Adolescent Psychiatry, Helsinki University and Helsinki University Hospital, Helsinki, Finland.
Adolescent Psychiatry, Helsinki University and Helsinki University Hospital, Helsinki, Finland; National Institute for Health and Welfare, Department of Health, Mental Health Units, Helsinki, Finland.
Child Abuse Negl. 2018 Mar;77:99-109. doi: 10.1016/j.chiabu.2017.12.007. Epub 2018 Jan 8.
We investigated whether psychiatric symptomatology, impulsivity, family and social dysfunction, and alcohol use mediate the relationship between adverse childhood experiences (ACEs) and suicidality. The study population comprised 206 adolescent psychiatric inpatients and 203 age- and gender-matched adolescents from the community. ACEs and suicidality were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime version, the Life Events Checklist, and a structured background data collection sheet. Psychiatric symptomatology was measured using the Symptom Checklist -90. Impulsivity, social dysfunction, and family dysfunction were measured using the Offer Self-Image Questionnaire, and alcohol use was assessed with the Alcohol Use Disorders Identification Test. A simple mediation test and multiple mediation analyses were conducted. A positive direct effect of ACEs on suicidality was observed. Also seen was a positive indirect effect of ACEs on suicidality through psychiatric symptomatology, impulsivity, and family and social dysfunctions. Alcohol misuse did not, however, mediate the relationship between ACEs and suicidality. According to the multiple mediation analyses, psychiatric symptomatology was the most significant mediator, followed by impulsivity. Psychiatric symptoms, impulsivity, and family and social dysfunctions are factors that should be taken into consideration when assessing suicidality in adolescents.
我们调查了精神症状、冲动、家庭和社会功能障碍以及酒精使用是否在不良童年经历（ACEs）与自杀意念之间起中介作用。研究人群包括 206 名青少年精神科住院患者和 203 名年龄和性别匹配的社区青少年。使用儿童期情感障碍和精神分裂症谱系的学校年龄儿童 - 现病史和终生版本、生活事件检查表和结构化背景数据收集表评估 ACEs 和自杀意念。使用症状检查表 -90 测量精神症状。使用自我形象问卷评估冲动、社会功能障碍和家庭功能障碍，使用酒精使用障碍识别测试评估酒精使用情况。进行了简单的中介测试和多重中介分析。观察到 ACEs 对自杀意念有正向直接影响。此外，还观察到 ACEs 通过精神症状、冲动和家庭与社会功能障碍对自杀意念产生正向间接影响。然而，酒精滥用并不能调节 ACEs 与自杀意念之间的关系。根据多重中介分析，精神症状是最重要的中介因素，其次是冲动。精神症状、冲动和家庭与社会功能障碍是评估青少年自杀意念时应考虑的因素。
