Division of Child & Adolescent Psychiatry and Department of Epidemiology, Columbia University Medical Center and The New York State Psychiatric Institute, 1051 Riverside Drive, Unit 72, New York, NY 10032, USA.
Division of Child & Adolescent Psychiatry, The New York State Psychiatric Institute, 1051 Riverside Drive, Unit 72, New York, NY 10032, USA.
Int J Environ Res Public Health. 2018 Mar 6;15(3):455. doi: 10.3390/ijerph15030455.
Adolescents' exposure to a peer's suicide has been found to be associated with, as well as to predict, suicidal ideation and behavior. Although postvention efforts tend to be school-based, little is known about the impact of a schoolmate's suicide on the school's student population overall. The present study seeks to determine whether there is excess psychological morbidity among students in a school where a schoolmate has died by suicide, and whether students' attitudes about coping and help-seeking strategies are more or less problematic in such schools. Students in twelve high schools in Suffolk and Westchester counties in New York State-2865 students at six schools where a student had died by suicide within the past six months, and 2419 students at six schools where no suicide had occurred within the current students' tenure-completed an assessment of their suicidal ideation and behavior, depressive symptoms, coping and help-seeking attitudes, stressful life events, and friendship with suicide decedent (if applicable). No excess morbidity (i.e., serious suicidal ideation/behavior and depression) was evident among the general student population after a schoolmate's death by suicide; however, the risk of serious suicidal ideation/behavior was elevated among students at exposed schools who had concomitant negative life events. There was a significant relationship between friendship with the decedent and morbidity, in that students who were friends, but not close friends, of the decedents had the greatest odds of serious suicidal ideation/behavior. Overall, students in exposed schools had more adaptive attitudes toward help-seeking; but this was not true of the decedents' friends or students with concomitant negative life events. The implications of the findings for postvention strategies are discussed.
青少年接触到同伴自杀事件，与自杀意念和行为有关，并且可以预测自杀意念和行为。尽管事后预防措施往往以学校为基础，但对于同学自杀对学校全体学生的影响知之甚少。本研究旨在确定在一名同学自杀身亡的学校中，是否有更多的学生存在心理病态，以及在这样的学校中，学生应对和寻求帮助策略的态度是否更成问题或不那么成问题。在纽约州萨福克县和威彻斯特县的 12 所高中，对 2865 名在过去 6 个月内有同学自杀的 6 所学校的学生和 2419 名在当前学生任期内没有自杀事件的 6 所学校的学生进行了自杀意念和行为、抑郁症状、应对和寻求帮助态度、生活压力事件以及与自杀死者的友谊（如适用）的评估。在同学自杀后，一般学生群体中没有明显的病态（即严重的自杀意念/行为和抑郁）；然而，在暴露于自杀事件的学校中，有同时发生的负面生活事件的学生，严重自杀意念/行为的风险升高。与死者的友谊与病态之间存在显著关系，即与死者是朋友但不是亲密朋友的学生，严重自杀意念/行为的可能性最大。总体而言，暴露于自杀事件的学校的学生对寻求帮助的态度更具适应性；但对于死者的朋友或同时发生负面生活事件的学生来说，情况并非如此。讨论了这些发现对事后预防策略的影响。
