Kaplan S J, Pelcovitz D, Salzinger S, Mandel F, Weiner M
Department of Psychiatry, North Shore University Hospital-NYU School of Medicine, Manhasset 11030, USA.
J Am Acad Child Adolesc Psychiatry. 1997 Jun;36(6):799-808. doi: 10.1097/00004583-199706000-00017.
The rate of suicide attempts and the exposure to risk factors for suicide in an unselected sample of confirmed cases of physically abused adolescents recruited directly from the New York State Central Register for Nassau and Suffolk Counties was compared with those of a community sample of nonabused adolescents.
Semistructured and structured diagnostic interviews were used in the assessment of psychopathology of adolescents and their parents
The proportion of adolescents attempting suicide did not differ for the two groups. However, the abused adolescents showed significantly greater exposure to risk factors for adolescent suicide, including family disintegration, and diagnoses of depression, disruptive behavior disorders, and substance abuse and dependence. Comparisons of the 8 physically abused adolescents who attempted suicide with the 91 who did not attempt suicide showed that the following factors were associated with significantly greater risk for suicide attempts: adolescents' perceptions of their families as lacking cohesiveness and maternal support, higher adolescent "hostility" ideation scores, adolescent diagnoses of disruptive disorders and conduct disorders, adolescent substance abuse/dependence, and exposure to a suicide attempt by a family member or a friend.
A transactional model of abuse, family and personal stressors, and the development of adolescent vulnerability leading to psychopathology is offered to explain the results.
直接从纽约州拿骚郡和萨福克郡中央登记处招募的确诊身体虐待青少年的未选样本中自杀未遂率及自杀风险因素暴露情况,与非受虐青少年社区样本进行比较。
采用半结构化和结构化诊断访谈评估青少年及其父母的精神病理学情况。
两组青少年自杀未遂比例无差异。然而,受虐青少年暴露于青少年自杀风险因素的情况显著更多,包括家庭解体以及抑郁症、破坏性行为障碍、物质滥用和依赖的诊断。将8名自杀未遂的受虐青少年与91名未自杀未遂的受虐青少年进行比较,结果显示以下因素与自杀未遂风险显著更高相关:青少年认为其家庭缺乏凝聚力和母亲支持、青少年“敌意”观念得分更高、青少年被诊断为破坏性行为障碍和品行障碍、青少年物质滥用/依赖,以及接触家庭成员或朋友的自杀未遂行为。
提出一种虐待、家庭和个人应激源以及导致精神病理学的青少年易感性发展的交互模型来解释研究结果。