Relationship between abuse experience with suicidal ideation and behavior of junior middle school students in Chongqing
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摘要:
目的 探究受虐待经历对初中生自杀意念和自杀未遂的影响, 为初中生的自杀预防提供依据。 方法 采用随机整群抽样方式, 从2020年6—9月对重庆市的调研数据中抽取25个区、县的初中生数据, 纳入分析10 289人。使用儿童期虐待问卷、中学生心理健康量表等进行调查, 并收集人口学信息、自杀意念和自杀行为。 结果 初中生自杀意念的报告率为20.93%, 自杀未遂的报告率为10.83%。多因素Logistic回归分析显示, 控制人口学变量及心理健康水平后, 情感虐待(OR=2.07)和情感忽视(OR=2.03)的发生与自杀意念的相关高于其他3种类型的儿童期虐待(OR躯体忽视=1.19, OR躯体虐待=1.60, OR性虐待=1.37, P值均 < 0.05);性虐待(OR=2.29)和躯体忽视(OR=1.87)的发生与初中生自杀未遂的相关高于其他3种类型的虐待(OR情感虐待=1.63, OR情感忽视=1.59, OR躯体虐待=1.50, P值均 < 0.01)。 结论 5种类型的虐待对初中生的自杀意念和自杀未遂均有重要影响, 且情感忽视和情感虐待对自杀意念的影响更大, 性虐待和躯体忽视对自杀未遂的影响更大。 Abstract:Objective To explore the relationship between abuse experience with suicidal ideation and suicide attempts of junior middle school students, and to provide a reference for suicide prevention of junior middle school students. Methods Cluster sampling method were used to selct 10 289 junior middle school students from 25 districts and counties of Chongqing were included in the analysis of this study from July to September in 2020. And Questionnaire on Abuse in Childhood and Mental Health Scale for Middle School Students were applied to collect the data about demographic information, suicide ideation and behavior. Results The prevalence of suicidal ideation and suicide attempts among junior middle school students were 20.93% and 10.83%, respectively. Multivariate Logistic regression model found that after controlling for demographic variables and mental health, emotional abuse (OR=2.07) and emotional neglect (OR=2.03) showed higher correlations with suicidal ideation than the other three types of childhood abuse(ORphysical neglect=1.19, ORphysical abuse=1.60, ORsexual abuse=1.37, P < 0.05); and sexual abuse (OR=2.29) and physical neglect (OR=1.87) showed higher associations with suicide attempt than the other three types of abuse(ORemotional abuse=1.63, ORemotional neglect=1.59, ORphysical abuse=1.50, P < 0.01). Conclusion All five types of child abuse were independent risk factors for suicidal ideation and suicide attempts, and emotional neglect and emotional abuse had a greater effect on suicidal ideation, sexual abuse and physical neglect had a greater effect on suicide attempts. -
Key words:
- Torture /
- Suicide /
- Behavior /
- Mental health /
- Regression analysis /
- Students
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表 1 不同人口统计学特征初中生自杀意念和自杀行为报告率比较
Table 1. Comparison of suicidal ideation and suicide attempts among junior middle school students with different demographic
人口统计学指标 人数 自杀意念 自杀行为 报告人数 χ2值 P值 报告人数 χ2值 P值 性别 女 6 168 2 154(34.92) 265.81 < 0.01 806(13.07) 80.06 < 0.01 男 4 121 826(20.04) 308(7.47) 年级 初一 5 932 1 639(27.63) 13.31 < 0.01 625(10.54) 1.27 0.53 初二 3 605 1 122(31.12) 430(11.18) 初三 752 219(29.12) 86(11.44) 地域 乡村 2 694 767(28.47) 13.91 < 0.01 270(10.02) 9.73 0.01 城镇 3 667 1 141(31.11) 444(12.11) 城市 3 928 1 072(26.15) 400(10.18) 父母是否离异 是 1 064 383(36.00) 28.53 < 0.01 157(14.76) 18.97 < 0.01 否 9 225 2 597(28.15) 957(10.37) 是否为独生子女 是 2 519 675(26.80) 7.61 0.01 233(9.25) 8.60 < 0.01 否 7 770 2 305(29.67) 881(11.34) 注： ( )内数字为报告率/%。 
