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目的 探讨医学专科新生童年期虐待经历与抑郁、焦虑症状之间的关系，以及手机依赖和睡眠质量在两者之间的链式中介作用。方法 在安徽医药高等专科学校和安庆医药高等专科学校采用整群抽样的方法，选取大一年级学生作为调查对象，于2019年11—12月及2020年11—12月进行基线和随访调查，纳入同时完成基线与随访的3662名学生，其中男生976名，女生2686名。采用儿童期虐待问卷、手机使用依赖自评问卷、匹兹堡睡眠质量指数量表、抑郁自评量表和焦虑自评量表，分别评定童年期虐待经历、手机依赖、睡眠质量、抑郁和焦虑症状。运用偏相关分析检验变量之间的关联；调整年龄、性别、城乡、独生子女状况、父母文化程度和家庭经济水平后，通过PROCESS软件的自举(Bootstrap)检验手机依赖和睡眠质量在童年期虐待经历和抑郁、焦虑症状关联之间的链式中介作用。结果 抑郁症状及焦虑症状检出率分别为8.49%和9.48%。偏相关分析显示，控制焦虑症状条件下，童年期虐待经历与手机依赖、睡眠质量、抑郁症状得分呈正相关(r=0.120,r=0.154,r=0.135,P<0.01),手机依赖与睡眠质量、抑郁症状呈正相关(r=0.333,r=0.135,P<0.01),睡眠质量与抑郁症状呈正相关(r=0.131,P<0.01);控制抑郁症状条件下，童年期虐待经历与手机依赖(r=0.108)、睡眠质量(r=0.147)、焦虑症状(r=0.092)呈正相关(P<0.01),手机依赖与睡眠质量(r=0.323)、焦虑症状(r=0.047)呈正相关(P<0.01),睡眠质量与焦虑症状呈正相关(r=0.100,P<0.01)。在调整性别、家庭所在地、独生子女状况、父母文化程度及家庭经济条件后，中介分析结果显示，手机依赖和睡眠质量在童年期虐待经历与抑郁、焦虑症状之间中介效应分别为0.076(95%CI 0.061～0.091,P<0.01)和0.062(95%CI 0.050～0.074,P<0.01),中介效应比例分别为23.58%和23.40%(P<0.01)。结论 童年期虐待经历会增加医学专科新生产生抑郁和焦虑症状的风险，还可以通过手机依赖和睡眠质量的链式中介作用间接提高抑郁和焦虑症状水平。
Abstract：OBJECTIVE To investigate the relationship between childhood abuse experiences and depression and anxiety symptoms in Anhui medical college students, as well as the chain mediating role of mobile phone dependence and sleep quality.METHODS Using cluster sampling, two schools-Anhui Medical College and Anqing Medical College selected first-year students as the subjects of the survey. Baseline and follow-up surveys were conducted in November-December 2019 and November-December 2020, including a total of 3662 students who completed both the baseline and the follow-up, among which there were 976 males and 2686 females. Childhood Trauma Questionnaire-28 Item Short Form, Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use, Pittsburgh Sleep Quality Index, Sleep-Rating Depression Scale and Sleep-Rating Anxiety Scale were used to evaluate childhood abuse experiences, mobile phone dependence, sleep quality, depression and anxiety symptoms, respectively. The partial correlations analysis was used to analyze the association between variables. After adjusting for age, gender, urban and rural areas, single-child status, parental education level and family economic level, the chain mediating effect of mobile phone dependence and sleep quality on the association between childhood abuse experiences and depression and anxiety symptoms was examined by bootstrap program and PROCESS software.RESULTS The detection rates of depressive symptoms and anxiety symptoms are 8.49% and 9.48%, respectively. As the partial correlations analysis shows, after controlling for anxiety symptoms, childhood abuse experiences showed significant positive correlations with mobile phone dependence, sleep quality, and depression symptom(r=0.120, r=0.154, r=0.135, P<0.01). Mobile phone dependence was significantly positively correlated with sleep quality and depression symptoms(r=0.333, r=0.135, P<0.01), and sleep quality showed a significant positive correlation with depression symptoms(r=0.131, P<0.01). After controlling for depression symptoms, childhood abuse experiences showed significant positive correlations with mobile phone dependence(r=0.108), sleep quality(r=0.147), and anxiety symptom(r=0.092, P<0.01). Mobile phone dependence was significantly positively correlated with sleep quality and anxiety symptoms(r=0.323, r=0.047, P<0.01), and sleep quality showed a significant positive correlation with anxiety symptoms(r=0.100, P<0.01). After adjusting for gender, family location, only child status, parental education level, and family economic conditions, the mediation analysis result indicate that mobile phone dependence and sleep quality played a chain mediating role between childhood abuse experiences and depression and anxiety symptoms, with the mediation effect of 0.076(95%CI 0.061-0.091,P<0.01)and 0.062(95%CI 0.050-0.074,P<0.01)and the mediation effect proportions of 23.58% and 23.40%(P<0.01), respectively.CONCLUSION Childhood abuse experiences can increase the risk of depression and anxiety symptoms in medical college students, and can also indirectly raise the level of depression and anxiety symptoms through the chain mediating role of mobile phone dependence and sleep quality.
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基本信息:
DOI：10.19813/j.cnki.weishengyanjiu.2025.06.011
中图分类号:R395.6;G444;G715.5
引用信息:
[1]曹贤妙,李书琴,李新,等.安徽省医学专科新生童年期虐待经历对抑郁、焦虑症状的影响——手机依赖和睡眠质量的链式中介作用[J].卫生研究,2025,54(06):950-957.DOI:10.19813/j.cnki.weishengyanjiu.2025.06.011.
基金信息:
国家自然科学基金(No.82073576); 安徽省高校自然科学基金(No.KJ2021ZD0151)
2025-11-14
2025-11-14