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农村青少年童年期虐待与自杀行为的关联

张艳梅 余毅震 唐杰 康纯 荣发娟 杨海军 杨旻 魏沙

张艳梅, 余毅震, 唐杰, 康纯, 荣发娟, 杨海军, 杨旻, 魏沙. 农村青少年童年期虐待与自杀行为的关联[J]. 中国学校卫生, 2021, 42(11): 1650-1654. doi: 10.16835/j.cnki.1000-9817.2021.11.012
引用本文: 张艳梅, 余毅震, 唐杰, 康纯, 荣发娟, 杨海军, 杨旻, 魏沙. 农村青少年童年期虐待与自杀行为的关联[J]. 中国学校卫生, 2021, 42(11): 1650-1654. doi: 10.16835/j.cnki.1000-9817.2021.11.012
ZHANG Yanmei, YU Yizhen, TANG Jie, KANG Chun, RONG Fajuan, YANG Haijun, YANG Min, WEI Sha.. Association between childhood maltreatment and suicide among rural adolescents[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(11): 1650-1654. doi: 10.16835/j.cnki.1000-9817.2021.11.012
Citation: ZHANG Yanmei, YU Yizhen, TANG Jie, KANG Chun, RONG Fajuan, YANG Haijun, YANG Min, WEI Sha.. Association between childhood maltreatment and suicide among rural adolescents[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(11): 1650-1654. doi: 10.16835/j.cnki.1000-9817.2021.11.012

农村青少年童年期虐待与自杀行为的关联

doi: 10.16835/j.cnki.1000-9817.2021.11.012
基金项目: 

国家自然科学基金项目 NSFC-81903349

湖北中医药大学青苗计划项目 2020ZZX025

详细信息
    作者简介:

    张艳梅(1990-), 女, 江西婺源人, 博士, 讲师, 主要研究方向为青少年心理行为健康

  • 中图分类号: G479 B844.2 G444

Association between childhood maltreatment and suicide among rural adolescents

  • 摘要:   目的  探讨童年期虐待与青少年自杀行为的关联,为制定自杀预防策略提供科学依据。  方法  采用多阶段分层整群随机抽样方法,从安徽、广东、云南、黑龙江和湖北农村地区共纳入16 271名中学生。采用结构化问卷收集研究对象一般情况、童年期忽视、虐待情况以及调查前1年内的自杀意念、自杀计划、自杀未遂情况,运用多因素Logistic回归模型分析童年期忽视、虐待与自杀意念、自杀计划和自杀未遂的关联。  结果  农村青少年自杀意念、自杀计划和自杀未遂的发生人数分别为2 453(15.1%)、1 164(7.2%)和572(3.5%)人,童年期忽视、中度和重度躯体虐待的发生人数分别为10 756(66.1%),4 311(26.5%)和703(4.3%)人。单因素分析显示,童年期忽视、虐待与自杀意念、自杀计划、自杀未遂相关均有统计学意义(P值均 < 0.05)。在控制年龄、性别、独生子女、父母文化程度、经济收入、情绪管理和社会支持因素后,童年期忽视、虐待与自杀意念、自杀计划、自杀未遂差异均有统计学意义(OR=1.62~5.14,P值均 < 0.05),其中重度躯体虐待的OR值(95%CI)分别为3.00(2.49~3.62),3.52(2.81~4.40), 5.14(3.87~6.83)。  结论  童年期忽视和虐待可能会增加农村青少年自杀行为发生风险,应积极采取有效措施减少童年期忽视虐待,预防自杀。
  • 表  1  不同组别农村青少年遭受儿童期忽视或虐待报告率比较

    Table  1.   Comparison of reported rates of childhood neglect or abuse among different groups of rural adolescents