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表 2 儿童期是否经历各类型虐待初中生自杀意念和自杀行为报告率比较
Table 2. Comparison of different types of child abuse and suicidal ideation and suicide attempts among junior middle school students
虐待类型 人数 自杀意念 自杀行为 报告人数 χ2值 P值 报告人数 χ2值 P值 情感虐待 是 7 143 2 696(37.74) 875.35 < 0.01 1 030(14.42) 312.30 < 0.01 否 3 146 284(9.03) 84(2.67) 情感忽视 是 6 992 2 642(37.79) 825.60 < 0.01 1 023(14.63) 327.02 < 0.01 否 3 297 338(10.25) 91(2.76) 躯体忽视 是 6 480 2 365(36.50) 482.90 < 0.01 974(15.03) 320.38 < 0.01 否 3 809 615(16.15) 140(3.68) 躯体虐待 是 3 241 1 491(46.00) 667.83 < 0.01 648(19.99) 411.79 < 0.01 否 7 048 1 489(21.12) 466(6.61) 性虐待 是 1 149 592(51.52) 319.96 < 0.01 342(29.77) 480.47 < 0.01 否 9 140 2 388(26.13) 772(8.45) 注： ( )内数字为报告率/%。
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表 3 不同心理健康水平初中生自杀意念和自杀行为报告率比较
Table 3. Comparison of different mental health level and suicidal ideation and suicide attempts among junior middle school students
心理健康水平 人数 自杀意念 自杀行为 良好 7 543 1 266(16.78) 348(4.61) 轻度 2 189 1 262(57.65) 474(21.65) 中度 512 413(80.66) 262(51.17) 偏重及严重 45 39(86.67) 30(67.67) 注：( )内数字为报告率/%。
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表 4 初中生童年期虐待与自杀意念及自杀行为的Logistic回归分析[OR值(OR值95%CI)，n=10 289]
Table 4. Logistic regression analysis of childhood abuse and suicidal ideation among junior middle school students[OR(OR 95%CI), n=10 289]
自变量 自杀意念 自杀行为 模型1 模型2 模型3 模型1 模型2 模型3 情感虐待 3.40(2.95~3.91) 3.16(2.75~3.65) 2.07(1.78~2.40) 2.82(2.22~3.55) 2.58(2.03~3.29) 1.63(1.27~2.11) 情感忽视 2.83(2.46~3.25) 2.66(2.30~3.06) 2.03(1.75~2.40) 2.44(1.91~3.10) 2.22(1.74~2.83) 1.59(1.23~2.06) 躯体忽视 1.34(1.20~1.51) 1.41(1.25~1.59) 1.19(1.04~1.35) 2.12(1.73~2.59) 2.23(1.82~2.73) 1.87(1.51~2.32) 躯体虐待 1.69(1.53~1.87) 1.91(1.72~2.12) 1.60(1.42~1.80) 1.72(1.49~1.98) 1.87(1.62~2.16) 1.50(1.29~1.75) 性虐待 1.61(1.41~1.85) 1.78(1.55~2.05) 1.37(1.17~1.60) 2.54(2.17~2.67) 2.78(2.36~3.27) 2.29(1.92~2.73) 心理健康水平 4.53(4.13~4.98) 3.51(3.16~3.90) 注：模型1无控制变量；模型2控制性别、年级、地域、父母是否离异、是否为独生子女、家庭年收入、学习成绩等级；模型3在模型2的基础上控制心理健康水平；P值均 < 0.01。
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[1] WHO. Global status report on preventing violence against children 2020: executive summary[M]. Geneva: WHO, 2020. [2] WHO. World health statistics 2021: monitoring health for the SDGs, sustainable development goals[M]. Geneva: WHO, 2021. [3] 杨东平, 杨旻. 中国教育发展报告(2018)[M]. 北京: 社会科学文献出版社, 2018: 257.YANG D P, YANG M. Annual report on China's education(2018)[M]. Beijing: Social Sciences Academic Press(China), 2018: 257. [4] 周菡, 余思, 刘勤学, 等. 儿童心理虐待与忽视和自杀意念的关系: 有调节的中介模型[J]. 