生活事件能否预测首次自杀企图?一项全国性纵向研究

IF 1.2 4区 社会学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Longitudinal and Life Course Studies Pub Date : 2024-04-22 DOI:10.1332/17579597Y2024D000000020
Mogens Nygaard Christoffersen, Lorraine Khan
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引用次数: 0

摘要

预防悖论描述的情况是,大多数企图自杀的病例来自低危或中危人群,只有少数来自 "高危 "人群。其假设是,低基准率加上多种原因,导致无法确定所有自杀未遂者都属于高危人群。研究首次自杀未遂等事件及其原因的最佳方法是收集事件历史数据。我们利用行政登记册,在 1980 年至 1985 年间出生的六个国家出生组群(N = 300,000 人)中确定了一个自杀行为高危人群,并对其 15 岁至 29 岁期间的行为进行了跟踪调查。风险参数的估算基于离散时间逻辑几率模型。首次尝试自杀的终生发生率为 4.5%。家庭背景和家庭育儿因素对后来的首次自杀未遂有预测作用。青少年被诊断出患有精神病或神经发育障碍(多动症、焦虑症、抑郁症、创伤后应激障碍),以及曾是暴力或性犯罪的受害者,都有助于建立解释模型。与预防悖论相反,研究结果表明,有可能识别出一个离散的高危群体(例如,有自杀倾向的青少年)。
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Can life events predict first-time suicide attempts? A nationwide longitudinal study.

The prevention paradox describes circumstances in which the majority of cases with a suicide attempt come from a population of low or moderate risk, and only a few from a 'high-risk' group. The assumption is that a low base rate in combination with multiple causes makes it impossible to identify a high-risk group with all suicide attempts. The best way to study events such as first-time suicide attempts and their causes is to collect event history data. Administrative registers were used to identify a group at higher risk of suicidal behaviour within a population of six national birth cohorts (N = 300,000) born between 1980 and 1985 and followed from age 15 to 29 years. Estimation of risk parameters is based on the discrete-time logistic odds-ratio model. Lifetime prevalence was 4.5% for first-time suicide attempts. Family background and family child-rearing factors were predicative of later first-time suicide attempts. A young person's diagnosis with psychiatric or neurodevelopmental disorders (ADHD, anxiety, depression, PTSD), and being a victim of violence or sex offences contributed to the explanatory model. Contrary to the prevention paradox, results suggest that it is possible to identify a discrete high-risk group (<12%) among the population from whom two thirds of all first-time suicide attempts occur, but one third of observed suicide attempts derived from low- to moderate-risk groups. Findings confirm the need for a combined strategy of universal, targeted and indicated prevention approaches in policy development and in strategic and practice responses, and some promising prevention strategies are presented.

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来源期刊
CiteScore
2.50
自引率
11.10%
发文量
43
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