应激与心理健康曲线关系的三水平元分析
The Curvilinear Relationship Between Stress and Mental Health: A Three-Level Meta-Analysis
陈一笛 1马金金 2甘怡群2
作者信息
- 1. 北京林业大学人文社会科学学院心理学系
- 2. 北京大学心理与认知科学学院; 北京市行为与心理健康重点实验室; 生物与机器智能教育部重点实验室
- 折叠
摘要
应激无处不在，影响着每一个人。剂量-反应理论认为应激会损坏心理健康，二者为线性关系，应激接种理论认为应激和心理健康是倒U型曲线关系。面对线性假说和曲线假说尚未达成一致的局面，本研究采用三水平曲线元分析 (PROSPERO平台预注册) 系统回顾了涉及应激二次项与心理健康效应值的研究，对涉及31422名参与者的23个研究中的59个一次项效应值和59个二次项效应值进行综合分析，对线性假设与曲线假设开展了竞争性的验证。结果表明应激一次项与心理健康之间存在中等程度的相关系数 (r = -0.173)，应激二次项与心理健康之间存在较小的偏相关系数 (sr = -0.053)，考虑到统计的限定性，为曲线假说提供了初步证据。此外，元回归发现人群特征和心理健康类型可以显著调节应激与心理健康之间的线性关系。在健康人群中，应激一次项负向预测心理健康，在创伤群体中，该效应值不显著。而当心理健康结果为负向时，应激一次项稳定的负向预测心理健康，当心理健康结果为正向时，该效应值不显著；人口学变量和应激特征的调节作用不显著。应激二次项和心理健康存在微小负相关，元回归提示调节效应均不显著。研究证明应激一次项与心理健康的关系仍然占据主导地位，应激与心理健康之间存在小效应的二次曲线关系，且存在较大的异质性，提示未来应该关注应激和心理健康的非线性模式及其作用条件，应该关注适度压力下个体潜能发挥和成长的可能性。同时，应激和心理健康的线性关系受到人群特征的影响，提示我们在未来的研究中，应更加关注研究对象与结果变量选择，需要结合特定人群特征和心理健康指标，才能更准确地理解应激对心理健康的作用机制与边界条件。
Abstract
Stress is a pervasive experience that affects individuals across multiple domains of daily life. A survey in the Lancet estimated that more than 500 million individuals worldwide experience stress-related mental health problems annually. Consequently, public concern has grown substantially, making the identification strategies to enhance mental health and resilience in the context of stress an urgent priority. Doseresponse theory posits a linear relationship where stress negatively impacts mental healtha perspective widely held by both the public and academia. However, over the past 15 years, research in positive psychology has suggested that moderate stress may foster resilience and adaptive psychological outcomes. According to stress inoculation theory, stress and mental health follow an inverted U-shaped trajectory. Thus, no consensus exists between the linear and curvilinear models.A systematic search was conducted across Web of Science, ProQuest, EBSCO, and PubMed, as well as the Chinese databases CNKI and WanFang Data to identify empirically studies reporting quadratic effects of stress on mental health. Data were analyzed in R using the metafor package. A three-level meta-analysis synthesized linear (r) and semi-partial (sr) effect sizes and tested for moderators. Publication bias was assessed using funnel plots, EggerMLMA regression, and the trim-and-fill method. A total of 23 studies (yielding 59 linear and 59 quadratic effect sizes) comprising 31,422 participants were included to compare the two hypotheses.Results indicated a moderate negative correlation for linear stress terms and a small negative partial correlation for quadratic terms. Overall, the linear association between stress and mental health remains dominant. However, given statistical power constraints, these findings offer some support for the curvilinear hypothesis, suggesting a potential curvilinear relationship between stress and mental health. Meta-regression analyses further revealed that stress measurement methods significantly moderated the curvilinear association, while population characteristics and types of mental health outcomes moderated the linear relationship. Specifically, stress was negatively associated with mental health in healthy populations, but this effect was non-significant in trauma-exposed groups. When outcomes reflected negative mental health, stress consistently predicted poorer outcomes, but showed no significant linear effect on positive mental health outcomes. By contrast, no statistically significant moderation was detected in association between the quadratic component of stress and mental health. Nevertheless, substantial heterogeneity was observed, indicating that future research should pay greater attention to nonlinear patterns linking stress and mental health and the conditions under which such patterns emerge. In particular, more attention should be given to the potential for individuals to fulfill their potential and experience positive growth under moderate levels of stress.These findings indicate a small but significant negative curvilinear relationship between stress and mental health, suggesting that moderate levels of stress may promote more favorable psychological outcomes. The variability of the linear relationship across populations underscores the importance of considering sample characteristics and outcome measures in future research. A more precise understanding of these mechanisms and boundary conditions is critical to clarifying the complex role of stress on mental health.关键词
应激/心理健康/曲线关系/三水平元分析Key words
stress/mental health/curvilinear relationship/three-level meta-analysis引用本文复制引用
陈一笛,马金金,甘怡群.应激与心理健康曲线关系的三水平元分析[EB/OL].(2026-04-20)[2026-04-22].https://chinaxiv.org/abs/202604.00230.学科分类
医学研究方法/医学现状、医学发展
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