中学生父母依恋与自杀未遂的关联

丁红丽; 汪妍; 彭畅; 程君菡; 荣发娟; 余毅震

doi:10.16835/j.cnki.1000-9817.2023.02.025

中学生父母依恋与自杀未遂的关联

doi: 10.16835/j.cnki.1000-9817.2023.02.025

华中科技大学同济医学院公共卫生学院儿少卫生与妇幼保健学系，湖北武汉 430030

基金项目:

国家自然科学基金项目 81573172

详细信息

作者简介:
丁红丽(1996-)，女，河南邓州人，在读硕士，主要研究方向为儿童青少年心理卫生

通讯作者:
余毅震，E-mail：yuyizhen650@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G444 G478 B844.2
计量
- 文章访问数: 311
- HTML全文浏览量: 141
- PDF下载量: 25
- 被引次数: 0
出版历程
- 收稿日期: 2022-06-13
- 修回日期: 2022-07-13
- 网络出版日期: 2023-03-02
- 刊出日期: 2023-02-25

Relationship between adolescent-parent attachment and attempted suicide among middle school students

Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan(430030), China

摘要

摘要: 目的了解中学生自杀未遂现状，并探讨其与父母依恋的关系，为中学生自杀行为的预防和控制提供依据。方法采用分层整群随机抽样法，抽取湖北省鄂州市和孝感市4 419名七至十二年级在校学生作为调查对象，使用父母和同评依恋量表(IPPA)、罗森博格自尊量表(RSES)、凯斯勒心理疾患量表(K10)进行问卷调查，并评定中学生自杀未遂情况。结果中学生自杀未遂检出率为6.8%。自杀未遂检出率在不同年级、家庭类型、父母感情、家庭管教方式、家庭月收入、自尊水平和心理困扰间差异均有统计学意义(χ²/t值分别为3.88，10.12，18.00，52.54，13.90，2.37，8.99，P值均 < 0.05)，有自杀未遂组的父亲依恋和母亲依恋得分(14.64±13.45，14.77±12.26)均低于无自杀未遂组(22.05±16.08，23.79±14.93)(t值分别为-9.07，-12.11，P值均 < 0.05)。Logistic回归分析表明，父亲依恋和母亲依恋均与中学生自杀未遂负向关联(父亲依恋，OR=0.99，95%CI=0.98~0.99；母亲依恋，OR=0.97，95%CI=0.96~0.98，P值均 < 0.05)；分层分析发现，父亲依恋与女生自杀未遂负向关联(OR=0.98，95%CI=0.97~0.99，P < 0.05)，而对男生影响无统计学意义。结论父母依恋可能是中学生自杀未遂的保护因素，父亲依恋对自杀未遂的影响存在性别差异。父母应当注重培养与子女之间的良好依恋关系，促进中学生健康成长。
- 客体依恋 /
- 自杀未遂 /
- 精神卫生 /
- 回归分析 /
- 中学生
Abstract: Objective To understand the current situation of suicide attempts in middle school students and to explore its relation with adolescent-parent attachment, to provide a basis for the prevention and control of middle school students suicidal behavior. Methods A total of 4 419 students from grades 7 to 12 in Ezhou City and Xiaogan City, Hubei Province were selected by stratified cluster random sampling. The Inventory of Parent and Peer Attachment, Rosenberg Self-Esteem Scale, Kessler Psychological Distress Scale were used to conduct a questionnaire Survey, and evaluated the suicide attempts of middle school students. Results The detection rate of attempted suicide among middle school students was 6.8%. The detection rate of attempted suicide varies among different grades, family types, parental relation, parenting style, family income, self-esteem level, and psychological distress(χ²/t=3.88, 10.12, 18.00, 52.54, 13.90, 2.37, 8.99, P < 0.05). The scores of paternal attachment and maternal attachment (14.64±13.45, 14.77±12.26) in the group with attempted suicide were lower than those without attempted suicide(22.05±16.08, 23.79±14.93)(t=-9.07, -12.11, P < 0.05). Logistic regression analysis showed that both paternal attachment and maternal attachment were associated with lower rate of suicide attempts among middle school students(paternal attachment, OR=0.99, 95%CI=0.98-0.99; maternal attachment OR=0.97, 95%CI=0.96-0.98), with paternal attachment for girls only(OR=0.98, 95%CI=0.97-0.99)(P < 0.05). Conclusion Adolescent-parent attachment may be a protective factor for middle school students suicide attempts. Sex-specific effects are observed in adolescent-father attachment in girls. Parents should pay attention to cultivating a good attachment relationship with their children and promote the healthy growth of middle school students.
- Object attachment /
- Suicide, attempted /
- Mental health /
- Regression analysis /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 不同人口学特征中学生自杀未遂检出率比较

