Marschall-Lévesque Shawn, Castellanos-Ryan Natalie, Parent Sophie, Renaud Johanne, Vitaro Frank, Boivin Michel, Tremblay Richard E, Séguin Jean R
Psychology Department, Université de Montréal, Montréal, Québec, Canada.
School of Psychoeducation, Université de Montréal, Montréal, Québec, Canada.
J Adolesc Health. 2017 Apr;60(4):380-387. doi: 10.1016/j.jadohealth.2016.09.019. Epub 2016 Nov 30.
Recent years have seen increased coverage of adolescent victimization and suicide. Both adolescent peer victimization and substance use have been associated with suicidal ideation, with evidence suggesting that all three factors are interrelated. There are at least four models which can explain the associations between these factors (i.e., self-medication, secondary mental disorder, bidirectional, and common factor). However, none of them is being empirically supported as the dominant model because few longitudinal studies have explored the association between these factors.
The present study compared longitudinal paths of all four models simultaneously using a cross-lagged model. This was done using self-reported measures of peer victimization, suicidal ideation, and alcohol use at age 13, 14, and 15 years in a longitudinal sample of 238 adolescents.
All three variables were moderately stable across time. Significant cross-lagged associations were found, showing that frequent peer victimization at age 13 years was associated with higher odds of having suicidal ideation at age 14 years (odds ratio, 1.82; p < .05). In turn, presence of suicidal ideation at age 14 years was significantly associated with higher alcohol use frequency at age 15 years (β = .13; p < .05).
Results support previous literature suggesting that peer victimization predates alcohol use and extends it by showing clear directionality between suicidal ideation and alcohol use over 1 year, supporting the self-medication model. Clarifying the empirical basis of these underlying models could allow for earlier prevention strategies, by targeting the risk factor that appears the earliest in the model.
近年来,青少年受害和自杀的报道有所增加。青少年同伴受害和物质使用都与自杀意念有关,有证据表明这三个因素相互关联。至少有四种模型可以解释这些因素之间的关联(即自我药疗、继发性精神障碍、双向性和共同因素)。然而,由于很少有纵向研究探讨这些因素之间的关联,因此没有一个模型得到实证支持成为主导模型。
本研究使用交叉滞后模型同时比较了所有四种模型的纵向路径。这是通过对238名青少年的纵向样本中13岁、14岁和15岁时同伴受害、自杀意念和酒精使用的自我报告测量来完成的。
所有三个变量随时间都有适度的稳定性。发现了显著的交叉滞后关联,表明13岁时频繁的同伴受害与14岁时有自杀意念的较高几率相关(优势比,1.82;p <.05)。反过来,14岁时存在自杀意念与15岁时较高的酒精使用频率显著相关(β =.13;p <.05)。
结果支持先前的文献,表明同伴受害先于酒精使用,并通过显示自杀意念和酒精使用在1年以上的明确方向性来扩展这一关系,支持自我药疗模型。通过针对模型中最早出现的风险因素,阐明这些潜在模型的实证基础可以制定更早的预防策略。