Article(id=1322185559351603918, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1322185527667839311, articleNumber=null, orderNo=null, doi=10.16016/j.2097-0927.202501029, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1736784000000, receivedDateStr=2025-01-14, revisedDate=1743868800000, revisedDateStr=2025-04-06, acceptedDate=null, acceptedDateStr=null, onlineDate=1793163202368, onlineDateStr=2026-10-28, pubDate=1752508800000, pubDateStr=2025-07-15, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793163202368, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793163202368, creator=13701087609, updateTime=1793163202368, updator=13701087609, issue=Issue{id=1322185527667839311, tenantId=1146029695717560320, journalId=1319373162502258839, year='2025', volume='47', issue='13', pageStart='1413', pageEnd='1555', issueExtLink='null', onlineDate='null', pubDate='1752508800000', pubDateStr='2025-07-15', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793163194815, creator='13701087609', updateTime=1793163440436, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322186557939892925, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1322185527667839311, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322186557939892926, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1322185527667839311, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1548, endPage=1555, ext={EN=ArticleExt(id=1322185559796200143, articleId=1322185559351603918, tenantId=1146029695717560320, journalId=1319373162502258839, language=EN, title=Comprehensive mental health assessment for soldiers and gender differences based on network analysis, columnId=1320434430452285710, journalTitle=Journal of Army Medical University, columnName=Military Psychology Medicine, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the network structural characteristics, core factors, and gender differences in the comprehensive assessment of mental health in military personnel.

Methods‍

A total of 4 105 officers and soldiers were subjected and surveyed using the Comprehensive Mental Health Assessment Questionnaire for Soldiers. Through network analysis, a network model for comprehensive mental health assessment of military personnel was constructed with the R qgraph Package. The core factors of their mental health were explored using the qgraph package, and the reliability of the network structure was evaluated using the bootnet package. Then a comparative analysis was conducted on the network characteristics of comprehensive mental health assessments between male and female participants using permutation tests with the NetworkComparisonTest package in R.

Results‍

In the network of the comprehensive assessment of military personnel mental health, the strongest association was observed between institutional trust and interpersonal trust, followed by interpersonal trust and sense of meaning in life, adaptability and positive coping, as well as depression and negative emotions, with a regularized partial correlation coefficient of 0.49, 0.45, 0.44, and 0.42, respectively. The core factors were interpersonal trust, work engagement, and institutional trust, with an expected influence of 1.095, 1.060, and 1.039, respectively. The 95% confidence intervals (CIs) obtained from the edge weight accuracy assessment were relatively narrow, and the correlation stability coefficient of the network was 0.75, indicating a stable and reliable network structure. Furthermore, there were significant differences in the network structure of comprehensive mental health assessments between male and female participants (M=0.335, P<0.001), especially in the core factor, interpersonal trust, with particularly significant gender difference (P<0.01).

Conclusion‍

Interpersonal trust, work engagement, and institutional trust are the core factors in the comprehensive assessment of military personnel’s mental health. There are gender differences in the network structure of the comprehensive assessment of mental health for military personnel.

, authors=Qiongyue ZHANG1, Yanzhen YANG2, Li PENG2, Chen XU2, Qian YANG2, Min LI2, authorsList=Qiongyue ZHANG, Yanzhen YANG, Li PENG, Chen XU, Qian YANG, Min LI, authorCompany=null, correspAuthors=Min LI, authorNote=null, correspAuthorsNote=null, copyrightStatement=© 2025 Journal of Army Medical University, copyrightOwner=Editorial Office of Journal of Army Medical University, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322185563764011739, articleId=1322185559351603918, tenantId=1146029695717560320, journalId=1319373162502258839, language=CN, title=基于网络分析的军人心理健康综合评估和性别差异比较, columnId=1322185559880086224, journalTitle=陆军军医大学学报, columnName=军事心理学, runingTitle=null, highlight=null, articleAbstract=
目的

探究军人心理健康综合评估的网络结构特征、核心因子以及性别差异。

方法

以4 105名军人为被试,采用《军人心理健康综合评估问卷》进行问卷调查。运用网络分析方法,通过Rqgraph包构建军人心理健康综合评估的网络模型;通过Rqgraph包探究军人心理健康的核心因子;通过Rbootnet包进行网络结构可靠性评估;通过R NetworkComparisionTest包,采用置换检验对不同性别军人的心理健康综合评估的网络特征进行对比分析。

