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中國軍人生活事件特點及其與社會支持、抑郁的相關研究

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  本文選題:中國軍人 + 生活事件特點; 參考:《第三軍醫(yī)大學》2014年碩士論文


【摘要】:研究背景和目的 有研究表明中國軍人的抑郁率為18.1%,近幾年我國軍人抑郁發(fā)生率呈現(xiàn)逐年上升的趨勢,在一些區(qū)域性針對特殊作業(yè)的軍人抑郁調(diào)查報道中發(fā)現(xiàn)中國軍人抑郁的發(fā)生率在25.2%-51.56%之間。生活事件(Life Events)是指來自環(huán)境或自身的引起個體生理、心理變化的各種應激源。它與抑郁發(fā)生關系緊密。研究表明,92%的抑郁癥病人在抑郁發(fā)病前存在生活事件的影響。軍人作為一個特殊的職業(yè)群體,其特殊的生活環(huán)境和工作性質(zhì)決定其面臨更為特殊、復雜的生活事件影響。常見的軍事生活事件例如訓練傷、退伍、親屬去世、家庭矛盾、經(jīng)濟困難等生活事件,都有可能促使軍人抑郁發(fā)生。對軍人生活事件特點的研究不僅可以探究生活事件在軍人精神疾病中的作用,而且可以通過生活事件的探討分析對軍人心理健康、作戰(zhàn)力生成和工作績效的影響,從軍事管理學的角度分析生活事件的表現(xiàn)形式及潛在危害,便于部隊開展教育,加強管理,提高戰(zhàn)斗力。 社會支持在抑郁的發(fā)生、發(fā)展、轉(zhuǎn)歸過程中起到緩沖作用。研究表明,擁有良好社會支持的軍人,即使在經(jīng)歷重大生活事件,抑郁發(fā)生率卻處于較低水平,即社會支持可以保護和緩沖生活事件對于身心健康的不良影響。研究軍人生活事件與社會支持關系,有利于更好地了解社會支持在生活事件中的作用過程,為部隊能夠更好的為官兵提供有效的支持提供幫助。 然而目前缺乏大樣本研究中國軍人生活事件的特點,及其與社會支持、抑郁的相關關系。因此,本研究采用針對軍事職業(yè)特點的軍人生活事件量表和社會支持量表,以及國際通用的流調(diào)中心抑郁量表,對全國范圍內(nèi)的陸、海、空、武警四個軍兵種軍人進行大規(guī)模的生活事件特點調(diào)查,旨在初步了解軍人生活事件的特點,及其與社會支持、抑郁的相關關系,建立其路徑模型,為軍人心理健康的維護提供依據(jù)。 對象與方法 本次調(diào)研在全軍海、陸、空、武警四個軍兵種共發(fā)放問卷1.14萬份,共獲有效問卷10505份,有效率92%。其中陸軍7634人,占72.7%;海軍1443人,占13.7%;空軍943人,占9%;武警485人,占4.6%;男性10397人(99%);女性108人(1%);平均年齡22.38±3.95歲。研究采用問卷調(diào)查法,數(shù)據(jù)分析采用SPSS和AMOS,對我國軍人生活事件的特點進行了分析,并就其與社會支持、抑郁的相關關系進行了深層次的探討。本研究首先對文獻回顧,分析國內(nèi)外軍人生活事件特點研究現(xiàn)狀,及其與社會支持、抑郁的相關關系研究情況。本課題包括四個研究,研究一進行了我國軍人生活事件特點的調(diào)查,并分析了在年齡、性別、軍種上的差異性;研究二分析了我國軍人生活事件與社會支持的相關關系;研究三分析了我國軍人生活事件與抑郁的相關關系;研究四建立了中國軍人社會支持、抑郁癥狀與生活事件的路徑模型。 結(jié)果 1.中國軍人生活事件的發(fā)生率具有普遍性,發(fā)生一次以上生活事件占調(diào)查總數(shù)的50.3%。其中位居前三的生活事件依次為:未來就業(yè)壓力大(占18.1%)、工作或?qū)W習任務重(占17.8%)、受到批評或懲罰(占14.6%)。 2.從性別差異上來看,中國男性軍人生活事件總刺激量和負性事件刺激量低于女性軍人,但正性生活事件刺激量顯著低于女軍人(3.34±0.10vs5.56±1.12,F(xiàn)=4.949,,P 0.05)。3.不同軍兵種軍人的生活事件刺激量存在顯著性差異。海軍軍人生活事件總刺激量(33.30±1.87vs25.50±0.76vs18.4±1.66vs15.1±2.19,F(xiàn)=14.656,P 0.0001)及負性生活事件刺激量高于陸軍、空軍、武警(29.23±1.78vs22.1±0.71vs15.35±1.52vs12.03±2.04,F(xiàn)=14.681,P 0.0001)。 4.不同職別軍人的生活事件刺激量存在顯著性差異。軍官生活事件總刺激量(49.79±2.81vs30.27±1.11vs14.97±0.58,F(xiàn)=158.235,P 0.0001)、負性生活事件(43.77±2.68vs26.92±1.05vs12.22±0.52,F(xiàn)=152.044,P 0.0001)、正性生活事件刺激量(6.01±0.37vs3.35±0.16vs2.75±0.14,F(xiàn)=46.764,P 0.0001)均高于士官、戰(zhàn)士,戰(zhàn)士低于士官。 5.不同年齡段軍人的生活事件刺激量存在顯著性差異。生活事件刺激量(80.73±7.13vs13.71±0.62vs1.45±0.79vs56.23±2.7vs49.59±17.74,F(xiàn)=325.134,P 0.0001)和負性事件刺激量(51.08±2.60vs11.28±0.56vs18.11±0.72vs74.12±6.88vs3.44±17.19,F(xiàn)=350.764,P 0.0001)隨年齡的增長逐漸增加,生活事件高發(fā)年齡為31~40歲,其次為26~30歲組,41歲后生活事件發(fā)生有下降趨勢。 6.不同社會支持狀態(tài)下的軍人其生活事件得分具有顯著性差異。社會支持度低的的軍人在生活事件總刺激量(36.77±1.66vs17.54±0.89,F(xiàn)=104.056,P 0.0001)和負性事件總刺激量(33.32±1.59vs14.45±0.82,F(xiàn)=111.360,P 0.0001)上顯著高于社會支持度高的軍人。 