Objective: To investigate the effect of empathy on depressive symptoms in adolescents and to explore the potential mediating role of family functioning in the effect of empathy on depressive symptoms.
Methods: The 2022 cross-sectional data from the Chengdu Positive Child Development (CPCD) cohort were analyzed in the study. A survey was conducted in Chengdu in June 2022, involving 3020 students in grades 5-8 from three randomly selected stratified schools. The Interpersonal Reactivity Index (IRI-C), the Chinese Family Assessment Instrument (C-FAI), and the Center for Epidemiologic Studies Depression Scale for Children (CES-DC) were used in the survey. Chi-square test or one-way analysis of variance was performed to examine the differences in various demographic characteristics (sex, grade, region, and total monthly household income) between groups of respondents, as well as the differences in family functioning, empathy, and depression. Pearson correlation coefficient was used to examine the correlation between family functioning, empathy, and depressive symptoms. Structural equation modeling and SPSS PROCESS component Model 4 were used to analyze whether family functioning played a mediating role in the effect of empathy on depressive symptoms in adolescents.
Results: The detection rate of depressive symptoms among survey respondents was 25.40%. The results of the difference analysis revealed significant differences in the detection rates of depressive symptoms among respondents of different grades, regions, and monthly household incomes (P<0.05). There was no significant difference in the detection rates of depressive symptoms between male and female students. There was a significant difference in the detection rate of depressive symptoms between respondents with different scores for family dysfunction and empathy ability (P<0.001). Correlation analysis results showed that empathy scores were negatively correlated with depression (r=-0.11, P<0.001), that family dysfunction was positively correlated with depression (r=0.29, P<0.001), and that empathy scores were negatively correlated with family functioning (r=-0.37, P<0.001). The mediating role of family dysfunction in the relationship between empathy and depressive symptoms was established, with the direct effect being 0.039 (95% confidence interval [CI]: 0.010-0.069, P<0.001) and the indirect effect value being -0.096 (95% CI: -0.115--0.079, P<0.001). The direct effect value accounted for 28.89% of the total effect value, while the mediation effect value accounted for 71.11% of the total effect value.
Conclusion: The empathy ability of adolescents is correlated to depressive symptoms, and family functioning plays a mediating role between empathy and depressive symptoms in adolescents. It is suggested that adolescents' empathy ability and family functioning should be enhanced through multiple channels to reduce the occurrence of depressive symptoms.
目的: 了解青少年共情对抑郁症状的影响，探索家庭功能在共情对抑郁症状的影响中潜在的中介作用。
方法: 本研究为“成都儿童正向成长队列（CPCD）” 的2022年横断面数据，使用人际反应指针量表（IRI-C）、儿童家庭功能评定量表（C-FAI）、流调中心儿童抑郁量表（CES-DC），于2022年6月对成都市三所分层随机选择学校的3020名5～8年级学生进行调查。采用卡方检验或单因素方差分析，考察不同人口统计学特征（性别、年级、地区和家庭月总收入）在调查对象群体间，家庭功能、共情和抑郁间的差异。采用Pearson相关考察家庭功能、共情和抑郁症状之间的相关性。运用结构方程模型，采用SPSS PROCESS组件Model 4分析家庭功能在青少年共情对其抑郁症状的影响中是否存在中介作用。
结果: 调查对象抑郁症状检出率为25.40%。差异性分析结果显示，抑郁症状检出率在不同年级、地区、家庭月收入间的差异有统计学意义（P<0.05），抑郁症状检出率在男女学生之间的差异没有统计学意义；抑郁症状检出率在家庭功能障碍、共情能力得分之间的差异均有统计学意义（P<0.001）；相关分析结果显示，共情得分与抑郁呈负相关（r=−0.11，P<0.001），家庭功能障碍与抑郁呈正相关（r=0.29，P<0.001），共情得分与家庭功能呈负相关（r=−0.37，P<0.001）。家庭功能障碍在共情对抑郁症状关系中的中介作用成立，直接效应为0.039〔95%置信区间（confidence interval, CI）：0.010～0.069，P<0.001〕；间接效应值为－0.096（95%CI：−0.115～−0.079，P<0.001）。直接效应值占总效应值的28.89%，中介效应值占总效应值的71.11%。
结论: 青少年共情能力与抑郁症状相关，家庭功能在青少年共情与抑郁症状间具有部分中介作用。建议通过多种渠道增强青少年共情能力和家庭功能，降低抑郁症状的发生。
Keywords: Adolescents; Depression; Empathy; Family functioning; Mediation.
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