Table 1. Comparison of the detection rate of suicide attempts among adolescents with different demographic characteristics

人口学指标	选项	人数	自杀未遂人数	χ²值	P值
学段	初中	2 831	208(7.3)	3.88	0.05
	高中	1 588	92(5.8)
性别	女	1 893	1 239(6.5)	0.44	0.51
	男	2 526	177(7.0)
家庭类型	核心家庭	2 901	200(6.9)	10.12	0.04
	大家庭	1 054	57(5.4)
	单亲家庭	251	26(10.4)
	重组家庭	102	6(5.9)
	隔代家庭	111	11(9.9)
父亲受教育程度	小学及以下	338	29(8.6)	4.62	0.20
	初中	2 141	129(6.0)
	高中或中专	1 425	103(7.2)
	本科或大专及以上	515	39(7.6)
母亲受教育程度	小学及以下	650	44(6.8)	0.79	0.85
	初中	2 262	147(6.5)
	高中或中专	1 197	86(7.2)
	本科或大专及以上	310	23(7.4)
父母感情	非常好	1 249	75(6.0)	18.00	< 0.01
	比较好	2 439	152(6.2)
	一般	557	50(9.0)
	不太好	82	11(13.4)
	关系恶劣	92	12(13.0)
家庭管教方式	严格	992	62(6.3)	52.54	< 0.01
	民主	2 529	138(5.5)
	溺爱	151	13(8.6)
	放任或漠不关心	89	17(19.1)
	粗暴	37	8(21.6)
	变化无常	621	62(10.0)
家庭人均月收入	< 1 000	211	20(9.5)	13.90	0.01
/元	1 000~2 999	1 181	76(6.4)
	3 000~4 999	2 107	124(5.9)
	5 000~7 999	679	53(7.8)
	≥8 000	241	27(11.2)
注： ()内数字为检出率/%。

下载: 导出CSV

表 2 中学生父母依恋、心理困扰与自杀未遂的多因素Logistic回归分析

Table 2. Multivariate Logistic regression analysis of teenage parental attachment and suicide attempt

自变量	男生(n=2 526)		女生(n=1 893)		合计(n=4 419)
自变量	OR值(OR值95%CI)	P值	OR值(OR值95%CI)	P值	OR值(OR值95%CI)	P值
学段(高中)	0.68(0.47~0.96)	0.03	0.84(0.54~1.28)	0.41	0.75(0.57~0.98)	0.03
心理困扰	1.04(1.02~1.06)	< 0.01	1.10(1.07~1.13)	< 0.01	1.06(1.04~1.08)	< 0.01
母亲依恋	0.98(0.96~0.99)	< 0.01	0.97(0.96~0.99)	< 0.01	0.97(0.96~0.98)	< 0.01
父亲依恋	1.00(0.98~1.01)	0.46	0.98(0.97~0.99)	0.02	0.99(0.98~0.99)	0.02
注：学段以初中为参照，心理困扰、母亲依恋、父亲依恋为连续型变量。

下载: 导出CSV

参考文献(31)

