Fergusson D M, Lynskey M T
Christchurch Health and Development Study, Christchurch School of Medicine, Christchurch Hospital, New Zealand.
J Am Acad Child Adolesc Psychiatry. 1995 May;34(5):612-22. doi: 10.1097/00004583-199505000-00013.
To estimate the prevalence of attempted suicide during adolescence in a birth cohort of New Zealand children studied to the age of 16 years and to examine the relationships among adolescent problems of adjustment, psychopathology, childhood circumstances, and risks of adolescent suicide attempts.
Attempted suicide, adolescent problems of adjustment, psychopathology, and childhood circumstances were assessed as part of a longitudinal study of a birth cohort of 954 New Zealand children studied at annual intervals to the age of 16 years.
By 16 years, 3.0% of the sample (4.2% of girls and 1.9% of boys) reported having made a suicide attempt. There were strong associations between attempted suicide and rates of adolescent problem behaviors or psychopathology; teenagers having problems of adjustment or psychiatric disorders were up to 22 times more likely to attempt suicide. Risks of attempted suicide were also higher among children from disadvantaged or dysfunctional family backgrounds. A loglinear model fitted to the measures of attempted suicide, adolescent psychopathology, problems of adjustment, and childhood circumstances suggested the presence of a causal chain process in which childhood problems were significantly (p < .005) related to increased risks of later psychopathology and problems of personal adjustment which were, in turn, related to significantly (p < .05) increased rates of attempted suicide.
A common pathway that leads to increased vulnerability to suicidal behavior involves early disadvantageous childhood and family circumstances, which lead to increased risks of adolescent psychopathology and problems of adjustment, which lead to increased risks and vulnerability to adolescent suicidal behaviors.
评估在一项针对新西兰儿童出生队列进行至16岁的研究中青少年自杀未遂的患病率，并探讨青少年适应问题、精神病理学、儿童期情况与青少年自杀未遂风险之间的关系。
作为对954名新西兰儿童出生队列进行的纵向研究的一部分，对自杀未遂、青少年适应问题、精神病理学和儿童期情况进行了评估，该队列每年进行一次研究，直至16岁。
到16岁时，样本中有3.0%（女孩为4.2%，男孩为1.9%）报告曾有过自杀未遂行为。自杀未遂与青少年问题行为或精神病理学发生率之间存在密切关联；有适应问题或精神疾病的青少年自杀未遂的可能性高达22倍。来自弱势或功能失调家庭背景的儿童自杀未遂风险也更高。一个适用于自杀未遂、青少年精神病理学、适应问题和儿童期情况测量指标的对数线性模型表明存在一个因果链过程，其中儿童期问题与后期精神病理学和个人适应问题风险增加显著相关（p <.005），而这些问题又与自杀未遂发生率显著增加（p <.05）相关。
导致自杀行为易感性增加的一个共同途径涉及早期不利的儿童期和家庭环境，这会导致青少年精神病理学和适应问题风险增加，进而导致青少年自杀行为风险和易感性增加。
