家庭冲突与中国青少年自杀行为的纵向关联：内化和外化问题的中介作用。
Longitudinal association of family conflict and suicidal behaviors among Chinese adolescents: The mediation effect of internalizing and externalizing problems.
机构信息
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China.
Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA.
出版信息
J Affect Disord. 2023 Jan 15;321:96-101. doi: 10.1016/j.jad.2022.10.028. Epub 2022 Oct 20.
OBJECTIVE
Family conflict is a risk factor for suicidal behaviors among adolescents. However, few longitudinal studies have investigated this association and explored the mediation effect of behavioral and emotional problems. This study aimed to examine the longitudinal association between family conflict, internalizing and externalizing problems, and suicidal behaviors in a large sample of Chinese adolescents.
METHOD
This longitudinal study of 7,072 adolescents was based on the Shandong Adolescent Behavior & Health Cohort (SABHC). Participants completed a self-administrated questionnaire to assess family conflict, internalizing and externalizing problems, suicidal behaviors, and family demographics at baseline. Excluding adolescents with any suicidal behavior at baseline (N = 839), others (N = 6,233) were allowed to report their internalizing and externalizing problems and suicidal behaviors one-year later. Path analyses were conducted to examine the mediation relationship of internalizing and externalizing problems between family conflict and suicidal behaviors.
RESULTS
Of 6,233 participants, mean age was 14.52 at baseline and 51.2% were males. Adolescents with subsequent suicidal behaviors reported higher scores in family conflict, internalizing and externalizing problems (Ps < 0.01). Path analyses showed that internalizing and externalizing problems played a significant mediating role in the associations of family conflict with suicidal behaviors after adjusting for covariates.
CONCLUSIONS
Family conflict is associated with suicidal behaviors in adolescents, which is partially mediated by internalizing and externalizing problems. Internalizing problems is the major mediator between family conflict and suicidal thought or suicide plan; however, internalizing and externalizing problems play similar mediating roles in the family conflict-suicide attempt link.
目的
家庭冲突是青少年自杀行为的一个风险因素。然而，很少有纵向研究调查这种关联，并探讨行为和情绪问题的中介作用。本研究旨在检验一个大样本中国青少年中家庭冲突、内化和外化问题与自杀行为之间的纵向关联。
方法
本纵向研究基于山东青少年行为与健康队列（SABHC），共纳入 7072 名青少年。参与者在基线时完成了一份自我报告问卷，以评估家庭冲突、内化和外化问题、自杀行为以及家庭人口统计学特征。排除基线时有任何自杀行为的青少年（N=839），其余（N=6233）在一年后报告内化和外化问题以及自杀行为。路径分析用于检验内化和外化问题在家庭冲突与自杀行为之间的中介关系。
结果
在 6233 名参与者中，平均年龄为 14.52 岁，男性占 51.2%。有后续自杀行为的青少年报告的家庭冲突、内化和外化问题得分更高（P<0.01）。路径分析显示，在调整了协变量后，内化和外化问题在家庭冲突与自杀行为的关联中起显著的中介作用。
结论
家庭冲突与青少年的自杀行为有关，内化和外化问题在其中起部分中介作用。内化问题是家庭冲突与自杀意念或自杀计划之间的主要中介因素；然而，内化和外化问题在家庭冲突与自杀企图之间起着相似的中介作用。
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