医学生健康危险行为与抑郁症状的关联:一项潜在转变分析

doi:10.16187/j.cnki.issn1001-4918.2025.05.13

摘要/Abstract

摘要： 选取某两所医学专科学校的4211名大一年级学生开展基线调查(T1),1年后进行随访(T2),通过问卷调查拟探讨医学生健康危险行为不同暴露模式以及各模式中健康危险行为的稳定性和转变特征,分析健康危险行为不同转变模式与抑郁症状的关联。结果发现:(1)67.6%医学生从大一至大二一直保持较稳定的生活行为,30.7%医学生由高风险组转变为低风险组(缓和组),1.7%医学生从低风险组转变为高风险组(恶化组);(2)与持续低危组医学生相比,处于持续高危组、缓和组和恶化组的医学生出现抑郁症状的风险均增加,且在持续高危组的医学生风险最大。结果提示医学生健康危险行为与抑郁症状风险增加有关,倡导积极健康的生活行为有益于医学生抑郁症状的防控。

关键词: 医学生, 健康危险行为, 抑郁症状, 潜在转变分析

Abstract: 4211 freshmen students from two medical colleges were selected for baseline survey (T1), followed up (T2) one year later. A questionnaire survey was conducted to explore the typologies of health risk behaviors and stability and transition characteristics of different exposure patterns in medical students, and to analyze the association between different transition patterns of health risk behaviors and depressive symptoms. The main findings of this study were as follows: (1) 67.6% of medical students have maintained a stable life behavior from freshman to sophomore years, 30.7% of the medical students changed from high risk group to low risk group (improvement group), and 1.7% of the college students changed from low risk group to high risk group (deterioration group); (2) Compared with the persistent low-risk group, medical students in the persistent high risk group, improvement group, and deterioration group had an increased risk of depressive symptoms in medical students, but in the persistent high-risk group had the highest risk. The results suggest that the health risk behaviors of medical students are associated with the increased risk of depressive symptoms, and advocating positive and healthy life behaviors is beneficial to the prevention and control of depressive symptoms in medical students.

Key words: medical student, health risk behavior, depressive symptoms, latent transition analysis

中图分类号:

B844

何婷婷, 荣璠, 李书琴, 万宇辉. 医学生健康危险行为与抑郁症状的关联:一项潜在转变分析[J]. 心理发展与教育, 2025, 41(5): 730-739.

HE Tingting, RONG Fan, LI Shuqin, WAN Yuhui. A Study of Latent Transition Analysis in Health Risk Behaviors and Association with Depressive Symptoms among Medical Students[J]. Psychological Development and Education, 2025, 41(5): 730-739.

