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Article(id=1325530054394143635, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325529948685091532, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025232, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1735833600000, receivedDateStr=2025-01-03, revisedDate=1740672000000, revisedDateStr=2025-02-28, acceptedDate=null, acceptedDateStr=null, onlineDate=1793960592125, onlineDateStr=2026-11-06, pubDate=1756051200000, pubDateStr=2025-08-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793960592125, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793960592125, creator=13701087609, updateTime=1793960592125, updator=13701087609, issue=Issue{id=1325529948685091532, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='8', pageStart='1065', pageEnd='1216', issueExtLink='null', onlineDate='null', pubDate='1756051200000', pubDateStr='2025-08-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793960566921, creator='13701087609', updateTime=1793960566921, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1138, endPage=1141, ext={EN=ArticleExt(id=1325530056180917140, articleId=1325530054394143635, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Association of stress and psychological resilience with dietary behavior among middle school students, columnId=1259565855189418448, journalTitle=Chinese Journal of School Health, columnName=Mental Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the influence of stress and psychological resilience on the dietary behavior of middle school students so as to privide a basis for the development of policies and interventions aimed at improving middle school students dietary behavior.

Methods

A total of 8 874 middle school students in Shanghai were surveyed using stratified cluster random sampling method from November 2019 to January 2020. The questionnaire included general information, dietary behavior, Perceived Stress Scale (PSS-10) and Connor-Davidson Resilience Scale (CD-RISC-10). Factor analysis was used to analyze the dietary behavior model. Logistic regression model was used to explore the correlation between stress, psychological resilience and dietary behavior in adolescents. Besides, a structural equation model was established to analyze the mediating effect of psychological resilience on stress and dietary behavior.

Results

The total score of psychological resilience among middle school students was (27.99±9.83), and the total score of stress was (25.56±7.06). Factor analysis categorized dietary behavior into two types: the high-energy dietary behavior and balanced dietary behavior. High-energy dietary behavior exhibited statistically significant differences across genders and schooling stage (χ2=41.37, 204.03), while balanced dietary behavior showed statistically significant differences across schooling stage and socioeconomic status (χ2=130.23, 96.53) (all P < 0.01). Logistic regression analysis showed that adolescents with moderate and high stress levels had an increased risks of high-energy dietary behavior (OR=1.25, 95%CI=1.12-1.39; OR=1.58, 95%CI=1.39-1.79) and a reduced likelihood of reduced balanced dietary behavior (OR=0.73, 95%CI=0.65-0.81; OR=0.53, 95%CI=0.47-0.60); adolescents with high levels of psychological resilience had a decreased risk of high-energy dietary behavior (OR=0.73, 95%CI=0.65-0.83), and those with moderate and high resilience levels showed improved balanced dietary behavior (OR=1.45, 95%CI=1.29-1.62; OR=2.50, 95%CI=2.21-2.84) (all P < 0.01). The mediating effect of psychological resilience between stress and high-energy dietary behavior or balanced dietary behavior accounted for 15.61% and 56.10% of the total effects, respectively.

Conclusions

Stress and psychological resilience are the influencing factors of dietary behavior in middle school students. Psychological resilience have a partial mediating effect between stress and high-energy dietary behavior or balanced dietary behavior.

, authors=Xiaoyan YU, Weiyi LU, Landuoduo DU, Jingfen ZHU*, authorsList=Xiaoyan YU, Weiyi LU, Landuoduo DU, Jingfen ZHU, authorCompany=null, correspAuthors=Jingfen ZHU, 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=1325530056503878549, articleId=1325530054394143635, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=压力和心理韧性与中学生饮食行为的关系, columnId=1259565858817491410, journalTitle=中国学校卫生, columnName=心理卫生, runingTitle=null, highlight=null, articleAbstract=
目的

