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Article(id=1325521376437740537, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325521023759691810, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025211, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1737648000000, receivedDateStr=2025-01-24, revisedDate=1749484800000, revisedDateStr=2025-06-10, acceptedDate=null, acceptedDateStr=null, onlineDate=1793958523139, onlineDateStr=2026-11-06, pubDate=1753372800000, pubDateStr=2025-07-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793958523139, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793958523139, creator=13701087609, updateTime=1793958523139, updator=13701087609, issue=Issue{id=1325521023759691810, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='7', pageStart='913', pageEnd='1064', issueExtLink='null', onlineDate='null', pubDate='1753372800000', pubDateStr='2025-07-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793958439054, creator='13701087609', updateTime=1793958439054, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1009, endPage=1013, ext={EN=ArticleExt(id=1325521379365364731, articleId=1325521376437740537, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Analysis of mental health status potential categories and related factors among primary and secondary school students in western Yunnan Province, columnId=1259565855189418448, journalTitle=Chinese Journal of School Health, columnName=Mental Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the mental health status and related factors among primary and secondary school students in western Yunnan Province, so ao to provide scientific evidences for advancing mental health education.

Methods

In June 2024, a stratified cluster sampling method was employed to select 4 584 students from 18 schools across Diqing Tibetan Autonomous Prefecture, Lincang City and Baoshan City three regions in western Yunnan Province. The Mental Health Test (MHT) was used for assessment. Latent class analysis (LCA) and Logistic regression were applied for data classification and related factor analysis respectively.

Results

The overall positive detection rate of MHT was 11.81%, with a mean total score of 40.50±19.25. The predominant issues were learning anxiety (58.4%), hypersensitivity tendency (31.1%), and self-blame tendency (23.1%). LCA categorized students into four groups: severe psychological problems group (74.4% detection rate), learning anxiety-hypersensitivity group (16.4%), learning anxiety-physical symptoms group (9.2%), and healthy group (0). Logistic regression revealed that compared with the healthy group, the severe problems group showed higher risks among females (OR=3.01), junior/senior high school students (OR=1.88/4.02), and those with authoritarian parenting (OR=3.54); the anxiety-hypersensitivity group had higher risks for females (OR=1.87), senior high students (OR=1.54), boarders (OR=1.31), and authoritarian parenting recipients (OR=1.85); the anxiety-physical symptoms group demonstrated increased risks among females (OR=2.22), senior high students (OR=2.58), and authoritarian parenting recipients (OR=2.74), while lower risks were observed for students with parent/grandparent guardians (OR=0.38) and non-only children (OR=0.58) (all P < 0.05).

Conclusions

Mental health problems are prominent among students in western Yunnan, with gender, grade level, boarding status, guardian type, and parenting style being key determinants. Recommendations include strengthening mental health education, prioritizing left-behind children's psychological well-being and promoting healthy development.

, authors=Fang HAN1, Qi WANG2, Yating WEN2, Xiaojuan LI2, Hongyu WEI2, Feng JIAO*, 2, authorsList=Fang HAN, Qi WANG, Yating WEN, Xiaojuan LI, Hongyu WEI, Feng JIAO, authorCompany=null, correspAuthors=Feng JIAO, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., copyrightOwner=null, 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=1325521386453737472, articleId=1325521376437740537, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=云南西部中小学生心理健康状况潜在类别及相关因素分析, columnId=1259565858817491410, journalTitle=中国学校卫生, columnName=心理卫生, runingTitle=null, highlight=null, articleAbstract=
目的

了解云南省西部中小学生心理健康状况及相关因素，为进一步推进心理健康教育工作提供科学依据。

方法

2024年6月，采用分层整群抽样方法选取云南省迪庆州、临沧市、保山市西部三地18所中小学校4 584名学生，使用心理健康诊断测验量表(MHT)评估，并通过潜在类别分析(LCA)和Logistic回归分析分别对数据进行分类和相关因素分析。

