Department of Human Development and Family Studies, The University of North Carolina at Greensboro, Greensboro, North Carolina.
Department of Psychology, City University of New York College of Staten Island, Staten Island, New York.
Depress Anxiety. 2019 May;36(5):423-432. doi: 10.1002/da.22889. Epub 2019 Mar 21.
Suicide is the second leading cause of death among youth worldwide, but low- and middle-income countries (LMICs) account for 78% of all suicides. The LMICs South Africa and Guyana rank high in the global suicide rates. To better understand and prevent suicide among the youth, the present study targets youths at high risk for suicide, in an LMIC, to contextually and representatively identify clinical risk factors for suicide.
One hundred-ninety youths, aged 11-21, separated from biological parents at the time of assessment, in South Africa and Guyana, were administered the Child Behavior Checklist and Behavior Assessment System for Children to assess clinical symptoms. The youths were asked about current suicide ideation and previous attempt(s). Self-report responses to clinical items yielded scale scores for depression, social stress, atypicality, somatization, anxiety, and ADHD. Using an integrative data analytic technique, clinical scale scores were standardized and used to predict suicidal behaviors in a binary logistic regression analysis.
Approximately 22% of Black South African youths and 60% of Guyanese youths endorsed suicide ideation and attempt or suicide attempt only. In fully adjusted analyses, the odds of atypicality and somatization were 1.96 and 1.67 times greater among the youths who endorsed suicidal ideation when compared with those who did not (p < .04). Youth social stress was significantly associated with the suicide attempt, controlling for model covariates (odds ratio [OR], 1.88, p = .05). Gender moderated the effect of somatization on youth suicide.
Our results contextualize how social stress, atypicality, and somatization relate to LMIC youth suicide. Further study on high-risk samples will contribute to generalizable suicide-prevention models.
自杀是全球青少年的第二大死因，但中低收入国家（LMICs）占所有自杀事件的 78%。在全球自杀率较高的国家中，南非和圭亚那属于 LMICs。为了更好地理解和预防青少年自杀，本研究针对处于 LMIC 中的高自杀风险青少年，从上下文和代表性的角度确定自杀的临床风险因素。
本研究共纳入 190 名青少年，年龄在 11-21 岁之间，在南非和圭亚那，他们在评估时与亲生父母分离，使用儿童行为检查表和儿童行为评估系统评估临床症状。询问青少年目前的自杀意念和之前的自杀企图。对临床项目的自我报告回答产生了抑郁、社会压力、非典型性、躯体化、焦虑和 ADHD 的量表分数。使用综合数据分析技术，对临床量表分数进行标准化，并在二元逻辑回归分析中预测自杀行为。
约 22%的南非黑人青少年和 60%的圭亚那青少年表示有自杀意念和尝试自杀或仅尝试自杀。在完全调整的分析中，与没有自杀意念的青少年相比，有自杀意念的青少年的非典型性和躯体化的几率分别高出 1.96 倍和 1.67 倍（p<0.04）。在控制模型协变量的情况下，青年社会压力与自杀企图显著相关（优势比 [OR]，1.88，p=0.05）。性别调节了躯体化对青少年自杀的影响。
我们的研究结果从上下文角度说明了社会压力、非典型性和躯体化与 LMIC 青少年自杀的关系。对高风险样本的进一步研究将有助于推广可预防自杀的模型。