    组别 选项 人数 遭受儿童期忽视或虐待 χ2 P
    性别 8 434 6 378(75.6) 3.33 0.07
    7 837 6 022(76.8)
    省份 安徽 3 319 2 683(80.8) 264.64 < 0.01
    云南 3 400 2 666(78.4)
    广东 3 252 2 403(73.9)
    黑龙江 3 087 2 047(66.3)
    湖北 3 213 2 601(81.0)
    独生子女 10 653 8 322(78.1) 62.06 < 0.01
    5 618 4 078(72.6)
    父亲文化程度 小学及以下 3 263 2 631(80.6) 67.60 < 0.01
    初中 8 355 6 326(75.9)
    高中 2 924 2 194(75.0)
    大学及以上 1 337 934(69.9)
    母亲文化程度 小学及以下 5 467 4 362(79.8) 78.08 < 0.01
    初中 7 252 5 479(75.6)
    高中 2 198 1 595(72.6)
    大学及以上 928 647(69.7)
    家庭人均月 较低 2 922 2 218(75.9) 2.91 0.23
    收入 中等 11 191 8 568(76.6)
    较高 2 144 1 606(74.9)
    情绪管理 2 372 2 019(85.1) 490.54 < 0.01
    11 983 9 292(77.5)
    1 826 1 040(57.0)
    社会支持 2 544 2 145(84.3) 392.48 < 0.01
    10 760 8 384(77.9)
    2 967 1 871(63.1)
    注: ()内数字为报告率/%;父/母文化程度、家庭收入、社会支持数据有缺失项。
    下载: 导出CSV

    表  2  农村青少年自杀意念与童年期忽视和躯体虐待的相关性分析[n = 16 271, OR值(OR值95%CI)]

    Table  2.   Association of suicide ideation with childhood neglect and maltreatment in rural adolescents [n = 16 271, OR(OR 95%CI)]

    自变量 模型1 模型2 模型3
    忽视
      无 1.00 1.00 1.00
      有 2.25(2.02~2.50)* 1.95(1.74~2.18)* 1.62(1.44~1.82)*
    躯体虐待
      无 1.00 1.00 1.00
      轻度 1.28(1.12~1.46)* 1.13(0.98~1.29) 1.13(0.98~1.30)
      中度 2.20(1.99~2.43)* 1.97(1.77~2.19)* 1.78(1.59~1.99)*
      重度 4.42(3.73~5.23)* 3.80(3.18~4.55)* 3.00(2.49~3.62)*
    注:模型1未调整变量;模型2调整年龄、性别、独生子女、父母文化程度、经济收入;模型3在模型2基础上调整情绪管理、社会支持。*P < 0.05。
    下载: 导出CSV

    表  3  农村青少年自杀计划与童年期忽视和躯体虐待的相关性分析[n = 16 271, OR值(OR值95%CI)]

    Table  3.   Association of suicide plans with childhood neglect and maltreatment in rural adolescents [n = 16 271, OR(OR 95%CI)]

    自变量 模型1 模型2 模型3
    忽视
      无 1.00 1.00 1.00
      有 2.40(2.06~2.80)* 2.04(1.73~2.40)* 1.66(1.40~1.97)*
    躯体虐待
      无 1.00 1.00 1.00
      轻度 1.29(1.07~1.56)* 1.13(0.93~1.38) 1.14(0.93~1.39)
      中度 2.19(1.90~2.52)* 1.88(1.62~2.19)* 1.67(1.43~1.95)*
      重度 5.65(4.61~6.93)* 4.58(3.69~5.69)* 3.52(2.81~4.40)*
    注:模型1未调整变量;模型2调整年龄、性别、独生子女、父母文化程度、经济收入;模型3在模型2基础上调整情绪管理、社会支持。*P < 0.05。
    下载: 导出CSV

    表  4  农村青少年自杀未遂与童年期忽视和躯体虐待的相关性分析[n = 16 271, OR值(OR值95%CI)]

    Table  4.   Association of suicide attempts with childhood neglect and maltreatment in rural adolescents [n = 16 271, OR(OR 95%CI)]

    自变量 模型1 模型2 模型3
    忽视
      无 1.00 1.00 1.00
      有 2.15(1.68~2.75)* 1.93(1.51~2.48)* 1.82(1.42~2.34)*
    躯体虐待
      无 1.00 1.00 1.00
      轻度 1.03(0.76~1.40) 1.02(0.75~1.39) 1.04(0.76~1.42)
      中度 2.39(1.93~2.96)* 2.23(1.80~2.77)* 2.18(1.75~2.71)*
      重度 6.65(5.04~8.77)* 5.53(4.17~7.33)* 5.14(3.87~6.83)*
    注:模型1未调整变量;模型2调整年龄、性别、独生子女、父母文化程度、经济收入;模型3在模型2基础上调整情绪管理、社会支持。*P < 0.05。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2021-06-22
  • 修回日期:  2021-07-14
  • 网络出版日期:  2021-12-01
  • 刊出日期:  2021-11-25

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