俄亥俄州青少年自杀潮期间社交媒体与自杀行为之间的关联
Associations Between Social Media and Suicidal Behaviors During a Youth Suicide Cluster in Ohio.
作者信息
Swedo Elizabeth A, Beauregard Jennifer L, de Fijter Sietske, Werhan Luke, Norris Kirkland, Montgomery Martha P, Rose Erica B, David-Ferdon Corinne, Massetti Greta M, Hillis Susan D, Sumner Steven A
机构信息
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
出版信息
J Adolesc Health. 2021 Feb;68(2):308-316. doi: 10.1016/j.jadohealth.2020.05.049. Epub 2020 Jul 7.
PURPOSE
Youth suicide clusters may be exacerbated by suicide contagion-the spread of suicidal behaviors. Factors promoting suicide contagion are poorly understood, particularly in the advent of social media. Using cross-sectional data from an ongoing youth suicide cluster in Ohio, this study examines associations between suicide cluster-related social media and suicidal behaviors.
METHODS
We surveyed 7th- to 12th-grade students in northeastern Ohio during a 2017-2018 suicide cluster to assess the prevalence of suicidal ideation (SI), suicide attempts (SAs), and associations with potential contagion-promoting factors such as suicide cluster-related social media, vigils, memorials, news articles, and watching the Netflix series 13 Reasons Why before or during the cluster. Generalized estimating equations examined associations between potential contagion-promoting factors and SI/SA, adjusting for nonmodifiable risk factors. Subgroup analyses examined whether associations between cluster-related factors and SI/SA during the cluster varied by previous history of SI/SA.
RESULTS
Among participating students, 9.0% (876/9,733) reported SI and 4.9% attempted suicide (481/9,733) during the suicide cluster. Among students who posted suicide cluster-related content to social media, 22.9% (267/1,167) reported SI and 15.0% (175/1,167) attempted suicide during the suicide cluster. Posting suicide cluster-related content was associated with both SI (adjusted odds ratio 1.7, 95% confidence interval 1.4-2.0) and SA during the cluster (adjusted odds ratio 1.7, 95% confidence interval 1.2-2.5). In subgroup analyses, seeing suicide cluster-related posts was uniquely associated with increased odds of SI and SA during the cluster among students with no previous history of SI/SA.
CONCLUSIONS
Exposure to suicide cluster-related social media is associated with both SI and SA during a suicide cluster. Suicide interventions could benefit from efforts to mitigate potential negative effects of social media and promote prevention messages.
目的
青少年自杀群聚现象可能会因自杀传染（自杀行为的传播）而加剧。促进自杀传染的因素目前了解甚少，尤其是在社交媒体出现的情况下。本研究利用俄亥俄州一个正在发生的青少年自杀群聚事件的横断面数据，考察与自杀群聚相关的社交媒体和自杀行为之间的关联。
方法
在2017 - 2018年自杀群聚事件期间，我们对俄亥俄州东北部7至12年级的学生进行了调查，以评估自杀意念（SI）、自杀未遂（SA）的发生率，以及与潜在的促进传染因素的关联，如与自杀群聚相关的社交媒体、守夜活动、纪念活动、新闻报道，以及在群聚事件之前或期间观看网飞电视剧《13个原因》。广义估计方程考察了潜在促进传染因素与SI/SA之间的关联，并对不可改变的风险因素进行了调整。亚组分析考察了群聚事件期间与群聚相关因素和SI/SA之间的关联是否因既往SI/SA病史而异。
结果
在参与调查的学生中，9.0%（876/9733）报告有自杀意念，4.9%（481/9733）在自杀群聚事件期间曾试图自杀。在向社交媒体发布与自杀群聚相关内容的学生中，22.9%（267/1167）报告有自杀意念，15.0%（175/1167）在自杀群聚事件期间曾试图自杀。发布与自杀群聚相关的内容与群聚事件期间的自杀意念（调整后的优势比为1.7，95%置信区间为1.4 - 2.0）和自杀未遂（调整后的优势比为1.7，95%置信区间为1.2 - 2.5）均相关。在亚组分析中，对于既往无自杀意念/自杀未遂病史的学生，在群聚事件期间看到与自杀群聚相关的帖子与自杀意念和自杀未遂几率增加有独特关联。
结论
在自杀群聚事件期间，接触与自杀群聚相关的社交媒体与自杀意念和自杀未遂均相关。自杀干预措施可受益于减轻社交媒体潜在负面影响并推广预防信息的努力。
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