Article(id=1241065979170574412, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241065978004557893, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202409428, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1727107200000, receivedDateStr=2024-09-24, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773822787324, onlineDateStr=2026-03-18, pubDate=1740412800000, pubDateStr=2025-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773822787324, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773822787324, creator=13701087609, updateTime=1773822787324, updator=13701087609, issue=Issue{id=1241065978004557893, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='4', pageStart='577', pageEnd='768', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773822787047, creator=13701087609, updateTime=1773823194927, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241067688831808347, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241065978004557893, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241067688831808348, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241065978004557893, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=654, endPage=659, ext={EN=ArticleExt(id=1241065979459981391, articleId=1241065979170574412, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Moderating effects of different types of physical activity on the association between leisure-time sedentary behavior and non-suicidal self-injurious behavior in secondary school students, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the moderating role of physical activity (PA) in the association between leisure-time sedentary behavior (LT-SB) and non-suicidal self-injurious behaviors (NSSI) among secondary vocational students in Guizhou Province, and to determine its significant value for providing a scientific basis for the prevention and intervention of NSSI among this group.

Methods

Students from a total of nine secondary schools in Guizhou Province were selected for a self-administered questionnaire survey through a multi-stage stratified whole cluster random sampling method from October to December 2023, and multiple linear regression was used to analyse the moderating effect of different types of PA on the association between LT-SB and NSSI among secondary students and to determine the critical value of the moderating effect by using Johnson-Neumann techniques (J-N techniques).

Results

The detection rate of NSSI among secondary vocational students in Guizhou Province was 27.5%, with male and female students' rates at 14.2% and 13.3%, respectively. Multiple linear regression showed that the interaction term coefficients of total PA, light physical activity (LPA), moderate physical activity (MPA), and vigorous physical activity (VPA) with LT-SB were -0.255, -0.220, -0.472, and -0.424 (P < 0.001), respectively, with MPA having the largest moderating effect. The J-N technique indicated that the association between LT-SB and NSSI weakened as the duration of PA increased, with critical values of 2.39 hours for total PA, 1.63 hours for LPA, 0.99 hours for MPA, and 1.11 hours for VPA.

Conclusion

When developing an exercise intervention to prevent NSSI behavior in secondary vocational students, approximately 1 hour of MPA per day may be the most appropriate and efficient option.

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目的

本研究旨在探讨贵州省中职学生的身体活动(PA)在闲暇时间久坐行为(LT-SB)与非自杀性自伤行为(NSSI)关联的调节作用及其临界值,为预防和干预中职学生NSSI提供科学依据。

方法

于2023年10至12月通过多阶段分层整群随机抽样方法抽取贵州省共9所中职学校学生进行自填式问卷调查,采用多元线性回归分析不同类型PA对中职学生LT-SB与NSSI关联的调节作用,并使用约翰逊-奈曼技术(J-N技术)确定调节效应的临界值。

结果

贵州省中职学生NSSI检出率为27.5%,其中,男生、女生检出率分别为14.2%和13.3%。多元线性回归显示,总PA、轻度身体活动(LPA)、中度身体活动(MPA)、重度身体活动(VPA)与LT-SB的交互项系数分别为-0.255、-0.220、-0.472、-0.424 (P<0.001),其中MPA的调节效应最大;J-N技术显示,随着PA时间的增加,LT-SB与NSSI之间的关联减弱,临界值分别为:总PA 2.39 h,LPA 1.63 h,MPA 0.99 h,VPA 1.11 h。

结论

在制定预防中职学生NSSI行为的运动干预措施时,大约每天1 h的MPA可能是最为适宜和高效的选择。

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庹安写,E-mail:
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韩杨(1998—),男,硕士在读,研究方向:儿少卫生学

