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加拿大保留地原住民中的自杀意念与自杀未遂:印第安寄宿学校的代际影响和累积效应

Suicide Ideation and Attempts among First Nations Peoples Living On-Reserve in Canada: The Intergenerational and Cumulative Effects of Indian Residential Schools.

作者信息

McQuaid Robyn Jane, Bombay Amy, McInnis Opal Arilla, Humeny Courtney, Matheson Kimberly, Anisman Hymie

机构信息

1 Department of Neuroscience, Carleton University, Ottawa, Ontario.

2 Department of Psychiatry and School of Nursing, Dalhousie University, Halifax, Nova Scotia.

出版信息

Can J Psychiatry. 2017 Jun;62(6):422-430. doi: 10.1177/0706743717702075. Epub 2017 Mar 29.

Abstract

OBJECTIVE

Suicide rates among Indigenous peoples in Canada are at least twice that of their non-Indigenous counterparts. Although contemporary stressors contribute to this increased risk, historical experiences such as the Indian Residential School (IRS) system may also have continuing links with the risk for suicidal thoughts and behaviors. The current investigation examined the intergenerational and cumulative links between familial IRS attendance in relation to lifetime suicide ideation and attempts among First Nations adults living on-reserve.

METHOD

Data from the 2008-2010 First Nations Regional Health Survey were analyzed, and participants comprised a representative sample of First Nations adults older than 18 years (weighted N = 127,338; IRS attendees were excluded). Of those who knew their familial IRS history, 38.0% had no history of attendance, 19.3% had a grandparent who attended, 16.2% had a parent who attended, and 26.5% had a parent and grandparent who attended.

RESULTS

Exposure of one previous familial generation to the IRS experience was associated with increased risk for lifetime suicide ideation (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.16 to 1.84; P = 0.001) and attempts (OR, 1.44; 95% CI, 1.07 to 1.94; P < 0.016) compared with those with no IRS history. Having 2 generations of IRS familial history was associated with greater odds of reporting a suicide attempt compared with having one generation (OR, 1.35; 95% CI, 1.05 to 1.75; P = 0.022), which was reduced when current levels of distress and ideation were accounted for.

CONCLUSION

Findings support the existence of linkages between intergenerational exposure to IRS and risk for suicidal ideation and attempts and for a potential cumulative risk in relation to suicide attempts across generations.

摘要

目的

加拿大原住民的自杀率至少是非原住民的两倍。尽管当代压力源导致了这种风险增加,但诸如印第安寄宿学校(IRS)系统等历史经历也可能与自杀念头和行为的风险存在持续关联。当前的调查研究了居住在保留地的原住民成年人中,家族性IRS就读经历与终身自杀意念及自杀未遂之间的代际和累积联系。

方法

对2008 - 2010年原住民地区健康调查的数据进行分析,参与者为18岁以上原住民成年人的代表性样本(加权N = 127,338;排除了有IRS就读经历的人)。在那些了解其家族IRS历史的人中,38.0%没有就读历史,19.3%有一位祖父母就读过,16.2%有一位父母就读过,26.5%有父母和祖父母都就读过。

结果

与没有IRS历史的人相比,前一代家族成员有IRS就读经历与终身自杀意念风险增加相关(比值比[OR],1.46;95%置信区间[CI],1.16至1.84;P = 0.001)以及自杀未遂风险增加相关(OR,1.44;95% CI,1.07至1.94;P < 0.016)。与有一代家族IRS历史相比,有两代家族IRS历史与报告自杀未遂的几率更高相关(OR,1.35;95% CI,1.05至1.75;P = 0.022),当考虑当前的痛苦和意念水平时,这种关联有所减弱。

结论

研究结果支持代际暴露于IRS与自杀意念和自杀未遂风险之间存在联系,以及跨代自杀未遂存在潜在累积风险。

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