非典型言语发展与青少年自伤的关联。
The Association Between Atypical Speech Development and Adolescent Self-Harm.
机构信息
School of Health and Social Care, University of Essex, Colchester, United Kingdom.
Norwich Medical School, University of East Anglia, United Kingdom.
出版信息
J Speech Lang Hear Res. 2023 May 9;66(5):1600-1617. doi: 10.1044/2023_JSLHR-21-00652. Epub 2023 Apr 20.
BACKGROUND
Adolescent self-harm is a major public health issue internationally. Various factors associated with adolescent self-harm have been identified, including being bullied and experiencing mental health problems. Stuttering and speech sound disorder are associated with both of these factors. It was hypothesized that both stuttering and speech sound disorder would be associated with self-harm. This is the first study to explore the relationship between communication disorders and adolescent self-harm.
METHOD
Secondary analysis of a large, longitudinal, prospective, community sample, the Avon Longitudinal Study of Parents and Children, was carried out. Clinicians identified children who stuttered or exhibited speech sound disorder at the age of 8 years. When the cohort members were 16 years old, they were asked to complete a questionnaire about self-harm. Multinomial logistic regression was used to examine the associations between stuttering and speech sound disorder and the self-harm outcomes, adjusting for other relevant factors.
RESULTS
Of 3,824 participants with data for both speech status and self-harm, 94 (2.5%; 95% confidence interval [CI; 2.0, 3.0]) stuttered at 8 years of age and 127 (3.3%; 95% CI [2.8, 3.9]) displayed speech sound disorder. Speech sound disorder at the age of 8 years was associated with self-harm with suicidal intent in both unadjusted and adjusted models. Differences between the adjusted and unadjusted models were small, suggesting that speech sound disorder is largely an independent risk factor for self-harm with suicidal intent. Stuttering at the age of 8 years was not associated with adolescent self-harm, and there was no association between speech sound disorder and self-harm without suicidal intent.
CONCLUSION
Compared with individuals without speech sound disorder, adolescents with speech sound disorder at the age of 8 years have twice the risk of reporting self-harm with suicidal intent, even when other important predictors are taken into account.
SUPPLEMENTAL MATERIAL
背景
青少年自残是一个国际性的重大公共卫生问题。已经确定了与青少年自残相关的各种因素，包括被欺负和心理健康问题。口吃和语音障碍与这两个因素都有关。据推测，口吃和语音障碍都与自残有关。这是第一项探索沟通障碍与青少年自残之间关系的研究。
方法
对一个大型的、纵向的、前瞻性的社区样本——雅芳纵向父母与子女研究（Avon Longitudinal Study of Parents and Children）进行了二次分析。临床医生在 8 岁时确定了口吃或表现出语音障碍的儿童。当队列成员年满 16 岁时，他们被要求完成一份关于自残的问卷。多变量逻辑回归用于检查口吃和语音障碍与自残结果之间的关联，同时调整了其他相关因素。
结果
在 3824 名既有语音状况又有自残数据的参与者中，94 人（2.5%；95%置信区间[CI；2.0，3.0]）在 8 岁时口吃，127 人（3.3%；95% CI [2.8, 3.9]）表现出语音障碍。未经调整和调整后的模型均显示，8 岁时的语音障碍与无自杀意图的自残有关。调整后和未调整模型之间的差异很小，表明语音障碍是有自杀意图的自残的主要危险因素。8 岁时的口吃与青少年自残无关，语音障碍与无自杀意图的自残之间也没有关联。
结论
与没有语音障碍的个体相比，8 岁时患有语音障碍的青少年报告有自杀意图的自残的风险增加了一倍，即使考虑到其他重要的预测因素也是如此。
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