The relationship between self-injurious behavior and suicide in a young adult population
The relationship between self-injurious behavior and suicide in a young adult population
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DOI：
10.1001/archpedi.161.7.634
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发表时间：
2007-07-01
影响因子：
--
通讯作者：
Knox, Kerry L.
中科院分区：
文献类型：
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作者：
Whitlock, Janis;Knox, Kerry L.
目的：自我伤害行为（SIB）是一种试图科普心理痛苦的行为，这种心理痛苦可能会同时发生，或者导致个体在经历了比他们能够有效缓解的更多的胁迫后产生自杀行为。随机抽样的8300名学生应邀参加了一个基于网络的调查，3069（37.0%）回答。其中大部分回答缺失或SIB或自杀状态无法确定的病例被忽略，得到2875个可用病例。暴露：自伤行为。主要结果测量：主要结果是自杀倾向;当考虑人口统计学特征、创伤史、痛苦、非正式求助和对生活的吸引力时，SIB状态对自杀倾向的调整优势比（AORs）。四分之一的样本报告SIB，自杀，或两者兼而有之; 40.3%的报告SIB也报告自杀。当控制人口统计学变量时，自伤行为状态可预测自杀倾向（AOR，6.2; 95%置信区间[CI]，4.9-7.8）。增加创伤和痛苦变量减弱了这种关系（AOR，3.7; 95%CI，2.7-4.9）。与仅报告自杀倾向的受访者相比，同时报告SIB的受访者更可能报告自杀意念（AOR，2.8; 95% CI，2.0-3.8）、计划（AOR，5.6; 95% CI，3.9-7.9）、手势（AOR，7.3; 95% CI，3.4-158）和企图（AOR，9.6; 95% CI，5.4-17.1）。终生SIB频率与自杀倾向呈曲线关系。结论：由于众所周知SIB不是一种自杀姿态，因此许多临床医生认为没有必要进行自杀评估。我们的研究结果表明，SIB的存在应该触发自杀评估。
Objective: To test the hypothesis that self-injurious behavior (SIB) signals an attempt to cope with psychological distress that may co-occur or lead to suicidal behaviors in individuals experiencing more duress than they can effectively mitigate.Design: Analysis of a cross-sectional data set of collegeage students.Setting: Two universities in the northeastern United States in the spring of 2005.Participants: A random sample of 8300 students invited to participate in a Web-based survey; 3069 (37.0%) responded. Cases in which a majority of the responses were missing or in which SIB or suicide status was indeterminable were omitted, resulting in 2875 usable cases.Exposure: Self-injurious behavior.Main Outcome Measures: Main outcome was suicidality; adjusted odds ratios (AORs) for suicidality by SIB status when demographic characteristics, history of trauma, distress, informal help-seeking, and attraction to life are considered.Results: One quarter of the sample reported SIB, suicidality, or both; 40.3% of those reporting SIB also report suicidality. Self-injurious behavior status was predictive of suicidality when controlling for demographic variables (AOR, 6.2; 95% confidence interval [CI], 4.9-7.8). Addition of trauma and distress variables attenuated this relationship (AOR, 3.7; 95% CI, 2.7-4.9). Compared with respondents reporting only suicidality, those also reporting SIB were more likely to report suicide ideation (AOR, 2.8; 95% CI, 2.0-3.8), plan (AOR, 5.6; 95% CI, 3.9-7.9), gesture (AOR, 7.3; 95% CI, 3.4-158), and attempt (AOR, 9.6; 95% CI, 5.4-17.1). Lifetime SIB frequency exhibits a curvilinear relationship to suicidality.Conclusions: Since it is well established that SIB is not a suicidal gesture, many clinicians assume that suicide assessment is unnecessary. Our findings suggest that the presence of SIB should trigger suicide assessment.