近年来，国内儿童青少年精神障碍的患病率迅速上升，青少年的心理健康危机成为社会关注的焦点。尽管精神医学与心理学领域的学者们对这一问题进行了大量讨论，但这些研究都未能关注到青少年群体的主体声音。本研究立足于青少年精神障碍患者的主位视角，回答了“作为青少年的精神障碍患者如何理解自身的精神疾痛”这一核心问题。本文对于东北某省会城市中一座省重点高中的四位学生精神障碍患者进行案例研究，呈现了这一群体的疾痛叙事。

本研究得出以下结论：首先，学生患者在对自身疾痛进行解释时，往往将其视为社会环境、家庭、学业与个体因素等多种力量交织的结果。其苦痛，即疾病带来的具身化的经验作为一种隐喻，在一定程度上投射出个体所陷入的特定社会结构困境。其次，青少年精神疾患的身份建构过程显示了家庭、同辈群体、学校教育乃至社会道德观念如何影响着患者对于疾痛的治疗与表达表达方式。在地方权力场景中，医学话语、家长制、学校教育间的系统性互动塑造着青少年精神疾患的疾痛体验。此外，本文揭示了嵌入在地方文化系统之中的精神疾痛所呈现出的多重意义：（1）疾痛可以作为一种“安全阀”让学生患者在学习与生活中获得更多的自主掌控权，并以此为自己无法在激烈的升学竞争中保持优绩而开脱；（2）家长与子女对于疾痛理解的差异反映了代际间的文化鸿沟，而家庭对于疾痛的回避态度则进一步加剧了学生的精神苦痛；（3）在学校中，教师对于学生的疾痛解释往往与有悖于学生角色的“越轨”行为联系起来，它作为学校在管理学生时的一种分类与话语策略，帮助学校实现了常规秩序的维持。

基于以上对于青少年精神障碍患者疾痛叙事的呈现与分析，本文提出社会长期以来对于精神疾病的污名化使得青少年患者缺乏相应的社会支持与合理疾痛表达的空间，而本研究在一定程度上弥补了以往研究所存在的青少年“失声”问题。

In recent years, the prevalence of mental disorders among children and adolescents in China has risen rapidly, and the mental health crisis among adolescents has become a focus of social concern. Although scholars in the fields of psychiatry and psychology have discussed this issue extensively, these studies have failed to focus on the subjective voices of adolescents. Based on the emic perspective of adolescents with mental disorders, this study answers the central question of how adolescents with mental disorders understand their mental illness. This paper presents a case study of four students with mental disorders from a provincial high school in a capital city in Northeast China, and presents the narratives of this group.

The following conclusions are drawn from this study: first, when explaining their illness, the student patients tended to view it as the result of a combination of social, familial, academic, and individual factors. Their suffering (the embodied experience of illness), serves as a metaphor that projects, to some extent, the specific socially structured dilemma in which the individual is caught. Secondly, the process of identity construction in adolescent mental disorders shows how family, peer group, schooling, and even societal morality influence the way in which patients treat and express their illness. In local power scenarios, systematic interactions between medical discourse, paternalism, and schooling shape adolescent psychiatric patients' experience of pain. Otherwise, this paper reveals the multiple meanings of mental illness embedded in the local cultural system: (1) illness can be used as a "safety valve" for students to gain more autonomy in their studies and lives, and as a way of justifying their inability to maintain their performance in the fierce competition for higher education; (2) the differences in the understanding of illness between parents and their children reflect the differences in the understanding of illness between parents and their children. Differences between parents' and children's understandings of illness reflect an intergenerational cultural divide, and the family's avoidance of illness further exacerbates students' mental suffering; (3) In schools, teachers' explanations of students' illness are often associated with "transgressive" behaviors that are contrary to the role of the student as a categorization and discursive strategy to help schools achieve the goal of "transgressing" the role of the student in school management. It serves as a categorization and discursive strategy to help the school maintain order.

Based on the above presentation and analysis of the illness narratives of adolescents with mental disorders, this paper suggests that the longstanding stigmatization of mental illness in society has resulted in a lack of social support and space for adolescents to reasonably express their illness, and that the present study has, to a certain extent, remedied the problem of adolescents' "lost voices" that existed in previous studies.