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目的了解中学生童年期不良经历和自杀行为的发生情况,为有效预防中学生自杀行为发生提供依据。方法采用分层整群抽样的方法,抽取蚌埠市5 116名中学生为研究对象,对其进行童年期虐待经历和自杀行为问卷调查。采用χ~2检验,比较不同性别中学生自杀行为及童年期虐待检出率的差异。建立多因素Logistic回归模型分析童年期不良经历对中学生自杀行为的影响。结果中学生自杀意念、自杀计划以及自杀未遂的检出率分别为15.6%,8.6%和3.4%,女生均高于男生,差异均有统计学意义(χ~2值分别为17.22,7.50,8.15,P值均<0.01)。女生情感虐待检出率高于男生,男生躯体虐待、性虐待、躯体忽视和家庭功能不全的检出率均高于女生,差异均有统计学意义(P值均<0.01)。有各种类型童年期不良经历者自杀意念、自杀计划以及自杀未遂的检出率均高于无相应不良经历者(P值均<0.05)。Logistic回归模型发现,各种童年期不良经历均会增加自杀意念、自杀计划以及自杀未遂发生风险;且随着不良经历类型数目的增加,各自杀行为的发生风险呈上升趋势(P值均<0.01)。结论童年期不良经历是中学生自杀意念、自杀计划以及自杀未遂发生的重要危险因素。加强对有童年期不良经历青少年的干预,可作为中学生自杀行为防控的重要举措。
Objective To understand the unhealthy experiences of middle school students during their childhood and the incidence of suicidal behavior and provide a basis for preventing secondary suicide. Methods By stratified cluster sampling method, 5,116 middle school students in Bengbu were selected as the research subjects, and their childhood abuse experiences and suicide behaviors were investigated. The χ ~ 2 test was used to compare the differences in suicide rates and childhood abuse among different gender middle school students. To establish a multivariate Logistic regression model to analyze the influence of childhood unhealthy experiences on the suicide behaviors of middle school students. Results The prevalence of suicidal ideation, suicide plan and attempted suicide among secondary school students were 15.6%, 8.6% and 3.4%, respectively. There were statistically significant differences among girls (χ ~ 2 = 17.22, 7.50, 8.15, P <0.01). The detection rate of emotional abuses in girls was higher than that of boys, and the detection rate of soma, sexual abuse, physical neglect and family dysfunction were higher in girls than in girls (P <0.01). The suicide ideation, suicide plan and the rate of attempted suicide of all kinds of childhood bad experiences were higher than those without corresponding bad experience (P <0.05). Logistic regression models found that various childhood misadjustments increased suicidal ideation, suicide plan and the risk of attempted suicide; and the incidence of suicide was increased with the increase of the number of bad experiences (P <0.01) ). Conclusion Adolescent unhealthy experience is an important risk factor for secondary school students’ suicidal ideation, suicide plan and attempted suicide. Strengthening the intervention of adolescents with bad experiences in childhood can be used as an important measure to prevent and control suicide among middle school students.