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教养方式是否能预测代表性青少年样本中的自杀未遂?

Is parenting style a predictor of suicide attempts in a representative sample of adolescents?

机构信息

Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Germany.

出版信息

BMC Pediatr. 2014 Apr 26;14:113. doi: 10.1186/1471-2431-14-113.

Abstract

BACKGROUND

Suicidal ideation and suicide attempts are serious but not rare conditions in adolescents. However, there are several research and practical suicide-prevention initiatives that discuss the possibility of preventing serious self-harm. Profound knowledge about risk and protective factors is therefore necessary. The aim of this study is a) to clarify the role of parenting behavior and parenting styles in adolescents' suicide attempts and b) to identify other statistically significant and clinically relevant risk and protective factors for suicide attempts in a representative sample of German adolescents.

METHODS

In the years 2007/2008, a representative written survey of N = 44,610 students in the 9th grade of different school types in Germany was conducted. In this survey, the lifetime prevalence of suicide attempts was investigated as well as potential predictors including parenting behavior. A three-step statistical analysis was carried out: I) As basic model, the association between parenting and suicide attempts was explored via binary logistic regression controlled for age and sex. II) The predictive values of 13 additional potential risk/protective factors were analyzed with single binary logistic regression analyses for each predictor alone. Non-significant predictors were excluded in Step III. III) In a multivariate binary logistic regression analysis, all significant predictor variables from Step II and the parenting styles were included after testing for multicollinearity.

RESULTS

Three parental variables showed a relevant association with suicide attempts in adolescents - (all protective): mother's warmth and father's warmth in childhood and mother's control in adolescence (Step I). In the full model (Step III), Authoritative parenting (protective: OR: .79) and Rejecting-Neglecting parenting (risk: OR: 1.63) were identified as significant predictors (p < .001) for suicidal attempts. Seven further variables were interpreted to be statistically significant and clinically relevant: ADHD, female sex, smoking, Binge Drinking, absenteeism/truancy, migration background, and parental separation events.

CONCLUSIONS

Parenting style does matter. While children of Authoritative parents profit, children of Rejecting-Neglecting parents are put at risk - as we were able to show for suicide attempts in adolescence. Some of the identified risk factors contribute new knowledge and potential areas of intervention for special groups such as migrants or children diagnosed with ADHD.

摘要

背景

自杀意念和自杀企图是青少年中严重但并非罕见的情况。然而,有一些研究和实际的预防自杀倡议讨论了预防严重自残的可能性。因此,深入了解风险和保护因素是必要的。本研究的目的是 a)阐明父母行为和教养方式在青少年自杀企图中的作用,b)在德国青少年的代表性样本中确定自杀企图的其他具有统计学意义和临床相关的风险和保护因素。

方法

在 2007/2008 年,对德国不同类型学校 9 年级的 44610 名学生进行了一项具有代表性的书面调查。在这项调查中,研究了自杀企图的终生患病率以及包括父母行为在内的潜在预测因素。进行了三步统计分析:I)作为基本模型,通过二元逻辑回归控制年龄和性别,探索了父母行为与自杀企图之间的关联。II)对 13 个额外的潜在风险/保护因素进行了单因素二元逻辑回归分析,单独分析每个预测因素。在第三步中排除无统计学意义的预测因素。III)在多元二元逻辑回归分析中,将第二步中所有具有统计学意义的预测变量和父母教养方式纳入后,对多重共线性进行检验。

结果

有三个父母变量与青少年自杀企图有相关关联-(均为保护因素):母亲在童年时的温暖和父亲的温暖以及母亲在青春期时的控制(第一步)。在全模型(第三步)中,权威型教养方式(保护:OR:.79)和拒绝忽视型教养方式(风险:OR:1.63)被确定为自杀企图的显著预测因素(p<.001)。还有七个变量被解释为具有统计学意义和临床相关性:ADHD、女性性别、吸烟、狂饮、旷课/逃学、移民背景和父母离异事件。

结论

教养方式很重要。虽然权威型父母的孩子受益,但拒绝忽视型父母的孩子则面临风险-正如我们在青少年自杀企图中所证明的那样。一些确定的风险因素为特殊群体(如移民或被诊断为 ADHD 的儿童)提供了新的知识和潜在的干预领域。

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