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Article(id=1241522922368594829, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202306367, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1687017600000, receivedDateStr=2023-06-18, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773931731073, onlineDateStr=2026-03-19, pubDate=1710000000000, pubDateStr=2024-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773931731073, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773931731073, creator=13701087609, updateTime=1773931731073, updator=13701087609, issue=Issue{id=1241522919977841545, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='5', pageStart='769', pageEnd='960', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773931730503, creator=13701087609, updateTime=1773931880386, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241523548695622547, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241523548695622548, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=842, endPage=847, ext={EN=ArticleExt(id=1241522922741887891, articleId=1241522922368594829, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=The relationship between adverse childhood experiences and depressive symptoms of junior middle school students: the mediating role of self-esteem and the regulating role of social support, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent Health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the mediating role of self-esteem in the relationship between childhood adverse experiences (ACEs) and depressive symptoms of junior high school students, and the regulatory effect of social support.

Methods

A total of 1 308 students from 3 junior middle schools in Xiangxi were selected by stratified random cluster sampling from February to April 2023. A questionnaire survey was conducted with the use of Childhood adverse experience questionnaire, Adolescent social support scale, PHQ-9 Depression symptom screening scale, and Rosenberg self-esteem scale. The data were analyzed by correlation analysis, intermediary analysis, and moderated intermediary model test.

Results

(1) ACEs positively predicted depressive symptoms of junior high school students (β=0.801, t=7.246, P<0.05), while self-esteem and social support negatively predicted depressive symptoms of junior high school students (β=-0.406, t=-14.276, P < 0.05; β =-0.027, t=-2.781, P < 0.05). (2) Self-esteem played a mediating role between ACEs and depressive symptoms (effect=0.468, P < 0.05), and the mediating effect accounted for 31.33% of the total effect. (3) Social support directly regulated the relationship between ACEs and depressive symptoms (β=-0.017, t=-3.043, P<0.01), and social support played a regulatory role in the latter half of the mediating pathway of “ACEs self-esteem and depressive symptoms” (β=-0.004, t=-2.887, P<0.01).

Conclusion

There is a mediating effect between ACEs and depressive symptoms of junior high school students, and self-esteem is the mediating variable of the relationship between them. Social support buffers the influence of ACEs on the risk of depressive symptoms of junior high school students and strengthens the relationship between self-esteem and depressive symptoms. Therefore, giving more care and social support to junior high school students with ACEs and improving their self-esteem will help prevent and reduce the occurrence of depressive symptoms.

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目的

探讨自尊在童年期不良经历（adverse childhood experiences，ACEs）与初中生抑郁症状关系间的中介作用，以及社会支持的调节作用。

方法

于2023年2-4月采用分层随机整群抽样法抽取湘西州3所初中学校共1 308名学生，使用《童年期不良经历问卷》《青少年社会支持量表》《PHQ-9抑郁症状筛查量表》《Rosenberg自尊量表》进行问卷调查,对数据进行相关性分析、中介分析、有调节的中介模型检验。

结果

（1）ACEs显著正向预测初中生抑郁症状（β=0.801，t=7.246，P<0.05），自尊和社会支持均显著负向预测初中生抑郁症状（β=-0.406，t=-14.276，P<0.05；β=-0.027，t=-2.781，P<0.05）。（2）自尊在ACEs与抑郁症状之间起部分中介作用（effect=0.468，P<0.05），中介效应占总效应的31.33%。（3）社会支持直接调节ACEs与抑郁症状的关系（β=-0.017，t=-3.043，P<0.01）；社会支持在“ACEs→自尊→抑郁症状”这一中介路径的后半段起调节作用（β=-0.004，t=-2.887，P<0.01）。

结论

ACEs与初中生抑郁症状之间存在有调节的中介效应，自尊是两者关系的中介变量；社会支持缓冲了ACEs对初中生抑郁症状发生风险的影响，强化了自尊对抑郁症状的影响关系。因此，给予ACEs初中生更多的关爱和社会支持，提高其自尊水平，有助于预防和减少抑郁症状的发生。

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张天成，E-mail:
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王澳伦（1999—），男，硕士在读，研究方向：青少年体质与健康促进

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王澳伦（1999—），男，硕士在读，研究方向：青少年体质与健康促进

