大学生创伤后成长现状及其与创伤后应激症状之间的中介路径

王亚; 向小润; 赵亚平; 谷海燕; 邓小凤; 孙溦

doi:10.3760/cma.j.cn501225-20260309-00099

大学生创伤后成长现状及其与创伤后应激症状之间的中介路径

doi: 10.3760/cma.j.cn501225-20260309-00099

1.
陆军军医大学（第三军医大学）第一附属医院江北院区派驻门诊部,重庆　401331
2.
陆军军医大学（第三军医大学）第一附属医院心外科,重庆　400038
3.
陆军军医大学（第三军医大学）第一附属医院急诊医学科,重庆　400038

基金项目:

重庆市自然科学基金面上项目 CSTB2022NSCQ-MSX1400

详细信息

通讯作者:
孙溦,Email：sunfamily@tmmu.edu.cn

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- 被引次数: 0
出版历程
- 收稿日期: 2026-03-09
- 网络出版日期: 2026-05-11

Current status of post-traumatic growth among university students and its mediation pathway with post-traumatic stress symptom

1.
The 958th Army Hospital Outpatient Department, Chongqing 401331, China
2.
Department of Cardiovascular Surgery, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
3.
Department of Emergency Medicine, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China

Funds:

General Program of Chongqing Natural Science Foundation CSTB2022NSCQ-MSX1400

More Information

Corresponding author: Sun Wei, Email: sunfamily@tmmu.edu.cn

摘要

摘要: 目的调查大学生创伤后成长（PTG）现状,探讨其与创伤后应激症状（PTSS）之间的中介路径。方法该研究为多中心横断面调查。2024年12月—2025年1月,采用便利抽样法,选取重庆市2所综合大学、1所医科大学中符合入选标准的18岁以上近1年经历生活应激事件的718名在校大学生,作为研究对象。采用自编人口学问卷调查大学生性别、年龄、年级、家庭结构等人口学资料；采用青少年生活事件量表调查大学生生活应激事件经历及是否受这些事件影响；采用创伤后应激障碍自评量表平民版、中文版PTG评定量表、简版心理弹性量表及中文版PERMA幸福指数量表,分别评估大学生PTSS、PTG、心理弹性和幸福感水平。将大学生按人口学资料和是否受生活应激事件影响分类,比较其PTG总评分；分析大学生PTG、PTSS、心理弹性及幸福感之间的相关性；筛选大学生PTG的独立影响因素；通过构建结构方程模型,分析幸福感和心理弹性在PTSS与PTG转化间的中介效应。结果共发放问卷718份,回收有效问卷647份,有效回收率为90.1%。大学生中,男584人、女63人,年龄18~27岁,年级为大一年级者84人、大二年级者178人、大三年级者196人、大四年级者189人,家庭结构为双亲家庭者582人、单亲家庭者65人,受生活应激事件影响者102人、未受生活应激事件影响者545人。大学生经历的生活应激事件包括躯体创伤、患急重病、人际关系紧张、学习压力大等27项。大学生PTSS、PTG、心理弹性和幸福感总评分分别为18.00（17.00,27.00）、64.00（41.00,80.00）、30.00（21.00,39.00）、118.00（90.00,135.00）分。不同年龄、家庭结构、生活应激事件影响大学生PTG总评分比较,差异均有统计学意义（Z值分别为-3.426、-2.285、-3.693,P<0.05）。大学生PTG总评分及其各维度评分与心理弹性总评分、幸福感总评分及其各维度评分均呈显著正相关（r值为0.377~0.653,P<0.05）。年龄、家庭结构、是否受应激事件影响、幸福感和心理弹性均是大学生PTG的独立影响因素（β值分别为-0.144、0.109、-0.151、0.181、0.603,P<0.05）。构建的模型为多重中介模型,在PTSS与PTG转化间,幸福感的单独中介效应及幸福感与心理弹性的链式中介效应均具有统计学意义（β值分别为-0.140、-0.287,95%CI分别为-0.224~-0.075、-0.381~-0.214,P<0.05）,幸福感与心理弹性的链式中介效应显著高于幸福感的单独中介效应（β=0.146,95%CI为0.027~0.275,P<0.05）。结论大学生PTG呈中等水平,幸福感和心理弹性在大学生PTSS与PTG转化间发挥链式中介作用。
- 创伤和损伤 /
- 韧性,心理 /
- 创伤后成长 /
- 幸福感 /
- 创伤后应激症状 /
- 创伤感知
Abstract: Objective To investigate the current status of post-traumatic growth (PTG) among university students, and to explore its translational pathway with post-traumatic stress symptom (PTSS). Methods This study was a multicenter cross-sectional survey. From December 2024 to January 2025, using convenience sampling, 718 university students aged ≥18 years who met the inclusion criteria and had experienced life stress events in the past year were selected from two comprehensive universities and one medical university in Chongqing as the study participants. A self-designed demographic questionnaire was used to collect demographic information of the university students, including gender, age, grade level, and family structure, etc. The adolescent self-rating life events checklist was used to assess university students' experiences of life stress events and whether they were affected by these events. The post-traumatic stress disorder checklist-civilian version, the Chinese-Posttraumatic Growth Inventory, the 10-item Connor-Davidson resilience scale, and the Chinese