臺灣青少年與其主要照顧者對青少年自我傷害、憂鬱症狀和幸福感報告一致度

Abstract

背景：家長覺察青少年心理健康狀況有助於促進其尋求幫助和早期介入。過去研究顯示，家長與青少年對青少年心理健康問題的報告之間存在差異。然而，以往關於家長覺察青少年自傷行為和心理健康狀況的研究有限。 目的：本研究主要探討青少年與其主要照顧者在報告青少年自傷行為、憂鬱症狀及心理幸福感一致性的程度，以及影響青少年與主要照顧者報告一致性之相關因素。 方法：本研究資料來自臺灣出生世代先驅研究（TBCS-P），共1417對青少年及其照顧者。研究使用Kappa評估青少年自傷行為報告的一致性，而憂鬱症狀、快樂和幸福感的報告一致性則使用組內相關係數（ICC）進行評估，並使用多重線性迴歸分析檢驗青少年與主要照顧者對青少年憂鬱症狀、快樂和幸福感報告差異的相關因素。 研究結果：結果顯示，照顧者與青少年在報告青少年自傷行為（k = 0.28）和憂鬱症狀（ICC = 0.28）的一致性較低，而在報告心理幸福感的一致性則為中等程度（ICC = 0.48及0.43）。總體而言，照顧者傾向低估青少年的自傷行為和憂鬱症狀，並高估其快樂和幸福感。心理健康較好的母親傾向低估青少年的憂鬱症狀和高估其快樂與幸福感。此外，男性家長照顧者傾向高估青少年的幸福感，且父母的高回應教養方式與高估青少年的幸福滿意度有關。 結論：照顧者與青少年在報告青少年自傷行為和憂鬱症狀方面的一致性較低，而在報告心理幸福感之一致性為中等程度。照顧者普遍低估青少年的自傷行為和憂鬱症狀，同時高估其快樂和幸福感。這些發現對於提高家長對青少年心理健康問題的認識具有重要意義。

Background: Parental detection of adolescents’ mental health issues could increase help-seeking and early intervention. Past research indicated discordance between caregivers’ and adolescents’ reports of adolescent mental health problems. However, previous studies on caregivers' awareness of adolescent self-harm and mental well-being were limited. Aim: This study aimed to investigate the extent of discordance between adolescents and caregivers in reporting adolescent self-harm, depressive symptoms, and psychological well-being, and identify the potential factors associated with this discordance. Method: Data for 1,417 pairs of adolescents and their caregivers were extracted from the Taiwan Birth Cohort Pilot Study (TBCS-P). Concordance in the reports of self-harm was assessed using Kappa, while those for depressive symptoms, happiness, and well-being satisfaction were evaluated using the Intraclass Correlation Coefficient (ICC). Multiple linear regression was employed to examine the factors associated with discordance in adolescents’ and caregivers’ reports of adolescent depressive symptoms, happiness, and well-being satisfaction. Result: The results showed low caregiver-adolescent concordance in reporting adolescent self-harm (k = 0.28) and depressive symptoms (ICC = 0.28), while concordance in reporting happiness and well-being satisfaction was moderate (ICC = 0.48 and 0.43, respectively). Overall, caregivers tended to underestimate adolescent self-harm and depressive symptoms while overestimating adolescent happiness and well-being. Mothers with better mental health tended to underestimate adolescent depressive symptoms and overestimate adolescent happiness and well-being. Additionally, male caregivers tended to overestimate adolescent happiness, and parents’ high responsiveness was associated with overestimating adolescent well-being satisfaction. Conclusion: The study revealed a low concordance between caregivers and adolescents in reporting self-harm and depressive symptoms, and a moderate concordance in reporting psychological well-being. Caregivers generally underestimated adolescent self-harm and depressive symptoms while overestimating their happiness and well-being. The findings have implications for parenting education to increase parents’ awareness of adolescents’ mental health issues.