结果

中小学生MHT总体阳性率为11.81%，总体平均分(40.50±19.25)分，学习焦虑(58.4%)、过敏倾向(31.1%)和自责倾向(23.1%)为主要问题。LCA将学生分为心理问题严重组、学习焦虑与过敏组、学习焦虑与身体症状组和健康组4类，心理问题检出率分别为74.4%，16.4%，9.2%，0。Logistic回归分析结果显示，与健康组相比，心理问题严重组中女生、初中和高中学生、严厉型管教方式的学生心理问题风险更高(OR值分别为3.01，1.88，4.02，3.54)；学习焦虑与过敏组中女生、高中生、住校生、严厉型管教方式的学生心理问题风险更高(OR值分别为1.87，1.54，1.31，1.85)；学习焦虑与身体症状组中女生、高中生、严厉型管教方式的学生心理问题风险更高(OR值分别为2.22，2.58，2.74)，监护人为父母与祖辈、非独生子女学生心理问题风险较低(OR值分别为0.38，0.58)(P值均＜0.05)。

结论

性别、学段、住校情况、监护人类型和管教方式为云南省西部中小学生心理健康问题主要相关因素。建议加强心理健康教育，关注留守儿童心理健康，促进中小学生健康成长。

, authors=韩芳1, 王琦2, 温雅婷2, 李小娟2, 魏鸿宇2, 焦锋*, 2, authorsList=韩芳, 王琦, 温雅婷, 李小娟, 魏鸿宇, 焦锋, authorCompany=null, correspAuthors=焦锋, authorNote=

韩芳(1986-), 女, 宁夏银川人, 硕士, 副教授, 主要研究方向为公共卫生预防医学

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焦锋，E-mal:
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(in Chinese), articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1325521388118876161, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325521376437740537, xref=1, ext=[AuthorCompanyExt(id=1325521388949348354, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325521376437740537, companyId=1325521388118876161, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Haiyuan College, Kunming Medical University, Kunming 650106, Yunnan Province, China), AuthorCompanyExt(id=1325521388970319875, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325521376437740537, companyId=1325521388118876161, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1昆明医科大学海源学院, 云南 650106)]), AuthorCompany(id=1325521389364584452, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325521376437740537, xref=2, ext=[AuthorCompanyExt(id=1325521389419110405, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325521376437740537, companyId=1325521389364584452, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2昆明医科大学公共卫生学院)])], figs=[ArticleFig(id=1325521414584934453, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325521376437740537, language=EN, label=Fig.1, caption=Conditional probabilities of items for four latent classes of primary and secondary school students mental health status, figureFileSmall=xjqNAvtRcsgzLPySpUa7mA==, figureFileBig=idj3xkIYTcqfR2k6CgYrJw==, tableContent=null), ArticleFig(id=1325521415797088310, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325521376437740537, language=CN, label=图1, caption=中小学生心理健康状况4种潜在类别各条目的条件概率, figureFileSmall=xjqNAvtRcsgzLPySpUa7mA==, figureFileBig=idj3xkIYTcqfR2k6CgYrJw==, tableContent=null), ArticleFig(id=1325521417931989047, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325521376437740537, language=EN, label=Tab.1, caption=

LCA fit indices for mental health status among primary and secondary school students(n=4 584)

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类别个数AIC值BIC值aBIC值Entropy值PBLRT值PLMR值
121 997.9522 046.1522 020.73———
218 732.4918 834.9118 780.900.82< 0.01< 0.01
318 446.4818 603.1218 520.510.79< 0.01< 0.01
418 380.2518 591.1218 479.910.81< 0.010.02
518 385.9618 624.0618 484.250.750.010.04
), ArticleFig(id=1325521418355613752, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325521376437740537, language=CN, label=表1, caption=

中小学生心理健康状况的LCA拟合指标(n=4 584)

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类别个数AIC值BIC值aBIC值Entropy值PBLRT值PLMR值
121 997.9522 046.1522 020.73———
218 732.4918 834.9118 780.900.82< 0.01< 0.01
318 446.4818 603.1218 520.510.79< 0.01< 0.01
418 380.2518 591.1218 479.910.81< 0.010.02
518 385.9618 624.0618 484.250.750.010.04
), ArticleFig(id=1325521420033335353, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325521376437740537, language=EN, label=Tab.2, caption=

Comparison of potential categories of psychological problems among primary and secondary school students in different groups