结果

军人心理健康综合评估网络中,制度信任与人际信任之间的关联最为紧密;其次为人际信任与生命意义、适应性与积极应对,以及抑郁与负性情绪,其正则化相关系数分别为0.49、0.45、0.44、0.42。军人心理健康综合评估网络中的核心因子为人际信任、工作投入和制度信任,三者的预期影响值分别为1.095、1.060、1.039;边权值准确性评估得到的95%CI较窄,网络的相关稳定性系数为0.75,表明网络结构稳定可靠;不同性别的军人在心理健康综合评估网络结构上存在显著差异(M=0.335,P<0.001);在人际信任这一核心因子上,性别差异显著(P<0.01)。

结论

人际信任、工作投入和制度信任是军人心理健康综合评估网络的核心因子,军人心理健康综合评估网络结构存在性别差异。

, authors=张琼月1, 杨艳贞2, 彭李2, 许辰2, 杨倩2, 李敏2, authorsList=张琼月, 杨艳贞, 彭李, 许辰, 杨倩, 李敏, authorCompany=null, correspAuthors=李敏, authorNote=

同等贡献者

ZHANG Qiongyue and YANG Yanzhen contributed equally to the article.

, correspAuthorsNote=
李 敏,E-mail:
LI Min,E-mail:
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Xining:Qinghai Normal University,2024., articleTitle=The relationship between interpersonal trust,peer relationship and alienation among junior high school students and their interventions, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322185564053418716, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, xref=1, ext=[AuthorCompanyExt(id=1322185564074390237, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, companyId=1322185564053418716, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Department of Nephrology,Amy Medical Center of PLA/Daping Hospital of Third Military Medical University,Chongqing), AuthorCompanyExt(id=1322185564086973150, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, companyId=1322185564053418716, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1陆军特色医学中心(第三军医大学大坪医院)肾内科)]), AuthorCompany(id=1322185564196025056, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, xref=2, ext=[AuthorCompanyExt(id=1322185564216996577, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, companyId=1322185564196025056, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Department of Military Psychology,Faculty of Medical Psychology,Army Medical University (Third Military Medical University),Chongqing,China), AuthorCompanyExt(id=1322185564229579490, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, companyId=1322185564196025056, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2陆军军医大学(第三军医大学)医学心理系军事心理学教研室,重庆)])], figs=[ArticleFig(id=1322185576644719371, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=EN, label=null, caption=null, figureFileSmall=rD/r/U4yECbqNIQ40zyzYQ==, figureFileBig=r+vaD+pAouGhTd3exhJ6Fw==, tableContent=null), ArticleFig(id=1322185576854434572, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=CN, label=图1, caption=军人心理健康综合评估网络结构

1:适应性;2:积极应对;3:正性情绪;4:工作投入;5:友谊;6:家庭满意度;7:制度信任;8:人际信任;9:生命意义感;10:抑郁;11:负性情绪;12:孤独感

, figureFileSmall=rD/r/U4yECbqNIQ40zyzYQ==, figureFileBig=r+vaD+pAouGhTd3exhJ6Fw==, tableContent=null), ArticleFig(id=1322185577064149773, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=EN, label=null, caption=null, figureFileSmall=Z/P2r+95DQN7mdYt6s1HcA==, figureFileBig=cOKjMFkQ7FNeQTNuSzpeqg==, tableContent=null), ArticleFig(id=1322185577265476366, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=CN, label=图2, caption=网络边权值的准确性估计, figureFileSmall=Z/P2r+95DQN7mdYt6s1HcA==, figureFileBig=cOKjMFkQ7FNeQTNuSzpeqg==, tableContent=null), ArticleFig(id=1322185577340973839, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=EN, label=null, caption=null, figureFileSmall=x6m5OZ7KZmaj92d6WVaMyg==, figureFileBig=w96ou9mELhbgiXljWQd0Zw==, tableContent=null), ArticleFig(id=1322185577403888400, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=CN, label=图3, caption=各因子预期影响的稳定性评估, figureFileSmall=x6m5OZ7KZmaj92d6WVaMyg==, figureFileBig=w96ou9mELhbgiXljWQd0Zw==, tableContent=null), ArticleFig(id=1322185577470997265, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=EN, label=null, caption=null, figureFileSmall=yVOxwxgjd9AwA/XX36aPVA==, figureFileBig=vjsvu8eecn9rUJN6fYCcpQ==, tableContent=null), ArticleFig(id=1322185577529717522, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=CN, label=图4, caption=女军人(左)和男军人(右)心理健康综合评估网络结构图

