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Article(id=1241759327422316551, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241759317016252418, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202406431, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1719331200000, receivedDateStr=2024-06-26, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773988094373, onlineDateStr=2026-03-20, pubDate=1727193600000, pubDateStr=2024-09-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773988094373, onlineIssueDateStr=2026-03-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773988094373, creator=13701087609, updateTime=1773988094373, updator=13701087609, issue=Issue{id=1241759317016252418, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='18', pageStart='3265', pageEnd='3456', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773988091898, creator=13701087609, updateTime=1773991617194, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241774103024174010, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241759317016252418, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241774103024174011, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241759317016252418, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3314, endPage=3319, ext={EN=ArticleExt(id=1241759329251033105, articleId=1241759327422316551, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=The developmental trajectory of early suicidal ideation in adolescents: an analysis based on latent variable mixed growth model, columnId=null, journalTitle=Modern Preventive Medicine, columnName=null, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the dynamic developmental trajectories of early suicidal ideation among adolescents, and the influence of factors such as gender, left-behind status, only-child status, boarding status, and social support on the trajectories of suicidal ideation development.

Methods

A cluster sampling method was employed to conduct three follow-up surveys among 989 7th-grade students in a certain urban middle school in Hunan Province from March to December 2023. The adolescent suicidal ideation scale (PANSI) and adolescent social support scale (CASSS) were used for questionnaire surveys. A latent growth mixture model (LGMM) was utilized to analyze and explore different categories of early suicidal ideation among adolescents.

Results

Four potential categories of developmental trajectories of early suicidal ideation among adolescents were identified, labeled as C1 group "high-risk-stable" (7.2%), C2 group "medium-risk-worsening" (8.8%), C3 group "medium-risk-stable" (11.1%) and C4 group "low-risk-stable" (72.9%). Being female, left-behind, and only-child were identified as risk factors for the developmental trajectories of early suicidal ideation (all P<0.05), while social support was identified as a protective factor for these trajectories.

Conclusion

The developmental trajectories of early suicidal ideation among adolescents exhibit significant heterogeneity among groups and individual differences.

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目的

考察青少年早期自杀意念的动态发展轨迹，以及性别、留守状态、是否独生、走读情况和社会支持等对自杀意念发展轨迹的影响。

方法

采取整群抽样法，于2023年3～12月选取湖南省某城区中学989名在校7年级学生进行3次追踪调查，使用青少年自杀意念量表(PANSI)与青少年社会支持量表(CASSS)进行问卷调查，采用LGMM模型分析探究青少年早期自杀意念的不同类别。

结果

青少年早期自杀意念的发展轨迹存在4个潜在类别，分别是C1组定义为“高风险—稳定型”（7.2%）、C2组定义为“中风险—恶化型”（8.8%）、C3组定义为“中风险—稳定型”（11.1%）以及C4组定义为“低风险—稳定型”（72.9%）。女生、留守、独生是青少年早期自杀意念发展轨迹的危险因素（均P<0.05），社会支持是发展轨迹的保护因素。

结论

青少年早期自杀意念的发展轨迹具有显著的群体异质性与个体差异性。

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张天成，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=yrKXtWMrF/P7/fp9xHeYXQ==, magXml=K7Qt97IwUNtEaqTPxuRE/A==, pdfUrl=null, pdf=U+5+RbVTI0Fplq6E1grlYg==, pdfFileSize=694413, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=96lyybGp4rZksuz2mHN73A==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=g5HNfvoFsNj9I8viv+BuVA==, mapNumber=null, authorCompany=null, fund=null, authors=

陈子逸(2000— )，男，硕士在读，研究方向：青少年体质健康促进研究

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陈子逸(2000— )，男，硕士在读，研究方向：青少年体质健康促进研究

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陈子逸(2000— )，男，硕士在读，研究方向：青少年体质健康促进研究

