Impact of childhood abuse on suicide-related behavior: Analysis using marginal structural models.
Impact of childhood abuse on suicide-related behavior: Analysis using marginal structural models.
复制标题
童年虐待对自杀相关行为的影响：使用边际结构模型进行分析。
DOI：
10.1016/j.jad.2018.02.034
复制
发表时间：
2018
影响因子：
6.6
通讯作者：
N. Kawakami
中科院分区：
文献类型：
--
作者：
E. Obikane;T. Shinozaki;D. Takagi;N. Kawakami
背景儿童期虐待与成人自杀行为有关，部分是由精神障碍引起的。然而，儿童期虐待的直接影响不确定，因为同样的危险因素是精神障碍和自杀行为的中介和混杂因素。本研究的目的是使用边际结构模型估计非精神障碍中介的儿童期虐待对自杀行为的直接影响。方法我们使用了日本成年人在东京和邻近县(日本关于分层、健康、收入和邻里的研究)的横断面数据。我们绘制了儿童虐待和自杀行为的因果图，并定义了暴露(儿童虐待)、混杂因素(年龄、儿童社交特征)、中介因素(精神障碍)、危险因素(应对、吸烟、饮酒、教育、身体健康)和结果(自杀行为)。结果在1776名男性和2016名女性参与者中，儿童期虐待对自杀行为的总体影响显著。身体虐待与自杀意念有关(风险比：男性2.11[95%可信区间：1.59-2.82]，女性2.15[1.69-2.72])，自杀计划(风险比：男性2.18[1.21-3.92]，女性2.14[1.24-3.74])，自杀未遂(风险比：男性2.11[1.14-5.10]，儿童虐待的测量是根据过去经历的自我报告进行的。结论我们的研究表明，儿童期虐待与成人自杀行为有关，其直接影响不是由精神障碍介导的。
BackgroundChildhood abuse is associated with adult suicidal behaviors, partially mediated by mental disorders. However, the direct effect of childhood abuse not mediated by mental disorders is uncertain because the same risk factors serve as mediators and confounders of mental disorders and suicidal behaviors. The aim of the study was to estimate the direct effect of childhood abuse not mediated by mental disorders on suicidal behaviors using marginal structural models.MethodsWe used cross-sectional data of Japanese adults in Tokyo and neighboring prefectures (The Japanese Study on Stratification, Health, Income, and Neighborhood). We developed a causal diagram of childhood abuse and suicidal behaviors, and defined exposures (childhood abuse), confounders (age, childhood social characteristics), mediators (mental disorders), risk factors (coping, smoking, alcohol consumption, education, physical health), and outcome (suicidal behaviors). We estimated the direct effect of childhood abuse according to sex using inverse-probability weighting at 2 points and compared to total and direct effects estimated by conventional regression models.ResultsOf 1776 male and 2016 female participants, childhood abuse showed significant total effects on suicidal behaviors. Physical abuse was associated with suicidal ideation (risk ratio: males 2.11 [95% confidence interval: 1.59–2.82], females 2.15 [1.69–2.72]), suicidal plan (risk ratio: males 2.18 [1.21–3.92], females 2.14 [1.24–3.74]), and suicidal attempt (risk ratio: males 2.11 [1.14–5.10], females 4.79 [2.93–7.83]) through direct effect.LimitationsChildhood abuse was measured according to self-report of the past experiences.ConclusionsOur study suggests that childhood abuse is associated with adult suicidal behaviors through direct effects not mediated by mental disorders.
童年身体虐待和中年身体健康：测试多途径生命历程模型。
DOI：
10.1016/j.socscimed.2009.04.011
发表时间：
2009
期刊：
Social science & medicine (1982)
影响因子：
--
作者：
Springer,KristenW
通讯作者：
Springer,KristenW