以世代研究探討復原力是否調節兒童時期家庭失能軌跡與青少年自殺意念的關聯性

Does resilience moderate the association between childhood family dysfunction trajectories and suicidal ideation in adolescents? A cohort study

曾琳雯(Janieka Cendana)

指導教授 ： 張書森

共同指導教授 ： 張齡尹(Ling-Yin Chang)

國立臺灣大學/公共衛生學院/健康行為與社區科學研究所/碩士(2021年)

https://doi.org/10.6342/NTU202102146

摘要

背景
自殺是全球 15 至 19 歲青少年的第三大死亡原因。 家庭對青少年能力與社會心理成熟度的發展有重大影響。 過去的研究發現，青少年的自殺行為與童年時間對其家庭狀況的感受有關。 然而，較少研究針對家庭功能與自殺意念之關聯性的調節因素。 復原力已被發現可以減輕某些風險因素與自殺意念的關聯， 然而，復原力對家庭失能和自殺意念之關聯的調節作用尚不清楚。
目標
本研究目的是檢視兒童中期的家庭失能軌跡與青少年期間自殺意念之間的關聯性，以及復原力是否對這關聯性有調節作用。
方法
資料來自台灣北部參與一項追蹤研究的 4195 名青少年。 使用群組化軌跡模型檢視家庭失能的發展軌跡。 使用二元羅吉斯迴歸檢視參與者的家庭失能軌跡與自殺意念的關聯。 通過在迴歸模型中包含適當的交互作用項以及概度比檢驗（likelihood ratio test）來檢查復元力的調節作用。
研究結果
分析結果發現四種家庭失能軌跡：持續性低失能 (20.7%)、失能逐步增加 (19.3%)、穩定中度失能 (25.7%)，和持續性高失能 (34.4%)。 與持續性低失能組相比，失能逐步增加、穩定中度失能，和持續性高失能軌跡的參與者更有可能在青少年時期產生自殺意念（校正後的勝算比 [adjusted odds ratio, aOR]分別為2.22，95%信賴區間 [CI] 1.63- 3.02；2.28，95% CI 1.70-3.07；3.38，95% CI 2.52-4.55）。 沒有統計證據力顯示復元力對家庭失能軌跡與自殺意念之間的關聯有調節作用（交互作用 p 值 = 0.56）。
結論
兒童時期家庭失能軌跡與青少年發生自殺意念有關，而復元力並沒有調節此關聯性。

關鍵字

自殺意念 ； 家庭失能軌跡 ； 調節作用 ； 青少年 ； 復原力

並列摘要

Background
Suicide is the third leading cause of death among adolescents aged 15 to 19 years worldwide. Family has important influences on developing adolescents’ capability and psychosocial maturity. Previous studies suggested that suicidal behaviours in adolescents were associated with children’s perceptions of their family’s conditions. However, less attention has been paid to factors that may moderate the association between family function and suicide ideation. Resilience has been shown to mitigate the association of some risk factors with suicide ideation. However, the moderating effect of resilience on the association between family dysfunction and suicide ideation is still unknown.
Aim
This study aimed to examine the association of family dysfunction trajectories in middle childhood with suicidal ideation during late adolescence and whether resilience moderates the association.
Methods
Data were from 4195 adolescents participating a longitudinal study in northern Taiwan. Developmental patterns of family dysfunction were examined using group-based trajectory modelling. Binary logistic regression was used to investigate the association between family dysfunction trajectories and suicidal ideation among participants. The moderating effect of resilience was examined by including appropriate interaction terms in the regression models and using the likelihood ratio test.
Results
Four trajectories of family dysfunction were identified: low-persistent (20.7%), escalating dysfunction (19.3%), moderate stable (25.7%), and high persistent (34.4%). Participants of escalating-dysfunction, moderate-stable and high-persistent family dysfunction trajectories were more likely to develop suicide ideation during adolescence compared to the low persistent group (adjusted odds ratio [aOR]=2.22, 95% confidence interval [CI] 1.63-3.02; 2.28, 95% CI 1.70-3.07; 3.38, 95% CI 2.52-4.55, respectively). There was no evidence for a moderating effect of resilience on the association between family dysfunction trajectories and suicide ideation (interaction p-value = 0.56).
Conclusion
Childhood family dysfunction trajectories were associated with the development of suicidal ideation in adolescents, while resilience did not moderate such an association.

並列關鍵字

Suicidal ideation ； family dysfunction trajectories ； moderation ； adolescents ； resilience

參考文獻

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