PERMA-Profiler were used to assess university students' levels of PTSS, PTG, psychological resilience, and well-being, respectively. University students were classified according to demographic information and whether they were affected by life stress events, and their total PTG scores were compared. Correlations between PTG and PTSS, psychological resilience, and well-being in university students were analyzed. Independent influencing factors for PTG among university students were identified. A structural equation model was constructed to analyze the mediating effects of well-being and psychological resilience on the translation between PTSS and PTG. Results Totally 718 questionnaires were distributed, and 647 valid questionnaires were returned, with a valid response rate of 90.1%. Among the university students, there were 584 males and 63 females, aged 18 to 27 years. There were 84 first-year students, 178 second-year students, 196 third-year students, and 189 fourth-year students by grade level. There were 582 students from two-parent families and 65 from single-parent families in the family structure. Totally 102 students were affected by life stress events, while 545 students were not affected by life stress events. The life stress events experienced by university students included 27 items, such as physical trauma, acute or serious illness, interpersonal tension, and academic pressure. The total scores of PTSS, PTG, psychological resilience, and well-being among university students were 18.00 (17.00, 27.00), 64.00 (41.00, 80.00), 30.00 (21.00, 39.00), and 118.00 (90.00, 135.00), respectively. Comparisons of total PTG scores among university students showed statistically significant differences by different age, family structure, and exposure to life stress events (with Z values of -3.426, -2.285, and -3.693, respectively, P<0.05). The total PTG score and its subdimension scores among university students were significantly positively correlated with the total psychological resilience score, the total well-being score and its subdimension scores (with r values of 0.377 to 0.653, P<0.05). Age, family structure, whether being affected by life stress events, well-being, and psychological resilience were independent influencing factors for PTG among university students (with β values of -0.144, 0.109, -0.151, 0.181, and 0.603, respectively, P<0.05). The constructed model was a multiple mediation model. Between PTSS and PTG, both the independent mediating effect of well-being and the serial mediating effects of well-being and psychological resilience were statistically significant (with β values of -0.140 and -0.287, respectively, 95% CI of -0.224 to -0.075 and -0.381 to -0.214, respectively, P<0.05), and the serial mediating effect of well-being and psychological resilience was significantly higher than the independent mediating effect of well-being (β=0.146, with a 95% CI of 0.027 to 0.275, P<0.05). Conclusions PTG among university students is at a moderate level. Well-being and psychological resilience play a serial mediating role in the translation between PTSS and PTG among university students.
- Wounds and injuries /
- Resilience, psychological /
- Post-traumatic growth /
- Well-being /
- Post-traumatic stress symptoms /
- Trauma perception
王亚：研究设计、数据收集、数据分析、论文撰写；向小润、赵亚平、谷海燕、邓小凤：实施研究、数据收集；孙溦：研究设计与指导、数据分析、论文修改

