童年情绪障碍的多维度影响因素分析

Multidemensional Analysis of Influencing Factors in Childhood Emotional Disorders

摘要: 目的：从生物–心理–社会多维度系统探讨童年情绪障碍的影响因素，重点考察母孕期危险因素、个体心理特征、家庭环境及父母教养方式的作用，为临床早期识别和综合干预提供科学依据。方法：选取2024年1月至2025年12月在西南康复医院心身科就诊的童年情绪障碍患儿120例作为病例组，同期在该院体检的健康儿童120例作为对照组。采用自编一般情况与母孕期情况调查表、父母教养方式评价量表、家庭环境量表中文版、儿童焦虑性情绪障碍筛查表、儿童抑郁量表、Conners父母用症状问卷、长处与困难问卷及青少年生活事件量表进行测评。采用方差膨胀因子(VIF)进行多重共线性诊断，运用单因素分析和多因素Logistic回归模型筛选童年情绪障碍的独立影响因素。结果：多重共线性诊断显示所有纳入变量的VIF值均小于5，不存在严重共线性问题。单因素分析显示，病例组与对照组在母孕期危险因素(母亲孕期焦虑/抑郁、孕期应激生活事件、孕期吸烟、低出生体重)、个体因素(性别、年龄、负性生活事件)、家庭因素(家庭结构、经济状况、父母心理健康)及教养方式等方面差异均有统计学意义(P < 0.05)。多因素Logistic回归分析显示，母亲孕期焦虑/抑郁(OR = 3.56)、孕期应激生活事件(OR = 2.89)、低出生体重(OR = 2.12)、女性(OR = 2.34)、青春期年龄(OR = 1.89)、负性生活事件暴露(OR = 3.45)、单亲/再婚家庭(OR = 2.18)、父母焦虑/抑郁史(OR = 2.78)、父母拒绝否认型教养方式(OR = 3.12)是独立危险因素；父母情感温暖理解型教养方式(OR = 0.52)是保护因素。结论：童年情绪障碍的发生受母孕期、个体、家庭和社会环境多层面因素的共同影响，各维度因素之间存在交互与累积效应，保护性因素对风险因素具有缓冲作用。母孕期危险因素的作用尤为值得关注。应重视对具有多重高危因素儿童的早期筛查，构建覆盖“孕期–儿童期–家庭”全链条的预防与干预体系。

Abstract: Objective: To systematically investigate the multidimensional factors associated with childhood emotional disorders from a bio-psycho-social perspective, with a focus on maternal prenatal risk factors, individual psychological characteristics, family environment, and parenting styles, so as to provide scientific evidence for early identification and comprehensive intervention. Methods: A total of 120 children diagnosed with childhood emotional disorders at the Department of Psychosomatic Medicine of Southwest Rehabilitation Hospital from January 2024 to December 2025 were enrolled as the case group, and 120 healthy children who underwent physical examinations at the same hospital during the same period were selected as the control group. Data were collected using a self-designed general information and maternal prenatal conditions questionnaire, the Egna Minnen av Barndoms Uppfostran, the Chinese version of the Family Environment Scale, the Screen for Child Anxiety Related Emotional Disorders, the Children’s Depression Inventory, the Conners Parent Symptom Questionnaire, the Strengths and Difficulties Questionnaire, and the Adolescent Self-Rating Life Events Checklist. Variance inflation factor (VIF) was used for multicollinearity diagnosis. Univariate analysis and multivariate Logistic regression were employed to identify independent factors associated with childhood emotional disorders. Results: Multicollinearity diagnosis showed that all VIF values were less than 5, indicating no severe collinearity. Univariate analysis showed that there were statistically significant differences (P < 0.05) between the case group and the control group in terms of maternal pregnancy-related risk factors (maternal anxiety/depression during pregnancy, stressful life events during pregnancy, smoking during pregnancy, and low birth weight), individual factors (gender, age, and negative life events), family factors (family structure, economic status, and parental mental health), and parenting styles. Multivariate Logistic regression analysis showed that maternal prenatal anxiety/depression (OR = 3.56), prenatal stressful life events (OR = 2.89), low birth weight (OR = 2.12), female gender (OR = 2.34), adolescent age (OR = 1.89), exposure to negative life events (OR = 3.45), single-parent/reconstituted family (OR = 2.18), parental history of anxiety/depression (OR = 2.78), and parental rejection/denial parenting style (OR = 3.12) were independent risk factors, while parental emotional warmth/understanding parenting style (OR = 0.52) was a protective factor. Conclusion: Childhood emotional disorders are influenced by multiple factors across prenatal, individual, family, and social domains. There are interactions and cumulative effects among factors across dimensions, and protective factors buffer the negative impact of risk factors. Early screening for children with multiple high-risk factors and the establishment of a comprehensive “pregnancy-childhood-family” prevention and intervention system should be prioritized.