King C A, Segal H G, Naylor M, Evans T
Department of Psychiatry, University of Michigan, Ann Arbor.
J Am Acad Child Adolesc Psychiatry. 1993 Nov;32(6):1198-206. doi: 10.1097/00004583-199311000-00013.
This study was designed to identify family and parental characteristics associated with suicidal behavior (active intent, gesture, attempt) among adolescent inpatients with mood disorders.
Subjects were 32 suicidal adolescent inpatients with mood disorders, 32 nonsuicidal adolescent inpatients with mood disorders, and 38 normal comparison adolescents. A group comparison design was used. Adolescent measures were the Family Assessment Device and two semistructured interviews (Hamilton Rating Scale for Depression, Social Adjustment Inventory for Children and Adolescents). Parent measures were the Symptom Checklist-90 and the Social Adjustment Scale-Self Report.
Fathers of suicidal adolescents reported more depression and family unit problems than did fathers of nonsuicidal and normal comparison adolescents, even after controlling for adolescents' depression severity. Suicidal adolescents, in turn, reported less active and communicative relationships with fathers. Differences among suicidal and nonsuicidal adolescents' perceptions of general family functioning were not significant after controlling for adolescents' depression severity.
Findings highlight the importance of treating the depressed and potentially suicidal adolescent within the family system and attending to the nature and quality of adolescents' relationships with fathers as well as with mothers. Findings also highlight interactions between suicidal adolescents' depression severity and their negative perceptions of family functioning.
本研究旨在确定与患有情绪障碍的青少年住院患者自杀行为（主动意图、姿态、企图）相关的家庭和父母特征。
研究对象包括32名患有情绪障碍的自杀青少年住院患者、32名患有情绪障碍的非自杀青少年住院患者以及38名正常对照青少年。采用组间比较设计。青少年测量工具为家庭评估量表以及两次半结构化访谈（汉密尔顿抑郁评定量表、儿童及青少年社会适应量表）。父母测量工具为症状自评量表90项和社会适应量表（自我报告）。
即使在控制了青少年的抑郁严重程度之后，自杀青少年的父亲报告的抑郁和家庭问题比非自杀青少年和正常对照青少年的父亲更多。反过来，自杀青少年报告与父亲的关系活跃度和沟通较少。在控制了青少年的抑郁严重程度之后，自杀青少年和非自杀青少年对家庭总体功能的认知差异并不显著。
研究结果凸显了在家庭系统中治疗抑郁且有潜在自杀倾向的青少年以及关注青少年与父亲及母亲关系的性质和质量的重要性。研究结果还凸显了自杀青少年的抑郁严重程度与其对家庭功能的负面认知之间的相互作用。
