Boston Medical Center, Department of Pediatrics, One Boston Medical Center Place, Boston, MA 02118, USA.
J Affect Disord. 2012 Feb;136(3):377-80. doi: 10.1016/j.jad.2011.11.019. Epub 2011 Dec 6.
Street youth represent a marginalized population marked by early mortality and elevated risk for suicide. It is not known to what extent childhood abuse and neglect predispose to suicide in this difficult-to-study population. This study is among the first to examine the relationship between childhood trauma and subsequent attempted suicide during adolescence and young adulthood among street youth.
From October 2005 to November 2007, data were collected for the At Risk Youth Study (ARYS), a cohort of 495 street-recruited youth aged 14-26 in Vancouver, Canada. Self-reported attempted suicide in the preceding six months was examined in relation to childhood abuse and neglect, as measured by the Childhood Trauma Questionnaire (CTQ), using logistic regression.
Overall, 46 (9.3%) youth reported a suicide attempt during the preceding six months. Childhood physical and sexual abuse were highly prevalent, with 201 (40.6%) and 131 (26.5%) of youth reporting history of each, respectively. Increasing CTQ score was related to risk for suicide attempt despite adjustment for confounders (adjusted odds ratio [AOR], 1.45 per standard deviation increase in score; 95% confidence interval [CI], 1.08-1.91).
Use of snowball sampling may not have produced a truly random sample, and reliance on self-report may have resulted in underreporting of risk behaviors among participants. Moreover, use of cross-sectional data limits the degree to which temporality can be concluded from the results of this study alone.
There exists a strong and graded association between childhood trauma and subsequent attempted suicide among street youth, an otherwise 'hidden' population. There is a need for effective interventions that not only prevent maltreatment of children but also aid youth at increased risk for suicide given prior history of trauma.
街头青年是一个边缘化的群体,其特点是早逝和自杀风险升高。在这个难以研究的群体中,童年期虐待和忽视在多大程度上导致自杀尚不清楚。本研究首次在街头青年中检验了童年创伤与青少年和青年期随后自杀企图之间的关系。
2005 年 10 月至 2007 年 11 月,在加拿大温哥华对街头招募的 495 名 14-26 岁的青年进行了风险青年研究(ARYS)的队列研究。采用童年创伤问卷(CTQ)测量童年期虐待和忽视,用 logistic 回归检验了过去 6 个月内报告的自杀企图与童年期虐待和忽视的关系。
495 名青年中,46 名(9.3%)报告过去 6 个月内有自杀企图。童年期躯体和性虐待非常普遍,分别有 201 名(40.6%)和 131 名(26.5%)的青年报告有过这两种经历。尽管进行了混杂因素调整,但 CTQ 评分的增加与自杀企图的风险相关(调整后的比值比[OR],每标准分增加 1.45;95%置信区间[CI],1.08-1.91)。
雪球抽样可能没有产生真正的随机样本,而且依赖于自我报告可能导致参与者报告风险行为不足。此外,横断面数据的使用限制了仅凭本研究结果就可以得出时间关系的程度。
在街头青年中,童年创伤与随后的自杀企图之间存在强烈且呈梯度关联,而这些青年是一个“隐藏”的群体。需要采取有效的干预措施,不仅要防止虐待儿童,还要帮助那些有创伤史的自杀风险增加的青年。