1:适应性;2:积极应对;3:正性情绪;4:工作投入;5:友谊;6:家庭满意度;7:制度信任;8:人际信任;9:生命意义感;10:抑郁;11:负性情绪;12:孤独感

, figureFileSmall=yVOxwxgjd9AwA/XX36aPVA==, figureFileBig=vjsvu8eecn9rUJN6fYCcpQ==, tableContent=null), ArticleFig(id=1322185577596826387, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
项目项目数Cronbach’s α系数本研究中的Cronbach’s α系数与BSI-18相关系数
适应性90.9100.971-0.469a
积极应对80.9060.961-0.383a
正性情绪90.9420.955-0.364a
工作投入80.9260.974-0.444a
友谊80.9140.960-0.312a
家庭满意度80.8340.688-0.390a
制度信任100.9210.970-0.452a
人际信任70.9360.982-0.447a
生命意义感50.9780.957-0.444a
抑郁80.8720.9520.648a
负性情绪60.8680.9190.647a
孤独感80.9260.9720.560a
), ArticleFig(id=1322185577710072596, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=CN, label=表1, caption=

军人心理健康综合评估问卷各因子的因子数、信度和与BSI-18的相关系数

, figureFileSmall=null, figureFileBig=null, tableContent=
项目项目数Cronbach’s α系数本研究中的Cronbach’s α系数与BSI-18相关系数
适应性90.9100.971-0.469a
积极应对80.9060.961-0.383a
正性情绪90.9420.955-0.364a
工作投入80.9260.974-0.444a
友谊80.9140.960-0.312a
家庭满意度80.8340.688-0.390a
制度信任100.9210.970-0.452a
人际信任70.9360.982-0.447a
生命意义感50.9780.957-0.444a
抑郁80.8720.9520.648a
负性情绪60.8680.9190.647a
孤独感80.9260.9720.560a
), ArticleFig(id=1322185577793958677, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
成分总计方差百分比成分总计方差百分比
139.67442.20781.9652.09
28.5819.12991.7061.815
35.3995.744101.6671.773
44.8285.136111.3441.43
53.8754.122121.1681.242
63.1713.373131.0611.128
72.0412.171
), ArticleFig(id=1322185577882039062, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=CN, label=表2, caption=

13个公因子载荷平方和

, figureFileSmall=null, figureFileBig=null, tableContent=
成分总计方差百分比成分总计方差百分比
139.67442.20781.9652.09
28.5819.12991.7061.815
35.3995.744101.6671.773
44.8285.136111.3441.43
53.8754.122121.1681.242
63.1713.373131.0611.128
72.0412.171
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因子总体
平均值
(n=4 105)
总体
标准差
(n=4 105)
总体
预期影响
(n=4 105)
男军人
平均值
(n=3 393)
男军人
标准差
(n=3 393)
男军人
预期影响
(n=3 393)
女军人
平均值
(n=712)
女军人
标准差
(n=712)
女军人
预期影响
(n=712)
适应性39.376.8690.59140.016.7590.57736.226.8140.659
积极应对34.486.6660.81534.886.6210.80732.506.7490.882
正性情绪33.3310.2190.44633.5910.4950.43832.018.8030.492
工作投入34.316.8101.060c34.776.8031.056c32.026.5601.076
友谊33.027.4910.87033.167.6620.89332.286.7290.700
家庭满意度35.994.8900.42636.144.8810.40735.205.1110.451
制度信任45.256.9731.039c45.846.7421.010c42.347.5921.072
人际信任32.204.6031.095c32.55bc4.4361.171ac30.475.1390.905
生命意义22.753.4900.87522.983.3950.84321.623.7790.957
抑郁9.934.7100.5899.754.6610.56510.764.8480.721
负性情绪7.363.0030.6197.172.8200.6008.253.6260.663
孤独感10.645.8590.10710.325.6530.10612.136.5460.052
), ArticleFig(id=1322185579735921432, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=CN, label=表3, caption=

