1～2年级医学生既往首发自杀意念后自杀未遂风险及危险因素分析

目的了解大一、大二医学生既往首发自杀意念后不同时间(年)向自杀未遂发展风险,探索促使这一发展过程的危险因素。方法安徽省3所医学院校(安徽医科大学、皖南医学院和蚌埠医学院)1~2年级共10 297名学生接受自填式问卷调查。其中自制问卷包括既往自杀行为史、儿童期不良经历史、家庭自杀史以及一般人口学资料;专用量表包括抑郁、贝克焦虑、Barratt冲动、攻击以及社会支持量表。有自杀意念向自杀未遂发展速度和风险采用寿命表法进行描述,促使这一发展过程的危险因素则采用Cox回归模型分析。结果 10 297名大学生中,16.52%学生称有过自杀意念,1.47%有自杀未遂。自杀意念向自杀未遂发展的累积发生率为8.88%。有自杀意念后的第一年自杀未遂的条件风险最高(7.02%),76.16%(n=115)的自杀未遂者发生在有自杀意念后的第一年。Cox回归模型的多因素分析结果显示父母离婚(OR=2.32,95%CI 1.28~4.21)、躯体虐待(OR=1.69,95%CI 1.20~2.37)和一级亲属自杀行为(OR=2.02,95%CI 1.25~3.25)等家庭不良事件,青少年行为冲动性(中/低:OR=1.88,95%CI 1.15~3.06;高/低:OR=2.09,95%CI1.30~3.36)以及较高的焦虑评分(高/低:OR=1.60,95%CI 1.10~2.33)是自杀意念向自杀未遂进一步发展的危险因素。结论青少年有自杀意念是近期自杀未遂的高危信号。家庭不良事件、青少年行为冲动性以及严重焦虑状态是有自杀意念者自杀未遂主要危险因素。     

青少年网络成瘾与自杀行为的相关关系

目的 了解网络成瘾与青少年自杀行为的相关关系,如果存在相关关系,并考察能否被抑郁以及冲动相关行为部分或全部解释.方法 合肥市3507名使用网络的中学生完成问卷调查.内容包括Young网络成瘾诊断量表,自杀行为、抑郁量表,冲动相关的行为以及不良经历等调查表.采用层次logistic回归模型在调整混杂因素的基础上,分析网络成瘾与青少年自杀行为的相关关系及抑郁和冲动相关行为在上述相关关系中的作用.结果 3507名学生有182名(5.2%)被诊断为网络成瘾;过去一年有自杀意念、计划和未遂的学生比例分别为27.4%、9.5%和2.6%.网络成瘾与自杀意念、计划和未遂的关联指标OR值分别为1.79(95%CI:1.32～2.44)、2.32(95%CI:1.57～3.42)和2.08(95%CI:1.03～4.22),调整人口学和不良经历变量后,网络成瘾与自杀未遂的关联无统计学意义.抑郁和冲动相关行为分别引入以网络成瘾为自变量的方程,网络成瘾与自杀意念和计划的关联出现不同程度的下降;相反,若将网络成瘾引入以抑郁或(和)冲动相关行为自变量的方程,抑郁或(和)冲动相关行为与自杀意念和计划的关联未见明显变化.结论 网络成瘾与自杀意念、自杀计划存在关联,且该关联的路径可能由抑郁和冲动相关行为介导.     