心理科学, 2019, 42(2): 335-342. https://www.cnki.com.cn/Article/CJFDTOTAL-XLKX201902012.htmZHOU H, YU S, LIU Q X, et al. The relationship between child psychological abuse and neglect and suicidal Ideation: moderated Mediation Model[J]. Psychol Sci, 2019, 42(2): 335-342. https://www.cnki.com.cn/Article/CJFDTOTAL-XLKX201902012.htm [5] 俞国良, 李森. 危机与转机: 童年期虐待对青少年心理健康的影响及应对策略[J]. 北京师范大学学报(社会科学版), 2021(1): 5-15. https://www.cnki.com.cn/Article/CJFDTOTAL-BJSF202101001.htmYU G L, LI S. Childhood maltreatment and its effect on adolescent internalizing and externalizing mental health problems: mechanisms and interventions[J]. J Beijing Norm Univ(Soc Sci), 2021(1): 5-15. https://www.cnki.com.cn/Article/CJFDTOTAL-BJSF202101001.htm [6] 曹鑫宇, 马自芳, 田苗, 等. 儿童期受虐待经历与大学生自杀意念的关联[J]. 中国学校卫生, 2020, 41(4): 506-509. doi: 10.16835/j.cnki.1000-9817.2020.04.007CAO X Y, MA Z F, TIAN M, et al. Relationship between childhood maltreatment and suicide ideation of college students[J]. Chin J Sch Health, 2020, 41(4): 506-509. doi: 10.16835/j.cnki.1000-9817.2020.04.007 [7] SACHS-ERICSSON N J, RUSHING N C, STANLEY L H, et al. In my end is my beginning: developmental trajectories of adverse childhood experiences to late-life suicide[J]. Aging Ment Health, 2016, 20(2): 1-27. http://www.onacademic.com/detail/journal_1000038176096610_30e6.html [8] FLYNN M, CICCHETTI D, ROGOSCH F. The prospective contribution of childhood maltreatment to low self-worth, low relationship quality, and symptomatology across adolescence: a developmental-organizational perspective[J]. Dev Psychol, 2014, 50(9): 2165-2175. doi: 10.1037/a0037162 [9] GONG M Q, ZHANG S, LI W Y, et al. Association between childhood maltreatment and suicidal ideation and suicide attempts among Chinese adolescents: the moderating role of depressive symptoms[J]. Int J Environ Res Public Health, 2020, 17(17): 6025. doi: 10.3390/ijerph17176025 [10] JOINER T E J R, SACHS-ERICSSON N J, WINGATE L R, et al. Childhood physical and sexual abuse and lifetime number of suicide attempts: a persistent and theoretically important relationship[J]. Behav Res Ther, 2007, 45(3): 539-547. doi: 10.1016/j.brat.2006.04.007 [11] 赵幸福, 张亚林, 李龙飞, 等. 中文版儿童期虐待问卷的信度和效度[J]. 中国临床康复, 2005(20): 18. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF200520049.htmZHAO X F, ZHANG Y L, LI L F, et al. Reliability and validity of the Chinese Version of Childhood Trauma Questionnaire[J]. Chin J Clin Rehabil, 2005(20): 18. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF200520049.htm [12] 张敏. 中文版儿童期虐待问卷信度及效度评价[J]. 中国公共卫生, 2011, 27(5): 669-670. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201105073.htmZHANG M. Reliabilly and validity of the Chinese Version of CTQ-SF[J]. Chin Public Health, 2011, 27(5): 669-670. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201105073.htm [13] 王极盛, 李焰, 赫尔实. 中国中学生心理健康量表的编制及其标准化[J]. 社会心理科学, 1997(4): 21-25.WANG J S, LI Y, HE E S. The Construction and standardization of Mental Health Inventroy of middle school students MMHl-60[J]. Sci Soc Psychol, 1997(4): 21-25. [14] 陈丹, 权治行, 艾梦瑶, 等. 