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(In Chinese), articleTitle=Effects of moderate intensity exercise on negative mood and monoamine neurotransmitters in Methamphet-amine addicts with anxiety symptoms, refAbstract=null)], funds=[Fund(id=1241065990553915842, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, awardId=S202210660063, language=CN, fundingSource=贵州省2022年省级大学生创新创业项目(S202210660063), fundOrder=null, country=null), Fund(id=1241065990658773448, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, awardId=gzwkj2023-476, language=CN, fundingSource=贵州省卫健委2023年科学技术基金项目(gzwkj2023-476), fundOrder=null, country=null), Fund(id=1241065990759436750, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, awardId=2023GZGXRW136, language=CN, fundingSource=贵州省高校人文社会科学研究项目(2023GZGXRW136), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241065982031089783, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, xref=1., ext=[AuthorCompanyExt(id=1241065982039478393, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, companyId=1241065982031089783, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou 561113, China), AuthorCompanyExt(id=1241065982047867002, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, companyId=1241065982031089783, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州 贵阳 561113)]), AuthorCompany(id=1241065982123364480, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, xref=2., ext=[AuthorCompanyExt(id=1241065982127558785, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, companyId=1241065982123364480, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.贵阳市开阳县疾病预防控制中心应急办公室)]), AuthorCompany(id=1241065982215639175, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, xref=3., ext=[AuthorCompanyExt(id=1241065982224027784, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, companyId=1241065982215639175, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.贵州医科大学医学人文学院)]), AuthorCompany(id=1241065982295330959, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, xref=4., ext=[AuthorCompanyExt(id=1241065982303719568, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, companyId=1241065982295330959, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4.贵州大学外国语学院)])], figs=[ArticleFig(id=1241065987676623233, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, language=EN, label=Fig.1, caption=Simple slope plots of the moderating effect of different types of PA on the association between LT-SB and NSSI, figureFileSmall=midXgbZt3Yrv3oV9ogASnA==, figureFileBig=Xm0sydZlhEbuv1jdunT5ig==, tableContent=null), ArticleFig(id=1241065987781480841, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, language=CN, label=图1, caption=不同类型PA对LT-SB与NSSI之间关联的调节作用的简单斜率图

注:低水平为M-SD,高水平为M+SD,(M为均数,SD为标准差)。

, figureFileSmall=midXgbZt3Yrv3oV9ogASnA==, figureFileBig=Xm0sydZlhEbuv1jdunT5ig==, tableContent=null), ArticleFig(id=1241065988016361873, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, language=EN, label=Fig.2, caption=Johnson-Neyman plots of the moderating effect of different types PA on the association between LT-SB and NSSI, figureFileSmall=NNC3Zhg8YPuGcK0I5GMNJQ==, figureFileBig=XO/Ex2HxDTNrFads9NpYJg==, tableContent=null), ArticleFig(id=1241065988121219479, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, language=CN, label=图2, caption=不同类型PA对LT-SB与NSSI之间关联的调节作用的Johnson-Neyman图

注:x轴表示不同类型身体活动时间(小时),y 轴表示静态行为对NSSI的影响。图中虚线位置为调节作用临界值,其左侧为显著范围(P<0.05),右侧为不显著范围(P>0.05),粗水平线表示观测数据的范围。

, figureFileSmall=NNC3Zhg8YPuGcK0I5GMNJQ==, figureFileBig=XO/Ex2HxDTNrFads9NpYJg==, tableContent=null), ArticleFig(id=1241065988226077084, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, language=EN, label=Table 1, caption=

General profile of the study population (n=2 364)

, figureFileSmall=null, figureFileBig=null, tableContent=
项目组别n(%)NSSI
M(P25, P75)
Z/χ2P
性别1 279(54.1)0.0(0.0,1.0)-2.3810.017
1 085(45.9)0.0(0.0,1.0)
家庭居住地农村1 536(65.0)0.0(0.0,1.0)-2.9340.003
城镇828(35.0)0.0(0.0,1.0)
独生子女317(13.4)0.0(0.0,1.0)-1.2710.204
2 047(86.6)0.0(0.0,1.0)
留守经历1 086(45.9)0.0(0.0,1.0)-3.1960.001
1 278(54.1)0.0(0.0,0.0)
恋爱经历986(41.7)0.0(0.0,2.0)-9.091<0.001
1 378(58.3)0.0(0.0,0.0)
家庭形态核心家庭1 201(50.8)0.0(0.0,1.0)10.9000.028
主干家庭467(19.8)0.0(0.0,1.0)
单亲家庭385(16.3)0.0(0.0,1.0)
联合家庭134(5.6)0.0(0.0,1.0)
重组家庭177(7.5)0.0(0.0,2.0)
超重/肥胖286(12.1)0.0(0.0,1.0)-0.0590.953
2 078(87.9)0.0(0.0,1.0)
吸烟988(41.8)0.0(0.0,2.0)-8.043<0.001
1 376(58.2)0.0(0.0,0.0)
饮酒1 497(63.3)0.0(0.0,1.0)-8.522<0.001
867(36.7)0.0(0.0,0.0)
), ArticleFig(id=1241065988356100511, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, language=CN, label=表1, caption=

