Kılıç Filiz, Coşkun Murat, Bozkurt Hasan, Kaya İlyas, Zoroğlu Salih
Department of Child and Adolescent Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey.
Department of Child and Adolescent Psychiatry, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
Psychiatry Investig. 2017 Mar;14(2):172-178. doi: 10.4306/pi.2017.14.2.172. Epub 2017 Mar 6.
To explore the role of trauma and dissociation over self-injurious behaviors (SIB) and suicide attempts (SA) in adolescents.
A total of 207 adolescents participated in the study. After conducting diagnostic interview, participants were divided into five groups as subjects with dissociative disorders (DD), attention deficit hyperactivity disorder (ADHD), major depressive disorder (MDD) and anxiety disorders (AD), and a control group (CG) without any psychiatric disorder. ADHD, MDD and AD groups were considered as non-dissociative disorders (non-DD group) in the present study.
There is no significant difference between groups in terms of number and age of the subjects (p>0.05). Among all participants SIB was reported in 32.2% of females (n=37) and 25% of males (n=23) while SA was reported in 29.6% of females (n=34) and 4.4% of males (n=4). Adolescents with DD were found to experience higher rates of SIB and SA than the other groups. Dissociation was the most important variable contributing to SIB and female gender was the most efficient variable for SA. Total trauma scores were also found to be significantly higher in DD group followed by non-DD and CG respectively.
SIB and SA are complex behavioral problems which may be associated with many psychiatric factors. However higher level dissociation seems as an important mediating factor, even regardless of psychiatric diagnosis, in the development of SIB and SA. More research is needed to further explore the factors effective over SIB and SA in adolescents.
探讨创伤和解离在青少年自我伤害行为（SIB）和自杀未遂（SA）中的作用。
共有207名青少年参与了该研究。在进行诊断访谈后，参与者被分为五组，分别为患有解离性障碍（DD）、注意力缺陷多动障碍（ADHD）、重度抑郁症（MDD）和焦虑症（AD）的受试者，以及一个没有任何精神疾病的对照组（CG）。在本研究中，ADHD、MDD和AD组被视为非解离性障碍组（非DD组）。
各组在受试者数量和年龄方面无显著差异（p>0.05）。在所有参与者中，报告有SIB的女性占32.2%（n = 37），男性占25%（n = 23）；报告有SA的女性占29.6%（n = 34），男性占4.4%（n = 4）。发现患有DD的青少年经历SIB和SA的比率高于其他组。解离是导致SIB的最重要变量，而女性性别是导致SA的最有效变量。还发现DD组的总创伤得分显著高于非DD组和CG组，其次是非DD组和CG组。
SIB和SA是复杂的行为问题，可能与许多精神因素有关。然而，即使不考虑精神疾病诊断，较高水平的解离似乎也是SIB和SA发生发展中的一个重要中介因素。需要更多的研究来进一步探索影响青少年SIB和SA的有效因素。
