Adolescent Suicidal Behavior and Substance Use: Developmental Mechanisms.
Adolescent Suicidal Behavior and Substance Use: Developmental Mechanisms.
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DOI：
10.4137/sart.s1044
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发表时间：
2008-10-31
期刊：
影响因子：
--
通讯作者：
Dougherty DM
中科院分区：
文献类型：
--
作者：
Dawes MA;Mathias CW;Richard DM;Hill-Kapturczak N;Dougherty DM
青少年自杀行为和药物使用令人不安地普遍。研究表明，青少年自杀行为和物质使用的一些病因机制重叠，但缺乏对这些行为及其因果基础之间复杂关系的清晰理解。越来越多的证据和素质模型强调冲动控制作为青少年自杀和物质使用行为的近端风险因素的重要性。本文献综述扩展了目前关于青少年自杀行为和物质使用之间关系的理论：（1）研究不良冲动控制、应激性生活事件、物质使用行为和生物学因素如何、何时以及在何种程度上影响青少年的发展;（2）提出了这些危险因素相互作用增加自杀行为和物质使用风险的因果机制;（3）提出具体的新假设，将素质模型扩展到有自杀和物质使用风险的青少年。更具体地说，提出了新的假设，预测压力生活事件和5-HT失调的遗传标记之间的双向关系;物质使用行为和冲动;物质使用行为和自杀企图。区分自杀和物质使用行为的不同发展轨迹的重要性，以及特定风险和保护机制的影响进行了讨论。建议使用新的统计方法，提供潜在的增长曲线和潜在的类模型的比较，以确定自杀行为和物质使用的发展轨迹的差异。从这些前瞻性纵向方法中获得的知识应能更好地了解特定风险和保护因素影响自杀行为和物质使用结局的时间、持续时间和程度。反过来，这些研究的结果应该为将来进行治疗和预防研究的研究人员提供信息。
Adolescent suicidal behaviors and substance use are disturbingly common. Research suggests overlap of some of the etiological mechanisms for both adolescent suicidal behavior and substance use, yet clear understanding of the complex relations between these behaviors and their causal underpinnings is lacking. A growing body of evidence and a diathesis model highlight the importance of impulse control as a proximal risk factor for adolescent suicidal and substance use behaviors. This literature review extends current theory on the relationships between adolescent suicidal behavior and substance use by: (1) examining how, when, and to what extent adolescent development is affected by poor impulse control, stressful life events, substance use behavior, and biological factors; (2) presenting proposed causal mechanisms by which these risk factors interact to increase risk for suicidal behaviors and substance use; and (3) proposing specific new hypotheses to extend the diathesis model to adolescents at risk for suicide and substance use. More specifically, new hypotheses are presented that predict bidirectional relationships between stressful life events and genetic markers of 5-HT dysregulation; substance use behavior and impulsivity; and substance use behavior and suicide attempts. The importance of distinguishing between different developmental trajectories of suicidal and substance use behaviors, and the effects of specific risk and protective mechanisms are discussed. Use of new statistical approaches that provide for the comparison of latent growth curves and latent class models is recommended to identify differences in developmental trajectories of suicidal behavior and substance use. Knowledge gained from these prospective longitudinal methods should lead to greater understanding on the timing, duration, and extent to which specific risk and protective factors influence the outcomes of suicidal behavior and substance use. In turn, findings from these studies should inform researchers who conduct future treatment and prevention studies.