农村青少年童年期虐待与自杀行为的关联

  目的  探讨童年期虐待与青少年自杀行为的关联,为制定自杀预防策略提供科学依据。  方法  采用多阶段分层整群随机抽样方法,从安徽、广东、云南、黑龙江和湖北农村地区共纳入16 271名中学生。采用结构化问卷收集研究对象一般情况、童年期忽视、虐待情况以及调查前1年内的自杀意念、自杀计划、自杀未遂情况,运用多因素Logistic回归模型分析童年期忽视、虐待与自杀意念、自杀计划和自杀未遂的关联。  结果  农村青少年自杀意念、自杀计划和自杀未遂的发生人数分别为2 453(15.1%)、1 164(7.2%)和572(3.5%)人,童年期忽视、中度和重度躯体虐待的发生人数分别为10 756(66.1%),4 311(26.5%)和703(4.3%)人。单因素分析显示,童年期忽视、虐待与自杀意念、自杀计划、自杀未遂相关均有统计学意义(P值均 < 0.05)。在控制年龄、性别、独生子女、父母文化程度、经济收入、情绪管理和社会支持因素后,童年期忽视、虐待与自杀意念、自杀计划、自杀未遂差异均有统计学意义(OR=1.62~5.14,P值均 < 0.05),其中重度躯体虐待的OR值(95%CI)分别为3.00(2.49~3.62),3.52(2.81~4.40), 5.14(3.87~6.83)。  结论  童年期忽视和虐待可能会增加农村青少年自杀行为发生风险,应积极采取有效措施减少童年期忽视虐待,预防自杀。      

广州市中学生网络成瘾与自杀相关行为的关系

了解中学生网络成瘾与自杀意念和自杀尝试的关系,为中学生自杀行为干预提供依据.方法 应用二阶段分层整群抽样方法,采用自编青少年健康知识问卷、Young网络成瘾量表、流调中心抑郁量表(CES-D)、Olweus儿童欺负问卷,于2016年11-12月对广州市3 229名初、高中学生进行匿名调查,使用Logistic回归模型分析网络成瘾与自杀行为的关系.结果 中学生网络成瘾报告率为14.68%,过去12个月自杀意念、自杀尝试的报告率分别为12.51%和2.04%.调整一般人口学因素后,网络成瘾与自杀意念和自杀尝试的关联OR值分别为3.88(95%CI=3.04~ 4.96)和2.42(95%CI=1.41~4.13),均有统计学意义;引入抑郁和欺负行为后,网络成瘾和自杀意念OR值下降至2.58(95%CI=1.99~3.34) (P<0.05),而与自杀尝试的关联无统计学意义.结论 中学生网络成瘾与自杀意念和自杀尝试均存在关联,可能由抑郁和欺负行为介导.中学生的网络成瘾和自杀问题应引起重视.     

大学生自杀行为相关因素比较分析

目的 了解大学生自杀发生率,分析影响自杀行为的相关因素.方法 采用分层整群随机抽样方法,问卷调查9808名大学生的自杀行为发生情况及相关因素.结果 自杀未遂的报告率为1.7%;有无自杀未遂的大学生在自杀态度、所认识的人发生自杀行为的情况及所遭受负性生活事件方面均有显著差异.多因素logistic回归分析显示,主要影响自杀行为的危险因素是:近一年感到绝望的频率高(OR=4.23,95%CI:3.05～5.85),一级亲属有过自杀行为(OR=2.85,95%CI:1.72～4.73),认识的人中有自杀行为(OR=2.82,95%CI:2.05-3.88),已发生过性行为(OR=2.73,95%CI:1.88～3.96),近一个月因心理问题对学习或日常生活有影响(OR=2.53,95%CI:1.80～3.56),女性(OR=2.47,95%CI:1.77～3.45)及其他有血缘关系的亲属有过自杀行为(OR=2.36,95%CI:1.63～3.41).结论 大学生的自杀行为受心理、生物、社会因素的共同作用,必须采取针对性措施对自杀行为实施有效干预.     

哈尔滨市大学生自杀意念调查及其影响因素研究

目的 了解哈尔滨市大学生自杀意念发生情况,分析其影响因素.方法 采用分层随机整群抽样的方法,用自编自杀意念、行为及危险因素调查表、自杀接受程度量表和社会支持量表作为工具对黑龙江省6所高校(哈尔滨工程大学、哈尔滨医科大学、黑龙江大学、黑龙江科技学院、哈尔滨师范大学和哈尔滨工业大学)的5240名学生进行问卷调查,评估大学生自杀意念的发生率及在不同困境下考虑自杀的可能性.结果 哈尔滨市大学生中有9.1%的人曾经有过自杀意念,1%的人有自杀未遂行为.logistic回归分析显示自杀意念的影响因素有性别、专业、父母关系、社会支持情况、对自杀的接受情况以及自杀未遂既往史.结论 大学生自杀意念现状不容忽视,为减少大学生自杀行为应采取针对性措施提高大学生心理健康水平.     

