2010~2020中国内地初中生心理健康问题检出率的元分析

doi:10.3724/SP.J.1042.2022.00965

摘要/Abstract

摘要：

初中生心理健康问题的检出率在诸多研究中存在很大分歧, 未能为心理健康政策制定和服务体系建设提供充分依据。为明确心理健康问题的整体检出率并澄清其影响因素, 对2010~2020年检索到的文献进行了元分析。结果发现, 初中生面临不同程度的心理健康问题, 其中焦虑、抑郁和自我伤害检出率排在前三位; 初中生心理健康问题随年代发展呈恶化趋势, 其中焦虑和自杀企图尤为明显; 初中生心理健康问题检出率饱受测量工具、检出标准和检出时间不统一的影响; 初中生心理健康问题检出率整体上随年级而增加, 其中焦虑尤为明显; 女生的心理健康问题检出率高于男生, 自杀尤为明显; 中西部地区的初中生比东北和东部地区更容易出现心理健康问题, 尤其是焦虑和自我伤害。未来应立足中国大地研制科学的测量工具和筛查标准并建立心理健康动态监测体系和学校心理健康服务体系。

关键词: 心理健康, 检出率, 初中生, 元分析

Abstract:

Junior high school students are in a stage of rapid development in physiology and psychology, and they are prone to some mental health problems when facing stressful events in life. In addition, with the advent of the digital age, contemporary junior high school students have become digital natives, and their mental health is facing greater challenges. Therefore, the mental health care of junior high school students is a realistic problem that can not be ignored. The prevalence of mental health problems of junior high school students is an important topic in many fields, but the results of the research on this problem are not consistent, and the detection rate varies greatly across studies, which brings confusion to mental health workers. It is necessary to integrate the original research and draw more general and accurate conclusions from the macro perspective, so as to provide high-quality evidence support for precise intervention of mental health. Therefore, based on literature review, the present study focuses on the prevalence of internalizing problems including anxiety, depression, sleep problems, suicidal ideation, and suicide plans, as well as the prevalence of externalizing problems including self-harm and suicide attempt among junior high school students.
By searching the Chinese National Knowledge Infrastructure database and Web of Science core collection database from 2010 to 2020, we obtained the final effective literatures including 50 articles about anxiety, 95 articles about depression, 21 articles about sleep problems, 26 articles about self-injury, and 30 articles about suicide. We used the software Comprehensive Meta-Analysis Version 3.3 and the random effect model for data analysis. The results showed that the prevalence of anxiety, depression, sleep problems, self-injury, and suicidal ideation were 26.9%, 23.9%, 16.7%, 22.4%, and 17.1%, respectively. The prevalence of suicide plans and suicide attempts were 6.6% and 3.9% separately. In addition, the moderating effect analysis found that in terms of anxiety, the moderating effects of publication year, measurement tools, detection time, grade, and economic region were significant, but the moderating effects of gender, only child or not and birthplace were not significant. In terms of depression, the moderating effects of measurement tools and detection time were significant, but the moderating effects of publication year, grade, gender, only child or not, birthplace, and economic region were not significant. In terms of sleep problems, the moderating effects of publication year, grade, gender and economic region were not significant. In terms of self-injury, the moderating effects of economic region were significant, but the moderating effects of publication year, measurement tools, grade, gender, only child or not, and birthplace were not significant. As to suicidal ideation, the moderating effects of measurement tools and gender were significant, but the moderating effects of publication year, grade and economic region were not significant. In terms of suicide plans, the moderating effect of grade was significant, but the moderating effects of grade, gender and economic region were not significant. Finally, in terms of suicide attempts, the moderating effect of publication year is significant, but the moderating effects of grade, gender and economic region were not significant.
In conclusion, junior high school students faced different levels of mental health problems, among which the prevalence of anxiety, depression, and self-injury rank in the top three. The prevalence of mental health problems of junior high school students showed a deteriorating trend with the development of the years, especially anxiety and suicide attempt. The prevalence of mental health problems of junior high school students is affected by the inconsistency of measurement tools, detection standards and detection time. In addition, the prevalence of mental health problems increased with grade, especially that of anxiety; The prevalence of mental health problems in girls is higher than that in boys, especially that of suicide. Students in the central and western regions in China are more likely to have mental health problems, especially anxiety and self-injury. In the future, we should develop scientific measurement tools and screening standards based on Chinese culture, and establish a dynamic monitoring system of mental health and a school mental health service system.

Key words: mental health, prevalence, junior high school student, meta-analysis

张亚利, 靳娟娟, 俞国良. (2022). 2010~2020中国内地初中生心理健康问题检出率的元分析. 心理科学进展 , 30(5), 965-977.

ZHANG Yali, JIN Juanjuan, YU Guoliang. (2022). Prevalence of mental health problems among junior high school students in Chinese mainland from 2010 to 2020: A meta-analysis. Advances in Psychological Science, 30(5), 965-977.

