山西省大学生自杀意念社会心理流行病学研究
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摘要
目的 了解山西省大学生自杀意念的基本分布情况，研究自杀意念的社会心理影响因素及其作用大小，并探讨部分生理生化指标和自杀意念的关系。
方法 采用多阶段分层随机整群抽样方法调查山西省普通高校一、二、三年级本专科大学生4882名，应用青少年生活事件量表、防御方式问卷、社会支持评定量表、SCL—90症状自评量表、简易应对方式问卷、自杀态度问卷、艾森克人格问卷，通过多元logistic回归分析和通径分析方法来研究自杀意念的影响因素及其作用大小。在先前研究的基础上，选取自杀意念组(112例)和非自杀意念组(128例)，应用北京博达技术研究所生产的DDX-200型电脑多功能心理生理能力测试仪测定生理心理指标，并在两组内分别测定其血清胆固醇值。
结果 大学生自杀意念发病率为13.8％。男性、医学类、二类学校比其相应女性、教育类、一类学校的学生自杀意念发病率高。生活事件是自杀意念的诱发因素但不起主要作用，心理疾病倾向则是产生自杀意念的主要影响因素。人格等因素总是直接或间接通过应对、防御等中间变量对自杀意念产生影响作用。血清胆固醇值、利手臂稳定性得
、、、~
山万医科大学硕士学位论丈
分与自杀意念呈负相关，视觉简单反应时的平均时间和错误次数与自
杀意念呈正相关。
结论对男性、医学类及教育档次低等的高校学生应教育其排除自
卑心理，增加课外活动。人格是自杀意念的基础性因素，负性生活事
件对自杀意念作用虽小却起到“扳机”作用，而心理疾病倾向则是自
杀意念的直接作用因素，三者依次递进有机整合最终产生自杀意念。
血清胆固醇值、利手手臂稳定性得分、视觉简单反应时中的平均时间
和错误次数与自杀意念有相关关系，其内在联系仍需进一步探讨。
Objective To evaluate the distribution of population,
psycho social factors associated with suicidal ideation, and relations between some physiological indexes and suicidal ideation of the undergraduates in Shanxi Province.
Method 4882 undergraduates from 6 universities in Shanxi
Province were investigated with multistage stratified random cluster sampling. Factors associated with suicidal ideation were analyzed with Logistic Regress and Path Analysis by Adolescent Self-Rate Life Events Check List (ASLEC), DSQ, Social Support Rating Scale, SCL-90, Simple Coping Modes Questionnaire, Suicide Attitude Questionnaire (QSA), EPQ. Some physiological indexes of 112 undergraduates with suicidal ideation and 128 controls were measured by DDX-200, and the serum cholesterol by CHOD-PAP at the same time.
Results 13.8% of subjects had suicidal ideation. The male, medical and ordinary college's students were the high-risk population with suicidal ideation. Life events were inducing
but not main factors of suicidal ideation, psychological diseased tendency was the first main factor. Personality affected directly or indirectly suicidal ideation through coping and defense style. Average time, error frequency of simple visual reaction time correlated with suicidal ideation positively, whereas serum cholesterol value and scores of facilitated arm stability experiment negatively.
Conclusions Self-abasement should be taken down , and
recreational action increased in male, medical students. Of the factors related to suicidal ideation, personality was sta-
bilized factor, life events were minor but "triggering" agents,
psychological diseased tendency was the principal factor. Above three factors were intergraded and resulted in suicidal ideation in chorus. The correlation between suicidal ideation and its physiological indexes such as serum cholesterol value, scores of facilitated arm stability experiment, and average time and error frequency of visual simple reaction time should be further studied.
