青少年自杀意念与家庭环境和心理弹性之间的关联研究

从恩朝, 吴彦, 蔡亦蕴, 陈海莹, 徐一峰

中国当代儿科杂志 ›› 2019, Vol. 21 ›› Issue (5) : 479-484.

PDF(1480 KB)
HTML
PDF(1480 KB)
HTML
中国当代儿科杂志 ›› 2019, Vol. 21 ›› Issue (5) : 479-484. DOI: 10.7499/j.issn.1008-8830.2019.05.016
论著·临床研究

青少年自杀意念与家庭环境和心理弹性之间的关联研究

  • 从恩朝, 吴彦, 蔡亦蕴, 陈海莹, 徐一峰
作者信息 +

Association of suicidal ideation with family environment and psychological resilience in adolescents

  • CONG En-Zhao, WU Yan, CAI Yi-Yun, CHEN Hai-Ying, XU Yi-Feng
Author information +
文章历史 +

摘要

目的 探讨青少年自杀意念与家庭环境因素和心理弹性之间的关系。方法 采用整群抽样法,于2014年12月对河南省新乡市3 230名初高中生进行一般社会资料问卷及Kutcher青少年抑郁量表(11项)(KADS-11)、家庭环境量表中文版(FES-CV)、中文版心理弹性量表(CD-RISC)评估测评后,采用多因素logistic回归分析和病例对照研究探讨青少年家庭环境和心理弹性与自杀意念之间的关联。结果 有效问卷为2 960份,有自杀意念者247例(8.50%),其中男性98例,女性149例。多因素logistic回归分析显示,控制了年龄和性别因素后,单亲/再婚家庭模式与青少年自杀意念风险增加有关(OR=2.655)。男性青少年的自杀意念与家庭亲密度(OR=0.750,P < 0.001)及组织性(OR=0.855,P=0.036)呈明显负关联,与家庭矛盾性呈明显正关联(OR=1.159,P=0.017)。女性青少年的自杀意念与家庭亲密度(OR=0.771,P < 0.001)、情感表达(OR=0.815,P=0.001)及知识性(OR=0.915,P=0.037)存在负性关联。CD-RISC量表评估显示,有自杀意念的青少年心理弹性总得分明显低于无自杀意念的青少年(P < 0.05),有自杀意念青少年该量表中的能力、忍受消极情感、接受变化和控制4个维度的得分均比无自杀意念青少年低(P < 0.05)。结论 青少年家庭环境亲密度是青少年自杀意念的保护因素;男性青少年的家庭组织性和女性青少年家庭情感表达与降低自杀风险有关;增强心理弹性可能有助于降低青少年的自杀意念。

Abstract

Objective To study the association of suicidal ideation with family environment and psychological resilience in adolescents. Methods Cluster sampling was used to perform an investigation among 3 230 junior and senior high school students in Xinxiang of Henan Province, China December 2014. A general social information questionnaire, 11-Item Kutcher Adolescent Depression Scale(KADS-11), Family Environment Scale-Chinese Version (FES-CV) and Connor-Davidson Resilience Scale (CD-RISC; Chinese version) were used for evaluation. A multivariate logistic regression analysis and a case-control study were used to investigate the association of suicidal ideation with family environment and psychological resilience in adolescents. Results A total of 2 960 usable questionnaires were received. Among the 2 960 adolescents, 247 (8.50%) had suicidal ideation (98 boys and 149 girls). The multivariate logistic regression analysis showed that after adjustment for age and sex, single-parent/remarried family was associated with an increased risk of suicidal ideation (OR=2.655). Suicidal ideation in boys was negatively correlated with family cohesion (OR=0.750, P < 0.001) and organization (OR=0.855, P=0.036) and was positively correlated with family conflict (OR=1.159, P=0.017). Suicidal ideation in girls were negatively correlated with family cohesion (OR=0.771, P < 0.001), emotional expression (OR=0.815, P=0.001) and intellectual-cultural orientation (OR=0.915, P=0.037). The adolescents with suicidal ideation had a significantly lower total score of psychological resilience than those without suicidal ideation (P < 0.05). Compared with those without suicidal ideation, the adolescents with suicidal ideation had significantly lower scores on 4 factors of the CD-RISC (ability, tolerance of negative emotions, acceptance of changes and control) (P < 0.05). Conclusions Family cohesion is a protective factor against suicidal ideation in adolescents. Family organization in boys and family emotional expression in girls are associated with a decreased risk of suicidal ideation. Enhanced psychological resilience may help to reduce the incidence of suicide ideation in adolescents.

