农村青年男女自杀死亡者心理状态和心理特征的心理解剖研究

Psychological autopsy study of gender-specific psychological characteristics of rural young suicides

目的:比较农村青年男女自杀死亡者的心理状态和心理特征,比较心理因素指标相关的自杀危险程度在农村青年男女间的差异。方法:在山东、辽宁、湖南随机抽取16个县/市,采用心理解剖方法对392例15～34岁自杀死亡者进行研究;并就心理因素指标相关的自杀危险程度与从调查地点随机抽取的416例同年龄段对照进行两水平多层非线性模型分析。结果:自杀死亡者中,男性相对于女性具有更高的绝望感、抑郁水平及特质焦虑程度(均P<0.05),冲动性和应对技能的性别差异没有统计学意义。心理因素指标相关的自杀危险程度比较,"问题解决"和"寻求代偿"能力对女性自杀死亡风险的降低作用显著高于男性(均P<0.05),"认知回避"和"发泄情绪"应对方式对男性自杀死亡风险的增加作用显著高于女性(均P<0.05)。结论:自杀死亡心理危险因素在农村青年男性自杀死亡者中评分更高,心理因素指标相关的自杀危险程度的性别比较多数没有显著性差异。

Objective： To compare the psychological characteristics between rural young male and female suicides, and compare the influences of the psychological factors on suicide between rural young men and women. Methods： Sixteen counties or county-level cities in Shandong, Liaoning and Hunan provinces were random- ly selected. Totally 392 suicides aged 15 ～ 34 years old were studied＇by using psychological autopsy method. Hierarchical Linear and Nonlinear Modeling （HLM） was applied to calculate the OR values of psychological factors by using 392 suicides and 416 controls with the same age range which were randomly selected from the 16 selected sites. Results： Rural young male suicides had more severe hopelessness, depression, and trait anxiety （Ps 〈 0. 05）. There was no significant gender difference in neither impnlsivity nor coping skills. The comparison of odds ratio values of the psychological factors showed that coping abilities of ＂problem solving＂ and ＂seeking compensation＂ significantly reduced suicide risks among rural young women （ P 〈 0. 05）. However, two kinds of negativecoping styles ＂cognitive evading＂ and ＂emotions release＂ significantly increased suicide risks among rural young men （P 〈0. 05）. Condusion： Comparing to rural young female suicides, male suicides have higher scores of the psychological risk factors for completed suicide, but there is no significant gender difference of the influences of most psychological risk factors on completed suicide.