新冠疫情波及范围广、延续时间长、隔离要求高，对全体民众产生不利影响。青少年经历疫情爆发、宅家学习和开学返校等应激事件，易产生焦虑抑郁等情绪问题。本研究旨在探讨生态系统理论视角下，疫情下初中学生焦虑抑郁的发展变化及接纳承诺疗法干预的有效性。研究一中，1735名初中生参与了2020年3月16日进行的焦虑抑郁自评，共535名学生参与了自2020年3月16日至2020年6月22日，每次间隔3-5个周共5次的测量。采用积极和消极情感学生量表（PANAS—C，Positive and Negative Affect Schedule-Children）、儿童抑郁障碍自评量表（DSRSC，Depression Self- rating Scale for Children）、儿童焦虑障碍自评量表（SCARED，Child Anxiety Related Emotional Disorders）进行数据收集。结果表明焦虑的检出率显著高于先前研究；焦虑抑郁随时间呈现V字型变化，可见疫情爆发和返校复学均引起学生应激反应，增加焦虑抑郁问题；女生较男生，高年级比低年级的心理健康状态更差；学业压力和亲子关系影响学生情绪健康；疫情常态化管理期中国青少年抑郁焦虑问题的解决之道，应由家长、学校和社会共同探索。研究二探索接纳承诺疗法改善青少年焦虑抑郁问题的效果。实验组共208人，平均年龄13.20（SD=1.75），女生99人（47.6%）；对照组共362人，平均年龄13.24（SD=1.59），女生179人（49.4%）。实验组学生接受每月一次，每次45分钟，共4次的干预课程并完成相关练习。对照组学生进行道德与法治课程或班会。中测结果显示接纳承诺疗法对改善青少年焦虑问题和消极情感有显著效果，后测未发现对焦虑、抑郁的积极改善。未来应持续优化正念课程，呼吁父母和学校的深度参与，逐步形成包含心理咨询、家长教育、学生心理健康课程等多层次、多维度、更具针对性的学生心理健康服务体系。本研究发现新冠疫情宅家学习期间，学生焦虑抑郁水平呈“V”型变化轨迹，且不同性别年级差异显著；接纳承诺疗法对改善初中生焦虑和消极情感有即时作用；未来应构架社会制度、学校教学和家庭教育的学生心理健康防控体系，以应对重大社会公共卫生事件对学生心理健康的负面影响。
其他摘要
COVID-19 had characteristics of wide range, long duration and high isolation requirements, which adversely affected all the people. Adolescents were prone to anxiety, depression and other emotional problems after experiencing stress events such as epidemic outbreak, studying at home and returning to school. The purpose of this study was to explore the development of anxiety and depression among students from the perspective of ecological systems theory and the effectiveness of acceptance and commitment therapy. In Study 1, 1735 junior high school students participated in the self-assessment of anxiety and depression at March 16 in 2020, and 535 students participated in the measurement from March 16 to June 22 in 2020, with an interval of 3-5 weeks for 5 times. Positive and Negative Affect Schedule-Children, Depression Self- rating Scale for Children, Child Anxiety Related Emotional Disorders were used to collect data. The results showed that the detection rate of anxiety was significantly higher than that of previous studies; anxiety and depression showed a V-shaped change over time, indicating that the outbreak of the epidemic and returning to school caused stress reaction of students, increasing the problem of anxiety and depression; the mental health status of girls was worse than that of boys, and that of senior students was worse than that of junior students; academic pressure and parent-child relationship affected students’ emotional health; the solution of depression and anxiety of adolescents in the period of normalization management of COVID-19 should be explored by parents, schools and society. Study 2 explored the effect of acceptance and commitment therapy on adolescent’s anxiety and depression. There were 208 subjects in the experimental group with an average age of 13.20 (SD = 1.75) and 99 females (47.6%), there were 362 subjects in the control group with an average age of 13.24 (SD = 1.59) and 179 females (49.4%). The experimental group received a 45 minutes intervention course once a month for 4 times and completed relevant assignments. The control group were given moral and rule of law courses or class meetings. The results of the mid-term test showed that acceptance and commitment therapy had a significant effect on decreasing adolescents' anxiety and negative emotion, while the post-test did not find any positive improvement on anxiety and depression. Future curriculum should constantly improve the mindfulness components, call on parents and schools to deeply participate in the curriculums, gradually establish a multi-level, multi-dimensional, more targeted mental health service system, including psychological counseling, parent education, student mental health courses. This study found that the students' anxiety and depression levels showed a "V" trend in the period of studying at home during COVID-19, and differences were significant in grades and grades; Acceptance and Commitment Therapy had immediate effect on improving junior high school students' anxiety and negative emotion; in the future, we should construct the prevention and control system of students' mental health based on social system, school teaching and family education to cope with the negative impact of major social public health events on students' mental health.
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