父母自主支持对青少年抑郁症患者自我认同感的影响^*

The Impact of Parents' Autonomous Support on the Self-Identity of Adolescent Patients With Depression

摘要

目的 基于患者的自我认同视角，探讨青少年抑郁症患者应对方式与父母自主支持、自我认同感的相关性及其中介效应。方法 选取2023年8月–2024年7月河北医科大学第一医院青少年抑郁症患者240例，采用基本信息调查表，简易应对方式量表（SCSQ）、父母自主支持量表（PASS）、自我认同感量表（SIS）进行问卷调查。Pearson相关分析青少年抑郁症患者应对方式、父母自主支持、自我认同感的相关性，并采用SPSS宏程序Process 4.1探究应对方式在父母自主支持与自我认同感间的中介作用。结果 本研究共发放问卷240份，有效问卷236份，回收率98.33%。236例青少年抑郁症患者积极应对方式得分（19.45±2.68）分，消极应对方式得分（18.97±5.04）分，PASS得分（42.73±9.98）分，SIS得分（48.64±7.73）分；Pearson相关性显示，积极应对方式与父母自主支持、自我认同感均呈正相关〔r=0.267，95%置信区间（CI）：0.154～0.381；r=0.207，95%CI：0.098～0.317〕；消极应对方式与父母自主支持、自我认同感均呈负相关（r=-0.173，95%CI：-0.290～-0.054；r=-0.153，95%CI：-0.265～-0.039）；父母自主支持与自我认同感呈正相关（r=0.182，95%CI：0.052～0.313）。Bootstrap法验证得出，中介路径为三条，路径1（父母自主支持→积极应对→自我认同感）：效应值0.070，95%CI：0.021～0.162，效应占比17.68%；路径2（父母自主支持→消极应对→自我认同感）：效应值0.020，95%CI：0.005～0.042，效应占比5.05%；路径3（父母自主支持→积极应对→消极应对→自我认同感）：效应值0.017，95%CI：0.005～0.033，效应占比4.29%。95%CI均不包含0，间接效应成立。结论 父母自主支持既可以对青少年抑郁症患者自我认同感产生直接作用，又可通过应对方式间接作用于患者自我认同感，积极应对方式介导了父母自主支持对自我认同感的正面效应，起到了一定程度的保护作用。

Abstract

Objective From the perspective of patients' self-identity, this article explores the correlations among coping strategies of adolescent patients with depression, parents' autonomous support, and self-identity, and also examines the mediating role of coping strategies. Methods A total of 240 adolescent patients with depression from the First Hospital of Hebei Medical University were selected between August 2023 and July 2024. Basic information questionnaires, the Simplified Coping Style Questionnaire (SCSQ), the Parental Autonomy Support Scale (PASS), and the Self-Identity Scale (SIS) were used for the survey. Pearson correlation analysis was conducted to examine the relationships among coping styles of adolescent patients with depression, parental autonomy support, and self-identity. The SPSS macro program Process 4.1 was used to analyze the mediating role of coping styles between parental autonomy support and self-identity. Results A total of 240 questionnaires were distributed in this study, and 236 valid questionnaires were collected, resulting in a recovery rate of 98.33%. The mean score for positive coping strategies among 236 adolescent patients with depression was (19.45 ± 2.68) points, while the mean score for negative coping strategies was (18.97 ± 5.04) points. The mean PASS score was (42.73 ± 9.98) points, and the mean SIS score was (48.64 ± 7.73) points. Pearson correlation analysis showed that positive coping strategies were positively correlated with parental autonomous support and self-identity (r = 0.267, 95% CI: 0.154-0.381; r = 0.207, 95% CI: 0.098-0.317). Negative coping strategies were negatively correlated with parental autonomous support and self-identity (r= -0.173, 95% CI: -0.290 to -0.054; r= -0.153, 95% CI: -0.265 to -0.039). Parental autonomous support was positively correlated with self-identity (r= 0.182, 95% CI: 0.052-0.313). The bootstrap method confirmed three mediating paths: Path 1 (parental autonomous support → positive coping → self-identity) had an effect value of 0.070 (95% CI: 0.021-0.162), accounting for 17.68% of the effect; Path 2 (parental autonomous support → negative coping → self-identity) had an effect value of 0.020 (95% CI: 0.005-0.042), accounting for 5.05% of the effect; Path 3 (parental autonomous support → positive coping → negative coping → self-identity) had an effect value of 0.017 (95% CI: 0.005-0.033), accounting for 4.29% of the effect. The 95% confidence intervals did not include 0, indicating that the indirect effects were significant. Conclusion Parental autonomous support can directly affect the self-identity of adolescent patients with depression and can also indirectly influence it through coping strategies. Positive coping strategies mediate the beneficial effect of parental autonomous support on self-identity and play a protective role.

关键词

抑郁症 / 青少年 / 中介效应

Key words

Depression / Adolescent / Mediating effect

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基金资助

*2024年度河北省医学科学研究课题计划(20241665)