| 其他摘要 | According to the statistical data from UNICEF, it is estimated that 1 in 7 (14%) 10-19-year-olds experience mental disorders globally. Adolescent mental disorders not only affect their life in the short term but can also continue to impact them during their adult years negatively. Therefore, twelve government departments, including the National Health Commission of the People’s Republic of China, have called for studies on early detection and intervention of children and adolescents with common psychobehavioral and mental disorders. Early detection and intervention of adolescent mental disorders are facilitated by the approach of rapid detection of adolescent mental disorders and the screening of major influencing factors. Previous studies have provided well-established scales to measure adolescent mental health and have partially explored a variety of influence factors on adolescent mental health. This study focuses on the early identification, prevention, and intervention of mental health problems in adolescents, and aims to identify the most important items for measuring adolescents' mental health from commonly-used scales, as well as to identify influential factors that are more closely related to the level of adolescents' mental health from a large number of potential influential factors.
The data for this study came from the National Student Mental Health Survey in the Chinese Mental Health Database. The survey covered 31 provinces (municipalities and autonomous regions) and included 192 elementary schools, 96 middle schools, 96 high schools, and 128 colleges and universities. Stratified sampling was used and all students in 2 classes in each school participated in the survey and a total of 68,191 valid questionnaires were obtained.
Based on the big data above, this study conducted an importance analysis of mental health measurement entries and influencing factors using the machine learning algorithm random forest. Based on the Dual-Factor Model of Mental Health, study 1 explored the rapid screening of adolescent mental health status using The Center for Epidemiological Studies Depression Scale (CESD-20), Generalized Anxiety Disorder Scale (GAD-7), and Brief Multidimensional Students' Life Satisfaction Scale (BMSLSS). Based on the Dual-Factor Model of Mental Health and the Bioecological Model, study 2 examined environmental factors more closely related to adolescent mental health.
The results of the importance analysis of the measurement entries in Study 1 showed that, (1) the five negative affection dimension entries of CESD-20 were the most important entries for measuring depression with a model accuracy of 90%; (2) the two negative cognitive and affective dimension entries of the GAD-7 were the most important entries for measuring anxiety with a model accuracy of 95%; (3) the overall life satisfaction entry and self-satisfaction entry in BMSLSS are the most important entries for measuring adolescent life satisfaction, with a model accuracy of 87%; (4) the 10 important measurements of adolescent mental health levels (Flourishing, Vulnerable, Symptomatic but content, Troubled) include all the entries in BMSLSS and the negative affection dimensions of CESD-20, with a model accuracy of 88%.
The results of the importance analysis of the influencing factors in Study 2 showed that grade and the influencing factors related to the school microsystem (school environment, peer relationships, school bullying, teacher-student relationships, and interest in learning) were more closely related to adolescent mental health levels. Of these, (1) the five factors are most closely related to adolescent depression: school climate, peer friendship, school bullying, grade, and teacher-student relationship; (2) the five factors are most closely related to adolescent anxiety: school climate, school bullying, grade, teacher-student relationship, and peer friendship; (3) the five factors are most closely related to adolescent life satisfaction: peer friendship, school climate, academic interest, father-student relationships, and grade; and (4) the five factors are most closely associated with four adolescent mental health levels: school climate, peer friendship, teacher-student relationships, grade, and school bullying.
In summary, this study provides a rapid method to detect adolescent mental problems and identifies the factors most closely related to adolescent mental health. Based on these findings, the main measurement entry for depression and anxiety is negative affection, so it is important for parents and schools to pay attention to adolescent negative moods in daily life in order to detect adolescent mental health problems as early as possible. Meanwhile, it is recommended to use tertiary defense preventive measures as well as intervention treatments for adolescents with different mental health levels by building a safe, friendly, and harmonious school climate, eliminating school bullying, enhancing adolescent emotion regulation skill, school belongness and the ability to cope with academic pressure. |
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