研究对象的一般情况(n=2 364)

, figureFileSmall=null, figureFileBig=null, tableContent=
项目组别n(%)NSSI
M(P25, P75)
Z/χ2P
性别1 279(54.1)0.0(0.0,1.0)-2.3810.017
1 085(45.9)0.0(0.0,1.0)
家庭居住地农村1 536(65.0)0.0(0.0,1.0)-2.9340.003
城镇828(35.0)0.0(0.0,1.0)
独生子女317(13.4)0.0(0.0,1.0)-1.2710.204
2 047(86.6)0.0(0.0,1.0)
留守经历1 086(45.9)0.0(0.0,1.0)-3.1960.001
1 278(54.1)0.0(0.0,0.0)
恋爱经历986(41.7)0.0(0.0,2.0)-9.091<0.001
1 378(58.3)0.0(0.0,0.0)
家庭形态核心家庭1 201(50.8)0.0(0.0,1.0)10.9000.028
主干家庭467(19.8)0.0(0.0,1.0)
单亲家庭385(16.3)0.0(0.0,1.0)
联合家庭134(5.6)0.0(0.0,1.0)
重组家庭177(7.5)0.0(0.0,2.0)
超重/肥胖286(12.1)0.0(0.0,1.0)-0.0590.953
2 078(87.9)0.0(0.0,1.0)
吸烟988(41.8)0.0(0.0,2.0)-8.043<0.001
1 376(58.2)0.0(0.0,0.0)
饮酒1 497(63.3)0.0(0.0,1.0)-8.522<0.001
867(36.7)0.0(0.0,0.0)
), ArticleFig(id=1241065988460958117, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, language=EN, label=Table 2, caption=

The partial correlation coefficients (r) for different types of PA, LT-SB, NSSI

, figureFileSmall=null, figureFileBig=null, tableContent=
变量 NSSILT-SB总PALPAMPAVPA
NSSI-1.000
LT-SB6.05±2.550.296c1.000
总PA1.31±0.64-0.156c-0.079c1.000
LPA0.45±0.40-0.071b-0.057b0.676c1.000
MPA0.40±0.31-0.121c-0.069b0.641c0.111c1.000
VPA0.46±0.33-0.106c-0.087c0.539c0.0270.097c1.000
), ArticleFig(id=1241065988578398632, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, language=CN, label=表2, caption=

不同类型PA、LT-SB、NSSI的偏相关系数 (r)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量 NSSILT-SB总PALPAMPAVPA
NSSI-1.000
LT-SB6.05±2.550.296c1.000
总PA1.31±0.64-0.156c-0.079c1.000
LPA0.45±0.40-0.071b-0.057b0.676c1.000
MPA0.40±0.31-0.121c-0.069b0.641c0.111c1.000
VPA0.46±0.33-0.106c-0.087c0.539c0.0270.097c1.000
), ArticleFig(id=1241065988683256237, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, language=EN, label=Table 3, caption=

Covariance diagnostics of LT-SB with PA, LPA, MPA, VPA

, figureFileSmall=null, figureFileBig=null, tableContent=
回归模型容差VIF
LT-SB-PA0.9901.011
LT-SB-LPA0.9941.006
LT-SB-MPA0.9991.001
LT-SB-VPA0.9941.006
), ArticleFig(id=1241065988788113842, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, language=CN, label=表3, caption=

