青少年自杀意念与家庭环境和心理弹性之间的关联研究

Association of suicidal ideation with family environment and psychological resilience in adolescents

摘要:

目的 探讨青少年自杀意念与家庭环境因素和心理弹性之间的关系。方法 采用整群抽样法，于2014年12月对河南省新乡市3 230名初高中生进行一般社会资料问卷及Kutcher青少年抑郁量表（11项）（KADS-11）、家庭环境量表中文版（FES-CV）、中文版心理弹性量表（CD-RISC）评估测评后，采用多因素logistic回归分析和病例对照研究探讨青少年家庭环境和心理弹性与自杀意念之间的关联。结果 有效问卷为2 960份，有自杀意念者247例（8.50%），其中男性98例，女性149例。多因素logistic回归分析显示，控制了年龄和性别因素后，单亲/再婚家庭模式与青少年自杀意念风险增加有关（OR=2.655）。男性青少年的自杀意念与家庭亲密度（OR=0.750，P < 0.001）及组织性（OR=0.855，P=0.036）呈明显负关联，与家庭矛盾性呈明显正关联（OR=1.159，P=0.017）。女性青少年的自杀意念与家庭亲密度（OR=0.771，P < 0.001）、情感表达（OR=0.815，P=0.001）及知识性（OR=0.915，P=0.037）存在负性关联。CD-RISC量表评估显示，有自杀意念的青少年心理弹性总得分明显低于无自杀意念的青少年（P < 0.05），有自杀意念青少年该量表中的能力、忍受消极情感、接受变化和控制4个维度的得分均比无自杀意念青少年低（P < 0.05）。结论 青少年家庭环境亲密度是青少年自杀意念的保护因素；男性青少年的家庭组织性和女性青少年家庭情感表达与降低自杀风险有关；增强心理弹性可能有助于降低青少年的自杀意念。

Abstract:

Objective To study the association of suicidal ideation with family environment and psychological resilience in adolescents. Methods Cluster sampling was used to perform an investigation among 3 230 junior and senior high school students in Xinxiang of Henan Province, China December 2014. A general social information questionnaire, 11-Item Kutcher Adolescent Depression Scale(KADS-11), Family Environment Scale-Chinese Version (FES-CV) and Connor-Davidson Resilience Scale (CD-RISC; Chinese version) were used for evaluation. A multivariate logistic regression analysis and a case-control study were used to investigate the association of suicidal ideation with family environment and psychological resilience in adolescents. Results A total of 2 960 usable questionnaires were received. Among the 2 960 adolescents, 247 (8.50%) had suicidal ideation (98 boys and 149 girls). The multivariate logistic regression analysis showed that after adjustment for age and sex, single-parent/remarried family was associated with an increased risk of suicidal ideation (OR=2.655). Suicidal ideation in boys was negatively correlated with family cohesion (OR=0.750, P < 0.001) and organization (OR=0.855, P=0.036) and was positively correlated with family conflict (OR=1.159, P=0.017). Suicidal ideation in girls were negatively correlated with family cohesion (OR=0.771, P < 0.001), emotional expression (OR=0.815, P=0.001) and intellectual-cultural orientation (OR=0.915, P=0.037). The adolescents with suicidal ideation had a significantly lower total score of psychological resilience than those without suicidal ideation (P < 0.05). Compared with those without suicidal ideation, the adolescents with suicidal ideation had significantly lower scores on 4 factors of the CD-RISC (ability, tolerance of negative emotions, acceptance of changes and control) (P < 0.05). Conclusions Family cohesion is a protective factor against suicidal ideation in adolescents. Family organization in boys and family emotional expression in girls are associated with a decreased risk of suicidal ideation. Enhanced psychological resilience may help to reduce the incidence of suicide ideation in adolescents.