生活事件与青少年自杀风险的关系及链式中介调节机制

Relationship between life events and suicide behaviors in adolescents and the chain intermediary effects

目的探究表达抑制对焦虑抑郁和自伤在生活事件与青少年自杀风险之间链式中介效应的调节作用。方法2021年11月,本研究通过分层整群抽样选取眉山和乐山6所中学的3680名中学生,采用青少年生活事件量表(adolescent self-rating life events checklist,ASLEC)、Achenbach青少年自评量表(2001年修订版)中文版(the Chinese version of achenbach youth self-report-2001 version,YSR-2001-CV)、非自杀性自伤行为评定问卷(adolescent non-suicidal self-injury assessment questionnaire,ANSAQ)、Gross-John情绪调节问卷(emotion regulation questionnaire,ERQ)、自杀行为问卷修订版(suicide behaviors questionnaire-revised,SBQ-R)进行调查,运用SPSS 28.0和Process 4.1完成分析。结果生活事件→自杀风险的总间接效应TIE=0.135(95%CI:0.12~0.16),P_(M)=82.82%。生活事件→焦虑抑郁→自杀风险的间接效应大于生活事件→自伤→自杀风险(95%CI:0.01~0.02)和生活事件→焦虑抑郁→自伤→自杀风险(95%CI:0.03~0.05)。表达抑制可调节焦虑抑郁→自伤(β=0.149,95%CI:0.11~0.19)和焦虑抑郁→自杀风险(β=0.157,95%CI:0.14~0.17)的关系,还调节生活事件→焦虑抑郁→自杀风险(P<0.001)和生活事件→焦虑抑郁→自伤→自杀风险(P<0.001)的中介效应。结论在生活事件与青少年自杀风险间存在有调节的链式中介效应,焦虑抑郁和自伤发挥链式中介作用,表达抑制可调节该中介。

Objective To explore the relationship between life events and suicide risks in adolescents,and to decipher the modulating effect of expressive suppression in the role of anxiety/depression and non-suicidal self-injury(NSSI)played in the above relationship.Methods In November 2021,a total of 3680 students were randomly selected from 6 middle schools in Meishan and Leshan using stratified cluster sampling method,and a questionnaire survey was conducted by using adolescent self-rating life events checklist(ASLEC),the Chinese version of Achenbach Youth Self-Report-2001 Version(YSR-2001-CV),Adolescent Non-suicidal Self-injury Assessment Questionnaire(ANSAQ),Emotion Regulation Questionnaire(ERQ),Suicide Behaviors Questionnaire-Revised(SBQ-R).SPSS 28.0 and Process 4.1 were used for data statistical analysis.Results The total indirect effect(TIE)of life events to suicide risk was 0.135(95%CI:0.12-0.16),P_(M) was 82.82%.Indirect effects of life events to anxiety/depression to suicide risk were bigger than that of life events to NSSI to suicide risk(95%CI:0.01-0.02)as well as that of life events to anxiety/depression to NSSI to suicide risk(95%CI:0.03-0.05).Expressive suppression could modulate the relationship between anxiety/depression and NSSI(β=0.149,95%CI:0.11-0.19)as well as between anxiety/depression and suicide risk(β=0.157,95%CI:0.14-0.17),and also modulate the intermediary effect of life events to anxiety/depression to suicide risk(P<0.001)and life events to anxiety/depression to NSSI to suicide risk(P<0.001).Conclusions There exists a chain intermediary effects between life events and suicide risk in adolescent,anxiety/depression and NSSI are major players in the chain,while expressive suppression modulates the whole chain.