Razin A M, O'Dowd M A, Nathan A, Rodriguez I, Goldfield A, Martin C, Goulet L, Scheftel S, Mezan P, Mosca J
Psychiatry Department, North Central Bronx Hospital, Montefiore Medical Centre, Albert Einstein College of Medicine, New York.
Gen Hosp Psychiatry. 1991 Jan;13(1):45-58. doi: 10.1016/0163-8343(91)90009-l.
Suicidal behavior is disproportionately frequent among inner-city Hispanic adolescent girls. In an attempt to generate a multifactorial set of hypotheses to explain this behavior, 33 such subjects consecutively admitted for suicidal behavior and 15 demographically identical nonsuicidal subjects were assessed by means of a structured interview. Mothers of all subjects were also assessed. Attempts were nearly always impulsive and nonlethal, though often with a stated wish to die. Nearly all were overdoses, and were precipitated by conflicts with mother or boyfriend. Mothers could usually identify the precipitants. Attempters' parents were less often born in the U.S., their mothers seemed medically less healthy, and their extended families were more often supported by public assistance, and had a higher incidence of criminal and psychiatric problems. School performance was poorer among attempters, who had suffered more and earlier losses, especially of biologic fathers, with whom fewer had ongoing relationships. They more often had boyfriends, had begun sexual activity, had recently lost friends, and expressed a mistrustful stance toward friendships. Similarly, their mothers had fewer friends and more often expressed a mistrustful stance. Relationships with mothers seemed more intense, desperate, and even violent, and attempters were much more often parentified, i.e., mothering their mothers. Although both groups often assumed caretaking roles in their families, attempters were more negatively described by themselves and by their mothers. While knowledge of suicidal models was common in both groups, attempters' mothers knew of even more models than did their daughters or the nonsuicidal subjects or their mothers. Notably, more attempters' mothers had themselves made attempts. Families of most attempters were usually mobilized by the attempt. These findings permit the construction of a putative profile of risk factors that can be tested more rigorously.
自杀行为在市中心的西班牙裔青少年女孩中极为常见。为了提出一系列多因素假设来解释这种行为，通过结构化访谈对33名因自杀行为而连续入院的此类受试者以及15名人口统计学特征相同的非自杀受试者进行了评估。所有受试者的母亲也接受了评估。自杀企图几乎总是冲动且非致命的，尽管她们常常表示想死。几乎所有自杀企图都是过量服药，且是由与母亲或男友的冲突引发的。母亲们通常能够识别出引发因素。自杀企图者的父母在美国出生的较少，他们的母亲在健康方面似乎较差，他们的大家庭更多地依靠公共援助维持生计，且犯罪和精神问题的发生率更高。自杀企图者的学业成绩较差，她们遭受的损失更多、更早，尤其是生父的离世，与生父仍保持联系的人较少。她们更常交男友，开始了性行为，最近失去了朋友，并且对友谊持不信任态度。同样，她们的母亲朋友较少，也更常表达不信任态度。与母亲的关系似乎更为强烈、绝望，甚至暴力，自杀企图者更常扮演母亲照顾母亲的角色，即承担起母亲的责任。尽管两组人在家庭中都经常承担照顾他人的角色，但自杀企图者对自己和母亲对她们的描述更为负面。虽然两组人都普遍了解自杀模式，但自杀企图者的母亲比她们的女儿、非自杀受试者或这些受试者的母亲了解的模式更多。值得注意的是，更多自杀企图者的母亲自己曾有过自杀企图。大多数自杀企图者的家庭通常会因自杀企图而动员起来。这些发现有助于构建一个可以更严格地进行检验的风险因素假定概况。