分析压力和心理韧性与中学生饮食行为的关系, 为制定改善中学生饮食行为的政策措施提供参考依据。

方法

2019年11月至2020年1月, 采用分层整群随机抽样方法抽取8 874名上海市中学生进行问卷调查, 调查内容包括一般情况、饮食行为、压力知觉量表(PSS-10)和康纳-戴维森弹性量表(CD-RISC-10)。利用因子分析法分析饮食行为模式, 采用Logistic回归模型探讨压力水平和心理韧性与中学生饮食行为的关系, 并建立结构方程模型分析心理韧性在压力水平和饮食行为中的中介作用。

结果

中学生心理韧性总分为(27.99±9.83)分, 压力总分为(25.56±7.06)分。通过因子分析法将饮食行为模式分为高能饮食行为和均衡饮食行为两组, 高能饮食行为在不同性别和学段中分布差异均有统计学意义(χ2值分别为41.37, 204.03), 均衡饮食行为在不同学段和社会阶层中分布差异均有统计学意义(χ2值分别为130.23, 96.53)(P值均 < 0.01)。Logistic回归模型分析结果显示, 中、高压力水平的中学生高能饮食行为风险增加(OR=1.25, 95%CI=1.12~1.39;OR=1.58, 95%CI=1.39~1.79), 均衡饮食行为减少(OR=0.73, 95%CI=0.65~0.81;OR=0.53, 95%CI=0.47~0.60);高水平心理韧性的中学生高能饮食行为的风险降低(OR=0.73, 95%CI=0.65~0.83), 中、高水平心理韧性的中学生均衡饮食行为增加(OR=1.45, 95%CI=1.29~1.62;OR=2.50, 95%CI=2.21~2.84)(P值均 < 0.01)。心理韧性在中学生压力与高能饮食行为和均衡饮食行为中的中介效应分别占总效应的15.61%和56.10%。

结论

压力及心理韧性是中学生的饮食行为的相关因素, 心理韧性在压力与高能饮食行为和均衡饮食行为中存在部分中介作用。

, authors=俞晓艳, 陆唯怡, 杜兰朵朵, 朱静芬*, authorsList=俞晓艳, 陆唯怡, 杜兰朵朵, 朱静芬, authorCompany=null, correspAuthors=朱静芬, authorNote=

俞晓艳(1987-), 女, 上海市人, 在读硕士, 主要研究方向为慢性病预防与控制、青少年健康

, correspAuthorsNote=
朱静芬，E-mail:
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Health behaviors and psychosocial determinants among primary and middle school students in Henan Province[J]. Chin J Sch Health, 2019, 40(8): 1162-1165. (in Chinese), articleTitle=null, refAbstract=null), Reference(id=1325530062715642840, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530054394143635, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=22, rfOrder=26, authorNames=null, journalName=null, refType=null, unstructuredReference=WHATNALL M C, PATTERSON A J, SIEW Y Y, et al. Are psychological distress and resilience associated with dietary intake among Australian university students?[J]. 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Appetite, 2010, 54(3): 473-479., articleTitle=null, refAbstract=null)], funds=[Fund(id=1325530060673016765, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530054394143635, awardId=null, language=CN, fundingSource=上海市公共卫生三年行动计划项目(GWV-10.1-XK15, GWVI-11.1-44), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1325530056763925398, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530054394143635, xref=null, ext=[AuthorCompanyExt(id=1325530056776508311, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530054394143635, companyId=1325530056763925398, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China), AuthorCompanyExt(id=1325530056789091224, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530054394143635, companyId=1325530056763925398, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=上海交通大学公共卫生学院, 上海 200025)])], figs=[ArticleFig(id=1325530058546504631, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530054394143635, language=EN, label=Tab.1, caption=

Comparison of distribution characteristics of eating behaviors among middle school students in different groups