中国内地医学生自杀意念影响因素系统评价

探讨医学生自杀意念影响因素,为相关院校采取早期干预措施提供依据.方法 检索PubMed、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(VIP)、中国期刊全文数据库(CNKI)及万方数据库,收集2000年以来公开发表的有关医学生自杀意念的文章,检索关键词包括自杀或自杀意念(Suicide or Suicidal ideation)、影响因素(influence factors)、医学生或大学生(Medical students or College students).应用Stata 11.0软件进行统计分析,合并不同条件下的自杀意念报告率,并报告影响因素的合并OR(95% CI)值.结果 共纳入22篇文献,累计研究对象40 320人.Meta 分析发现,医学生总体自杀意念报告率为12.9%(95%CI=9.7%~16.1%),既往自杀意念报告率为17.7%(95%CI=12.6%~22.9%),1 a自杀意念报告率为7.9%(95% CI=4.8%~10.9%),1周自杀意念报告率为9.7%(95%CI=3.4%~16.0%).独生子女(OR=1.214,95% CI=1.042~1.415)、特殊家庭(OR=1.399,95% CI=1.187~ 1.650)是自杀意念的危险因素.结论 应重点关注来自特殊家庭及独生子女医学生,采取综合干预措施减少医学生的自杀意念.     

宁夏生态移民自杀意念现况及其影响因素分析

目的 了解宁夏生态移民自杀意念的现况,分析影响移民人群自杀意念的危险因素,为预防自杀提供参考.方法 在宁夏地区生态移民安置区,采用多阶段抽样方法,抽取≥18岁常住农村居民2 000人,采用中文版复合型国际诊断交谈表-计算机辅助入户进行访谈,以近1年来是否认真考虑过自杀为自杀意念阳性判断标准.自杀意念危险因素分析采用Logistic回归模型.结果 近1年生态移民自杀意念报告率为5.31％ (95％ CI:4.21％ ～6.41％),年龄标化后生态移民自杀意念发生率为5.73％(95％ CI:4.59％～6.87％),不同性别移民自杀意念标化报告率[男性为3.02％ (95％ CI:1.66％ ～4.38％)、女性为7.44％(95％ CI:5.80％ ～9.07％)]差异有统计学意义(x2=13.12,P＜0.001),近1年回、汉族移民自杀意念报告率分别为6.07％和4.46％,差异无统计学意义(x2=2.06,P =0.150).Logistic回归分析进入方程的因素有:女性(OR=2.25,95％ CI:1.30～3.89)、年龄(OR=1.03,95％ CI:1.01～1.04)、精神障碍史阳性(OR=4.54,95％ CI:2.89～7.15)、县外移民(OR=1.59,95％CI:1.00 ～2.54).结论 影响生态移民自杀意念的因素是多方面的,精神障碍史阳性、女性、高年龄以及县外移民自杀意念发生风险增加.     

综合医院医师防范住院患者自杀的方法与措施

自杀是人类的悲剧。全球每年约有100．120万人自杀死亡：世界上每40秒钟有1人成功自杀．每3分钟有1人自杀未遂：自杀是15～35岁年轻人死亡原因前三位之一：每一位自杀者要严重影响至少6个人（指亲友）。自杀给家庭和社区带来的心理、社会和财务上的影响是无法估量的。自杀是生物、遗传、心理、社会、文化和环境诸因素相互作用的结果。根据北京地区40家综合医院住院病人自杀意念、自杀未遂的出现率及其危险因素的调查显示．在2914例年龄大于15岁的住院病人中，187人（6．42％；95％CI为5．58％～7．64％1有过自杀意念，其危险因素排列为：近1年感到绝望的频率高（OR=9．2.95％CI为6．5～12．9）、亲属有过自杀行为（4.3，2-3．8．31、调查当时有重性抑郁发作（2．7，1．7～4．3）、熟人有过自杀行为（2．0，1．3．2．9）、年龄小于55岁（1．7，1．2．2．3）、女性（1．5，1．1—2．1）。     

