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有自杀意念和行为史的小学生的神经认知和临床特征。

Neurocognitive and clinical characteristics of elementary school-aged children with a history of suicidal thoughts and behaviors.

机构信息

Columbia University, NY, New York, United States of America.

Bluestone Counseling, Columbus, OH, United States of America.

出版信息

J Affect Disord. 2023 Oct 15;339:318-324. doi: 10.1016/j.jad.2023.07.038. Epub 2023 Jul 11.

Abstract

BACKGROUND

Suicidal thoughts and behaviors (STBs) in elementary school-aged youth have increased in recent years. Understanding the risks associated with childhood STBs is necessary for prevention efforts.

METHODS

The current study examined clinical and neurocognitive characteristics of a community sample of elementary school-aged children with (STB+) and without (STB-) a history of STBs. The final sample included 93 families with children average age of 7.8 years (SD = 1.3). Children in this sample were racially diverse, evenly split by sex, and most identified as non-Hispanic. Neurocognitive functioning was assessed using computerized behavioral measures. Child clinical characteristics were assessed using self-report measures and STB history was assessed using semi-structured interviews.

RESULTS

Of the 93 families, 64 STB- children and 29 STB+ children participated. On average, STB+ children were older, reported higher levels of depressive and anxiety symptoms, and were more likely to have a parental history of suicidal behavior (PH+). Regarding neurocognitive functioning, STB+ children exhibited lower raw scores for both the NIH Dimensional Change Card Sort Task (NIH-DCCS) and NIH Flanker Inhibitory Control and Attention Test (NIH-Flanker). Multivariable regression analyses revealed raw scores for NIH-DCCS and NIH-Flanker, PH+ status, and child age were associated with childhood STBs.

LIMITATIONS

Prospective data is needed to confirm cross-sectional findings.

CONCLUSIONS

Poorer neurocognitive functioning and PH+ status may serve as risk markers for STBs in elementary school-aged children. Targeting prevention programming for these risks may reduce the likelihood of STBs in at-risk elementary school-aged youth.

摘要

背景

近年来,小学生的自杀意念和行为(STBs)有所增加。了解与儿童 STBs 相关的风险对于预防工作是必要的。

方法

本研究考察了有(STB+)和无(STB-)自杀意念史的小学生社区样本的临床和神经认知特征。最终样本包括 93 个家庭,儿童平均年龄为 7.8 岁(SD=1.3)。该样本中的儿童种族多样,性别分布均匀,大多数是非西班牙裔。使用计算机化行为测量来评估神经认知功能。使用自我报告测量来评估儿童的临床特征,使用半结构化访谈来评估自杀意念史。

结果

在 93 个家庭中,有 64 名 STB-儿童和 29 名 STB+儿童参加了研究。平均而言,STB+儿童年龄较大,报告的抑郁和焦虑症状水平较高,并且更有可能有自杀行为的父母史(PH+)。在神经认知功能方面,STB+儿童在 NIH 维度变化卡片分类任务(NIH-DCCS)和 NIH 侧抑制控制和注意力测试(NIH-Flanker)的原始分数均较低。多变量回归分析显示,NIH-DCCS 和 NIH-Flanker 的原始分数、PH+状态和儿童年龄与儿童 STBs 相关。

局限性

需要前瞻性数据来确认横断面研究结果。

结论

较差的神经认知功能和 PH+状态可能是小学生 STBs 的风险标志物。针对这些风险的预防计划可能会降低高危小学生发生 STBs 的可能性。

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