Objective To explore the effects of childhood trauma, alexithymia and bullying victimization on internalizing problems among higher vocational nursing students and the underlying mechanism. Methods From Mav to June in 2021 , an online questionnaire survey was conducted on 1 455 female students from the nursing department of a vocational college in Beijing ,using scales including Delaware bullying victimization scale-student ( DBVS-S ) , childhood trauma questionnaires-shoe form ( CTQ-SF )，20-item toronto alexithymia scale ( TAS-20 ) , center for epidemiologic studies depression scale ( CES-D ) and generalized anxiety disorder scale-7 ( GAD-7)，to analyze the mediating roles of alexithymia and bullying victimization that played in the relationship between childhood traumatic experience and internalization problems. Results The scores of childhood trauma among, 1 455 nursing, students in higher vocational college in Beijing, was (20.4016.87)points, the score of alexithymia was (28.2719.83)points the score of bullying, victimization was(18.4015.44)points, and the score of internalization problems of depression and anxiety was (5.15士5.53)and (2.90士4.15)points respectively. The detection rate of depression tendency was 14.26%, and the detection rate of high risk of depression was 5.15%. The detection rates of mild, moderate and severe anxiety were 20.62% 3.78% and 2.75%, respectively. Three dimensions of childhood trauma , two dimensions of alexithymia and four dimensions of bullying, victim were positively correlated with the two indicators of internalization problems (r=0.044-0.821,a11 P<0.05). The childhood trauma experience not only had the direct effect on the internalization problems of nursing students in higher vocational colleges , but also exerted the indirect effect through three paths , inducing the mediating roles that alexithymia and bullying victimization played , respectively，and the chain mediating, effects that was formed by alexithymia and bullying, victimization. The total mediating, effect was 0.276,95% CI was 0.238-0.315. Conclusion The childhood trauma experience is one of important predictors for internalization problems in nursing students , and alexithymia and bullying victims exert the multiple mediating effects in the relationship between childhood trauma experience and internalization problems.

目的 了解高级职业(高职)院校护生童年创伤经历、述情障碍、欺凌受害对其内化问题的影响及作用机制.方法 2021年5-6月,以北京市某职业学院护理系1 455名女生为调查对象,通过网络平台进行问卷调查,采用特拉华欺负受害量表(学生卷)(delaware bullying victimization scale-student,DBVS-S)、童年期创伤量表(childhood trauma questionnaires-short form,CTQ-SF)、多伦多述情障碍量表(20-item toronto alexithymia scale,TAS-20)、流调中心抑郁量表(center for epidemiologic studies depression scale,CES-D)简版、广泛性焦虑量表(generalized anxiety disorder scale-7,GAD-7)考察述情障碍、欺凌受害在护生童年创伤经历与其内化问题间的中介作用.结果 北京某高职院校1 455名护生童年创伤得分为(20.40±6.87)分,述情障碍得分为(28.27±9.83)分,欺凌受害得分为(18.40±5.44)分,内化问题抑郁和焦虑指标得分为(5.15±5.53)和(2.90±4.15)分.抑郁倾向检出率为15.26％,抑郁高风险检出率为5.15％;轻、中、重度焦虑水平的检出率分别为20.62％、3.78％、2.75％.童年创伤3个维度、述情障碍2个维度、欺凌受害4个维度与内化问题的2个指标呈两两正相关(r=0.044～0.821,均P＜0.05).童年期创伤对高职护生内化问题不仅存在直接效应,还可通过3条间接路径间接产生影响,分别是述情障碍、欺凌受害各自的中介作用,以及述情障碍和欺凌受害形成的链式中介作用.总的中介效应为0.276,95％CI为0.238～0.315.结论 童年创伤经历是预测护生内化问题的重要因素,述情障碍和欺凌受害在其中存在多重中介效应.