大学生故意自伤行为与自杀行为的相关性研究

目的 了解大学生故意自伤行为和自杀行为的发生情况,并分析其相关性.方法 整群选取某医科大学4063名一、二年级在校生为研究对象,采用x2检验比较不同性别大学生故意自伤行为、自杀行为检出率差异,建立多因素logistic回归模型拟合多种研究变量对故意自伤行为-自杀行为的影响.结果 4063名大学生最近1年故意自伤行为检出率为13.4％,其中单次自伤检出率为3.7％,多次自伤检出率为9.6％,男生高于女生;最近1年自杀意念、自杀计划、自杀未遂和自杀行为的检出率分别为4.5％、1.4％、0 6％和4.9％,性别间差异无统计学意义(P＞0.05).采用多元logistic回归分析,以有自伤无自杀组为参考,有自伤有自杀组表现为积极应对程度低(OR=0.5,95％CI:0.3 ～ 0.8)、伙伴个数相对较少(3～5个vs.≤2个:OR=0.6,95％CI:0.3 ～0.9;≥6个vs.≤2个:OR=0.4,95％CI:0.2～0.8);消极应对(OR=2.1,95％CI:1.2 ～ 3.7)、抑郁症状(OR=2.9,95％CI:1.6 ～ 5.2)、焦虑症状(OR=2.2,95％CI:1,2 ～ 3.8)、睡眠问题(OR=1.7,95％CI:1.1～2.8)、自评体型偏胖(偏胖vs.正常:OR=2.0,95％CI:1.1～3.6)较为常见.logistic回归分析发现,大学生故意自伤行为者中自杀行为的发生风险显著增加(OR=4.7,95％CI:3.5～6.4),而抑郁、应对方式、自评体型等社会心理因素会减弱两者的关联程度(OR=3.3,95％CI:2.4 ～ 4.5).自杀行为发生的风险随自伤次数的增加而增加(OR=3.1 ～ 10.0),社会心理因素也会减弱两者的关联(OR=2.4～5.9).结论 自伤行为虽然不是个体自杀行为发生的信号,但有必要在自伤者中开展自杀行为发生可能性的评估.     

Measuring effective early childhood teaching behaviors

The Early Childhood Teacher Observation Checklist was developed to record teaching behaviors in group settings for young children. The checklist was tested in observations of 57 preservice and inservice teachers. The instrument seems to be an accurate means of measuring teacher competency for research purposes.This research was supported by grants from the Kansas State University Chapter of Phi Delta Kappa and the Bureau of General Research, Graduate School, Kansas State University.     

Another look at heterosocial behaviors: one side of the early intimate sexual behaviors coin

The number of adolescent births is once again on the rise. Heterosocial competence described as successful interactions (i.e., heterosocial behaviors) with males (Grover, Nangler, & Zeff, 2005; Grover, Nangler, Serwik, & Zeff, 2007) is one emerging factor that has been found to be associated with adolescent sexual behavior. The aims of this cross sectional design study with 159 African American middle-school girls using the theory of reasoned action (Ajzen & Fishbein, 1980) were to describe and assess the relationship between heterosocial behaviors and sexual behaviors. Data was obtained using four surveys. The results suggest that heterosocial behaviors were a significant predictor of sexual behaviors (p < .001).     

Adolescents’ expectations for the future predict health behaviors in early adulthood

