Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China; Centre for Educational and Health Psychology, Sichuan University, Chengdu, China; Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China.
Gen Hosp Psychiatry. 2018 Nov-Dec;55:90-97. doi: 10.1016/j.genhosppsych.2018.09.013. Epub 2018 Oct 2.
This study aimed to examine the frequency of suicidal ideation (SI) and identify exposure variables, mental health, and sleep-related risk factors of SI among adolescents following the 2013 Ya'an earthquake.
Participants consisted of 5563 adolescent students selected through random sampling from 11 primary and high schools in the counties most severely affected by the earthquake. They were asked to complete the Pittsburgh Sleep Quality Index, Children's Revised Impact of Event Scale-13, Short Mood and Feelings Questionnaire, and Screen for Child Anxiety-Related Emotional Disorders. Multinomial logistic analysis was used to identify possible relationships between SI and psychopathology, sleep problems, earthquake exposures or demographic characteristics. The mediation analysis was used to identify direct and indirect effects among sleep problems, psychopathology, earthquake exposures and SI.
Our findings suggest that 29.5% of the sample experienced SI during the past year (12.9% once, 11.9% twice, 2.6% on 3-4 occasions and 2.1% on at least 5 occasions). Multiple sleeping problems, including trouble falling asleep, shorter sleep duration, and daytime dysfunction, showed independent associations with SI. The mediation analysis suggested that depression and anxiety mainly mediated the association of sleep with SI.
This study was cross-sectional and did not include controls. No baseline data were collected prior to the earthquake.
SI can be a serious problem among adolescents following a major earthquake, especially those who are older, who live in one-child households, or who are female. Years after a disaster, we found that exposure severity, psychopathology and sleep impairment all contributed to SI, and that earthquake exposure may have disrupted sleep and worsened mood, which in turn may have impacted SI. By enhancing teenagers' sleep management and shaping their activities, post-disaster intervention programs may help prevent SI among Chinese adolescents.
本研究旨在调查 2013 年雅安地震后青少年自杀意念（SI）的发生频率，并确定其与暴露变量、心理健康和睡眠相关的危险因素。
通过随机抽样，从受灾最严重的 11 所中小学中选取 5563 名青少年学生作为研究对象。他们被要求完成匹兹堡睡眠质量指数、儿童修订后的事件影响量表-13、短情绪和感觉问卷以及儿童焦虑相关情绪障碍筛查量表。采用多项逻辑回归分析来识别 SI 与精神病理学、睡眠问题、地震暴露或人口统计学特征之间的可能关系。采用中介分析来识别睡眠问题、精神病理学、地震暴露与 SI 之间的直接和间接影响。
研究结果表明，在过去一年中，有 29.5%的样本经历过 SI（12.9%仅出现过一次，11.9%出现过两次，2.6%出现过 3-4 次，2.1%出现过 5 次或以上）。多种睡眠问题，包括入睡困难、睡眠时间较短和白天功能障碍，与 SI 呈独立相关。中介分析表明，抑郁和焦虑主要介导了睡眠与 SI 的关系。
本研究为横断面研究，未包括对照组。在地震发生之前，没有收集基线数据。
在重大地震后，SI 可能是青少年面临的一个严重问题，尤其是那些年龄较大、来自独生子女家庭或女性的青少年。在灾难发生多年后，我们发现暴露严重程度、精神病理学和睡眠障碍都导致了 SI，而地震暴露可能扰乱了睡眠并恶化了情绪，从而可能影响了 SI。通过加强青少年的睡眠管理和调整其活动，可以帮助中国青少年预防 SI 的发生。
