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Article(id=1322168444515111789, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322167989802217791, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.04.016, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1736956800000, receivedDateStr=2025-01-16, revisedDate=1769875200000, revisedDateStr=2026-02-01, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159121874, onlineDateStr=2026-10-28, pubDate=1771948800000, pubDateStr=2026-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159121874, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159121874, creator=13701087609, updateTime=1793159121874, updator=13701087609, issue=Issue{id=1322167989802217791, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='4', pageStart='529', pageEnd='704', issueExtLink='null', onlineDate='null', pubDate='1771948800000', pubDateStr='2026-02-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159013461, creator='13701087609', updateTime=1793159013461, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=639, endPage=645, ext={EN=ArticleExt(id=1322168444737409902, articleId=1322168444515111789, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Family communication patterns of depressed adolescents and its influencing factors, columnId=1220689488284668633, journalTitle=Chinese Nursing Research, columnName=Comprehensive Study, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the characteristics of family communication patterns among depressed adolescents,and to analyze their influencing factors,so as to provide reference for formulating personalized auxiliary plans for the prevention and control of depression among adolescents.

Methods

By using the convenience sampling method,a total of 563 depressed adolescents were selected as the research subjects who visited the outpatient department of psychological medicine in a tertiary grade A hospital in Zhengzhou city,Henan province from October 2023 to August 2024.The investigation was conducted by using the general information questionnaire,the Center for Epidemiologic Studies Depression Scale(CES-D), the Revised Family Communication Patterns Instrument(RFCP),the Emotion Regulation Questionnaire(ERQ) and the Adolescents Self-harm Scale.

Results

The characteristics of family communication pattern among depressed adolescents were mainly protective type in 183 cases(32.5%).The total score of the RFCP was 5.64±0.92.The score of conversation orientation was 2.91±0.87.The score of obedience orientation was 2.71±0.94.The results of linear regression analysis showed that the gender of depressed adolescents,whether they were the only child,whether they had history of being left behind,the educational level of the mother,the place of residence,the average monthly income per capita of the family,the score of Adolescents Self-harm Scale,and the score of ERQ were the influencing factors of family communication patterns(P<0.05).

Conclusions

Medical staff should formulate targeted intervention measures based on the influencing factors of family communication patterns,to help depressed adolescents and their parents actively cope with the disease,improve their family communication patterns,and thereby alleviate their negative emotions and psychological disorders.

, authors=Xiaoyu CAI, Yingqi HUANG, Xingjuan WANG, Hui XU, authorsList=Xiaoyu CAI, Yingqi HUANG, Xingjuan WANG, Hui XU, authorCompany=null, correspAuthors=Hui XU, authorNote=null, correspAuthorsNote=
XU Hui， E-mail：
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目的

调查抑郁青少年家庭沟通模式特征，并分析其影响因素，为青少年抑郁防控制定个性化辅助方案提供参考。

方法

采用便利抽样法，于2023年10月—2024年8月选取在河南省郑州市某三级甲等医院心理医学科门诊就诊的563例抑郁青少年为研究对象，采用一般资料调查表、流调中心抑郁量表、家庭沟通模式量表、情绪调节问卷、青少年自我伤害问卷进行调查。

结果

抑郁青少年的家庭沟通模式特征以保护型［183例（32.5%）］为主。家庭沟通模式量表总分为（5.64±0.92）分，谈话导向得分为（2.91±0.87）分，服从导向得分为（2.71±0.94）分。线性回归分析结果显示，抑郁青少年性别、是否独生子女、是否有留守经历、母亲文化程度、居住地、家庭人均月收入、自伤行为得分、情绪调节得分是家庭沟通模式的影响因素（P<0.05）。

结论

医护人员应根据家庭沟通模式的影响因素制定针对性干预措施，帮助抑郁青少年及其父母积极应对疾病，改善其家庭沟通模式，从而减轻其负性情绪和心理疾病。

, authors=蔡小雨, 黄颖琪, 王兴娟, 徐晖*, *, authorsList=蔡小雨, 黄颖琪, 王兴娟, 徐晖, authorCompany=null, correspAuthors=徐晖, authorNote=

