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自杀念头与行为及其与男性和女性过渡性生活事件的关联:基于国际网络样本的研究结果。

Suicidal Thoughts and Behaviors and Their Associations With Transitional Life Events in Men and Women: Findings From an International Web-Based Sample.

作者信息

Milton Alyssa Clare, Davenport Tracey A, Iorfino Frank, Flego Anna, Burns Jane M, Hickie Ian B

机构信息

Brain and Mind Centre, University of Sydney, Camperdown, Australia.

The Movember Foundation, Melbourne, Australia.

出版信息

JMIR Ment Health. 2020 Sep 11;7(9):e18383. doi: 10.2196/18383.

Abstract

BACKGROUND

Although numerous studies have demonstrated sex differences in the prevalence of suicidal thoughts and behaviors (STB), there is a clear lack of research examining the similarities and differences between men and women in terms of the relationship between STB, transitional life events, and the coping strategies employed after experiencing such events when they are perceived as stressful.

OBJECTIVE

This study aims to examine the differences between men's and women's experiences of STB, sociodemographic predictors of STB, and how coping responses after experiencing a stressful transitional life event predict STB.

METHODS

A web-based self-report survey was used to assess the health and well-being of a voluntary community-based sample of men and women aged 16 years and older, living in Australia, Canada, New Zealand, the United Kingdom, and the United States, who were recruited using web-based social media promotion and snowballing.

RESULTS

In total, 10,765 eligible web-based respondents participated. Compared with men, a significantly greater proportion of women reported STB (P<.001) and endorsed experiencing a transitional life event as stressful (P<.001). However, there were no gender differences in reporting that the transitional life event or events was stressful for those who also reported STB. Significant sociodemographic adjusted risk factors of STB included younger age; identifying as a sexual minority; lower subjective social connectedness; lower subjective intimate bonds; experiencing a stressful transitional life event in the past 12 months; living alone (women only); not being in employment, education, or training (women only); suddenly or unexpectedly losing a job (men only); and experiencing a relationship breakdown (men only). Protective factors included starting a new job, retiring, having a language background other than English, and becoming a parent for the first time (men only). The results relating to coping after experiencing a self-reported stressful transitional life event in the past 12 months found that regardless of sex, respondents who reported STB compared with those who did not were less likely to engage in activities that promote social connections, such as talking about their feelings (P<.001). Coping strategies significantly explained 19.0% of the STB variance for men (F=14.64; P<.001) and 22.0% for women (F=36.45; P<.001).

CONCLUSIONS

This research highlights multiple risk factors for STB, one of which includes experiencing at least one stressful transitional life event in the past 12 months. When individuals are experiencing such events, support from services and the community alike should consider using sex-specific or targeted strategies, as this research indicates that compared with women, more men do nothing when experiencing stress after a transitional life event and may be waiting until they experience STB to engage with their social networks for support.

摘要

背景

尽管众多研究已证实自杀念头和行为(STB)的患病率存在性别差异,但明显缺乏研究来考察男性和女性在STB、过渡性生活事件以及经历此类被视为压力事件后所采用的应对策略之间关系方面的异同。

目的

本研究旨在考察男性和女性在STB经历、STB的社会人口学预测因素方面的差异,以及经历压力性过渡性生活事件后的应对反应如何预测STB。

方法

采用基于网络的自我报告调查,以评估居住在澳大利亚、加拿大、新西兰、英国和美国的16岁及以上基于社区的自愿样本中男性和女性的健康与幸福状况,这些样本通过基于网络的社交媒体推广和滚雪球抽样方式招募。

结果

共有10765名符合条件的基于网络的受访者参与。与男性相比,报告有STB的女性比例显著更高(P<.001),且认可经历过渡性生活事件有压力的女性比例也更高(P<.001)。然而,对于那些同时报告有STB的人而言,在报告过渡性生活事件有压力方面不存在性别差异。STB的显著社会人口学调整风险因素包括年龄较小;认同为性少数群体;主观社会联系较低;主观亲密关系较低;在过去12个月内经历压力性过渡性生活事件;独自生活(仅女性);未就业、未接受教育或培训(仅女性);突然或意外失业(仅男性);以及经历关系破裂(仅男性)。保护因素包括开始新工作、退休、有非英语语言背景以及首次成为父母(仅男性)。关于在过去12个月内经历自我报告的压力性过渡性生活事件后的应对结果发现,无论性别,报告有STB的受访者与未报告的受访者相比,参与促进社会联系活动(如谈论自己感受)的可能性更小(P<.001)。应对策略显著解释了男性STB变异的19.0%(F = 14.64;P<.001)和女性的22.0%(F = 36.45;P<.001)。

结论

本研究突出了STB的多个风险因素,其中之一包括在过去12个月内经历至少一次压力性过渡性生活事件。当个体经历此类事件时,服务机构和社区的支持应考虑采用针对性别或有针对性的策略,因为本研究表明,与女性相比,更多男性在经历过渡性生活事件后的压力时无所作为,可能直到经历STB才会与社交网络寻求支持。

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