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Article(id=1325530816281072589, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325530655635039055, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025308, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1750348800000, receivedDateStr=2025-06-20, revisedDate=1754064000000, revisedDateStr=2025-08-02, acceptedDate=null, acceptedDateStr=null, onlineDate=1793960773772, onlineDateStr=2026-11-06, pubDate=1761321600000, pubDateStr=2025-10-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793960773772, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793960773772, creator=13701087609, updateTime=1793960773772, updator=13701087609, issue=Issue{id=1325530655635039055, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='10', pageStart='1369', pageEnd='1520', issueExtLink='null', onlineDate='null', pubDate='1761321600000', pubDateStr='2025-10-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793960735472, creator='13701087609', updateTime=1793960735472, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1396, endPage=1400, ext={EN=ArticleExt(id=1325530820852863950, articleId=1325530816281072589, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Association between mental health status and adverse childhood experiences among sexual minority college students in Guangxi, columnId=1325530667274228558, journalTitle=Chinese Journal of School Health, columnName=Column on Mental Health Effects of Adverse Experiences, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the association between mental health status and adverse childhood experiences (ACEs) among sexual minority college students, so as to provide a scientific basis for mental health education and health promotion in universities.

Methods

From January to February 2024, convenience and cluster sampling methods were used to select 1 792 college students from 11 colleges in Guangxi. A self-reporting method was applied to identify 476 sexual minority individuals. The Symptom Check-List 90 (SCL-90) and the Simplified Chinese Adverse Childhood Experiences International Questionnaire (SC-ACE-IQ) were employed to assess mental health and ACEs. Multivariate Logistic regression analysis was conducted to examine the associations.

Results

The detection rates of all psychological issues among sexual minority college students in Guangxi were significantly higher than those of non-sexual minority college students (χ2=56.01-91.39, all P < 0.01). Except for physical neglect, bullying, and community violence, sexual minority students exhibited higher reporting rates of other ACEs types compared to non-sexual minority students (χ2=4.52-13.34, all P < 0.05). The total ACEs score for college students was 1.00 (1.00, 2.00), while the SCL-90 total score was 96.00 (113.00, 160.00). Spearman correlation analysis revealed a positive correlation between ACEs total scores and SCL-90 total scores (r=0.29, P < 0.05). Additionally, all ACEs subscales, including emotional neglect, physical neglect, emotional abuse, sexual abuse, parental loss, domestic violence, and community violence were positively correlated with corresponding SCL-90 subscale scores (r=0.05-0.22, all P < 0.05). Multivariate Logistic regression analysis showed that family violence increased the risk of mental health issues for sexual minority students (OR=1.61, 95%CI=1.26-2.09); emotional neglect (OR=1.05, 95%CI=1.00-1.10), physical neglect (OR=1.20, 95%CI=1.06-1.35), sexual abuse (OR=1.49, 95%CI=1.15-1.93) increased mental health risks for non-sexual minority students (all P < 0.05). The cumulative effects of ACEs were all statistically significant in the total sample and both subgroups (all P < 0.05).

Conclusion

Mental health status among sexual minority college students in Guangxi is associated with ACEs, and their well-being requires active attention

, authors=Mingming DONG1, 2, Junshang WEN3, Dongping HUANG*, 3, Hui LIU4, Ran LIANG5, authorsList=Mingming DONG, Junshang WEN, Dongping HUANG, Hui LIU, Ran LIANG, authorCompany=null, correspAuthors=Dongping HUANG, 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=1325530844437435344, articleId=1325530816281072589, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=广西性少数大学生心理健康状况与童年期不良经历的关联, columnId=1325530669090362192, journalTitle=中国学校卫生, columnName=不良经历的心理健康效应专栏, runingTitle=null, highlight=null, articleAbstract=
目的

探讨性少数大学生心理健康状况与童年期不良经历(ACEs)的关联，为高校心理健康教育与健康促进提供科学依据。

方法

2024年1—2月，采用方便抽样与整群抽样相结合的方法选取广西11所高校1 792名大学生，采用自我报告法筛查性少数群体(476名)，运用症状自评量表(SCL-90)、简体中文版童年期不良经历国际量表(SC-ACE-IQ)调查其心理健康与ACEs情况，并使用多因素Logistic回归分析两者关联。