蔡小雨，护士，硕士研究生在读

, correspAuthorsNote=
徐晖，E-mail：
XU Hui， E-mail：
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satisfaction:extending the VSA model, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322530056619012501, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, xref=1, ext=[AuthorCompanyExt(id=1322530056627401110, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, companyId=1322530056619012501, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1School of Nursing and Health, Zhengzhou University, Henan 450001 China), AuthorCompanyExt(id=1322530056635789719, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, companyId=1322530056619012501, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1郑州大学护理与健康学院，河南 450001)])], figs=[ArticleFig(id=1322530058875548088, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, language=EN, label=Table 1, caption=

Distribution of family communication patterns among depressed adolescents(n=563)

, figureFileSmall=null, figureFileBig=null, tableContent=
项目例数构成比（%）
放任型9917.6
保护型18332.5
多元型17230.5
一致型10919.4
), ArticleFig(id=1322530058955239865, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, language=CN, label=表1, caption=

抑郁青少年家庭沟通模式分布（n=563）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目例数构成比（%）
放任型9917.6
保护型18332.5
多元型17230.5
一致型10919.4
), ArticleFig(id=1322530059018154426, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, language=EN, label=Table 2, caption=

Scores of family communication patterns,emotion regulation and self-harm behaviors of depressed adolescents（x±s，n=563）

, figureFileSmall=null, figureFileBig=null, tableContent=
量表项目得分
RFCP总分5.64±0.92
谈话导向2.91±0.87
服从导向2.71±0.94
ERQ认知重评26.64±7.48
表达抑制17.10±5.00
青少年自我伤害问卷总分9.20±1.56
), ArticleFig(id=1322530059085263291, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, language=CN, label=表2, caption=

抑郁青少年家庭沟通模式、情绪调节及自伤行为得分（x±s，n=563）

, figureFileSmall=null, figureFileBig=null, tableContent=
量表项目得分
RFCP总分5.64±0.92
谈话导向2.91±0.87
服从导向2.71±0.94
ERQ认知重评26.64±7.48
表达抑制17.10±5.00
青少年自我伤害问卷总分9.20±1.56
), ArticleFig(id=1322530059160760764, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, language=EN, label=Table 3, caption=

Univariate analysis of influencing factors of family communication patterns among depressed adolescents（x±s，n=563）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类例数谈话导向服从导向
性别男2683.07±0.842.62±0.94
女2952.80±0.812.76±0.94
t值3.977-1.765
P<0.0010.078
年龄12~15岁2892.85±0.872.79±0.94
16~18岁2743.01±0.792.62±0.94
t值-2.2652.206
P0.0240.028
年级初中1972.82±0.882.81±0.91
高中3662.99±0.802.66±0.95
t值-2.2161.791
P0.0270.074
独生子女是1023.20±0.882.73±0.90
否4612.87±0.812.70±0.95
t值3.6250.279
P<0.0010.781
留守经历是2422.89±0.792.26±0.88
否3212.96±0.873.05±0.84
t值-0.997-10.676
P0.318<0.001
居住地农村3973.00±0.772.61±0.92
城市1662.76±0.952.96±0.94
t值2.782-4.086
P0.006<0.001
家庭人均月收入<1 000元342.61±0.802.90±1.09
1 000~3 000元1592.88±0.702.63±0.92
3 001~5 000元2063.03±0.882.68±0.93
>5 000元1642.92±0.892.78±0.93
F值2.9451.204
P0.0350.308
母亲文化程度小学及以下972.73±0.732.60±0.89
初中2252.89±0.812.72±0.95
高中1673.02±0.872.66±0.97
专科或本科623.07±0.852.98±0.87
研究生123.17±1.212.70±1.02
F值2.7281.795
P0.0360.128
父亲文化程度小学及以下752.80±0.792.64±0.94
初中2712.99±0.752.62±0.90
高中1352.90±0.902.78±0.98
专科或本科752.88±0.973.00±0.96
研究生73.07±1.302.38±0.95
F值1.0163.001
P0.4100.018
), ArticleFig(id=1322530059240452541, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, language=CN, label=表3, caption=