军人(总体)和不同性别心理健康综合评估各因子得分和中心性指标

, figureFileSmall=null, figureFileBig=null, tableContent=
因子总体
平均值
(n=4 105)
总体
标准差
(n=4 105)
总体
预期影响
(n=4 105)
男军人
平均值
(n=3 393)
男军人
标准差
(n=3 393)
男军人
预期影响
(n=3 393)
女军人
平均值
(n=712)
女军人
标准差
(n=712)
女军人
预期影响
(n=712)
适应性39.376.8690.59140.016.7590.57736.226.8140.659
积极应对34.486.6660.81534.886.6210.80732.506.7490.882
正性情绪33.3310.2190.44633.5910.4950.43832.018.8030.492
工作投入34.316.8101.060c34.776.8031.056c32.026.5601.076
友谊33.027.4910.87033.167.6620.89332.286.7290.700
家庭满意度35.994.8900.42636.144.8810.40735.205.1110.451
制度信任45.256.9731.039c45.846.7421.010c42.347.5921.072
人际信任32.204.6031.095c32.55bc4.4361.171ac30.475.1390.905
生命意义22.753.4900.87522.983.3950.84321.623.7790.957
抑郁9.934.7100.5899.754.6610.56510.764.8480.721
负性情绪7.363.0030.6197.172.8200.6008.253.6260.663
孤独感10.645.8590.10710.325.6530.10612.136.5460.052
), ArticleFig(id=1322185579844973337, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
因子P值因子P值
适应性0.402制度信任0.482
积极应对0.436人际信任0.007
正性情绪0.553生命意义0.183
工作投入0.829抑郁0.238
友谊0.053负性情绪0.706
家庭满意度0.625孤独感0.671
), ArticleFig(id=1322185579920470810, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322185559351603918, language=CN, label=表4, caption=

不同性别军人各因子预期影响的差异性检验的P值

, figureFileSmall=null, figureFileBig=null, tableContent=
因子P值因子P值
适应性0.402制度信任0.482
积极应对0.436人际信任0.007
正性情绪0.553生命意义0.183
工作投入0.829抑郁0.238
友谊0.053负性情绪0.706
家庭满意度0.625孤独感0.671
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基于网络分析的军人心理健康综合评估和性别差异比较
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张琼月 1 , 杨艳贞 2 , 彭李 2 , 许辰 2 , 杨倩 2 , 李敏 2
陆军军医大学学报 | 军事心理学 2025,47(13): 1548-1555
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陆军军医大学学报 |军事心理学 2025 , 47 (13) : 1548 -1555
基于网络分析的军人心理健康综合评估和性别差异比较
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张琼月1, 杨艳贞2, 彭李2, 许辰2, 杨倩2, 李敏2
作者信息
  • 1陆军特色医学中心(第三军医大学大坪医院)肾内科
  • 2陆军军医大学(第三军医大学)医学心理系军事心理学教研室,重庆
通讯作者:
李 敏,E-mail:
LI Min,E-mail:
作者简介:

同等贡献者

ZHANG Qiongyue and YANG Yanzhen contributed equally to the article.

Comprehensive mental health assessment for soldiers and gender differences based on network analysis
Qiongyue ZHANG1, Yanzhen YANG2, Li PENG2, Chen XU2, Qian YANG2, Min LI2
Affiliations
  • 1Department of Nephrology,Amy Medical Center of PLA/Daping Hospital of Third Military Medical University,Chongqing
  • 2Department of Military Psychology,Faculty of Medical Psychology,Army Medical University (Third Military Medical University),Chongqing,China
出版时间: 2025-07-15 doi: 10.16016/j.2097-0927.202501029
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目的

探究军人心理健康综合评估的网络结构特征、核心因子以及性别差异。

方法

以4 105名军人为被试,采用《军人心理健康综合评估问卷》进行问卷调查。运用网络分析方法,通过Rqgraph包构建军人心理健康综合评估的网络模型;通过Rqgraph包探究军人心理健康的核心因子;通过Rbootnet包进行网络结构可靠性评估;通过R NetworkComparisionTest包,采用置换检验对不同性别军人的心理健康综合评估的网络特征进行对比分析。

结果

军人心理健康综合评估网络中,制度信任与人际信任之间的关联最为紧密;其次为人际信任与生命意义、适应性与积极应对,以及抑郁与负性情绪,其正则化相关系数分别为0.49、0.45、0.44、0.42。军人心理健康综合评估网络中的核心因子为人际信任、工作投入和制度信任,三者的预期影响值分别为1.095、1.060、1.039;边权值准确性评估得到的95%CI较窄,网络的相关稳定性系数为0.75,表明网络结构稳定可靠;不同性别的军人在心理健康综合评估网络结构上存在显著差异(M=0.335,P<0.001);在人际信任这一核心因子上,性别差异显著(P<0.01)。

结论

人际信任、工作投入和制度信任是军人心理健康综合评估网络的核心因子,军人心理健康综合评估网络结构存在性别差异。

军人  /  心理健康综合评估  /  网络分析  /  核心因子  /  性别差异
Objective

To explore the network structural characteristics, core factors, and gender differences in the comprehensive assessment of mental health in military personnel.