结果

广西性少数大学生心理健康问题及各因子检出率均高于非性少数群体(χ2=56.01~91.39，P值均 < 0.01)。除身体忽视、霸凌、社区暴力外，性少数大学生其余各种类型ACEs报告率均高于非性少数群体(χ2=4.52~13.34，P值均 < 0.05)。大学生ACEs总分为1.00(1.00, 2.00)分，SCL-90总分为96.00(113.00, 160.00)分。Spearman相关分析显示，ACEs总分与SCL-90总分呈正相关(r=0.29)；ACEs中情感忽视、身体忽视、情感虐待、性虐待、失去父母、家庭暴力、社区暴力因子与SCL-90各因子得分均呈正相关(r=0.05~0.22)(P值均 < 0.05)。多因素Logistic回归分析结果显示，家庭暴力会增加性少数大学生心理健康问题的风险(OR=1.61，95%CI=1.26~2.09)；情感忽视(OR=1.05，95%CI=1.00~1.10)、身体忽视(OR=1.20，95%CI=1.06~1.35)、性虐待(OR=1.49，95%CI=1.15~1.93)均会增加非性少数大学生心理健康问题的风险；在总样本和两类群体中，ACEs的累积效应均有统计学意义(P值均 < 0.05)。

结论

广西性少数大学生心理健康状况与ACEs存在关联，应积极关注有ACEs大学生的心理健康状况。

, authors=董铭洺1, 2, 文俊上3, 黄东萍*, 3, 刘慧4, 梁然5, authorsList=董铭洺, 文俊上, 黄东萍, 刘慧, 梁然, authorCompany=null, correspAuthors=黄东萍, authorNote=

董铭洺(1986-)，女，河北沧州人，博士，副教授，主要研究方向为大学生心理健康促进

, correspAuthorsNote=
黄东萍，E-mail：
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董铭洺(1986-)，女，河北沧州人，博士，副教授，主要研究方向为大学生心理健康促进

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董铭洺(1986-)，女，河北沧州人，博士，副教授，主要研究方向为大学生心理健康促进

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PLoS One, 2019, 14(2): e0211850., articleTitle=null, refAbstract=null)], funds=[Fund(id=1325530907272302600, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, awardId=null, language=CN, fundingSource=国家自然科学基金项目(22366007)；广西高校中青年教师科研基础能力提升项目(2022KY0065), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1325530851416757201, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, xref=1, ext=[AuthorCompanyExt(id=1325530851441923026, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, companyId=1325530851416757201, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1School of Marxism, Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China), AuthorCompanyExt(id=1325530851513226195, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, companyId=1325530851416757201, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1广西医科大学马克思主义学院，南宁 530021)]), AuthorCompany(id=1325530852758934484, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, xref=2, ext=[AuthorCompanyExt(id=1325530852779906005, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, companyId=1325530852758934484, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2广西医科大学学生工作处，南宁 530021)]), AuthorCompany(id=1325530855657198550, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, xref=3, ext=[AuthorCompanyExt(id=1325530856047268823, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, companyId=1325530855657198550, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3广西医科大学公共卫生学院，南宁 530021)]), AuthorCompany(id=1325530858106672088, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, xref=4, ext=[AuthorCompanyExt(id=1325530858144420825, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, companyId=1325530858106672088, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4桂林医科大学公共卫生学院，南宁 530021)]), AuthorCompany(id=1325530860363207642, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, xref=5, ext=[AuthorCompanyExt(id=1325530860606477275, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, companyId=1325530860363207642, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=5广西科技大学党委宣传部，南宁 530021)])], figs=[ArticleFig(id=1325530897302443008, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, language=EN, label=Tab.1, caption=

Comparison of detection rates of psychological problems in sexual minority and non-sexual minority college students

, figureFileSmall=null, figureFileBig=null, tableContent=
组别人数躯体化强迫人际关系敏感抑郁焦虑敌对恐怖偏执精神病性其他心理健康问题
性少数47698(20.59)215(45.17)175(36.76)171(35.92)131(27.52)121(25.42)121(25.42)118(24.79)131(27.52)146(30.67)186(39.08)
非性少数1 316102(7.75)348(26.44)240(18.24)205(15.58)148(11.25)108(8.21)136(10.33)121(9.19)136(10.33)165(12.54)258(19.60)
总体1 792200(11.16)563(31.42)415(23.16)376(20.98)279(15.57)229(12.78)257(14.34)239(13.34)267(14.90)311(17.35)444(24.78)
χ2值56.8156.0166.3986.0669.2091.3963.5472.2180.0878.8970.06
P值< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01
), ArticleFig(id=1325530898363600896, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, language=CN, label=表1, caption=

性少数与非性少数大学生心理健康问题及各因子检出率比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别人数躯体化强迫人际关系敏感抑郁焦虑敌对恐怖偏执精神病性其他心理健康问题
性少数47698(20.59)215(45.17)175(36.76)171(35.92)131(27.52)121(25.42)121(25.42)118(24.79)131(27.52)146(30.67)186(39.08)
非性少数1 316102(7.75)348(26.44)240(18.24)205(15.58)148(11.25)108(8.21)136(10.33)121(9.19)136(10.33)165(12.54)258(19.60)
总体1 792200(11.16)563(31.42)415(23.16)376(20.98)279(15.57)229(12.78)257(14.34)239(13.34)267(14.90)311(17.35)444(24.78)
χ2值56.8156.0166.3986.0669.2091.3963.5472.2180.0878.8970.06
P值< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01
), ArticleFig(id=1325530900053905409, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, language=EN, label=Tab.2, caption=

