Cross-national analysis of the associations between traumatic events and suicidal behavior: findings from the WHO World Mental Health Surveys.
Cross-national analysis of the associations between traumatic events and suicidal behavior: findings from the WHO World Mental Health Surveys.
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DOI：
10.1371/journal.pone.0010574
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发表时间：
2010-05-13
期刊：
影响因子：
3.7
通讯作者：
Nock MK
中科院分区：
文献类型：
--
作者：
Stein DJ;Chiu WT;Hwang I;Kessler RC;Sampson N;Alonso J;Borges G;Bromet E;Bruffaerts R;de Girolamo G;Florescu S;Gureje O;He Y;Kovess-Masfety V;Levinson D;Matschinger H;Mneimneh Z;Nakamura Y;Ormel J;Posada-Villa J;Sagar R;Scott KM;Tomov T;Viana MC;Williams DR;Nock MK
社区和临床数据表明，创伤暴露与自杀行为（即自杀意念、计划和尝试）之间存在关联。然而，很少有研究评估哪些创伤能够唯一预测：自杀行为的首次发作、从自杀意念到计划和企图的进展，或者每种形式的自杀行为随着时间的推移持续存在。此外，关于发展中国家此类协会的数据很少。当前的研究解决了这些问题。有关创伤暴露和随后首次自杀行为的数据是通过对参与世卫组织世界心理健康调查的 21 个国家的 102,245 名（18 岁以上）受访者家庭进行的结构化访谈收集的。双变量和多变量生存模型测试了创伤事件的类型和数量与随后的自杀行为之间的关系。一系列创伤事件与自杀行为有关，其中性暴力和人际暴力始终表现出最强烈的影响。创伤事件的次数与自杀意念/企图之间存在剂量反应关系；然而，随着事件的增多，关联的强度会减弱。尽管一系列创伤事件与自杀意念的发生有关，但很少有事件可以预测哪些有自杀意念的人会发展为自杀计划和企图，或随着时间的推移自杀行为的持续性。高收入、中等收入和低收入国家的关联通常是一致的。这项研究提供了比以前更详细的关于创伤事件和自杀行为之间关系的信息，并表明这种关联在发达国家和发展中国家都相当一致。这些数据强调了心理创伤作为一个主要公共卫生问题的重要性，并强调了筛查创伤暴露的存在和积累作为自杀意念和企图的危险因素的重要性。
Community and clinical data have suggested there is an association between trauma exposure and suicidal behavior (i.e., suicide ideation, plans and attempts). However, few studies have assessed which traumas are uniquely predictive of: the first onset of suicidal behavior, the progression from suicide ideation to plans and attempts, or the persistence of each form of suicidal behavior over time. Moreover, few data are available on such associations in developing countries. The current study addresses each of these issues. Data on trauma exposure and subsequent first onset of suicidal behavior were collected via structured interviews conducted in the households of 102,245 (age 18+) respondents from 21 countries participating in the WHO World Mental Health Surveys. Bivariate and multivariate survival models tested the relationship between the type and number of traumatic events and subsequent suicidal behavior. A range of traumatic events are associated with suicidal behavior, with sexual and interpersonal violence consistently showing the strongest effects. There is a dose-response relationship between the number of traumatic events and suicide ideation/attempt; however, there is decay in the strength of the association with more events. Although a range of traumatic events are associated with the onset of suicide ideation, fewer events predict which people with suicide ideation progress to suicide plan and attempt, or the persistence of suicidal behavior over time. Associations generally are consistent across high-, middle-, and low-income countries. This study provides more detailed information than previously available on the relationship between traumatic events and suicidal behavior and indicates that this association is fairly consistent across developed and developing countries. These data reinforce the importance of psychological trauma as a major public health problem, and highlight the significance of screening for the presence and accumulation of traumatic exposures as a risk factor for suicide ideation and attempt.
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影响因子：
3.7
作者：
ALLISON, PD
通讯作者：
ALLISON, PD
影响因子：
--
作者：
McLaughlin, Katie A.;Green, Jennifer Greif;Gruber, Michael J.;Sampson, Nancy A.;Zaslavsky, Alan M.;Kessler, Ronald C.
通讯作者：
Kessler, Ronald C.
DOI：
10.1097/00004583-199912000-00009
发表时间：
1999-12-01
影响因子：
13.3
作者：
Brown, J;Cohen, P;Smailes, EM
通讯作者：
Smailes, EM
DOI：
10.1097/00004583-199610000-00023
发表时间：
1996-10-01
影响因子：
13.3
作者：
Fergusson, DM;Lynskey, MT;Horwood, LJ
通讯作者：
Horwood, LJ
影响因子：
3.7
作者：
EFRON, B
通讯作者：
EFRON, B