参考文献

Alebachew, W., Semahegn, A., Ali, T., & Mekonnen, H. (2019). Prevalence, associated factors and consequences of substance use among health and medical science students of Haramaya University, eastern Ethiopia, 2018:A cross-sectional study. BMC Psychiatry, 19(1), 343. https://doi.org/10.1186/s12888-019-2340-z
Almojali, A. I., Almalki, S. A., Alothman, A. S., Masuadi, E. M., & Alaqeel, M. K. (2017). The prevalence and association of stress with sleep quality among medical students.Journal of Epidemiology and Global Health, 7(3), 169-174.
Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall, Inc.
Bruffaerts, R., Mortier, P., Kiekens, G., Auerbach, R. P., Cuijpers, P., Demyttenaere, K.,… Kessler, R. C. (2018). Mental health problems in college freshmen: Prevalence and academic functioning. Journal of Affective Disorders, 225, 97-103.
Cleveland, M. J., Lanza, S. T., Ray, A. E., Turrisi, R., & Mallett, K. A. (2012). Transitions in first-year college student drinking behaviors: Does pre-college drinking moderate the effects of parent- and peer-based intervention components? Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors, 26(3), 440-450.
Holahan, C. J., Holahan, C. K., Lim, S., & Powers, D. A. (2021). Living with asmoker and multiple health-risk behaviors. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 55(4), 287-297.
Hu, J., Yang, R., Li, D., Zhao, S., Wan, Y., Tao, F., … Zhang, S. (2021). A latent class analysis of psychological symptoms and health risk behaviors among Chinese adolescents. Asian Journal of Psychiatry, 55, 102518. https://doi.org/10.1016/j.ajp.2020.102 518
Hultgren, B. A., Turrisi, R., Cleveland, M. J., Mallett, K. A., Reavy, R., Larimer, M. E., … Hospital, M. M. (2019). Transitions in drinking behaviors across the college years: A latent transition analysis. Addictive Behaviors, 92, 108-114.
Javaeed, A., Zafar, M. B., Iqbal, M., & Ghauri, S. K. (2019). Correlation between Internet addiction, depression, anxiety and stress among undergraduate medical students in Azad Kashmir.Pakistan Journal of Medical Sciences, 35(2), 506-509.
Karyotaki, E., Cuijpers, P., Albor, Y., Alonso, J., Auerbach, R. P., Bantjes, J.,… Kessler, R. C. (2020). Sources of stress and their associations with mental disorders among college students: Results of the World Health Organization World Mental Health Surveys International College Student Initiative. Frontiers in Psychology, 11, 1759. https://doi.org/10.3389/fpsyg.2020.01759
Keller, S., Maddock, J. E., Laforge, R. G., Velicer, W. F., & Basler, H. D. (2007). Binge drinking and health behavior in medical students.Addictive Behaviors, 32(3), 505-515.
Liu, S., Wing, Y. K., Hao, Y., Li, W., Zhang, J., & Zhang, B. (2019). The associations of long-time mobile phone use with sleep disturbances and mental distress in technical college students: A prospective cohort study.Sleep, 42(2), 213. https://doi.org/10.1093/sleep/zsy213
Liu, T., Zhong, S., Liao, X., Chen, J., He, T., Lai, S., & Jia, Y. (2015). AMeta-analysis of oxidative stress markers in depression. PLoS ONE, 10(10), e0138904. https://doi.org/10.1371/journal.pone.0138904