Comparison of report rates of ACEs among sexual minority and non-sexual minority college students

, figureFileSmall=null, figureFileBig=null, tableContent=
组别人数情感忽视身体忽视情感虐待身体虐待性虐待家庭中有酒精或毒品滥用者家庭精神病史
性少数476218(45.80)80(16.81)53(11.13)32(6.72)54(11.34)20(4.20)20(4.20)
非性少数1 316506(38.45)195(14.82)92(6.99)51(3.88)89(6.76)26(1.98)25(1.90)
总体1 792724(40.40)275(15.35)145(8.09)83(4.63)143(7.98)46(2.57)45(2.51)
χ2值7.540.927.525.799.386.066.66
P值< 0.010.34< 0.010.02< 0.010.010.01
组别人数家庭成员被监禁失去父母家庭暴力霸凌社区暴力经历≥1种ACEs经历≥4种ACEs
性少数47620(4.20)104(21.85)140(29.41)72(15.13)49(10.29)358(75.21)77(16.18)
非性少数1 31629(2.20)199(15.12)282(21.43)224(17.02)119(9.04)917(69.68)129(9.80)
总体1 79249(2.73)303(16.91)422(23.55)296(16.52)168(9.38)1 275(71.15)206(11.50)
χ2值4.5210.7911.930.780.514.9413.34
P值0.03< 0.01< 0.010.380.480.03< 0.01
), ArticleFig(id=1325530900913737730, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, language=CN, label=表2, caption=

性少数和非性少数大学生ACEs报告率比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别人数情感忽视身体忽视情感虐待身体虐待性虐待家庭中有酒精或毒品滥用者家庭精神病史
性少数476218(45.80)80(16.81)53(11.13)32(6.72)54(11.34)20(4.20)20(4.20)
非性少数1 316506(38.45)195(14.82)92(6.99)51(3.88)89(6.76)26(1.98)25(1.90)
总体1 792724(40.40)275(15.35)145(8.09)83(4.63)143(7.98)46(2.57)45(2.51)
χ2值7.540.927.525.799.386.066.66
P值< 0.010.34< 0.010.02< 0.010.010.01
组别人数家庭成员被监禁失去父母家庭暴力霸凌社区暴力经历≥1种ACEs经历≥4种ACEs
性少数47620(4.20)104(21.85)140(29.41)72(15.13)49(10.29)358(75.21)77(16.18)
非性少数1 31629(2.20)199(15.12)282(21.43)224(17.02)119(9.04)917(69.68)129(9.80)
总体1 79249(2.73)303(16.91)422(23.55)296(16.52)168(9.38)1 275(71.15)206(11.50)
χ2值4.5210.7911.930.780.514.9413.34
P值0.03< 0.01< 0.010.380.480.03< 0.01
), ArticleFig(id=1325530901786152963, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, language=EN, label=Tab.3, caption=

Correlation between ACEs and SCL-90 scores among college students(r, n=1 792)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量情感忽视身体忽视情感虐待身体虐待性虐待家庭中有酒精或毒品滥用者家庭精神病史家庭成员被监禁失去父母家庭暴力霸凌社区暴力ACEs总分
躯体化0.14*0.12**0.14**0.09**0.14**0.06*0.07**0.06*0.08**0.20**-0.010.10**0.24**
强迫0.19**0.11**0.13**0.09**0.12*0.050.08**0.020.06**0.22**0.010.10**0.27**
人际关系敏感0.20**0.10**0.13**0.11**0.15**0.05*0.09**0.030.07**0.21**0.020.10**0.29**
抑郁0.19**0.12**0.14**0.08**0.15**0.05*0.06**0.030.08**0.20**0.030.10**0.28**
焦虑0.15**0.13**0.13**0.08**0.14**0.040.050.020.06*0.20**0.010.09**0.25**
敌对0.14**0.13**0.15**0.10**0.11**0.05*0.06**0.020.07**0.20**-0.010.10**0.24**
恐怖0.12**0.11**0.07**0.030.13**0.040.050.030.05*0.14**-0.000.05*0.18**
偏执0.16**0.14**0.14**0.09**0.13**0.030.08**0.010.06**0.18**0.040.09**0.25**
精神病性0.16**0.13**0.14**0.08**0.15**0.040.06**0.030.06**0.19**0.020.08**0.25**
其他0.14**0.12**0.14**0.08**0.13**0.030.08**0.040.05*0.21**0.030.12**0.25**
SCL-90总分0.20**0.12**0.15**0.09**0.15**0.05*0.08**0.030.07**0.22**0.020.11**0.29**
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大学生ACEs与SCL-90得分的相关性(r值，n=1 792)

