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流动儿童歧视知觉与心理健康关系的元分析

中文摘要英文摘要

本研究基于心理健康双因素模型,通过运用元分析技术探讨流动儿童歧视知觉与各项心理健康指标的关系,以及调节变量对二者关系的影响,以期为提升流动儿童心理健康提供有效借鉴。经过文献检索和筛选,共纳入原始文献3篇,含49个独立样本,被试总数达到40351名。根据同质性检验结果,选择随机效应模型分析发现,流动儿童歧视知觉与积极心理健康指标存在中等程度的负相关(r=-0.323,95%CI为[-0.378,-0.266]),与消极心理健康指标存在中等程度的正相关(r = 0.41, 95%CI为[0.36,0.458])。流动儿童歧视知觉测量工具、学龄段对流动儿童歧视知觉与积极心理健康的关系存在显著的调节效应,而对流动儿童歧视知觉与消极心理健康的关系不存在显著的调节效应。同时,元回归分析结果发现,性别对二者的关系不存在显著的调节效应。后续研究应该进一步探索流动儿童歧视知觉与心理健康间的调节变量,结合中国流动儿童心理发展特点, 探索提升流动儿童心理健康水平的新路径。

Previous studies have found temporal differences in posttraumatic stress disorder (PTSD) development. Clinical workers and researchers have also demonstrated that symptoms of PTSD differ by stage after traumatic events. Recently, the symptom network perspective has contributed substantially to the development of psychopathology due to its important advantage in understanding the role of psychological symptoms in mental disorders. An increasing number of analyses adopting the network approach to study PTSD symptoms have also provided novel insights into PTSD symptomatology. However, changes in children's long-term PTSD symptomatology are poorly understood. The current study aims to identify changes in the network of PTSD symptoms among children through the network approach.A four-year longitudinal study was conducted from 4 months after the Wenchuan earthquake. Four assessments were conducted at four (T1;September 2008), 29 (T2; October 2010), 40 (T3; September 2011) and 52 (T4; September 2012) months following the earthquake. Ultimately, 197 children completed assessments at each time point. The children were in grades four and six at T1 and attended two primary schools located in Beichuan County. Symptoms of PTSD were assessed by the University of California at Los Angeles PTSD Reaction Index based on the DSM-IV. Network analysis was implemented with the qgraph package in R following the standard guidelines by Epskamp and Fried.Flashbacks exhibited relatively high centrality at all time points, while other symptoms with high centrality varied across time points. Emotional cue reactivity exhibited high centrality at 4 months, and its centrality decreased over time. Foreshortened future exhibited high centrality at 4, 29 and 40 months, but its centrality decreased to a low level at 52 months. Intrusive thoughts exhibited low centrality at 4 months, but the centrality of this symptom increased to a high level at 29 months. Physiological cue reactivity exhibited low centrality at 4 months, and its centrality increased over time. These findings indicated the distinct temporal variability in the centrality of some PTSD symptoms. The global connectivity of the network increased from 4 to 40 months and then decreased at 52 months.The current study enhanced the knowledge of child PTSD symptomatology. Flashbacks might play a key role in the evolution of PTSD symptoms. In addition, different core symptoms might contribute to early and chronic PTSD structures. Emotional cue reactivity and foreshortened future might play key roles in early PTSD structures and then recover in later stages following disasters. Physiological cue reactivity and intrusive thoughts might be core symptoms in chronic PTSD structures. The phenomenon of the increased connectivity of the PTSD symptom network at 40 months may be one reason why previous trauma leads to vulnerability to PTSD. Overall, our study highlighted temporal differences in PTSD symptoms. Different core symptoms in early and chronic PTSD structures should be treated as targets at different stages following disasters in clinical practice.

温恒福、李欣、张淳淦、韩毅初、程淑华

10.3724/SP.J.1041.2020.01313

医学研究方法神经病学、精神病学教育

创伤后应激障碍网络分析纵向研究发展差异症状学

温恒福,李欣,张淳淦,韩毅初,程淑华.流动儿童歧视知觉与心理健康关系的元分析[EB/OL].(2023-03-27)[2025-08-22].https://chinaxiv.org/abs/202303.08674.点此复制

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