Methods‍

A total of 4 105 officers and soldiers were subjected and surveyed using the Comprehensive Mental Health Assessment Questionnaire for Soldiers. Through network analysis, a network model for comprehensive mental health assessment of military personnel was constructed with the R qgraph Package. The core factors of their mental health were explored using the qgraph package, and the reliability of the network structure was evaluated using the bootnet package. Then a comparative analysis was conducted on the network characteristics of comprehensive mental health assessments between male and female participants using permutation tests with the NetworkComparisonTest package in R.

Results‍

In the network of the comprehensive assessment of military personnel mental health, the strongest association was observed between institutional trust and interpersonal trust, followed by interpersonal trust and sense of meaning in life, adaptability and positive coping, as well as depression and negative emotions, with a regularized partial correlation coefficient of 0.49, 0.45, 0.44, and 0.42, respectively. The core factors were interpersonal trust, work engagement, and institutional trust, with an expected influence of 1.095, 1.060, and 1.039, respectively. The 95% confidence intervals (CIs) obtained from the edge weight accuracy assessment were relatively narrow, and the correlation stability coefficient of the network was 0.75, indicating a stable and reliable network structure. Furthermore, there were significant differences in the network structure of comprehensive mental health assessments between male and female participants (M=0.335, P<0.001), especially in the core factor, interpersonal trust, with particularly significant gender difference (P<0.01).

Conclusion‍

Interpersonal trust, work engagement, and institutional trust are the core factors in the comprehensive assessment of military personnel’s mental health. There are gender differences in the network structure of the comprehensive assessment of mental health for military personnel.

