大学生2年随访期间自杀意念与自杀尝试流行现状及影响因素分析
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摘要
目的了解大学生2年在校期间自杀意念与自杀尝试流行现状及影响因素,为制定更有针对性的自杀预防体系提供参考。方法采用整群抽样方法,抽取广州某医科院校学生2 291名,采用自编自杀态度调查、个体自杀风险调查、个体健康状态调查与青少年生存理由量表(Reasons of Living Inventory for Adolescents,RFL-A)、五因素正念度量表(Five Facet Mindfulness Questionnaire,FFMQ)以及自杀行为问卷—修订版(Suicidal Behaviors Questionnaire-Revised,SBQ-R)进行追踪研究,2次施测时间分别是2014年9月和2016年9月。结果大学生在校2年间自杀意念流行率为6.33%,自杀尝试流行率为2.01%;Logistic回归分析显示,在校2年间患有精神疾病(OR=10.31,95%CI=3.26～32.61)、对自杀持接受态度(OR=1.66,95%CI=1.21～2.27)、入校时自杀风险高(OR=1.41,95%CI=1.29～1.54)的大学生更容易产生自杀意念,而在校2年间患有重大躯体疾病(OR=0.23,95%CI=1.38～13.95)、在校2年间患有精神疾病(OR=8.68,95%CI=2.10～35.94)、对自杀持接受态度(OR=1.19,95%CI=1.17～3.13)、入校时自杀风险高(OR=1.34,95%CI=1.17～1.53)的大学生更容易产生自杀尝试。结论既往自杀风险高、对自杀持接受态度以及精神、身体状态较差的大学生是自杀意念与自杀尝试的高危人群。应采取针对性的自杀预防措施。
Objective To establish a more targeted suicide prevention system by exploring the prevalence and influence factors of suicidal ideation and suicidal attempt among college students during the 2-year follow-up, and to provide a reference for making more targeted system to prevent suicidal attempt. Methods The pre-test and the post-test were conducted among 2 291 college students by using self-made suicidal attitude survey, self-made suicide risk survey during college, self-made health status survey during college, Reasons of Living Inventory for Adolescents( RFL-A),Five Facet Mindfulness Questionnaire( FFMQ) and Suicidal Behaviors Questionnaire-Revised( SBQ-R) in September 2014 and September 2016, respectively. Results The prevalence rate of suicidal ideation and attempt was 6.33% and 2.01%, respectively. Logistic regression analysis showed that students who had the history of mental illness during the college( OR = 10.31, 95%CI = 3.26-32.61), who could accept suicide( OR = 1.66, 95%CI =1.21-2.27) and those who had higher suicidal risk( OR = 1.41, 95% CI = 1.29-1.54) were more likely to have suicidal ideation,while students who had the history of physical illness( OR = 0.23, 95%CI = 1.38-13.95) and mental illness( OR = 8.68, 95% CI =2.10-35.94), who could accept suicide( OR = 1.19, 95%CI = 1.17-3.13) and those who had higher suicidal risk( OR = 1.34, 95%CI = 1.17-1.53) had higher risk of suicidal attempt. Conclusion College students who have higher suicidal risk in the past, who could accept suicide and those who are in the poor mental and physical condition are at higher risk of suicidal ideation and suicide attempt, of which the physical disease plays a role in the transition from the suicidal ideation to the suicide attempt. The targeted measures of prevention and control should be taken.
Objective To establish a more targeted suicide prevention system by exploring the prevalence and influence factors of suicidal ideation and suicidal attempt among college students during the 2-year follow-up, and to provide a reference for making more targeted system to prevent suicidal attempt. Methods The pre-test and the post-test were conducted among 2 291 college students by using self-made suicidal attitude survey, self-made suicide risk survey during college, self-made health status survey during college, Reasons of Living Inventory for Adolescents( RFL-A),Five Facet Mindfulness Questionnaire( FFMQ) and Suicidal Behaviors Questionnaire-Revised( SBQ-R) in September 2014 and September 2016, respectively. Results The prevalence rate of suicidal ideation and attempt was 6.33% and 2.01%, respectively. Logistic regression analysis showed that students who had the history of mental illness during the college( OR = 10.31, 95%CI = 3.26-32.61), who could accept suicide( OR = 1.66, 95%CI =1.21-2.27) and those who had higher suicidal risk( OR = 1.41, 95% CI = 1.29-1.54) were more likely to have suicidal ideation,while students who had the history of physical illness( OR = 0.23, 95%CI = 1.38-13.95) and mental illness( OR = 8.68, 95% CI =2.10-35.94), who could accept suicide( OR = 1.19, 95%CI = 1.17-3.13) and those who had higher suicidal risk( OR = 1.34, 95%CI = 1.17-1.53) had higher risk of suicidal attempt. Conclusion College students who have higher suicidal risk in the past, who could accept suicide and those who are in the poor mental and physical condition are at higher risk of suicidal ideation and suicide attempt, of which the physical disease plays a role in the transition from the suicidal ideation to the suicide attempt. The targeted measures of prevention and control should be taken.
