太原市中学生自杀意念与社会生态学风险因素暴露水平的相关性

蒲鑫; 永忠甜; 王凯; 王立言; 陈晋; 王莉; 白淘

doi:10.16835/j.cnki.1000-9817.2023.10.020

太原市中学生自杀意念与社会生态学风险因素暴露水平的相关性

doi: 10.16835/j.cnki.1000-9817.2023.10.020

蒲鑫¹,
永忠甜¹,
王凯¹,
王立言²,
陈晋³,
王莉¹,
白淘^{1, 4, ,}

1.
山西医科大学公共卫生学院儿少卫生学教研室，太原 030000
2.
太原市中小学学生卫生保健所
3.
山西医科大学汾阳学院基础医学部
4.
山西医科大学第一临床医学院

基金项目: 中国青少年行为健康新型风险因素监测与队列研究(横向合作项目)

详细信息

作者简介:
蒲鑫(1998-)，男，四川巴中人，在读硕士，主要研究方向为生命早期环境因素暴露对健康的影响

通讯作者:
白淘，E-mail：baitao@sxmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G444 R179 R193
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- 被引次数: 0
出版历程
- 收稿日期: 2023-07-24
- 修回日期: 2023-08-23
- 网络出版日期: 2023-10-27
- 刊出日期: 2023-10-25

Association between suicidal ideation and exposure to social-ecological risk factors among middle school students in Taiyuan City

PU Xin¹,
YONG Zhongtian¹,
WANG Kai¹,
WANG Liyan²,
CHEN Jin³,
WANG Li¹,
BAI Tao^{1, 4
, ,}

1.
Department of Child and Adolescent Health, School of Public Health, Shanxi Medical University, Taiyuan(030000), China

摘要

摘要: 目的了解太原市中学生自杀意念现状及其与社会生态学风险因素暴露水平的相关性，为探讨中学生自杀意念发生原因及采取有效预防措施提供参考依据。方法 2021年10—11月，采用多阶段分层随机整群抽样法选取太原市5所中学共2 639名初、高中学生进行一般人口学特征、社会生态学风险水平和自杀意念问卷调查。采用SPSS 26.0软件对数据进行χ²检验和二元Logistic回归分析。结果中学生总体自杀意念检出率为24.7%，不同性别、年级、家庭居住地、母亲文化程度、感知家庭经济条件、关系密切的朋友数量、自我感觉学习负担的中学生自杀意念检出率差异均有统计学意义(χ²值分别为38.17，13.44，10.77，8.15，19.76，18.95，59.75，P值均 < 0.05)；调整一般人口学特征等因素后，二元Logistic回归分析结果显示，社会生态学中个人维度中风险、个人维度高风险、家庭维度中风险、家庭维度高风险、学校维度高风险、文化维度中风险、文化维度高风险与中学生自杀意念的检出率均呈正相关(OR值分别为1.38，2.28，1.97，3.28，1.71，1.48，2.15，P值均 < 0.05)。结论中学生自杀意念的产生与社会生态学微系统中个人、家庭和学校的影响有关，同时也与宏系统中文化环境有关。应在开展个人、家庭和学校层面自杀意念干预的同时加强社会文化建设，减少不良因素对青少年心理健康的影响。
- 自杀 /
- 社会生态学 /
- 精神卫生 /
- 回归分析 /
- 学生
Abstract: Objective To understand the current situation of suicidal ideation among middle school students in Taiyuan City and its correlation with exposure to social-ecological risk factors, so as to provide a reference basis for exploring the causes of suicidal ideation among middle and high school students and formulating effective preventive measures. Methods A questionnaire survey was conducted among 2 639 middle school students in urban and rural areas of Taiyuan City by multistage stratified random cluster sampling, including general demography characteristics, social ecological risk factors and suicidal ideation. SPSS 26.0 software was used for Chi-squared test and binary Logistic regression analysis. Results The overall detection rate of suicidal ideation was 24.7%. There were statistically significant differences in the detection rate of suicidal ideation among middle school students in different gender, grade, family residence, maternal education level, perceived family economic conditions, number of close friends, self-perceived academic burden (χ²=38.17, 13.44, 10.77, 8.15, 19.76, 18.95, 59.75, P < 0.05). After adjusting the general demography characteristics, the binary Logistic regression showed that moderate and high risk in the individual, family and cultural dimension, and high risk in the school dimension of the social ecology were all positively correlated with suicidal ideation among middle school students (OR=1.38, 2.28, 1.97, 3.28, 1.48, 2.15, 1.71, P < 0.05). Conclusion The suicidal ideation among middle school students is related to individuals, families, and schools in the social ecological microsystem, as well as the cultural environment in the macro system. It is necessary to conduct intervention in suicidal ideation at the individual, family, and school levels, meanwhile, strengthening social and cultural construction to reduce the impact of adverse factors on the mental health among adolescents.
- Suicide /
- Social ecology /
- Mental health /
- Regression analysis /
- Students
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表 1 不同人口学特征中学生自杀意念检出率比较