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Chinese Journal of Clinical Psychology, 2023, 31(4): 1013-1018, 949., articleTitle=Effects of childhood unhappiness on college students' depression: a moderated chain model, refAbstract=null)], funds=[Fund(id=1241678328613106435, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, awardId=22YJA880086, language=CN, fundingSource=教育部人文社科规划基金项目(22YJA880086), fundOrder=null, country=null), Fund(id=1241678329204503307, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, awardId=21A0346, language=CN, fundingSource=湖南省教育厅科学研究重点项目(21A0346), fundOrder=null, country=null), Fund(id=1241678329837843218, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, awardId=Jdy22194, language=CN, fundingSource=吉首大学校级科研项目资助(Jdy22194), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241678293804577212, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, xref=null, ext=[AuthorCompanyExt(id=1241678293829743039, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, companyId=1241678293804577212, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=College of Sports Science, Jishou University, Jishou, Hunan 416000, China), AuthorCompanyExt(id=1241678293838131647, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, companyId=1241678293804577212, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=吉首大学体育科学学院，湖南 吉首 416000)])], figs=[ArticleFig(id=1241678320681677465, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, language=EN, label=Figure 1, caption=Moderated mediation model, figureFileSmall=e+JS5FKy29LsQhiNeWsr1Q==, figureFileBig=kPWAi/s4VQ/XvOcoOmQPnA==, tableContent=null), ArticleFig(id=1241678321679921824, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, language=CN, label=图1, caption=有调节的中介模型, figureFileSmall=e+JS5FKy29LsQhiNeWsr1Q==, figureFileBig=kPWAi/s4VQ/XvOcoOmQPnA==, tableContent=null), ArticleFig(id=1241678322011271849, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, language=EN, label=Figure 2, caption=Mediating of social support between ACEs and depressive symptoms, figureFileSmall=Q3Zx65OMRO2WwLtExn7cuQ==, figureFileBig=3v4ndfRi2gUFAEZV6RirJA==, tableContent=null), ArticleFig(id=1241678322405536431, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, language=CN, label=图2, caption=社会支持在ACEs与抑郁症状之间的调节, figureFileSmall=Q3Zx65OMRO2WwLtExn7cuQ==, figureFileBig=3v4ndfRi2gUFAEZV6RirJA==, tableContent=null), ArticleFig(id=1241678323038876344, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, language=EN, label=Figure 3, caption=Mediating of social support between self-esteem and depressive symptoms, figureFileSmall=Ak1YM/juhmfo1Wo7Ekp9fg==, figureFileBig=rTNlw/GXnC4T3xv9T11rag==, tableContent=null), ArticleFig(id=1241678323328283328, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, language=CN, label=图3, caption=社会支持在自尊与抑郁症状之间的调节, figureFileSmall=Ak1YM/juhmfo1Wo7Ekp9fg==, figureFileBig=rTNlw/GXnC4T3xv9T11rag==, tableContent=null), ArticleFig(id=1241678323835794120, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, language=EN, label=Table 1, caption=

Scores of each variable and correlation analysis

, figureFileSmall=null, figureFileBig=null, tableContent=
变量得分（）童年期不良经历社会支持自尊抑郁症状
童年期不良经历0.81±1.341
社会支持61.32±16.33-0.333**1
自尊28.76±5.45-0.283**0.600**1
抑郁症状13.66±4.780.393**-0.391**-0.509**1
), ArticleFig(id=1241678324422996686, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, language=CN, label=表1, caption=

各变量得分及相关分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量得分（）童年期不良经历社会支持自尊抑郁症状
童年期不良经历0.81±1.341
社会支持61.32±16.33-0.333**1
自尊28.76±5.45-0.283**0.600**1
抑郁症状13.66±4.780.393**-0.391**-0.509**1
), ArticleFig(id=1241678324733375189, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, language=EN, label=Table 2, caption=

Tests of the mediation model of self-esteem

, figureFileSmall=null, figureFileBig=null, tableContent=
回归方程拟合指标系数显著性P值
结果变量预测变量R值R2值F值β t值
自尊ACEs0.2830.080113.842-1.0930.102-10.670<0.001
抑郁症状ACEs0.3930.154237.8911.5020.09715.424<0.001
抑郁症状ACEs0.5710.326315.3561.0340.09111.401<0.001
自尊-0.4280.024-18.233<0.001
), ArticleFig(id=1241678324859204314, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, language=CN, label=表2, caption=