, figureFileSmall=null, figureFileBig=null, tableContent=
组别选项人数高能饮食行为均衡饮食行为
低分组高分组χ2值低分组高分组χ2值
性别男4 4882 219(49.44)2 269(50.56)41.37**2 241(49.93)2 247(50.07)1.72
女4 3861 870(42.64)2 516(57.36)2 129(48.54)2 257(51.46)
学段初中5 8423 010(51.52)2 832(48.48)204.03**2 622(44.88)3 220(55.12)130.23**
高中3 0321 079(35.59)1 953(64.41)1 748(57.65)1 284(42.35)
社会阶层低2 6961 281(47.51)1 415(52.49)5.291 492(55.34)1 204(44.66)96.53**
中3 1071 384(44.54)1 723(55.46)1 570(50.53)1 537(49.47)
高3 0711 424(46.37)1 647(53.63)1 308(42.59)1 763(57.41)
心理韧性低水平3 1741 273(40.11)1 901(59.89)164.91**2 030(63.96)1 144(36.04)570.48**
中水平2 7861 194(42.86)1 592(57.14)1 369(49.14)1 417(50.86)
高水平2 9141 622(55.66)1 292(44.34)971(33.32)1 943(66.68)
压力低水平3 0481 646(54.00)1 402(46.00)166.07**1 084(35.56)1 964(64.44)469.41**
中水平2 9601 374(46.42)1 586(53.58)1 459(49.29)1 501(50.71)
高水平2 8661 069(37.30)1 797(62.70)1 827(63.75)1 039(36.25)
), ArticleFig(id=1325530058630390712, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530054394143635, language=CN, label=表1, caption=

不同组别中学生饮食行为的分布比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别选项人数高能饮食行为均衡饮食行为
低分组高分组χ2值低分组高分组χ2值
性别男4 4882 219(49.44)2 269(50.56)41.37**2 241(49.93)2 247(50.07)1.72
女4 3861 870(42.64)2 516(57.36)2 129(48.54)2 257(51.46)
学段初中5 8423 010(51.52)2 832(48.48)204.03**2 622(44.88)3 220(55.12)130.23**
高中3 0321 079(35.59)1 953(64.41)1 748(57.65)1 284(42.35)
社会阶层低2 6961 281(47.51)1 415(52.49)5.291 492(55.34)1 204(44.66)96.53**
中3 1071 384(44.54)1 723(55.46)1 570(50.53)1 537(49.47)
高3 0711 424(46.37)1 647(53.63)1 308(42.59)1 763(57.41)
心理韧性低水平3 1741 273(40.11)1 901(59.89)164.91**2 030(63.96)1 144(36.04)570.48**
中水平2 7861 194(42.86)1 592(57.14)1 369(49.14)1 417(50.86)
高水平2 9141 622(55.66)1 292(44.34)971(33.32)1 943(66.68)
压力低水平3 0481 646(54.00)1 402(46.00)166.07**1 084(35.56)1 964(64.44)469.41**
中水平2 9601 374(46.42)1 586(53.58)1 459(49.29)1 501(50.71)
高水平2 8661 069(37.30)1 797(62.70)1 827(63.75)1 039(36.25)
), ArticleFig(id=1325530058697499577, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530054394143635, language=EN, label=Tab.2, caption=

Multivariate Logistic regression analysis of stress and resilience on eating behaviors of middle school students (n=8 874)

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量选项高能饮食行为均衡饮食行为
OR值(95%CI)P值OR值(95%CI)P值
压力低水平1.001.00
中水平1.25(1.12~1.39)＜0.010.73(0.65~0.81)＜0.01
高水平1.58(1.39~1.79)＜0.010.53(0.47~0.60)＜0.01
心理韧性低水平1.001.00
中水平1.05(0.94~1.18)0.411.45(1.29~1.62)＜0.01
高水平0.73(0.65~0.83)＜0.012.50(2.21~2.84)＜0.01
), ArticleFig(id=1325530058772997050, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530054394143635, language=CN, label=表2, caption=

压力与心理韧性和中学生饮食行为的多因素Logistic回归分析(n=8 874)

