童年创伤影响青少年抑郁患者自杀意念的路径:归因风格与心理弹性的链式中介作用OA
The pathways of childhood trauma affecting suicidal ideation in adolescent patients with depression:the chain mediating role of attributional style and psychological resilience
目的 探讨童年创伤对青少年抑郁患者自杀意念的影响,并分析心理弹性与归因风格的链式中介作用.方法 选取2023年12月至2025年7月于广元市精神卫生中心就诊的青少年抑郁患者为抑郁障碍组,同期招募健康青少年为对照组.比较2组基线资料和儿童期虐待问卷(CTQ)、自杀意念量表(PANSI)、青少年心理弹性量表(CD-RISC)及归因风格问卷(ASQ)得分;采用Pearson相关分析探讨CTQ得分、CD-RISC得分、ASQ得分、PANSI得分之间的相关性;采用Process宏程序构建模型,验证心理弹性与归因风格的链式中介路径在童年创伤影响自杀意念中的作用.结果 共纳入250例研究对象,其中抑郁障碍组143例,对照组107例.抑郁障碍组CTQ、PANSI、消极归因得分均高于对照组(P<0.05).CTQ得分与PANSI得分(r=0.523)、ASQ消极归因得分(r=0.457)呈正相关,与ASQ积极归因得分(r=-0.421)、CD-RISC得分(r=-0.404)呈负相关(P<0.05).链式中介模型分析显示,童年创伤对自杀意念的总效应值为0.523(P<0.001).心理弹性与归因风格在其中发挥显著的部分中介作用,总间接效应值为0.340,占总效应的65.01%.其中,CTQ→CD-RISC→ASQ消极归因→PANSI的链式中介路径显著(效应值为0.027,占总效应的5.16%).结论 童年创伤影响青少年抑郁患者自杀意念,而心理弹性和归因风格发挥链式中介作用.临床应增强患者心理弹性机能,改善消极悲观的归因风格,可缓解童年创伤造成的抑郁压力,降低自杀意念及行为的发生风险.
Objective To investigate the impact of childhood trauma on suicidal ideation in adolescent patients with depression,and analyze the chain mediating roles of psychological resilience and attributional style.Methods Adolescent patients with depression who visited Guangyuan Mental Health Center from December 2023 to July 2025 were enrolled as the depressive disorder group,and healthy adolescents were recruited during the same period as the control group.Baseline data and scores from the Childhood Trauma Questionnaire(CTQ),Positive and Negative Suicide Ideation Inventory(PANSI),Connor-Davidson Resilience Scale(CD-RISC),and Attributional Style Questionnaire(ASQ)were compared.Pearson correlation analysis was used to explore the correlations among CTQ score,CD-RISC score,ASQ score,and PANSI score.Process macro was used to construct a model,verifying the mediating role of the chain pathway between psychological resilience and attributional style in the influence of childhood trauma on suicidal ideation.Results A total of 250 subjects were included,consisting of 143 in the depressive disorder group and 107 in the control group.The CTQ,PANSI,and negative attribution scores in the depressive disorder group were significantly higher than those in the control group(P<0.05).The CTQ score was positively correlated with PANSI score(r=0.523)and ASQ negative attribution score(r=0.457),and negatively correlated with ASQ positive attribution score(r=-0.421)and CD-RISC score(r=-0.404)(P<0.05).Chain mediation model analysis revealed that the total effect of childhood trauma on suicidal ideation was 0.523(P<0.001).Psychological resilience and attributional style exerted significant partial mediating effects,with a total indirect effect of 0.340,accounting for 65.01%of the total effect.Among these,the chain-mediated pathway from CTQ to CD-RISC to ASQ negative attribution and ultimately to PANSI was statistically significant(effect size=0.027,accounting for 5.16%of the total effect).Conclusion Childhood trauma influences suicidal ideation in adolescents with depression,with psychological resilience and attributional style playing a chain-like mediating role.Clinically,enhancing patients'psychological resilience and improving negative and pessimistic attributional styles can alleviate the depressive stress caused by childhood trauma,thereby reducing risk of suicidal ideation and behaviour.
敖江莎;吴博;雷驰;何佩;李相利
广元市精神卫生中心心理咨询与治疗中心(四川 广元 628000)广元市精神卫生中心精神科(四川 广元 628000)广元市精神卫生中心儿少精神科(四川 广元 628000)广元市精神卫生中心儿少精神科(四川 广元 628000)咸阳市中心医院精神科(陕西 咸阳 712000)
医药卫生
童年创伤抑郁自杀意念心理弹性归因风格链式中介青少年
Childhood traumaDepressionSuicidal ideationPsychological resilienceAttributional styleChain mediationAdolescent
《医学新知》 2026 (7)
734-742,中插3,10
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