关键词

自杀意念 / 亲密度 / 心理弹性 / 青少年

Key words

Suicidal ideation / Cohesion / Psychological resilience / Adolescent

引用本文

导出引用
从恩朝, 吴彦, 蔡亦蕴, 陈海莹, 徐一峰. 青少年自杀意念与家庭环境和心理弹性之间的关联研究[J]. 中国当代儿科杂志. 2019, 21(5): 479-484 https://doi.org/10.7499/j.issn.1008-8830.2019.05.016
CONG En-Zhao, WU Yan, CAI Yi-Yun, CHEN Hai-Ying, XU Yi-Feng. Association of suicidal ideation with family environment and psychological resilience in adolescents[J]. Chinese Journal of Contemporary Pediatrics. 2019, 21(5): 479-484 https://doi.org/10.7499/j.issn.1008-8830.2019.05.016

参考文献

[1] Shain B; Committee on Adolescence. Suicide and suicide attempts in adolescents[J]. Pediatrics, 2016, 138(1). pii:e20161420.
[2] Li ZZ, Li YM, Lei XY, et al. Prevalence of suicidal ideation in Chinese college students:a meta-analysis[J]. PLoS One, 2014, 9(10):e104368.
[3] Nock MK, Green JG, Hwang I, et al. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents:results from the National Comorbidity Survey Replication Adolescent Supplement[J]. JAMA Psychiatry, 2013, 70(3):300-310.
[4] Pan YJ, Juang KD, Lu SR, et al. Longitudinal risk factors for suicidal thoughts in depressed and non-depressed young adolescents[J]. Aust N Z J Psychiatry, 2017, 51(9):930-937.
[5] Raleva M. Early life stress:a key link between childhood adversity and risk of attempting suicide[J]. Psychiatr Danub, 2018, 30(Suppl 6):341-347.
[6] Obikane E, Shinozaki T, Takagi D, et al. Impact of childhood abuse on suicide-related behavior:analysis using marginal structural models[J]. J Affect Disord, 2018, 234:224-230.
[7] Leadbeater BJ, Ames ME, Linden-Carmichael AN. Age-varying effects of cannabis use frequency and disorder on symptoms of psychosis, depression, and anxiety in adolescents and adults[J]. Addiction, 2019, 114(2):278-293.
[8] Costello EJ, Mustillo S, Erkanli A, et al. Prevalence and development of psychiatric disorders in childhood and adolescence[J]. Arch Gen Psychiatry, 2003, 60(8):837-844.
[9] Xu Y, Wang C, Shi M. Identifying Chinese adolescents with a high suicide attempt risk[J]. Psychiatry Res, 2018, 269:474-480.
[10] 屈坚定, 高伟娜, 余星池. 中国青少年自杀意念[J]. 青年研究, 2002(6):44-49.
[11] 朱孔美, 王传玲, 王东. 伴自杀倾向青少年抑郁症患者的焦虑、抑郁与家庭环境相关性分析[J]. 中国民康医学, 2015, 27(22):77-78.
[12] 费立鹏, 沈其杰, 郑延平, 等. "家庭亲密度和适应性量表"和"家庭环境量表"的初步评价-正常家庭与精神分裂症家庭成员对照研究[J]. 中国心理卫生杂志, 1991, 5(5):198-202.
[13] 周慧鸣, 郝楠, 杜亚松, 等. 中文版Kutcher青少年抑郁量表测评青少年样本的效度与信度[J]. 中国心理卫生杂志, 2015, 32(6):413-418.
[14] Connor KM, Davidson JR. Development of a new resilience scale:the the Connor-Davidson Resilience Scale (CD-RISC)[J]. Depress Anxiety, 2003, 18(2):76-82.
[15] Yu XN, Lau JT, Mak WW, et al. Factor structure and psychometric properties of the Connor-Davidson Resilience Scale among Chinese adolescents[J]. Compr Psychiatry, 2011, 52(2):218-224.
[16] Jiang M, Hu Z, Cao Y. Suicide deaths concentrated in Beijing universities[J]. Am J Psychiatry, 2007, 164(11):1758.
[17] Phillips MR, Li X, Zhang Y. Suicide rates in China, 1995-99[J]. Lancet, 2002, 359(9309):835-840.
[18] Park S. Gender-specific factors of suicide ideation among adolescents in the Republic of Korea:a nationally representative population-based study[J]. Arch Psychiatr Nurs, 2013, 27(5):253-259.