LT-SB与PA、LPA、MPA、VPA的共线性诊断

, figureFileSmall=null, figureFileBig=null, tableContent=
回归模型容差VIF
LT-SB-PA0.9901.011
LT-SB-LPA0.9941.006
LT-SB-MPA0.9991.001
LT-SB-VPA0.9941.006
), ArticleFig(id=1241065988913942970, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, language=EN, label=Table 4, caption=

Modulation of NSSI association by different types of PAs

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
LT-SB0.484c0.443c
总PA-1.059c-0.875c
LPA-0.802c-0.655c
MPA-1.456c-1.279c
VPA-1.511c-1.259c
LT-SB*总PA-0.274c-0.255c
LT-SB*LPA-0.260c-0.220b
LT-SB*MPA-0.471c-0.472c
LT-SB*VPA-0.441c-0.424c
), ArticleFig(id=1241065989022994877, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065979170574412, language=CN, label=表4, caption=

不同类型PA对NSSI关联的调节作用

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
LT-SB0.484c0.443c
总PA-1.059c-0.875c
LPA-0.802c-0.655c
MPA-1.456c-1.279c
VPA-1.511c-1.259c
LT-SB*总PA-0.274c-0.255c
LT-SB*LPA-0.260c-0.220b
LT-SB*MPA-0.471c-0.472c
LT-SB*VPA-0.441c-0.424c
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中职学生不同类型身体活动对闲暇时间久坐行为与非自杀性自伤行为关联的调节作用
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韩杨 1 , 王连花 1 , 李秋硕 1 , 孔维森 2 , 李众 3 , 冷佩洪 3 , 庄礼润 3 , 李兵 4 , 庹安写 3
现代预防医学 | 儿少卫生与妇幼保健 2025,52(4): 654-659
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现代预防医学 | 儿少卫生与妇幼保健 2025, 52(4): 654-659
中职学生不同类型身体活动对闲暇时间久坐行为与非自杀性自伤行为关联的调节作用
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韩杨1, 王连花1, 李秋硕1, 孔维森2, 李众3, 冷佩洪3, 庄礼润3, 李兵4, 庹安写3
作者信息
  • 1.贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州 贵阳 561113
  • 2.贵阳市开阳县疾病预防控制中心应急办公室
  • 3.贵州医科大学医学人文学院
  • 4.贵州大学外国语学院
  • 韩杨(1998—),男,硕士在读,研究方向:儿少卫生学

通讯作者:

庹安写,E-mail:
Moderating effects of different types of physical activity on the association between leisure-time sedentary behavior and non-suicidal self-injurious behavior in secondary school students
Yang HAN1, Lian-hua WANG1, Qiu-shuo LI1, Wei-sen KONG2, Zhong LI3, Pei-hong LENG3, Li-run ZHUANG3, Bing LI4, An-xie TUO3
Affiliations
  • School of Public Health, Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou 561113, China
出版时间: 2025-02-25 doi: 10.20043/j.cnki.MPM.202409428
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目的

本研究旨在探讨贵州省中职学生的身体活动(PA)在闲暇时间久坐行为(LT-SB)与非自杀性自伤行为(NSSI)关联的调节作用及其临界值,为预防和干预中职学生NSSI提供科学依据。

方法

于2023年10至12月通过多阶段分层整群随机抽样方法抽取贵州省共9所中职学校学生进行自填式问卷调查,采用多元线性回归分析不同类型PA对中职学生LT-SB与NSSI关联的调节作用,并使用约翰逊-奈曼技术(J-N技术)确定调节效应的临界值。

结果

贵州省中职学生NSSI检出率为27.5%,其中,男生、女生检出率分别为14.2%和13.3%。多元线性回归显示,总PA、轻度身体活动(LPA)、中度身体活动(MPA)、重度身体活动(VPA)与LT-SB的交互项系数分别为-0.255、-0.220、-0.472、-0.424 (P<0.001),其中MPA的调节效应最大;J-N技术显示,随着PA时间的增加,LT-SB与NSSI之间的关联减弱,临界值分别为:总PA 2.39 h,LPA 1.63 h,MPA 0.99 h,VPA 1.11 h。

