Suicidal Thoughts and Attempts Among US High School Students: Trends and Associated Health-Risk Behaviors, 1991-2011
Suicidal Thoughts and Attempts Among US High School Students: Trends and Associated Health-Risk Behaviors, 1991-2011
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DOI：
10.1016/j.jadohealth.2013.07.024
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发表时间：
2014-01-01
影响因子：
7.6
通讯作者：
Kann, Laura
中科院分区：
文献类型：
--
作者：
Lowry, Richard;Crosby, Alexander E.;Kann, Laura
目的：描述美国高中生自杀想法和企图的长期趋势，以及与自杀想法和企图相关的健康风险行为类型。方法：对1991-2011年每两年进行一次的11项全国青少年危险行为调查数据进行分析。每次调查都采用了具有全国代表性的9-12年级学生样本，并提供了大约14,000名学生的数据。使用控制种族/民族和年级的性别分层逻辑回归模型，我们分析了自杀想法和企图流行的长期趋势。计算调整患病率比率（APR）来衡量自杀风险与广泛的健康风险行为之间的关系。结果：1991-2011年期间，女大学生的自杀念头（认真考虑过自杀、计划过自杀）和自杀未遂（任何自杀未遂、伤害需就医）均显著下降；在男学生中，只有自杀念头明显减少。2011年，与没有自杀念头或企图的学生相比，与自杀企图最相关的健康风险行为是注射毒品（APR=12.8）、在校园里携带武器（APR=9.7）和使用甲基苯丙胺（APR=8.7）；在男学生中，相关性最强的是IDU （APR=22.4）、使用呕吐/泻药控制体重（APR=17.1）和被迫发生性行为（APR=14.8）。结论：以学校为基础的自杀预防计划应考虑对与自杀企图密切相关的健康风险行为进行保密筛查，以帮助识别自杀风险增加的学生，并酌情向自杀和其他预防服务（例如，药物滥用和暴力预防）提供转介。由爱思唯尔公司代表青少年健康和医学协会出版。
Purpose: To describe secular trends in suicidal thoughts and attempts and the types of health-risk behaviors associated with suicidal thoughts and attempts among U. S. high school students.Methods: Data were analyzed from 11 national Youth Risk Behavior Surveys conducted biennially during 1991-2011. Each survey employed a nationally representative sample of students in grades 9-12 and provided data from approximately 14,000 students. Using sex-stratified logistic regression models that controlled for race/ethnicity and grade, we analyzed secular trends in the prevalence of suicidal thoughts and attempts. Adjusted prevalence ratios (APR) were calculated to measure associations between suicide risk and a broad range of health-risk behaviors.Results: During 1991-2011, among female students, both suicidal thoughts (seriously considered suicide; made a plan to attempt suicide) and attempts (any attempt; attempt with injury requiring medical treatment) decreased significantly; among male students, only suicidal thoughts decreased significantly. During 2011, compared with students with no suicidal thoughts or attempts, the health-risk behaviors most strongly associated with suicide attempts among female students were injection drug use (APR=12.8), carrying a weapon on school property (APR=9.7), and methamphetamine use (APR=8.7); among male students, the strongest associations were for IDU (APR=22.4), using vomiting/laxatives for weight control (APR=17.1), and having been forced to have sex (APR=14.8).Conclusions: School-based suicide prevention programs should consider confidential screening for health-risk behaviors that are strongly associated with suicide attempts to help identify students at increased risk for suicide and provide referrals to suicide and other prevention services (e. g., substance abuse and violence prevention) as appropriate. Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine.