探討不同風險程度的國中生之憂鬱情緒的保護與資源因子

Examining protective and resources factors for depression among junior high school students experiencing different levels of family risk

陳杏容(Hsing-Jung Chen)

《中華輔導與諮商學報》 50期 (2017/12) Pp. 29-61

https://doi.org/10.3966/172851862017120050002

摘要

嚴重的憂鬱會提高少年的自殺率，而主要照顧者有酒癮或酒癮與精神疾病共病之少年有更高的風險罹患憂鬱情緒，故本研究探索在不同風險程度下，哪些正向因素可預測國中生之憂鬱情緒，以作為處遇規劃之參考。立基於復原力的觀點，可同時預測高低風險少年之憂鬱者稱之資源因子，只能預測高風險少年之憂鬱者稱之保護因子。透過多元迴歸分析台灣教育長期追蹤之國一與國二資料（15999人），本研究發現多數的變項僅能預測低風險少年的憂鬱情緒。正向個人特質、家庭溝通支持、獎勵式教養、學校依附、參與運動社團皆能預測低風險少年的憂鬱情緒，其中以家庭溝通與支持、學校依附的預測力最高。而家庭溝通與支持、正向個人特質分別能預測酒癮家庭少年與共病家庭少年之憂鬱情緒。根據研究結果，建議以校園作為第一級憂鬱預防的場域，創造一個吸引少年的校園氛圍、提供壓力因應訓練、並鼓勵規律運動。此外，提升家庭溝通與支持或個人壓力因應能力對身處在高風險或一般家庭的少年都有幫助。

關鍵字

家庭溝通與支持 ； 酒癮與精神疾病共病 ； 運動 ； 學校依附 ； 藝術

並列摘要

Severe depression will decrease young people's social functioning and increase their suicidal behaviors. This is especially true for those who have a parent with an alcohol problem or comorbidity of alcohol and psychiatric problems. Interventions incorporating a risk-reducing approach may not effectively help children of a parent with an alcohol problem or comorbidity of alcohol and psychiatric problems because risks related to alcohol problems such as genetics, mental illness, and chronic life stress are not easy to manage, minimize, or eliminate. Therefore, the knowledge of positive factors of influence is crucial for the advanced development of intervention programs. Unfortunately, although a great number of studies have identified risks related to alcohol problems, only a few studies have focused on positive factors. Few studies clarify which factors have a positive influence across different family risk levels. It is unclear whether the positive factors derived from the research on youths in low-risk families can be effective on youths who have a parent with an alcohol problem or comorbidity of alcohol and psychiatric problems. Based on the resilience perspective, the aim of this research is to investigate what kinds of positive factors can predict depression among junior high school students who come from families with different risk levels. The resource factors are defined as factors that can predict depression for youths experiencing high- and low-risk levels, whereas protective factors are defined as factors that can predict depression for youths experiencing high-risk levels (i.e. having a parent with an alcohol problem or comorbidity of alcohol and psychiatric problems). The junior high school students' data derived from the Taiwan Education Panel Survey (n=15,999) and the Stata 13.0 statistical software were used for this study. Descriptive statistics for sample characteristics, correlations for variable relationships, cronbach's alpha for internal reliability, power analysis for detecting effect sizes as well as intra-class correlation analysis for examining the issues of the nested effect were performed before multiple regression analyses. Seven main predictors, along with three control variables (i.e. the first wave of depression, gender, and family financial status), were included in regression models that presented the low-risk family, the family of a parent with an alcohol problem, and the family with comorbidity of alcohol and psychiatric problems. The research has four major findings. (1) Most predictors predict the depression for youths from low-risk families only. (2) Positive individual characteristics, family communication with support, positive reinforcement parenting, school attachment, and sports engagement were negatively associated with depression among low-risk youths. Among those factors, school attachment (B = -.04, p ＜.001) and family communication with support (B = -.04, p ＜.001) have the strongest influence on depression. (3) Family supportive communication (B = -.05, p ＜.05) is the only predictor that significantly predicts depression among youths from families with an alcohol problem. (4) The positive individual characteristic (B = -.23, p ＜.05) is the only one that significantly predicts depression among youths from families with comorbid alcohol and psychiatric problems. According to the research findings, the implications emphasize the primary prevention of depression through school where Taiwanese youths spend most of their time besides family time. It is important to create a welcoming school environment for every adolescent regardless of their grades and family backgrounds, to provide students with stress-coping training courses, and to encourage students to exercise regularly. Moreover, enhancing services, such as parent-child counseling in Family Education Centers, can help improve family communication with support that further benefits the emotional development of youths regardless of their being in high- or low-risk families.

並列關鍵字

Art ； communication with support ； comorbidity of alcohol and psychiatric problems ； school attachment ； sport

參考文獻

王鈞逸、楊聯琦、黃僅喻、張合富(2015)。運動對憂鬱症影響之探討。台中科大體育學刊。11，132-137。

王琡棻、盧台華(2014)。國小資優生與一般生復原力保護因子之比較研究。中華輔導與諮商學報。40，1-26。

王齡竟、陳毓文(2010)。家庭衝突、社會支持與青少年憂鬱情緒：檢視同儕、專業與家外成人支持的緩衝作用。中華心理衛生學刊。23(1)，65-97。

余文章、洪偉欽(2009)。運動與憂鬱症之探討。嘉大體育健康休閒期刊。8(1)，228-234。

吳書昀(2011)。兒童少年家庭照顧者之照顧經驗初探。社會政策與社會工作學刊。15(2)，79-140。