青少年初期身心健康變化及其動態影響變因之討論

The Impact of Dynamic Factors on Trajectories of Early Adolescent Depressive Symptom

研究目的：本研究運用一項長達三年（1996-1999），有關青少年成長與發展調適問題的貫時性追蹤資料，嘗試突破橫斷性資料的研究困限，應用潛在成長曲線模型分析（Latent Growth Curve Model），將青少年跨時間的憂鬱症狀軌跡描繪成型。家庭是青少年最為熟悉且受到最多直接影響的生長脈絡，也是影響青少年身心健康發展的關鍵性結構因素。本研究納入個體自尊、與家庭脈絡下的因子（父母親嚴厲管教與低親子關係滿意度），以做為耙梳幾個危險因素，對於青少年憂鬱症狀初始狀態與變化率產生的負向與長久影響。研究方法：以944個國中青少年學生重覆填答之測量資料，做為分析青少年初期身心健康變化及其動態影響變因。研究結果：1.在影響青少年憂鬱症狀發展的動態變因方面，青少年的低自尊會同步影響青少年憂鬱症狀發展的初始狀態與軌跡發展，是造成青少年「暴露」在長期憂鬱症狀之下的最關鍵危險因子。2.進一步分析家庭脈絡之不利危險因素對於青少年憂鬱症狀變化的影響發現：不良的親子互動關係確實會對青少年的憂鬱症狀發展造成深遠的影響。3.青少年的憂鬱症狀受母親嚴厲管教的影響僅及於起始狀態；但低親子關係滿意度卻是影響青少年長期憂鬱症狀發展的動態變因之一。研究結論：自尊、家庭脈絡中的動態變因對青少年憂鬱症狀發展，確實具不同時序的影響效果。

Purpose: This study uses data derived from a panel study (1996-1999) of Taiwanese adolescent development and adaptation to break through the limitations of cross-sectional studies and to model the trajectory of adolescents’ depressive symptoms over time with the latent growth curve model. Several latent constructs related to adolescents’ low self-esteem and their family context (such as harsh parenting and low satisfaction with the parentchild relationship) are treated as risk factors in order to examine the key mechanisms that negatively influenced the initial status and the rate of change in the adolescents’ trajectories of depressive symptoms. Methods: Participants were 944 junior high school students who completed repeated measurements which were used to examine their individual trajectories and the impact of dynamic factors on early adolescent depressive symptoms. Results: The analysis showed that low self-esteem is the most influential risk factor on the trajectory of adolescent depressive symptoms, affecting both initial status and the rate of change of the trajectory. The vertical relationship between parents and children in the daily family context is a dynamic latent construct for adolescent depression. The perception of harsh parenting by the adolescent had impact only on the adolescent’s initial status of depressive symptoms, while low-satisfaction with the parent-child relationship had significant influence on the long-term changing trajectory of the adolescent’s depressive symptoms. Conclusions: The findings indicate that the impact of dynamic factors on trajectory of adolescents’ depressive symptoms varies over the long term.