一项全国性成年人调查中的其他指向和自我指向的暴力形式及其与 DSM-IV 物质使用和其他精神障碍的关系。
Other- and self-directed forms of violence and their relationships to DSM-IV substance use and other psychiatric disorders in a national survey of adults.
机构信息
Alcohol Epidemiologic Data System, CSR, Incorporated, Arlington, VA 22201, USA.
出版信息
Compr Psychiatry. 2013 Oct;54(7):731-9. doi: 10.1016/j.comppsych.2013.02.003. Epub 2013 Apr 13.
OBJECTIVE
To examine associations between DSM-IV psychiatric disorders and other- and self-directed violence in the general population.
METHODS
Data were obtained from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 & 2 (n=34,653). Four violence categories were derived from a latent class analysis (LCA) of 5 other-directed and 4 self-directed violent behavior indicators. Multinomial logistic regression examined class associations for gender, race-ethnicity, age and DSM-IV substance use, mood, anxiety, and personality disorders.
RESULTS
Approximately 16% of adults reported some form of violent behavior distributed as follows: other-directed only, 4.6%; self-directed only, 9.3%; combined self- and other-directed, 2.0%; and no violence, 84.1%. The majority of the DSM-IV disorders included in this study were significantly and independently related to each form of violence. Generally, other-directed violence was more strongly associated with any substance use disorders (81%) and any personality disorders (42%), while self-directed violence was more strongly associated with mood (41%) and anxiety disorders (57%). Compared with these two forms of violence, the smaller group with combined self- and other-directed violence was more strongly associated with any substance use disorders (88%), mood disorders (63%), and personality disorders (76%).
CONCLUSION
Findings from this study are consistent with recent conceptualizations of disorders as reflecting externalizing disorders and internalizing disorders. The identification of the small category with combined forms of violence further extends numerous clinical studies which established associations between self- and other-directed violent behaviors. The extent to which the combined violence category represents a meaningful and reliable category of violence requires further detailed studies.
目的
研究 DSM-IV 精神障碍与普通人群中其他和自我指向暴力之间的关联。
方法
数据来自全国酒精相关状况流行病学调查（NESARC）波 1 和 2（n=34653）。从 5 种其他指向和 4 种自我指向暴力行为指标的潜在类别分析（LCA）中得出了 4 种暴力类别。多项逻辑回归检查了性别、种族-民族、年龄和 DSM-IV 物质使用、情绪、焦虑和人格障碍的类别关联。
结果
大约 16%的成年人报告了某种形式的暴力行为，分布如下：仅其他指向，4.6%；仅自我指向，9.3%；自我和其他指向的组合，2.0%；无暴力，84.1%。本研究中包括的大多数 DSM-IV 障碍与每种形式的暴力均具有显著和独立的相关性。一般来说，其他指向的暴力与任何物质使用障碍（81%）和任何人格障碍（42%）的关联更为密切，而自我指向的暴力与情绪障碍（41%）和焦虑障碍（57%）的关联更为密切。与这两种形式的暴力相比，具有自我和其他指向的组合形式的较小群体与任何物质使用障碍（88%）、情绪障碍（63%）和人格障碍（76%）的关联更为密切。
结论
本研究的结果与最近将障碍概念化为反映外化障碍和内化障碍的概念一致。对具有自我和其他指向的组合形式的小类别进行识别进一步扩展了许多临床研究，这些研究建立了自我和其他指向的暴力行为之间的关联。具有组合暴力类别的程度是否代表一种有意义和可靠的暴力类别需要进一步详细的研究。
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