Table 1. Comparison of the detection rate of suicide ideation in different demography groups among middle school students

人口学指标	选项	人数	自杀意念	χ²值	P值
性别	男	1 311	255(19.5)	38.17	< 0.01
	女	1 328	396(29.8)
年级	初一	433	91(21.0)	13.44	0.02
	初二	451	98(21.7)
	初三	416	115(27.6)
	高一	450	103(22.9)
	高二	454	116(25.6)
	高三	435	128(29.4)
独生子女^*	否	1 096	271(24.7)	0.06	0.80
	是	1 494	363(24.3)
家庭居住地^*	农村	202	49(24.3)	10.77	< 0.01
	乡镇	675	135(20.0)
	城市	1 750	462(26.4)
家庭人口数^*	2~3	956	233(24.4)	0.89	0.83
	4	1 239	300(24.2)
	5	262	64(24.4)
	≥6	125	35(28.0)
父亲文化程度^*	小学及以下	245	64(26.1)	2.81	0.42
	初中	987	230(23.3)
	高中或中专	722	175(24.2)
	大专或大专以上	659	176(26.7)
母亲文化程度^*	小学及以下	276	66(23.9)	8.15	0.04
	初中	980	215(21.9)
	高中或中专	701	180(25.7)
	大专或大专以上	659	184(27.9)
感知家庭经济条件^*	差	42	16(38.1)	19.76	< 0.01
	较差	237	79(33.3)
	中等	1 909	437(22.9)
	较好	376	105(27.9)
	好	56	11(19.6)
关系密切的朋友数量^*	没有	43	18(41.9)	18.95	< 0.01
	1~2	603	179(29.7)
	3~5	1 254	286(22.8)
	≥6	720	163(22.6)
自我感觉学习负担^*	很轻	41	13(31.7)	59.75	< 0.01
	轻	106	19(17.9)
	一般	1 633	328(20.1)
	重	715	236(33.0)
	很重	120	45(37.5)
注： ()内数字为检出率/%；*表示该项目存在缺失值。

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表 2 不同社会生态学风险因素暴露水平中学生自杀意念检出率比较

Table 2. Comparison of the detection rate of suicidal ideation among middle school students at different levels of exposure to social ecological risk factors

维度	暴露水平	人数	自杀意念人数	χ²值	P值
个人	低	696	87(12.5)	168.86	< 0.01
	中	1 349	307(22.8)
	高	594	257(43.3)
家庭	低	803	94(11.7)	179.98	< 0.01
	中	1 183	282(23.8)
	高	653	275(42.1)
学校	低	769	111(14.4)	32.50	< 0.01
	中	1 213	263(21.7)
	高	657	277(42.2)
社区	低	713	129(18.1)	28.00	< 0.01
	中	1 248	310(24.8)
	高	678	212(31.3)
政策	低	692	129(18.7)	27.34	< 0.01
	中	1 394	348(25.0)
	高	553	174(31.5)
时间	低	1 402	306(21.8)	27.38	< 0.01
	中	892	223(25.0)
	高	345	122(35.4)
文化	低	767	108(14.1)	106.73	< 0.01
	中	1 153	276(23.9)
	高	719	267(37.1)
注： ()内数字为检出率/%。

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参考文献(25)

