学业压力与青少年抑郁症状及自伤行为的关系
学业压力与青少年抑郁症状及自伤行为的关系：一项在英格兰开展的纵向前瞻性研究
The association between academic pressure and adolescent depressive symptoms and self-harm: a longitudinal, prospective study in England
—《柳叶刀·儿童与青少年健康》第10卷，第4期，2026年4月—
【摘要】背景：学业压力可能会增加青少年抑郁和自伤的风险。然而，针对这种关联的纵向研究尚属匮乏，且现有研究存在局限性。本研究旨在探讨从青少年时期至成年早期，个体感知的学业压力水平与随后出现的抑郁症状及自伤行为之间的关联。我们的假设是：较高的学业压力水平将与较严重的抑郁症状及较高的自伤风险相关联。方法：在这项纵向研究中，我们使用了来自“埃文父母与子女纵向研究”（Avon Longitudinal Study of Parents and Children，英国埃文地区）的数据，该数据集涵盖了出生于1991至1992年的青少年群体。本研究关注的主要暴露因素是15岁时测定的学业压力，该指标通过一份“学校经历问卷”中的相关条目进行测量（总分范围：0–9分）。研究结局包括：在16至22岁期间的五个时间点，利用《简版情绪与感受问卷》（Short Mood and Feelings Questionnaire）评估的抑郁症状（总分范围：0–26分）；以及在16至24岁期间的四个时间点，通过自伤问卷评估的自伤行为。数据分析采用多重插补后的样本数据，运用多层模型进行统计建模：针对抑郁症状采用线性模型，针对自伤行为（指过去一年内的自伤情况）采用Logistic模型；分析过程分别在调整协变量之前和之后进行。结果：本研究共纳入了4714名青少年（其中女性2725名 [57.8%]，男性1989名 [42.2%]）。在经过全面协变量调整的模型中，15岁时的学业压力每增加1分，其随后出现的抑郁症状评分便相应增加0.43分（95%置信区间 [CI]：0.36–0.51）。这种关联在16岁时评估抑郁症状时表现得最为显著（增加0.53分；95% CI：0.42–0.64），但在22岁时进行评估时，这种关联依然存在（增加0.35分；95% CI：0.23–0.47）。关于自伤行为，在经过全面协变量调整的模型中，学业压力每增加1分，发生自伤行为的几率（Odds）便增加8%（调整后的优势比 [Odds Ratio] 为1.08；95% CI：1.01–1.16），且这种关联强度随时间推移未见显著变化。解读：我们的研究结果支持这一假设：学业压力是青少年抑郁症状，乃至可能出现的自伤行为的一个潜在的可干预风险因素。针对减轻学业压力的干预措施可予以开发并进行评估。
[Summary] Background: Academic pressure could increase the risk of adolescent depression and self-harm. However, there are few longitudinal studies of this association, and those that exist have limitations. We aimed to investigate associations between perceived levels of academic pressure and subsequent depressive symptoms and self-harm from adolescence to early adulthood. Our hypothesis was that higher levels of academic pressure would be associated with higher levels of depressive symptoms and self-harm. Methods: In this longitudinal study, we used data from the Avon Longitudinal Study of Parents and Children (Avon, UK) that includes adolescents born in 1991–92. Our primary exposure of interest was academic pressure measured at age 15 years, using items from a school experiences questionnaire (total scores 0–9). Outcomes were depressive symptoms assessed with the Short Mood and Feelings Questionnaire at five timepoints between age 16 years and 22 years (total scores 0–26), and a self-harm questionnaire at four timepoints between age 16 years and 24 years. Analyses were linear (depressive symptoms) and logistic (self-harm in the previous year) multilevel models in samples with multiply imputed data, before and after adjustments. Findings: We included 4714 adolescents (2725 [57·8%] female, 1989 [42·2%] male). In fully adjusted models, a 1-point increase in academic pressure at age 15 years was associated with a 0·43 (95% CI 0·36–0·51) point increase in depressive symptoms. This association was largest when depressive symptoms were assessed at age 16 years (0·53, 0·42–0·64), but remained at age 22 years (0·35, 0·23–0·47). For self-harm, in fully adjusted models, each 1-point increase in academic pressure was associated with 8% higher odds of self-harm (adjusted odds ratio 1·08, 1·01–1·16), with no differences over time. Interpretation: Our findings support the hypothesis that academic pressure is a potential modifiable risk factor for adolescent depressive symptoms, and possibly self-harm. Interventions to reduce academic pressure could be developed and evaluated.
论文原文：Xuchen Guo, Marie A E Mueller, Jessica M Armitage, et al. (2026). The association between academic pressure and adolescent depressive symptoms and self-harm: a longitudinal, prospective study in England. The Lancet ? Child & Adolescent Health, Volume 10, Issue 4, Pages 265-272. April 2026.
https://doi.org/10.1016/S2352-4642(25)00342-6
（翻译兼责任编辑：MARY）
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