中学生童年期虐待经历和近期负性生活事件与自杀心理行为的关联

高鑫; 万宇辉; 谢阳; 蒋志成; 李书琴; 张一; 曹秀菁; 陶芳标

doi:10.16835/j.cnki.1000-9817.2021.03.018

中学生童年期虐待经历和近期负性生活事件与自杀心理行为的关联

doi: 10.16835/j.cnki.1000-9817.2021.03.018

安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/人口健康教育部重点实验室，合肥 230032

基金项目:

国家自然科学基金项目 81773453

详细信息

作者简介:
高鑫(1996-)，男，安徽淮南人，在读硕士，主要研究方向为儿童青少年卫生

通讯作者:
曹秀菁，E-mail：xiujingcao@yeah.net

中图分类号: B 844.2 G 444 G 478
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- 被引次数: 0
出版历程
- 收稿日期: 2020-11-27
- 修回日期: 2021-02-03
- 网络出版日期: 2021-04-20
- 刊出日期: 2021-03-25

Association between childhood abuse and recent negative life events with suicidal psychological behavior of middle school students

Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei(230032), China

摘要

摘要: 目的分析童年期受虐待和近期负性生活事件与自杀心理行为的关联，为中学生自杀心理行为的防控提供参考。方法 2019年10—12月，采用分层整群抽样方法，抽取深圳、南昌和沈阳3个地区7 986名在校中学生，使用童年期虐待问卷(Child Trauma Questionnaire, CTQ)和青少年负性生活事件量表(Adolescent Self-rating Life Events Checklist, ASLEC)等进行调查，了解一般人口统计学指标、童年期虐待经历、近期负性生活事件和自杀心理行为等信息，建立多因素Logistic回归模型分析童年期虐待和近期负性生活事件与自杀心理行为的关联。结果中学生自杀意念和自杀未遂的报告率分别为22.9%和4.7%。控制相关因素的影响，随着童年期虐待水平和近期负性生活事件水平的升高，中学生自杀心理行为呈增加趋势(P值均<0.05)。相对低虐待和低生活事件水平者，高水平虐待经历且高负性生活事件者自杀意念和自杀未遂风险显著增加(OR值分别为10.43，19.75，P值均<0.05)。结论童年期虐待和近期负性生活事件是中学生自杀心理行为的重要影响因素，开展针对性的干预有利于中学生自杀心理行为的防控。
- 虐待儿童 /
- 生活变动事件 /
- 自杀 /
- 精神卫生 /
- 回归分析 /
- 学生
Abstract: Objective To investigate the relationship between childhood abuse and recent negative life events with suicidal ideation and attempt, and to provide reference for prevention and control of suicidal behaviors in middle school students. Methods Stratified cluster sampling method was used to select 7 986 middle school students from Shenzhen, Nanchang and Shenyang as participants. Questionnaire survey was conducted to collect information on demographic indicators, childhood abuse, negative life events, suicidal ideation and suicide attempt, etc. Logistic regression was used to analyze the relationship between childhood abuse experience and negative life events with suicidal ideation and suicide attempt. Results The prevalence of suicidal ideation and suicide attempt was 22.9% and 4.7%. After adjusted for confounding variables, with the increase of childhood abuse and negative life events, suicidal ideation and attempt in middle school students showed an increasing trend(P<0.05). Compared those with low level of childhood abuse and negative life events, students with high childhood abuse and high negative life events had a higher suicidal ideation and suicide attempt risk, the multiple adjusted odds ratio was 10.43 and 19.75(P<0.05). Conclusion Childhood abuse and negative life events are important risk factors affecting suicidal ideation and attempt in middle school students. Strategies to reduce childhood abuse and negative life events should be an integral component of targeted mental health interventions.
- Child abuse /
- Life change events /
- Suicide /
- Mental health /
- Regression analysis /
- Students

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表 1 不同组别中学生自杀意念与自杀未遂报告率比较

Table 1. Distribution of suicidal ideation and suicide attempts among secondary school students

