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童年创伤对青少年抑郁症患者抑郁症状的影响：心理弹性和睡眠质量的中介作用

余思烨,王高华,舒畅

* 通信作者：王高华 单位：武汉大学人民医院精神科；湖北省神经精神病研究所

摘要

目的：探讨童年创伤对青少年首发抑郁症患者抑郁症状的影响，并考察心理弹性和睡眠质量的中介作用，为抑郁症的早期干预提供参考。

方法：采用童年创伤问卷（CTQ）、匹兹堡睡眠质量指数量表（PSQI）、心理弹性量表（CD-RISC）和贝克抑郁量表第2版（BDI-II）对140名青少年首发抑郁症患者进行评估。

结果：青少年首发抑郁症患者CTQ评分与PSQI评分、BDI-II评分呈正相关（r=0.330、0.414，P均<0.01），与CD-RISC评分呈负相关（r= -0.307，P<0.01）；PSQI评分与BDI-II评分呈正相关（r=0.538，P<0.01），与CD-RISC评分呈负相关（r= 0.218，P<0.01）；CD-RISC评分与BDI-II评分呈负相关（r= -0.431，P<0.01）。心理弹性和睡眠质量在童年创伤与抑郁症状之间起部分中介作用。

结论：童年创伤对青少年首发抑郁症患者抑郁症状的影响受到心理弹性和睡眠质量的部分中介作用。

关键词：童年创伤；青少年抑郁症；心理弹性；睡眠质量

ABSTRACT

Objective: This study was aimed to investigate the mediating role of psychological resilience and sleep quality between childhood trauma and depressive symptoms in first-episode adolescent depression, providing guidance for the early preventions of depression.

Methods: A total of 140 adolescents with first-episode depression were assessed using the Childhood Trauma Questionnaire (CTQ), Pittsburgh Sleep Quality Index (PSQI), Connor-Davidson Resilience Scale (CD-RISC), and Beck Depression Inventory-II (BDI-II).

Results: In adolescents with first-episode depression, CTQ scores were positively correlated with PSQI scores and BDI-II scores (r=0.330, 0.414, P<0.01), and negatively correlated with CD-RISC scores (r=-0.307, P<0.01); PSQI scores were positively correlated with BDI-II scores (r=0.538, P<0.01), and negatively correlated with CD-RISC scores (r=-0.218, P<0.01); CD-RISC scores were negatively correlated with BDI-II scores (r=-0.431, P<0.01). Psychological resilience and sleep quality partially mediated the relationship between childhood trauma and depression.

Conclusion : The impact of childhood trauma on depressive symptoms in adolescent depression is partially mediated by psychological resilience and sleep quality.

Key words: Childhood trauma; Adolescent depression; Psychological resilience; Sleep quality

引用本文 / How to Cite This Article

余思烨,王高华,舒畅.童年创伤对青少年抑郁症患者抑郁症状的影响：心理弹性和睡眠质量的中介作用[J]. 国际精神病学杂志, 2026, 53(2): 481-484

参考文献

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[31] [2] Wickersham A, Sugg H V R, Epstein S, et al. Systematic review and meta-analysis: the association between child and adolescent depression and later educational attainment[J][J]. J Am Acad Child Adolesc Psychiatry, 2021, 60(1): 105-118.

[32] [3] Lippard E T C, Nemeroff C B. The devastating clinical consequences of child abuse and neglect: increased disease vulnerability and poor treatment response in mood disorders[J][J]. Am J Psychiatry, 2020, 177(1): 20-36.

[33] [4] Xie P, Wu K, Zheng Y, et al. Prevalence of childhood trauma and correlations between childhood trauma, suicidal ideation, and social support in patients with depression, bipolar disorder, and schizophrenia in southern China[J][J]. J Affect Disord, 2018, 228(): 41-48.

[34] [5] Zhang Y, Hu Y, Yang M. The relationship between family communication and family resilience in Chinese parents of depressed adolescents: a serial multiple mediation of social support and psychological resilience[J][J]. BMC Psychol, 2024, 12(1): 33-.

[35] [6] Poole J C, Dobson K S, Pusch D. Childhood adversity and adult depression: The protective role of psychological resilience[J][J]. Child Abuse Negl, 2017, 64(): 89-100.

[36] [7] Kajeepeta S, Gelaye B, Jackson C L, et al. Adverse childhood experiences are associated with adult sleep disorders: a systematic review[J][J]. Sleep Med, 2015, 16(3): 320-330.

[37] [8] Steiger A, Pawlowski M. Depression and sleep[J][J]. Int J Mol Sci, 2019, 20(3): 607-.

[38] [9] Bernstein D P, Stein J A, Newcomb M D, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire[J][J]. Child Abuse Negl, 2003, 27(2): 169-190.