[1]	FLEISCHMANN A, DE LEO D. The World Health Organization's report on suicide: a fundamental step in worldwide suicide prevention[J]. Crisis, 2014, 35(5): 289-291. doi: 10.1027/0227-5910/a000293
[2]	STATHAM D J, HEATH A C, MADDEN P A, et al. Suicidal behaviour: an epidemiological and genetic study[J]. Psychol Med, 1998, 28(4): 839-855. doi: 10.1017/S0033291798006916
[3]	陈武朝. 急诊室自杀未遂就诊患者自杀行为相关特征及危险因素研究[D]. 长沙: 中南大学, 2014. CHEN W C. Related characteristics of suicidal behavior and risk factors of patients with attempted suicide at emergency room[D]. Changsha: Central South University, 2014. (in Chinese)
[4]	ASBERG M, TRASKMAN L, THOREN P. 5-HIAA in the cerebrospinal fluid. A biochemical suicide predictor?[J]. Arch Gen Psychiatry, 1976, 33(10): 1193-1197. doi: 10.1001/archpsyc.1976.01770100055005
[5]	廖翠萍. 中国大学生自杀未遂的研究分析[D]. 重庆: 重庆医科大学, 2018. LIAO C P. A research and analysis on the attempted suicide of Chinese college students[D]. Chongqing: Chongqing Medical University, 2018. (in Chinese)
[6]	SHEFTALL A H, MATHIAS C W, FURR R M, et al. Adolescent attachment security, family functioning, and suicide attempts[J]. Attach Hum Dev, 2013, 15(4): 368-383. doi: 10.1080/14616734.2013.782649
[7]	琚晓燕. 青少年依恋的测量及其与自尊、社会适应性关系研究[D]. 金华: 浙江师范大学, 2005. JU X Y. The Chinese translation of IPPA and adolescent attachment in relation to self-esteem and social adaptation[D]. Jinhua: Zhejiang Normal University, 2005. (in Chinese)
[8]	潘雪. 高职大学生父母依恋对人际适应的影响[D]. 成都: 四川师范大学, 2021. PAN X. The influence of parental attachment on interpersonal adaptation of vocational college students[D]. Chengdu: Sichuan Normal University, 2021. (in Chinese)
[9]	吕岚琪. 家庭背景、学业成绩对青少年性观念的影响[D]. 上海: 上海社会科学院, 2019. LYU L Q. The influence of family background and academic achievement on adolescents' sexual concepts[D]. Shanghai: Shanghai Academy of Social Sciences, 2019. (in Chinese)
[10]	张迎黎, 张亚林, 张迎新, 等. 修订版青少年依恋问卷中文版在初中生中应用的信效度[J]. 中国心理卫生杂志, 2011, 25(1): 66-70. doi: 10.3969/j.issn.1000-6729.2011.01.015 ZHANG Y L, ZHANG Y L, ZHANG Y X, et al. Reliability and validity of Chinese version of revised inventory of parent and peer attachment in junior students[J]. Chin Ment Health J, 2011, 25(1): 66-70. (in Chinese) doi: 10.3969/j.issn.1000-6729.2011.01.015
[11]	王海燕. 单亲家庭高职生亲子依恋对自尊的影响: 人际敏感中介效应[J]. 太原城市职业技术学院学报, 2019(12): 69-73. doi: 10.3969/j.issn.1673-0046.2019.12.026 WANG H Y. The influence of parent-child attachment of vocational students from single-parent families on self-esteem: the mediating effect of interpersonal sensitivity[J]. J Taiyuan Urban Vocat Coll, 2019(12): 69-73. (in Chinese) doi: 10.3969/j.issn.1673-0046.2019.12.026
[12]	PENG C, HU W, YUAN S, et al. Self-harm, suicidal ideation, and suicide attempts in Chinese adolescents involved in different sub-types of bullying: a cross-sectional study[J]. Front Psychiatry, 2020, 11(565364).
[13]	吴桐, 杨柠溪, 蔡丽, 等. 自悯对社交焦虑的影响: 自尊和评价恐惧的中介作用[J]. 中国临床心理学杂志, 2021, 29(1): 169-172, 178. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY202101034.htm WU T, YANG N X, CAI L, et al. Self-compassion and social anxiety: the mediation effect of self-esteem and fear of evaluation[J]. Chin J Clin Psychol, 2021, 29(1): 169-172, 178. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY202101034.htm
[14]	徐浩, 熊华英, 陈跃辉, 等. 凯斯勒心理疾患量表中文10项版与6项版在大学生心理调查中的应用[J]. 现代预防医学, 2013, 40(24): 4493-4496. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201324003.htm XU H, XIONG H Y, CHEN Y H, et al. The application of the Chinese Version of K6 and K10 Screening Scales for psychological distress on the psychological investigation of college students[J]. Mod Prev Med, 2013, 40(24): 4493-4496. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201324003.htm
[15]	ANDERSON T M, SUNDERLAND M, ANDREWS G, et al. The 10-item Kessler Psychological Distress Scale (K10) as a screening instrument in older individuals[J]. Am J Geriatr Psychiatry, 2013, 21(7): 596-606. doi: 10.1016/j.jagp.2013.01.009
[16]	万宇辉, 刘婉, 孙莹, 等. 童年期虐待的不同形式与中学生自杀行为关联性研究[J]. 中华流行病学杂志, 2016, 37(4): 506-511. doi: 10.3760/cma.j.issn.0254-6450.2016.04.013 WAN Y H, LIU W, SUN Y, et al. A study on the correlation between different forms of childhood abuse and suicidal behaviors of middle school students[J]. Chin J Epidemiol, 2016, 37(4): 506-511. (in Chinese) doi: 10.3760/cma.j.issn.0254-6450.2016.04.013
