皮质醇在不良童年经历与抑郁症状关联中的中介作用及性别差异

目的 探讨不良童年经历对抑郁症状的影响及皮质醇水平的中介作用和性别的调节作用。方法 采用多阶段随机抽样的方法抽取206名中学生。采用不良童年经历量表（ACE-IQ）、流调中心抑郁量表（CES-D）对其进行测量；采用化学发光分析方法检测皮质醇水平。结果 不良童年经历与皮质醇水平和抑郁症状呈正相关（r=0.14，P＜0.05；r=0.43，P＜0.01），皮质醇水平与抑郁症状呈正相关（r=0.22，P＜0.01）。皮质醇水平在不良童年经历和抑郁症状之间起部分中介作用（β=0.17，t=2.590，P＜0.05），中介效应占总效应的5.4%。性别对不良童年经历与抑郁症状的中介过程存在调节作用（中介作用的后半路径）（β=0.14，t=2.184，P＜0.05）；对于女生，皮质醇水平可以正向预测抑郁症状（β=0.05，t=4.176，P＜0.05）；对于男生，皮质醇不能预测抑郁症状（β=0.00，t=4.209，P＞0.05）。结论 皮质醇水平通过不良童年经历间接影响青少年的抑郁症状，且受到性别的调节。

Mediating role of cortisol in the association between adverse childhood experience and depressive symptoms and gender differences

Objective To explore the effects of adverse childhood experiences on depressive symptoms and the mediating role of cortisol levels and the moderating effect of sex. Methods A total of 206 middle school students were selected by multi-stage random sampling and measured by the Adverse Childhood Questionnaire (ACE-IQ) and the Center for Epidemiologic Studies Depression Scale (CES-D). Cortisol levels were measured by chemiluminescence analysis. Results Adverse childhood experiences were positively correlated with cortisol levels and depressive symptoms (r=0.14, P＜0.05; r=0.43, P＜0.01＝, and cortisol levels were positively associated with depressive symptoms (r=0.22, P<0.01) Cortisol mediated the effect of adverse childhood experiences on depressive symptoms, accounting for 6% of the total effect. Cortisol partially mediated the association between adverse childhood experiences and depressive symptoms (β=0.17, t=2.590, P＜0.05, accounting for 5.4% of the total effect. Moreover, gender could regulate the second half of the mediating process between adverse childhood experiences and depressive symptoms (β=0.14, t=2.184, P＜0.05. Specifically, for women, cortisol levels could positively predict depressive symptoms (β=0.05, t=4.176, P＜0.05, but nor for men (β=0.00, t=4.209, P＞0.05). Conclusion Cortisol levels indirectly affect the depressive symptoms of adolescents through adverse childhood experiences and are regulated by gender.