方法 采用多阶段分层随机整群抽样方法调查山西省普通高校一、二、三年级本专科大学生4882名，应用青少年生活事件量表、防御方式问卷、社会支持评定量表、SCL—90症状自评量表、简易应对方式问卷、自杀态度问卷、艾森克人格问卷，通过多元logistic回归分析和通径分析方法来研究自杀意念的影响因素及其作用大小。在先前研究的基础上，选取自杀意念组(112例)和非自杀意念组(128例)，应用北京博达技术研究所生产的DDX-200型电脑多功能心理生理能力测试仪测定生理心理指标，并在两组内分别测定其血清胆固醇值。
结果 大学生自杀意念发病率为13.8％。男性、医学类、二类学校比其相应女性、教育类、一类学校的学生自杀意念发病率高。生活事件是自杀意念的诱发因素但不起主要作用，心理疾病倾向则是产生自杀意念的主要影响因素。人格等因素总是直接或间接通过应对、防御等中间变量对自杀意念产生影响作用。血清胆固醇值、利手臂稳定性得
、、、~
山万医科大学硕士学位论丈
分与自杀意念呈负相关，视觉简单反应时的平均时间和错误次数与自
杀意念呈正相关。
结论对男性、医学类及教育档次低等的高校学生应教育其排除自
卑心理，增加课外活动。人格是自杀意念的基础性因素，负性生活事
件对自杀意念作用虽小却起到“扳机”作用，而心理疾病倾向则是自
杀意念的直接作用因素，三者依次递进有机整合最终产生自杀意念。
血清胆固醇值、利手手臂稳定性得分、视觉简单反应时中的平均时间
和错误次数与自杀意念有相关关系，其内在联系仍需进一步探讨。
Objective To evaluate the distribution of population,
psycho social factors associated with suicidal ideation, and relations between some physiological indexes and suicidal ideation of the undergraduates in Shanxi Province.
Method 4882 undergraduates from 6 universities in Shanxi
Province were investigated with multistage stratified random cluster sampling. Factors associated with suicidal ideation were analyzed with Logistic Regress and Path Analysis by Adolescent Self-Rate Life Events Check List (ASLEC), DSQ, Social Support Rating Scale, SCL-90, Simple Coping Modes Questionnaire, Suicide Attitude Questionnaire (QSA), EPQ. Some physiological indexes of 112 undergraduates with suicidal ideation and 128 controls were measured by DDX-200, and the serum cholesterol by CHOD-PAP at the same time.
Results 13.8% of subjects had suicidal ideation. The male, medical and ordinary college's students were the high-risk population with suicidal ideation. Life events were inducing
but not main factors of suicidal ideation, psychological diseased tendency was the first main factor. Personality affected directly or indirectly suicidal ideation through coping and defense style. Average time, error frequency of simple visual reaction time correlated with suicidal ideation positively, whereas serum cholesterol value and scores of facilitated arm stability experiment negatively.
Conclusions Self-abasement should be taken down , and
recreational action increased in male, medical students. Of the factors related to suicidal ideation, personality was sta-
bilized factor, life events were minor but "triggering" agents,
psychological diseased tendency was the principal factor. Above three factors were intergraded and resulted in suicidal ideation in chorus. The correlation between suicidal ideation and its physiological indexes such as serum cholesterol value, scores of facilitated arm stability experiment, and average time and error frequency of visual simple reaction time should be further studied.
引文
1 翟书涛．21世纪自杀及其预防研究展望．临床精神医学杂志，2000，10(1)：41-43
2 Paulina FK. Psychological interventions for the suicide adolescent. Am J Psychotherapy, 1994, 48(1): 52-63
3 张克让，罗锦秀，韩向明等．大学新生自杀观念及其影响因素分析．中国心理卫生杂志，1999，13(3)：144-145
4 Deykin EY, Buka SL. Suicide ideation and attempts among chemically dependent adolescents. Am J public Health, 1994, 84(4): 634-639