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下载: 全尺寸图片幻灯片

图 1 基于647名大学生创伤后应激症状、创伤后成长、幸福感和心理弹性构建的多重中介模型

注：图中椭圆形中为潜变量,矩形中为观测变量；潜变量指向观测变量的箭头上的数字为标准化因子载荷,表示观测变量对潜变量的解释力；潜变量之间的箭头上的数字为标准化路径系数,表示变量之间的直接影响强度；e为残差项,观测变量的e表示测量误差,潜变量的e表示模型未能解释的变异部分,e1~e26为残差编号；CD1~CD10为心理弹性的10个观测变量；^aP<0.05表示标准化路径系数具有统计学意义

下载: 全尺寸图片幻灯片

Table 1. 647名大学生在不同人口学资料和生活应激事件影响下创伤后成长总评分比较[分,M（Q₁,Q₃）]

项目与分类	人数	创伤后成长总评分	统计量值	P值
性别
男	584	68.00（41.25,80.00）	Z=-1.706	0.088
女	63	59.00（40.00,69.00）	Z=-1.706	0.088
年龄（岁）
≤20	127	69.00（54.00,85.00）	Z=-3.426	<0.001
>20	520	63.00（36.00,78.00）	Z=-3.426	<0.001
年级
大一	84	66.50（28.25,76.00）	H=7.793	0.050
大二	178	69.00（39.75,80.00）
大三	196	67.50（48.25,83.75）
大四	189	60.00（38.00,77.50）
民族
汉族	576	64.00（42.00,79.00）	Z=-0.078	0.938
少数民族	71	63.50（37.75,81.50）	Z=-0.078	0.938
是否为独生子女
是	270	64.00（37.75,80.00）	Z=-0.461	0.645
否	377	65.00（43.50,79.50）	Z=-0.461	0.645
受教育程度
大专	263	65.00（32.00,78.00）	Z=-1.660	0.097
本科	384	63.50（43.00,80.00）	Z=-1.660	0.097
是否为学生干部
是	216	63.50（46.25,81.00）	Z=-1.091	0.275
否	431	64.00（39.00,79.00）	Z=-1.091	0.275
家庭结构
双亲家庭	582	63.00（40.00,78.00）	Z=-2.285	0.022
单亲家庭	65	74.00（48.50,90.50）	Z=-2.285	0.022
是否受生活应激事件影响
是	102	53.00（32.75,67.25）	Z=-3.693	<0.001
否	545	69.00（44.50,80.00）	Z=-3.693	<0.001
注：生活应激事件统计近1年情况

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Table 2. 是否受生活应激事件影响大学生的核心心理指标总评分比较[分,M（Q₁,Q₃）]

分类	人数	创伤后应激症状总评分	心理弹性总评分	幸福感总评分
受影响	102	39.00（28.00,45.50）	24.50（17.75,33.25）	94.50（75.00,121.00）
未受影响	545	17.00（17.00,21.00）	35.00（24.00,40.00）	122.00（98.00,143.00）
Z值		-13.053	-5.555	-5.701
P值		<0.001	<0.001	<0.001
注：生活应激事件统计近1年情况

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Table 3. 647名大学生创伤后成长、创伤后应激症状、心理弹性及幸福感之间的相关性分析结果