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变量情感忽视身体忽视情感虐待身体虐待性虐待家庭中有酒精或毒品滥用者家庭精神病史家庭成员被监禁失去父母家庭暴力霸凌社区暴力ACEs总分
躯体化0.14*0.12**0.14**0.09**0.14**0.06*0.07**0.06*0.08**0.20**-0.010.10**0.24**
强迫0.19**0.11**0.13**0.09**0.12*0.050.08**0.020.06**0.22**0.010.10**0.27**
人际关系敏感0.20**0.10**0.13**0.11**0.15**0.05*0.09**0.030.07**0.21**0.020.10**0.29**
抑郁0.19**0.12**0.14**0.08**0.15**0.05*0.06**0.030.08**0.20**0.030.10**0.28**
焦虑0.15**0.13**0.13**0.08**0.14**0.040.050.020.06*0.20**0.010.09**0.25**
敌对0.14**0.13**0.15**0.10**0.11**0.05*0.06**0.020.07**0.20**-0.010.10**0.24**
恐怖0.12**0.11**0.07**0.030.13**0.040.050.030.05*0.14**-0.000.05*0.18**
偏执0.16**0.14**0.14**0.09**0.13**0.030.08**0.010.06**0.18**0.040.09**0.25**
精神病性0.16**0.13**0.14**0.08**0.15**0.040.06**0.030.06**0.19**0.020.08**0.25**
其他0.14**0.12**0.14**0.08**0.13**0.030.08**0.040.05*0.21**0.030.12**0.25**
SCL-90总分0.20**0.12**0.15**0.09**0.15**0.05*0.08**0.030.07**0.22**0.020.11**0.29**
), ArticleFig(id=1325530904814440454, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, language=EN, label=Tab.4, caption=

Multivariate Logistic regression analysis of mental health problems of sexual and non-sexual minority college students and ACEs[OR(95%CI)]

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ACEs类型总样本(n=1 792)性少数(n=476)非性少数(n=1 316)
情感忽视1.06(1.02~1.10)**1.05(0.99~1.12)1.05(1.00~1.10)*
身体忽视1.18(1.08~1.28)**1.13(0.97~1.31)1.20(1.06~1.35)**
情感虐待1.04(0.70~1.53)0.91(0.45~1.85)1.18(0.70~1.98)
身体虐待1.06(0.70~1.60)0.82(0.38~1.78)1.14(0.65~1.93)
性虐待1.23(1.04~1.47)*0.91(0.70~1.18)1.49(1.15~1.93)**
家庭中有酒精或毒品滥用者0.69(0.31~1.48)0.45(0.12~1.58)0.75(0.24~2.05)
家庭精神病史1.21(0.60~2.37)1.05(0.34~3.22)1.24(0.46~3.10)
家庭成员被监禁0.97(0.46~1.95)1.42(0.42~4.74)0.86(0.30~2.22)
失去父母1.15(0.80~1.65)1.02(0.54~1.92)1.22(0.74~1.96)
家庭暴力1.20(1.05~1.37)**1.61(1.26~2.09)**1.03(0.86~1.24)
霸凌0.79(0.44~1.39)1.17(0.51~2.67)0.68(0.25~1.60)
社区暴力1.13(0.85~1.47)1.47(0.83~2.69)1.08(0.76~1.48)
经历≥1种ACEs1.68(1.27~2.24)**1.91(1.16~3.22)*1.56(1.10~2.24)*
经历≥4种ACEs2.35(1.68~3.28)**2.41(1.33~4.45)**2.05(1.32~3.15)**
), ArticleFig(id=1325530905665884167, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530816281072589, language=CN, label=表4, caption=

性少数与非性少数大学生心理健康问题与ACEs多因素Logistic回归分析[OR值(95%CI)]

