Department of Psychiatry, Columbia University, New York, NY, USA.
Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA.
Soc Psychiatry Psychiatr Epidemiol. 2020 Mar;55(3):319-327. doi: 10.1007/s00127-019-01772-0. Epub 2019 Sep 9.
Adolescent suicide ideation (SI) often portends more grievous suicidal behavior; yet, long-term studies of what risk factors predict SI are limited. We employ a multi-wave longitudinal design to investigate the impact of earlier social contexts on change in SI.
A community sample of 748 youths drawn from the Children in the Community (CIC) study was first assessed with the CIC Youth SI Scale at mean age 13.7 (range 9-18) (baseline) and in two follow-ups over 10 years. GEE Poisson Regression was used to estimate SI between ages 10 and 25 (intercept set at age midpoint of 17), and to examine associations between baseline measures of parent, peer, and school social contexts and subsequent change in SI. Analyses were controlled for demographic characteristics and known risks for SI: sexual or physical abuse before age 18 (obtained by official reports) and major depressive disorder (MDD, diagnosed by psychiatric interview at baseline and follow-ups).
SI declined significantly by age 17 with greater mother affection (β = - 0.091, SE = 0.037), peer friendship quality (β = - 0.115, SE = 0.034), peer social support (β = - 0.116, SE = 0.042), and school engagement (β = - 0.083, SE = 0.045, trend), but increased significantly with more parent punishment (β = 0.143, SE = 0.045) and school conflict (β = 0.168, SE = 0.042). SI associations with sexual or physical abuse (β = 0.299, SE = 0.137) and MDD (β = 0.777, SE = 0.130) were independent of other effects.
Earlier social contexts influence change in SI independent of each other and of known risks for SI in community youths, and may be a resource for intervention efforts to deter future SI.
青少年自杀意念（SI）常常预示着更严重的自杀行为；然而，关于哪些风险因素预测 SI 的长期研究有限。我们采用多波纵向设计来研究早期社会环境对 SI 变化的影响。
从社区儿童研究（CIC）中抽取了 748 名青少年作为社区样本，他们在平均年龄 13.7 岁（范围为 9-18 岁）（基线）时首次接受 CIC 青少年 SI 量表评估，并在 10 年内进行了两次随访。使用广义估计方程泊松回归来估计 10 至 25 岁之间的 SI（截距设置在 17 岁的年龄中点），并检验基线时父母、同伴和学校社会环境指标与随后 SI 变化之间的关联。分析控制了人口统计学特征和 SI 的已知风险：18 岁之前的性或身体虐待（通过官方报告获得）和主要抑郁障碍（MDD，在基线和随访时通过精神病学访谈诊断）。
SI 在 17 岁时显著下降，与更多的母亲关爱（β=-0.091，SE=0.037）、同伴友谊质量（β=-0.115，SE=0.034）、同伴社会支持（β=-0.116，SE=0.042）和学校参与（β=-0.083，SE=0.045，趋势）呈负相关，但与更多的父母惩罚（β=0.143，SE=0.045）和学校冲突（β=0.168，SE=0.042）呈正相关。SI 与性或身体虐待（β=0.299，SE=0.137）和 MDD（β=0.777，SE=0.130）的关联独立于其他效应。
早期社会环境相互独立，且独立于社区青少年 SI 的已知风险，影响 SI 的变化，并且可能是干预努力的资源，以阻止未来的 SI。