结论

在制定预防中职学生NSSI行为的运动干预措施时,大约每天1 h的MPA可能是最为适宜和高效的选择。

身体活动  /  闲暇时间久坐行为  /  非自杀性自伤行为  /  中职学生  /  调节作用
Objective

To investigate the moderating role of physical activity (PA) in the association between leisure-time sedentary behavior (LT-SB) and non-suicidal self-injurious behaviors (NSSI) among secondary vocational students in Guizhou Province, and to determine its significant value for providing a scientific basis for the prevention and intervention of NSSI among this group.

Methods

Students from a total of nine secondary schools in Guizhou Province were selected for a self-administered questionnaire survey through a multi-stage stratified whole cluster random sampling method from October to December 2023, and multiple linear regression was used to analyse the moderating effect of different types of PA on the association between LT-SB and NSSI among secondary students and to determine the critical value of the moderating effect by using Johnson-Neumann techniques (J-N techniques).

Results

The detection rate of NSSI among secondary vocational students in Guizhou Province was 27.5%, with male and female students' rates at 14.2% and 13.3%, respectively. Multiple linear regression showed that the interaction term coefficients of total PA, light physical activity (LPA), moderate physical activity (MPA), and vigorous physical activity (VPA) with LT-SB were -0.255, -0.220, -0.472, and -0.424 (P < 0.001), respectively, with MPA having the largest moderating effect. The J-N technique indicated that the association between LT-SB and NSSI weakened as the duration of PA increased, with critical values of 2.39 hours for total PA, 1.63 hours for LPA, 0.99 hours for MPA, and 1.11 hours for VPA.

Conclusion

When developing an exercise intervention to prevent NSSI behavior in secondary vocational students, approximately 1 hour of MPA per day may be the most appropriate and efficient option.