7.中國軍人整體抑郁發(fā)生率(18.1%,17.4%-18.8%,95%CI)低于中國常模(33.3%),抑郁的發(fā)生與生活事件存在顯著相關(r=0.382,P0.01),其中負性生活事件發(fā)生同軍人抑郁水平存在顯著正相關(r=0.385,P0.01)。生活事件是抑郁發(fā)生的危險因素。 8.社會支持與抑郁癥的發(fā)生呈顯著負相關(r=-0.46,p0.001),社會支持度越高抑郁癥狀越少,社會支持的缺乏增加個體患抑郁癥的風險,適宜的社會支持有利于促進抑郁癥的康復。高社會支持是降低抑郁發(fā)生的緩沖、保護性因素。 結(jié)論 1.中國軍人生活事件的發(fā)生較為普遍,并且存在著群體性的特點,其中工作與未來發(fā)展是中國軍人群體中最顯著的壓力源。生活事件存在性別、軍種、職級和年齡的差異。女性軍人正性生活事件刺激量高于男性軍人;海軍生活事件總刺激量及負性生活事件刺激量大于陸軍、空軍、武警;軍官生活事件總量、負性事件及正性事件均高于士官和戰(zhàn)士,而戰(zhàn)士低于士官;生活事件高發(fā)年齡段為31~40歲,其次為26~30歲組。 2.我國軍人的社會支持在性別、軍種、職別、年齡段均有較大的差異性,且軍人社會支持與生活事件均呈顯著負相關,正性事件與社會支持的相關性較弱,負性生活事件與社會支持程度呈負向反應。高社會支持的軍人較低社會支持的軍人擁有更多社會資源應對生活事件,避免了生活事件特別是負性生活事件的累積。 3.中國軍人抑郁發(fā)生同生活事件存在顯著正相關,負性生活事件發(fā)生同軍人抑郁水平存在顯著正相關。由于生活事件(正性或負性)引發(fā)的強烈應激條件和抑郁患者的負性認知加工偏向,正性生活事件可能無法作為抑郁發(fā)生或緩解的保護性因素。 4.社會支持-抑郁癥狀-生活事件的路徑分析顯示,生活事件是抑郁發(fā)生的危險因素,而社會支持是防治抑郁發(fā)生的緩沖、保護性因素。高社會支持可有效降低生活事件所帶來的負面影響,降低抑郁的發(fā)生率。
[Abstract]:Background and purpose of research
Studies have shown that the depression rate of Chinese soldiers is 18.1%. In recent years, the incidence of depression in military personnel in China has been increasing year by year. In some regional reports of special operations for military depression, the incidence of depression in Chinese soldiers is found to be between 25.2%-51.56%. The life event (Life Events) refers to the cause from the environment or itself. A variety of stressors of individual physiology and psychological change. It is closely related to depression. The study shows that 92% of the depressive patients have the influence of life events before the onset of depression. As a special occupational group, the special living environment and the nature of their work decide that they are facing more special and complex life events. Military life events such as training injuries, veterans, relatives' death, family contradictions, economic difficulties and other life events may promote the occurrence of depression in military personnel. The study of the characteristics of military life events can not only explore the role of life events in military mental illness, but also analyze the mental health of soldiers through the discussion of life events, From the angle of military management, the form and potential harm of life events are analyzed from the angle of military management. It is convenient for the army to carry out education, strengthen management and improve the fighting ability.