military personnel  /  comprehensive mental health assessment  /  network analysis  /  core factors  /  gender differences
张琼月, 杨艳贞, 彭李, 许辰, 杨倩, 李敏. 基于网络分析的军人心理健康综合评估和性别差异比较. 陆军军医大学学报, 2025 , 47 (13) : 1548 -1555 . DOI: 10.16016/j.2097-0927.202501029
Qiongyue ZHANG, Yanzhen YANG, Li PENG, Chen XU, Qian YANG, Min LI. Comprehensive mental health assessment for soldiers and gender differences based on network analysis[J]. Journal of Army Medical University, 2025 , 47 (13) : 1548 -1555 . DOI: 10.16016/j.2097-0927.202501029
在国内外军事斗争日益激烈的局势下,军人心理健康是急需关注的问题。国内外许多研究表明,军人心理健康水平较低[1-2],且存在性别差异[3-4],但这些研究都只是将没有心理疾病作为衡量心理健康水平的唯一指标。
近年来,在积极心理学的影响下,越来越多的研究者将主观幸福感、生活满意度等积极指标融入到心理健康的研究领域中,强调心理健康是个体没有心理疾病症状和拥有高主观幸福感这两种状态的共存[5],形成了心理健康双因素模型。该模型提供了看待心理健康的一种新视角,指出心理健康状态除指消极心理健康状态的消除外,还应包括积极心理健康状态的获得。然而,当前许多有关心理健康双因素模型的研究中,关于积极心理健康状态和消极心理健康状态的评定,没有统一的量表。有的采用生活满意度、积极情绪、生活幸福感、创伤后成长来评定积极心理健康状态,有的用抑郁、焦虑和攻击行为等来评定消极心理健康状态[6-9]。不同的评估方法使得许多研究之间无法进行比较。为此,2009年美军在“军队全维健康”(total force fitness,TFF)计划基础上提出用于评价心理健康的军事需求资源模型(military demand and resource model,MDR)理论[10],并开发包含积极和消极心理健康状态的全面评估工具(global assessment tool,GAT)[11]用于军人心理健康的评估和维护。但我军始终没有统一的评估工具。为填补该空白,2022年本课题组以MDR为理论基础,按照GAT的内容结构并结合我军军人心理健康特点,编制我国军人心理健康综合评估问卷,初始问卷包括16个因子:适应性、积极应对、消极应对、灾难化思维、性格优势、抑郁、正性情绪、负性情绪、乐观、家庭支持、家庭满意度、工作投入、孤独感、友谊、组织信任和生命意义。经过专家评价、预试验和正式试验的项目分析和信效度分析,最终形成了包含适应性、积极应对、正性情绪、工作投入、友谊、家庭满意度、制度信任、人际信任、生命意义感、抑郁、负性情绪、孤独感12个因子94个题项的《军人心理健康综合评估问卷》[12]。本研究采用该量表来评估军人群体心理健康综合状态。
精神障碍网络分析理论认为,精神疾病或心理学构念(潜变量)的发展与维持可由内部各个症状或组成成分(观察变量)之间的交互作用来解释[13-14]。与之相对应的研究方法是网络分析方法。该方法是将精神疾病或心理学构念中的观察变量作为“节点”纳入到一个网络结构中,各个节点之间的相互关系由“连线”的有无、粗细和虚实来判断,通过节点中心性指标可以找到潜在的干预靶点。因为当中心性高的节点被激活时,更有可能通过与其他节点之间连接边将激活传播到整个网络[15]。因此对军人开展心理健康综合评估,采用网络分析方法构建军人心理健康综合评估网络,寻找提升军人心理健康水平的关键靶点,对于实践中制定有效的军人心理健康干预策略具有重要意义。
本研究以某部官兵为研究对象,采用网络分析方法探索心理健康综合评估的网络结构、核心因子与性别差异,为构建更优化的军人心理健康综合评估体系提供新的视角,同时为提升部队军人心理健康总体水平探寻潜在的干预靶点。
利用例行心理健康筛查的安排,于2023年10-11月对某部多个点位在岗未外出执行任务或休假的军人进行问卷调查。为保证结果的真实性和有效性,被试均被告知测试目的及方法,并要求其独立完成问卷。共收回问卷4 470份,其中男性3 699份,女性771份。纳入标准:答题率>90%;排除标准:存在直线作答、存在规律作答模式。最终获得有效问卷4 105份,有效率91.83%。其中,男性3 393份,有效率91.73%;女性712份,有效率92.35%。
自编基本情况问卷,调查某部军人的年龄、是否独生、婚姻状况及文化程度等情况。
采用本课题组编制的《军人心理健康综合评估问卷》测量官兵的综合心理健康。该问卷包含适应性、积极应对、抑郁等12个因子,共94个项目。该问卷已被证实与简明症状量表(brief symptom inventory 18,BSI-18)具有较高的关联效度[8]。其中每个因子所对应的项目数和Cronbach’s α系数以及与BSI-18的相关系数见表1。
采用Harman单因素检验方法进行共同方法偏差检验。对所有测量的94个因子做未经旋转的主成分分析,得出13个特征根大于1的公因子,见表2,其中第1个公因子可以解释所有变异的42.207%,略高于40%但小于推荐临界值50%,因此本研究不存在严重的共同方法偏差。