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Differences in non-suicidal self-injury behaviors between only-child and non-only-child adolescents with mood disorders: a cross-sectional study[J]. 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Relationships between different forms of social support and suicidal ideation and gender differences analysis among medical college students inAnhui Province[J]. Chinese Journal of Disease Control & Prevention, 2019, 23(1): 80-84. （In Chinese), articleTitle=Relationships between different forms of social support and suicidal ideation and gender differences analysis among medical college students inAnhui Province, refAbstract=null), Reference(id=1241759367662469435, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, doi=null, pmid=null, pmcid=null, year=2023, volume=16, issue=null, pageStart=4617, pageEnd=4627, url=null, language=null, rfNumber=[24], rfOrder=42, authorNames=Lan ZS, Liu HQ, Huang XF, journalName=Psychology Research and Behavior Management, refType=null, unstructuredReference=Lan ZS, Liu HQ, Huang XF, et al. 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Psychology Research and Behavior Management, 2023, 16: 4617-4627., articleTitle=The impact of academic pressure and peer support on adolescents’ loneliness: a polynomial regression and response surface analysis, refAbstract=null)], funds=[Fund(id=1241759353628328803, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, awardId=22YJ880086, language=CN, fundingSource=教育部规划基金项目(22YJ880086), fundOrder=null, country=null), Fund(id=1241759353817072498, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, awardId=21A0346, language=CN, fundingSource=湖南省教育厅重点项目(21A0346), fundOrder=null, country=null), Fund(id=1241759353938707323, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, awardId=JGY2023009, language=CN, fundingSource=吉首大学研究生科研创新项目(JGY2023009), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241759338818240710, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, xref=null, ext=[AuthorCompanyExt(id=1241759338885349582, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, companyId=1241759338818240710, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=College of Sports Science, Jishou University, Jishou, Hunan 416000, China), AuthorCompanyExt(id=1241759338897932497, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, companyId=1241759338818240710, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=吉首大学体育科学学院，湖南 吉首 416000)])], figs=[ArticleFig(id=1241759349538882215, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, language=EN, label=Fig.1, caption=Estimated mean values and growth trajectories for each latent class, figureFileSmall=/ZsGx2Yjdw9KbdmZRHsJCA==, figureFileBig=96lyybGp4rZksuz2mHN73A==, tableContent=null), ArticleFig(id=1241759351153689269, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, language=CN, label=图1, caption=每个潜在类别的估计均值和增长轨迹, figureFileSmall=/ZsGx2Yjdw9KbdmZRHsJCA==, figureFileBig=96lyybGp4rZksuz2mHN73A==, tableContent=null), ArticleFig(id=1241759351799612119, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, language=EN, label=Table 1, caption=

Presents the descriptive statistics and correlation analysis for each measurement time point

, figureFileSmall=null, figureFileBig=null, tableContent=
变量123456
1　自杀意念T125.74±7.861.000
2　自杀意念T225.69±9.120.836a1.000
3　自杀意念T326.02±10.680.832a0.856a1.000
4　主观支持55.91±11.97-0.375a-0.350a-0.335a1.000
5　客观支持60.68±15.72-0.340a-0.395a-0.329a0.520a1.000
6　支持利用度60.35±16.68-0.370a-0.364a-0.378a0.540a0.592a1.000
), ArticleFig(id=1241759351946412767, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, language=CN, label=表1, caption=

各施测时间点统计性描述及相关性分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量123456
1　自杀意念T125.74±7.861.000
2　自杀意念T225.69±9.120.836a1.000
3　自杀意念T326.02±10.680.832a0.856a1.000
4　主观支持55.91±11.97-0.375a-0.350a-0.335a1.000
5　客观支持60.68±15.72-0.340a-0.395a-0.329a0.520a1.000
6　支持利用度60.35±16.68-0.370a-0.364a-0.378a0.540a0.592a1.000
), ArticleFig(id=1241759352156127982, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, language=EN, label=Table 2, caption=

Presents the model fitting results of latent class analysis for the developmental trajectories of early suicidal ideation among adolescents

, figureFileSmall=null, figureFileBig=null, tableContent=
模型KLOG(L)AICBICaBICEntropyLMRBLRT类别概率
18-7 395.89814 807.79714 845.02014 819.616----
211-7 130.35014 282.70014 333.88114 298.9510.983<0.01<0.010.83/0.17
314-7 024.43014 076.86114 142.00114 097.5440.986<0.01<0.010.10/0.07/0.83
417-6 994.01914 022.03814 101.13714 047.1540.929<0.01<0.010.11/0.09/0.73/0.07
520-6 968.57813 977.15514 070.21214 006.7030.8400.12<0.010.50/0.07/0.23/0.09/0.11
), ArticleFig(id=1241759352365843197, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, language=CN, label=表2, caption=

青少年早期自杀意念发展轨迹潜在类别分析模型拟合结果

, figureFileSmall=null, figureFileBig=null, tableContent=
模型KLOG(L)AICBICaBICEntropyLMRBLRT类别概率
18-7 395.89814 807.79714 845.02014 819.616----
211-7 130.35014 282.70014 333.88114 298.9510.983<0.01<0.010.83/0.17
314-7 024.43014 076.86114 142.00114 097.5440.986<0.01<0.010.10/0.07/0.83
417-6 994.01914 022.03814 101.13714 047.1540.929<0.01<0.010.11/0.09/0.73/0.07
520-6 968.57813 977.15514 070.21214 006.7030.8400.12<0.010.50/0.07/0.23/0.09/0.11
), ArticleFig(id=1241759352638472971, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, language=EN, label=Table 3, caption=

The average membership probabilities of each latent class

, figureFileSmall=null, figureFileBig=null, tableContent=
C1C2C3C4
C11.000.000.000.00
C20.010.980.010.00
C30.000.020.910.07
C40.000.000.030.97
), ArticleFig(id=1241759352823022360, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, language=CN, label=表3, caption=

各潜在类别的平均归属概率

, figureFileSmall=null, figureFileBig=null, tableContent=
C1C2C3C4
C11.000.000.000.00
C20.010.980.010.00
C30.000.020.910.07
C40.000.000.030.97
), ArticleFig(id=1241759352953045799, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, language=EN, label=Table 4, caption=