[1]	WASSERMAN D, CARLI V, IOSUE M, et al. Suicide prevention in ch-ildhood and adolescence: a narrative review of current knowledge on risk and protective factors and effectiveness of interventions[J]. Asia Pac Psychiatry, 2021, 13(3): e12452. doi: 10.1111/appy.12452
[2]	徐慧琼, 万宇辉, 许韶君, 等. 中学生非自杀性自伤行为与自杀意念和自杀未遂的关联[J]. 中国心理卫生杂志, 2019, 33(10): 774-778. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS201910011.htm XU H Q, WAN Y H, XU S J, et al. The association between non suicidal self injury behavior, suicidal ideation, and attempted suicide among middle school students[J]. Chin Ment Health J, 2019, 33(10): 774-778. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS201910011.htm
[3]	HUBERS A A M, MOADDINE S, PEERSMANN S H M, et al. Suicidal ideation and subsequent completed suicide in both psychiatric and non-psychiatric populations: a Meta-analysis[J]. Epidemiol Psychiatr Sci, 2018, 27(2): 186-198. doi: 10.1017/S2045796016001049
[4]	魏梦琦, 刘燕. 初中生自杀意念的影响因素[J]. 济宁医学院学报, 2023, 46(2): 117-120. https://www.cnki.com.cn/Article/CJFDTOTAL-JNYY202302010.htm WEI M Q, LIU Y. The influencing factors of suicidal ideation among middle school students[J]. J Jining Med Univ, 2023, 46(2): 117-120. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JNYY202302010.htm
[5]	TWINTOH R F, ANKU P J, AMU H, et al. Childcare practices among teenage mothers in Ghana: a qualitative study using the ecological systems theory[J]. BMC Public Health, 2021, 21(1): 16. doi: 10.1186/s12889-020-09889-7
[6]	TAISUKE H, TAKASHIGE A, FUMI K, et al. Five-point Likert Scaling on MRI predicts clinically significant prostate carcinoma[J]. BMC Urol, 2015, 15(1): 1471-2490.
[7]	张一. 社会生态学风险因素与多基因风险评分的交互作用对青少年健康危害行为聚集的影响[D]. 合肥: 安徽医科大学, 2022. ZHANG Y. The impact of the interaction between social ecological risk factors and poly-genicrisk scores on the aggregation of health risk behaviors in adolescents[D]. Hefei: Anhui Medical University, 2022. (in Chinese)
[8]	MALAN L, SMUTS C, BAUMGARTNER J, et al. Missing data imputation via the expectation-maximization algorithm can improve principal component analysis aimed at deriving biomarker profiles and dietary patterns[J]. Nutr Res, 2020, 75: 67-76. doi: 10.1016/j.nutres.2020.01.001
[9]	YAN Y, GAI X. Prevalence and correlational factors of suicidal ideation and suicide attempts among chinese adolescents[J]. Front Psychol, 2022, 13: 911502. doi: 10.3389/fpsyg.2022.911502
[10]	王秋英, 黄巧敏, 迟新丽. 初中生自杀意念及影响因素的3年纵向研究[J]. 中国心理卫生杂志, 2022, 36(2): 124-128. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS202202006.htm WANG Q Y, HUANG Q M, CHI X L. A three-year longitudinal study on suicide ideation and its influencing factors among junior high school students[J]. Chin Ment Health J, 2022, 36(2): 124-128. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS202202006.htm
[11]	文心. 症状自评量表(SCL-90)测试[J]. 职业教育(下旬刊), 2016(7): 55-57. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDJL201607024.htm WEN X. Symptom Self-Rating Scale (SCL-90) test[J]. Vocat Educ(Next Ten-Day Issue), 2016(7): 55-57. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZDJL201607024.htm
[12]	李献云, 费立鹏, 张亚利, 等. Beck自杀意念量表中文版在大学学生中应用的信效度[J]. 中国心理卫生杂志, 2011, 25(11): 862-866. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS201111017.htm LI X Y, FEI L P, ZHANG Y L, et al. The reliability and validity of the Chinese Version of the Beck Suicide Intention Scale in university students[J]. Chin Ment Health J, 2011, 25(11): 862-866. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS201111017.htm