采用SPSS 27.0进行描述性统计,采用R-4.4.1进行网络分析。在网络分析中,通过Rqgraph包构建心理健康综合评估网络。《军人心理健康综合评估问卷》的12个因子作为网络的12个节点,选用高斯图像模型(Gaussian graphical model,GGM),各因子之间的非参数斯皮尔曼等级相关系数矩阵作为GGM的数据输入,引入惩罚因子(penalization factor),以删除网络中联系程度相对较弱的连线[16]。网络结构中两节点之间的连线代表2个因子之间的相关关系,绿线表示正相关,红线表示负相关;连线越粗,表示2个因子之间的关联越大[17]。
其次,通过Rqgraph包计算网络节点的中心性指标。节点中心性指标包括中介性、接近性、强度和预期影响。中介性是指一个节点在任意2个节点的最短路径中的次数;接近性反映了一个节点到其他节点的平均距离;强度指某个节点与其他节点连接强度的绝对值之和[17]。预期影响表示一个节点对其他节点的影响程度[18]。当节点之间仅存在正关联时,多采用强度中心性作为判断核心因子的指标。而当节点之间存在负关联时,则采用预期影响[19]。由于本研究的网络结构中,节点间存在负关联,因此选用预期影响作为节点中心性衡量标准,预期影响值越高,表明因子越核心。
再次,采用Rbootnet包进行网络结构可靠性评估。网络结构可靠性评估是分析网络模型时的重要步骤,旨在验证网络估计的稳定性和可重复性,主要评价指标包括边权值准确性评估、相关稳定性系数(correlation stability coefficient,CS-coefficient)等[17]。边权值准确性评估通过非参数自助法,得到边权值的95%CI,95%CI越窄,表明边权值准确性越高。相关稳定性系数主要通过样本下降自助法来衡量网络参数在不同数据子集间的相关性。高稳定性表明网络在不同数据条件下保持一致,低稳定性则意味着网络结构易受抽样波动或外界干扰影响。以往研究建议相关稳定性系数不应低于0.25,最好高于0.50[17]。
使用R NetworkComparisionTest包,采用置换检验进行性别间网络结构不变性、网络整体连接强度(global strength,GS)不变性和中心性不变性的显著性检验,为保证检验的质量执行5 000次置换[20-21]。
通过R qgraph包构建心理健康综合评估网络图(图1)。图中连线表示二者之间的相关关系,绿线表示正相关,红线表示负相关;连线越粗,表示2个因子之间的关联越大。从图中可以看出,制度信任(7)与人际信任(8)之间的关联最为紧密;其次为人际信任(8)与生命意义(9)之间、适应性(1)与积极应对(2)之间,以及抑郁(10)与负性情绪(11)之间关系都较为紧密,其正则化相关系数分别为0.49、0.45 、0.44、0.42。适应性、积极应对、正性情绪、工作投入、友谊、家庭满意度、制度信任、人际信任和生命意义这9个因子彼此之间呈正相关,而抑郁、负性情绪、孤独感这3个因子彼此之间呈正相关,与上述9个因子均呈负相关。
通过Rqgraph包计算网络节点的中心性指标。由于本研究的网络结构中,节点间存在负关联,因此选用预期影响作为节点中心性衡量标准。表3显示了心理健康综合评估网络中各因子的预期影响值(Z分数)。结果显示,于样本总体而言,人际信任预期影响最大(1.095);其次是工作投入(1.060)和制度信任(1.039)。说明人际信任、工作投入和制度信任是军人心理健康综合评估的核心因子。
采用无参数自助法(2000 bootstraps)对边权值准确性进行评估,得到边权值准确性图(图2)。图中,红线表示本研究中样本的边权值,黑线表示自助法评估的平均边权值。灰色区域表示由自助法计算得出的置信区间。横坐标代表正则化偏相关系数,纵坐标代表网络中的边。从图中可以看出,边权值的95%CI较窄,表明网络边权值的评估是相对准确的。
采用样本下降自助法(2000 bootstraps)对因子中心性的稳定性进行评估,结果见图3。图中表示在随机丢弃x%样本和原始样本的相关值,阴影区域表示2.5%~97.5%的范围。结果显示,中介度的稳定性系数为0.283>0.250;接近度、预期影响和强度的稳定性系数均为0.75>0.5。本研究以预期影响指标为衡量标准,表明当样本量丢掉75%时,与原始样本仍存在0.7的高度相关,说明网络具有较好的稳定性。
使用R NetworkComparisionTest包,采用置换检验进行性别间网络结构不变性、网络整体连接强度不变性和中心性不变性的显著性检验,结果见表3和图4。
从表3可以看出,男军人心理健康综合评估的核心因子为人际信任(1.171)、工作投入(1.056)和制度信任(1.010);女军人心理健康综合评估的核心因子为工作投入(1.076)和制度信任(1.072)。
从图4可以看出,不同性别的军人群体中制度信任(7)与人际信任(8)之间的关联都是最紧密的;其次适应性(1)与积极应对(2)之间,以及抑郁(10)与负性情绪(11)之间。但是在人际信任(8)与生命意义(9)的关联上,女军人的关联强度明显低于男军人。
通过对不同性别的网络进行比较发现,二者在网络结构上存在差异(M=0.335,P<0.001)、在整体连接强度上不存在差异[GS(女)=5.65,GS(男)=5.57,P>0.05]。不同性别军人各因子预期影响的差异性检验的P值见表4,可见男女军人仅在人际信任因子上差异显著(P<0.01)。进一步对男女军人人际信任进行独立样本t检验,结果发现男军人人际信任显著高于女军人(P<0.01,表3)。
本研究采用网络分析方法对军人心理健康综合评估网络结构、核心因子以及性别差异进行了探索,研究结果可能为进一步理解军人心理健康并制定相关干预措施提供重要的靶点。
