Resilience - based multifactorial model of depression among people who lost an only - child in China

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2021 Jan 28;46(1):75-83. doi: 10.11817/j.issn.1672-7347.2021.190301.
[Article in English, Chinese]

Abstract

Objectives: There are almost one million families who lost their only child in China, and 65.6% of them had severe and long lasting depression and needed timely psycho-intervention. This study aims to explore the relationship among resilience and its influential factors, and to compare their effect on depression.

Methods: A total of 212 only-child loss person in 9 administrative regions in Changsha were assessed by using Connor-Davidson Resilience Scale, Zung Self-rating Depression Scale, Simplified Coping Style Questionnaire, Simplified Eysenck Personality Questionnaire, Social Support Rating Scale, and General Self-efficacy Scale. A hypothetical model was tested based on Kumpfer resilience framework and stress-coping theory.

Results: The influential factors of resilience were: positive coping (the total effect value was 0.480), support utilization (the total effect value was 0.359), neuroticism (the total effect value was -0.326), negative coping (the total effect value was 0.279), extraversion (the total effect value was 0.219), and objective support (the total effect value was 0.077). The process of individual-environment interaction showed a greater impact on resilience, which had a direct effect on depression (the total effect value was -0.344, 67.1%), and also indirect effect through self-efficacy (the total effect value was -0.169). The total effect of resilience accounted for 20.1% of the total effect of all variables.

Conclusions: Resilience mainly impacts depression directly, and can negatively predict depression in only-child loss parents. Resilience, located before self-efficacy, is a significant stress mediating variables. Personality traits and support utilization indirectly impact resilience via negative and positive coping. The key to promote the reorganization of resilience is the process of individual-environmental interaction, involving support utilization, positive coping, and some sorts of negative coping strategies, which plays an important role in developing a resilience intervention program and can improve the depression of the only-child loss person.

目的: 中国失独家庭已多达百万个,65.6%的失独者存在严重而持久的抑郁情绪,需要及时干预。本研究旨在探索心理弹性与其影响因素的交互作用,比较心理弹性及其影响因素对于失独者抑郁的效应。方法: 采用Connor-Davidson心理弹性量表、Zung抑郁自评量表、简易应对方式问卷、艾森克简式量表中国版、社会支持评定量表、一般自我效能感量表对长沙市9个行政区域212名失独者进行入户调查。基于Kumpfer心理弹性框架和心理应激多因素作用过程的理论模式构建假设模型并进行验证。结果: 心理弹性的影响因素有:积极应对(总效应值为0.480)、支持利用(总效应值为0.359)、精神质(总效应值为-0.326)、消极应对(总效应值为0.279)、内外倾(总效应值为0.219)、客观支持(总效应值为0.077)。心理弹性对抑郁的影响以直接效应为主(总效应值为-0.344,占67.1%),也通过自我效能感发挥间接效应(总效应值为-0.169),心理弹性的总效应值占所有变量总效应的20.1%。结论: 心理弹性受到人格、积极应对、社会支持等应激中介变量的直接和间接作用;心理弹性对抑郁主要产生直接负性效应,是定位于自我效能感之前的重要应激中介变量。个体-环境互动作用过程对心理弹性的影响较大,人格和支持利用通过影响消极应对、积极应对进而间接影响心理弹性。提高心理弹性应当关注个体-环境作用过程,即利用支持、积极应对、适当的消极应对,进而影响个体对自我的积极评价,这将是开发心理弹性干预方案以改善失独者抑郁的重要内容。.

Keywords: depression; only-child loss person; resilience; stress; structural equation model.

MeSH terms

  • Adaptation, Psychological*
  • Child
  • China / epidemiology
  • Extraversion, Psychological
  • Humans
  • Only Child*
  • Surveys and Questionnaires