中老年危机热线来电者的应激源与自杀危险性

PSYCH OpenIR > 中国科学院心理研究所回溯数据库(1956-2010)

	中老年危机热线来电者的应激源与自杀危险性
其他题名	Stressors and suicidality of middle-aged and elder crisis line callers
	杨戎
	2009-05-21
摘要	目的: 心理社会危机与精神障碍是导致自杀行为的两大应激源。本文探讨遭遇心理社会危机或精神障碍，或同时遭遇两者情况下，中老年危机热线来电者在个体人口学特征、抑郁程度、自杀危险和应激复合性上的差异，以利制定有效干预策略。方法: 二次分析全国危机热线自2002年12月至2008年12月使用《北京心理危机研究与干预中心热线自杀危险评估（本人版）》收集的 1,092名45岁及以上中老年来电者的数据资料。根据数据库分类系统对来电者属心理社会危机、精神心理问题或混合的判别，分组比较总体来电者（48.2%, 32.3%, 19.5%）、自杀意念者（43.7%, 33.0%, 23.3%）和2周前自杀未遂者（33.6%, 42.3%, 24.1%）三类人群；分组比较关系或非关系性危机、单一或叠加应激源。使用X2检验和Tukey-type与Multinomial Logistic Regression等统计方法。结果: 与既往研究结果一致，女性（71.3%, X2=13.45, P<0.001），特别是遭遇关系性危机的女性（76.8%, X2=25.12, P<0.001）更可能因心理社会危机求助热线。总体来电者中，混合组（78.5%, P<0.001）和问题组（68.7%, P<0.05）重性抑郁发作检出率显著高于危机组（57.1%）；混合组自杀意念检出率（71.4%）显著高于危机组（53.8%, P<0.001）和问题组（60.9%, P<0.05）；混合组（16.6%, P<0.05）和问题组（18.5%, P<0.01）2周前自杀未遂检出率显著高于危机组（9.8%）；混合组超过一半来电者（51.8%）绝望程度在50%以上，显著高于危机组的35.6%（P<0.01）和问题者组的38.2%（P<0.05）。三类人群中危机者未求医比例均显著高于另两组（X2=241.35, 146.56, 50.87; P <0.001）。与单一危机组相比，叠加危机组的轻、重度抑郁和既往抑郁诊断比例（14.0% vs. 17.4%; 54.9% vs. 65.2%; 0 vs. 2.2%; X2=14.35，P<0.01），以及自杀意念（51.1% vs. 64.0%, P <0.05）和2周前自杀未遂检出率（8.4% vs. 15.0%, P <0.05）也显著高于单一危机组。有更多叠加危机者绝望程度在50%以上（51.9% vs. 31.0%，X2=11.96，P<0.01）。结论: 与研究假设一致，同时遭遇两类应激源和遭遇叠加危机的中老年来电者，抑郁程度和自杀危险更高。应针对应激源制定干预策略，并重点促进危机者的求医行为。
其他摘要	Objective: Psychosocial crisis and psychiatric disorders are two stressors for suicide action. This study will explore the differences on demographic characteristics, severity of depression, and suicidality of middle-aged and elder crisis line callers under the influences of psychosocial crisis or psychiatric disorders or two simultaneously-mixed stressors, in order to develop effective intervention strategies for crisis line. Methods: Analysis data of 1,092 cases selected from national crisis line callers aged 45 and over who were assessed with “Suicide risk assessment” during the period from December, 2002 to December, 2008. The sample were divided into three groups of psychosocial crisis, mental health problems, and mixed-stressors of three types of general callers (48.2%, 32.3%, 19.5%), callers with current suicide ideation (43.7%, 33.0%, 23.3%) and callers attempted suicide 2 weeks prior to the call (33.6%, 42.3%, 24.1%) respectively according to the operators’ judgments of the callers’ claimed difficult situations and classification system of crisis line database. X2 test and Tukey-type and Multinomial Logistic Regression multiple comparison methods are applied to analysis the differences of the three groups. Results: In agreement with previous studies, more females (71.3%, X2=13.45, P<0.001), especially females influenced by relationship stressors (76.8%, X2=25.12, P<0.001) made the call for crisis. Among general callers, the check-out rates of Major Depression Episode of mixed-stressor callers (78.5%, P<0.001) and problem callers (68.7%, P<0.05) were significantly higher than that of crisis callers (57.1%). The check-out rates of suicide ideation of mixed-stressor callers (71.4%) were significantly higher than that in crisis callers (53.8%, P<0.001) and problem callers (60.9%, P<0.05). The check-out rates of prior suicide attempts of mixed-stressor (16.6%, P<0.05) and problem callers (18.5%, P<0.01) were significantly higher than that of crisis callers (9.8%). More than half of the mixed-stressor callers (51.8%) reported over 50% degree of hopelessness, which was significantly higher than that of crisis callers (35.6%, P<0.01) and problem callers (38.2%, P<0.05). Fewer crisis callers sought medical help than problem and mixed-stressor callers among three types of callers (X2=241.35, 146.56, 50.87; P<0.001). Compare to non-compound crisis callers, the proportion of minor, severe depression and prior depression diagnosis (14.0% vs. 17.4%; 54.9% vs. 65.2%; 0 vs. 2.2%; X2=14.35，P<0.01), suicide ideation (51.1% vs. 64.0%, P<0.05) and prior suicide attempts (8.4% vs. 15.0%, P<0.05) in compound crisis callers were significantly higher. There were more compound crisis callers with over 50% hopelessness (51.9% vs. 31.0%，X2=11.96，P<0.01). Conclusion: As predicted, among middle-aged and elderly participants, mixed-stressor and compound crisis callers were higher in degree of severity of depression and suicidality. Intervention strategies should be developed addressing to specific stressor or stressors. The promotions of crisis callers’ medical help seeking behavior need to be emphasized.
关键词	中老年来电者危机热线心理社会危机精神障碍自杀
学位类型	硕士
语种	中文
学位授予单位	中国科学院心理研究所
学位授予地点	心理研究所
文献类型	学位论文
条目标识符	http://ir.psych.ac.cn/handle/311026/4440
专题	中国科学院心理研究所回溯数据库(1956-2010)
推荐引用方式 GB/T 7714	杨戎. 中老年危机热线来电者的应激源与自杀危险性[D]. 心理研究所. 中国科学院心理研究所,2009.

条目包含的文件
文件名称/大小	文献类型	版本类型	开放类型	使用许可
10001_12509T312杨戎_pa（595KB）			开放获取	--	浏览请求全文