冲动性和攻击性对大学生自杀未遂行为的影响

The impulsiveness and aggression among suicide attempters in college students

目的了解冲动性及攻击性对大学生自杀未遂行为的影响。方法采用《自杀态度与心理健康状况问卷(大学版-Ⅳ)》对重庆市随机抽取的11所大学的12000名大学生进行调查。比较有无自杀未遂大学生中文版Barratt冲动行为量表与Buss和Perry攻击问卷的评估结果,分析冲动性及攻击性人格对大学生发生自杀行为的影响。结果收集有效问卷9808份,大学生自杀未遂的报告率为1.7%(169/9808)。自杀未遂组的冲动行为量表中的非计划性、行动冲动性和认知冲动性及总分均高于无自杀未遂组(P<0.001)。自杀未遂组Buss和Perry攻击问卷的总分及身体攻击、言语攻击、愤怒、敌意、指向自我的攻击等各因子分均高于无自杀未遂组(P<0.01)。多因素条件logistic回归分析显示,与自杀未遂最密切有关的独立危险因素排列为:攻击性总分高(OR=20.81,95%CI:12.36～35.03,P<0.01),行动冲动性分高(OR=4.32,95%CI:2.33～8.01,P<0.01),冲动性总分高(OR=3.37,95%CI:1.65～8.42,P<0.01),非计划性分值高(OR=3.12,95%CI:1.75～5.56,P<0.01),自杀意念强(OR=2.54,95%CI:1.75～3.70,P<0.01),已发生过性行为(3.12,95%CI:1.75～5.56,P<0.01),女性(OR=2.15,95%CI:1.48～3.14,P<0.01),指向自我的攻击分值高(OR=1.89,95%CI:1.24～2.88,P<0.01)。结论有自杀未遂的大学生更多体现出冲动性及攻击性人格,对大学生冲动性自杀行为应采取不一样的干预方案。

Objective To assess the relationship of impulsiveness and aggression with suicidal behavior and to estimate the prevalence of suicide attempts in college students in the Chongqing municipal region. Methods The ＂suicide attitude and mental health status questionnaire （university version-IV ）＂ developed by the Beijing suicide research and prevention center at Beijing huilongguan hospital was administered to 9808 students from 11 colleges in the Chongqing municipal region who were selected by muhi-stage stratified random methods. The subscale scores for the impulsiveness and aggression behavior scales from Chinese versions of the Barratt impulsiveness scale （BIS-CV） and the Buss-Perry aggression questionnaire （AQ-CV） were analyzed. Results One hundred sixty-nine （1.7%） of the 9808 students reported suicide attempt. Compared to students who did not report prior attempts, suicide attempters had significantly higher total and sub-scale scores on the impulsiveness scale （P 〈 0.001 ）, higher scores on the aggression scale, including the total scale and the subscales for physical aggression, verbal aggression, anger, hostility and aggression towards self （P 〈 0.001 ）. Unconditional logistic regression analysis showed the risk factors for suicide attempt as following： high level of total aggression（OR = 20.81, 95%CI：12.36 - 35.03, P 〈 0.01）, high level of motor impulsiveness（OR = 4.32, 95%CI： 2.33 - 8.01 ,P 〈 0.01）,high level of total impulsiveness （OR = 3.37, 95%CI： 1.65 - 8.42, P 〈 0.01 ）, high level of non-planning （OR = 3.12, 95%CI： 1.75 - 5.56,P 〈 0.01）, high deathwish （OR = 2.54, 95%CI： 1.75 - 3.70, P 〈 0.01）, having had sex behavior（3.12, 95%CI： 1.75 - 5.56,P 〈 0.01）, female （OR = 2.15, 95%CI：1.48 - 3.14,P 〈 0.01）, high level of aggression to self （OR = 1.89, 95%CI：1.24 - 2.88, P 〈 0.01）. Conclusions College students who report prior suicide attempts are more likely to have high levels of impulsiveness and aggression than those who do not report prior attempts, suggesting that different intervention programs should be taken to different students to prevent college students suicide attempt.