自尊的中介模型检验

, figureFileSmall=null, figureFileBig=null, tableContent=
回归方程拟合指标系数显著性P值
结果变量预测变量R值R2值F值β t值
自尊ACEs0.2830.080113.842-1.0930.102-10.670<0.001
抑郁症状ACEs0.3930.154237.8911.5020.09715.424<0.001
抑郁症状ACEs0.5710.326315.3561.0340.09111.401<0.001
自尊-0.4280.024-18.233<0.001
), ArticleFig(id=1241678325328966371, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, language=EN, label=Table 3, caption=

Analysis of mediating effects of self-esteem

, figureFileSmall=null, figureFileBig=null, tableContent=
效应β(95%CI) 效果量(%)
总效应1.502(1.311～1.693)0.098
直接效应1.034(0.856～1.211)0.09168.67
间接效应0.468(0.358～0.588)0.05931.33
), ArticleFig(id=1241678326209770216, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, language=CN, label=表3, caption=

自尊的中介效应分析

, figureFileSmall=null, figureFileBig=null, tableContent=
效应β(95%CI) 效果量(%)
总效应1.502(1.311～1.693)0.098
直接效应1.034(0.856～1.211)0.09168.67
间接效应0.468(0.358～0.588)0.05931.33
), ArticleFig(id=1241678327015076592, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, language=EN, label=Table 4, caption=

The association between adverse childhood experiences and depressive symptoms is moderated by a mediating effect test

, figureFileSmall=null, figureFileBig=null, tableContent=
回归方程拟合指标系数显著性P值
结果变量预测变量R值R2值F值β t值
抑郁症状ACEs0.5800.336131.8990.8010.1117.246<0.001
自尊-0.4060.028-14.276<0.001
社会支持-0.0270.010-2.7810.006
ACEs*社会支持-0.0170.006-3.0430.002
自尊*社会支持-0.0040.001-2.8870.004
), ArticleFig(id=1241678327694553848, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522922368594829, language=CN, label=表4, caption=

童年期不良经历与抑郁症状的关系有调节的中介效应检验

, figureFileSmall=null, figureFileBig=null, tableContent=
回归方程拟合指标系数显著性P值
结果变量预测变量R值R2值F值β t值
抑郁症状ACEs0.5800.336131.8990.8010.1117.246<0.001
自尊-0.4060.028-14.276<0.001
社会支持-0.0270.010-2.7810.006
ACEs*社会支持-0.0170.006-3.0430.002
自尊*社会支持-0.0040.001-2.8870.004
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童年期不良经历与初中生抑郁症状的关系——自尊的中介作用和社会支持的调节作用
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王澳伦 , 张天成 , 郭淑媛 , 张福兰
现代预防医学 | 儿少卫生与妇幼保健 2024,51(5): 842-847
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现代预防医学 | 儿少卫生与妇幼保健 2024, 51(5): 842-847
童年期不良经历与初中生抑郁症状的关系——自尊的中介作用和社会支持的调节作用
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王澳伦, 张天成 , 郭淑媛, 张福兰
作者信息
  • 吉首大学体育科学学院，湖南 吉首 416000

    • 王澳伦（1999—），男，硕士在读，研究方向：青少年体质与健康促进

通讯作者:

张天成，E-mail:
The relationship between adverse childhood experiences and depressive symptoms of junior middle school students: the mediating role of self-esteem and the regulating role of social support
Ao-lun WANG, Tian-cheng ZHANG , Shu-yuan GUO, Fu-lan ZHANG
Affiliations
  • College of Sports Science, Jishou University, Jishou, Hunan 416000, China
出版时间: 2024-03-10 doi: 10.20043/j.cnki.MPM.202306367
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摘要
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目的

探讨自尊在童年期不良经历（adverse childhood experiences，ACEs）与初中生抑郁症状关系间的中介作用，以及社会支持的调节作用。

方法

于2023年2-4月采用分层随机整群抽样法抽取湘西州3所初中学校共1 308名学生，使用《童年期不良经历问卷》《青少年社会支持量表》《PHQ-9抑郁症状筛查量表》《Rosenberg自尊量表》进行问卷调查,对数据进行相关性分析、中介分析、有调节的中介模型检验。