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量选项高能饮食行为均衡饮食行为
OR值(95%CI)P值OR值(95%CI)P值
压力低水平1.001.00
中水平1.25(1.12~1.39)＜0.010.73(0.65~0.81)＜0.01
高水平1.58(1.39~1.79)＜0.010.53(0.47~0.60)＜0.01
心理韧性低水平1.001.00
中水平1.05(0.94~1.18)0.411.45(1.29~1.62)＜0.01
高水平0.73(0.65~0.83)＜0.012.50(2.21~2.84)＜0.01
), ArticleFig(id=1325530060450718651, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530054394143635, language=EN, label=Tab.3, caption=

Mediating effect of resilience between stress and eating behaviors of middle school students(n=8 874)

, figureFileSmall=null, figureFileBig=null, tableContent=
效应模型高能饮食行为均衡饮食行为
效应值(95%CI)效应占比/%效应值(95%CI)效应占比/%
中介效应0.03(0.02~0.05)15.61-0.12(-0.13~-0.10)56.10
直接效应0.17(0.15~0.20)84.39-0.09(-0.12~-0.06)43.90
总效应0.21(0.19~0.23)100.00-0.21(-0.22~-0.19)100.00
), ArticleFig(id=1325530060542993340, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530054394143635, language=CN, label=表3, caption=

心理韧性在压力与中学生饮食行为间的中介作用(n=8 874)

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效应模型高能饮食行为均衡饮食行为
效应值(95%CI)效应占比/%效应值(95%CI)效应占比/%
中介效应0.03(0.02~0.05)15.61-0.12(-0.13~-0.10)56.10
直接效应0.17(0.15~0.20)84.39-0.09(-0.12~-0.06)43.90
总效应0.21(0.19~0.23)100.00-0.21(-0.22~-0.19)100.00
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压力和心理韧性与中学生饮食行为的关系
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俞晓艳 , 陆唯怡 , 杜兰朵朵 , 朱静芬 *
中国学校卫生 | 心理卫生 2025,46(8): 1138-1141
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中国学校卫生 |心理卫生 2025 , 46 (8) : 1138 -1141
压力和心理韧性与中学生饮食行为的关系
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俞晓艳, 陆唯怡, 杜兰朵朵, 朱静芬*
作者信息
  • 上海交通大学公共卫生学院, 上海 200025
通讯作者:
朱静芬，E-mail:
作者简介:

俞晓艳(1987-), 女, 上海市人, 在读硕士, 主要研究方向为慢性病预防与控制、青少年健康

Association of stress and psychological resilience with dietary behavior among middle school students
Xiaoyan YU, Weiyi LU, Landuoduo DU, Jingfen ZHU*
Affiliations
  • School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
出版时间: 2025-08-25 doi: 10.16835/j.cnki.1000-9817.2025232
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摘要
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目的

分析压力和心理韧性与中学生饮食行为的关系, 为制定改善中学生饮食行为的政策措施提供参考依据。

方法

2019年11月至2020年1月, 采用分层整群随机抽样方法抽取8 874名上海市中学生进行问卷调查, 调查内容包括一般情况、饮食行为、压力知觉量表(PSS-10)和康纳-戴维森弹性量表(CD-RISC-10)。利用因子分析法分析饮食行为模式, 采用Logistic回归模型探讨压力水平和心理韧性与中学生饮食行为的关系, 并建立结构方程模型分析心理韧性在压力水平和饮食行为中的中介作用。

结果

中学生心理韧性总分为(27.99±9.83)分, 压力总分为(25.56±7.06)分。通过因子分析法将饮食行为模式分为高能饮食行为和均衡饮食行为两组, 高能饮食行为在不同性别和学段中分布差异均有统计学意义(χ2值分别为41.37, 204.03), 均衡饮食行为在不同学段和社会阶层中分布差异均有统计学意义(χ2值分别为130.23, 96.53)(P值均 < 0.01)。Logistic回归模型分析结果显示, 中、高压力水平的中学生高能饮食行为风险增加(OR=1.25, 95%CI=1.12~1.39;OR=1.58, 95%CI=1.39~1.79), 均衡饮食行为减少(OR=0.73, 95%CI=0.65~0.81;OR=0.53, 95%CI=0.47~0.60);高水平心理韧性的中学生高能饮食行为的风险降低(OR=0.73, 95%CI=0.65~0.83), 中、高水平心理韧性的中学生均衡饮食行为增加(OR=1.45, 95%CI=1.29~1.62;OR=2.50, 95%CI=2.21~2.84)(P值均 < 0.01)。心理韧性在中学生压力与高能饮食行为和均衡饮食行为中的中介效应分别占总效应的15.61%和56.10%。