Liu, Z., Liu, R., Zhang, Y., Zhang, R., Liang, L., Wang, Y.,… Wang, F. (2021). Association between perceived stress and depression among medical students during the outbreak of COVID-19: The mediating role of insomnia. Journal of Affective Disorders, 292, 89-94.
Mu, W., Li, K., Tian, Y., Perlman, G., Michelini, G., Watson, D.,… Kotov, R. (2023). Dynamic risk for first onset of depressive disorders in adolescence: Does change matter? Psychological Medicine, 53(6), 2352-2360.
Onaemo, V. N., Fawehinmi, T. O., & D'Arcy, C. (2020). Alcoholuse disorder and the Persistence/Recurrence of major depression: Le trouble de l'usage de l'alcool et la persistance/récurrence de la dépression majeure. Canadian journal of psychiatry. Revue Canadienne de Psychiatrie, 65(9), 652-663.
Plana-Ripoll, O., Pedersen, C. B., Agerbo, E., Holtz, Y., Erlangsen, A., Canudas-Romo, V.,… Laursen, T. M. (2019). A comprehensive analysis of mortality-related health metrics associated with mental disorders: A nationwide, register-based cohort study. Lancet, 394(10211), 1827-1835.
Puthran, R., Zhang, M. W., Tam, W. W., & Ho, R. C. (2016). Prevalence of depression amongst medical students: A meta-analysis.Medical Education, 50(4), 456-468.
Ramo, D. E., Thrul, J., Vogel, E. A., Delucchi, K., & Prochaska, J. J. (2020). Multiplehealth risk behaviors in young adult smokers: Stages of change and stability over time. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 54(2), 75-86.
Romm, K. F., Metzger, A., Gentzler, A. L., & Turiano, N. A. (2022). Transitions in risk-behavior profiles among first-year college students.Journal of American College Health, 70(7), 2210-2219.
Singer, E. A. (2007). The transtheoretical model and primary care: "TheTimes They Are A Changin". Journal of the American Academy of Nurse Practitioners, 19(1), 11-14.
Smith, A. N., Higgins, L. Q., & Higgins, S. (2022). Behaviorchange trajectories and metabolic syndrome risk factor clustering during the transition to college: A feasibility pilot study. International Journal of Exercise Science, 15(5), 125-141.
Tresno, F., Ito, Y., & Mearns, J. (2012). Self-injurious behavior and suicide attempts among Indonesian college students.Death Studies, 36(7), 627-639.
Uddin, R., Lee, E. Y., Khan, S. R., Tremblay, M. S., & Khan, A. (2020). Clustering of lifestyle risk factors for non-communicable diseases in 304,779 adolescents from 89 countries: A global perspective. Preventive Medicine, 131, 105955. https://doi.org/10.1016/j.ypmed.2019.105955
Underwood, J. M., Brener, N., Thornton, J., Harris, W. A., Bryan, L. N., Shanklin, S. L., … Dittus, P. (2020). Overview and methods for the youth risk behavior surveillance system-United States, 2019. MMWR Supplements, 69(1), 1-10.
Wang, M., Qiaowen, D., Xiangyang, B., Haosheng, Y., & Wendeng, Y. (2017). Performance of the entropy as an index of classification accuracy in latent profile analysis: A monte carlo simulation study. Acta Psychologica Sinica, 49(11), 1473-1482.
Werneck, A. O., Peralta, M., Tesler, R., & Marques, A. (2022). Cross-sectional and prospective associations of lifestyle risk behaviors clustering with elevated depressive symptoms among middle-aged and older adults.Maturitas, 155, 8-13.