引文
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[14]GIBB B E,ANDOVER M S,BEACH S R H.Suicidal ideation and attitudes toward suicide[J].Suic Life-Threat Behav,2015,36(1):12-18.
[15]吴明证,方霞,孙晓玲,等.情绪、态度与行为的关系:基于APE模型[J].心理科学,2013(3):706-710.
[16]MONNIN J,THIEMARD E,VANDEL P,et al.Sociodemographic and psychopathological risk factors in repeated suicide attempts:gender differences in a prospective study[J].J Aff Dis,2012,136(1/2):35-43.
[17]刘宝鹏.农村自杀未遂结局及其相关因素的前瞻性队列研究[D].济南:山东大学,2017.
[18]艾明.重庆市大学生自杀未遂及相关因素研究[D].重庆:重庆医科大学,2008.
[2]PHILLIPS M R,LI X,ZHANG Y,et al.Suicide rates in China[J].Lancet,2002,359(9325):2274-2275.
[3]KLONSKY E D,MAY A M,SAFFER B Y.Suicide,suicide attempts,and suicidal ideation[J].Annu Rev Clin Psycho,2016,12(1):307-330.
[4]OSMAN A,DOWNS W R,KOPPER B A,et al.The reasons for Living Inventory for Adolescents(RFL-A):development and psychometric properties[J].J Clin Psychol,1998,54(8):1063.
[5]赵久波.中国大学生自杀行为流行现况及三因素预警系统的初步研究[D].广州:南方医科大学,2013.
[6]BAER R A,SMITH G T,HOPKINS J,et al.Using self-report assessment methods to explore facets of mindfulness[J].Assessment,2006,13(1):27-45.
[7]DENG Y Q,LIU X H,RODRIGUEZ M A,et al.The Five Facet Mindfulness Questionnaire:psychometric properties of the Chinese version[J].Mindfulness,2011,2(2):123-128.
[8]OSMAN A,BAGGE C L,GUTIERREZ P M,et al.The Suicidal Behaviors Questionnaire-Revised(SBQ-R):validation with clinical and nonclinical samples[J].Assessment,2001,8(4):443-454.
[9]肖水源,周亮,徐慧兰.危机干预与自杀预防(二):自杀行为的概念与分类[J].临床精神医学杂志,2005,15(5):298-299.
[10]和红,杨洋.大学生抑郁自杀意念及影响因素的路径分析[J].中国学校卫生,2015,36(1):80-83.
[11]葛瑞钦,郑德伟,张增国,等.大学生自杀未遂与攻击性抑郁焦虑的相关分析[J].中国学校卫生,2016,37(8):1260-1263.
[12]CAVANAGH J T,CARSON A J,SHARPE M,et al.Psychological autopsy studies of suicide:a systematic review[J].Psychol Med,2003,33(3):395.
[13]PHILLIPS M R,YANG G,ZHANG Y,et al.Risk factors for suicide in China:a national case-control psychological autopsy study[J].Lancet,2002,360(9347):1728.
[14]GIBB B E,ANDOVER M S,BEACH S R H.Suicidal ideation and attitudes toward suicide[J].Suic Life-Threat Behav,2015,36(1):12-18.
[15]吴明证,方霞,孙晓玲,等.情绪、态度与行为的关系:基于APE模型[J].心理科学,2013(3):706-710.
[16]MONNIN J,THIEMARD E,VANDEL P,et al.Sociodemographic and psychopathological risk factors in repeated suicide attempts:gender differences in a prospective study[J].J Aff Dis,2012,136(1/2):35-43.
[17]刘宝鹏.农村自杀未遂结局及其相关因素的前瞻性队列研究[D].济南:山东大学,2017.
[18]艾明.重庆市大学生自杀未遂及相关因素研究[D].重庆:重庆医科大学,2008.