[17]	韦敏, 汤永隆, 李士颖, 等. 重庆市初中生受虐待经历与自杀意念和行为的关联[J]. 中国学校卫生, 2021, 42(11): 1679-1682, 1687. doi: 10.16835/j.cnki.1000-9817.2021.11.018 WEI M, TANG Y L, LI S Y, et al. The relationship between abuse experience and suicidal ideation and behavior of junior high school students in Chongqing[J]. Chin J Sch Health, 2021, 42(11): 1679-1682, 1687. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.11.018
[18]	丁莉文, 施正丽, 刘元元, 等. 中低收入国家青少年自杀未遂及其影响因素的性别比较研究: 基于全球学校学生健康调查数据的分析[J]. 现代预防医学, 2021, 48(18): 3309-3312, 3316. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202118010.htm DING L W, SHI Z L, LIU Y Y, et al. A gender comparative study on suicide attempts and influencing factors among adolescents in low-and middle-income countries: an analysis based on the data from the Global School Student Health Survey[J]. Mod Prev Med, 2021, 48(18): 3309-3312, 3316. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202118010.htm
[19]	杨海燕, 蔡太生, 何影. 父母依恋和同伴依恋与高中生行为问题的关系[J]. 中国临床心理学杂志, 2010, 18(1): 106-108. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201001036.htm YANG H Y, CAI T S, HE Y. Parent attachment, peers attachment and high school students' behavior problems[J]. Chin J Clin Psychol, 2010, 18(1): 106-108. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201001036.htm
[20]	易尚辉. 湖南省中学生自杀行为现况及影响因素分析[D]. 长沙: 中南大学, 2007. YI S H. Analysis of the current suicidal behavior and influencing factor of middle school students in Hunan Province[D]. Changsha: Central South University, 2007. (in Chinese)
[21]	谢雪妮, 韩云涛, 焦锋. 昆明市中学生自杀行为和家庭因素分析[J]. 昆明医科大学学报, 2013, 34(10): 18-21. https://www.cnki.com.cn/Article/CJFDTOTAL-KMYX201310007.htm XIE X N, HAN Y T, JIAO F. Analysis of middle school students suicide behavior and family factors in Kunming City[J]. J Kunming Med Univ, 2013, 34(10): 18-21. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-KMYX201310007.htm
[22]	郝宇霞. 单亲家庭早期养育行为及其问题研究[D]. 大连: 辽宁师范大学, 2020. HAO Y X. A study on early parenting behavior of single parent family and its problems[D]. Dalian: Liaoning Normal University, 2020. (in Chinese)
[23]	刘秀萍. 天津市大、中学生自杀现象分析研究[D]. 天津: 天津大学, 2009. LIU X P. Research on college and middle school student' suicide of Tianjin[D]. Tianjin: Tianjin University, 2009. (in Chinese)
[24]	郭敏. 家庭教养方式对子女心理健康的影响[J]. 内蒙古统计, 2020(5): 54-56. https://www.cnki.com.cn/Article/CJFDTOTAL-LMTJ202005021.htm GUO M. The influence of family parenting style on children's mental health[J]. Stat Inner Mongolia, 2020(5): 54-56. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-LMTJ202005021.htm
[25]	颜秋歌. 农村青少年自杀行为现状及其影响因素研究[D]. 武汉: 华中科技大学, 2017. YAN Q G. Cross-national prevalence and influencing factors of suicidal behavior among Chinese rural adolescents[D]. Wuhan: Huazhong University of Science and Technology, 2017. (in Chinese)
[26]	潘彦谷, 张大均, 李知洋. 亲子和同伴依恋对初中生心理素质发展的影响: 个人中心分析视角[J]. 心理发展与教育, 2021(4): 558-567. https://www.cnki.com.cn/Article/CJFDTOTAL-XLFZ202104012.htm PAN Y G, ZHANG D J, LI Z Y. The influence of parent-child and peer attachment on the psychological development of junior high school students: personal-centric analysis perspective[J]. Psychol Dev Educ, 2021(4): 558-567. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XLFZ202104012.htm
[27]	邓伟, 朱志惠. 高中生父母同伴依恋与网络成瘾的关系[J]. 中国健康心理学杂志, 2018, 26(5): 746-750. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL201805029.htm DENG W, ZHU Z H. Relational of parent and peer attachment to Internet addiction among high school students[J]. Chin J Health Psychol, 2018, 26(5): 746-750. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL201805029.htm
[28]	陈良, 毛亚南. 中学生父母依恋对生命意义感的影响: 人际适应的中介作用[J]. 教育导刊, 2019(10): 26-30. https://www.cnki.com.cn/Article/CJFDTOTAL-JYDK201910005.htm CHEN L, MAO Y N. The influence of parental attachment of middle school students on the meaning of life: the mediating role of interpersonal adaptation[J]. J Educ Dev, 2019(10): 26-30. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JYDK201910005.htm
[29]	MAIMON D, BROWNING C R, BROOKS-GUNN J. Collective efficacy, family attachment, and urban adolescent suicide attempts[J]. J Health Soc Behav, 2010, 51(3): 307-324.
[30]	HEYDARI A, TEYMOORI A, NASIRI H. The effect of parent and peer attachment on suicidality: the mediation effect of self-control and anomie[J]. Commun Ment Health J, 2015, 51(3): 359-364.
[31]	RAUDINO A, FERGUSSON D M, HORWOOD L J. The quality of parent/child relationships in adolescence is associated with poor adult psychosocial adjustment[J]. J Adolesc, 2013, 36(2): 331-340.