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ACEs类型总样本(n=1 792)性少数(n=476)非性少数(n=1 316)
情感忽视1.06(1.02~1.10)**1.05(0.99~1.12)1.05(1.00~1.10)*
身体忽视1.18(1.08~1.28)**1.13(0.97~1.31)1.20(1.06~1.35)**
情感虐待1.04(0.70~1.53)0.91(0.45~1.85)1.18(0.70~1.98)
身体虐待1.06(0.70~1.60)0.82(0.38~1.78)1.14(0.65~1.93)
性虐待1.23(1.04~1.47)*0.91(0.70~1.18)1.49(1.15~1.93)**
家庭中有酒精或毒品滥用者0.69(0.31~1.48)0.45(0.12~1.58)0.75(0.24~2.05)
家庭精神病史1.21(0.60~2.37)1.05(0.34~3.22)1.24(0.46~3.10)
家庭成员被监禁0.97(0.46~1.95)1.42(0.42~4.74)0.86(0.30~2.22)
失去父母1.15(0.80~1.65)1.02(0.54~1.92)1.22(0.74~1.96)
家庭暴力1.20(1.05~1.37)**1.61(1.26~2.09)**1.03(0.86~1.24)
霸凌0.79(0.44~1.39)1.17(0.51~2.67)0.68(0.25~1.60)
社区暴力1.13(0.85~1.47)1.47(0.83~2.69)1.08(0.76~1.48)
经历≥1种ACEs1.68(1.27~2.24)**1.91(1.16~3.22)*1.56(1.10~2.24)*
经历≥4种ACEs2.35(1.68~3.28)**2.41(1.33~4.45)**2.05(1.32~3.15)**
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广西性少数大学生心理健康状况与童年期不良经历的关联
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董铭洺 1, 2 , 文俊上 3 , 黄东萍 *, 3 , 刘慧 4 , 梁然 5
中国学校卫生 | 不良经历的心理健康效应专栏 2025,46(10): 1396-1400
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中国学校卫生 |不良经历的心理健康效应专栏 2025 , 46 (10) : 1396 -1400
广西性少数大学生心理健康状况与童年期不良经历的关联
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董铭洺(1986-)，女，河北沧州人，博士，副教授，主要研究方向为大学生心理健康促进

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董铭洺(1986-)，女，河北沧州人，博士，副教授，主要研究方向为大学生心理健康促进

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董铭洺1, 2, 文俊上3, 黄东萍*, 3 , 刘慧4, 梁然5
作者信息
  • 1广西医科大学马克思主义学院，南宁 530021
  • 2广西医科大学学生工作处，南宁 530021
  • 3广西医科大学公共卫生学院，南宁 530021
  • 4桂林医科大学公共卫生学院，南宁 530021
  • 5广西科技大学党委宣传部，南宁 530021
通讯作者:
黄东萍，E-mail：
作者简介:

董铭洺(1986-)，女，河北沧州人，博士，副教授，主要研究方向为大学生心理健康促进

Association between mental health status and adverse childhood experiences among sexual minority college students in Guangxi
Mingming DONG1, 2, Junshang WEN3, Dongping HUANG*, 3 , Hui LIU4, Ran LIANG5
Affiliations
  • 1School of Marxism, Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
出版时间: 2025-10-25 doi: 10.16835/j.cnki.1000-9817.2025308
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摘要
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目的

探讨性少数大学生心理健康状况与童年期不良经历(ACEs)的关联，为高校心理健康教育与健康促进提供科学依据。

方法

2024年1—2月，采用方便抽样与整群抽样相结合的方法选取广西11所高校1 792名大学生，采用自我报告法筛查性少数群体(476名)，运用症状自评量表(SCL-90)、简体中文版童年期不良经历国际量表(SC-ACE-IQ)调查其心理健康与ACEs情况，并使用多因素Logistic回归分析两者关联。

结果

广西性少数大学生心理健康问题及各因子检出率均高于非性少数群体(χ2=56.01~91.39，P值均 < 0.01)。除身体忽视、霸凌、社区暴力外，性少数大学生其余各种类型ACEs报告率均高于非性少数群体(χ2=4.52~13.34，P值均 < 0.05)。大学生ACEs总分为1.00(1.00, 2.00)分，SCL-90总分为96.00(113.00, 160.00)分。Spearman相关分析显示，ACEs总分与SCL-90总分呈正相关(r=0.29)；ACEs中情感忽视、身体忽视、情感虐待、性虐待、失去父母、家庭暴力、社区暴力因子与SCL-90各因子得分均呈正相关(r=0.05~0.22)(P值均 < 0.05)。多因素Logistic回归分析结果显示，家庭暴力会增加性少数大学生心理健康问题的风险(OR=1.61，95%CI=1.26~2.09)；情感忽视(OR=1.05，95%CI=1.00~1.10)、身体忽视(OR=1.20，95%CI=1.06~1.35)、性虐待(OR=1.49，95%CI=1.15~1.93)均会增加非性少数大学生心理健康问题的风险；在总样本和两类群体中，ACEs的累积效应均有统计学意义(P值均 < 0.05)。

结论

广西性少数大学生心理健康状况与ACEs存在关联，应积极关注有ACEs大学生的心理健康状况。

精神卫生  /  生活变动事件  /  回归分析  /  学生
Objective

To explore the association between mental health status and adverse childhood experiences (ACEs) among sexual minority college students, so as to provide a scientific basis for mental health education and health promotion in universities.