结论

压力及心理韧性是中学生的饮食行为的相关因素, 心理韧性在压力与高能饮食行为和均衡饮食行为中存在部分中介作用。

压力  /  精神卫生  /  饮食习惯  /  回归分析  /  青少年
Objective

To analyze the influence of stress and psychological resilience on the dietary behavior of middle school students so as to privide a basis for the development of policies and interventions aimed at improving middle school students dietary behavior.

Methods

A total of 8 874 middle school students in Shanghai were surveyed using stratified cluster random sampling method from November 2019 to January 2020. The questionnaire included general information, dietary behavior, Perceived Stress Scale (PSS-10) and Connor-Davidson Resilience Scale (CD-RISC-10). Factor analysis was used to analyze the dietary behavior model. Logistic regression model was used to explore the correlation between stress, psychological resilience and dietary behavior in adolescents. Besides, a structural equation model was established to analyze the mediating effect of psychological resilience on stress and dietary behavior.

Results

The total score of psychological resilience among middle school students was (27.99±9.83), and the total score of stress was (25.56±7.06). Factor analysis categorized dietary behavior into two types: the high-energy dietary behavior and balanced dietary behavior. High-energy dietary behavior exhibited statistically significant differences across genders and schooling stage (χ2=41.37, 204.03), while balanced dietary behavior showed statistically significant differences across schooling stage and socioeconomic status (χ2=130.23, 96.53) (all P < 0.01). Logistic regression analysis showed that adolescents with moderate and high stress levels had an increased risks of high-energy dietary behavior (OR=1.25, 95%CI=1.12-1.39; OR=1.58, 95%CI=1.39-1.79) and a reduced likelihood of reduced balanced dietary behavior (OR=0.73, 95%CI=0.65-0.81; OR=0.53, 95%CI=0.47-0.60); adolescents with high levels of psychological resilience had a decreased risk of high-energy dietary behavior (OR=0.73, 95%CI=0.65-0.83), and those with moderate and high resilience levels showed improved balanced dietary behavior (OR=1.45, 95%CI=1.29-1.62; OR=2.50, 95%CI=2.21-2.84) (all P < 0.01). The mediating effect of psychological resilience between stress and high-energy dietary behavior or balanced dietary behavior accounted for 15.61% and 56.10% of the total effects, respectively.

Conclusions

Stress and psychological resilience are the influencing factors of dietary behavior in middle school students. Psychological resilience have a partial mediating effect between stress and high-energy dietary behavior or balanced dietary behavior.