[39] [10] 赵幸福, 张亚林, 李龙飞, 等. 中文版儿童期虐待问卷的信度和效度[J][J]. 中国临床康复, 2005, 9(20): 105-107.

[40] [11] Liu J, Wang Y, Wilson A, et al. Anticipating Unipolar Depression and Bipolar Depression in young adult with first episode of depression using childhood trauma and personality[J][J]. Front Public Health, 2023, 10(): 1061894-.

[41] [12] Buysse D J, Reynolds III C F, Monk T H, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research[J][J]. Psychiatry Res, 1989, 28(2): 193-213.

[42] [13] 刘贤臣, 唐茂芹, 胡蕾, 等. 匹兹堡睡眠质量指数的信度和效度研究[J][J]. 中华精神科杂志, 1996, 29(2): 103-107.

[43] [14] Tang J, Liao Y, Kelly B C, et al. Gender and regional differences in sleep quality and insomnia: a general population-based study in Hunan Province of China[J][J]. Sci Rep, 2017, 7(1): 43690-.

[44] [15] Connor K M, Davidson J R T. Development of a new resilience scale: The Connor‐Davidson resilience scale (CD‐RISC)[J][J]. Depress Anxiety, 2003, 18(2): 76-82.

[45] [16] Yu X, Zhang J. Factor analysis and psychometric evaluation of the Connor-Davidson Resilience Scale (CD-RISC) with Chinese people[J][J]. Soc Behav Personal, 2007, 35(1): 19-30.

[46] [18] 王振, 苑成梅, 黄佳, 等. 贝克抑郁量表第2版中文版在抑郁症患者中的信效度[J][J]. 中国心理卫生杂志, 2011, 25(06): 476-480.

[47] [19] Wu P C. Longitudinal measurement invariance of Beck Depression Inventory–II in early adolescents[J][J]. Assessment, 2017, 24(3): 337-345.

[48] [20] 罗学荣, 汤信海, 申艳梅. 青少年抑郁症的评估与管理[J][J]. 中国儿童保健杂志, 2024, 32(07): 700-703.

[49] [21] Ventimiglia I, Van der Watt A S J, Kidd M, et al. Association between trauma exposure and mood trajectories in patients with mood disorders[J][J]. J Affect Disord, 2020, 262(): 237-246.

[50] [22] Kim Y K, Ham B J, Han K M. Interactive effects of genetic polymorphisms and childhood adversity on brain morphologic changes in depression[J][J]. Prog Neuropsychopharmacol Biol Psychiatry, 2019, 91(): 4-13.

[51] [23] Silva R C, Maffioletti E, Gennarelli M, et al. Biological correlates of early life stressful events in major depressive disorder[J][J]. Psychoneuroendocrinology, 2021, 125(): 105103-.

[52] [24] Ding H, Han J, Zhang M, et al. Moderating and mediating effects of resilience between childhood trauma and depressive symptoms in Chinese children[J][J]. J Affect Disord, 2017, 211(): 130-135.

[53] [25] 从恩朝, 蔡亦蕴, 陈海莹, 等. 青少年抑郁情绪与心理弹性、家庭环境因素的关联[J][J]. 中国医药导报, 2019, 16(17): 31-34.

[54] [26] 黄乾坤, 舒燕萍, 岳雅. 人格特质、心理弹性、应对方式对舍曲林治疗女性青少年首发抑郁障碍效果的影响[J][J]. 四川精神卫生, 2024, 37(01): 33-38.

[55] [27] Urrila A S, Paunio T, Palomäki E, et al. Sleep in adolescent depression: physiological perspectives[J][J]. Acta Physiol (Oxf), 2015, 213(4): 758-777.

[56] [28] Vieira I S, Moreira F P, Mondin T C, et al. Resilience as a mediator factor in the relationship between childhood trauma and mood disorder: a community sample of young adults[J][J]. J Affect Disord, 2020, 274(): 48-53.

[57] [30] Luo B, Yang Y, Zhang D, et al. Sleep disorders mediate the link between childhood trauma and depression severity in children and adolescents with depression[J][J]. Front Psychiatry, 2022, 13(): 993284-.

[58] [31] Schonning V, Sivertsen B, Hysing M, et al. Childhood maltreatment and sleep in children and adolescents: A systematic review and meta-analysis[J][J]. Sleep Med Rev, 2022, 63(): 101617-.

[59] [32] Murphy F, Nasa A, Cullinane D, et al. Childhood trauma, the HPA axis and psychiatric illnesses: a targeted literature synthesis[J][J]. Frontiers in psychiatry, 2022, 13(): 748372-.

[60] [33] Dressle R J, Feige B, Spiegelhalder K, et al. HPA axis activity in patients with chronic insomnia: a systematic review and meta-analysis of case–control studies[J][J]. Sleep medicine reviews, 2022, 62(): 101588-.

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