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波多黎各青少年早期的自杀尝试和自杀意念的发展过程。

Suicide Attempts and Course of Suicidal Ideation among Puerto Rican Early Adolescents.

机构信息

Department of Psychology, Hunter College, City University of New York, 695 Park Avenue, Room 611HN, New York, NY, 10065, USA.

Division of Gender, Sexuality and Health, Columbia University and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.

出版信息

J Abnorm Child Psychol. 2019 Oct;47(10):1723-1734. doi: 10.1007/s10802-019-00554-1.

Abstract

Suicidal behavior increases substantially during early adolescence, a critical understudied developmental period. This study reports on the prevalence of suicidal ideation, suicide attempts, and course of suicidal ideation among Puerto Rican early adolescents, a high-risk group for suicidal behavior in adulthood. Gender differences and the prospective association of psychiatric disorders with course of suicidal ideation are examined. Participants were 1228 Puerto Rican adolescents (ages 10-13 at wave 1; 48% female) and parents, selected through probability-based sampling, assessed yearly across three waves. Adolescents and parents reported via Diagnostic Interview Schedule for Children-IV about 12-month suicide attempts and suicidal ideation (further categorized as never present, onset, recurrence, and remission), mood and anxiety disorders; parents reported on disruptive disorders. Over the three waves, 9.5% early adolescents thought about suicide and 2.1% attempted suicide. In adjusted multinomial regression models, compared to those with never present suicidal ideation, female gender was related to onset of suicidal ideation (OR = 2.60; 95% CI, 1.22-5.55). Disruptive disorders were related to onset (OR = 5.80; 95% CI, 2.06-16.32) and recurrence of suicidal ideation (OR = 5.07, 95% CI, 1.14-22.47), mood disorders were related to remission (OR = 14.42, 95% CI, 3.90-53.23), and anxiety disorders to onset of suicidal ideation (OR = 3.68, 95% CI, 1.75-7.73). Our findings inform strategies tailored for early adolescents. To address onset of suicidal ideation, prevention should focus on girls and those with anxiety or disruptive disorders. When ideation is recurrent, interventions oriented to reduce disruptive behavior and its consequences may help achieve remission.

摘要

自杀行为在青少年早期显著增加,这是一个被严重低估的发育阶段。本研究报告了波多黎各青少年的自杀意念、自杀企图和自杀意念过程的流行率,他们是成年后自杀行为的高风险群体。研究检查了性别差异和精神障碍与自杀意念过程的前瞻性关联。参与者是 1228 名波多黎各青少年(第 1 波时年龄为 10-13 岁;48%为女性)及其父母,他们通过概率抽样选择,在三个波次中每年进行评估。青少年及其父母通过儿童诊断访谈量表第四版报告了 12 个月的自杀企图和自杀意念(进一步分为从未出现、出现、复发和缓解)、情绪和焦虑障碍;父母报告了破坏性行为障碍。在三个波次中,有 9.5%的青少年有过自杀念头,2.1%的青少年有过自杀企图。在调整后的多项回归模型中,与从未出现自杀意念的青少年相比,女性性别与自杀意念的出现相关(OR=2.60;95%CI,1.22-5.55)。破坏性行为障碍与自杀意念的出现(OR=5.80;95%CI,2.06-16.32)和复发(OR=5.07,95%CI,1.14-22.47)相关,情绪障碍与缓解(OR=14.42,95%CI,3.90-53.23)相关,焦虑障碍与自杀意念的出现(OR=3.68,95%CI,1.75-7.73)相关。我们的研究结果为针对青少年的特定策略提供了信息。为了应对自杀意念的出现,预防应侧重于女孩和那些有焦虑或破坏性行为障碍的人。当意念复发时,旨在减少破坏性行为及其后果的干预措施可能有助于实现缓解。

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Annu Rev Clin Psychol. 2019 May 7;15:425-450. doi: 10.1146/annurev-clinpsy-050718-095625. Epub 2019 Feb 20.

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