Associations of adverse childhood experiences and social support with self-injurious behaviour and suicidality in adolescents
Associations of adverse childhood experiences and social support with self-injurious behaviour and suicidality in adolescents
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DOI：
10.1192/bjp.2018.263
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发表时间：
2018-11
期刊：
影响因子：
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通讯作者：
Y. Wan;Ruoling Chen;Shuang-shuang Ma;Danielle McFeeters;Ying Sun;J. Hao;F. Tao
中科院分区：
文献类型：
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作者：
Y. Wan;Ruoling Chen;Shuang-shuang Ma;Danielle McFeeters;Ying Sun;J. Hao;F. Tao
背景关于不良童年经历和社会支持对社区青少年非自杀性自伤、自杀意念和自杀企图的交互作用，以及这些影响的性别差异的研究很少。目的探讨不良经历和社会支持对青少年自伤、自杀意念和自杀企图的影响，并探讨性别差异。方法2013-2014年在全国三省开展校本健康调查。共有14 820名10-20岁的学生完成了标准问卷，记录了ace、社会支持、自伤、自杀意念和自杀企图的详细情况。结果89.4%的参与者报告了一种或多种ace。自伤、自杀意念和自杀企图发生率分别为26.1%、17.5%和4.4%；所有这些都与ace增加和社会支持降低显著相关。低社会支持与高社会支持中自伤的多重校正比值比女孩为2.27 (95% CI 1.85-2.67)，男孩为1.81 (95% CI 1.53-2.14)，两者的比值（两比值比，ROR）为1.25 （P = 0.037）。高ace分数（5-6分）、社会支持中低的女生自杀倾向风险高于男生（RORs分别为2.34、1.84、2.02，P均< 0.05）。结论不良经历和低社会支持与中国青少年自伤和自杀风险增加有关。改善社会支持的战略，特别是对有大量不良经历的女性青少年的社会支持，应成为有针对性的心理健康干预措施的一个组成部分。利益声明无。
Background There is little investigation on the interaction effects of adverse childhood experiences (ACEs) and social support on non-suicidal self-injury (NSSI), suicidal ideation and suicide attempt in community adolescent populations, or gender differences in these effects. Aims To examine the individual and interaction effects of ACEs and social support on NSSI, suicidal ideation and suicide attempt in adolescents, and explore gender differences. Method A school-based health survey was conducted in three provinces in China between 2013–2014. A total of 14 820 students aged 10–20 years completed standard questionnaires, to record details of ACEs, social support, NSSI, suicidal ideation and suicide attempt. Results Of included participants, 89.4% reported one or more category of ACEs. The 12-month prevalence of NSSI, suicidal ideation and suicide attempt was 26.1%, 17.5% and 4.4%, respectively; all were significantly associated with increased ACEs and lower social support. The multiple adjusted odds ratio of NSSI in low versus high social support was 2.27 (95% CI 1.85–2.67) for girls and 1.81 (95% CI 1.53–2.14) for boys, and their ratio (Ratio of two odds ratios, ROR) was 1.25 (P = 0.037). Girls with high ACEs scores (5–6) and moderate or low social support also had a higher risk of suicide attempt than boys (RORs: 2.34, 1.84 and 2.02, respectively; all P < 0.05). Conclusions ACEs and low social support are associated with increased risk of NSSI and suicidality in Chinese adolescents. Strategies to improve social support, particularly among female adolescents with a high number of ACEs, should be an integral component of targeted mental health interventions. Declaration of interest None.