自杀行为的应激敏感模型初探

A Preliminary Study of Stress Sensitization Model in Suicide

目的：依据应激敏感模型,初步探讨自杀行为和儿童期逆境、负性生活事件的关系.方法：采用一般资料问卷、儿童期不良经历（ACE）问卷和生活事件量表对自杀未遂入院患者64人及正常对照91人进行问卷调查,并分别将ACE得分和负性生活事件刺激量进行二分类,前者分为低逆境（ACE=0～1）和高逆境（ACE≥2）,后者分为低负性事件（负性生活事件刺激量＜4）和高负性事件（负性生活事件刺激量≥4）.结果：高逆境可增加个体经历高负性生活事件的危险度（OR=3.04,95％CI=1.57,5.91）；高逆境和高负性生活事件均可单独增加自杀行为的发生风险（OR=6.39,95％CI=3.07,13.31；OR=7.03,95％CI=3.25,15.22）.当个体处于高逆境水平时,即使负性生活事件水平较低,自杀行为发生风险仍较高（OR=8.217,95％CI=1.75,8.67）.结论：儿童期逆境和负性生活事件与自杀行为的关系符合应激敏感模型.

Objective： To preliminarily investigate the relationship of suicide behavior with childhood adversity and negative life event based on a stress sensitization model. Methods： There were two groups in this study, suicide group （n= 64） and control group （n=91）. All the participates completed the self-administered general information questionnaire, Ad- verse Childhood Experiences Questionnaire and Life Event Scale. The scores of adverse childhood experiences （ACE） and negative life events （NLES） were dichotomized into low adversity （ACE=0-1） and high adversity （ACE ≥2）, and low NLE （NLES〈3.5） and high NLES （NLES ≥ 3.5）, respectively. Results： High adversity increased 3.04-fold of risk of high NLES （95%CI=1.57, 5.91）. High adversity and high NLES increased the risk of suicide behavior separately（OR=6.39, 3.07, 13.31 and OR=7.03, 95%CI=3.25, 15.22, respectively）. Even low NLES raised the risk of suicide behavior in individuals with high adversity. Conclusion： The associations of childhood adversity and negative life events with suieide behavior aecorde with the stress sensitization model.