Pressure  /  Mental health  /  Food habits  /  Regression analysis  /  Adolescent
俞晓艳, 陆唯怡, 杜兰朵朵, 朱静芬. 压力和心理韧性与中学生饮食行为的关系. 中国学校卫生, 2025 , 46 (8) : 1138 -1141 . DOI: 10.16835/j.cnki.1000-9817.2025232
Xiaoyan YU, Weiyi LU, Landuoduo DU, Jingfen ZHU. Association of stress and psychological resilience with dietary behavior among middle school students[J]. Chinese Journal of School Health, 2025 , 46 (8) : 1138 -1141 . DOI: 10.16835/j.cnki.1000-9817.2025232
正文
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青少年时期的不健康饮食行为会对成年后的饮食行为产生长期负面的影响，增加肥胖、心血管疾病等慢性疾病的发生风险[1]。青少年的饮食行为受到个体、人际和环境等多种因素的综合影响[2]，其中心理因素正逐渐成为研究者关注的焦点。压力是对有害事件或刺激的感知、评价和应对过程，并影响个体的生理或情绪状态[3]。研究发现，当青少年面临较高压力水平时，他们更倾向于摄入不健康的食物，并减少对健康食物的选择[4]。心理韧性是指个体面对逆境、失败和压力等负性事件时所展现的身心适应特质或能力[5]，是心理健康的重要标志，同时也有助于促进青少年健康饮食行为的形成[6]。本研究通过探讨青少年压力和心理韧性对饮食行为的影响，为制定改善青少年饮食行为的政策措施提供理论依据。
1　对象与方法
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1.1　对象
采用分层随机整群抽样方法，于2019年11月至2020年1月在上海市从16个行政区中随机抽取4个区。在抽中区内，中学根据初中、高中分层，初中根据公办、民办分层，高中根据普通和重点分层，根据在校生比例抽取初中11所(民办3所、公办8所)，高中6所(普通4所、重点2所)。以被抽取学校所有在校学生为调查对象，共发放问卷9 037份，收回有效问卷8 874份，有效率为98.20%。其中男生4 488名，女生4 386名；初中生5 842名，高中生3 032名。平均年龄(13.66±1.89)岁。本次调查经上海交通大学公共卫生学院伦理委员会批准(批号：SJUPN201703)，并获得调查对象的知情同意。
1.2　方法
1.2.1　一般情况
调查内容包括性别、出生年月、学段等个人基本特征及父母职业和文化程度等家庭基本特征。青少年的社会阶层由其父母的文化程度和职业类型进行评估[7]，文化程度从小学及以下、初中、高中或中专、大专至大学及以上分别赋值1~5；职业类型根据职业声望从低到高分为6个等级，分别赋值1~6；父母职业及文化程度得分相加后除以2得到社会阶层得分，分数越高表示社会阶层越高，总分根据三分位数分为低、中、高3个水平。
1.2.2　饮食行为
参考美国疾病预防控制中心的青少年危险行为监测问卷(Youth Risk Behavior Surveillance Questionnaire, YRBSQ)[8]的饮食行为内容设计调查问卷，收集最近1周内含糖饮料、油炸食物、甜食、新鲜水果、蔬菜和早餐消费数据。并根据消费频次进行赋分，其中含糖饮料、油炸食物、甜食、新鲜水果和蔬菜的赋值为“每周0次=0，每周1~6次=1，每周7次及以上=2”，早餐赋值为“每周0次=0，每周1~6次=1，每周7次=2”。
1.2.3　压力
采用压力知觉量表(Perceived Stress Scale，PSS-10)[9]，共有10题，采用5点计分法(1~5分)，总分10~50分。分值越高代表知觉到的压力程度越强，得分根据三分位数分为低、中、高3个水平。本研究中该量表的Cronbach α系数为0.84。
1.2.4　心理韧性
采用康纳-戴维森弹性量表(Connor-Davidson Resilience Scale，CD-RISC-10)[10]，量表共10个项目，采用Likert 5级计分，即“从不这样”=0分至“总是这样”=4分，量表总分为各项目计分直接相加，总分为0~40分，分值越高代表心理韧性越强，得分根据三分位数分为低、中、高3个水平。本研究该量表的Cronbach α系数为0.96。
