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儿童忽视与自杀行为:来自国家共病调查复制研究的发现。

Childhood neglect and suicidal behavior: Findings from the National Comorbidity Survey Replication.

机构信息

Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo 187-8553, Japan; Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden.

Department of Sociology, Harvard University, Cambridge, MA, USA.

出版信息

Child Abuse Negl. 2020 May;103:104400. doi: 10.1016/j.chiabu.2020.104400. Epub 2020 Mar 5.

Abstract

BACKGROUND

Although child neglect is common, there has been comparatively little research on it or its specific forms and their effects on mental health in adulthood.

OBJECTIVE

This study aimed to examine the association between exposure to different forms of childhood neglect and lifetime suicidal behavior among a nationally representative sample of adults in the U.S. general population.

METHODS

Data were analyzed from 5665 adults that were drawn from the National Comorbidity Survey Replication (NCS-R). Information was obtained on 'care', 'supervisory' and 'medical' neglect in childhood and lifetime suicidal behavior (ideation, plan, attempt). Lifetime psychiatric disorders were based on the World Mental Health - Composite International Diagnostic Interview. Logistic regression analysis was used to examine the associations.

RESULTS

In fully adjusted models, any neglect was associated with significantly increased odds for all forms of suicidal behavior (suicidal ideation, odds ratio [OR]: 1.80, 95 % confidence interval [CI]: 1.42-2.29; plan, OR: 2.27, 95 % CI: 1.78-2.91; attempt, OR: 2.05, 95 % CI: 1.63-2.59, all p < 0.001). In unadjusted analyses all individual forms of neglect were significantly associated with all forms of suicidal behavior. However, when all forms of neglect were included together in the fully adjusted models, care neglect was no longer significantly associated with any form of suicidal behavior.

CONCLUSION

Different forms of childhood neglect are associated with suicidal behavior in adults independent of common mental disorders. Future studies should focus on childhood neglect subtypes in order to better understand the effects of neglect on adult mental health.

摘要

背景

尽管儿童忽视现象普遍存在,但针对其具体形式及其对成年人心理健康的影响,相关研究相对较少。

目的

本研究旨在调查美国普通人群中,不同形式的儿童忽视与终生自杀行为之间的关系。

方法

本研究的数据来源于美国国家共病调查再访谈(NCS-R),共分析了 5665 名成年人的数据。这些数据涉及儿童时期的“照料”、“监管”和“医疗”忽视以及终生自杀行为(意念、计划和尝试)。终生精神障碍的诊断基于世界心理健康-复合国际诊断访谈。采用逻辑回归分析来检验关联。

结果

在完全调整后的模型中,任何形式的忽视均与所有形式的自杀行为显著相关(自杀意念的比值比[OR]:1.80,95%置信区间[CI]:1.42-2.29;自杀计划的 OR:2.27,95%CI:1.78-2.91;自杀尝试的 OR:2.05,95%CI:1.63-2.59,均 P<0.001)。在未调整的分析中,所有个体形式的忽视均与所有形式的自杀行为显著相关。然而,当所有形式的忽视都被纳入完全调整后的模型中时,照料忽视与任何形式的自杀行为不再显著相关。

结论

不同形式的儿童忽视与成年人的自杀行为有关,而与常见的精神障碍无关。未来的研究应关注儿童忽视的亚型,以便更好地理解忽视对成年人心理健康的影响。

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