失眠在中学生童年创伤与自杀风险之间的中介作用

Mediating effect of insomnia in the relationship between childhood trauma and suicide risk in middle school students

目的探讨失眠在中学生童年创伤与自杀风险间的中介作用。方法采用童年创伤问卷(childhood trauma questionnaire,CTQ)、失眠严重程度指数(insomnia severity index,ISI)、自杀行为问卷修订版(suicidal behaviors questionnaire-revised,SBQ-R)等对3442名中学生进行调查。根据SBQ-R总分分组,≤6分为低自杀风险组,≥7分为高自杀风险组,最终本研究纳入低自杀风险组2168人、高自杀风险组1274人。采用SPSSAU 21.0在线统计软件进行共同方法偏差检验、描述统计、方差分析和相关分析,并构建结构方程模型,用Bootstrap法进行中介效应检验。结果(1)高自杀风险组与低自杀风险组在年级、性别2个方面均差异有统计学意义(χ^(2)=11.144,83.737,均P<0.05);在童年创伤经历种类和失眠严重程度2个方面均差异有统计学意义(χ^(2)=292.211,333.998,均P<0.05)。(2)高自杀风险组童年创伤总分[(43.92±10.50)分]高于低自杀风险组[(37.74±6.93)分](F=351.78,P<0.01),高自杀风险组失眠得分[(10.66±5.54)分]高于低自杀风险组[(7.04±4.76)分](F=379.25,P<0.01)。(3)童年创伤总分与自杀风险得分呈正相关(r=0.415,P<0.01),与失眠得分呈正相关(r=0.306,P<0.01),失眠得分与自杀风险得分显著正相关(r=0.399,P<0.01);控制人口学资料、焦虑、抑郁后,相关性仍然显著(均P<0.01)。(4)路径分析及中介效应检验表明,童年创伤对失眠呈正向影响(β=0.30,P<0.01),失眠对自杀风险呈正向影响(β=0.29,P<0.01),童年创伤对自杀风险呈正向影响(β=0.33,P<0.01);失眠的中介效应占总效应的21.21%,控制人口学资料、焦虑、抑郁后,中介效应占总效应的10.66%。结论童年创伤和失眠对中学生自杀风险有显著影响,失眠在童年创伤与中学生自杀风险间起部分中介作用,及时对创伤个体的睡眠进行管理,可降低中学生自杀风险。

Objective To explore the mediating role of insomnia between childhood trauma and suicide risk in middle school students.Methods Childhood trauma questionnaire(CTQ),insomnia severity index(ISI)and suicidal behaviors questionnaire-revised(SBQ-R)were used to investigate 3442 middle school students.According to the total score of the SBQ-R,those who scored less than or equal to 6 were divided into low suicide risk group,and those who scored more than or equal to 7 were divided into high suicide risk group.In this study,there were 2168 students in the low suicide risk group and 1274 students in the high suicide risk group.SPSSAU 21.0 online statistical software was used for common method deviation test,descriptive statistics,variance analysis and correlation analysis,and structural equation model was constructed,and Bootstrap method was used for mediation effect test.Results(1)There were statistically significant differences between the high suicide risk group and the low suicide risk group in terms of grade and gender(χ^(2)=11.144,83.737,both P<0.05),and there were statistically significant differences in the types of childhood trauma and the severity of insomnia(χ^(2)=292.211,333.998,both P<0.05).(2)The total score of childhood trauma in the high suicide risk group(43.92±10.50)was higher than that in the low suicide risk group(37.74±6.93)(F=351.78,P<0.01),and the score of insomnia in the high suicide risk group(10.66±5.54)was higher than that in the low suicide risk group(7.04±4.76)(F=379.25,P<0.01).(3)The total score of childhood trauma was positively correlated with the score of suicide risk(r=0.415,P<0.01),and the total score of childhood trauma was positively correlated with the score of insomnia(r=0.306,P<0.01),and the score of insomnia was significantly positively correlated with the score of suicide risk(r=0.399,P<0.01).After controlling for demographic data,anxiety and depression,the correlation was still significant(P<0.01).(4)Path analysis and mediation test showed that childhood trauma had a positive effect on insomnia(β=0.30,P<0.01),insomnia had a positive effect on suicide risk(β=0.29,P<0.01),and childhood trauma had a positive effect on suicide risk(β=0.33,P<0.01).The mediating effect of insomnia accounted for 21.21%of the total effect.After controlling for demographic data,anxiety and depression,the mediating effect accounted for 10.66%of the total effect.Conclusion Childhood trauma and insomnia have a significant impact on the suicide risk among middle school students.Insomnia plays a partial mediating role between childhood trauma and middle school students'suicide risk.Timely management of the sleep disturbances of traumatized individuals can reduce the suicide risk among middle school students.