Social support plays a buffer role in the occurrence, development, and outcome of depression. Research shows that soldiers with good social support are at a lower rate of depression, even during major life events, that is, social support can protect and buffer the adverse effects of life events on physical and mental health. Social support is conducive to a better understanding of the role of social support in life events, and to provide effective support for the army to provide effective support for officers and soldiers.
However, there are no large samples to study the characteristics of military life events in China and their relationship with social support and depression. Therefore, this study adopts the military life events scale and social support scale for military occupation, as well as the international general depression scale of the flow center, which is the four national land, sea, air and armed police. The investigation of the characteristics of large scale life events was carried out by military and military soldiers. The purpose was to understand the characteristics of military life events, and their relationship with social support and depression, and to establish a path model to provide a basis for the maintenance of soldiers' mental health.
Object and method
A total of 11 thousand and 400 questionnaires were issued by four military armed forces in the army sea, land, air and armed police. There were 10505 effective questionnaires, of which 7634 of the army, 72.7% in the army, 1443 in the Navy, 13.7%, 943 in the air force, 9%, 485 in the armed police, 4.6%, male 10397 (99%) and female 10505. The characteristics of military life events in China were analyzed with SPSS and AMOS, and the relationship between them and social support and depression was deeply discussed. This study first reviewed the literature and analyzed the status of the research on the characteristics of military life events at home and abroad, and the correlation with social support and depression. The study included four studies, one conducted a survey of the characteristics of military life events in China, and analyzed the differences in age, sex, and military species. Two the relationship between military life events and social support in China was analyzed. Three the relationship between military life events and depression in China was analyzed. Study four established a path model of social support, depressive symptoms and life events among Chinese servicemen.
Result
1. the incidence of military life events in China was universal, and more than one life event accounted for 50.3%. of the total number of investigations. Among them, the top three of the life events were in turn: the future employment pressure (18.1%), the job or the study task (17.8%), was criticized or punished (14.6%).