抑郁青少年家庭沟通模式影响因素的单因素分析（x±s，n=563）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类例数谈话导向服从导向
性别男2683.07±0.842.62±0.94
女2952.80±0.812.76±0.94
t值3.977-1.765
P<0.0010.078
年龄12~15岁2892.85±0.872.79±0.94
16~18岁2743.01±0.792.62±0.94
t值-2.2652.206
P0.0240.028
年级初中1972.82±0.882.81±0.91
高中3662.99±0.802.66±0.95
t值-2.2161.791
P0.0270.074
独生子女是1023.20±0.882.73±0.90
否4612.87±0.812.70±0.95
t值3.6250.279
P<0.0010.781
留守经历是2422.89±0.792.26±0.88
否3212.96±0.873.05±0.84
t值-0.997-10.676
P0.318<0.001
居住地农村3973.00±0.772.61±0.92
城市1662.76±0.952.96±0.94
t值2.782-4.086
P0.006<0.001
家庭人均月收入<1 000元342.61±0.802.90±1.09
1 000~3 000元1592.88±0.702.63±0.92
3 001~5 000元2063.03±0.882.68±0.93
>5 000元1642.92±0.892.78±0.93
F值2.9451.204
P0.0350.308
母亲文化程度小学及以下972.73±0.732.60±0.89
初中2252.89±0.812.72±0.95
高中1673.02±0.872.66±0.97
专科或本科623.07±0.852.98±0.87
研究生123.17±1.212.70±1.02
F值2.7281.795
P0.0360.128
父亲文化程度小学及以下752.80±0.792.64±0.94
初中2712.99±0.752.62±0.90
高中1352.90±0.902.78±0.98
专科或本科752.88±0.973.00±0.96
研究生73.07±1.302.38±0.95
F值1.0163.001
P0.4100.018
), ArticleFig(id=1322530059332727230, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, language=EN, label=Table 4, caption=

Correlation between emotional regulation, self-harm behavior and family communication patterns in depressed adolescents(r value)

, figureFileSmall=null, figureFileBig=null, tableContent=
项目认知重评表达抑制青少年自我伤害谈话导向服从导向
认知重评1.000
表达抑制-0.0171.000
青少年自我伤害-0.385①0.203①1.000
谈话导向0.481①-0.195①-0.264①1.000
服从导向-0.324①0.242①0.344①-0.468①1.000
① P<0.05。
), ArticleFig(id=1322530061035614655, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, language=CN, label=表4, caption=

抑郁青少年情绪调节、自伤行为与家庭沟通模式的相关性（r值）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目认知重评表达抑制青少年自我伤害谈话导向服从导向
认知重评1.000
表达抑制-0.0171.000
青少年自我伤害-0.385①0.203①1.000
谈话导向0.481①-0.195①-0.264①1.000
服从导向-0.324①0.242①0.344①-0.468①1.000
① P<0.05。
), ArticleFig(id=1322530061127889344, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, language=EN, label=Table 5, caption=

Variable assignment situation

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变量赋值方式
性别男=1，女=2
年龄12~15岁=1，16~18岁=2
年级初中=1，高中=2
独生子女否=0，是=1
留守经历否=0，是=1
居住地农村=1，城市=2
家庭人均月收入<1 000元=1，1 000~3 000元=2，3 001~5 000元=3，>5 000元=4
母亲文化程度小学及以下=1，初中=2，高中=3，专科或本科=4，研究生=5
父亲文化程度小学及以下=1，初中=2，高中=3，专科或本科=4，研究生=5
), ArticleFig(id=1322530061203386817, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, language=CN, label=表5, caption=

变量赋值情况

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值方式
性别男=1，女=2
年龄12~15岁=1，16~18岁=2
年级初中=1，高中=2
独生子女否=0，是=1
留守经历否=0，是=1
居住地农村=1，城市=2
家庭人均月收入<1 000元=1，1 000~3 000元=2，3 001~5 000元=3，>5 000元=4
母亲文化程度小学及以下=1，初中=2，高中=3，专科或本科=4，研究生=5
父亲文化程度小学及以下=1，初中=2，高中=3，专科或本科=4，研究生=5
), ArticleFig(id=1322530061287272898, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, language=EN, label=Table 6, caption=

Multiple linear regression analysis of influencing factors of family communication patterns among depressed adolescents

