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青少年适应障碍者如何应对压力情境?与自杀风险的关系。

How do adolescents with Adjustment Disorder cope with stressful situations? Relationship with suicidal risk.

机构信息

Child and Youth Mental Health Center, Vidal i Barraquer Foundation, Santa Coloma de Gramenet, Barcelona, Spain.

University of Barcelona, Spain; Institute of Neurosciences, Barcelona, Spain; Group of Studies about Measure Invariance and Analysis of Change (GEIMAC), Barcelona, Spain.

出版信息

Rev Psiquiatr Salud Ment (Engl Ed). 2020 Apr-Jun;13(2):63-72. doi: 10.1016/j.rpsm.2018.11.002. Epub 2018 Dec 14.

Abstract

OBJECTIVE

Little is known about the role of coping in relation to suicidal risk in adolescents with Adjustment Disorder (AD). The present study aimed to assess the relation between suicidal ideation and intention and coping strategies in a clinical sample of adolescents with AD, paying special attention to gender differences.

MATERIAL AND METHOD

Self-reported questionnaires about suicidal ideation and intention and coping strategies were administered to 108 adolescents with an AD diagnosis.

RESULTS

Compared with the normative population, adolescents with an AD diagnosis made more use of Acceptance-Resignation (an avoidance-type coping strategy) and less use of Positive Reappraisal (an approach-type coping strategy). Nevertheless, gender introduced some peculiarities. A relationship was observed between the use of certain coping strategies and suicidal ideation and intention, but with notable differences depending on gender: significant and high correlations were found between these two variables in AD boys, both in the total approach score (r=.53, p<.01) and in the total avoidant score (r=.60, p<.01), with coping strategies explaining 41% of suicidal ideation and intention; in girls, in contrast, the only significant relationship was with an avoidant strategy, Emotional Discharge (r=.25, p<.05), although it had low explanatory power.

CONCLUSIONS

Coping strategies must be taken into consideration when assessing and treating adolescents with AD at risk of suicide, especially in the case of boys. The absence of association between coping strategies and suicidal risk in girls is discussed, and some therapeutic proposals are presented.

摘要

目的

对于患有适应障碍(AD)的青少年,应对方式与自杀风险的关系知之甚少。本研究旨在评估 AD 青少年患者的自杀意念和自杀意图与应对策略之间的关系,并特别关注性别差异。

材料和方法

对 108 名 AD 诊断的青少年进行了自杀意念和自杀意图以及应对策略的自我报告问卷评估。

结果

与正常人群相比,AD 诊断的青少年更多地使用接受-放弃(回避型应对策略),较少使用积极重新评估(应对策略)。然而,性别也存在一些特殊性。某些应对策略与自杀意念和自杀意图之间存在相关性,但性别存在显著差异:AD 男孩的两种变量之间存在显著和高度相关,在总应对得分(r=.53,p<.01)和总回避得分(r=.60,p<.01)上均存在显著相关,应对策略解释了 41%的自杀意念和自杀意图;相比之下,在女孩中,只有一种回避策略,即情绪宣泄(r=.25,p<.05)与自杀意念和自杀意图存在显著相关,但解释能力较低。

结论

在评估和治疗有自杀风险的 AD 青少年时,特别是在男孩中,必须考虑应对策略。本文讨论了女孩的应对策略与自杀风险之间缺乏关联的问题,并提出了一些治疗建议。

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