Methods

From January to February 2024, convenience and cluster sampling methods were used to select 1 792 college students from 11 colleges in Guangxi. A self-reporting method was applied to identify 476 sexual minority individuals. The Symptom Check-List 90 (SCL-90) and the Simplified Chinese Adverse Childhood Experiences International Questionnaire (SC-ACE-IQ) were employed to assess mental health and ACEs. Multivariate Logistic regression analysis was conducted to examine the associations.

Results

The detection rates of all psychological issues among sexual minority college students in Guangxi were significantly higher than those of non-sexual minority college students (χ2=56.01-91.39, all P < 0.01). Except for physical neglect, bullying, and community violence, sexual minority students exhibited higher reporting rates of other ACEs types compared to non-sexual minority students (χ2=4.52-13.34, all P < 0.05). The total ACEs score for college students was 1.00 (1.00, 2.00), while the SCL-90 total score was 96.00 (113.00, 160.00). Spearman correlation analysis revealed a positive correlation between ACEs total scores and SCL-90 total scores (r=0.29, P < 0.05). Additionally, all ACEs subscales, including emotional neglect, physical neglect, emotional abuse, sexual abuse, parental loss, domestic violence, and community violence were positively correlated with corresponding SCL-90 subscale scores (r=0.05-0.22, all P < 0.05). Multivariate Logistic regression analysis showed that family violence increased the risk of mental health issues for sexual minority students (OR=1.61, 95%CI=1.26-2.09); emotional neglect (OR=1.05, 95%CI=1.00-1.10), physical neglect (OR=1.20, 95%CI=1.06-1.35), sexual abuse (OR=1.49, 95%CI=1.15-1.93) increased mental health risks for non-sexual minority students (all P < 0.05). The cumulative effects of ACEs were all statistically significant in the total sample and both subgroups (all P < 0.05).

Conclusion

Mental health status among sexual minority college students in Guangxi is associated with ACEs, and their well-being requires active attention