5 翟书涛．自杀学的精神病学侧面．国外医学精神病学分册，1991，18(10)：1-6
6 崔玉花，方明昭，马长锁．大学生自杀者社会心理因素和临床特点．中国临床心理学杂志，1998，6(3)：177-179
7 张克让，罗锦绣，韩向明等．大学新生自杀观念及其影响因素分析．中国心理卫生杂志，1999，13(3)：144-145
8 梁军林，孙录，赵静波等．中学生自杀意念发生率及其影响因素分析．临床精神医学杂志，2000，10(3)：144-146
9 刘花清，费立鹏．1990-1994年中国城乡老年人自杀死亡问题分析．中国老年学杂志，1996，16(5)：264-265
10 邱育平，桂曼今．自杀意念少女3394例心理健康分析．中国学校
卫生，1997，18(1)：13—15
11 王玉翠，杨登平．服毒自杀60例社会心理因素分析．临床荟萃，1997，12(9)：413—415
12 杨云滨，刘筱娴．麻城农村妇女自杀危险因素的1：2配比病例—对照研究．意外伤害论文汇编，1999，11：66—81
13 翁正，张敬悬，刘庆桂等．农村自杀未遂者家庭环境、亲密度及适应性的对照研究．中国心理卫生杂志，1996，10(4)：148—150
14 童慧琦，徐俊冕，周云．抑郁障碍中抑郁、绝望与自杀行为研究．中国心理卫生杂志，1996，10(2)：84—86
15 赵汉清，崔庶，端义扬等．抑郁症患者的自杀行为与甲状腺激素对地塞米松的反应．中华精神科杂志，2000，33(2)：76
16 Alec Roy, Gunnar Rylander, Marco Sarchiapone. Genetic Studies of Suicidal Behavior. The Psychiatric Clinics of North America, 1997, 20(3) 595-611
17 Stanley M, Stanley B. Postmortem evidence for serotonin's role in suicide. J Olin Psychiatry, 1990, 51(suppl 4): 22
18 翟书涛．21世纪自杀及其预防研究展望．临床精神医学杂志，2000，10(1)：41-43
19 Biegon A. Anger, suicide ideation, and attempted suicide. Biol Psychiatry, 1991, 29: 199
20 Roy A, Karoum F, Pollack S. Marked reduction in indexes of dopamine metabolism among patients with depression who attempt suicide. Arch Gen Psychiatry, 1992, 49: 447
21 Schmidtte RE. Perceived abuse and neglect as risk factors for suicidal behavior in adolescent inpatients. Acta
Psychiatry Scand, 1989, 79: 276
22 Roy A. Suicidal ideation and acts of selfharm among dublin school children. Biol Psychiatry, 1992, 32: 812
23 Lindberg G, Bingefors K, Ranstam J, et al. Use of calcium channel blockers and risk of suicide: ecological findings confirmed in population based study. British medical journal, 1998, 316: 741-745
24 Hallas J. Evidence of depression provoked by cardiovascular medication: a prescription sequence symmetry analysis. Epidemiology, 1996, 7: 478-484
25 Nicholas R, Shayne N, Ronald D. Cohort study on calcium channel blockers, other cardiovascular agents, and the prevalence of depression. Br J clin Phormacol, 1999, 487: 230-233
26 Burless C, De Leo D. Methodological issues in community surveys of suicide ideators and attempters. Crisis, 2001, 22(3): 109-124
27 Hintikka J, Pesonen T, Saarinen P, et al. Suicidal ideation in the Finnish general population, A 12-month follow-up study. Soc Psychiatry Psychiatr Epidemiol, 2001, 36(12): 590-594
28 Osullivan M, Fitagerald M. Suicidal ideation and acts of selfharm among Dublin school children. J Adolesc, 1998, 21: 427
29 Burless C, De Leo D. Methodological issues in community
surveys of suicide ideators and attempters. Crisis, 2001, 22(3): 109-24
30 Supe AN. A study of stress in medical students at Seth G. S. Medical College. J Postgrad Med, 1998, 44(1): 1-6
31 余小鸣，籍红，周凯等．231名医学生自杀意向、自杀态度及相关作用的初步分析．中国学校卫生，1998，19(5)：375-376
32 梁宝勇，郭倩玉．关于应对的一些思考与实证研究Ⅲ．应对方式与人格．中国临床心理学，2000，8(1)：7-9
33 IiFeld FW. Coping Styles of Chicaga Adults: Effectiveness. Arch Gen psychiatry, 1980, 37: 1239-1243