, figureFileSmall=null, figureFileBig=null, tableContent=
因变量自变量回归系数标准误标准化回归系数t值P
谈话导向常量2.2960.21710.592<0.001
认知重评0.0500.0040.44712.644<0.001
表达抑制-0.0300.006-0.177-5.051<0.001
母亲文化程度0.1270.0330.1473.789<0.001
性别-0.2070.058-0.124-3.584<0.001
是否独生子女0.4190.0920.1944.548<0.001
居住地-0.4060.085-0.222-4.753<0.001
家庭人均月收入0.0920.0370.0992.5050.013
服从导向常量3.0550.17217.720<0.001
是否有留守经历-0.6790.067-0.357-10.167<0.001
青少年自我伤害0.0110.0020.1824.693<0.001
认知重评-0.0280.005-0.223-5.860<0.001
表达抑制0.0350.0070.1845.143<0.001
), ArticleFig(id=1322530061383741891, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168444515111789, language=CN, label=表6, caption=

抑郁青少年家庭沟通模式影响因素的多元线性回归分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
因变量自变量回归系数标准误标准化回归系数t值P
谈话导向常量2.2960.21710.592<0.001
认知重评0.0500.0040.44712.644<0.001
表达抑制-0.0300.006-0.177-5.051<0.001
母亲文化程度0.1270.0330.1473.789<0.001
性别-0.2070.058-0.124-3.584<0.001
是否独生子女0.4190.0920.1944.548<0.001
居住地-0.4060.085-0.222-4.753<0.001
家庭人均月收入0.0920.0370.0992.5050.013
服从导向常量3.0550.17217.720<0.001
是否有留守经历-0.6790.067-0.357-10.167<0.001
青少年自我伤害0.0110.0020.1824.693<0.001
认知重评-0.0280.005-0.223-5.860<0.001
表达抑制0.0350.0070.1845.143<0.001
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抑郁青少年家庭沟通模式及影响因素
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蔡小雨 , 黄颖琪 , 王兴娟 , 徐晖 *, *
护理研究 | 综合研究 2026,40(4): 639-645
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护理研究 |综合研究 2026 , 40 (4) : 639 -645
抑郁青少年家庭沟通模式及影响因素
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蔡小雨, 黄颖琪, 王兴娟, 徐晖*, *
作者信息
  • 1郑州大学护理与健康学院，河南 450001
通讯作者:
徐晖，E-mail：
XU Hui， E-mail：
作者简介:

蔡小雨，护士，硕士研究生在读

Family communication patterns of depressed adolescents and its influencing factors
Xiaoyu CAI, Yingqi HUANG, Xingjuan WANG, Hui XU
Affiliations
  • 1School of Nursing and Health, Zhengzhou University, Henan 450001 China
    • Corresponding Author:
    XU Hui， E-mail：
出版时间: 2026-02-25 doi: 10.12102/j.issn.1009-6493.2026.04.016
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摘要
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目的

调查抑郁青少年家庭沟通模式特征，并分析其影响因素，为青少年抑郁防控制定个性化辅助方案提供参考。

方法

采用便利抽样法，于2023年10月—2024年8月选取在河南省郑州市某三级甲等医院心理医学科门诊就诊的563例抑郁青少年为研究对象，采用一般资料调查表、流调中心抑郁量表、家庭沟通模式量表、情绪调节问卷、青少年自我伤害问卷进行调查。

结果

抑郁青少年的家庭沟通模式特征以保护型［183例（32.5%）］为主。家庭沟通模式量表总分为（5.64±0.92）分，谈话导向得分为（2.91±0.87）分，服从导向得分为（2.71±0.94）分。线性回归分析结果显示，抑郁青少年性别、是否独生子女、是否有留守经历、母亲文化程度、居住地、家庭人均月收入、自伤行为得分、情绪调节得分是家庭沟通模式的影响因素（P<0.05）。

结论

医护人员应根据家庭沟通模式的影响因素制定针对性干预措施，帮助抑郁青少年及其父母积极应对疾病，改善其家庭沟通模式，从而减轻其负性情绪和心理疾病。

青少年  /  抑郁  /  家庭沟通模式  /  情绪调节  /  自伤行为  /  影响因素
Objective

To investigate the characteristics of family communication patterns among depressed adolescents,and to analyze their influencing factors,so as to provide reference for formulating personalized auxiliary plans for the prevention and control of depression among adolescents.

