卫生研究

目的 探讨医学新生适应性、情绪调节自我效能感与焦虑、抑郁的关系，并分析情绪调节自我效能感在适应与心理健康间的中介作用。方法 采用分层整群随机抽样法，于2022年11月对安徽省芜湖市两所医学院校1866名医学新生进行调查。使用大学新生适应性量表、情绪调节自我效能感量表、广泛性焦虑量表简版和抑郁症状量表简版评估新生适应性、情绪调节能力及心理健康状况。采用Pearson相关分析医学新生适应性、情绪调节自我效能感和焦虑、抑郁的相关性，再运用Bootstrap中介效应检验探讨情绪调节自我效能感在医学新生适应性和焦虑、抑郁之间的中介效应。结果 被调查的1866名医学新生的年龄为(18.78±1.23)岁，其中男生727名(39.0%),女生1139名(61.0%)。医学新生的焦虑、抑郁检出率分别为11.68%(218/1866)和12.33%(230/1866)。医学新生总体适应性均分为3.46±0.51,其中学习适应性得分最低(3.21±0.67)。学校适应性评分与焦虑(r=-0.482)、抑郁(r=-0.505)评分呈显著负相关(P<0.01),而与表达积极情绪效能感、管理消极情绪效能感呈显著正相关(r=0.412、r=0.467,均P<0.01);表达积极情绪效能感、管理消极情绪效能感与焦虑(r=-0.205,r=-0.358)、抑郁评分(r=-0.246,r=-0.345)均呈显著负相关(P<0.01)。管理消极情绪效能感在新生适应与焦虑(间接效应β=-0.083,SE=0.013, 95%CI-0.109～-0.059)、抑郁(间接效应β=-0.068,SE=0.013, 95%CI-0.093～-0.043)存在显著部分中介作用(效应占比分别为16%和13%)。结论 医学新生适应性及情绪调节自我效能感与焦虑、抑郁情绪密切相关；新生适应性不仅可直接负向预测焦虑、抑郁水平，还能通过提升管理消极情绪的自我效能感间接降低心理风险。

OBJECTIVE To investigate the relationship between college adaptation, emotion regulation self-efficacy, and anxiety/depression among medical freshmen, and to analyze the mediating role of emotion regulation self-efficacy in the association between adaptation and mental health, providing evidence for targeted psychological interventions.METHODS A cross-sectional study was conducted in November 2022 using a stratified cluster random sampling, involving 1866 medical freshmen from two colleges in Wuhu City, Anhui Province. The student adaptation to College Questionnaire, Self-Regulation of Emotion Self-Efficacy Scale, Generalized Anxiety Disorder-2, and Patient Health Questionnaire-2 were used to assess adaptation, emotion regulation self-efficacy, anxiety, and depression, respectively. Pearson correlations analysis was conducted to examine the associations between medical freshmen's college adaptation, emotion regulation self-efficacy, and anxiety/depression. Subsequently, bias-corrected Bootstrap mediation analysis(5000 resamples) was employed to test the mediating role of emotion regulation self-efficacy in the relationship between college adaptation and anxiety/depression.RESULTS The average age of the 1866 surveyed medical freshmen was(18.78±1.23) years old, with 727 males(39.0%) and 1139 females(61.0%). The prevalence rates of anxiety and depression were 11.68%(218/1866) and 12.33%(230/1866), respectively. The overall adaptation score of medical freshmen was 3.46±0.51, with the lowest score observed in learning adaptation(3.21±0.67). College adaptation demonstrated significantly negative correlations with anxiety/depression(r=-0.482 and-0.505, P<0.01), and positive associations with expressive positive emotion self-efficacy and regulatory negative emotion self-efficacy(r=0.412,r=0.467, both P<0.01). Positive emotion regulation efficacy and negative emotion management efficacy demonstrated significant negative correlations with anxiety scores(r=-0.205, r=-0.358) and depression scores(r=-0.246, r=-0.345), respectively(P<0.01). Mediation analysis demonstrated that regulatory negative emotion self-efficacy partially mediated the relationship between adaptation and anxiety(indirect effect β=-0.083, SE=0.013, 95%CI-0.109 to-0.059; proportion mediated: 16%) and depression(β=-0.068, SE=0.013, 95%CI-0.093 to-0.043; proportion mediated: 13%).CONCLUSION Medical freshmen's adaptation and emotion regulation self-efficacy are closely related to anxiety and depressive emotions. Adaptation can not only directly and negatively predict the levels of anxiety and depression, but also indirectly reduce psychological risks by enhancing the self-efficacy in managing negative emotions.