Bergen Helen A, Martin Graham, Richardson Angela S, Allison Stephen, Roeger Leigh
Department of Psychiatry, University of Queensland Mental Health Center, Royal Brisbane Hospital, Herston, Queensland 4029, Australia.
J Am Acad Child Adolesc Psychiatry. 2003 Nov;42(11):1301-9. doi: 10.1097/01.chi.0000084831.67701.d6.
To investigate relationships between self-reported sexual abuse, depression, hopelessness, and suicidality in a community sample of adolescents.
In 1995, students (mean age 13 years) from 27 high schools in Australia (n = 2,603) completed a questionnaire including measures of depressive symptoms (Center for Epidemiologic Studies Depression Scale), hopelessness, sexual abuse, and suicidality. Data analysis included logistic regression.
Sexual abuse is associated with suicidality, both directly and indirectly through hopelessness and depressive symptoms in the model developed. High suicide risk (behavior exceeding thoughts such as plans and threats, or deliberate self-injury) is strongly correlated with suicide attempts (odds ratio 28.8, 95% CI 16-52, p <.001). Hopelessness is associated with high suicide risk only, whereas depressive symptoms are associated with high suicide risk and attempts. Hopelessness is more strongly associated with sexual abuse in boys than girls. Depressive symptoms are more strongly associated with high suicide risk in girls than boys. Controlling for other variables, sexual abuse is independently associated with suicide attempts in girls but not boys.
Clinical assessment should consider gender differences in relationships between sexual abuse, depressive symptoms, hopelessness, and suicidality. Sexually abused girls may be at increased risk of attempting suicide, independent of other psychopathology.
在一个青少年社区样本中调查自我报告的性虐待、抑郁、绝望和自杀倾向之间的关系。
1995年，来自澳大利亚27所高中的学生（平均年龄13岁，n = 2603）完成了一份问卷，其中包括抑郁症状（流行病学研究中心抑郁量表）、绝望、性虐待和自杀倾向的测量。数据分析包括逻辑回归。
在建立的模型中，性虐待与自杀倾向直接相关，也通过绝望和抑郁症状间接相关。高自杀风险（行为超过计划和威胁等想法，或故意自我伤害）与自杀未遂密切相关（优势比28.8，95%可信区间16 - 52，p <.001）。绝望仅与高自杀风险相关，而抑郁症状与高自杀风险和自杀未遂均相关。绝望在男孩中与性虐待的关联比女孩更强。抑郁症状在女孩中与高自杀风险的关联比男孩更强。在控制其他变量后，性虐待与女孩的自杀未遂独立相关，但与男孩无关。
临床评估应考虑性虐待、抑郁症状、绝望和自杀倾向之间关系的性别差异。遭受性虐待的女孩可能有更高的自杀未遂风险，独立于其他精神病理学因素。