图/表 7

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心理健康问题种类	k	被试数	效应值及95%的置信区间			异质性检验
心理健康问题种类	k	被试数	检出率	下限	上限	I²	p
焦虑	50	83879	0.27	0.24	0.31	99.18	<0.001
抑郁	95	196096	0.24	0.22	0.26	99.31	<0.001
睡眠问题	21	61190	0.17	0.15	0.19	97.85	<0.001
自我伤害	24	98408	0.22	0.17	0.29	99.73	<0.001
自杀意念	26	128622	0.17	0.15	0.19	98.96	<0.001
自杀计划	8	29534	0.07	0.05	0.09	97.99	<0.001
自杀企图(未遂)	16	114040	0.04	0.04	0.05	94.10	<0.001

心理健康问题种类	k	被试数	效应值及95%的置信区间			异质性检验
心理健康问题种类	k	被试数	检出率	下限	上限	I²	p
焦虑	50	83879	0.27	0.24	0.31	99.18	<0.001
抑郁	95	196096	0.24	0.22	0.26	99.31	<0.001
睡眠问题	21	61190	0.17	0.15	0.19	97.85	<0.001
自我伤害	24	98408	0.22	0.17	0.29	99.73	<0.001
自杀意念	26	128622	0.17	0.15	0.19	98.96	<0.001
自杀计划	8	29534	0.07	0.05	0.09	97.99	<0.001
自杀企图(未遂)	16	114040	0.04	0.04	0.05	94.10	<0.001

调节变量	异质性检验			类别	k	检出率	95% CI
调节变量	Q_B	df	p	类别	k	检出率	下限	上限
测量工具 + 检出标准	30.48	3	<0.001	CSSAS2	3	0.35	0.25	0.47
				MSSMHS2	11	0.44	0.38	0.51
				SAS50	15	0.25	0.21	0.29
				SCARED23	10	0.26	0.22	0.32
检出时间	25.89	2	<0.001	1周	25	0.24	0.20	0.27
				3个月	10	0.26	0.21	0.32
				近来	12	0.41	0.35	0.48
年级	6.98	2	0.03	初一	13	0.25	0.19	0.32
				初二	13	0.28	0.21	0.35
				初三	11	0.39	0.30	0.48
性别	1.93	1	0.17	男生	18	0.24	0.20	0.28
性别	1.93	1	0.17	女生	18	0.28	0.24	0.33
独生与否	0.01	1	0.94	独生	7	0.23	0.19	0.29
独生与否	0.01	1	0.94	非独生	7	0.24	0.19	0.29
生源地	0.05	1	0.83	城镇	4	0.29	0.19	0.41
生源地	0.05	1	0.83	农村	4	0.31	0.21	0.43
经济区域	23.82	3	<0.001	东北	3	0.11	0.06	0.18
				东部	17	0.24	0.20	0.28
				中部	12	0.26	0.21	0.32
				西部	17	0.35	0.29	0.41

调节变量	异质性检验			类别	k	检出率	95% CI
调节变量	Q_B	df	p	类别	k	检出率	下限	上限
测量工具 + 检出标准	30.48	3	<0.001	CSSAS2	3	0.35	0.25	0.47
				MSSMHS2	11	0.44	0.38	0.51
				SAS50	15	0.25	0.21	0.29
				SCARED23	10	0.26	0.22	0.32
检出时间	25.89	2	<0.001	1周	25	0.24	0.20	0.27
				3个月	10	0.26	0.21	0.32
				近来	12	0.41	0.35	0.48
年级	6.98	2	0.03	初一	13	0.25	0.19	0.32
				初二	13	0.28	0.21	0.35
				初三	11	0.39	0.30	0.48
性别	1.93	1	0.17	男生	18	0.24	0.20	0.28
性别	1.93	1	0.17	女生	18	0.28	0.24	0.33
独生与否	0.01	1	0.94	独生	7	0.23	0.19	0.29
独生与否	0.01	1	0.94	非独生	7	0.24	0.19	0.29
生源地	0.05	1	0.83	城镇	4	0.29	0.19	0.41
生源地	0.05	1	0.83	农村	4	0.31	0.21	0.43
经济区域	23.82	3	<0.001	东北	3	0.11	0.06	0.18
				东部	17	0.24	0.20	0.28
				中部	12	0.26	0.21	0.32
				西部	17	0.35	0.29	0.41

调节变量	异质性检验			类别	k	检出率	95% CI
调节变量	Q_B	df	p	类别	k	检出率	下限	上限
测量工具 + 检出标准	36.79	8	<0.001	CDI19	12	0.23	0.18	0.29
				CESD16	7	0.30	0.22	0.38
				CESD20	11	0.23	0.18	0.29
				DSRSC15	9	0.22	0.17	0.28
				MSSMHS2	9	0.38	0.30	0.46
				SCL2	3	0.13	0.07	0.21
				SDS50	11	0.37	0.30	0.45
				SDS53	6	0.33	0.24	0.43
				CSSDS2	3	0.19	0.11	0.30
检出时间	9.15	2	0.01	1周	67	0.25	0.22	0.28
				2周	16	0.19	0.15	0.25
				近来	8	0.36	0.26	0.46
年级	3.91	2	0.14	初一	33	0.25	0.21	0.29
				初二	32	0.28	0.24	0.33
				初三	29	0.31	0.26	0.36
性别	1.13	1	0.29	男生	29	0.25	0.21	0.29
性别	1.13	1	0.29	女生	28	0.28	0.24	0.32
独生与否	0.61	1	0.44	独生	13	0.26	0.20	0.32
独生与否	0.61	1	0.44	非独生	13	0.29	0.23	0.37
生源地	1.35	1	0.25	城镇	12	0.27	0.22	0.34
生源地	1.35	1	0.25	农村	12	0.33	0.26	0.39
经济区域	2.01	3	0.57	东北	5	0.26	0.17	0.39
				东部	37	0.23	0.20	0.27
				中部	23	0.22	0.18	0.27
				西部	23	0.27	0.22	0.32