摘要
目的:非自杀性自伤(non-suicidal self-injury,NSSI)行为常与抑郁、焦虑症状共存于青少年群体,共同损害其心理健康。NSSI行为与抑郁、焦虑及睡眠问题的相互影响关系目前尚不明确。本研究旨在探索青少年失眠、焦虑、抑郁症状与NSSI行为的关联模式。方法:对来自湖南省湘南地区3所中学的4 319名中学生使用失眠严重程度指数量表(Insomnia Severity Index,ISI)、广泛性焦虑障碍量表(Generalized Anxiety Disorder-7 items,GAD)、患者健康问卷(Patient Health Questionaire-9 items,PHQ)和青少年自我伤害量表(Adolescent Self-Injury Scale,ASIS)分别收集失眠、焦虑、抑郁和自我伤害行为状况,并进行网络分析。结果:网络分析结果显示,抑郁症状中自杀意念与NSSI行为密切关联(边权重=0.15);失眠症状ISI6(他人注意到的睡眠问题)、焦虑症状GAD2(无法控制的担忧)和抑郁症状PHQ2(情绪低落)是疾病网络的高强度中心性的症状(强度分别为0.88,0.80和0.76);焦虑症状GAD5(坐立不安)、GAD6(易怒)、GAD7(感到害怕)和抑郁症状PHQ2(情绪低落)、PHQ3(睡眠问题)和PHQ8(运动迟缓/激越)是网络结构中的桥接症状(桥接强度分别为0.95、1.32、1.23、1.21、1.32、1.27)。结论:坐立不安、易怒、感到害怕、情绪低落、睡眠问题和运动迟缓/激越可能是有效干预青少年失眠、焦虑、抑郁症状和NSSI行为的靶点症状。
Objective:Non-suicidal self-injury(NSSI)often coexists with depressive and anxiety symptoms in adolescents,jointly impairing their mental health.However,the interplay between NSSI and symptoms of depression,anxiety,and sleep problems remain unclear.This study aims to explore the association patterns among insomnia,anxiety,depression,and NSSI behaviors in adolescents.Methods:A total of 4319 students from three secondary schools in southern Hunan Province were assessed using the Insomnia Severity Index(ISI),Generalized Anxiety Disorder-7 items(GAD),Patient Health Questionaire-9 items(PHQ),and the Adolescent Self-Injury Scale(ASIS)to evaluate insomnia symptoms,depressive symptoms,and NSSI behaviors,respectively.Network analysis was then conducted to examine the interrelationships among these symptom domains.Results:Network analysis indicated that suicidal ideation within depressive symptoms was closely associated with NSSI(edge weight=0.15).Among the symptoms,ISI6(sleep problems noticed by others,an insomnia symptom),GAD2(difficulty controlling worries,an anxiety symptom),and PHQ2(low mood,a depressive symptom)exhibited high strength centrality in the disease network(strength values:0.88,0.80,and 0.76,respectively).Additionally,anxiety symptoms including GAD5(restlessness),GAD6(irritability),GAD7(feeling afraid),and depressive symptoms including PHQ2(low mood),PHQ3(sleep problems),and PHQ8(psychomotor retardation/agitation)were identified as bridge symptoms in the network structure(bridge strength values=0.95,1.32,1.23,1.21,1.32,and 1.27,respectively).Conclusion:Restlessness,irritability,feeling afraid,feeling down,sleep problems,and psychomotor agitation/retardation may serve as key target symptoms for effective interventions addressing insomnia,anxiety,depression,and NSSI among adolescents.
作者
席畅
曾成伟
张安琪
曾奕欣
曾灿
XI Chang;ZENG Chengwei;ZHANG Anqi;ZENG Yixin;ZENG Can(Department of Psychology,School of Humanity and Management,Hunan University of Chinese Medicine,Changsha 410208;Department of Psychology,School of Educational Science,Shaoguan University,Shaoguan 512005,China)
出处
《中南大学学报(医学版)》
北大核心
2025年第9期1545-1554,共10页
Journal of Central South University (Medical Science)
基金
国家自然科学基金(82301740)
湖南省自然科学基金(2023JJ40489)
湖南省教育厅科学研究项目(22B0363)。
关键词
青少年
失眠
焦虑
抑郁
非自杀性自伤行为
adolescents
insomnia
anxiety
depression
non-suicidal self-injury behaviors