Physical activity  /  Leisure-time sedentary behaviour  /  Non-suicidal self-injurious behavior  /  Secondary vocational students  /  Moderating effect
韩杨, 王连花, 李秋硕, 孔维森, 李众, 冷佩洪, 庄礼润, 李兵, 庹安写. 中职学生不同类型身体活动对闲暇时间久坐行为与非自杀性自伤行为关联的调节作用. 现代预防医学, 2025 , 52 (4) : 654 -659 . DOI: 10.20043/j.cnki.MPM.202409428
Yang HAN, Lian-hua WANG, Qiu-shuo LI, Wei-sen KONG, Zhong LI, Pei-hong LENG, Li-run ZHUANG, Bing LI, An-xie TUO. Moderating effects of different types of physical activity on the association between leisure-time sedentary behavior and non-suicidal self-injurious behavior in secondary school students[J]. Modern Preventive Medicine, 2025 , 52 (4) : 654 -659 . DOI: 10.20043/j.cnki.MPM.202409428
非自杀性自伤行为(Non-suicidal Self-injury, NSSI)是指青少年故意破坏或改变身体组织而无自杀意图的行为,如切割、刮擦、灼伤或撞击物体等方式[1]。全球范围内,NSSI的检出率不断上升[2],是一个日益严峻的公共卫生问题[3],对青少年心理健康和社会功能造成严重影响,并具有较强的自杀行为预测力[4]。研究表明,NSSI的影响因素是多方面的,涉及人口学、社会学、心理学和躯体健康等[5]。目前,心理疗法是治疗NSSI的主要方法,而药物治疗尚未显示出特异性疗效[6]。因此,早期识别NSSI 的影响因素并进行及时干预,是预防和减少NSSI 发生的关键策略。
在NSSI的影响因素中,久坐行为(Sedentary Behavior, SB)与生活方式息息相关,其中,闲暇时间SB(Leisure-time Sedentary Behavior, LT-SB)与其他的SB相比,LT-SB更为重要,它与多种不良健康结局密切相关[7],且是一项可改变和可避免的危险因素。而身体活动(Physical Activity, PA)则是改善心理健康状况的有效途径[8],也是制定干预措施的主要依据。研究表明,SB与NSSI正相关,PA则能减少NSSI[9-10],一项干预研究进一步显示,运动可显著降低SB引起的NSSI行为冲动[11],这提示对于SB与NSSI的关系,PA可能存在调节作用。但不同类型PA影响SB与NSSI间的关联及调节作用的临界值仍缺乏研究的证据。鉴于中职学生在身心发展和所处环境上的特殊性[12],本研究旨在探索不同类型PA对中职学生SB与NSSI关系的调节作用及临界值,为制定NSSI有效干预措施及促进中职学生身心健康发展提供科学依据。
于2023年10至12月通过多阶段分层整群随机抽样方法,根据贵州省2022年经济水平按好、中、差分层,抽取3个市,每个市随机抽3所中职学校,再以年级分层随机选取 2个班级,每个班级50人左右。由现场调查人员发放纸质问卷,本次共发放问卷2 500份,回收有效问卷2 364份,有效率为94.6 %。本研究得到参与者的知情同意,并已获得贵州医科大学伦理委员会的批准(批准号: 20230181)。
现场调查的主要方式为自填式问卷调查,调查人员经培训后,收集人口学特征、生活方式、闲暇时间久坐行为、身体活动、非自杀性自伤行为等数据。
通过自我报告提供过去一周内参与SB的天数和平均时间。平均每日静态行为时间=(每项静态行为天数×每项静态行为平均时间)/7。SB包括看电视、使用手机、电脑等电子产品、搭乘机动交通工具、坐着聊天、上课、写家庭作业和看书阅读(课外时间)。该问卷重测信度系数为0.606,相关系数为0.689[13]。由于中职学生上课时长统一,因此上课时间不纳入分析。
PA的信息是通过基于国际身体活动问卷(IPAQ)的标准问卷收集的,该问卷在既往研究中得到了验证和使用[14-15]。 通过自我报告提供过去一周内参与PA的天数和平均时间。平均每日身体活动时间=(每项身体活动天数×每项身体活动平均时间)/7。PA包括三类:轻度身体活动(简称LPA;如散步)、中等程度身体活动(定义为导致呼吸或心率小幅增加,简称MPA;如快走、休闲自行车/滑板、羽毛球/乒乓球/网球、做家务)、剧烈程度的身体活动(定义为引起出汗和呼吸困难,简称VPA;如游泳、跑步、篮球/足球、爬楼梯、搬重物)。上述中各种PA的单次平均时间≥10分钟时方被计入。该问卷重测信度系数为0.71~0.93之间,相关系数为0.743[15]
