我国青少年近视的发病率逐年增高，并呈现出低龄化的趋势，近视普遍化使得近视给青少年带来的心理危害常被忽视。以往对疾病的研究表明，疾病会影响个体的认知水平，影响患者的心理健康，疾病程度越严重越容易出现负面疾病感知，而认知治疗理论强调认知因素对人的行为和情绪的影响，也有研究表明疾病感知能够在疾病程度与消极情绪之间起到中介的作用。在近视与抑郁之间关系的以往研究中，学者得出了相互矛盾的结论，可能是研究群体对近视的认知不同造成的。因此，本研究引入近视感知的概念，探讨近视感知在青少年近视与抑郁的关系中所起的作用，参照以往对疾病感知的界定研究认为，对近视的消极感知是近视中学生心理问题的主要影响因素，而对中学生访谈中发现中学生也主要存在“近视是智慧形象、近视是正常现象”这两种认知。因此本文从近视的“消极感知”“智慧形象”“正常现象”三方面对近视感知进行探讨。从社会工作角度，通过改变青少年对近视的不良认知，达到缓解负面情绪，减少抑郁发生的效果，为近视青少年心理问题疏导提供新的视角。

本研究采用目的抽样对3172名农村地区中学生展开调查，采用简版流调中心抑郁量表（CES-D-10）与近视感知问卷对变量进行测量。描述了不同人口学变量下中学生近视与抑郁的分布特点，探讨中学生近视程度、近视感知、抑郁三者之间的关系，并分析近视感知在其中所起到的中介/调节作用，主要研究结果如下：

第一，初中生近视率为58%，中高度近视占13.1%，女生、高年级的学生近视率更高。

第二，正常视力初中生抑郁发病率为22.3%，近视初中生生抑郁发病率为27.9%，中高度近视的学生比视力正常学生出现抑郁情绪的风险更高。

第三，初中生近视程度与抑郁存在相关关系。相较于正常视力，学生近视程度越严重，抑郁得分越高。

第四，“消极感知”与抑郁正相关；“智慧形象”、“正常现象”与抑郁关系不显著。

第五，近视程度与抑郁的关系中，近视的“消极感知”在二者之间是起中介作用，将近视视为 “正常现象”起调节的作用，“智慧形象”调节作用不显著。

根据研究结果，本研究认为社会工作者可以采用理性情绪模式等认知疗法，对中学生近视的消极感知进行干预，纠正错误认知，引导中学生树立良心思维方式，正确看待近视。另可通过近视预防、心理健康引导、不良情绪干预等方式，促进近视中学生身心良性发展。

The prevalence of myopia among adolescents in China is increasing year by year and is trending towards a younger age. The prevalence of myopia makes the psychological harm it brings to adolescents often overlooked. Previous research on illness has shown that illness affects the cognitive level of the individual and affects the psychological well-being of the patient, and that the more severe the illness, the more likely negative illness perceptions are to occur, while cognitive therapy theory emphasises the influence of cognitive factors on human behaviour and emotions, and studies have also shown that illness perception can mediate the relationship between illness level and negative emotions. In previous studies on the relationship between myopia and depression, scholars have reached conflicting conclusions, possibly due to differences in the perceptions of myopia among the study groups. Therefore, this study introduces the concept of myopia perception to explore the role of myopia perception in the relationship between myopia and depression in adolescents. With reference to previous studies defining illness perception, it is concluded that negative perception of myopia is the main influencing factor of psychological problems among myopic secondary school students, and interviews with secondary school students also revealed that secondary school students mainly have the two perceptions of "myopia is an image of intelligence and myopia is a normal phenomenon The interviews with secondary school students also revealed that secondary school students mainly have the perceptions of "myopia as an intellectual image and myopia as normal". This paper therefore explores myopia perceptions in terms of "negative perceptions", "intellectual images" and "normal phenomena", and uses this to explore the effects of alleviating negative emotions and reducing depression. From a social work perspective, by changing adolescents' negative perceptions of myopia, the effect of alleviating negative emotions and reducing the occurrence of depression can be achieved, providing a new perspective on the management of psychological problems in myopic adolescents.

The study used a purposive sample of 3172 secondary school students in rural areas, and measured the variables using the short version of the Centre for Streaming Investigation Depression Scale (CES-D-10) and the Myopia Perception Questionnaire. The distribution characteristics of myopia and depression among secondary school students under different demographic variables were described, the relationship between myopia, myopia perception and depression among secondary school students was explored, and the mediating/moderating role played by myopia perception was analysed, with the following main findings.

Firstly, the myopia rate among junior high school students was 58 %, with moderate to high myopia accounting for 13.1%, and the rate was higher among girls and students in higher grades.

Second, the prevalence of depression was 22.3 % for normal vision junior high school students and 27.9 % for myopic junior high school students, with students with moderate to high myopia being at higher risk of depression than those with normal vision.

Third, there was a correlation between the degree of myopia and depression among junior high school students. The more severe myopia students had compared to normal vision, the higher the depression score.

Fourth, "negative perception" was positively related to depression; "intellectual image" and "normalcy" were not significantly related to depression.

Fifth, in the relationship between myopia and depression, the "negative perception" of myopia mediated the relationship between the two, and the "normal phenomenon" of myopia played a moderating role, while the "wisdom image The moderating effect of "wisdom image" was not significant.

Based on the findings, this study concludes that social workers can use cognitive therapies such as the rational-emotional model to intervene in secondary school students' negative perceptions of myopia, correct misperceptions and guide secondary school students to develop a conscientious way of thinking and view myopia correctly. In addition, myopia prevention, mental health guidance and adverse emotion intervention can be used to promote the positive physical and psychological development of myopic secondary school students.