在军人心理健康综合评估网络结构中,人际信任与制度信任之间的关联最为紧密。人际信任指建立在直接交往经验和信任情感基础上的信任关系,主要依赖于个人与个人之间的直接互动和了解;制度信任指建立在间接的、惩戒式或预防式的制度机制上的信任关系。这种信任在军队中主要依赖于军队的条令条例等正式规范来保障,二者都是社会信任体系中的2个重要组成部分,具有相互补充的作用。已有研究表明,人际信任和制度信任都会影响个体对于COVID-19的症状感知[22]和生活满意度[23],进而影响个体的心理健康。人际信任与生命意义感之间的关联也较为紧密,与现有研究一致。人际关系是生命意义感的重要源泉,生命意义感更高的人对他人具有更积极的态度或认知,适应力更强、安全感更高,进而表现出更高的人际信任[24]。适应性与积极应对之间的关系也较为紧密,在有关大学生、脑卒中患者等有关研究中,都表明积极应对有助于个体适应变化的新环境[25-26]。此外,消极情绪与抑郁之间联系也较为紧密,实际上抑郁的核心因子之一便是情绪低落。
网络中心性分析结果显示,人际信任、工作投入和制度信任具有最大预期影响,表明其中心性程度最高。按照网络分析理论,这3个因子在军人心理健康综合评估网络中与其他项目之间存在最紧密的关联,其激活可能会最大程度地扩散至整个网络。这为提升官兵心理健康综合水平提供了潜在干预靶点。这提示从组织层面注重建立官兵人际信任和制度信任,促进官兵工作投入度,对于维护和提升官兵心理健康综合水平非常重要。
网络结构可靠性分析结果显示,军人心理健康综合评估网络可靠性系数为0.75,这表明当75%的样本被丢弃时,军人心理健康综合评估网络结构仍与原样本保持0.7的高度相关,意味着军人心理健康综合评估问卷中12个因子组成的网络结构倾向于形成一个自我维持的系统,网络结构75%的变异可由内部项目相互影响,受网络外部其他变量的影响有限[27]。因此,探索军人心理健康综合评估问卷网络结构内部的核心因子,并对其进行干预,对于激发和维持军人综合心理健康状态具有重要意义。
不同性别军人心理健康综合评估的网络结构和核心因子的差异比较表明,男女军人心理健康综合评估网络结构存在差异,主要表现在人际信任与生命意义的关联上,男军人的关联强度明显高于女军人。此外,不同性别军人心理健康综合评估的中心性指标表明,男女军人心理健康综合评估核心因子都包含工作投入和制度信任,但在人际信任上差异显著,人际信任是影响男军人心理健康的核心因子。进一步分析还发现,男军人在人际信任项目上得分显著高于女军人。现有许多有关人际信任的性别差异研究中,得到的结论不一致。如,有关大学生的研究中,发现男生的人际信任显著高于女生[28];而有关初中生的研究中,男生显著低于女生[29]或者没有差异[30];本研究中,在人际信任因子上男军人显著高于女军人。说明在以男性居多的军人群体中,女同志要建立起人际信任比男性更难。女性在人际关系中更看重心理安全感,因此在做出信任决策时会有更多的疑虑。而男性在人际关系中更看重志同道合和任务完成情况,因此在人际信任的建立上更少内耗。人际信任,在男军人网络结构中起着核心作用,说明加强营造充满平等、团结、互助、和谐的军营环境,对于维护和提升男军人综合心理健康水平至关重要。
本研究存在以下局限性:首先,研究结果基于横断面数据,只能获得军人心理健康综合评估问卷各因子间的相关性,无法推断因果关系,后期可开展追踪调查获取纵向数据,构建时间网络模型来探索各项目之间的演变规律。此外本文中所用的军人心理健康综合评估问卷的实证研究较少,缺少相关研究进行对照比较,未来可进一步开展相关研究探索。
综上所述,本研究采用网络分析方法对军人心理健康综合评估的网络特征、核心因子及性别差异进行了研究。发现军人心理健康综合评估网络中,制度信任与人际信任之间的关联最为紧密;其次为人际信任与生命意义、适应性与积极应对,以及抑郁与负性情绪;人际信任、工作投入和制度信任是网络中的核心因子,其激活可能会更有效地提升官兵心理健康水平;该网络具有较好的稳定性,受外界影响较少;男女军人的网络结构存在差异,相比女军人,人际信任在男军人综合心理健康网络中具有更加重要的作用。

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2025年第47卷第13期
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doi: 10.16016/j.2097-0927.202501029
  • 接收时间:2025-01-14
  • 首发时间:2026-10-28
  • 出版时间:2025-07-15
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  • 收稿日期:2025-01-14
  • 修回日期:2025-04-06
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    1陆军特色医学中心(第三军医大学大坪医院)肾内科
    2陆军军医大学(第三军医大学)医学心理系军事心理学教研室,重庆

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LI Min,E-mail:
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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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