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组别选项人数心理问题严重组学习焦虑与过敏组学习焦虑与身体症状组健康组χ2值P值
性别男2 236150(6.7)535(23.9)76(3.4)1 475(66.0)103.13< 0.01
女2 348322(13.7)765(32.6)120(5.1)1 141(48.6)
学段小学1 572108(6.9)435(27.7)60(3.8)969(61.6)68.42< 0.01
初中1 653165(10.0)413(25.0)60(3.6)1 015(61.4)
高中1 359196(14.4)453(33.3)75(5.5)635(46.8)
独生子女是80287(10.9)209(26.1)48(6.0)458(57.0)6.02>0.05
否3 782382(10.1)1 089(28.8)148(3.9)2 163(57.2)
是否住校是3 207356(11.1)962(30.0)135(4.2)1 754(54.7)18.55< 0.01
否1 377114(8.3)337(24.5)62(4.5)864(62.7)
监护人父母3 868383(9.9)1 095(28.3)159(4.1)2 231(57.7)14.41< 0.05
祖辈60075(12.5)178(29.6)24(4.0)323(53.9)
其他*11611(9.2)29(25.0)14(11.8)62(54.0)
管教方式放任型7712(15.7)9(11.8)6(7.8)50(64.7)86.79< 0.01
民主型3 383277(8.2)930(27.5)122(3.6)2 054(60.7)
严厉型1 018170(16.7)338(33.2)62(6.1)448(44.0)
纵容型10611(10.1)22(20.3)6(5.8)67(63.8)
), ArticleFig(id=1325521420792504378, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325521376437740537, language=CN, label=表2, caption=

不同组别中小学生心理问题潜在类别构成比较

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组别选项人数心理问题严重组学习焦虑与过敏组学习焦虑与身体症状组健康组χ2值P值
性别男2 236150(6.7)535(23.9)76(3.4)1 475(66.0)103.13< 0.01
女2 348322(13.7)765(32.6)120(5.1)1 141(48.6)
学段小学1 572108(6.9)435(27.7)60(3.8)969(61.6)68.42< 0.01
初中1 653165(10.0)413(25.0)60(3.6)1 015(61.4)
高中1 359196(14.4)453(33.3)75(5.5)635(46.8)
独生子女是80287(10.9)209(26.1)48(6.0)458(57.0)6.02>0.05
否3 782382(10.1)1 089(28.8)148(3.9)2 163(57.2)
是否住校是3 207356(11.1)962(30.0)135(4.2)1 754(54.7)18.55< 0.01
否1 377114(8.3)337(24.5)62(4.5)864(62.7)
监护人父母3 868383(9.9)1 095(28.3)159(4.1)2 231(57.7)14.41< 0.05
祖辈60075(12.5)178(29.6)24(4.0)323(53.9)
其他*11611(9.2)29(25.0)14(11.8)62(54.0)
管教方式放任型7712(15.7)9(11.8)6(7.8)50(64.7)86.79< 0.01
民主型3 383277(8.2)930(27.5)122(3.6)2 054(60.7)
严厉型1 018170(16.7)338(33.2)62(6.1)448(44.0)
纵容型10611(10.1)22(20.3)6(5.8)67(63.8)
), ArticleFig(id=1325521421232906299, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325521376437740537, language=EN, label=Tab.3, caption=

Multivariate Logistic analysis of latent classes for detection rate of psychological problems among primary and secondary school students[OR(95%CI), n=4 584]

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自变量选项心理问题严重组学习焦虑与过敏组学习焦虑与身体症状组
性别女3.01(2.31~3.92)*1.87(1.58~2.21)*2.22(1.53~3.23)*
学段初中1.88(1.28~2.77)*0.87(0.69~1.11)1.11(0.65~1.93)
高中4.02(2.69~5.99)*1.54(1.19~1.99)*2.58(1.49~4.46)*
监护人父母1.04(0.45~2.40)0.98(0.56~1.72)0.32(0.15~0.70)*
祖辈1.76(0.72~4.29)1.19(0.65~2.19)0.38(0.15~0.96)*
独生子女否0.86(0.62~1.19)0.98(0.78~1.23)0.58(0.38~0.90)*
是否住校是0.88(0.62~1.25)1.31(1.04~1.65)*0.81(0.50~1.31)
管教方式放任型1.87(0.82~4.26)0.44(0.18~1.06)1.81(0.60~5.43)
纵容型1.18(0.51~2.71)0.71(0.38~1.32)1.43(0.49~4.16)
严厉型3.54(2.68~4.68)*1.85(1.51~2.27)*2.74(1.83~4.12)*
), ArticleFig(id=1325521422537334844, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325521376437740537, language=CN, label=表3, caption=

中小学生心理问题潜在类别多因素Logistic分析[OR值(95%CI)，n=4 584]

