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小学适龄儿童的临床风险因素、情绪反应性/调节与自杀意念

Clinical risk factors, emotional reactivity/regulation and suicidal ideation in elementary school-aged children.

作者信息

Sheftall Arielle H, Vakil Fatima, Armstrong Sarah E, Rausch Joseph R, Feng Xin, Kerns Kathryn A, Brent David A, Bridge Jeffrey A

机构信息

Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, USA; Department of Pediatrics, The Ohio State University, College of Medicine, USA.

Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, USA.

出版信息

J Psychiatr Res. 2021 Jun;138:360-365. doi: 10.1016/j.jpsychires.2021.04.021. Epub 2021 Apr 19.

Abstract

OBJECTIVE

Suicidal behavior (SB) in young children is rare yet in 2019, suicide was the fifth leading cause of death in 5-12-year-old youth. Understanding the risks associated with childhood suicidal ideation (SI) and SB will determine which factors should be targeted for prevention programming. This study examined clinical characteristics and emotional reactivity/regulation (ERR) in children with (SI+) and without (SI-) SI.

METHOD

One hundred seventeen children, 6-9 years, and one biological parent were enrolled. Children completed interviews concerning SI/SB and parents completed interviews/self-reports about SI/SB, psychiatric distress, and history of abuse/neglect and their child's SI/SB, mental health, and ERR. Independent t-tests and Chi-square analyses using Bonferroni correction were conducted to examine SI group differences. Variables were then screened using forward stepwise logistic regression to determine association with SI + status. The final logistic regression included variables that survived screening procedures only.

RESULTS

Univariate analyses revealed SI + children were more likely to have a parental history of suicide attempt (PH+), higher rates of current psychotropic medication use, higher scores on the CBCL-DSM oriented scales (e.g., ADHD problems), and higher negative affect compared to SI- children. After analytic screening procedures, PH+, anxiety problems, ADHD problems, and anger survived. The final logistic regression revealed PH + status and anxiety problems were associated with SI + status.

CONCLUSION

Long-term follow-up is needed to determine if these factors are predictive of a first-time suicide attempt in this at-risk group.

摘要

目的

幼儿自杀行为(SB)较为罕见,但在2019年,自杀是5至12岁青少年的第五大死因。了解与儿童自杀意念(SI)和SB相关的风险将确定哪些因素应成为预防计划的目标。本研究调查了有SI(SI+)和无SI(SI-)的儿童的临床特征以及情绪反应性/调节(ERR)。

方法

招募了117名6至9岁的儿童及其一名亲生父母。儿童完成了关于SI/SB的访谈,父母完成了关于SI/SB、精神痛苦、虐待/忽视史以及他们孩子的SI/SB、心理健康和ERR的访谈/自我报告。采用独立样本t检验和经Bonferroni校正的卡方分析来检验SI组间差异。然后使用向前逐步逻辑回归对变量进行筛选,以确定与SI+状态的关联。最终的逻辑回归仅纳入了在筛选过程中留存下来的变量。

结果

单因素分析显示,与SI-儿童相比,SI+儿童更有可能有父母自杀未遂史(PH+)、当前使用精神药物的比例更高、在CBCL-DSM定向量表上得分更高(如注意力缺陷多动障碍问题),且消极情绪更高。经过分析筛选程序后,PH+、焦虑问题、注意力缺陷多动障碍问题和愤怒留存了下来。最终的逻辑回归显示,PH+状态和焦虑问题与SI+状态相关。

结论

需要进行长期随访,以确定这些因素是否可预测这一高危群体的首次自杀未遂情况。

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