组别	选项	人数	自杀意念			自杀未遂
组别	选项	人数	报告人数	χ²值	P值	报告人数	χ²值	P值
性别	男	3 886	686(17.7)	110.91	< 0.01	118(3.1)	46.96	< 0.01
	女	4 120	1 139(27.6)			260(6.3)
是否独生子女	是	2 769	642(23.2)	0.27	0.61	156(5.6)	7.63	0.01
	否	5 217	1 183(22.7)			222(4.3)
家庭所在地	农村	1 089	219(20.1)	9.45	0.01	55(5.1)	1.32	0.52
	乡镇	1 459	311(21.3)			61(4.2)
	城市	5 438	1 295(23.8)			262(4.8)
父亲文化程度	小学及以下	942	217(23.0)	5.85	0.12	66(7.0)	17.49	< 0.01
	初中	2 485	535(21.5)			94(3.8)
	高中	2 370	537(22.7)			104(4.4)
	专科及以上	2 189	536(24.5)			114(5.2)
母亲文化程度	小学及以下	1 459	336(23.0)	1.58	0.67	78(5.3)	8.24	0.04
	初中	2 432	536(22.0)			91(3.7)
	高中	2 181	514(23.6)			116(5.3)
	专科及以上	1 914	439(22.9)			93(4.9)
家庭经济状况	差	1 030	335(32.5)	62.86	< 0.01	73(7.1)	26.97	< 0.01
	中等	5 284	1 137(21.5)			205(3.9)
	好	1 672	353(21.1)			100(6.0)
童年期虐待水平	低	2 799	348(12.4)	448.53	< 0.01	45(1.6)	188.11	< 0.01
	中	2 608	538(20.6)			93(3.6)
	高	2 579	939(36.4)			240(9.3)
负性生活事件水平	低	4 090	479(11.7)	590.24	< 0.01	68(1.7)	175.31	< 0.01
	高	3 896	1 346(34.5)			310(8.0)
注： ()内数字为报告率/%。

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表 2 童年期虐待和负性生活事件与中学生自杀意念的Logistic回归分析

Table 2. Logistic regression analysis of childhood abuse and negative life events and suicidal ideation among secondary school students

童年期虐待水平+ 负性生活事件水平	人数	自杀意念人数	模型1			模型2
童年期虐待水平+ 负性生活事件水平	人数	自杀意念人数	OR值	95%CI	P值	OR值	95%CI	P值
低+低	1 929	17(0.9)	1.00			1.00
低+高	870	28(3.2)	2.56	2.04~3.21	< 0.01	2.64	2.10~3.32	< 0.01
中+低	1 188	16(1.3)	1.43	1.14~1.81	< 0.01	1.48	1.17~1.88	0.01
中+高	1 420	770(5.4)	3.86	3.17~54.69	< 0.01	4.16	3.41~5.07	< 0.01
高+低	973	35(3.6)	1.98	1.57~2.50	< 0.01	2.21	1.75~2.79	< 0.01
高+高	1 606	205(12.8)	9.59	7.97~11.53	< 0.01	10.43	8.63~12.60	< 0.01
注：模型1无控制变量；模型2控制年龄、性别、家庭所在地和家庭经济状况；()内数字为报告率/%。

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表 3 童年期虐待和负性生活事件与中学生自杀未遂的Logistic回归分析

Table 3. Logistic regression analysis of childhood abuse and negative life events and suicide attempts among secondary school students

童年期虐待水平+ 负性生活事件水平	人数	自杀未遂人数	模型1			模型2
童年期虐待水平+ 负性生活事件水平	人数	自杀未遂人数	OR值	95%CI	P值	OR值	95%CI	P值
低+低	1 929	17(0.9)	1.00			1.00
低+高	870	28(3.2)	3.74	2.04~6.87	< 0.01	3.92	2.13~7.22	< 0.01
中+低	1 188	16(1.3)	1.54	0.77~3.05	0.22	1.66	0.83~3.30	0.15
中+高	1 420	770(5.4)	6.45	3.80~10.95	< 0.01	7.48	4.38~12.75	< 0.01
高+低	973	35(3.6)	4.20	2.34~7.53	< 0.01	5.03	2.80~9.06	< 0.01
高+高	1 606	205(12.8)	16.46	9.99~27.12	< 0.01	19.75	11.92~32.75	< 0.01
注：模型1无控制变量；模型2控制年龄、性别、家庭所在地和家庭经济状况；()内数字为报告率/%。

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