34 Barrios LC, Everett SA, Simon TR, et al. Suicide ideation among US college students: Associations with other injury risk behaviors. J Am Coll Health, 2000, 48(5): 195-198
35 Thoits PA. Dimensions of life events that infkuence psychological distress: an evaluation and synthesis of the literature. Psychological Stress. Acdemic Press, 1983: 33-103
36 赵虎，周逸如，陈树乔等．大学生心理防御机制四年随访观察．中国心理卫生杂志，2001，15(4)278-280
37 Sarason JG. Assesing the impact of life change: development of life experiences survey, J of consulting and clinical Psychology, 1998, 46(2): 932
38 杨德森编．中国生活事件量表《行为医学》．湖南师大出版社，1990，285
39 张迪然，郑勇，屠礼红等．贵州省少数民族和汉族大学生的心理健康
及其个性因素分析．中华精神科杂志，1997，30(2)：103-106
40 Rubio CT, Lubin B. college students mental health: a person environment interactional analysis. J Clin Psychol, 1986, 42: 205-212
41 谢建文，赵惜辉，古国谋等．精神疾病患者自杀意念和企图与血清胆固醇水平的关系．临床精神医学杂志，1998，8(6)：344-345
42 高秀花．抑郁症患者的自杀意念与血清总胆固醇水平．山东精神医学，2001，14(1)：13～14
43 Carpenter KM, Hasin DS, Allison Db, et al. Relationships between obesity and DSM-Ⅳ major depressive disorder, suicide ideation, and suicide attempts: results from a general population study. American journal of public health, 2000, 90 (2): 251-257
44 陈仲庚编．实验临床心理学，第一版．北京大学出版社，1992，459-460
45 陈仲庚编．实验临床心理学，第一版．北京大学出版社，1992，45-51
46 Van Heeringen C. Suicide in adolescents. Int Clin Psychopharmacol, 2001, 16(Suppl2): 1-6
2 Paulina FK. Psychological interventions for the suicide adolescent. Am J Psychotherapy, 1994, 48(1): 52-63
3 张克让，罗锦秀，韩向明等．大学新生自杀观念及其影响因素分析．中国心理卫生杂志，1999，13(3)：144-145
4 Deykin EY, Buka SL. Suicide ideation and attempts among chemically dependent adolescents. Am J public Health, 1994, 84(4): 634-639
5 翟书涛．自杀学的精神病学侧面．国外医学精神病学分册，1991，18(10)：1-6
6 崔玉花，方明昭，马长锁．大学生自杀者社会心理因素和临床特点．中国临床心理学杂志，1998，6(3)：177-179
7 张克让，罗锦绣，韩向明等．大学新生自杀观念及其影响因素分析．中国心理卫生杂志，1999，13(3)：144-145
8 梁军林，孙录，赵静波等．中学生自杀意念发生率及其影响因素分析．临床精神医学杂志，2000，10(3)：144-146
9 刘花清，费立鹏．1990-1994年中国城乡老年人自杀死亡问题分析．中国老年学杂志，1996，16(5)：264-265
10 邱育平，桂曼今．自杀意念少女3394例心理健康分析．中国学校
卫生，1997，18(1)：13—15
11 王玉翠，杨登平．服毒自杀60例社会心理因素分析．临床荟萃，1997，12(9)：413—415
12 杨云滨，刘筱娴．麻城农村妇女自杀危险因素的1：2配比病例—对照研究．意外伤害论文汇编，1999，11：66—81
13 翁正，张敬悬，刘庆桂等．农村自杀未遂者家庭环境、亲密度及适应性的对照研究．中国心理卫生杂志，1996，10(4)：148—150
14 童慧琦，徐俊冕，周云．抑郁障碍中抑郁、绝望与自杀行为研究．中国心理卫生杂志，1996，10(2)：84—86
15 赵汉清，崔庶，端义扬等．抑郁症患者的自杀行为与甲状腺激素对地塞米松的反应．中华精神科杂志，2000，33(2)：76
16 Alec Roy, Gunnar Rylander, Marco Sarchiapone. Genetic Studies of Suicidal Behavior. The Psychiatric Clinics of North America, 1997, 20(3) 595-611
17 Stanley M, Stanley B. Postmortem evidence for serotonin's role in suicide. J Olin Psychiatry, 1990, 51(suppl 4): 22
18 翟书涛．21世纪自杀及其预防研究展望．临床精神医学杂志，2000，10(1)：41-43
19 Biegon A. Anger, suicide ideation, and attempted suicide. Biol Psychiatry, 1991, 29: 199
20 Roy A, Karoum F, Pollack S. Marked reduction in indexes of dopamine metabolism among patients with depression who attempt suicide. Arch Gen Psychiatry, 1992, 49: 447
21 Schmidtte RE. Perceived abuse and neglect as risk factors for suicidal behavior in adolescent inpatients. Acta
