累积生态风险与抑郁的关系:有调节的中介模型
文献类型：学位论文
| 作者 | 王德文 |
| 答辩日期 | 2022-12 |
| 文献子类 | 硕士 |
| 授予单位 | 中国科学院大学 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 刘正奎 |
| 关键词 | 累积生态风险 抑郁 心理韧性 |
| 学位名称 | 理学硕士 |
| 学位专业 | 临床心理 |
| 其他题名 | The Association between Cumulative Ecological Risks and Depression Disorder: Mediated Mediation Models |
| 中文摘要 | It consists of natural and social environments in the earth, which are closely related to human beings and filling with many known and unknown ecological risks. Any kind of ecological risks, such as natural environment with high altitude, low temperature and lack of oxygen, or social environment with low economic levels, and insufficient medicine or care, will affect both people's physical and mental health. The ecological risks will have a cumulative effect across time in a synergistic, superimposed manner. Since the inception of the human society, the depression disorder has been with the mankind. According to the prediction by WHO, the depression disorder will become the most disease burden in the world by 2030. Most previous studies on cumulative ecological risks have been limited to the risk factors of family, school, and community. Few has been conducted on the influence of cumulative ecological risks on depression disorder, especially under the ubiquitous highly risk environment. With the changing of the earth's ecological status and the increasing extreme weather phenomena, human will face severe challenges to survival. Therefore, it is imperative to strengthen the study on the relationship between cumulative ecological risks under the highly ecological risk environment and depression disorder. This study explores the correlation between cumulative ecological risks and depression disorder through epidemiological method as well as health risk assessment methods in Study 1 by using the following data: (1) CFPS database of 2016-2017; (2) 2016 Survey database of Living Status of Chinese Adults in Yushu, Qinghai Province; (3) China Statistical Yearbook of Health and Family Planning (2017); (4) Statistical Yearbook of China (2017); (5) ChinaAtlas (2016). Results showed that: (1)The higher the altitude, the higher risk of moderate/severe depression disorder among the 26 provinces/municipalities/autonomous regions. The risk of moderate/severe depression disorder in Yushu, Qinghai, with the average altitude of 4,200 meters above sea level, is 4.51 times higher than that in the regions with low or no altitude risk. (2) The risk of low regional economic development is also positively correlated with the depression score of its residents; (3) The risk of moderate/severe depression disorder is significantly higher in the regions where medical or health care resources are severely under-allocated; (4) By the assessment of cumulative ecological risks among 26 provinces/municipalities/autonomous in China, Qinghai Yushu Prefecture has the highest score, which means one with high risks in elevation, low level of regional economic development and inadequate allocation of medical or health care resources. In Study 2, the database of the 2016 Qinghai Yushu Chinese Adult Living Conditions Survey was used, through the regression models by Hayes' SPSS macro program PROCESS, to examine the mediating role of resilience between individual meso-micro cumulative risks and depression disorder, and the moderating effects of gender, marriage, and educational status on the mediation effect. The results showed that: (1) Individuals with high ecological risks have a predictive effect on depression disorder, and the higher the cumulative risk, the higher the risk in depression disorder; (2) Resilience partially mediates the correlation between cumulative risks and depression disorder, and the higher the cumulative risks, the lower the resilience, which increases the risk in depression disorder; (3) Compared with men, women are more likely to be less resilient and thus at greater risk in depression disorder than men because of higher individual cumulative risks; (4) The results of the study showed that