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自变量选项心理问题严重组学习焦虑与过敏组学习焦虑与身体症状组
性别女3.01(2.31~3.92)*1.87(1.58~2.21)*2.22(1.53~3.23)*
学段初中1.88(1.28~2.77)*0.87(0.69~1.11)1.11(0.65~1.93)
高中4.02(2.69~5.99)*1.54(1.19~1.99)*2.58(1.49~4.46)*
监护人父母1.04(0.45~2.40)0.98(0.56~1.72)0.32(0.15~0.70)*
祖辈1.76(0.72~4.29)1.19(0.65~2.19)0.38(0.15~0.96)*
独生子女否0.86(0.62~1.19)0.98(0.78~1.23)0.58(0.38~0.90)*
是否住校是0.88(0.62~1.25)1.31(1.04~1.65)*0.81(0.50~1.31)
管教方式放任型1.87(0.82~4.26)0.44(0.18~1.06)1.81(0.60~5.43)
纵容型1.18(0.51~2.71)0.71(0.38~1.32)1.43(0.49~4.16)
严厉型3.54(2.68~4.68)*1.85(1.51~2.27)*2.74(1.83~4.12)*
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云南西部中小学生心理健康状况潜在类别及相关因素分析
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韩芳 1 , 王琦 2 , 温雅婷 2 , 李小娟 2 , 魏鸿宇 2 , 焦锋 *, 2
中国学校卫生 | 心理卫生 2025,46(7): 1009-1013
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中国学校卫生 |心理卫生 2025 , 46 (7) : 1009 -1013
云南西部中小学生心理健康状况潜在类别及相关因素分析
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韩芳1, 王琦2, 温雅婷2, 李小娟2, 魏鸿宇2, 焦锋*, 2
作者信息
  • 1昆明医科大学海源学院, 云南 650106
  • 2昆明医科大学公共卫生学院
通讯作者:
焦锋，E-mal:
作者简介:

韩芳(1986-), 女, 宁夏银川人, 硕士, 副教授, 主要研究方向为公共卫生预防医学

Analysis of mental health status potential categories and related factors among primary and secondary school students in western Yunnan Province
Fang HAN1, Qi WANG2, Yating WEN2, Xiaojuan LI2, Hongyu WEI2, Feng JIAO*, 2
Affiliations
  • 1Haiyuan College, Kunming Medical University, Kunming 650106, Yunnan Province, China
出版时间: 2025-07-25 doi: 10.16835/j.cnki.1000-9817.2025211
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摘要
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目的

了解云南省西部中小学生心理健康状况及相关因素，为进一步推进心理健康教育工作提供科学依据。

方法

2024年6月，采用分层整群抽样方法选取云南省迪庆州、临沧市、保山市西部三地18所中小学校4 584名学生，使用心理健康诊断测验量表(MHT)评估，并通过潜在类别分析(LCA)和Logistic回归分析分别对数据进行分类和相关因素分析。

结果

中小学生MHT总体阳性率为11.81%，总体平均分(40.50±19.25)分，学习焦虑(58.4%)、过敏倾向(31.1%)和自责倾向(23.1%)为主要问题。LCA将学生分为心理问题严重组、学习焦虑与过敏组、学习焦虑与身体症状组和健康组4类，心理问题检出率分别为74.4%，16.4%，9.2%，0。Logistic回归分析结果显示，与健康组相比，心理问题严重组中女生、初中和高中学生、严厉型管教方式的学生心理问题风险更高(OR值分别为3.01，1.88，4.02，3.54)；学习焦虑与过敏组中女生、高中生、住校生、严厉型管教方式的学生心理问题风险更高(OR值分别为1.87，1.54，1.31，1.85)；学习焦虑与身体症状组中女生、高中生、严厉型管教方式的学生心理问题风险更高(OR值分别为2.22，2.58，2.74)，监护人为父母与祖辈、非独生子女学生心理问题风险较低(OR值分别为0.38，0.58)(P值均＜0.05)。

结论

性别、学段、住校情况、监护人类型和管教方式为云南省西部中小学生心理健康问题主要相关因素。建议加强心理健康教育，关注留守儿童心理健康，促进中小学生健康成长。

精神卫生  /  回归分析  /  潜在类别分析  /  学生
Objective

To investigate the mental health status and related factors among primary and secondary school students in western Yunnan Province, so ao to provide scientific evidences for advancing mental health education.

