青少年憂鬱情緒與多元風險因子：個別效果與累積效果的驗證

Adolescent Depressive Mood and Multiple Risk Factors: A Test of Individual and Cumulative Effects

黃昱得(Yu-Te Huang)

《中華心理衛生學刊》 27卷3期 (2014/09) Pp. 327-355

https://doi.org/10.30074/FJMH.201409_27(3).0001

摘要

研究目的：根據生態系統理論，青少年憂鬱情緒的風險因子多方面地散佈在環境中。過去的文獻除了探討個別風險因子對憂鬱情緒的解釋力外，也以累積風險指標來探究累積效果以及扣板機效應。本研究以性別、家庭經濟壓力、親子衝突、負向同儕關係以及學業期望壓力作為憂鬱情緒的風險因子，除檢視個別效果外，也以累積風險指標來驗證累積效果。研究方法：本研究對象為台灣地區就讀於高中、高職、五專一至三年級、18歲以下的青少年。經多階段叢集抽樣後，共有1,307位青少年參與團體問卷施測。考量資料的完整性，故僅針對填答完整者（N=1,196），以交叉表分析、單因子變異數分析、趨勢分析、多元邏輯迴歸及多元線性迴歸來驗證研究假設。研究結果：多元線性迴歸分析指出家庭經濟壓力、親子衝突、負向同儕關係以及學業期望壓力越高者，其憂鬱情緒得分越高。本研究也證實了風險因子具有累積效果，但扣板機效應僅展現在以累積風險指標來預測個體是否有罹患憂鬱症的風險時。研究結論：由於危險因子具有累積效果，本研究建議心理衛生專業應進行系統性的風險因子評估，並針對面臨多元風險因子的青少年進行密集性的介入協助。

關鍵字

憂鬱情緒 ； 風險因子 ； 個別效果 ； 累積效果 ； 累積風險指數

並列摘要

Purpose: The ecological system model posits that the depressogenic risk factors that exist in a person's ecosystem exert a negative impact on an individual's mental health. Previous researchers have also proposed analysis of the cumulative effects of individual factors in order to better capture the impact of a cluster of risk factors. This study investigated the association between depressive mood and a group of risk factors that are known to be salient among adolescents in Taiwan. The risk factors investigated included gender, family economic stress, parent-adolescent conflict, negative peer relationships, and academic expectation stress. The cumulative risk index was used as a proxy for investigating the impact of multiple risk factors. Method: A multi-stage cluster sampling method was used to select respondents. Self-report questionnaires were completed by 1,307 students in high schools, vocational high schools, and junior colleges, but only 1,196 questionnaires with complete answers were entered into statistical analyses. Cross-tabulation, oneway ANOVA, trend analysis, Pearson correlation, hierarchical linear regression models, and multiple logistic regressions were used to test the hypotheses of individual and cumulative effects. Results: The linear regression analyses indicated that each risk factor was a significant predictor of the adolescents' depressive mood. Although the hypothesis of cumulative effects was verified, the findings on the triggering effect varied with the analytical approach. Conclusions: Given the evidence for cumulative effects of multiple risk factors, mental health professionals need to use the ecological perspective in assessing depressogenic risk factors and designing intensive services to address multiple risk factors.

並列關鍵字

depressive mood ； risk factors ； individual effect ； cumulative effect ； cumulative risk index

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