变量	PTG	自我转变	人生感悟	与他人关系	新的可能	个人力量	PTSS	闯入症状	回避/麻木症状	警觉症状	心理弹性	幸福感	成就	积极情绪	意义	人际关系	投入
PTG		—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—
自我转变	0.876^a		—	—	—	—	—	—	—	—	—	—	—	—	—	—	—
人生感悟	0.959^a	0.793^a		—	—	—	—	—	—	—	—	—	—	—	—	—	—
与他人关系	0.923^a	0.774^a	0.844^a		—	—	—	—	—	—	—	—	—	—	—	—	—
新的可能	0.928^a	0.755^a	0.859^a	0.860^a		—	—	—	—	—	—	—	—	—	—	—	—
个人力量	0.930^a	0.743^a	0.923^a	0.833^a	0.853^a		—	—	—	—	—	—	—	—	—	—	—
PTSS	-0.183^a	-0.041	-0.175^a	-0.185^a	-0.210^a	-0.182^a		—	—	—	—	—	—	—	—	—	—
闯入症状	-0.196^a	-0.063	-0.195^a	-0.198^a	-0.202^a	-0.201^a	0.872^a		—	—	—	—	—	—	—	—	—
回避/麻木症状	-0.163^a	-0.039	-0.155^a	-0.166^a	-0.191^a	-0.160^a	0.913^a	0.809^a		—	—	—	—	—	—	—	—
警觉症状	-0.240^a	-0.081^a	-0.237^a	-0.226^a	-0.254^a	-0.242^a	0.864^a	0.700^a	0.723^a		—	—	—	—	—	—	—
心理弹性	0.647^a	0.514^a	0.648^a	0.589^a	0.608^a	0.653^a	-0.300^a	-0.321^a	-0.283^a	-0.320^a		—	—	—	—	—	—
幸福感	0.575^a	0.438^a	0.578^a	0.553^a	0.521^a	0.548^a	-0.348^a	-0.341^a	-0.328^a	-0.342^a	0.654^a		—	—	—	—	—
成就	0.571^a	0.451^a	0.567^a	0.547^a	0.521^a	0.540^a	-0.352^a	-0.337^a	-0.328^a	-0.349^a	0.649^a	0.960^a		—	—	—	—
积极情绪	0.562^a	0.431^a	0.571^a	0.532^a	0.509^a	0.534^a	-0.348^a	-0.340^a	-0.330^a	-0.346^a	0.636^a	0.964^a	0.911^a		—	—	—
意义	0.556^a	0.428^a	0.570^a	0.525^a	0.490^a	0.544^a	-0.330^a	-0.336^a	-0.307^a	-0.329^a	0.642^a	0.963^a	0.931^a	0.920^a		—	—
人际关系	0.516^a	0.377^a	0.516^a	0.512^a	0.481^a	0.483^a	-0.327^a	-0.328^a	-0.311^a	-0.314^a	0.606^a	0.937^a	0.862^a	0.897^a	0.886^a		—
投入	0.547^a	0.424^a	0.548^a	0.524^a	0.496^a	0.524^a	-0.293^a	-0.276^a	-0.282^a	-0.287^a	0.601^a	0.929^a	0.862^a	0.876^a	0.854^a	0.845^a
注：基于创伤后成长（PTG）、创伤后应激症状（PTSS）、幸福感总评分及其各维度评分及心理弹性总评分分析,PTG包括自我转变、人生感悟、与他人关系、新的可能、个人力量5个维度,PTSS包括闯入症状、回避/麻木症状、警觉症状3个维度,幸福感包括成就、积极情绪、意义、人际关系、投入5个维度；表中数据为r值,表示对应行变量与列变量之间的相关性,^aP<0.05表示相关性具有统计学意义；空白表示该位置无须填写数据；“—”表示数据重复

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Table 4. 647名大学生创伤后成长的影响因素分层回归分析结果

分层与自变量	B值	β值	P值
第1层
年龄（岁）	2.590	-0.144	<0.001
家庭结构	11.087	0.109	0.005
是否受生活应激事件影响	12.601	-0.151	<0.001
第2层
创伤后应激症状（分）	0.150	0.055	0.100
心理弹性（分）	1.496	0.603	<0.001
幸福感（分）	0.150	0.181	<0.001
注：生活应激事件统计近1年情况

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Table 5. 647名大学生PTSS与PTG转化间的中介效应分析结果

中介路径	β值	95%CI	效应占比（%）	P值
PTSS—幸福感—PTG	-0.140	-0.224~-0.075	25.13	<0.001
PTSS—心理弹性—PTG	-0.026	-0.091~0.046	4.67	0.493
PTSS—幸福感—心理弹性—PTG	-0.287	-0.381~-0.214	51.53	<0.001
注：PTSS为创伤后应激症状,PTG为创伤后成长