Methods

In June 2024, a stratified cluster sampling method was employed to select 4 584 students from 18 schools across Diqing Tibetan Autonomous Prefecture, Lincang City and Baoshan City three regions in western Yunnan Province. The Mental Health Test (MHT) was used for assessment. Latent class analysis (LCA) and Logistic regression were applied for data classification and related factor analysis respectively.

Results

The overall positive detection rate of MHT was 11.81%, with a mean total score of 40.50±19.25. The predominant issues were learning anxiety (58.4%), hypersensitivity tendency (31.1%), and self-blame tendency (23.1%). LCA categorized students into four groups: severe psychological problems group (74.4% detection rate), learning anxiety-hypersensitivity group (16.4%), learning anxiety-physical symptoms group (9.2%), and healthy group (0). Logistic regression revealed that compared with the healthy group, the severe problems group showed higher risks among females (OR=3.01), junior/senior high school students (OR=1.88/4.02), and those with authoritarian parenting (OR=3.54); the anxiety-hypersensitivity group had higher risks for females (OR=1.87), senior high students (OR=1.54), boarders (OR=1.31), and authoritarian parenting recipients (OR=1.85); the anxiety-physical symptoms group demonstrated increased risks among females (OR=2.22), senior high students (OR=2.58), and authoritarian parenting recipients (OR=2.74), while lower risks were observed for students with parent/grandparent guardians (OR=0.38) and non-only children (OR=0.58) (all P < 0.05).

Conclusions

Mental health problems are prominent among students in western Yunnan, with gender, grade level, boarding status, guardian type, and parenting style being key determinants. Recommendations include strengthening mental health education, prioritizing left-behind children's psychological well-being and promoting healthy development.