结果

（1）ACEs显著正向预测初中生抑郁症状（β=0.801，t=7.246，P<0.05），自尊和社会支持均显著负向预测初中生抑郁症状（β=-0.406，t=-14.276，P<0.05；β=-0.027，t=-2.781，P<0.05）。（2）自尊在ACEs与抑郁症状之间起部分中介作用（effect=0.468，P<0.05），中介效应占总效应的31.33%。（3）社会支持直接调节ACEs与抑郁症状的关系（β=-0.017，t=-3.043，P<0.01）；社会支持在“ACEs→自尊→抑郁症状”这一中介路径的后半段起调节作用（β=-0.004，t=-2.887，P<0.01）。

结论

ACEs与初中生抑郁症状之间存在有调节的中介效应，自尊是两者关系的中介变量；社会支持缓冲了ACEs对初中生抑郁症状发生风险的影响，强化了自尊对抑郁症状的影响关系。因此，给予ACEs初中生更多的关爱和社会支持，提高其自尊水平，有助于预防和减少抑郁症状的发生。

初中生  /  童年期不良经历  /  抑郁症状  /  自尊  /  社会支持
Objective

To explore the mediating role of self-esteem in the relationship between childhood adverse experiences (ACEs) and depressive symptoms of junior high school students, and the regulatory effect of social support.

Methods

A total of 1 308 students from 3 junior middle schools in Xiangxi were selected by stratified random cluster sampling from February to April 2023. A questionnaire survey was conducted with the use of Childhood adverse experience questionnaire, Adolescent social support scale, PHQ-9 Depression symptom screening scale, and Rosenberg self-esteem scale. The data were analyzed by correlation analysis, intermediary analysis, and moderated intermediary model test.

Results

(1) ACEs positively predicted depressive symptoms of junior high school students (β=0.801, t=7.246, P<0.05), while self-esteem and social support negatively predicted depressive symptoms of junior high school students (β=-0.406, t=-14.276, P < 0.05; β =-0.027, t=-2.781, P < 0.05). (2) Self-esteem played a mediating role between ACEs and depressive symptoms (effect=0.468, P < 0.05), and the mediating effect accounted for 31.33% of the total effect. (3) Social support directly regulated the relationship between ACEs and depressive symptoms (β=-0.017, t=-3.043, P<0.01), and social support played a regulatory role in the latter half of the mediating pathway of “ACEs self-esteem and depressive symptoms” (β=-0.004, t=-2.887, P<0.01).

Conclusion

There is a mediating effect between ACEs and depressive symptoms of junior high school students, and self-esteem is the mediating variable of the relationship between them. Social support buffers the influence of ACEs on the risk of depressive symptoms of junior high school students and strengthens the relationship between self-esteem and depressive symptoms. Therefore, giving more care and social support to junior high school students with ACEs and improving their self-esteem will help prevent and reduce the occurrence of depressive symptoms.