Methods

By using the convenience sampling method,a total of 563 depressed adolescents were selected as the research subjects who visited the outpatient department of psychological medicine in a tertiary grade A hospital in Zhengzhou city,Henan province from October 2023 to August 2024.The investigation was conducted by using the general information questionnaire,the Center for Epidemiologic Studies Depression Scale(CES-D), the Revised Family Communication Patterns Instrument(RFCP),the Emotion Regulation Questionnaire(ERQ) and the Adolescents Self-harm Scale.

Results

The characteristics of family communication pattern among depressed adolescents were mainly protective type in 183 cases(32.5%).The total score of the RFCP was 5.64±0.92.The score of conversation orientation was 2.91±0.87.The score of obedience orientation was 2.71±0.94.The results of linear regression analysis showed that the gender of depressed adolescents,whether they were the only child,whether they had history of being left behind,the educational level of the mother,the place of residence,the average monthly income per capita of the family,the score of Adolescents Self-harm Scale,and the score of ERQ were the influencing factors of family communication patterns(P<0.05).

Conclusions

Medical staff should formulate targeted intervention measures based on the influencing factors of family communication patterns,to help depressed adolescents and their parents actively cope with the disease,improve their family communication patterns,and thereby alleviate their negative emotions and psychological disorders.

adolescents  /  depression  /  family communication patterns  /  emotion regulation  /  self-harming behavior  /  influencing factors
蔡小雨, 黄颖琪, 王兴娟, 徐晖. 抑郁青少年家庭沟通模式及影响因素. 护理研究, 2026 , 40 (4) : 639 -645 . DOI: 10.12102/j.issn.1009-6493.2026.04.016
Xiaoyu CAI, Yingqi HUANG, Xingjuan WANG, Hui XU. Family communication patterns of depressed adolescents and its influencing factors[J]. Chinese Nursing Research, 2026 , 40 (4) : 639 -645 . DOI: 10.12102/j.issn.1009-6493.2026.04.016
