初中学生家庭功能对自杀相关行为的影响:抑郁的中介作用

Effect of Family Function on Suicide-Related Behaviors of Junior Middle School Students:The Mediating Effect of Depression

目的了解目前初中学生自杀相关行为的流行情况,探索抑郁在家庭功能影响自杀相关行为中的中介作用。方法使用青少年危险行为监测问卷(YRBSS)自杀相关问题、儿童家庭功能评定量表(C-FAI)、流调中心儿童抑郁量表(CES-DC)对成都市三所中学2572名初中学生进行面对面调查,利用结构方程模型进行分析。结果受访的中学生自杀相关行为检出率为26.01%,其中,自杀意念、自杀计划、自杀未遂的检出率依次为24.38%、13.49%和10.77%。抑郁在家庭功能对自杀相关行为的影响中起部分中介作用,直接效应值为0.170(95%CI:0.117~0.218,P<0.001),间接效应值为0.205(95%CI:0.176~0.234,P<0.001),中介效应值占总效应值的54.67%。结论家庭功能低下会增加中学生自杀相关行为的发生风险,这一作用大部分是通过影响儿童心理健康来实现的。改善家庭功能,不仅能改善儿童心理状况,还能减少自杀相关行为。

Objective To examine the prevalence of suicide-related behaviors among junior middle school students,and to explore the mediating role of depression in the relationship between suicide-related behaviors and family function.Methods A total of 2572 junior middle school students from three middle schools in Chengdu were interviewed face-to-face by using suicide-related items from Youth Risk Behavior Surveillance System(YRBSS),Chinese Family Assessment Instrument(C-FAI),and Center for Epidemiologic Studies Depression Scale for Children(CES-DC).The mediating role of depression was analyzed with structural equation model.Results The prevalence of suiciderelated behaviors was 26.01%among the respondents.The prevalence of suicide ideation,suicide plan and suicide attempt were 24.38%,13.49%and 10.77%,respectively.Depression played a partial mediating role in how family function impacted on suicide-related behaviors,presenting a direct effect value of 0.170(95%CI:0.117-0.218,P<0.001)and an indirect effect value of 0.205(95%CI:0.176-0.234,P<0.001),with the mediating effect accounting for 54.67%of the total effect.Conclusion Poor family function may increase the risk of suicide-related behaviors,and this effect is produced mostly through the impact on children’s mental health.Improving family function will not only improve children’s psychological status,but also reduce suicide-related behaviors.