Junior high school students  /  Adverse childhood experience  /  Depressive symptoms  /  Self-esteem  /  Social support
王澳伦, 张天成, 郭淑媛, 张福兰. 童年期不良经历与初中生抑郁症状的关系——自尊的中介作用和社会支持的调节作用. 现代预防医学, 2024 , 51 (5) : 842 -847 . DOI: 10.20043/j.cnki.MPM.202306367
Ao-lun WANG, Tian-cheng ZHANG, Shu-yuan GUO, Fu-lan ZHANG. The relationship between adverse childhood experiences and depressive symptoms of junior middle school students: the mediating role of self-esteem and the regulating role of social support[J]. Modern Preventive Medicine, 2024 , 51 (5) : 842 -847 . DOI: 10.20043/j.cnki.MPM.202306367
正文
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抑郁症状是指心情低落、兴趣下降、躯体不适等一系列症状的总称[1]，长时间的抑郁症状会发展为抑郁症，2019年我国青少年抑郁症状发生率达24.3%[2]，初中生高达37.9%[3]。初中生内心世界变化剧烈，心理脆弱而敏感，处在身心发展的重要阶段，易受成长环境因素影响而产生心理健康问题。研究表明童年期不良经历（adverse childhood experiences，ACEs）与青少年抑郁的发生关系密切[4-5]。因此，探讨ACEs对初中生抑郁症状的影响及其作用机制，对于及早发现初中生心理健康问题并开展有效干预，促进青少年身心健康发展十分必要。
ACEs包括虐待、忽视和家庭功能不全等不良事件，中学生ACEs检出率近90%[6]。研究表明ACEs与青少年抑郁呈正相关，ACEs青少年患抑郁症的风险是无ACEs青少年的1.75倍[7]。基于此，可以推断ACEs可直接预测初中生抑郁症状，其作用机制需进一步研究。
自尊是心理健康和个体发展的重要指标，是一种自我保护意识，是对自我价值的肯定与接纳[8]。童年期遭遇不良经历直接导致安全感、归属感、成就感出现不同程度的缺失，影响总体自尊水平[9]。众多学者表明ACEs对自尊有负向预测作用，在儿童期有情感忽视[10]、被虐待[11]、父母离异[12]等经历的青少年，其自尊水平低于未经历者。抑郁易感模型强调了自尊对抑郁的负向预测作用，关注自尊水平可缓解青少年的抑郁症状[13]，自尊在其他不良事件与心理健康关系中起中介作用[14]。基于此，本研究提出假设H1：自尊在ACEs与初中生抑郁症状的关系中起中介作用。
社会支持作为一种重要的社会资源，在相同的压力情境中社会支持较高的个体较少出现抑郁情绪，社会支持可以对抑郁产生缓冲效应机制[15]。社会支持在ACEs与众多健康效应关联中起调节作用，不同水平的社会支持会影响中学生身心健康问题的检出率，社会支持的水平会影响抑郁症状发生率的高低，有力的社会支持是个体遭受不良事件与抑郁水平的一个保护因素[16]。基于此，本研究提出假设H2：社会支持调节ACEs和抑郁症状关系的直接路径。
有研究表明，社会支持与自尊之间存在关联，个体感知到的社会支持越高其自尊水平也就越高[17]。低自尊个体因为常处于消极的社会评价与反馈中，其表现为负性注意偏向；而高自尊个体因为常得到肯定或赞扬，其更倾向于注意社会环境中的正性信息[18]。还有研究发现，社会支持具有增强个体自我主观评价，调动个体积极品质来提高不良环境适应能力的作用，有利于乐观品质的培养，自尊水平的提高，从而减少负性情绪的增加[19]。基于此，本研究提出假设H3：社会支持调节“ACEs→自尊→抑郁症状”的后半段路径。
综上，本研究构建了一个有调节的中介模型，探讨自尊、社会支持对ACEs与抑郁症状关系的影响路径及作用机制，以期为在青少年早期经历过ACEs的初中生给予更多支持和关爱，提升他们的自尊和社会支持水平，缓解或减少青少年后期乃至成人后的精神病理症状，为开展初中生心理健康干预、完善青少年社会心理建设提供参考。见图1。
1　对象与方法
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1.1　研究对象
