Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford, UK.
Eur Child Adolesc Psychiatry. 2010 Jun;19(6):513-23. doi: 10.1007/s00787-009-0065-0. Epub 2009 Sep 26.
The aims of this study were to identify in what ways adolescents who cut themselves differ from those who take overdoses, and to investigate the role of contagion in these behaviours. Data from an anonymous self-report questionnaire survey of 6,020 adolescents in 41 schools were analysed. Comparison of 220 adolescents who reported self-cutting in the previous year with 86 who had taken overdoses in the previous year as the sole method of deliberate self-harm (DSH) showed that far more of those who cut themselves had friends who had also engaged in DSH in the same period (OR 2.84, 95% CI 1.5-5.3, P < 0.001), and fewer had sought help from friends before cutting (OR 0.5, 95% CI 0.3-0.9, P < 0.02). Self-cutting usually involved less premeditation. Analyses at both the individual and school level showed that the association between engaging in DSH and exposure to DSH amongst peers was largely confined to girls who cut themselves. There are important differences between adolescents who cut themselves and those who take overdoses. Contagion may be an important factor in DSH by adolescents, especially in girls who cut themselves. These findings are relevant to the design of prevention and treatment programmes.
本研究旨在明确尝试割腕与过量服药这两种不同自杀方式的青少年之间存在哪些差异，并探究其中的感染因素。我们对 41 所学校的 6020 名青少年进行了匿名自填式问卷调查，对其中 220 名在过去一年中有过割腕行为、86 名有过过量服药行为的青少年进行了对比分析，这两种行为是他们唯一采取过的蓄意自伤行为。结果显示，割腕青少年的朋友中，曾在同一时期进行过蓄意自伤行为的人数是过量服药青少年的 2.84 倍（OR 2.84，95%CI 1.5-5.3，P < 0.001），而在割腕前曾向朋友求助的人数则是过量服药青少年的 0.5 倍（OR 0.5，95%CI 0.3-0.9，P < 0.02）。割腕行为通常缺乏事先的谋划。在个体和学校两个层面的分析中均表明，青少年间的蓄意自伤行为与对同伴蓄意自伤行为的暴露之间存在很强的关联性，这主要局限于割腕的女孩群体。割腕的青少年与过量服药的青少年之间存在重要差异。感染可能是青少年蓄意自伤的一个重要因素，尤其是对于割腕的女孩群体。这些发现与预防和治疗方案的设计息息相关。
