The mediating effect of school life maladjustment on the relationship between autistic traits and depression in vocational college students
CHENG Shaogui and GAO Peng contributed equally to this article
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摘要:
目的 探究自闭特质对抑郁的影响，了解学校生活适应不良在关系链中的作用，为抑郁症状的干预提供线索。 方法 以六安市、安庆市2所高职院校全体在校1、2年级学生为研究对象，调查人口统计学特征、自闭特质水平、学校生活适应不良及抑郁状况。采用多因素logistic回归分析模型分析自闭特质对学校生活适应不良和抑郁发生的影响，运用Bootstrap中介检验分析学校生活适应不良在其中发挥的作用及大小。 结果 纳入了3 316名研究对象，无抑郁1 667人，占50.3%。轻度抑郁1 071人，中度抑郁542人，重度抑郁36人，分别占32.3%、16.3%、1.1%。多因素logistic回归分析模型分析显示：参考低自闭水平，高自闭特质为学校适应不良和抑郁发生的危险因素(OR=1.810, 95% CI: 1.260~2.601, P=0.001；OR=4.940, 95% CI: 3.429~7.119, P < 0.001)。中介效应分析显示：学校生活适应不良在自闭特质与抑郁关系链中起部分中介作用，间接效应占44.07%。 结论 自闭特质水平不仅可以直接影响抑郁，也可以通过学生学校生活适应不良去间接影响抑郁。积极的学校适应可以缓解高自闭特质对于抑郁发生的不良影响，为降低高职学生抑郁不良心理，应着重关注学生们的学校适应情况。 Abstract:Objective To investigate the impact of autistic traits on depression and to understand the role of maladaptation to school life in the relationship chain, providing clues for the intervention of depression symptoms. Methods The study included all first and second grade students from two vocational colleges in Lu′an and Anqing cities. Demographic characteristics, levels of autistic traits, maladaptation to school life, and depression status were investigated. A multiple logistic regression model was used to analyze the effect of autistic traits on maladaptation to school life and depression. The mediating effect of maladaptation on school life was studied using Bootstrap. Results A total of 3 316 subjects were included, among whom 1 667 (50.3%) had no depression, 1 071 (32.3%) had mild depression, 542 (16.3%) had moderate depression, and 36 (1.1%) had severe depression. The multiple logistic regression models showed that high levels of autistic traits were risk factors for maladaptation to school life and depression (OR=1.810, 95% CI: 1.260-2.601, P=0.001; OR=4.940, 95% CI: 3.429-7.119, P < 0.001). The mediating effect analysis showed that maladaptation to school life partially mediated the relationship chain between autistic traits and depression, with an indirect effect accounting for 44.07% of the total effect. Conclusions The level of autistic traits can not only directly affect depression but also indirectly affect it through maladaptation to school life. Positive adaptation to school life can alleviate the adverse effects of high autistic traits on depression. Therefore, to reduce the incidence of depression among vocational college students, attention should be paid to their adaptation to school life. -
图 1 自闭特质、学校生活适应不良与抑郁关系路径图
1.a为自变量自闭特质预测中介变量学校生活适应不良的β值。2.b为中介变量预测因变量抑郁的β值。3.c为总效应的β值。4.c′为自变量预测因变量的直接效应β值。
1表示P < 0.001。Figure 1. Pathway map of autistic traits, school life maladjustment, and depression
1.a is the β value of school life maladjustment. 2.b is the β value of depression. 3.c is the β value of the total effect. 4.c ′is the β value of the direct effect of the independent variable.