[13]	徐明津. 神经质人格特质对青少年自杀意念的影响: 有中介的调节模型[J]. 教育测量与评价, 2021(4): 57-64. https://www.cnki.com.cn/Article/CJFDTOTAL-PJYC202104008.htm XU M J. The influence of neuroticism personality traits on adolescent suicide ideation: mediated regulation model[J]. Educ Meas Eval, 2021(4): 57-64. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-PJYC202104008.htm
[14]	罗逸浩, 黄艳苹, 苏斌原. 高校研究生抑郁、焦虑、孤独感和自杀意念的关系[J]. 中国健康心理学杂志, 2021, 29(9): 1412-1415. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL202109028.htm LUO Y H, HUANG Y P, SU B Y. The relationship between depression, anxiety, loneliness, and suicidal ideation among graduate students in universities[J]. Chin J Health Psychol, 2021, 29(9): 1412-1415. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL202109028.htm
[15]	李峥嵘. 大学生父母教养方式、反刍思维与自杀意念的关系研究[D]. 武汉: 华中师范大学, 2019. LI Z R. A study on the relationship between parental rearing patterns, rumination thinking, and suicidal ideation among college students[D]. Wuhan: Central China Normal University, 2019. (in Chinese)
[16]	WALSH E, HERRING M, MCMAHON J. Perspectives of youth in Ireland on school-based mental health and suicide prevention: the MYSTORY study[J]. Health Promot Int, 2023, 38(3): daad049.
[17]	LEE J, CHUN J, KIM J. A social-ecological approach to understanding the relationship between cyberbullying victimization and suicidal ideation in south Korean adolescents: the moderating effect of school connectedness[J]. Int J Environ Res Public Health, 2021, 18(20): 10623.
[18]	张姝玥, 林艳, 黄婷. 中学生生命意义与主观幸福感心理健康自杀意念的相关性[J]. 中国学校卫生, 2013, 34(8): 927-928, 931. doi: 10.16835/j.cnki.1000-9817.2023.09.033 ZHANG S Y, LIN Y, HUANG T. The correlation between the meaning of life and subjective well-being, mental health, and suicidal ideation in middle school students[J]. Chin J Sch Health, 2013, 34(8): 927-928, 931. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.09.033
[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.1000-9817.2021.03.018 GAO X, WAN Y H, XIE Y, et al. The association between childhood abuse experiences and recent negative sexual events in middle school students and suicidal psychological behavior[J]. Chin J Sch Health, 2021, 42(3): 392-395, 398. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.03.018
[20]	SCHMIDT C N, PUFFER E S, BROVERMAN S, et al. Is social-ecological risk associated with individual HIV risk beliefs and behaviours: an analysis of Kenyan adolescents' local communities and activity spaces[J]. Global Public Health, 2021, 17(22): 3670-3685.
[21]	许昌秀. 新时代中国青年健康成长路径探寻: 基于社会生态系统理论下"战疫一代"的研究[J]. 新生代, 2022(6): 68-73. https://www.cnki.com.cn/Article/CJFDTOTAL-XSDA202206012.htm XU C X. Exploring the healthy growth path of chinese youth in the new era: research on the "War Epidemic Generation" based on the social ecological systems theory theory[J]. Cenozoic, 2022(6): 68-73. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XSDA202206012.htm
[22]	JANSSEN I, ROSU A. Undeveloped green space and free-time physical activity in 11 to 13-year-old children[J]. Int J Behav Nutr Phys Act, 2015, 12(1): 26.
[23]	LIPPERMAN-KREDA S, FINAN L J, KOWITT S D. Youth daily exposure to tobacco outlets and cigarette smoking behaviours: does exposure within activity space matter?[J]. Addict, 2020, 115(9): 1728-1735.
[24]	NAVARRO J, TUDGE J. Technologizing bronfenbrenner: neo-ecological theory[J]. Curr Psychol, 2022: 1-17. DOI: 10.1007/s12144-022-02738-3.
[25]	王雅婷, 肖水源, 郭晓艳, 等. 中国中学生自杀意念相关因素的系统综述和Meta分析[J]. 中国心理卫生杂志, 2019, 33(6): 464-469. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS201906015.htm WANG Y T, XIAO S Y, GUO X Y, et al. Systematic review and Meta-analysis of factors related to suicidal ideation of Chinese middle school students[J]. Chin Ment Health J, 2019, 33(6): 464-469. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS201906015.htm