正文
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青少年时期为个人成长的关键期，因此阶段的特殊性，处于该阶段的青少年易受家庭、学习、学校等多方面的压力，若无有效排解途径，负面情绪长期积压，容易造成心理问题，其中抑郁情绪是发生最为普遍、影响较为严重的心理问题之一。抑郁情绪严重影响青少年的身心健康发展，妨碍青少年正常的学习和生活，还可能会引发自杀行为[1]。抑郁情绪的发生、发展及转归与社会心理因素，特别是家庭因素紧密相关[2]。在众多家庭因素中，家庭沟通对青少年心理和行为的影响是最直接有力的[3-4]。家庭沟通模式指家庭成员互相分享和交流信息、想法和感情的过程,是个体家庭功能的主要表现形式[5]。目前，关于家庭沟通模式的相关研究多集中于癌症[6]或健康人群[7]，较少有针对抑郁青少年家庭沟通模式研究。因此，本研究调查抑郁青少年家庭沟通模式特征及影响因素，旨在为其制定针对性的干预方案，为改善抑郁青少年家庭沟通关系和促进其心理健康提供参考和依据。
1　对象与方法
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1.1　对象
采用便利抽样法，于2023年10月—2024年8月选取河南省郑州市某三级甲等医院心理医学科门诊就诊的青少年为研究对象。纳入标准：经精神科主治医师及以上的专科执业医生首诊；年龄12~18岁，能独立完成问卷评分；流调中心抑郁量表（Center for Epidemiologic Studies Depression Scale，CES-D）标准分≥16分；病人或者其法定监护人充分了解本研究内容并签署知情同意书。排除标准：患有精神分裂症谱系和其他精神病性障碍者；患有严重躯体疾病及脑器质性疾病者；不能配合完成检测者。本研究已通过郑州大学伦理委员会审批（审批号：ZZUIRB2023-302）。
1.2　调查工具
1.2.1　一般资料调查表
由研究者自行设计，包括性别、年龄、年级、是否独生子女、是否有留守经历、父亲文化程度、母亲文化程度、居住地和家庭人均月收入。
1.2.2　CES-D
采用CES-D评估青少年的抑郁情绪。该量表由陈祉妍等[8]修订形成，要求被调查者对最近1周出现的抑郁感受的频度进行评价。包括20个条目，采用4级计分，0分为没有或几乎没有，1分为少有，2分为常有，3分为几乎一直有，总分为0~60分，量表得分越高，说明被试者出现抑郁情绪的可能性越大。当CES-D得分≥16分时，说明有抑郁情绪[9]。本研究中该问卷的Cronbach's α系数为0.90。
1.2.3　情绪调节问卷（Emotion Regulation Questionnaire，ERQ）
ERQ由Gross等[10]研发，中文版ERQ由王力等[11]修订。从认知重评和表达抑制2个维度对抑郁青少年的情绪调节倾向进行测量，包括10个条目，其中条目1、条目3、条目5、条目7~8、条目10得分相加为认知重评维度得分，条目2、条目4、条目6、条目9得分相加为表达抑制维度的得分,采用7级计分法，1分为完全不同意，7分为完全同意，量表得分越高代表对该策略的使用频率越高。本研究中认知重评维度的Cronbach's α系数为0.85，表达抑制维度的Cronbach's α系数为0.72。
1.2.4　青少年自我伤害问卷（Adolescents Self-harm Scale）
青少年自我伤害问卷由冯玉[12]修订和编制，包括19个条目，分别为18种故意自伤的方式，以及1个开放式问题。每个条目都包括自伤行为频率和对自身伤害程度自评2部分，频率部分分为4个等级，分别是0次、1次、2~4次、5次及以上；伤害程度自评部分分为5个等级，分别为无、轻、中、重和极重。采用Likert 5级计分法，利用频率和自评的乘积表示每个项目上自伤的严重程度，总分为所有项目得分之和，得分越高，表示自伤程度越严重。本研究中该问卷的Cronbach's α系数为0.91。
1.2.5　家庭沟通模式量表(Revised Family Communication Patterns Instrument，RFCP)
RFCP共26个条目，条目1~15为谈话导向分量表，条目16~26为服从导向分量表，每个分量表的得分为此维度中所有条目的均分。家庭沟通-谈话导向的得分越高，代表个体家庭沟通的自由互动氛围越多，父母鼓励孩子自由表达自己的想法和观点，并接受与孩子间的观点分歧，决定了家庭成员在多大程度上可以舒适地、不受约束地讨论；家庭沟通-服从导向的得分越高，代表个体家庭沟通的严肃氛围越多，要求所有家庭成员在态度、信仰和价值观上保持一致的程度，在各种话题中的互动频率都较低。以中位数为界划分4种不同的家庭类型：多元型（高谈话导向和低服从导向型）、一致型（高谈话导向和高服从导向并重）、保护型（低谈话导向和高服从导向）以及放任型（低谈话导向和低服从导向）。本研究中该量表中谈话导向的Cronbach's α系数为0.93，服从导向的Cronbach's α系数为0.92。