Wilkinson, P. O., Qiu, T., Neufeld, S., Jones, P. B., & Goodyer, I. M. (2018). Sporadic and recurrent non-suicidal self-injury before age 14 and incident onset of psychiatric disorders by 17 years: Prospective cohort study.The British Journal of Psychiatry : The Journal of Mental Science, 212(4), 222-226.
Wu, Z., Yue, Q., Zhao, Z., Wen, J., Tang, L., Zhong, Z.,… Zhang, X. (2023). A cross-sectional study of smoking and depression among US adults: NHANES (2005-2018). Frontiers in Public Health, 11, 1081706. https://doi.org/10.3389/fpubh.2023.1081 706
Xiu, X., Qian, Q., & Wu, S. (2022). Mental health problems and associated factors among high school students in Shandong province of China: A cross-sectional study.International Journal of Environmental Research and Public Health, 19(14), 8478. https://doi.org/10.3390/ijerph19148478
Ye, Y. L., Wang, P. G., Qu, G. C., Yuan, S., Phongsavan, P., & He, Q. Q. (2016). Associations between multiple health risk behaviors and mental health among Chinese college students.Psychology, Health & Medicine, 21(3), 377-385.
Zhang, L., Bi, X., & Ding, Z. (2021). Health lifestyles and Chinese oldest-old's subjective well-being-evidence from a latent class analysis.BMC Geriatrics, 21(1), 206. https://doi.org/10.1186/s12877-021-02121-0
Zung W. W. (1965). A self-rating depression scale. Archives of General Psychiatry, 12, 63-70.
曹文君. (2012). 健康促进行为与健康危险因素的潜变量分析及其应用(博士学位论文). 第四军医大学, 西安.
邓福春. (2014). 大学生网络成瘾现状及其对策调查. 职业卫生与病伤, 29(3), 212-214.
翟爽, 陶舒曼, 伍晓艳, 杨娅娟, 项建民, 徐永生, … 陶芳标. (2022). 白介素-10在大学生健康危险行为与抑郁症状关联中的中介作用. 卫生研究, 51(3), 353-360.
顾怀婷, 刘根义, 李晶. (2018). 大学生非自杀性自伤行为与抑郁、述情障碍的相关性. 中国健康心理学杂志, 26(1), 6-9.
刘景, 何嘉嘉, 金正格, 李书琴, 蒋志成, 李若瑜, 万宇辉. (2021). 专科生睡眠时间与负性情绪症状的关联. 中国学校卫生, 42(11), 1670-1673+1678.
刘贤臣, 唐茂芹, 胡蕾, 王爱祯, 吴宏新, 赵贵芳, … 李万顺. (1996). 匹兹堡睡眠质量指数的信度和效度研究. 中华精神科杂志, 2, 103-107.
马永红, 谭姣, 牛轩, 赵鑫坤, 李萌, 陈兴文. (2022). 医学院校大学生手机依赖与睡眠质量的多因素logistic回归分析. 职业与健康, 38(13), 1835-1838.
陶芳标. (主编). (2017). 儿童少年卫生学. 北京: 人民卫生出版社.
陶舒曼, 付继玲, 王惠, 郝加虎, 陶芳标. (2013). 青少年手机使用依赖自评问卷编制及其在大学生中的应用. 中国学校卫生, 34(1), 26-29.
万宇辉, 高荣, 陶兴永, 陶芳标, 胡传来. (2012). 大学生故意自伤行为与自杀行为的相关性研究. 中华流行病学杂志, 33(5), 474-477.
万宇辉, 刘婉, 郝加虎, 陶芳标. (2018). 青少年非自杀性自伤行为评定问卷的编制及其信效度评价. 中国学校卫生, 39(2), 170-173.
万宇辉, 刘婉, 孙莹, 郝加虎, 陶芳标. (2016). 童年期虐待的不同形式与中学生自杀行为关联性研究. 中华流行病学杂志, 37(4), 506-511.
王陈芳, 谢阳, 李婷婷, 伍晓艳, 陶舒曼, 陶芳标. (2021). 大学生睡眠时型与聚集性健康危险行为的关联. 现代预防医学, 48(24), 4482-4486.
王洪, 马文燕, 高朋, 李海君. (2023). 地方本科院校贫困生焦虑抑郁现状及应对策略. 黑龙江科学, 14(5), 102-104.
王蜜源, 韩芳芳, 刘佳, 黄凯琳, 彭红叶, 黄敏婷, 赵振海. (2020). 大学生抑郁症状检出率及相关因素的meta分析. 中国心理卫生杂志, 34(12), 1041-1047.
魏明, 李新华, 王伟琼, 倪佳莉, 赵冬. (2014). 医学生睡眠质量现状调查. 中国健康心理学杂志, 22(3), 454-455.
肖水源, 杨德森. (1987). 社会支持对身心健康的影响. 中国心理卫生杂志, 4, 183-187.
杨娅娟, 徐洪吕, 王颖, 谢阳, 邹立巍, 李婷婷, … 伍晓艳. (2021). 医学生健康危害行为的潜在类别及其与抑郁症状的关联. 中国学校卫生, 42(4), 583-586+592.
赵海, 马迎华, 吕晓静, 庄丽丽, 吕晓辉, 田野, 宋娟. (2012). 天津某理工科高校学生健康危险行为影响因素分析. 中国学校卫生, 33(5), 524-526+528.
周浩, 龙立荣. (2004). 共同方法偏差的统计检验与控制方法. 心理科学进展, 12(6), 942-950.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed

[1]	叶文婷, 滕召军, 黎杨杨, 崔宏晶, 聂倩. 父母心理控制、高中生抑郁症状及其生命意义感的纵向关系:一项交叉滞后模型分析[J]. 心理发展与教育, 2025, 41(5): 710-719.
[2]	曾子豪, 彭丽仪, 詹林, 刘双金, 欧阳晓优, 丁道群, 黎志华, 胡义秋, 方晓义. 儿童期受虐对大学生抑郁症状的影响:主观幸福感的中介和基因的调节作用[J]. 心理发展与教育, 2023, 39(2): 276-285.
[3]	杨晓霞, 陈亮, 曹衍淼, 毕馨文, 陈光辉, 张文新. 青少年早期同伴侵害的亚类别及其稳定性:个体定向的分析[J]. 心理发展与教育, 2020, 36(2): 146-156.
[4]	晏妮, 于尧. 在美国样本中母亲抑郁症状与儿童退缩的关系:教养行为的中介作用[J]. 心理发展与教育, 2017, 33(1): 1-10.