Mental health  /  Life change events  /  Regression analysis  /  Students
董铭洺, 文俊上, 黄东萍, 刘慧, 梁然. 广西性少数大学生心理健康状况与童年期不良经历的关联. 中国学校卫生, 2025 , 46 (10) : 1396 -1400 . DOI: 10.16835/j.cnki.1000-9817.2025308
Mingming DONG, Junshang WEN, Dongping HUANG, Hui LIU, Ran LIANG. Association between mental health status and adverse childhood experiences among sexual minority college students in Guangxi[J]. Chinese Journal of School Health, 2025 , 46 (10) : 1396 -1400 . DOI: 10.16835/j.cnki.1000-9817.2025308
正文
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性少数群体指在性倾向、性别认同、性别表达等方面属于少数的群体，通常由女同性恋者、男同性恋者、双性恋者、跨性别者、性取向存疑者、酷儿、双灵人及其他性相关身份者组成[1]。一项以中国大学生为样本的调查显示，性少数群体占11.55%，其中同性恋者占2.05%，双性恋者占5.11%，其他性取向者占4.39%[2]。童年期不良经历(adverse childhood experiences, ACEs)是指18岁以前所遭受健康、生存、发育、心理或生理方面的实际或潜在的各种损害的统称[3]。研究发现，ACEs是抑郁、焦虑和强迫症状等众多心理问题和躯体病症的重要根源之一[4]。最近的研究显示，在性少数群体中如欺凌、虐待等ACEs报告率更高，且和其成年期抑郁相关[5-6]。本研究旨在调查大学生性少数群体心理健康状况与ACEs之间的关联，为社会、学校和家庭促进大学生心理健康工作提供科学依据。
1　对象与方法
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1.1　对象
2024年1—2月，采用方便抽样方法选取广西壮族自治区桂林、柳州、南宁3个地区共11所高校，以班级为单位整群选取研究对象，共选取41个班级，现场集中填写在线问卷进行基线资料收集。纳入标准：(1)广西高校注册在籍大学生；(2)自愿参与本次调查；(3)沟通理解能力正常，能独立完成问卷者。排除标准：正在服用精神类药物的学生，休学、退学等非在校状态学生。经知情同意后，共收集问卷1 801份，排除没有完成或填写有明显错误的问卷后，收回有效问卷1 792份，有效率99.50%。其中女生1 142名(63.73%)，男生650名(36.27%)；年龄18~25岁，平均年龄(20.06±1.07)岁。本研究通过广西医科大学医学伦理委员会审批(审批文号：2024KY0002)，所有研究对象均知情同意后进行问卷调查。
1.2　方法
1.2.1　一般情况
自行设计问卷进行调查，包括性别、民族、年级、是否独生子女、家庭类型、生源地、家庭经济状况、父母文化程度等。
1.2.2　性取向和性别认同
参考其他研究[2, 7-8]对于性取向分类的做法，性取向通过问题“以下哪个选项更好描述您的性取向”来调查，选项包括“无性恋、女同性恋、男同性恋、异性恋、双性恋、泛性恋、未列出”；其中“无性恋、泛性恋”为其他性取向，“男同性恋、女同性恋”为同性恋者。另外，将选择“无性恋、女同性恋、男同性恋、双性恋、泛性恋”者列入性少数群体；选择“异性恋、未列出”者，列入非性少数群体。性别认同通过问题“如果只能选择一个选项，请问您认为下列哪个最能描述您”来调查，选项包括“男性、女性、跨性别男性、跨性别女性、性别酷儿、非二元性别者、性别非常规者、易装者、未列出”；其中“跨性别男性、跨性别女性”为跨性别者，“性别酷儿、非二元性别者、性别非常规者、易装者”为性别认同。另外，将选择“跨性别男性、跨性别女性、性别酷儿、非二元性别者、性别非常规者、易装者”的列入性少数范围；选择“男性、女性、未列出”的列入非性少数范围。
1.2.3　症状自评量表(Symptom Check-List 90, SCL-90)[9]
用于评估16岁以上个体在近一周内所体验到的各种心理症状和躯体不适感。量表共90个条目，包含躯体化、强迫、人际关系敏感、抑郁、焦虑、敌对、恐惧、偏执、精神病性、其他10个因子。采用5级评分法：“1=没有”至“5=严重”，总分90~450分，得分越高代表个体存在的心理健康问题越严重。本研究将总分>160分判定为存在心理健康问题，因子平均得分>2分为存在该项心理症状。本研究中该量表的Cronbach α系数为0.95。
1.2.4　简体中文版童年期不良经历国际量表(Simplified Chinese Adverse Childhood Experiences International Questionnaire, SC-ACE-IQ)
量表源于2016年世界卫生组织编制的童年不良经历国际版问卷(Adverse Childhood Experience International Questionnaire, ACE-IQ)[10]，由Chen等[11]采用大陆医学生群体将其汉化为SC-ACE-IQ，从多个维度测量个体18岁前的童年不良经历情况。量表涉及4个维度、12种类型的ACEs，分别为童年期的(情感、身体)忽视、(情感、身体、性)虐待、家庭功能不良(家庭中有酒精或毒品滥用者、家庭精神病史、家庭成员被监禁、失去父母、家庭暴力)和家庭外暴力(霸凌、社区暴力)。采取二分计分法，每一个ACE类别选择“是”记1分(存在该类型ACE)，选择“否”记0分，总分0~12分。本研究将得分≥1分确定为存在ACEs，分值越高表示存在ACEs的种类越多。本研究中该量表的Cronbach α系数为0.93。
1.3　质量控制
所有发放问卷的调查员均接受一对一的规范化培训，由调查员在课堂上组织班级学生集中在线填答。回收问卷后对问卷的一致性、逻辑性、准确性、完整性等进行核查, 剔除不合格问卷。
1.4　统计学分析
使用SPSS 27.0软件进行数据分析，近似服从正态分布的计量资料以(x±s)表示，用M(P25, P75)表示呈偏态分布的计量资料。分类变量以频数和百分率表示，组间比较采用χ2检验。用Spearman相关分析探讨ACEs与心理症状之间的相关性；调整民族、是否独生子女、家庭类型、生源地、家庭经济状况、父/母受教育程度等因素后，以是否存在心理健康问题(是=1，否=0)为因变量，以是否有各种ACE类型(是=1，否=0)、是否经历≥1种ACEs(是=1，否=0)、是否经历≥4种ACEs(是=1，否=0)为自变量进行多因素Logistic回归分析，进一步探讨心理健康问题与ACEs的关联，双侧检验水准α=0.05。
