童年期不良经历与中学生自杀行为的关联性研究

Correlations between adverse childhood experiences and suicidal behavior among middle school students

目的了解中学生童年期不良经历和自杀行为的发生情况,为有效预防中学生自杀行为发生提供依据。方法采用分层整群抽样的方法,抽取蚌埠市5 116名中学生为研究对象,对其进行童年期虐待经历和自杀行为问卷调查。采用χ^2检验,比较不同性别中学生自杀行为及童年期虐待检出率的差异。建立多因素Logistic回归模型分析童年期不良经历对中学生自杀行为的影响。结果中学生自杀意念、自杀计划以及自杀未遂的检出率分别为15.6%,8.6%和3.4%,女生均高于男生,差异均有统计学意义（χ^2值分别为17.22,7.50,8.15,P值均〈0.01）。女生情感虐待检出率高于男生,男生躯体虐待、性虐待、躯体忽视和家庭功能不全的检出率均高于女生,差异均有统计学意义（P值均〈0.01）。有各种类型童年期不良经历者自杀意念、自杀计划以及自杀未遂的检出率均高于无相应不良经历者（P值均〈0.05）。Logistic回归模型发现,各种童年期不良经历均会增加自杀意念、自杀计划以及自杀未遂发生风险;且随着不良经历类型数目的增加,各自杀行为的发生风险呈上升趋势（P值均〈0.01）。结论童年期不良经历是中学生自杀意念、自杀计划以及自杀未遂发生的重要危险因素。加强对有童年期不良经历青少年的干预,可作为中学生自杀行为防控的重要举措。

Objective To know the prevalence of adverse childhood experiences and suicidal behavior among middle school students, and to provide evidence for suicide prevention. Methods By using clustered stratified sampling method, 5 116 middle school students were chosen and entered a self-designed questionnaire survey. Multi-variate Logistic regression model was established to analyze the effect of childhood abuse on suicide behavior among middle school students. Results The positive rate of suicide ideation, suicide plan and suicide attempts were 15. 6%, 8. 6% and 3. 4% respectively, with girls ＇ higher than boys ＇（ χ2=17.227,508.15,P〈0.01）. The positive rate of emotional abuse was higher in girls than that in boys. The positive rate of physical abuse, sexual abuse, emotional neglect, physical neglect and family dysfunction were all higher in boys than in girls（ P〈0.01）. The positive rate of suicide ideation, suicide plan and suicide attempts were higher among the students with adverse childhood experiences（ P〈0.05）. Logistic regression model revealed that adverse childhood experiences could add risks of suicide ideation, suicide plan and suicide attempts. The risks of suicide behavior increased with the sum of adverse experiences items increasing（ P 0.01）.Conclusion Adverse childhood experiences are the important risk factors to suicide ideation, suicide plan and suicide attempts among middle school students. Enhancing the intervention for the students with adverse childhood experiences can be taken as an important measure for the prevention and control of suicide behavior among middle school students.