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

doi:10.7499/j.issn.1008-8830.2019.05.016

PDF(1480 KB)

Chinese Journal of Contemporary Pediatrics ›› 2019, Vol. 21 ›› Issue (5) : 479-484. DOI: 10.7499/j.issn.1008-8830.2019.05.016

CLINICAL RESEARCH

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 +

History +

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.

Key words

Suicidal ideation / Cohesion / Psychological resilience / Adolescent

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

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

References

[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.