韧性缓冲了睡眠问题对青少年到青年期自杀意念轨迹的影响。
Resilience buffers the effects of sleep problems on the trajectory of suicidal ideation from adolescence through young adulthood.
机构信息
Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
出版信息
Soc Sci Med. 2021 Jun;279:114020. doi: 10.1016/j.socscimed.2021.114020. Epub 2021 May 10.
OBJECTIVES
To examine both the between-person and within-person effects of sleep problems on the trajectory of suicidal ideation from ages 14 to 22 and investigate whether resilience moderates the effects. Age and sex differences were explored in the main and interaction effects of sleep problems and resilience on suicidal ideation.
METHODS
The study sample included 2491 adolescents (1260 males and 1231 females) who participated in a prospective study spanning 2009 through 2016 in northern Taiwan. Sex-stratified multilevel models were used to examine the between-person and within-person effects of sleep problems and the moderating effects of resilience on the trajectory of suicidal ideation in males and females.
RESULTS
Across adolescents, higher levels of sleep problems contributed to an elevated risk of suicidal ideation for both sexes. Within individuals, a higher risk of suicidal ideation was observed when an adolescent's sleep problems exceeded their typical levels. The within-person effects of sleep problems were further determined to vary by age in males, with the effects gradually decreasing throughout late adolescence but increasing again in young adulthood. The buffering effects of resilience were only observed in females. The relationships between the within-person effects of sleep problems and suicidal ideation were only significant in female adolescents with low levels of resilience.
CONCLUSIONS
Our findings extend the research by demonstrating both the between-person and within-person association between sleep problems and suicidal ideation. We further revealed age and sex differences in the within-person effects of sleep problems and the buffering effects of resilience. Prevention and intervention programs that target sleep problems could be tailored based on individuals' age, sex, and levels of resilience to prevent suicidal ideation.
目的
考察睡眠问题对 14 岁至 22 岁自杀意念轨迹的个体间和个体内影响，并探讨韧性是否调节这些影响。探讨了睡眠问题和韧性对自杀意念的主要和交互作用在性别和年龄上的差异。
方法
本研究样本包括 2491 名青少年（男性 1260 名，女性 1231 名），他们参加了 2009 年至 2016 年在台湾北部进行的一项前瞻性研究。使用分层多水平模型来检验睡眠问题的个体间和个体内效应，以及韧性对男性和女性自杀意念轨迹的调节作用。
结果
在所有青少年中，较高水平的睡眠问题会增加两性自杀意念的风险。在个体内部，当青少年的睡眠问题超过其典型水平时，自杀意念的风险更高。睡眠问题的个体内效应进一步被确定在男性中因年龄而异，随着青春期后期逐渐降低，但在成年早期再次增加。韧性的缓冲作用仅在女性中观察到。只有在韧性水平较低的女性青少年中，睡眠问题的个体内效应与自杀意念之间才存在显著关系。
结论
我们的研究结果扩展了睡眠问题与自杀意念之间的个体间和个体内关联的研究。我们进一步揭示了睡眠问题的个体内效应和韧性的缓冲作用在性别和年龄上的差异。针对睡眠问题的预防和干预计划可以根据个体的年龄、性别和韧性水平进行定制，以预防自杀意念。
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