2　结果
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2.1　一般人口学情况
1 792名调查对象中，自我报告为异性恋者占70.54%(1 264名)、同性恋者占3.18%(57名)、双性恋者占8.87%(159名)、跨性别者占9.26%(166名)；其他性取向和性别认同者占5.25%(94名)；另有52名在性取向和性别认同的题目上选择了“未列出”。结果显示，性少数大学生的比例为26.56%(476名)。性少数和非性少数群体在性别[男生：110名(23.11%)，540名(41.03%)；女生：366名(76.90%)，776名(58.97%)]、家庭类型[核心家庭：404名(84.87%)，1 180名(89.67%)；单亲离异家庭：34名(7.14%)，58名(4.41%)；重组家庭：14名(2.94%)，39名(2.96%)；丧亲家庭：24名(5.04%)，39名(2.96%)]分布上差异均有统计学意义(χ2值分别为48.59，9.90，P值均 < 0.05)。
2.2　性少数和非性少数大学生心理健康问题检出率及SCL-90得分比较
性少数大学生SCL-90得分中位数为142.50(102.00, 196.25)，存在心理健康问题者占39.08%；非性少数大学生SCL-90得分中位数为108.50(94.00, 144.00)，存在心理健康问题者占19.60%。两类群体心理健康问题中的10个因子检出率差异均有统计学意义(P值均 < 0.05)。见表1。
2.3　性少数和非性少数大学生ACEs比较
性少数大学生在情感忽视、情感虐待、身体虐待、性虐待、家庭中有酒精或毒品滥用者、家庭精神病史、家庭成员被监禁、失去父母、家庭暴力等9种ACEs类型上，与非性少数大学生相比，报告率差异均有统计学意义(P值均 < 0.05)；两类群体经历≥1和≥4种ACEs报告率的差异均有统计学意义(P值均 < 0.05)。见表2。
2.4　大学生心理健康问题与ACEs的关联
纳入的1 792名广西大学生ACEs总分中位数为1.00(1.00，2.00)，SCL-90总分中位数为96.00(113.00，160.00)。Spearman相关分析显示，ACEs总分与SCL-90总分呈正相关；ACEs情感忽视、身体忽视、情感虐待、性虐待、失去父母、家庭暴力、社区暴力因子与SCL-90及其各因子得分均呈正相关(P值均 < 0.05)。见表3。多因素Logistic回归分析结果表明，在总样本中，情感忽视、身体忽视、性虐待、家庭暴力会增加大学生心理健康问题风险；对于性少数群体，家庭暴力会增加其心理健康问题风险；对于非性少数群体，情感忽视、身体忽视和性虐待会增加其心理健康问题风险(P值均 < 0.05)。在总样本和两类群体中，ACEs的累积效应均有统计学意义(P值均 < 0.05)。见表4。
3　讨论
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本研究结果显示，广西性少数大学生的比例(26.56%)高于全国样本(11.55%)[2]，可能与少数民族地区文化包容性、地域人口流动性、数据采集方法等因素有关；其心理症状总分及10项因子分均高于非性少数群体，与已有研究结果相似[2, 8, 12-14]，由于“少数群体压力”[15]，印证其为心理健康高风险人群。
研究采用本土化SC-ACE-IQ量表，证实性少数群体经历更严重的ACEs，与Austin等[16]的研究结果一致。该群体存在“双重创伤”：除普遍ACEs外，还因性别身份的“非规范性”遭受额外的家庭排斥，以及偏见、歧视、污名等少数群体压力，ACEs正是在结构性不平等和健康差异的背景下发生的[17]。性少数大学生报告遭受多重ACEs的比例更高，且呈现累积效应。考虑到多重创伤的叠加会进一步破坏个体的心理韧性、认知模式与社会适应能力，性少数群体风险叠加效应更为显著。先前的研究也发现，ACEs与心理健康状况不佳存在关联[18]，但未专门针对性少数大学生群体，也没有比较ACEs对不同群体心理健康的影响模式是否存在差异。本研究通过分析性少数与非性少数群体ACEs对心理健康影响的差异化模式，揭示了家庭暴力是性少数大学生心理健康问题的关键风险因素，而在非性少数大学生中，情感忽视、身体忽视、性虐待是风险因素，原因可能是性少数群体在家庭环境中更易因身份认同问题遭遇冲突或压力，这对正在形成的依恋系统会产生有害影响[19]，家庭暴力会直接破坏核心支持系统，加剧创伤体验，导致心理问题发生。研究进一步证实了经历多种ACEs对大学生心理健康的显著影响，且两类群体累积的不良经历都会加剧心理问题的发生。
本研究仍存在一定的局限：采用横断面设计，因果关系的推断受到限制；未纳入保护性因素的分析，无法明确其在ACEs与心理健康间的调节作用。未来可以通过纵向研究进一步探索ACEs与性少数大学生心理健康的动态关系，扩大样本量并纳入更多ACEs类型，更精准地解析ACEs对性少数群体心理健康的作用路径。
基金
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  • 国家自然科学基金项目(22366007)；广西高校中青年教师科研基础能力提升项目(2022KY0065)
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2025年第46卷第10期
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doi: 10.16835/j.cnki.1000-9817.2025308
  • 接收时间：2025-06-20
  • 首发时间：2026-11-06
  • 出版时间：2025-10-25
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  • 收稿日期：2025-06-20
  • 修回日期：2025-08-02
基金
国家自然科学基金项目(22366007)；广西高校中青年教师科研基础能力提升项目(2022KY0065)
作者信息
    1广西医科大学马克思主义学院，南宁 530021
    2广西医科大学学生工作处，南宁 530021
    3广西医科大学公共卫生学院，南宁 530021
    4桂林医科大学公共卫生学院，南宁 530021
    5广西科技大学党委宣传部，南宁 530021

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