青少年心理健康状况及影响因素[J]. 中国健康心理学杂志, 2020, 28(9): 1402-1409. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL202009028.htmCHEN D, QUAN Z X, AI M Y, et al. Adolescent mental health and influencing factors[J]. Chin J Health Psychol, 2020, 28(9): 1402-1409. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL202009028.htm [15] 张延婷. 12~18岁中学生暴力遭遇量表的研制及应用研究[D]. 长沙: 中南大学, 2014.ZHANG Y T. Development and application of Violence Experience Scale for 12-18 years old middle school students[D]. Changsha: Central South University, 2014. [16] 胡梓悦, 李鹏声, 郭蓝, 等. 深圳市中学生儿童期虐待与抑郁症状关系[J]. 中国公共卫生, 2019, 35(6): 703-707. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201906012.htmHU Z Y, LI P S, GUO L, et al. Correlation between childhood maltreatment and depressive symptoms among middle school students in Shenzhen City[J]. Chin J Public Health, 2019, 35(6): 703-707. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201906012.htm [17] 张紫微, 余春艳, 袁萍, 等. 儿童期不良经历与青春早期抑郁的关联性[J]. 中国学校卫生, 2019, 40(6): 874-877. doi: 10.16835/j.cnki.1000-9817.2019.06.023ZHANG Z W, YU C Y, YUAN P, et al. Relationship between adverse childhood experiences and depression in early adolescence[J]. Chin J Sch Health, 2019, 40(6): 874-877. doi: 10.16835/j.cnki.1000-9817.2019.06.023 [18] 董永海, 刘芸, 刘磊, 等. 中国中学生自杀相关行为报告率的Meta分析[J]. 中国学校卫生, 2014, 35(4): 532-536. http://www.cjsh.org.cn/article/id/zgxxws201404018DONG Y H, LIU Y, LIU L, et al. Reported rate of suicide-related behaviors among Chinese adolescents: a Meta-analysis[J]. Chin J Sch Health, 2014, 35(4): 532-536. http://www.cjsh.org.cn/article/id/zgxxws201404018 [19] 高鑫, 万宇辉, 谢阳, 等. 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[J]. 中国学校卫生, 2021, 42(3): 392-395, 398. doi: 10.16835/j.cnki.1000-9817.2021.03.018GAO X, WAN Y H, XIE Y, et al. Association between childhood abuse and recent negative life events with suicidal psychological behavior of middle school students[J]. Chin J Sch Health, 2021, 42(3): 392-395, 398. doi: 10.16835/j.cnki.1000-9817.2021.03.018 [20] 谌丁艳, 周丽, 黄园园, 等. 深圳市中学生心理亚健康状况及其与自杀心理行为的相关性[J]. 中国学校卫生, 2019, 40(3): 381-383. doi: 10.16835/j.cnki.1000-9817.2019.03.018CHEN D Y, ZHOU L, HUANG Y Y, et al. Psychological sub-health status and its relationship with suicidal behaviors among middle school students in Shenzhen[J]. Chin J Sch Health, 2019, 40(3): 381-383. doi: 10.16835/j.cnki.1000-9817.2019.03.018 [21] KANN L, MCMANUS T, HARRIS W A, et al. Youth risk behavior surveillance-united states, 2017[J]. MMWR Surveill Summ, 2018, 67(8): 1. [22] 肖亚男, 陶芳标, 许韶君, 等. 童年期虐待与青少年自我伤害行为关系[J]. 中国公共卫生, 2008, 24(9): 1028-1030. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW200809001.htmXIAO Y N, TAO F B, XU S J, et al. Self-injurious behaviors in adolescents with repeated childhood abuse[J]. Chin J Public Health, 2008, 24(9): 1028-1030. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW200809001.htm -
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