The longitudinal relationship between dissociative symptoms and self-harm in adolescents: a population-based cohort study
The longitudinal relationship between dissociative symptoms and self-harm in adolescents: a population-based cohort study
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DOI：
10.1007/s00787-023-02183-y
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发表时间：
2023-03-08
影响因子：
6.4
通讯作者：
Kasai，Kiyoto
中科院分区：
文献类型：
--
作者：
Tanaka，Riki;Ando，Shuntaro;Kasai，Kiyoto
以往的研究报道分离症状（DIS）与青少年自残（SH）相关。然而，这些研究大多是横断面的，这限制了对它们理论关系的理解。我们的目的是调查一般青少年人群中DIS和SH之间的纵向关系。我们使用的数据来自东京青少年队列研究（N= 3007）。在第1和第2次（T1和T2）（分别为12岁和14岁）评估DIS和SH。使用家长报告儿童行为检查表（CBCL）评估DIS，严重分离症状（SDIS）被定义为得分高于前10百分位。采用自我报告问卷对1年内的SH经历进行评估。采用回归分析检验了DIS与SH之间的纵向关系。使用逻辑回归分析，我们进一步调查了由于持续的SDIS而在T2发生SH的风险，反之亦然。T1时的DIS倾向于预测T2时的SH（比值比（OR） 1.11, 95% CI 0.99 ~ 1.25,p= 0.08），而T1时的SH不能预测T2时的DIS （B = - 0.03, 95% CI - 0.26 ~ 0.20,p= 0.81）。与没有SDIS的青少年相比，持续性SDIS患者T2时发生SH的风险增加（OR 2.61, 95% CI 1.28 ~ 5.33,p= 0.01）。DIS倾向于预测未来的SH，但SH不能预测未来的DIS。DIS可能是预防青少年SH的目标。应高度关注患有SDIS的青少年，因为他们发生性生殖疾病的风险增加。
Previous studies have reported that dissociative symptoms (DIS) are associated with self-harm (SH) in adolescents. However, most of these studies were cross-sectional, which limits the understanding of their theoretical relationship. We aimed to investigate the longitudinal relationship between DIS and SH in the general adolescent population. We used data from the Tokyo Teen Cohort study (N= 3007). DIS and SH were assessed at times 1 and 2 (T1 and T2) (12 years of age and 14 years of age, respectively). DIS were assessed using the parent-report Child Behavior Checklist (CBCL), and severe dissociative symptoms (SDIS) were defined as a score above the top 10th percentile. The experience of SH within 1 year was assessed by a self-report questionnaire. The longitudinal relationship between DIS and SH was examined using regression analyses. Using logistic regression analyses, we further investigated the risk for SH at T2 due to persistent SDIS and vice versa. DIS at T1 tended to predict SH at T2 (odds ratio (OR) 1.11, 95% CI 0.99 to 1.25,p= 0.08), while SH at T1 did not predict DIS at T2 (B = − 0.03, 95% CI − 0.26 to 0.20,p= 0.81). Compared with adolescents without SDIS, those with persistent SDIS had an increased risk of SH at T2 (OR 2.61, 95% CI 1.28 to 5.33,p= 0.01). DIS tended to predict future SH, but SH did not predict future DIS. DIS may be a target to prevent SH in adolescents. Intensive attention should be given to adolescents with SDIS due to their increased risk of SH.