于2023年2-4月，通过分层随机整群抽样法，选取了湘西土家族苗族自治州（简称湘西州）的3所初中学校。以年级分层后，通过抽签法从每个年级中选取3个班级，对班级所有学生发放问卷，共对27个班级的1 324名学生进行了调查。收回有效问卷1 308份，有效率98.79%。所有测试对象均知情同意，签署了知情同意书，自愿参与。本次调查通过了吉首大学伦理委员会审查(No.JSDX-2023-0046)。调查对象纳入标准：（1）在受访学校就读的7～9年级学生；（2）有基本的读书写字能力，能独立完成问卷。剔除问卷的标准：（1）问卷答案全部统一的乱填问卷；（2）问卷题目未填写完整。
1.2　研究工具
1.2.1　童年期不良经历
由肖琴[20]等翻译修订的《童年期不良经历问卷》，总得分在0～10分，得分越高表示童年期不良经历越多。本次调查中问卷的Cronbachα系数为0.734。
1.2.2　社会支持
由叶悦妹[21]等编制的《青少年社会支持量表》，总得分在0～85分，得分越高表示社会支持水平越高。本次调查中量表的Cronbach α系数为0.951。
1.2.3　抑郁症状
由Kroenke K[22]编制的《PHQ-9抑郁症筛查量表》，共9个题目，评估调查对象过去两周内抑郁症状的频率和困扰程度。采用5点评分法，总得分在0～45分，得分越高表示抑郁症状越严重。本次调查中量表的Cronbach α系数为0.842。
1.2.4　自尊水平
由王孟成[23]等修订的《Rosenberg自尊量表》，共10个题目，问卷采用4点计分法，很不符合到非常符合依次记1～4分，其中3、5、8、9、10题目为反向计分，总得分在0～40分，得分越高，自尊水平越高。本次调查中量表的Cronbach α系数为0.847。
1.3　质量控制
调查前统一对调查人员进行培训，调查在班主任的配合下进行，以班级为单位统一发放问卷，使用统一指导语，问卷匿名填写，问卷当场发放且当场回收，剔除无效问卷。
1.4　统计学处理
采用Harman单因素检验法进行共同方法偏差检验；采用皮尔逊相关法对ACEs、抑郁症状、社会支持、自尊两两之间的关系进行相关性检验；使用SPSS宏程序PROCESS对ACEs、自尊、社会支持与初中生抑郁症状之间作用机制进行有调节的中介模型分析。通过抽取5 000次Bootstrap样本，获取参数估计的标准误和Bootstrap置信区间，若置信区间不包括0，则为显著。检验水准α=0.05。
2　结果
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2.1　共同方法偏差检验
采用Harman单因素检验法进行共同方法偏差检验，结果发现：首个因子解释的变异量为37.3%，小于40%的临界值，表明本研究的数据不存在严重的共同方法偏差。
2.2　描述统计与相关分析
分析结果表明：ACEs和自尊、社会支持均呈显著负相关，自尊和社会支持呈显著正相关，抑郁症状和ACEs呈显著正相关，抑郁症状和自尊、社会支持均呈显著负相关。各变量得分及相关系数见表1。
2.3　自尊的中介作用
使用Hayes编制的SPSS宏程序模型4检验自尊的中介作用。结果表明：ACEs对自尊预测作用显著；ACEs对抑郁症状预测作用显著，且当放入中介变量自尊后，其预测作用依然显著，见表2。ACEs对抑郁症状水平产生的直接效应量为1.034，95%CI不包含0，说明ACEs对抑郁症状水平产生的直接效应显著；间接效应量为0.468，95%CI不包含0，说明自尊在ACEs与抑郁症状水平之间产生的间接效应显著，自尊在ACEs与抑郁症状之间起部分中介作用，自尊的中介模型成立，假设1得到验证，见表3。
2.4　ACEs与抑郁症状的关系
有调节的中介效应分析　采用SPSS宏程序中的模型15检验社会支持在自尊中介ACEs与抑郁症状关系模型上直接路径和间接路径后半段的调节作用。
ACEs对抑郁症状的正向预测作用显著（β=0.801，P<0.01），自尊对抑郁症状的负向预测显著（β=-0.406，P<0.01），社会支持对抑郁症状的负向预测显著（β=-0.027，P<0.01），ACEs和社会支持的交互项对抑郁症状预测显著（β=-0.017，P<0.01），即社会支持显著调节ACEs与抑郁症状关系间的直接路径，假设2得到验证；自尊和社会支持的交互项对抑郁症状预测显著（β=-0.004，P<0.01），即社会支持显著调节“ACEs→自尊→抑郁症状”这一中介路径的后半段，假设3得到验证。见表4。
为了进一步验证假设H2和H3，分别取社会支持正负一个标准差绘制简单斜率效应分析图。图2结果显示，低水平和高水平社会支持均显著影响ACEs与抑郁症状的关系（β=1.067，t=11.119，P<0.01；β=0.534，t=3.055,P<0.01），当社会支持处于高水平时，ACEs对抑郁症状正向预测作用得到抑制，表明随着社会支持水平的升高，ACEs对初中生抑郁症状发生风险的影响降低，验证了社会支持在ACEs与抑郁症状关系的直接路径上起调节作用。
图3结果显示，低水平和高水平社会支持均显著影响自尊与抑郁症状的关系（β=-0.347，t=-10.569,P<0.01；β=-0.465，t=-12.589,P<0.01），当社会支持处于高水平时，自尊对抑郁症状负向预测作用增强明显（β=-0.347增强为β=-0.465），表明随着社会支持水平的升高，自尊对初中生抑郁症状的积极影响得到加强，进一步验证社会支持在自尊中介ACEs与抑郁症状关系的后半段路径起调节作用。