使用中文版青少年非自杀性自伤评估问卷(ANSAQ)进行评估,ANSAQ包括行为和功能部分,评估过去一年内相关行为发生的频率。本研究采用行为部分,包含两个维度的12个项目(有无明显的组织损伤),采用Likert 5级计分,“0=没有”至“4=总是”,12种自伤行为中任何一种发生次数≥1次则界定为有NSSI。得分越高表示NSSI程度越严重。行为问卷的Cronbach α系数为0.921,重测信度为0.843[16]
调查前:咨询专业人士确保问卷可靠性,进行预调查;对调查员进行严格培训,统一调查口径、方法与标准;调查中:每份问卷完成后核查人员对问卷所有项目进行检查,及时查漏补缺;保证每份问卷内容填写完整;调查后:对问卷逻辑错误检查,问卷进行双人双录入,对数据进行一致性检验。
使用EpiData 3.1建立数据库并进行双人双录入,用SPSS 26.0进行统计分析。采用K-S正态性检验对数据进行检验,NSSI得分呈非正态,采用M(P25, P75) 表示,定性资料用频数和构成比表示,组间比较采用Mann-Whitney U检验或Kruskal-Wallis H秩和检验,利用控制变量的偏相关分析各变量的相关性、多元线性回归分析不同PA、LT-SB与NSSI的关联。并使用R 4.3.0的 “interactions” 包绘制J-N图,计算出不同类型PA在LT-SB与NSSI关联的调节效应临界值。检验水准α=0.05。
在2 364名中职学生中,中位年龄为16 (16,17)岁,发生NSSI行为有650名(27.5%),男生336名(14.2%),女生314名(13.3%)。经检验,不同性别、家庭居住地、留守经历、恋爱经历、家庭形态、吸烟、饮酒的中职学生的NSSI得分差异均有统计学意义(P<0.05),见表1
本次调查中职学生的平均LT-SB时间、总PA时间、LPA时间、MPA时间、VPA时间分别为6.05 h/天、1.31 h/天,0.45 h/天、0.40 h/天、0.46 h/天。进一步偏相关分析表明,NSSI得分与LT-SB之间呈正相关(r=0.296,P<0.05),另外,总PA、LPA、MPA、VPA与NSSI得分均呈负相关(r=-0.156、-0.071、-0.121、-0.106,P<0.05),不同类型PA与LT-SB均呈负相关(r=-0.079、-0.057、-0.069、-0.087,P<0.05),见表2
在进行多元线性回归分析之前,本研究进行了共线性诊断,结果显示,LT-SB与各类型PA之间不存在共线性(见表3)。多元线性回归分析显示,在未调整任何变量的模型1中,不同类型身体活动对NSSI均有显著的负向预测作用,且与LT-SB的交互项也对NSSI起到了显著负向预测作用;在调整了性别、家庭居住地、留守经历、恋爱经历、家庭形态、吸烟、饮酒等变量后(模型2),总PA、LPA、MPA、VPA与LT-SB的交互项系数分别为-0.255、-0.220、-0.472、-0.424 (P<0.001),见表4。由简单斜率图可见,不同类型的PA负向调节了LT-SB与NSSI的关系,其中MPA对LT-SB与NSSI关联的调节作用最强,见图1
为进一步可视化PA和LT-SB交互对NSSI显著影响的取值范围,通过采用J-N技术并控制相关协变量,结果显示,LT-SB与NSSI之间的关联随着PA时间的增加而减弱。此外,在一定程度上,这种关联不再显著,总PA临界值为2.39 h,LPA临界值为1.63 h,MPA临界值为0.99 h,VPA临界值为1.11 h,见图2
在本项针对贵州省中职学生的横断面研究中,NSSI的检出率为27.5%,研究揭示了LT-SB与NSSI行为之间的显著正相关性及PA与NSSI行为之间显著负相关,同时发现不同类型PA在LT-SB与NSSI行为之间的不同调节作用,并进一步可视化了不同PA调节作用的临界值,结果显示,在一定范围内,MPA在调节中职生LT-SB与NSSI之间的关联具有更强的效应。本研究显示,贵州省中职学生NSSI的检出率为27.5%,这一结果低于重庆市的调查结果(38.8%)[17],但与国内青少年NSSI的Meta分析结果(27.4%)相近[18],可能与地区间在社会经济发展水平和教育水平上的差异有关。女生和男生(14.2%)的NSSI患病率接近,但NSSI得分存在显著性别差异,这可能与男女在心理特征和应对压力方式上的差异有关[19]。除以上因素外,本次研究还显示家庭居住地、留守经历、恋爱经历、家庭形态、吸烟、饮酒等因素与NSS也有一定的关联,但各因素与NSSI的关系仍需进一步研究。
