Risk and protective factors underlying depression and suicidal ideation in Autism Spectrum Disorder
Risk and protective factors underlying depression and suicidal ideation in Autism Spectrum Disorder
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DOI：
10.1002/da.22759
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发表时间：
2018-07-01
影响因子：
7.4
通讯作者：
Trollor, Julian
中科院分区：
文献类型：
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作者：
Hedley, Darren;Uljarevic, Mirko;Trollor, Julian
背景：患有自闭症谱系障碍(ASD)的人有自杀念头和行为的风险显著增加。鉴于孤独症患者的社交困难往往导致社会孤立，进而增加抑郁的风险，本研究考察了孤独和社会支持作为与抑郁和自杀意念相关的潜在风险和保护因素。方法：样本包括185名年龄在14-80岁的自闭症患者(92名女性)。结果：49%的受试者的抑郁评分在临床范围内，36%的受试者最近有过自杀意念。几乎占样本50%的女性比男性的抑郁得分更高，但在自杀意念方面，男性和女性之间没有发现差异。回归分析表明，孤独感、对社会支持的满意度和自闭症特征可以预测抑郁得分。对社会支持的满意度可以预测自杀意念，然而，在考虑到抑郁的影响后，社会支持满意度不再是一个重要的预测因素。路径分析表明，孤独感和社会支持满意度对自杀意念有中介作用，孤独感和社会支持满意度对自杀意念有中介作用。男性和女性的人际关系模式几乎相同。结论：本研究支持孤独和社会支持分别作为自闭症患者抑郁和自杀意念的保护性因素和风险因素的模型。
Background: People with Autism Spectrum Disorder (ASD) are at significantly increased risk of suicidal thoughts and behavior. Given that social difficulties in ASD often lead to social isolation, which can in turn increase the risk for depression, this study examined loneliness and social support as potential risk and protective factors associated with depression and suicidal ideation.Method: The sample comprised 185 people (92 females) with ASD aged 14 to 80 years who were participating in a national survey.Results: Forty-nine percent of participants returned scores in the clinical range for depression and 36% reported recent suicidal ideation. Females, comprising almost 50% of the sample, returned higher depression scores than males, however no differences were identified between males and females in terms of suicidal ideation. Regression analyses revealed that loneliness, satisfaction with social support, and ASD traits predicted depression scores. Satisfaction with social support predicted suicidal ideation, however, it was no longer a significant predictor after the effects of depression were taken into account. Path analysis showed that ASD trait severity was independently related to depression, that the effect of number of social supports on depression was mediated by loneliness and satisfaction with social support, and that effects of loneliness and satisfaction with social support on suicidal ideation were mediated by depression. The pattern of relationships was nearly identical for males and females.Conclusions: This study supports a model whereby loneliness and social support operate respectively as protective and risk factors for depression and suicidal ideation in ASD.