Unplanned and Planned Suicide Behavior in China

描述(由申请人提供)：现有数据表明，计划外行为和计划外行为具有不同的相关性，可能需要不同的预防策略。然而，数据受到小样本、不受控制的数据、不充分的规划措施以及自杀未遂(相对于自杀)的样本的限制。拟议的研究在一项严格的对照研究中克服了这些限制。目的1检验以下假设：非计划(相对于计划)的自杀行为与更大的急性应激有关，更有可能在发生严重生活事件之前发生，但与较低的抑郁症状和较低的慢性应激有关。Aim 2测试了以下假设：意外行为与较年轻的年龄和农村(相对于城市)居住地有关。在目标3中，将构建自杀未遂的多变量模型，并基于该模型识别计划内和计划外自杀企图之间的关联。为了达到这些目的，在二次分析拨款中，将分析两个大型病例对照数据集：1)519例自杀死者和536例非自杀伤害死亡对照；2)312例自杀未遂者和312例活着的社区对照。所有数据均收集于中国(Phillips，PI)。收集了关于自杀及其伤害死亡控制的数据，以反映一般人口的社会人口学。自杀未遂者来自一家综合医院，对照组是性别、年龄和地点匹配的社区成员。数据是用严格的方法收集的。这些数据集将被单独分析，尽管使用相同的基本方法--无序多项Logistic回归。这项研究提供了一次难得的机会来研究自杀未遂，尤其是自杀的异质性，这对自杀率非常高的中国以及作为自杀计划的连续统一体的美国的预防具有启示意义，以及许多超越文化的危险因素。

DESCRIPTION (provided by applicant): Available data indicate that unplanned versus planned acts have different correlates and may require different prevention strategies. However, data are limited by small samples, uncontrolled data, inadequate measures of planning, and samples of attempted suicide (as opposed to suicide). The proposed study overcomes these limitations in a rigorous, controlled investigation. Aim 1 tests the hypotheses that unplanned (versus planned) acts of suicidal behavior are associated with greater acute stress, are more likely to be preceded by a severe life event, but are associated with lower depressive symptoms and lower chronic stress. Aim 2 tests the hypotheses that unplanned acts are associated with younger age and rural (versus urban) residency. In Aim 3, a multivariate model of attempted suicide will be constructed, and correlates of planned versus unplanned suicide attempts will be identified based on the model. To address these aims, in this secondary analysis grant, two large, case-control datasets will be analyzed: 1) 519 suicide decedents and 536 nonsuicide injury death controls, and 2) 312 suicide attempters and 312 living community controls. All data were gathered in China (Phillips, PI). Data on suicides and their injury death controls were gathered to reflect the sociodemography of the general population. Suicide attempters were sampled from a general hospital, and controls were community members matched for gender, age, and location. Data were gathered using rigorous methods. The data sets will be analyzed separately although with the same basic approach - unordered multinomial logistic regression. The study represents a rare opportunity to examine the heterogeneity in attempted suicide and particularly in suicide, with implications for prevention in China where the suicide rate is very high, but also in the U.S. as a continuum of suicidal planning, as well as numerous risk factors, transcend cultures.