2. in terms of gender differences, the total stimulus amount and negative event stimulus of Chinese men's military life events were lower than those of the female soldiers, but the stimulus amount of positive life events was significantly lower than that of women soldiers (3.34 + 0.10vs5.56 + 1.12, F=4.949, P 0.05). There were significant differences in the life events of different military soldiers in.3.. The total stimulus volume (33.30 + 1.87vs25.50 + 0.76vs18.4 + 1.66vs15.1 + 2.19, F=14.656, P 0.0001) and negative life events were higher than that of the army, air force, armed police (29.23 + 1.78vs22.1 + 0.71vs15.35 + 1.52vs12.03 + 2.04, F=14.681, P 0.0001).
4. there were significant differences in the amount of life events in different servicemen. The total stimulus amount of officers' life events (49.79 + 2.81vs30.27 + 1.11vs14.97 + 0.58, F=158.235, P 0.0001), negative life events (43.77 + 2.68vs26.92 + 1.05vs12.22 + 0.52, F=152.044, P 0.0001), positive life events stimulation (6.01 + 0.37vs3.35 + 0.16vs2.75 + 0.14, F=) 46.764, P 0.0001) were higher than sergeants, warriors and soldiers than NCO.
5. there were significant differences in the number of life events in different age groups. The stimulus amount of life events (80.73 + 7.13vs13.71 + 0.62vs1.45 + 0.79vs56.23 + 2.7vs49.59 + 17.74, F=325.134, P 0.0001) and negative event stimulation (51.08 + 2.60vs11.28 + 0.56vs18.11 + 0.72vs74.12 + 6.88vs3.44 + 17.19, F=350.764, P 0.0001) increased with age The length of life gradually increased, the incidence of high life events was 31~40 years old, followed by 26~30 years old group, and after 41 years of life, there was a downward trend in life events.
6. soldiers with different social support have significant differences in their life events. The total stimulus volume of life events (36.77 + 1.66vs17.54 + 0.89, F=104.056, P 0.0001) and negative event total stimulus (33.32 + 1.59vs14.45 + 0.82, F= 111.360, P 0.0001) of the soldiers with low social support were significantly higher than those of high social support.
7. the overall incidence of depression in Chinese soldiers (18.1%, 17.4%-18.8%, 95%CI) was lower than the Chinese norm (33.3%). There was a significant correlation between the occurrence of depression and life events (r=0.382, P0.01). There was a significant positive correlation between the occurrence of negative life events and the level of depression (r=0.385, P0.01). The life events were the risk factors for depression.
8. social support has a significant negative correlation with the occurrence of depression (r=-0.46, p0.001), the higher the social support is, the less depressive symptoms, the lack of social support to increase the risk of individual depression. Appropriate social support is beneficial to promote the rehabilitation of depression. High social support is a buffer and protective factor for lowering the incidence of depression.
conclusion
1. the occurrence of military life events in China is more common, and there are group characteristics. Work and future development are the most significant stressors in the Chinese military group. There are gender, military, professional and age differences in life events. The amount of irritation and negative life events was greater than that of the army, the air force, the armed police, the total amount of life events of the officers, the negative events and the positive events were higher than the sergeant and the soldiers, but the soldiers were lower than the sergeant. The age of the high incidence of life events was 31~40 years, followed by the group of 26~30 years.
2. the social support of military personnel in our country has great differences in gender, military, professional and age, and the military social support has a significant negative correlation with life events, the correlation between positive events and social support is weak, negative life events and social support are negative. The servicemen with higher social support are lower social support soldiers. Having more social resources to cope with life events and avoiding the accumulation of life events, especially negative life events.
3. the occurrence of depression in Chinese servicemen has a significant positive correlation with life events. There is a significant positive correlation between negative life events and the level of soldiers' depression. Due to the strong stress conditions caused by life events (positive or negative) and negative cognitive processing of depressed patients, positive life events may not be depressive or mitigate. Protective factors.
4. the path analysis of social support - depressive symptoms - life events shows that life events are the risk factors for depression, and social support is a buffer and protective factor for the prevention and treatment of depression. High social support can effectively reduce the negative effects of life events and reduce the incidence of depression.
【學位授予單位】:第三軍醫(yī)大學
【學位級別】:碩士
【學位授予年份】:2014
【分類號】:B842

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