1 indicates that P < 0.001.表 1 不同人口统计学特征下自闭特质水平的分布情况
Table 1. The distribution of autism trait levels with different demographic characteristics
特征Characteristic 合计Total (n=3 316) 自闭特质水平[人数(占比/%)] Autistic trait level [Number of people (proportion/%)] Z/χ2值value P值value 低自闭组Low autism group (n=365) 普通组General group (n=2 585) 高自闭组High autism group (n=366) 性别Gender 2.088 0.352 男Male 845(25.5) 86(10.2) 656(77.6) 103(12.2) 女Female 2 471(74.5) 279(11.0) 1 929(78.1) 263(10.6) 居住地Residence 17.415 < 0.001 农村Country 1 852(55.9) 179(97) 1 443(77.9) 230(12.4) 乡镇Township 806(24.3) 98(12.2) 620(79.9) 88(10.9) 城市City 658(19.8) 88(13.4) 522(79.3) 48(7.3) 父亲文化程度Paternal education 10.693 0.005 小学或以下Primary school or below 978(29.5) 91(9.3) 760(77.7) 127(13.0) 初高中Junior and senior high school 2 066(62.3) 238(11.5) 1 610(77.9) 218(10.6) 专科或以上College degree or above 272(8.2) 36(13.2) 215(79.0) 21(7.7) 父亲职业Paternal occupation 0.605 0.739 农林牧渔劳动者Peasant 235(7.1) 23(9.8) 185(78.7) 27(11.5) 工人Worker 1 895(57.1) 23(10.7) 1 476(77.9) 216(11.4) 私营业主Private owner 520(15.7) 75(14.4) 402(77.3) 43(8.3) 待岗下业Waiting for the job 118(3.6) 5(4.2) 95(80.5) 18(15.3) 其他Other 548(16.5) 59(10.8) 427(77.9) 62(11.3) 母亲文化程度Maternal education 6.403 0.041 小学或以下Primary school or below 1 583(47.1) 172(10.9) 1 216(76.8) 195(12.3) 初高中Junior and senior high school 1 563(47.1) 168(10.7) 1 243(79.5) 152(9.7) 专科或以上College degree or above 170(5.1) 25(14.7) 1 243(79.5) 152(9.7) 母亲职业Maternal occupation 3.205 0.201 农林牧渔劳动者Peasant 202(6.1) 26(12.9) 156(77.2) 20(9.9) 工人Worker 1 432(43.2) 163(11.4) 1 107(77.3) 162(11.3) 私营业主Private owner 420(12.7) 57(13.6) 328(78.1) 35(8.3) 待岗下业Waiting for the job 845(25.5) 80(9.5) 668(79.1) 97(11.5) 其他Other 417(12.6) 39(11.0) 2 585(78.0) 336(11.0) 亲兄弟姐妹数/个Number of siblings/each 0.537 0.765 0 353(10.6) 40(11.3) 276(78.2) 37(10.5) 1 1 989(60.0) 225(11.3) 1 541(77.5) 223(11.2) 2 678(20.4) 67(9.9) 534(78.8) 77(11.4) ≥3 296(8.9) 33(11.1) 234(79.1) 29(9.8) 早产Premature birth 8.406 0.078 是Yes 186(5.6) 22(11.8) 144(77.4) 20(10.8) 否No 2 623(79.1) 303(11.6) 2 042(77.8) 278(10.6) 不清楚Unclear 507(15.3) 40(7.9) 399(78.7) 68(13.4) 单亲家庭Single parent or not 6.635 0.036 是Yes 148(4.5) 21(14.2) 103(69.6) 24(16.2) 否No 3 168(95.5) 344(10.9) 2 482(78.3) 342(10.8) 留守经历Stay experience 5.193 0.075 无留守经历No stay experience 1 523(45.9) 175(11.5) 1 207(79.3) 141(9.3) 单亲留守Single parent left behind 575(17.3) 56(9.7) 437(76.0) 82(14.3) 双亲留守Parents stay behind 1 218(36.7) 134(11.0) 941(77.3) 143(11.7) 自评成绩状况Self-evaluation of performance status 5.970 0.051 优秀Outstanding 118(3.6) 15(12.7) 92(78.0) 11(9.3) 良好Good 968(29.2) 115(11.9) 795(78.4) 94(9.7) 一般Normal 2 066(62.3) 224(10.8) 1 604(77.6) 238(11.5) 较差Worse 164(4.9) 11(6.7) 130(79.3) 23(14.0) 自评家庭经济状况Self-assessment of family finances 38.615 < 0.001 很差Very bad 74(2.2) 3(4.1) 53(71.6) 18(24.3) 较差Worse 558(16.8) 50(9.0) 410(73.5) 98(17.6) 中等Intermediate 2 495(75.2) 284(11.4) 1 980(79.4) 231(9.3) 