if increasing one unit in cumulative risks, the decrease in resilience would be greater for those who had not attended school than for those who had attended school, suggesting that education may be conducive to the development of resilience; if increasing one unit in resilience, the depression score would be lower for those who had not attended school compared to those who had attended school, suggesting that the protective effect of resilience on depression disorder was more significant for those who had not attended school. At the same time, those who had attended school were more likely to experience a greater risk of depression disorder due to greater cumulative risks than those who had not attended school, suggesting that attending school also increases cumulative risks for individual; (5) Compared to those not in marriage, respondents in marriage were more likely to gain greater cumulative risks, less resilient, and thus at greater risk of experiencing depression disorder. The conclusions of this study are: the risk of moderate/severe depression disorder is higher in the regions with higher ecological risks such as altitude, low regional economic development, and inadequate allocation of health resources; in the regions with high ecological risks, the greater the individual's meso-micro cumulative risks, the weaker the resilience and the higher the risk in depression disorder. Women are more likely than men to have weaker resilience and higher risk in depression disorder due to their higher cumulative risk. Education is both beneficial to the cultivation of resilience and increases cumulative ecological risks, so education shows a "double-edged sword" moderating effect in the results. It hints that the way and content of education system should be well adjusted. Compared with those who are not married, those who are married are more likely to have greater cumulative risks and thus lower resilience, and thus more likely to experience the higher risk in depression disorder, suggesting that the further study should be focus on the effect of marital quality on depression disorder. |
| 英文摘要 | 环境生态由与人类密切相关的各种自然环境与人文社会环境组成。在环境生态中存在着许多已知与未知风险，如高海拔低温缺氧的自然环境，经济发展水平低下、医疗卫生资源配置不足等人文社会环境，均影响着人类的身心健康。随着时间的推移，环境生态风险会产生累积效应，以协同、叠加的方式对个体身心健康产生不良的影响。自人类社会诞生以来，抑郁一直伴随着人类社会的发展，根据WHO的预测，2030年抑郁症将成为世界疾病负担的首位。以往有关累积生态风险与抑郁的研究，大多仅局限于家庭、学校、社区等范围内的风险因素探讨，学术界针对环境生态高风险下个体累积生态风险与抑郁及其发生机制等问题的研究鲜见。随着地球生态环境的变化，极端天气现象频发，人类社会将面临着越来越严峻的生存环境挑战，因此，加强环境生态高风险下累积生态风险与抑郁的研究势在必行。 本文在研究一中利用2016-2017年CFPS和青海玉树中国成年人生活状况调查的数据库，以及《中国卫生和计划生育统计年鉴(2017)》、《中国统计年鉴 (2017)》和《中国地图集(2016)》等资料，通过流行病学关联测量方法以及健康风险评估方法，探讨环境生态累积风险与抑郁的关系。研究结果:(1)在我国26个省/市/自治区中，海拔风险越高的省/市/自治区，其居民的中/重度抑郁风险越大，平均海拔4200米以上的青海玉树地区，其居民催患中/重度抑郁的风险比平均海拔2000米以下的低风险或无风险的省/市/自治区明显提高;(2)经济发展低水平的省/市/自治区，其居民遭遇抑郁的风险比经济发展高水平地区更高;(3)医疗卫生资源配置严重不足的省/市/自治区，其居民遭遇中/重度抑郁风险显著高于医疗卫生资源配置充足地区;(4)在我国26个省/市/自治区的环境生态累积风险评估中，青海玉树州得分最高，分析结果发现青海玉树州属于典型的高海拔风险、地区经济发展低水平风险及医疗卫生资源配置不足的环境生态高风险地区。 本文在研究二中利用2016年青海玉树中国成年人生活调查的数据库，通过Haye的SPSS宏程序PROCESS建立回归模型，考察在环境生态高风险下，心理韧性在个体累积风险因素与抑郁之间的中介作用，以及性别、婚姻、受教育情况对心理韧性的调节效应。研究结果:C1)在环境高生态风险下个体累积风险对抑郁具有预测作用，累积风险越大个体遭遇抑郁的风险越高;C2)中介效应模型结果显示，个体累积风险对抑郁的直接效应和心理韧性的中介效应分别占总效应的66.67%和33.33%，这说明在个体中微观风险对抑郁的影响机制中，心理韧性起到了部分中介作用，可以降低个体催患抑郁的风险的1/3; (3)相对于男性而言，女性更容易因为个体累积风险加大而使心理韧性更弱，从而增加遭受抑郁的风险;(4)研究结果显示个体累积风险每升高一个单位，没有上过学的调查对象心理韧性下降幅度比上过学的更大，提示受教育可能有利于个体心理韧性的培育;另外，心理韧性每增加一个单位，没有上过学的调查对象的抑郁得分相较于有上过学者而言更低，说明心理韧性对抑郁的保护性作用在没有上过学的调查对象更加显著;相对于没有上过学的调查对象，有上过学的调查对象更容易因个体累积风险的提高而增加遭遇抑郁的风险，提示受教育也会使个体累积风险的增加;(5)研究结果显示相对于非在婚者而言，在婚的调查对象更容易使个体累积风险增大，从而心理韧性减弱，进而增加遭遇抑郁风险。 综上，本研究认为海拔高度、地区经济发展低水平以及医疗卫生资源配置不足等环境生态风险较大的省/市/自治区，其居民遭受中/重度抑郁的风险就越大;在环境高生态风险地区，个体累积风险越大，其心理韧性就越弱，遭受抑郁的风险就越高;女性比男性更容易因为个体累积风险加大而使心理韧性更弱，从而遭受抑郁的风险更大;受教育情况既有利于心理韧性的培育，又会增加个体累积生态风险，故受教育情况在心理韧性中介模型的结果中显示出“双刃剑”的调节效应，提示要加强教育体制的改革;相对于非在婚者而言，在婚的调查对象更容易因为个体累积风险更大，从而降低心理韧性，进而更容易遭遇抑郁的风险，提示要更加关注婚姻质量对个体抑郁的影响。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/45065]  |
| 专题 | 心理研究所_应用研究版块 |
| 推荐引用方式 GB/T 7714 | 王德文. 累积生态风险与抑郁的关系:有调节的中介模型[D]. 中国科学院心理研究所. 中国科学院大学. 2022. |
入库方式： OAI收割
来源：心理研究所
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