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目的：依据应激敏感模型,初步探讨自杀行为和儿童期逆境、负性生活事件的关系。方法：采用一般资料问卷、儿童期不良经历(ACE)问卷和生活事件量表对自杀未遂入院患者64人及正常对照91人进行问卷调查,并分别将ACE得分和负性生活事件刺激量进行二分类,前者分为低逆境(ACE=0~1)和高逆境(ACE≥2),后者分为低负性事件(负性生活事件刺激量<4)和高负性事件(负性生活事件刺激量≥4)。结果：高逆境可增加个体经历高负性生活事件的危险度(OR=3.04,95%CI=1.57,5.91);高逆境和高负性生活事件均可单独增加自杀行为的发生风险(OR=6.39,95%CI=3.07,13.31;OR=7.03,95%CI=3.25,15.22)。当个体处于高逆境水平时,即使负性生活事件水平较低,自杀行为发生风险仍较高(OR=8.217,95%CI=1.75,8.67)。结论：儿童期逆境和负性生活事件与自杀行为的关系符合应激敏感模型。
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Objective: To preliminarily investigate the relationship of suicide behavior with childhood adversity and negative life event based on a stress sensitization model. Methods: There were two groups in this study, suicide group(n=64) and control group(n=91). All the participates completed the self-administered general information questionnaire, Adverse Childhood Experiences Questionnaire and Life Event Scale. The scores of adverse childhood experiences(ACE) and negative life events(NLES) were dichotomized into low adversity(ACE=0-1) and high adversity(ACE≥2), and low NLE(NLES3.5) and high NLES(NLES≥3.5), respectively. Results: High adversity increased 3.04-fold of risk of high NLES(95%CI=1.57, 5.91). High adversity and high NLES increased the risk of suicide behavior separately(OR=6.39, 3.07, 13.31and OR=7.03, 95%CI=3.25, 15.22, respectively). Even low NLES raised the risk of suicide behavior in individuals with high adversity. Conclusion: The associations of childhood adversity and negative life events with suicide behavior accorde with the stress sensitization model.
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1 Dube SR, Anda RF, Felitti VJ, et al. Childhood abuse,household dysfunction, and the risk of attempted suicidethroughout the life span: Findings from the Adverse Child-hood Experiences Study. JAMA: The Journal of the Ameri-can Medical Association, 2001, 286(24): 3089-3096
2 Mandelli L, Carli V, Roy A, et al. The influence of child-hood trauma on the onset and repetition of suicidal behav-ior: An investigation in a high risk sample of male prison-ers. Journal of Psych Iatric Research, 2011, 45(6): 742-747
3 李献云，杨荣山，张迟. 自杀未遂危险因素的病例对照研究. 中华流行病学杂志，2001，22(4)：281-283
4 彭俊，刘波，费立鹏，等. 中南地区自杀危险因素的病例对照研究. 中国心理卫生杂志，2008，22(4)：309
5 张艳萍，李献云，王黎君，等. 自杀与其它伤害死亡全国性对照研究. 中国心理卫生杂志，2005，18(12)：861-864
6 Maunder RG, Peladeau N, Savage D, et al.. The prevalenceof childhood adversity among healthcare workers and its re-lationship to adult life events, distress and impairment.Child Abuse and Neglect, 2010, 34(2): 114-123
7 McLaughlin KA, Conron KJ, Koenen KC, et al. Childhoodadversity, adult stressful life events, and risk of past-yearpsychiatric disorder: A test of the stress sensitization hypo-thesis in a population-based sample of adults. Psycholog-ical Medicine, 2010, 40(10): 1647-1658
8 Hammen C, Henry R, Daley SE. Depression and sensitiza-tion to stressors among young women as a function of child-hood adversity. Journal of Consulting and Clinical Psycho-logy, 2000, 68(5): 782-787
9 Roberts AL, Mclaughlin KA, Conron KJ, et al. Adulthoodstressors, history of childhood adversity, and risk of perpe-tration of intimate partner violence. American Journal ofPreventive Medicine, 2011, 40(2): 128-138
10 肖琴. 安徽省医学生儿童期不良经历与相关风险行为的关联研究. 合肥：安徽医科大学，2008
11 张亚林，杨德森. 生活事件量表. 见：汪向东，王希林，马弘，编著. 心理卫生评定量表手册. 增刊．中国心理卫生杂志，1999．101-108
12 Korkeila J, Vahtera J, Nabi H. Childhood adversities, adult-hood life events and depression. Journal of Affective Disor-ders, 2010, 127 (1-3): 130-138
13 ten Have M, van Dorsselaer S, de Graaf R. Prevalence andrisk factors for first onset of suicidal behaviors in the Neth-erlands Mental Health Survey and Incidence Study-2. Jour-nal of Affective Disorders, 2012, 147(1-3): 205-211
14 李献云，费立鹏，张艳萍. 负性生活事件与自杀行为研究.中国神经精神疾病杂志，2008，34(3)：156-160
15 Phillips MR, Yang G, Zhang Y, et al. Risk factors for sui-cide in China: A national case control psychological auto-psy study. The Lancet, 2002, 360(9347): 1728-1736
16 Heim C, Nemeroff CB. The role of childhood trauma in theneurobiology of mood and anxiety disorders: preclinical andclinical studies. Biological Psychiatry, 2001, 49(12): 1023-1039
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