Mental health  /  Regression analysis  /  Latent class analysis  /  Students
韩芳, 王琦, 温雅婷, 李小娟, 魏鸿宇, 焦锋. 云南西部中小学生心理健康状况潜在类别及相关因素分析. 中国学校卫生, 2025 , 46 (7) : 1009 -1013 . DOI: 10.16835/j.cnki.1000-9817.2025211
Fang HAN, Qi WANG, Yating WEN, Xiaojuan LI, Hongyu WEI, Feng JIAO. Analysis of mental health status potential categories and related factors among primary and secondary school students in western Yunnan Province[J]. Chinese Journal of School Health, 2025 , 46 (7) : 1009 -1013 . DOI: 10.16835/j.cnki.1000-9817.2025211
正文
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心理健康问题在青少年群体中呈长期上升的趋势[1-3]，而中小学时期对于塑造个体性格、推动认知发展及构建世界观具有不可估量的重要性。2022年数据显示，我国抑郁症患者人数已近5 000万，其中儿童及青少年占比达30.28%[4]，心理健康问题正呈现低龄化趋势[5]。为改善学生心理健康状况，国家相继出台了《全面加强和改进新时代学生心理健康工作专项行动计划2023—2025年》等一系列政策文件[6]。云南省位于我国西南边陲，交通受限，教育资源相对匮乏，为当地青少年在获取心理健康信息和资源方面带来了挑战。鉴于此，本研究聚焦于云南省西部地区，旨在深入调查中小学生的心理健康状况及其相关因素，采用潜在类别分析(latent class analysis, LCA)方法将学生的心理健康分为不同类别，以更精准地识别学生心理问题的多样性和复杂性，为制定针对性的心理健康干预措施提供科学依据。
1　对象与方法
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1.1　对象
采用分层整群抽样方法，于2024年6月选取云南省迪庆州、临沧市、保山市西部三地，每地再根据经济水平、民族构成、地理位置等因素选取1~3个县市，每个县市选取1~2所中学和小学(四至六年级)，每个年级抽取1~2个班级，共18所学校，发放问卷5 590份，收回有效问卷4 584份，问卷有效率为82.00%(1 006份问卷调查结果不可信，予以排除)。其中男生2 236名(48.8%)，女生2 348名(51.2%)；小学生1 572名(34.3%)，初中生1 653名(36.1%)，高中生1 359名(29.6%)；城市学生2 508名(54.7%)，农村学生2 076名(45.3%)；走读生1 377名(30.0%)，住校生3 207名(70.0%)。所有研究对象监护人均签署知情同意书，确保其自愿参与研究并了解研究目的及过程，研究已通过昆明医科大学伦理委员会审查(批件号：HYXY2024MEC00004)。
1.2　方法
问卷包括两部分，第一部分为自编式问卷，包括人口学信息(性别、年龄等)；第二部分采用心理健康诊断测验量表(Mental Health Test，MHT)[7]，量表Cronbach α系数>0.8，效度达到测量学要求，该量表包含8个内容量表和1个效度量表，共100题。内容量表包括学习焦虑、对人焦虑、孤独倾向、自责倾向、过敏倾向、身体症状、恐怖倾向和冲动倾向，将8个内容量表分值划分为2分类资料，＞8分=1，≤8分=0，总分≥65分或内容量表>8分者提示心理问题呈阳性；效度量表包含10个条目，如果被试者选择了极端选项则该条目得1分，总分＞6分提示结果不可信。
1.3　质量控制
调查前，采用标准化培训统一调查员指导语及注意事项，现场配备心理教师应对研究对象突发情绪反应。课题组选择其中1所中学进行预调查，2周后对同一对象复测以检验信度，Cronbach α系数均>0.8。调查后采用双轨录入系统进行数据双盲录入，设置逻辑校验规则，剔除规律作答、效度不合格及关键变量缺失＞10%的问卷。
1.4　统计学分析
数据采用SPSS 25.0软件包进行统计分析，计数资料用频数或百分率描述，计量资料用(x ± s)描述。采用Mplus 8.0软件进行LCA。最优模型确定标准[8]：(1)赤池信息准则(akaike information criterion，AIC)、贝叶斯信息量准则(Bayesian information criterion，BIC)、调整的BIC(sample size-adjusted BIC，aBIC)的值越小，表明模型的拟合效果越佳；(2)信息熵指数(entropy)的值若大于0.8，提示类别划分的准确率能够超过90%；(3)罗-门德尔-鲁宾校正似然比检验(Lo-Mendell-Rubin adjusted likelihood ratio test，LMR)和基于Bootstrap的似然比检验(Bootstrap likelihood ratio test，BLRT)的P值若小于0.05，则表明k类模型的拟合程度相较于k-1类模型更为优越；(4)平均归属概率矩阵对角线上的值若均高于0.7，则表明模型的分类结果是可接受的。在确定最优模型之后，对相关因素进行χ2检验及多元Logistic回归分析，检验水准α=0.05。
2　结果
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2.1　中小学生总体心理健康状况
中小学生MHT总分心理问题呈阳性者541名，阳性率为11.80%，总体平均得分(40.50±19.25)分。MHT分量表阳性率从高到低依次为学习焦虑58.4%(2 679名)、过敏倾向31.1%(1 426名)、自责倾向23.1%(1 059名)、对人焦虑15.6%(715名)、身体症状14.8%(678名)、恐怖倾向8.6%(393名)、冲动倾向7.3%(333名)；得分依次为(8.10±3.83，5.70±2.79，4.95±3.00，4.38±2.74，4.96±3.46，3.01±2.75，2.70±2.68，2.61±2.44)。
