Social Capital and Suicidal Ideation in Community-Dwelling Older Residents: A Multilevel Analysis of 10,094 Subjects in Japan
Social Capital and Suicidal Ideation in Community-Dwelling Older Residents: A Multilevel Analysis of 10,094 Subjects in Japan
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DOI：
10.1016/j.jagp.2016.10.014
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发表时间：
2017-01-01
影响因子：
7.2
通讯作者：
Takao, Soshi
中科院分区：
文献类型：
--
作者：
Noguchi, Masayuki;Kobayashi, Tomoko;Takao, Soshi
目的：社会资本，群体的集体资源，包括对信任和互惠的看法，被认为是自杀的重要因素。我们在调整了社区老年人的社会支持后，研究了个人和社区层面的社会资本与自杀意念的关系。研究方法：2010年8月，我们向日本冈山县3个农村自治市的所有65岁以上的居民（N = 21，232）发送了问卷，共收回13，919份问卷（回复率：65.6%）。最终分析包括10，094名参与者。结局变量为自杀意念。暴露变量是个人层面的不信任和缺乏互惠（1级），这些变量的汇总反应从35个社区的城市（2级）。协变量包括年龄、性别、教育程度、婚姻状况、同居人数、居住年限、自评社会经济状况、残疾、社会支持和心理困扰。采用多水平logistic回归分析获得比值比（OR）和95%置信区间（CI）。结果如下：在调整了社会支持和心理困扰后，我们发现不信任和缺乏互惠只与个人层面的自杀意念有关。分层分析显示，在心理困扰的受试者中，不信任与自杀意念在个人水平（OR：1.88; 95%CI：1.42-2.51）和社区水平（OR：1.98; 95%CI：1.02-3.81）上相关。结论：我们的研究结果表明，个人和社区层面的社会资本是自杀意念的一个可能的保护因素，特别是对有心理困扰的人。
Objective: Social capital, the collective resources of groups including perceptions of trust and reciprocity, is recognized as an important contributor to suicide. We examined the association of individual-and community-level social capital with suicidal ideation after adjusting for social support among older adults living in the community. Methods: In August 2010 we sent questionnaires to all residents aged 65 years and older living in 3 rural municipalities (N = 21,232) in Okayama Prefecture, Japan; 13,919 questionnaires were returned (response rate: 65.6%). The final analysis included 10,094 participants. The outcome variable was suicidal ideation. Exposure variables were individual-level mistrust and lack of reciprocity (level 1), and the aggregated responses of these variables from 35 communities in the municipalities (level 2). Covariates included age, sex, educational attainment, marital status, the number of cohabitants, years of residence, self-rated socioeconomic status, disability, social support, and psychological distress. Multilevel logistic regression analysis was performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Results: After adjusting for social support and psychological distress, we found that mistrust and lack of reciprocity were only associated with suicidal ideation at the individual level. Stratified analysis showed that among subjects with psychological distress, mistrust was associated with suicidal ideation at individual (OR: 1.88; 95% CI: 1.42-2.51) and community levels (OR: 1.98; 95% CI: 1.02-3.81). Conclusions: Our findings show that individual-and community-level social capital is a possible protective factor for suicidal ideation, particularly for people with psychological distress.