12): 126-131.(in Chinese)
[2] World Health Organization.Mental health of adolescents[EB/OL].(2024-10-10)[2025-03-18].https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health.
[3] Li F, Cui Y, Li Y, et al.Prevalence of mental disorders inschool children and adolescents in China: Diagnostic data from detailed clinical assessments of 17 524 individuals[J].J Child Psychol Psychiatry, 2022, 63(1):34-46.
[4] Werner-Seidler A,Spanos S, Calear AL, et al.School-based depression and anxiety prevention programs: An updated systematic review and meta-analysis[J].Clin Psychol Rev, 2021, 89:102079.
[5] Zhang WY, Song XH, Wang XB, et al.Network analysis of core factors related to non-suicidal self-injury in adolescents with mood disorders[J].Front Psychiatry,2025,16:1557351.
[6] Liu DL, Cui ZX, Zhang QW, et al.The mediating role of specific coping styles in the relationship between perceived social support and depressive symptoms in adolescents[J].2023,325:647-655.
[7] Peng ML, Zhang L, Wu QP, et al.The effects of childhood trauma on nonsuicidal self-injury and depressive severity among adolescents with major depressive disorder: The diffe-rent mediating roles of positive and negative coping styles[J].J Affect Disord, 2024,361:508-514.
[8] Cheng F, Hu C, Zhang W, et al.The influence of parenting style and coping behavior on nonsuicidal self-injury behavior in different genders based on path analysis[J].PeerJ, 2022, 10:e14507.
[9] Kafali HY, Kalyoncu T, Ozbaran B, et al.Association between caregivers′ coping and children′s psychiatric symptoms in the heart transplantation process: A pilot study[J].Artif Organs, 2021, 45(4):354-363.
[10] Shao L, Zhong J, Wu H, et al.The mediating role of coping in the relationship between family function and resilience in adolescents and young adults who have a parent with lung cancer[J].Support Care Cancer, 2022, 30(6):5259-5267.
[11] Campo-Arias A, Caballero-Domínguez CC.Confirmatory factor analysis of the family APGAR questionnaire[J].Rev Colomb Psiquiatr, 2021,50(4):234-237.
[12] 金琼.神经症、抑郁症患者家庭功能特点及患者与父母间家庭功能的知觉差异[D].合肥:安徽医科大学,2011.
Jin Q.Characteristics of family functioning of neurosis and depression patients and perceptual differences between patients and parents[D].Hefei: Anhui Medical University, 2011.(in Chinese)
[13] Kenny DA,Kashy DA,Cook WL Dyadic data analysis[M].New York:Guilford Press,2006.
[14] 吕繁,顾湲.家庭APGAR问卷及其临床应用[J].国外医学(医院管理分册),1995,12(2): 56-59.
Lyu F, Gu Y.The family APGAR questionnaire and its clinical applications[J].Foreign Medical Sciences (Section of Hospital Management), 1995, 12(2): 56-59.(in Chinese)
[15] 解亚宁.简易应对方式量表信度和效度的初步研究[J].中国临床心理学杂志,1998,6(2):114-115.
Xie YN.Preliminary study on reliability and validity of Simplified Coping Style Questionnaire[J].Chin J Clin Psychol, 1998, 6(2): 114-115.(in Chinese)
[16] 颜虹,徐勇勇.医学统计学[M].3版.北京: 人民卫生出版社,2022: 254-255.
Yan H, Xu YY.Medical statistics[M].3rd ed.Beijing: People′s Medical Publishing House, 2022: 254-255.(in Chinese)
[17] 雷辉,黄雅晴,张小崔.家庭关怀度对初中生自伤行为的影响:有调节的中介模型[J].中国临床心理学杂志,2022,30(4): 852-860.
Lei H, Huang YQ, Zang XC.Family care and self-injury in junior middle school students: A mediated moderating model[J].Chin J Clin Psychol, 2022,30(4): 852-860.(in Chinese)
[18] Andrade JJDC, Silva ACO, Frazão IDS, et al.Family functionality and burden of family caregivers of users with mental disorders[J].Rev Bras Enferm, 2021, 74(5):e20201061.
[19] Yang WL, Zhang XN, Li YT, et al.Advanced heart failure patients and family caregivers health and function: Randomised controlled pilot trial of online dignity therapy[J].BMJ Support Palliat Care, 2024, 14:e1361-1371.
[20] Liu M, Liu HJ, Qin ZZ, et al.Effects of physical activity on depression, anxiety, and stress in college students: The chain-based mediating role of psychological resilience and coping styles[J].Front Psychol, 2024, 15:1396795.
[21] Xie XY, Liu JF, Gong X, et al.Relationship between childhood trauma and nonsuicidal self-injury among adolescents with depressive disorder: Mediated by negative life events and coping style[J].Neuropsychiatr Dis Treat, 2023, 19:2271-2281.
[22] Guariglia L, Ieraci S, Villani V, et al.Copingstyle in glioma patients and their caregiver: Evaluation during disease trajectory[J].Front Neurol, 2021, 12:709132.
[23] Ma AN, Yang Y, Guo S, et al. Adolescent resilience and mobile phone addiction in Henan Province of China: Impacts of chain mediating, coping style[J].PLoS One, 2022, 17(12):e0278182.
[24] 王素红,朱雪丽,于洋洋,等.青少年抑郁症患者及其主要照料者的应对方式与家庭韧性关系的主客体互倚模型[J].新乡医学院学报,2025,42(3): 236-241.
Wang SH, Zhu XL, Yu YY, et al.The analysis of the relationship of the coping styles of depressed adolescents and their primary caregivers with family resilience based on an actor-partner interdependence model[J].Journal of Xinxiang Medical University, 2025, 42(3): 236-241.(in Chinese)
[25] Wen ZX, Zhang YX, Shi J, et al.Relationship between family function and depression among caregivers of patients with acute pesticide poisoning: A cross sectional study[J].BMC Public Health, 2025,25(1):1252.
[26] Mercier A, Dorris L, Brunklaus A,et al.Trauma, coping, and adjustment when parenting a child with Dravet syndrome[J].Eur J Paediatr Neurol, 2025, 54:96-106.
[27] Shao L, Zhong JD, Wu HP, et al.The mediating role of coping in the relationship between family function and resilience in adolescents and young adults who have a parent with lung cancer[J].Support Care Cancer, 2022, 30(6):5259-5267.
[28] Olson DH, Sprenkle DH, Russell CS.Circumplex model of marital and family systems: I.Cohesion and adaptability dimensions, family types, and clinical applications[J].Fam Process, 1979, 18(1): 3-28.
[29] Xiang GC, Li QQ, Xiao MY, et al.Goal setting and attaining: Neural correlates of positive coping style and hope[J].Psychophysiology, 2021, 58(10):e13887.
[30] Renske VDC, Renate B, Kayla G, et al.Neural responses for evaluating self and mother traits in adolescence depend on mother-adolescent relationships[J].Soc Cogn Affect Neurosci, 2019, 14(5):481-492.

基金资助

上海交通大学医学院护理学科建设项目(2024)