较好Preferably 173(5.2) 24(13.9) 132(76.3) 17(9.8) 很好Fine 16(0.5) 4(25.0) 10(62.5) 2(12.5) 每周大强度运动次数Number of vigorous exercise per week 2.139 0.343 < 1 534(161) 73(13.7) 407(76.2) 54(10.1) 1~ < 3 1 766(53.3) 187(10.6 1 376(77.9) 203(11.5) 3~ < 5 674(20.3) 64(9.5) 537(79.7) 73(10.8) ≥5 342(10.3) 41(12.0) 265(77.5) 36(10.5) 亲密伙伴数/个Number of close partners/number 62.087 < 0.001 0 73(2.2) 1(1.4) 52(71.2) 20(27.4) 1~ < 3 1 272(38.4) 96(7.5) 996(78.3) 180(14.2) 3~ < 6 1 517(45.7) 199(13.1) 1 189(78.4) 129(8.5) ≥6 454(13.7) 69(15.2) 348(76.7) 37(8.1) 近1年内自伤行为Self-harm within the last year 15.106 0.001 无No 3 130(94.4) 351(11.2) 2 449(78.2) 330(10.5) 有Yes 186(5.6) 14(7.5) 136(73.1) 36(19.4) 学校生活适应不良Maladjustment in school life 86.121 < 0.001 否No 1 448(43.7) 214(14.8) 1 143(78.9) 91(6.3) 是Yes 1 868(56.3) 151(8.1) 1 442(77.2) 275(14.7) 抑郁Depressed 157.833 < 0.001 否No 1 667(50.3) 273(16.4) 1 290(77.4) 104(6.2) 是Yes 1 649(49.7) 92(5.6) 1 295(78.5) 262(15.9) 
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表 2 4种抑郁症状在不同自闭特质水平的检出情况
Table 2. Detection of 4 kinds of depressive symptoms at different autistic trait levels
自闭特质Autistic trait 抑郁症状[人数(占比/%)] Depressive symptoms [Number of people (proportion/%)] Z/χ2值value P值value 无抑郁Normal (n=1 667) 轻度抑郁Mild depression (n=1 071) 中度抑郁Moderate depression (n=542) 重度抑郁Major depression (n=36) 低自闭Low autism 273(74.8) 62(17.0) 27(7.4) 3(0.8) 160.415 < 0.001 普通组Normal 1 290(49.9) 852(33.0) 416(16.1) 27(1.0) 高自闭High autism 104(28.4) 157(42.9) 99(27.0) 6(1.6)
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表 3 不同特质水平与抑郁症状及学校适应不良的关联
Table 3. Association of different trait levels with depressive symptoms and school maladjustment
自闭特质水平Autistic trait level 模型1 Model 1 模型2 Model 2 模型3 Model 3 模型4 Model 4 OR值value (95% CI) P值value OR值value (95% CI) P值value OR值value (95% CI) P值value OR值value (95% CI) P值value 低自闭Low autism 1.000 1.000 1.000 1.000 普通组Normal 2.979(2.323~3.819) < 0.001 2.654(2.016~3.494) < 0.001 1.788(1.432~2.233) < 0.001 1.137(0.881~1.467) 0.324 高自闭High autism 7.476(5.386~10.375) < 0.001 4.94(3.429~7.119) < 0.001 4.283(3.124~5.872) < 0.001 1.81(1.260~2.601) 0.001
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表 4 学校生活适应不良中介作用模型的回归分析(标准化)
Table 4. Regression analysis of the mediating role model of school life maladjustment (standardized)
预测变量Predictor 模型1 Model 1 模型2 Model 2 模型3 Model 3 β值value t值value β值value t值value β值value t值value 自闭特质Autistic trait 0.336 20.554 ① 0.265 15.810 ① 0.188 13.526 ① 学校生活适应不良Maladjustment in school life 0.559 40.193 ① r2 0.113 0.070 0.404 F值value 422.447 ① 249.947 ① 1 121.864 ① 注：1.模型1为自闭特质预测抑郁。2.模型2为自闭特质预测学校生活适应不良。3.模型3为自闭特质和学校生活适应不良共同预测抑郁。
①P < 0.001。
Note: 1.Model 1, autistic traits predicted depression. 2.In model 2, autistic traits predict school life maladjustment.3.In Model 3, autistic traits and maladjustment to school life co-predicted depression.
①P < 0.001.
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