1.3　质量控制
所有调查人员均经过统一培训并具备流行病学调查经验。调查采用线上问卷(问卷星)进行，要求调查对象独立完成问卷。现场配备专员说明问卷填写注意事项和提供填写指导。调查结束后由2名专业人员负责数据整理，剔除无效样本和处理缺失值等，以确保数据的有效性。
1.4　统计学分析
采用SPSS 23.0统计软件进行数据分析，定量资料采用(x±s)描述，定性资料用频数(百分比)描述，组间比较采用χ2检验。采用因子分析法提取饮食行为模式，并根据因子得分按中位数法将饮食行为分成低分组(＜P50)和高分组(≥P50)。采用Spearman相关性分析探究压力、心理韧性和饮食行为的关系。采用Logistic回归分析压力及心理韧性对饮食行为的影响，并校正性别、学段、社会阶层等因素。应用Mplus 8.0软件构建模型，通过Bootstrap法进行中介效应检验。采用双侧检验，均以P＜0.05表示有统计学意义。
2　结果
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2.1　中学生饮食行为模式因子分析
通过因子分析检验得出KMO统计量为0.63，Bartlett's球形检验P＜0.01，因此本样本适合进行因子分析。因子载荷≥5时，认为其在该主成分上具有良好代表性。结果显示特征根>1的因子有2个，第1主因子的贡献率为28.89%，在“含糖饮料”“甜食”“油炸食物”指标上的因子载荷值分别为0.76，0.75，0.75，将其命名为“高能饮食行为”。第2主因子的贡献率为27.93%，在“水果”“蔬菜”“早餐”指标上的因子载荷值分别为0.76，0.79，0.66，命名为“均衡饮食行为”。
2.2　中学生不同饮食行为模式的分布特征
女生高能饮食行为高分组比例(57.36%)高于男生(50.56%)，初中生高能饮食行为高分组比例(48.48%)低于高中生(64.41%)(P值均＜0.01)。不同社会阶层中学生的高能饮食行为分布差异无统计学意义(P＞0.05)。低、中、高心理韧性水平的中学生高能饮食行为高分组占比分别为59.89%，57.14%和44.34%，低、中、高压力水平者高能饮食行为高分组占比分别为46.00%，53.58%和62.70%，差异均有统计学意义(P值均＜0.01)。
不同性别间中学生的均衡饮食行为分布差异无统计学意义(P＞0.05)。初中生的均衡饮食行为高分组占比为55.12%，高于高中生的42.35%；高社会阶层的青少年均衡饮食行为高分组占比为57.41%，中、低社会阶层分别为49.47%和44.66%，差异有统计学意义；中学生心理韧性水平从低到高水平的均衡饮食行为高分组占比依次是36.05%，50.86%和66.68%；低压力水平中学生均衡饮食行为的高分组占比为64.44%，中、高压力水平的分别为50.71%，36.25%，差异均有统计学意义(P值均＜0.01)。见表1。
2.3　压力及心理韧性与中学生饮食行为的相关性
中学生心理韧性总分为(27.99±9.83)分，压力总分为(25.56±7.06)分。Spearman相关性分析结果显示，压力与中学生均衡饮食行为呈负相关(r=-0.26)，与中学生高能饮食行为呈正相关(r=0.22)；心理韧性与中学生均衡饮食行为呈正相关(r=0.27)，与中学生高能饮食行为呈负相关(r=-0.19)(P值均＜0.01)。
2.4　压力及心理韧性与中学生饮食行为关联的Logistic回归分析
控制性别、学段和社会阶层后，分别以中学生高能饮食行为和均衡饮食行为作为因变量(低分组=0，高分组=1)，压力及心理韧性作为自变量进行Logistic回归分析。结果显示，与低压力水平相比，中、高水平压力的中学生发生高能饮食行为的风险增高(OR值分别为1.25，1.58)，而均衡饮食行为的发生减少(OR值分别为0.73，0.53)(P值均＜0.01)。与低水平心理韧性组相比，高水平心理韧性的中学生高能饮食行为发生风险降低(OR=0.73)；中、高水平心理韧性均可增加中学生均衡饮食行为的发生(OR值分别为1.45，2.50)(P值均＜0.01)。见表2。
2.5　心理韧性在压力与中学生饮食行为间的中介作用
以压力为自变量，分别以中学生高能饮食行为和均衡饮食行为为因变量，心理韧性为中介变量，性别、学段及社会阶层为控制变量，建立中介效应模型。结果显示，压力能够直接预测中学生高能饮食行为和均衡饮食行为(P值均＜0.01)，并且心理韧性在中学生的压力和高能饮食行为及均衡饮食行为之间存在中介作用，中介效应占比分别为15.61%和56.10%。见表3。
3　讨论
