Prevalence and Family-Related Factors Associated With Suicidal Ideation, Suicide Attempts, and Self-injury in Children Aged 9 to 10 Years
Prevalence and Family-Related Factors Associated With Suicidal Ideation, Suicide Attempts, and Self-injury in Children Aged 9 to 10 Years
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DOI：
10.1001/jamanetworkopen.2019.20956
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发表时间：
2020-02-07
影响因子：
13.8
通讯作者：
Barch, Deanna M.
中科院分区：
文献类型：
--
作者：
DeVille, Danielle C.;Whalen, Diana;Barch, Deanna M.
虽然自杀是美国儿童死亡的主要原因，儿童自杀率稳步上升，但人们对儿童自杀意念和行为知之甚少。目的评估青春期前儿童自杀意念、自杀未遂和非自杀性自伤的总体患病率，以及与自杀和自伤相关的家庭相关因素。设计、设置和参与者：横断面研究，对青少年大脑认知发展（ABCD）研究的基线样本进行回顾性分析。这项多中心调查采用了流行病学知情的学校招募策略，考虑了21个ABCD站点和整个美国的人口组成。样本包括9至10岁的儿童及其照顾者。主要结局和测量：儿童及其看护者在儿童情感障碍和精神分裂症量表的计算机化版本中报告的终生自杀意念、自杀企图和非自杀性自伤。结果共有11814名9 ~ 10岁儿童（47.8%为女孩，52.0%为白色）及其照顾者被纳入研究。经分层后社会人口学加权后，近似患病率为6.4%（95% CI，5.7%-7.3%）终生被动自杀意念史; 4.4%（95% CI，3.9%-5.0%）非特异性主动自杀意念; 2.4%（95% CI，2.1%-2.7%）的方法、意图或计划的主动意念; 1.3%（95% CI，1.0%-1.6%）的自杀企图; 9.1%（95% CI，8.1-10.3）的非自杀性自伤。经性别、家族史、内在和外在问题以及相关心理社会变量的协变后，高家庭冲突与自杀意念显著相关（比值比[OR]，1.12; 95% CI，1.07-1.16）和非自杀性自伤（OR，1.09; 95%CI，1.05-1.14），父母监护程度低与思维能力显著相关（OR，0.97; 95%CI，0.95-0.98），尝试（OR，0.91; 95%CI，0.86-0.97），和非自杀性自伤（OR，0.95; 95%CI，0.93-0.98）;这些结果在内部复制后一致。大多数儿童自杀和自伤的报告要么是未知的，要么没有报告他们的照顾者。结论和相关性本研究表明，家庭因素，包括高家庭冲突和低父母的监督，与自杀和自我伤害的儿童。未来的研究和正在进行的预防和干预工作可能会受益于家庭因素的检查。这项横断面研究估计了9至10岁儿童自杀意念、自杀企图和非自杀性自伤的总体患病率，并检查了家庭相关因素与自杀和自伤的关联。问题青春期前儿童自杀的普遍程度如何，某些家庭因素是否与儿童的自杀倾向有关？结果在11814名儿童和他们的照顾者从青少年大脑认知发展研究的基线样本的横断面分析，自杀意念和行为的发生率在青春期前的儿童高于先前估计。在对相关的社会人口统计学和临床变量进行统计学控制后，家庭冲突和父母监控不足与儿童的自杀倾向相关。这些发现强调了家庭因素与儿童自杀意念和行为之间的联系。
Importance Although suicide is a leading cause of death for children in the United States, and the rate of suicide in childhood has steadily increased, little is known about suicidal ideation and behaviors in children. Objective To assess the overall prevalence of suicidal ideation, suicide attempts, and nonsuicidal self-injury, as well as family-related factors associated with suicidality and self-injury among preadolescent children. Design, Setting, and Participants Cross-sectional study using retrospective analysis of the baseline sample from the Adolescent Brain Cognitive Development (ABCD) study. This multicenter investigation used an epidemiologically informed school-based recruitment strategy, with consideration of the demographic composition of the 21 ABCD sites and the United States as a whole. The sample included children aged 9 to 10 years and their caregivers. Main Outcomes and Measures Lifetime suicidal ideation, suicide attempts, and nonsuicidal self-injury as reported by children and their caregivers in a computerized version of the Kiddie Schedule for Affective Disorders and Schizophrenia. Results A total of 11814 children aged 9 to 10 years (47.8% girls; 52.0% white) and their caregivers were included. After poststratification sociodemographic weighting, the approximate prevalence rates were 6.4% (95% CI, 5.7%-7.3%) for lifetime history of passive suicidal ideation; 4.4% (95% CI, 3.9%-5.0%) for nonspecific active suicidal ideation; 2.4% (95% CI, 2.1%-2.7%) for active ideation with method, intent, or plan; 1.3% (95% CI, 1.0%-1.6%) for suicide attempts; and 9.1% (95% CI, 8.1-10.3) for nonsuicidal self-injury. After covarying by sex, family history, internalizing and externalizing problems, and relevant psychosocial variables, high family conflict was significantly associated with suicidal ideation (odds ratio [OR], 1.12; 95% CI, 1.07-1.16) and nonsuicidal self-injury (OR, 1.09; 95% CI, 1.05-1.14), and low parental monitoring was significantly associated with ideation (OR, 0.97; 95% CI, 0.95-0.98), attempts (OR, 0.91; 95% CI, 0.86-0.97), and nonsuicidal self-injury (OR, 0.95; 95% CI, 0.93-0.98); these findings were consistent after internal replication. Most of children's reports of suicidality and self-injury were either unknown or not reported by their caregivers. Conclusions and Relevance This study demonstrates the association of family factors, including high family conflict and low parental monitoring, with suicidality and self-injury in children. Future research and ongoing prevention and intervention efforts may benefit from the examination of family factors.This cross-sectional study estimates the overall prevalence of suicidal ideation, suicide attempts, and nonsuicidal self-injury among children aged 9 to 10 years and examines the association of family-related factors with suicidality and self-injury.Question How common is suicidality among preadolescent children, and are certain family factors associated with children's suicidality? Findings In a cross-sectional analysis of 11814 children and their caregivers from the baseline sample from the Adolescent Brain Cognitive Development study, the prevalence of suicidal ideation and behaviors among preadolescent children was higher than previously estimated. Family conflict and low parental monitoring were associated with children's suicidality after statistically controlling for relevant sociodemographic and clinical variables. Meaning These findings highlight the association between family factors and children's suicidal ideation and behaviors.