1.3　资料收集和质量控制
严格按照纳入与排除标准筛选调查对象，在病人挂号候诊期间进行，利用等待时间线下填写问卷。调查前，由研究者本人向病人说明本研究的目的和要求，介绍填写要求和注意事项，征求知情同意后发放纸质版问卷引导受访者完成，以自愿的方式参加，未发放任何报酬。问卷尽量由调查对象独立完成，对填写困难的调查对象，由研究者本人口述问卷内容协助其填写。问卷由研究者本人当场回收，逐项核对问卷，避免漏填，保证问卷的有效性。本研究共发放问卷600份，回收问卷600份，其中有效问卷563份，有效回收率为93.83%。
1.4　统计学方法
采用SPSS 27.0软件进行统计分析。符合正态分布的定量资料以均数±标准差（x±s）表示，组间比较采用t检验和方差分析。不符合正态分布的定量资料以中位数（四分位数）[M(P25,P75)]表示，采用秩和检验。定性资料以频数、百分比（%）表示，采用χ2检验。家庭沟通模式与情绪调节和自伤行为的相关性采用Pearson相关性分析。分别以家庭沟通-谈话导向和家庭沟通-服从导向沟通为因变量，进行2次多元逐步线性回归分析2种家庭沟通模式的影响因素。以P<0.05为差异有统计学意义。
2　结果
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2.1　抑郁青少年家庭沟通模式特征
563例抑郁青少年年龄12~18（15.48±1.80）岁，其中男268例（47.6%），女295例（52.4%），家庭沟通模式特征以保护型为主，见表1。
2.2　抑郁青少年家庭沟通模式、情绪调节及自伤行为得分(见表2)
2.3　抑郁青少年家庭沟通模式影响因素的单因素分析（见表3）
2.4　抑郁青少年家庭沟通模式与情绪调节、自伤行为的相关性（见表4）
2.5　抑郁青少年家庭沟通模式影响因素的多因素分析
分别以谈话导向家庭沟通模式和服从导向家庭沟通模式为因变量构建2个多元线性回归模型。以单因素分析及相关性分析中有统计学意义的变量为自变量，分类变量赋值情况见表5，其余变量原值输入。采用逐步法进行多元线性回归。经P-P图验证2个多元线性回归模型残差近似正态分布；德宾-沃森分别为1.642，1.651，说明残差间相互独立；自变量的方差膨胀因子（VIF）分别为1.023~1.873、1.019~1.244，说明不存在多重共线性问题。结果显示，性别、居住地、家庭人均月收入、是否独生子女、母亲文化程度、认知重评、表达抑制是门诊就诊抑郁青少年病人谈话导向沟通模式的影响因素；是否有留守经历、青少年自我伤害、认知重评、表达抑制是抑郁青少年病人服从导向沟通模式的影响因素（均P<0.05），见表6。
3　讨论
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3.1　抑郁青少年家庭沟通模式特征
本研究结果显示，抑郁青少年病人家庭中，家庭沟通模式保护型最多（32.5%），其次为多元型（30.5%），而一致型和放任型分别占19.4%和17.6%，家庭沟通类型分布具有差异性，与朱秀凌[13]研究结果不一致。分析原因可能为研究人群不同，抑郁青少年本身的沟通意向要低于正常青少年。另外，在抑郁青少年家庭中，青少年父母为了避免不必要的冲突，会减少沟通频率[14]。由此可见，抑郁青少年的家庭沟通模式值得关注。
3.2　抑郁青少年家庭沟通模式的影响因素
3.2.1　性别
本研究结果显示，性别是家庭沟通模式的影响因素。男性抑郁青少年更易采用谈话导向家庭沟通模式，可能原因与大脑发育及性激素有关[15]，男性青少年可能比女性青少年发育晚，女性青少年在青春期时的心理会更为敏感、易变和复杂[16]。女性青少年遇到问题时常采取封闭自己的行为方式，而男性青少年更倾向于通过与他人谈话沟通的方式释放自身内在的压力[17]。因此，建议医护人员定制个性化的干预措施激励不同性别的青少年主动改变不良家庭沟通类型。
3.2.2　是否为独生子女
本研究结果显示，独生子女的抑郁青少年更易采用谈话导向家庭沟通模式。可能原因是：在独生子女家庭中，父母为青少年投入大量的精力与资源。根据资源稀释理论[18]，家庭中孩子的数量与可获得家庭资源成反比，孩子数量越多，家庭资源分配越不均等，尤其是心理资源（父母的情感关怀和陪伴等），让被忽视的青少年产生焦虑、自卑、被抛弃的负面情绪，从而回避或者拒绝沟通[19]。因此，医护人员应告诉父母要给予抑郁青少年更多的陪伴，增加抑郁青少年的安全感，减轻负性情绪。
3.2.3　留守经历
