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山东大学学报 (医学版) ›› 2026, Vol. 64 ›› Issue (3): 65-77.doi: 10.6040/j.issn.1671-7554.0.2024.1411

• “儿童青少年心理健康”重点专题 • 上一篇    

青少年情绪障碍患者及其照顾者病耻感与家庭复原力的关系:基于主客体互倚模型

沈君1,周爽2,杜苗1,蒋颖1   

  • 发布日期:2026-03-19
  • 通讯作者: 蒋颖. E-mail:jiangy@sumhs.edu.cn
  • 基金资助:
    上海交通大学医学院护理学科建设项目;上海高校教师产学研践习计划(A3-0200-24-311008-10)

Relationship between stigma and family resilience in adolescents with emotional disorders and their caregivers: an actor-partner interdependence model

SHEN Jun1, ZHOU Shuang2, DU Miao1, JIANG Ying1   

  1. 1. School of Nursing and Health Management, Shanghai University of Medicine &
    Health Sciences, Shanghai 201318, China;
    2. Second Nursing Department, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
  • Published:2026-03-19

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摘要： 目的 了解青少年情绪障碍患者及其照顾者病耻感与家庭复原力现状,探讨双方病耻感与家庭复原力的关系。 方法 采用便利抽样法,选择2023年12月至2024年7月在上海市某三级精神科专科医院儿童青少年精神科门诊进行复诊随访的281对青少年情绪障碍患者及其照顾者为研究对象。采用一般资料调查表、中文版家庭复原力评估量表、贬低-歧视感知量表进行调查,使用两独立样本t检验、单因素方差分析、配对样本t检验和Pearson相关分析进行统计学处理,采用Mplus 8.3构建主客体互倚模型,分析患者及其照顾者病耻感和家庭复原力相互影响的路径关系。 结果 青少年情绪障碍患者家庭复原力得分(86.98±18.05)显著低于其照顾者(95.31±9.71,P<0.001);患者贬低-歧视感知得分(29.04±6.87)与其照顾者得分(29.69±5.26)间的差异无统计学意义(P>0.05)。Pearson相关分析显示,患者家庭复原力得分与照顾者家庭复原力得分呈正相关(r=0.192,P<0.01),与自身及照顾者贬低-歧视感知得分呈负相关(r=-0.442、-0.240,P均<0.01)。照顾者家庭复原力得分与自身及患者贬低-歧视感知得分呈负相关(r=-0.314、-0.204,P均<0.01)。患者贬低-歧视感知得分与照顾者得分呈正相关(r=0.238,P<0.01)。主客体互倚模型显示:主体效应方面,患者和照顾者的贬低-歧视感知得分均显著负向预测其自身的家庭复原力得分(β=-0.328、-0.273,P均<0.001);客体效应方面,患者的贬低-歧视感知得分显著负向预测照顾者的家庭复原力得分(β=-0.138,P<0.05),同时照顾者的贬低-歧视感知得分也显著负向预测患者的家庭复原力得分(β=-0.143,P<0.01)。通过平等约束检验,发现病耻感对家庭复原力的影响的主客体效应相似。 结论 青少年情绪障碍患者及其照顾者的病耻感程度不仅对各自的家庭复原力水平有显著影响,同时也存在交互影响。临床干预应采用家庭为中心的整体干预策略,同时关注患者和照顾者的需求,减轻双方的疾病病耻感,以提升家庭整体复原力。

关键词: 情绪障碍, 青少年, 照顾者, 父母, 病耻感, 家庭复原力, 主客体互倚模型

Abstract: Objective To understand the current status of stigma and family resilience in adolescents with emotional disorders and their caregivers, and to explore the relationship between stigma and family resilience in both groups. Methods A total of 281 pairs of adolescents with emotional disorders and their caregivers were recruited using conve-nience sampling during follow-up visits to the Child and Adolescent Psychiatry Outpatient Department of a tertiary specialty psychiatric hospital in Shanghai between December 2023 and July 2024. Data were collected using a general information questionnaire, the Chinese version of the Family Resilience Assessment Scale(FRAS-C), and the Perceived Devaluation-Discrimination Scale(PDD). Independent two-sample t-test, one-way analysis of variance(ANOVA), paired samples t-test, and Pearson correlation analysis were employed for statistical analysis. The actor-partner interdependence model(APIM)was constructed using Mplus 8.3 to analyze the pathways of influence between stigma and family resilience among patients and their caregivers. Results Family resilience scores were significantly lower for adolescents with emotional disorders(86.98±18.05)than for their caregivers(95.31±9.71)(t=-7.442, P<0.001). However, no significant difference was found between patients(29.04±6.87)and caregivers(29.69±5.26)PDD scores(t=-1.423, P>0.05). Pearson correlation analysis revealed that patients family resilience scores were positively correlated with caregivers family resilience scores(r=0.192, P<0.01)and negatively correlated with patients and caregivers PDD scores(r=-0.442 and r=-0.240, both P<0.01). Caregivers family resilience scores were negatively correlated with their own and the patients PDD scores(r=-0.314 and r=-0.204, both P<0.01). Patients PDD scores were positively correlated with caregivers PDD scores(r=0.238, P<0.01). The actor-partner interdependence model revealed that for the actor effects, both the patients and the caregivers perceived devaluation-discrimination significantly negatively predicted their own family resilience scores(β=-0.328 and β=-0.273, both P<0.001). For partner effects, patients perceived devaluation-discrimination significantly negatively predicted their caregivers family resilience scores(β=-0.138, P<0.05), and caregivers perceived devaluation-discrimination significantly negatively predicted patients family resilience scores(β=-0.143, P<0.01). Equality constraint tests revealed that the actor and partner effects of stigma on family resilience were similar for patients and caregivers. Conclusion The levels of stigma experienced by adolescents with emotional disorders and their caregivers significantly affect family resilience and interact with each other. To improve overall family resilience, clinical interventions should take a family-centered, comprehensive approach that addresses the needs of patients and caregivers alike and reduces stigma for both.

Key words: Emotional disorders, Adolescents, Caregivers, Parents, Stigma, Family resilience, Actor-partner interdependence model

中图分类号: 

  • R749.94
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