Psychiatry Scand, 1989, 79: 276
22 Roy A. Suicidal ideation and acts of selfharm among dublin school children. Biol Psychiatry, 1992, 32: 812
23 Lindberg G, Bingefors K, Ranstam J, et al. Use of calcium channel blockers and risk of suicide: ecological findings confirmed in population based study. British medical journal, 1998, 316: 741-745
24 Hallas J. Evidence of depression provoked by cardiovascular medication: a prescription sequence symmetry analysis. Epidemiology, 1996, 7: 478-484
25 Nicholas R, Shayne N, Ronald D. Cohort study on calcium channel blockers, other cardiovascular agents, and the prevalence of depression. Br J clin Phormacol, 1999, 487: 230-233
26 Burless C, De Leo D. Methodological issues in community surveys of suicide ideators and attempters. Crisis, 2001, 22(3): 109-124
27 Hintikka J, Pesonen T, Saarinen P, et al. Suicidal ideation in the Finnish general population, A 12-month follow-up study. Soc Psychiatry Psychiatr Epidemiol, 2001, 36(12): 590-594
28 Osullivan M, Fitagerald M. Suicidal ideation and acts of selfharm among Dublin school children. J Adolesc, 1998, 21: 427
29 Burless C, De Leo D. Methodological issues in community
surveys of suicide ideators and attempters. Crisis, 2001, 22(3): 109-24
30 Supe AN. A study of stress in medical students at Seth G. S. Medical College. J Postgrad Med, 1998, 44(1): 1-6
31 余小鸣，籍红，周凯等．231名医学生自杀意向、自杀态度及相关作用的初步分析．中国学校卫生，1998，19(5)：375-376
32 梁宝勇，郭倩玉．关于应对的一些思考与实证研究Ⅲ．应对方式与人格．中国临床心理学，2000，8(1)：7-9
33 IiFeld FW. Coping Styles of Chicaga Adults: Effectiveness. Arch Gen psychiatry, 1980, 37: 1239-1243
34 Barrios LC, Everett SA, Simon TR, et al. Suicide ideation among US college students: Associations with other injury risk behaviors. J Am Coll Health, 2000, 48(5): 195-198
35 Thoits PA. Dimensions of life events that infkuence psychological distress: an evaluation and synthesis of the literature. Psychological Stress. Acdemic Press, 1983: 33-103
36 赵虎，周逸如，陈树乔等．大学生心理防御机制四年随访观察．中国心理卫生杂志，2001，15(4)278-280
37 Sarason JG. Assesing the impact of life change: development of life experiences survey, J of consulting and clinical Psychology, 1998, 46(2): 932
38 杨德森编．中国生活事件量表《行为医学》．湖南师大出版社，1990，285
39 张迪然，郑勇，屠礼红等．贵州省少数民族和汉族大学生的心理健康
及其个性因素分析．中华精神科杂志，1997，30(2)：103-106
40 Rubio CT, Lubin B. college students mental health: a person environment interactional analysis. J Clin Psychol, 1986, 42: 205-212
41 谢建文，赵惜辉，古国谋等．精神疾病患者自杀意念和企图与血清胆固醇水平的关系．临床精神医学杂志，1998，8(6)：344-345
42 高秀花．抑郁症患者的自杀意念与血清总胆固醇水平．山东精神医学，2001，14(1)：13～14
43 Carpenter KM, Hasin DS, Allison Db, et al. Relationships between obesity and DSM-Ⅳ major depressive disorder, suicide ideation, and suicide attempts: results from a general population study. American journal of public health, 2000, 90 (2): 251-257
44 陈仲庚编．实验临床心理学，第一版．北京大学出版社，1992，459-460
45 陈仲庚编．实验临床心理学，第一版．北京大学出版社，1992，45-51
46 Van Heeringen C. Suicide in adolescents. Int Clin Psychopharmacol, 2001, 16(Suppl2): 1-6