The Center for Family Safety and Healing at Nationwide Children's Hospital, 655 East Livingston Avenue, Columbus, OH 43205, USA.
Center for Suicide Prevention and Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 444 Butterfly Gardens Drive, Columbus, OH 43215, USA.
Child Abuse Negl. 2023 Oct;144:106351. doi: 10.1016/j.chiabu.2023.106351. Epub 2023 Jul 27.
Emotional maltreatment and poor family functioning are known risks for youth suicide, but few studies have examined these issues as prospective predictors of future attempts.
Examine family functioning and suicide risk associated with emotional maltreatment in youth with a lifetime history of major depressive disorder (MDD) and the prospective association of emotional maltreatment and family functioning with future suicide attempts.
Participants included 321 youth aged 12-15 years (251 with emotional maltreatment; 70 with no emotional maltreatment) recruited from a metropolitan children's hospital from 2011 to 2018. Prospective analyses included 280 youths (221 with emotional maltreatment; 59 without emotional maltreatment).
Semi-structured interviews and self-reports assessed family functioning and suicidal thoughts and behaviors in youth with and without emotional maltreatment at baseline, 6-month, 1-year, and 2-year follow-up. Multivariate analyses examined whether emotional maltreatment predicted future suicide attempts, beyond the effect of prior suicide attempts.
Emotionally maltreated youth reported significantly lower scores for family adaptability, cohesion, and family alliance, and higher rates of suicidal ideation and suicide attempts, compared to youth without emotional maltreatment. Youth experiencing multiple forms of abuse were significantly more likely to attempt suicide at future timepoints, however this association was attenuated after controlling for prior suicide attempts.
Youth who experienced emotional maltreatment had a significantly higher percentage of past suicidal thoughts and behaviors and significantly less favorable scores for family functioning associated with an increased suicide risk. Findings support family-focused suicide prevention strategies as a promising approach to reduce youth suicide.
情感虐待和不良家庭功能是青少年自杀的已知风险因素，但很少有研究将这些问题作为未来自杀企图的前瞻性预测因素进行研究。
检查有过一生期重性抑郁障碍（MDD）病史的青少年中与情感虐待相关的家庭功能和自杀风险，以及情感虐待和家庭功能与未来自杀企图的前瞻性关联。
参与者包括 2011 年至 2018 年间从大都市儿童医院招募的 321 名 12-15 岁的青少年（251 名有情感虐待；70 名无情感虐待）。前瞻性分析包括 280 名青少年（221 名有情感虐待；59 名无情感虐待）。
半结构化访谈和自我报告评估了基线、6 个月、1 年和 2 年随访时有和无情感虐待的青少年的家庭功能和自杀想法和行为。多变量分析检验了情感虐待是否在既往自杀企图的影响之外，预测未来自杀企图。
与无情感虐待的青少年相比，经历情感虐待的青少年报告家庭适应性、凝聚力和家庭联盟的得分明显较低，自杀意念和自杀企图的发生率明显较高。经历多种形式虐待的青少年在未来时间点自杀的可能性明显更高，但在控制既往自杀企图后，这种关联减弱。
经历情感虐待的青少年过去有更高比例的自杀想法和行为，家庭功能得分明显较差，自杀风险增加。研究结果支持以家庭为中心的自杀预防策略，这是减少青少年自杀的一种有前途的方法。