3　讨论
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本研究结果表明，自尊在ACEs与抑郁症状之间起部分中介作用；社会支持可以有效调节ACEs与抑郁症状之间的关系，具体而言，高水平社会支持能降低ACEs对抑郁症状的不良影响，能增强自尊对抑郁症状的积极影响。
3.1　ACEs与抑郁症状的关系
本研究结果进一步验证了ACEs对个体抑郁症状的正向预测作用。童年期遭受虐待和忽视的个体，其人际关系敏感，抑郁、焦虑、敌对、偏执等症状因子分的检出率比未经历者更高，可能由此导致严重的抑郁发生[24-25]。童年期受到忽视的孩子往往缺乏自信、缺少安全感，易产生认知偏差和自我消极信念，并且童年期忽视通常和其他不良家庭经历一起发生，从而增加个体抑郁症状发生的风险。因此，在青少年早期及时减少或阻断ACEs的发生，增强个体积极信念，提高个体认知水平，有助于改善ACEs初中生的抑郁症状。
3.2　自尊的中介作用
本研究表明ACEs不仅能直接预测初中生抑郁症状，也能通过自尊的中介作用间接预测初中生抑郁症状，与其他学者研究一致。ACEs初中生抑制控制功能不足，容易导致内心敏感、恐惧和焦虑，在学习负担、社会交际等问题的诱发下，出现抑郁症状的风险明显增加[26]。低自尊个体容易形成自卑、自我限制、自我否定等性格，常把问题的根源归结于自身，从而增加患抑郁的风险；高自尊个体，有着较高的自我认同和自信水平，其患抑郁症状的风险也会降低[27]。因此，增强ACEs初中生自尊水平，可有效提升个体的自我价值感和自我认同感，进而降低ACEs初中生抑郁症状的水平。
3.3　社会支持的调节作用
本研究发现社会支持对ACEs青少年起着保护作用，降低了ACEs对初中生抑郁症状发生风险的影响，这与社会支持缓冲器模型的研究结论相一致[15]。高社会支持个体在学校更能感受到来自同学和老师的关心与支持，当遇到困难和烦恼时会主动向同学和老师寻求帮助，及时排解不良情绪带来的负面影响。随着年龄的增长，同伴在初中生的生活中充当着越来越重要的角色，如个体感知到来自同伴的支持越多，其自我积极评价越高，抑郁程度就越低[28]。家庭是孩子生活的底气和自信的来源，在幸福的家庭氛围中成长的孩子，更容易形成积极乐观的人生态度和社会适应能力，能够更好地应对生活中的不良事件，降低抑郁症状的发生风险。因此，家庭和学校可以通过有意识地提高初中生的社会支持水平，有效促进ACEs保护行为并减少抑郁症状的发生。
本研究还发现社会支持对自尊与初中生抑郁症状间的影响关系具有显著的强化作用。当处于青春期的初中生获得较多社会支持时，更能感受到现实生活中的关爱和肯定，获得感和价值感得到提升，自尊水平也随之提高，而高自尊水平又会产生较高的自我评价，形成更为积极的自我认识，进而可以有效缓解个体的焦虑和抑郁等负面情绪。因此，在关爱ACEs初中生的同时提高其自尊水平，并采取积极措施有效提升他们的社会支持水平可明显改善ACEs对初中生抑郁症状的影响。
本研究不足之处，一是横断面研究难以推断因果关系和动态变化；二是样本仅限于湘西州初中生，代表性不足；三是未充分挖掘影响ACEs和抑郁症状关系的因素。未来研究应加强纵向研究，扩大取样范围、增加样本量，深入探讨影响两者关系的因素及作用机制，为ACEs初中生抑郁症状的有效干预提供更多思路。
基金
收起
  • 教育部人文社科规划基金项目(22YJA880086)
  • 湖南省教育厅科学研究重点项目(21A0346)
  • 吉首大学校级科研项目资助(Jdy22194)
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2024年第51卷第5期
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doi: 10.20043/j.cnki.MPM.202306367
  • 接收时间：2023-06-18
  • 首发时间：2026-03-19
  • 出版时间：2024-03-10
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  • 收稿日期：2023-06-18
基金
教育部人文社科规划基金项目(22YJA880086)
湖南省教育厅科学研究重点项目(21A0346)
吉首大学校级科研项目资助(Jdy22194)
作者信息
    吉首大学体育科学学院，湖南 吉首 416000

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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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