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本研究发现高中生相较于初中生更容易出现高能饮食行为，而均衡饮食行为情况略差，与北京市的研究结果一致[11]。由于高中生的学业压力较大，可能会通过摄入高能量的食物来宣泄情绪。青少年的饮食行为存在性别差异，本研究发现女生更易发生高能饮食行为，但与现有研究结果并不一致[12-13]。本研究中高社会阶层的中学生更倾向于保持均衡的饮食行为。中学生的社会阶层主要由父母的教育水平、职业和家庭经济情况等决定，受过良好教育的父母拥有较丰富的营养知识储备，可以做出更合理的食物选择，而家庭经济影响健康食品的消费能力[14-15]。
本研究发现压力会增加中学生的高能饮食行为风险并减少均衡饮食行为发生，与以往研究结果相似[16]。其原因可能是身体在压力下会激活下丘脑－垂体－肾上腺轴，导致皮质醇激素的分泌过多，促进食欲并增加甜食和高脂肪零食摄入[3]。此外，个体对压力的无助感和自我效能可能导致压力对其饮食行为产生不同的影响。研究发现，当中学生对应对压力表现出自信时，更倾向于摄入较多的水果和蔬菜，而当他们对管理压力感到无助时，则表现出更多情绪性进食行为，并频繁摄入高能量/低营养食物[17]。反之，饮食行为也会影响压力。研究表明，不吃早餐和过量摄入含糖饮料及快餐等会加剧压力及负性情绪的产生[18-19]，而摄入充足的水果和蔬菜对中学生的心理健康具有积极影响[20]。因此，应引导中学生有效管理压力，选择适当的应对策略，以稳定个体情绪并促进健康饮食行为，形成良性循环。
心理韧性对青少年的健康饮食行为具有积极影响[21]。本研究中，心理韧性能够促进中学生的均衡饮食行为，并且减少高能饮食行为。在大学生中也同样观察到相似结果[22]。其原因可能是心理韧性较高的个体会更积极地应对压力和调节情绪[23-24]，因此不太倾向于采用消极的应对策略来改善情绪和缓解压力[6]。此外，研究发现心理韧性高的中学生对其身体满意程度普遍较高[25]，由此也更有可能选择较为健康的饮食行为。
本研究发现压力不仅可直接影响中学生饮食行为，还可通过心理韧性间接影响。并且在本研究中，心理韧性在压力与中学生均衡饮食行为间的中介作用较大，提示心理韧性可能与均衡饮食行为的形成更为密切。有研究显示，心理韧性与健康饮食以及挑食行为密切相关[6]；而情绪性进食者通常会过量消费甜食、饮料和高能量食物[26]。因此，通过提升中学生的心理韧性水平，可降低压力对均衡饮食行为的负向影响，也一定程度缓解压力对于高能饮食行为的促进作用，有效改善中学生的饮食行为。
本研究还存在一定的局限性。首先，研究为横断面研究，无法确定压力和心理韧性对中学生饮食行为的因果关系及纵向中介关系，未来需要开展更多干预性或纵向研究以深入探讨。其次，研究对象的数据收集采用自我报告形式，结果可能存在回忆偏倚，未来的研究可考虑使用客观测量方法提高调查数据的可靠性。
基金
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  • 上海市公共卫生三年行动计划项目(GWV-10.1-XK15, GWVI-11.1-44)
文献
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2025年第46卷第8期
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doi: 10.16835/j.cnki.1000-9817.2025232
  • 接收时间：2025-01-03
  • 首发时间：2026-11-06
  • 出版时间：2025-08-25
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  • 收稿日期：2025-01-03
  • 修回日期：2025-02-28
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上海市公共卫生三年行动计划项目(GWV-10.1-XK15, GWVI-11.1-44)
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    上海交通大学公共卫生学院, 上海 200025

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朱静芬，E-mail:
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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