Health-related behaviors in adolescence establish trajectories of risk for obesity and chronic degenerative diseases, and they represent an important pathway through which socio-economic environments shape patterns of morbidity and mortality. Most behaviors that promote health involve making choices that may not pay off until the future, but the factors that predict an individual’s investment in future health are not known. In this paper we consider whether expectations for the future in two domains relevant to adolescents in the U.S.—perceived chances of living to middle age and perceived chances of attending college—are associated with an individual’s engagement in behaviors that protect health in the long run. We focus on adolescence as an important life stage during which habits formed may shape trajectories of disease risk later in life. We use data from a large, nationally representative sample of American youth (the US National Longitudinal Study of Adolescent Health) to predict levels of physical activity, fast food consumption, and cigarette smoking in young adulthood in relation to perceived life chances in adolescence, controlling for baseline health behaviors and a wide range of potentially confounding factors. We found that adolescents who rated their chances of attending college more highly exercised more frequently and smoked fewer cigarettes in young adulthood. Adolescents with higher expectations of living to age 35 smoked fewer cigarettes as young adults. Parental education was a significant predictor of perceived life chances, as well as health behaviors, but for each outcome the effects of perceived life chances were independent of, and often stronger than, parental education. Perceived life chances in adolescence may therefore play an important role in establishing individual trajectories of health, and in contributing to social gradients in population health.     

Variations in associations of health risk behaviors among ethnic minority early adolescents

PurposeTo investigate patterns of vulnerability and protection factors associated with risk behaviors and the co-occurrence of risk behaviors in minority ethnicity early adolescents.MethodsAnalysis of data from the Research with East London Adolescents Community Health Survey (RELACHS), a school-based study of a representative sample of 2789 adolescents age 11–14 in 2001 (sample 73% non-Caucasian, 21% born outside the United Kingdom). Questionnaire data were obtained on sociodemographic variables, ethnicity, smoking, drinking, drug use, psychological well-being, physical health, and social support from family and peers. Models of associations for each behavior and co-occurrence of risk behaviors (defined as engaging in ≥ 2 behaviors) were developed by hierarchical stepwise logistic regression.ResultsTwo hundred ninety-two (10.9%) reported 1 risk behavior, 84 (3.1%) reported 2, and 25 (0.9%) reported 3 behaviors. In multivariate models, psychological morbidity was associated with higher risk of all behaviors and co-occurrence, while higher family support was associated with lower risk in all models. Non-Caucasian ethnicity was associated with lower risk of regular smoking and co-occurrence but not drinking or drugs. Birth outside the United Kingdom was associated with lower risk for individual behaviors but not co-occurrence. Religion and religious observance were associated with lower risk of smoking and drinking but not drug use or co-occurrence. Peer connectedness was associated with drug use, but with increased risk. Socioeconomic status was associated only with smoking.ConclusionsPatterns of associations of personal, family, and environmental factors appear to differ between smoking, drinking, lifetime drug use, and the co-occurrence of these behaviors. Hypotheses regarding common factors related to health risk behaviors may be misleading in ethnic minorities and immigrants. Co-occurrence may represent a distinct behavioral domain of risk that is partly culturally determined.     

An analytic scheme to compare the early childhood teachers' classroom behaviors and environment

An analytic scheme applied to physical space, materials, and teacher behavior was used. In this process, the ideas and experiences of two teachers (one in nursery school and the other in kindergarten) were sorted and categorized. Teacher N's environment is more open, soft and has complex and super units, but she fails to interact with the children. She provides a variety of learning alternatives. Teacher K's setting is very closed, hard and simple, although she has good rapport with the children.     

Motivating cancer prevention and early detection behaviors using psychologically tailored messages

Tailoring health messages to make them salient to recipients is a strategy to motivate cancer prevention and early detection behaviors. Various tactics can be used to tailor health materials; our approach involves tailoring messages to individual differences in the psychological processes by which people understand health information. To summarize our tailoring approach, we review findings from six field experiments (four published, two pending publication) conducted in collaboration with the National Cancer Institute's (NCI's) Cancer Information Service (CIS) examining the utility of psychologically tailored messages. Messages were tailored to individual variability in the following: (a) need for cognition, (b) monitor/blunting coping style, (c) health locus of control, and (d) regulatory focus. Collectively, the findings suggest that, as hypothesized, messages congruent with the recipients' psychological style of health information processing (i.e., matched messages) are more persuasive in promoting screening mammography and fruit and vegetable consumption than mismatched messages. This line of research provides evidence for the utility of psychological tailoring as a health communication strategy and direction for developing effective health messages in a variety of settings.