本研究结果显示，有无留守经历是家庭沟通模式的影响因素。有留守经历的抑郁青少年不易与父母采用服从导向沟通，可能原因是留守青少年常由祖父母照顾，长期处于与父母分离的状态可能导致留守青少年处于被忽视的状态，父母缺乏与留守抑郁青少年进行心理和思想沟通的机会[20]。抑郁青少年更易产生疏离感和攻击性，常不会采用服从沟通处理问题。因此，医护人员应告诉父母尽量创造更多的机会与孩子真诚地沟通，以实际行动去培养孩子的沟通能力。
3.2.4　母亲文化程度
本研究结果显示，母亲文化程度越高的抑郁青少年更易采用谈话导向家庭沟通模式。可能原因是文化程度高的母亲是青少年发生抑郁的保护因素[21]。母亲相较于父亲陪伴青少年的时间较长，母亲文化程度越高，其看待问题的角度就越全面，学习能力也越强，能及时掌握正确的沟通技巧，意识到身心健康及全面发展对青少年的重要性[22]。建议抑郁青少年母亲要注重提高抑郁情绪相关知识水平，尊重理解青少年，减少批评、指责，使青少年感受到更多的关爱与温暖，从而愿意和父母沟通，提高沟通能力。
3.2.5　居住地
本研究结果显示，居住在农村的抑郁青少年易采用谈话导向家庭沟通模式，而居住在城市的抑郁青少年则倾向服从导向家庭沟通模式，原因可能是生活环境不一样。研究显示，城市环境可能会影响个体大脑结构[23]，也可影响脱氧核糖核酸的甲基化[24]，或者改变下丘脑垂体-肾上腺皮质轴的活动[25]，而这些改变都更容易使青少年产生抑郁情绪，从而减少沟通频率；也可能与城市学业竞争大[26]、压力大[27]有关。因此，建议青少年父母在房间分布、居住安排上多考虑亲子关系带来的正向作用，鼓励青少年多参加活动。
3.2.6　家庭人均月收入
本研究结果显示，家庭人均月收入是家庭沟通模式的影响因素。个体在青少年阶段对家庭经济状况认知较之前更为清楚,也更能感知到家庭经济压力[28]。并且青少年和同伴相处、交往增多，同伴间比较也相应增加，社会认知理论指出，外界环境通过个体主观感知影响其行为[29]。同时，家庭经济压力较大时，青少年易产生心理压力和精神负担[30]，阻碍青少年及其父母彼此间的沟通与协作[31-32]。建议抑郁青少年父母为孩子提供有利于成长发展的环境，促进青少年心理健康的发展。
3.2.7　自伤行为
本研究结果发现，自伤行为是服从导向家庭沟通模式的影响因素。青少年由于自我意识的不断增强，会表现出更多的探索和冒险行为[33]，首次自伤行为常在青春期早期发生，且与抑郁情绪密切相关[34]。抑郁青少年自伤行为得分越高，沟通越不畅，可能原因是青少年无法通过恰当的沟通渠道调节不良情绪，宣泄生活压力，进而选择自伤行为逃避沟通[35]。因此，医护人员应以家庭为中心进行干预，通过减少自伤行为，强化抑郁青少年与其父母的情感交流。
3.2.8　情绪调节
本研究结果发现，情绪调节是家庭沟通模式的影响因素。一方面，认知重评越高的抑郁青少年更易采用谈话导向家庭沟通模式，能够主动改变对情绪事件的理解和认识[36]，增强用语言表达情绪、问题解决及控制情绪反应的能力，从而主动和其父母进行沟通；另一方面，表达抑制越高的抑郁青少年更易采用服从导向家庭沟通模式的方式消极解决问题，而非直面或积极沟通问题。根据修订版脆弱-压力-适应模型[37]，当抑郁青少年面对不良事件或者情绪时，表达抑制促进其采用消极的应对方式，例如回避、服从沟通或者拒绝沟通，反之相反。因此，医护人员应关注抑郁青少年的情绪调节方法，帮助抑郁青少年学会调节情绪，增强抑郁青少年及其父母之间的沟通。
4　小结
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本研究发现，抑郁青少年家庭沟通问题严峻，性别、是否独生子女、有无留守经历、家庭人均月收入、居住地、母亲文化程度、自伤行为、情绪调节都是家庭沟通模式的主要影响因素。因此，今后医护人员可以依据抑郁青少年的家庭状况和自我调节制定针对性的抑郁情绪的干预方案，以期减轻其抑郁情绪。但本研究采用横断面调查，不能判断各因素之间的因果关系，未来可开展纵向研究探讨家庭沟通模式随病情改变的动态变化过程。

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doi: 10.12102/j.issn.1009-6493.2026.04.016
  • 接收时间：2025-01-16
  • 首发时间：2026-10-28
  • 出版时间：2026-02-25
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  • 收稿日期：2025-01-16
  • 修回日期：2026-02-01
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    1郑州大学护理与健康学院，河南 450001

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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