本次调查中职学生的平均LT-SB时间为6.05 h /天,低于先前研究的报道(9.43 h /天)[20],这可能由于本研究未将上课时间纳入分析。此外,总身体活动平均时间为1.31 h /天,中等及以上强度身体活动(MVPA,为MPA与VPA时间之和)水平为0.86 h /天,低于国家推荐量(每日至少参加1 h MVPA),这提示了中职学生可能存在较高的静态行为时间和较低的身体活动时间。多元线性回归结果显示,LT-SB与NSSI呈正相关,而PA与NSSI呈负相关,与既往研究一致[10,21]。当探讨不同类型PA在LT-SB与NSSI关联的调节作用时,本研究发现,相较于LPA和VPA,MPA在调节中职生LT-SB与NSSI之间的关联具有更强的效应。首先,对于LPA,如散步等日常低强度活动,虽然能够带来一定的生理健康益处,但其对心理健康的调节作用可能相对有限,其原因可能与LPA可能不足以激活与情绪提升相关的生理机制有关,例如释放脑源性神经营养因子和血浆内啡肽等,这些生化指标对心理健康和情绪调节具有多方面的积极影响[22]。其次,虽然VPA能够带来显著的生理健康益处,但VPA(尤其是耗竭的体育活动)更可能会导致身体和心理上的过度负荷,产生消极的情绪反应,从而对心理健康产生负面影响[23]。相比之下,MPA适中的生理刺激有助于促进心肺功能和肌肉发展,同时MPA降低了肿瘤坏死因子(TNF)-α、白细胞介素-6(IL- 6)和白细胞介素-1β(IL- 1β)等炎症因子水平,这些指标的降低会引起基础神经活动的激活[24],因此MPA能有效改善心理健康水平,从而降低NSSI的发生。此外,MPA对身体的负荷较小,不易造成过度疲劳和伤害,更适合大多数中职生的身体条件和运动习惯。
本研究通过应用J-N技术,为中职学生通过PA干预非自杀性自伤行为NSSI提供了科学的依据,揭示了一系列关键的时间阈值:总PA的最优干预时间为2.39 h,LPA为1.63 h,MPA为0.99 h,而VPA为1.11 h,这些特定时长下的身体活动对降低NSSI的积极影响达到峰值。这也提示,PA对LT-SB与NSSI之间的调节效应并非随着身体活动量的线性增加而单调增强,而是存在一个最优区间。当PA量超过这个区间时,其调节效应可能会减弱,甚至变得不显著。神经递质假说或许可以解释这种内在联系,即身体活动可能通过影响神经递质的释放来改善情绪,但该正面效应似乎存在一个饱和点,超过此点后,额外的身体活动量未必能带来更多心理健康的增益[25]。对于中职学生群体而言,这些发现尤为关键,由于其特殊的学习环境和生活阶段,中职学生面临不同的心理压力,如同伴压力、职业选择的不确定性和对未来规划的焦虑等多重心理挑战。然而,相比于普通中学生,中职学生通常承受较轻的学业负担,并拥有更多的个人自由分配时间,这不仅为他们参与身体活动提供了有利条件,也凸显了通过PA作为干预NSSI策略的可行性和重要性。
综上,适量的MPA可能是中职学生NSSI干预的最佳选择,应当鼓励中职生更多参与适量的MPA,并为之提供科学的运动指导和支持,值得注意的是,身体活动应控制在理想区间,即大约每日1 h内,以实现最佳的心理健康效益。最后,需要指出的是,虽然本研究揭示了不同类型PA对LT-SB与NSSI关联的调节作用及其临界值,但鉴于本研究为横断面调查,无法对关联进行因果推断,需前瞻性研究进一步验证;此外,与客观测量的加速度计相比,通过IPAQ自我报告测量PA和LT-SB的方式存在一定的回忆偏倚,其精确度可能存在一定差异,但采用IPAQ测量已经得到广泛应用和认可[14-15]。未来的研究应当进一步探索不同类型的PA对中职学生NSSI影响的具体机制,以及如何根据个体差异和PA的临界值来优化身体活动干预方案。
  • 贵州省2022年省级大学生创新创业项目(S202210660063)
  • 贵州省卫健委2023年科学技术基金项目(gzwkj2023-476)
  • 贵州省高校人文社会科学研究项目(2023GZGXRW136)
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2025年第52卷第4期
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doi: 10.20043/j.cnki.MPM.202409428
  • 接收时间:2024-09-24
  • 首发时间:2026-03-18
  • 出版时间:2025-02-25
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  • 收稿日期:2024-09-24
基金
贵州省2022年省级大学生创新创业项目(S202210660063)
贵州省卫健委2023年科学技术基金项目(gzwkj2023-476)
贵州省高校人文社会科学研究项目(2023GZGXRW136)
作者信息
    1.贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州 贵阳 561113
    2.贵阳市开阳县疾病预防控制中心应急办公室
    3.贵州医科大学医学人文学院
    4.贵州大学外国语学院

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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
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