2.2　中小学生心理健康状况潜在类别分析
选取8个内容量表为外显变量，表1显示AIC、BIC、aBIC指标随着类别的增加逐渐变小，在第5类别处变大，LMR、BLRT的P值< 0.05，且Entropy值>0.8，模型拟合结果良好。综合以上结果得出，将学生的心理健康分为4种潜在类别最为合理，其类别概率见图1。C1总分普遍在65分以上，命名为心理问题严重组，其心理问题检出率为85.9%(402名)；C2在学习焦虑与过敏倾向上概率更高，命名为学习焦虑与过敏组，其心理问题检出率为6.8%(88名)；C3在学习焦虑与身体症状上概率较高，命名为学习焦虑与身体症状组，其心理问题检出率为25.4%(50名)；C4总分普遍较低，命名为健康组，其心理问题检出率为0。
2.3　中小学生心理健康状况潜在类别的单因素分析
中小学生的各潜在类别在性别、学段、是否住校、监护人和管教类型组间分布差异均有统计学意义(P值均＜0.05)。见表2。
2.4　中小学生心理健康状况潜在类别的多因素Logistic分析
以4个潜在分类作为响应变量，将健康组设为基准组，将单变量分析中所有变量作为预测因子，构建多元Logistic回归模型。结果显示，与健康组相比，心理问题严重组女生、初中和高中生、严厉型管教方式的中小学生心理问题风险更高(OR值分别为3.01，1.88，4.02，3.54)；学习焦虑与过敏组女生、高中生、住校生、严厉型管教方式的学生心理问题风险更高(OR值分别为1.87，1.54，1.31，1.85)；学习焦虑与身体症状组女生、高中生、严厉型管教方式的学生心理问题风险更高(OR值分别为2.22，2.58，2.74)，监护人为父母与祖辈、非独生子女学生心理问题风险较低(OR值分别为0.32，0.38，0.58)(P值均＜0.05)。见表3。
3　讨论
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本研究结果显示，云南省西部中小学生的MHT总体阳性率为11.80%，低于2023年上海市的16.6%[9]，但高于2023年陕西省的4.53%[10]以及2022年山东胶州市的2.94%[11]。云南省西部农村地区教育资源相对匮乏，存在心理健康教育课程缺失或不完善等问题[12]，使中小学生的心理健康问题难以得到及时有效的关注和干预，在一定程度上导致了心理问题检出率的上升。MHT分量表所揭示的三大心理问题——学习焦虑、过敏倾向和自责倾向，与众多学者先前的研究成果高度吻合，均凸显了学习焦虑在学生心理困扰中的核心地位[13-16]。这一现象可能源自多方面因素的共同影响：县级教育行政部门面临的考核压力、教师专业发展水平不足导致的教学效率低下，以及家长教育焦虑的加剧等。
LCA将学生心理健康状况分为4类，且性别间差异有统计学意义，心理问题严重组中的女生比例高于男生，表明女生可能更易受到心理健康问题的影响。女生在面对学业、人际关系等压力时可能表现出更高的敏感性[17]。其次，学段因素也与学生的心理健康状况相关，心理问题严重组中的高中学生比例高于小学及初中学生，可能与高中学业负担加重、升学压力增大以及青春期心理变化等多重因素有关。另外，心理问题严重组中的住校学生比例高于走读学生，可能与住校生活带来的孤独感、适应困难以及缺乏家庭支持等因素有关。由祖辈监护的学生在心理问题严重组中的比例高于其他监护人类型，可能与隔代抚养带来的沟通障碍、教育方式差异以及缺乏父母直接关爱等因素有关[18]。
多因素Logistic回归分析中，与健康组对比时，心理问题严重组女生、初中和高中学生心理问题风险更高。提示相较于女生，男生在面对心理健康问题时可能展现出更强的韧性或适应能力；同时，小学生相较于其他年龄段的学生，可能由于学业压力较小、生活节奏相对简单，而表现出较低的心理健康风险；在学习焦虑与过敏组中，男生、初中生、走读生心理问题风险更低。表明这些群体可能在学习压力、过敏反应等方面具有更强的应对能力或较少的触发因素。特别是走读生，他们可能因能够频繁与家人交流、获得家庭支持而展现出更好的心理调适能力[19]；在学习焦虑与身体症状组中，女生、高中生及接受严厉管教的学生在全部心理问题类别中风险显著增高。这些发现强调了家庭环境和个人特征在心理健康中的重要性。父母作为直接监护人，可能通过提供情感支持、监督学习以及培养良好生活习惯等方式，有助于减轻孩子的学习焦虑和身体症状[20]。此外，非独生子女可能因家庭中的兄弟姐妹互动而学会了分享、合作和解决问题，从而增强了心理韧性[21]。
根据以上分析结果结合云南西部情况，政府应特别重视并统筹推进“减轻义务教育阶段学生过重作业负担和校外培训负担”“提升学校教育质量和服务水平，提升课后服务质量”政策的有效实施，明确县(市、区)及各部门职责，建立适应地区特点的督查考评机制；学校层面可以结合云南西部地区的文化背景和学生特点，开发适合当地的心理健康教育课程，帮助学生建立符合地域特色的心理健康观念，并为每位学生建立心理健康档案，并定期进行测评，及时发现并解决学生的心理问题，特别是针对学习焦虑等常见问题。

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2025年第46卷第7期
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doi: 10.16835/j.cnki.1000-9817.2025211
  • 接收时间：2025-01-24
  • 首发时间：2026-11-06
  • 出版时间：2025-07-25
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  • 收稿日期：2025-01-24
  • 修回日期：2025-06-10
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    1昆明医科大学海源学院, 云南 650106
    2昆明医科大学公共卫生学院

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