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自杀轨迹的发展模型。

Developmental model of suicide trajectories.

机构信息

Monique Séguin, PhD, Université du Québec en Outaouais, Department of Psychology, Gatineau, Québec, and McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec; Guy Beauchamp, PhD, Marie Robert, PhD, Université du Québec en Outaouais, Department of Psychology, Gatineau, Québec; Mélanie DiMambro, MSc, Gustavo Turecki, MD, PhD, McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec, Canada.

出版信息

Br J Psychiatry. 2014 Aug;205(2):120-6. doi: 10.1192/bjp.bp.113.139949. Epub 2014 May 8.

Abstract

BACKGROUND

Most developmental studies on suicide do not take into account individual variations in suicide trajectories.

AIMS

Using a life course approach, this study explores developmental models of suicide trajectories.

METHOD

Two hundred and fourteen suicides were assessed with mixed methods. Statistical analysis using combined discrete-time survival (DTS) and growth mixture modelling (GMM) generated various trajectories, and path analysis (Mplus) identified exogenous and mediating variables associated with these trajectories.

RESULTS

Two groups share common risk factors, and independently of these major risk factors, they have different developmental trajectories: the first group experienced a high burden of adversity and died by suicide in their early 20s; and the second group experienced a somewhat moderate or low burden of adversity before they took their own life. Structural equation modelling identified variables specific to the early suicide trajectory: conduct and behavioural difficulties, social isolation/conflicts mediated by school-related difficulties, the end of a love relationship, and previous suicide attempts.

CONCLUSIONS

Psychosocial adversity between 10 and 20 years of age may warrant key periods of intervention.

摘要

背景

大多数关于自杀的发展研究都没有考虑到自杀轨迹的个体差异。

目的

本研究采用生命历程方法探讨自杀轨迹的发展模型。

方法

使用混合方法评估了 214 例自杀案例。使用联合离散时间生存(DTS)和增长混合物建模(GMM)的统计分析生成了各种轨迹,并使用路径分析(Mplus)确定了与这些轨迹相关的外生和中介变量。

结果

两个组有共同的风险因素,并且独立于这些主要风险因素,他们有不同的发展轨迹:第一组经历了高度的逆境负担,并在 20 岁出头时自杀身亡;第二组在自杀之前经历了一定程度的中度或轻度逆境负担。结构方程模型确定了与早期自杀轨迹相关的特定变量:行为和行为困难、与学校相关困难有关的社交孤立/冲突、恋爱关系结束以及先前的自杀企图。

结论

10 岁至 20 岁之间的心理社会逆境可能需要关键的干预时期。

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