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在伤害发生之前:有故意自伤行为的青少年的儿童期多动困难——来自DALSC队列研究的结果

Before the damage is done: Early childhood hyperactivity difficulties in adolescents with deliberate self-harm - findings from the DALSC cohort.

作者信息

Evald Therese A, Møhl Bo

机构信息

The Finance Committee, City Council of Copenhagen, Copenhagen, Denmark.

Faculty of Humanities, Aalborg University, Aalborg, Denmark.

出版信息

Scand J Child Adolesc Psychiatr Psychol. 2021 Jan 4;8:176-188. doi: 10.21307/sjcapp-2020-018. eCollection 2020.

Abstract

BACKGROUND

Deliberate self-harm (DSH) is a growing issue among Danish adolescents, and a dramatic increase in the incidence of DSH has been observed since the turn of the millennium. The importance of early childhood factors on later development has been established, but research on the trajectories of DSH is still scarce, and longitudinal studies are much needed.

METHOD

Participants were 3,291 children and their mothers from The Danish Longitudinal Survey of Children (DALSC), a Danish population-based birth cohort from 1995. Logistic regression and mediation analyses were used to examine significant early childhood determinants of self-harming behavior in adolescence.

RESULTS

The study found that 17.9% of the children had a history with DSH at the age of 18 years. A significant relationship was found between the likelihood of DSH at the age of 18 years and hyperactivity difficulties assessed through the Strengths and Difficulties Questionnaire (SDQ) at 3 and 7 years of age. Using a mediation model, it is documented that difficulties in peer relationships at the age of 11 years is a partial mediator explaining 19% of the variation.

LIMITATIONS

i) a vague definition of self-harm in the questionnaires; ii) lack of sample representation as children of lower socio-economic groups have lower participation rates, and only Danish-ethnicity children have been sampled; iii) possibility of omitted variable bias.

CONCLUSION

The adolescents engaging in DSH are experiencing a more complex range of psychosocial problems than those who do not have experience with DSH. The main finding of the study is that hyperactivity as a risk factor for the development of DSH in adolescence can be identified as early as 3-7 years of age. This relationship between the very early occurring hyperactivity and later DSH, to the best of our knowledge, has not previously been described.

摘要

背景

蓄意自伤(DSH)在丹麦青少年中是一个日益严重的问题,自千禧年之交以来,DSH的发病率急剧上升。幼儿期因素对后期发育的重要性已得到证实,但关于DSH轨迹的研究仍然很少,非常需要纵向研究。

方法

参与者是来自丹麦儿童纵向调查(DALSC)的3291名儿童及其母亲,DALSC是一个基于丹麦人群的1995年出生队列。采用逻辑回归和中介分析来研究青少年自伤行为的重要幼儿期决定因素。

结果

研究发现,17.9%的儿童在18岁时有DSH病史。在18岁时发生DSH的可能性与通过3岁和7岁时的优势与困难问卷(SDQ)评估的多动困难之间存在显著关系。使用中介模型证明,11岁时同伴关系困难是一个部分中介因素,解释了19%的变异。

局限性

i)问卷中自伤的定义模糊;ii)缺乏样本代表性,因为社会经济地位较低群体的儿童参与率较低,且仅对丹麦族裔儿童进行了抽样;iii)存在遗漏变量偏差的可能性。

结论

与没有DSH经历的青少年相比,参与DSH的青少年经历的心理社会问题范围更复杂。该研究的主要发现是,多动作为青少年DSH发展的一个风险因素,早在3至7岁时就可以被识别出来。据我们所知,这种早期出现的多动与后期DSH之间的关系此前尚未被描述过。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/344a/7879016/516528625dfb/sjcapp-08-018-g001.jpg

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