[19] Lee K, Namkoong K, Choi WJ, et al. The relationship between parental marital status and suicidal ideation and attempts by gender in adolescents:results from a nationally representative Korean sample[J]. Compr Psychiatry, 2014,55(5):1093-1099.
[20] Harris TL, Molock SD. Cultural orientation, family cohesion, and family support in suicide ideation and depression among African American college students[J]. Suicide Life Threat Behav, 2000, 30(4):341-353.
[21] Au AC, Lau S, Lee MT. Suicide ideation and depression:the moderation effects of family cohesion and social self-concept[J]. Adolescence, 2009, 44(176):851-868.
[22] van Goethem A, van Hoof A, Orobio de Castro B, et al. The role of reflection in the effects of community service on adolescent development:a meta-analysis[J]. Child Dev, 2014, 85(6):2114-2130.
[23] Hill RM, Oosterhoff B, Kaplow JB. Prospective identification of adolescent suicide ideation using classification tree analysis:Models for community-based screening[J]. J Consult Clin Psychol, 2017, 85(7):702-711.
[24] Rapp AM, Lau A, Chavira DA. Differential associations between social anxiety disorder, family cohesion, and suicidality across racial/ethnic groups:Findings from the National Comorbidity Survey-Adolescent (NCS-A)[J]. J Anxiety Disord, 2017, 48:13-21.
[25] Dubow EF, Tisak J, Causey D, et al. A two-year longitudinal study of stressful life events, social support, and social problem-solving skills:contributions to children's behavioral and academic adjustment[J]. Child Dev, 1991, 62(3):583-599.
[26] Lowry R, Johns MM, Gordon AR, et al. Nonconforming gender expression and associated mental distress and substance use among high school students[J]. JAMA Pediatr, 2018, 172(11):1020-1028.
[27] Peterson CM, Matthews A, Copps-Smith E, et al. Suicidality, self-harm, and body dissatisfaction in transgender adolescents and emerging adults with gender dysphoria[J]. Suicide Life Threat Behav, 2017, 47(4):475-482.
[28] Sigfusdottir ID, Asgeirsdottir BB, Gudjonsson GH, et al. Suicidal ideations and attempts among adolescents subjected to childhood sexual abuse and family conflict/violence:the mediating role of anger and depressed mood[J]. J Adolesc, 2013, 36(6):1227-1236.
[29] Li Y, Li Y, Cao J. Factors associated with suicidal behaviors in mainland China:a meta-analysis[J]. BMC Public Health, 2012, 12:524.
[30] Jakobsen IS, Larsen KJ. Suicide risk assessment in adolescents-C-SSRS, K10, and READ[J]. Crisis, 2017, 38(4):247-254.
[31] Chung J, Lam K, Ho KY, et al. Relationships among resilience, self-esteem, and depressive symptoms in Chinese adolescents[J]. J Health Psychol, 2018:1359105318800159. doi:10.1177/1359105318800159.[Epub ahead of print].
[32] Siegmann P, Teismann T, Fritsch N, et al. Resilience to suicide ideation:a cross-cultural test of the buffering hypothesis[J]. Clin Psychol Psychother, 2018, 25(1):e1-e9.

基金

上海交通大学医学院附属精神卫生中心院级课题(2014-YJ-01)。

PDF(1480 KB)
HTML

Accesses

Citation

Detail

段落导航
相关文章

/