Psychological characteristics, stressful life events and deliberate self-harm: findings from the Child & Adolescent Self-harm in Europe (CASE) Study
Psychological characteristics, stressful life events and deliberate self-harm: findings from the Child & Adolescent Self-harm in Europe (CASE) Study
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DOI：
10.1007/s00787-011-0210-4
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发表时间：
2011-10-01
影响因子：
6.4
通讯作者：
Arensman, Ella
中科院分区：
文献类型：
--
作者：
Madge, Nicola;Hawton, Keith;Arensman, Ella
有证据表明，心理特征和压力性生活事件是青少年故意自残的促成因素。这些联系，以及自我伤害和心理健康和生活事件之间的剂量反应关系的可能性，在七个国家的学校为基础的研究的背景下进行了调查。在比利时、英格兰、匈牙利、爱尔兰、荷兰、挪威和澳大利亚的中学，有3万多人，主要是15岁和16岁的奥尔兹，完成了匿名问卷调查。学生们被要求报告自我伤害的想法和情节，完成抑郁和焦虑症状，冲动和自尊的量表，并指出他们生活中的压力事件。自残的程度和频率是根据他们是否想过伤害自己或报告单一或多个自残事件来判断的。多项逻辑回归评估在何种程度上区分不同的自我伤害历史的青少年之间的心理特征和压力的生活事件。自我伤害史的严重程度增加与更大的抑郁，焦虑和冲动和更低的自尊以及所有十种生活事件类别的患病率增加有关。女性、较高冲动性、经历他人自杀或自残、身体虐待或性虐待、对性取向的担忧独立地区分了单次发作的自伤者和只有自伤想法的青少年。女性，更高的抑郁症，更低的自尊，经历自杀或自我伤害的其他人，和麻烦与警察独立区分多个-从单集自我伤害。这些发现加强了心理特征和压力生活事件在青少年自我伤害中的重要性，但仍然表明，某些因素比其他因素更有可能受到牵连。
There is evidence to suggest that both psychological characteristics and stressful life events are contributory factors in deliberate self-harm among young people. These links, and the possibility of a dose-response relationship between self-harm and both psychological health and life events, were investigated in the context of a seven-country school-based study. Over 30,000, mainly 15 and 16 year olds, completed anonymous questionnaires at secondary schools in Belgium, England, Hungary, Ireland, the Netherlands, Norway and Australia. Pupils were asked to report on thoughts and episodes of self-harm, complete scales on depression and anxiety symptoms, impulsivity and self-esteem and indicate stressful events in their lives. Level and frequency of self-harm was judged according to whether they had thought about harming themselves or reported single or multiple self-harm episodes. Multinomial logistic regression assessed the extent to which psychological characteristics and stressful life events distinguished between adolescents with different self-harm histories. Increased severity of self-harm history was associated with greater depression, anxiety and impulsivity and lower self-esteem and an increased prevalence of all ten life event categories. Female gender, higher impulsivity and experiencing the suicide or self-harm of others, physical or sexual abuse and worries about sexual orientation independently differentiated single-episode self-harmers from adolescents with self-harm thoughts only. Female gender, higher depression, lower self-esteem, experiencing the suicide or self-harm of others, and trouble with the police independently distinguished multiple- from single-episode self-harmers. The findings reinforce the importance of psychological characteristics and stressful life events in adolescent self-harm but nonetheless suggest that some factors are more likely than others to be implicated.