| 王丽华,章莹,刘鑫惠,等.基于结构方程模型的青少年故意服药行为的心理社会危险因素及风险路径分析[J].安徽医药,2026,30(10):2012-2019. |
| 基于结构方程模型的青少年故意服药行为的心理社会危险因素及风险路径分析 |
| Psychosocial risk factors and risk pathway analysis of adolescents' intentional drug taking behavior based on structural equation model |
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| DOI：10.3969/j.issn.1009-6469.2026.10.020 |
| 中文关键词: 自我伤害 自我用药 自杀 抑郁 焦虑 结构方程 青少年 故意服药 危险因素 风险路径 |
| 英文关键词: Self-harm Self medication Suicide Depression Anxiety Structural equation Teenagers Deliberately tak-ing medicine Risk factor Risk pathways |
| 基金项目:保定市科技计划自筹经费项目( 2541ZF131) |
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| 摘要点击次数: 92 |
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| 中文摘要: |
| 目的基于结构方程模型探究青少年故意服药行为的心理社会危险因素，明确各因素对故意服药行为的影响路径，为青少年自杀预防及干预提供科学依据。方法横断面研究。选取 2022年 5月至 2025年 3月首都医科大学附属北京儿童医院保定医院就诊或体检的 228例青少年为研究对象，依据是否存在故意服药行为分为病例组( 106例，有故意服药行为)和对照组(122例，无故意服药行为)。采用一般情况及病史问卷收集研究对象人口学特征与既往病史，使用贝克自杀意念量表( BSI-CV)、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评估心理与情绪状态；运用巴瑞特冲动性量表( BIS)、父母教养方式评价量表( EMBU)、社会支持评定量表( SSRS)、青少年生活事件量表( ASLEC)评估其冲动水平、家庭教养、社会支持及生活应激情况。通过 logistic回归分析筛选青少年故意服药行为的心理社会危险因素，采用 SPSS 26.0、AMOS 24.0软件构建结构方程模型( SEM)解析各因素对故意服药行为的影响路径。结果两组病人一般资料在校园霸凌、父母婚姻状况、成长环境、既往病史比较差异有统计学意义(均 P<0.05)单因素分析显示，病例组在 BSI-CV自杀意念和自杀风险评分、 HAMD评分、 HAMA评分、 BIS评分、 ASLEC评分上均显著高于对照，组，社会支持评分( 28.95±4.42)分显著低于对照组( 39.21±5.36)分(均 P<0.05)； EMBU结果显示，病例组父母情感温暖得分( 45.72±7.01)分低于对照组( 53.28±7.54)分( P<0.05)父母严厉惩罚得分( 29.35± 5.62)分高于对照组( 22.67±4.31)分( P<0.05)。 logistic回归分析表明，自杀意念强度( OR=2.72，P=0.00，1)、抑郁情绪( OR=4.99，P =0.005)、焦虑情绪( OR=3.90，P=0.006)自杀风险(OR=1.58，P=0.002)冲动性人格(OR=1.31，P=0.008)、负性事件(OR=1.32，P= 0.037)是故意服药行为的主要心理社会危、险因素。结构方程模型拟合度、良好，路径分析显示，青少年故意服药行为受多因素直接、间接影响(均 P<0.05)，自杀意念强度正向影响冲动性人格及故意服药行为(直接效应 0.36)；抑郁 /焦虑情绪正向作用于冲动性人格、自杀风险及故意服药行为；负性生活事件正向影响自杀风险(间接效应 0.06)及故意服药行为；自杀风险、冲动性人格均直接正向影响故意服药行为。结论青少年故意服药行为受自杀意念、抑郁 /焦虑等多因素驱动，预防干预需筛查自杀 |
| 英文摘要: |
| Objective To explore the psychosocial risk factors for intentional drug taking behavior in adolescents based on structuralequation model, and to clarify the influence pathways of each factor, so as to provide a scientific basis for adolescent suicide preventionand intervention.Methods Cross-sectional study. From May 2022 to March 2025, 228 adolescents were enrolled for medical treat-ment or physical examination in Baoding Hospital of Beijing Children's Hospital Affiliated to Capital Medical University. They were di-vided into a case group (106 cases with intentional medication behavior) and a control group (122 cases without intentional medicationbehavior) based on the presence or absence of such behavior. The demographic characteristics and medical history of the subjects werecollected by general information and medical history questionnaire, and the psychological and emotional state was evaluated by theBeck scale for suicide ideation-Chinese version (BSI-CV), Hamilton depression rating scale (HAMD) and Hamilton anxiety rating scale(HAMA). Barratt impulsiveness scale (BIS), egna minnen av barndoms uppfostran (EMBU), social support rating scale (SSRS) and ado-lescent self-rating life events checklist (ASLEC) were used to evaluate their impulsivity, parenting styles, social support and life stress.The psychosocial risk factors for adolescents' intentional drug taking behavior were identified by logistic regression, and structuralequation modeling (SEM) was constructed using SPSS 26.0 and AMOS 24.0 to analyze the influence pathways of each factor on inten-tional drug taking behavior.Results There were statistically significant differences between the two groups in general data regardingcampus bullying, parental marital status, living environment, and medical history (all P<0.05). Univariate analysis showed that the case group had significantly higher scores than the control group in BSI-CV (suicidal ideation and suicide risk subscales), HAMD, HAMA,BIS, and ASLEC, while the social support score was significantly lower in the case group than in the control group [(28.95±4.42) points vs. (39.21±5.36) points, all P<0.05]. The EMBU results showed that the case group had lower scores of parental emotional warmth [(45.72±7.01) points vs. (53.28±7.54) points, P<0.05] and higher scores of parental harsh punishment [(29.35±5.62) points vs. (22.67± 4.31) points, P<0.05] compared with the control group. Logistic regression analysis identified the intensity of suicidal ideation (OR= 2.72, P=0.001), depression (OR=4.99, P=0.005), anxiety (OR=3.90, P=0.006), suicide risk (OR=1.58,P=0.002), Impulsive personality (OR=1.31, P=0.008) and negative life events (OR=1.32, P=0.037) as the main psychosocial risk factors for intentional drug taking. Thestructural equation model demonstrated good fit. Path analysis revealed that adolescents' intentional drug taking behavior was directlyand indirectly influenced by many factors (all P<0.05), and the intensity of suicidal ideation positively affected impulsive personalityand intentional drug taking behavior (direct effect: 0.36). Depression/anxiety had positive effects on impulsive personality, suicide riskand intentional drug taking behavior; Negative life events positively affected suicide risk (indirect effect: 0.06) and intentional drug tak-ing behavior; Suicide risk and impulsive personality had direct and positive effects on intentional drug use.Conclusions Adolescents' intentional drug taking behavior is driven by many factors, such as suicidal ideation, and depression/anxiety. Preventive interventionshould focus on screening for suicidal ideation and emotional disorders, reducing negative life events, optimizing social support, improv-ing impulse control and cutting off risk transmission. |
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