Univariate analysis of developmental trajectories of early suicidal ideation among adolescents across latent classes

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总体低风险—稳定型
(n=565)		中风险—稳定型
(n=86)		中风险—恶化型
(n=68)		高风险—稳定型
(n=56)		x2/F值P值
性别[例(百分比,%)]41.825<0.001
男377(48.6)312(55.2)26(30.2)28(41.2)11(19.6)
女398(51.4)253(44.8)60(69.8)40(58.8)45(80.4)
留守状态[例(百分比,%)]32.136<0.001
留守73(9.4)36(6.4)9(10.5)14(20.6)14(25.0)
非留守702(90.6)529(93.6)77(89.5)54(79.4)42(75.0)
是否独生[例(百分比,%)]12.983<0.001
独生154(19.9)96(17.0)27(31.4)19(27.9)12(21.4)
非独生621(80.1)469(83.0)59(68.6)49(72.1)44(78.6)
走读情况[例(百分比,%)]1.3940.707
走读629(81.2)463(81.9)70(81.4)53(77.9)43(76.8)
住宿146(18.8)102(18.1)16(18.6)15(22.1)13(23.2)
主观支持[分,]15.66±4.0016.27±3.7914.69±4.2714.90±3.6511.96±3.7824.891<0.001
客观支持[分,]20.87±4.8521.55±4.7420.53±4.4119.35±4.7016.39±4.0123.954<0.001
支持利用度[分,]18.98±4.6919.68±4.5117.85±4.3918.01±4.7114.84±4.6923.135<0.001
), ArticleFig(id=1241759353120817974, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, language=CN, label=表4, caption=

青少年早期自杀意念发展轨迹潜在类别的单因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总体低风险—稳定型
(n=565)		中风险—稳定型
(n=86)		中风险—恶化型
(n=68)		高风险—稳定型
(n=56)		x2/F值P值
性别[例(百分比,%)]41.825<0.001
男377(48.6)312(55.2)26(30.2)28(41.2)11(19.6)
女398(51.4)253(44.8)60(69.8)40(58.8)45(80.4)
留守状态[例(百分比,%)]32.136<0.001
留守73(9.4)36(6.4)9(10.5)14(20.6)14(25.0)
非留守702(90.6)529(93.6)77(89.5)54(79.4)42(75.0)
是否独生[例(百分比,%)]12.983<0.001
独生154(19.9)96(17.0)27(31.4)19(27.9)12(21.4)
非独生621(80.1)469(83.0)59(68.6)49(72.1)44(78.6)
走读情况[例(百分比,%)]1.3940.707
走读629(81.2)463(81.9)70(81.4)53(77.9)43(76.8)
住宿146(18.8)102(18.1)16(18.6)15(22.1)13(23.2)
主观支持[分,]15.66±4.0016.27±3.7914.69±4.2714.90±3.6511.96±3.7824.891<0.001
客观支持[分,]20.87±4.8521.55±4.7420.53±4.4119.35±4.7016.39±4.0123.954<0.001
支持利用度[分,]18.98±4.6919.68±4.5117.85±4.3918.01±4.7114.84±4.6923.135<0.001
), ArticleFig(id=1241759353330533189, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, language=EN, label=Table 5, caption=

Multivariate logistic regression analysis of developmental trajectories of early suicidal ideation among adolescents across latent categories

, figureFileSmall=null, figureFileBig=null, tableContent=
项目回归系数标准误Wald
χ2值		P值OR值（95%CI）
中风险-稳定型
常量0.4780.6840.4890.484-
性别-1.0780.25517.927<0.0010.340(0.207~0.560)
留守状态0.5800.4082.0240.1551.786(0.803~3.971)
是否独生0.8130.2689.2130.0022.255(1.334~3.812)
主观支持-0.0670.0363.4770.0620.935(0.871~1.003)
客观支持-0.0030.0280.0140.9050.997(0.943~1.053)
支持利用度-0.0550.0313.1780.0750.946(0.891~1.006)
中风险-恶化型
常量0.4710.7530.3920.531-
性别-0.5830.2684.7460.0290.558(0.331~0.943)
留守状态1.3470.35914.043<0.0013.844(1.901~7.774)
是否独生0.7410.3045.9460.0152.098(1.156~3.805)
主观支持-0.0340.0420.6820.4090.966(0.890~1.048)
客观支持-0.0750.0325.4260.0200.928(0.871~0.988)
支持利用度-0.0300.0360.6980.4030.970(0.903~1.042)
高风险-稳定型
常量5.6780.89939.937<0.001-
性别-1.6910.38119.707<0.0010.184(0.087~0.389)
留守状态1.4010.42111.0960.0014.059(1.780~9.257)
是否独生0.5050.3921.6640.1971.657(0.769~3.571)
主观支持-0.1730.04912.559<0.0010.841(0.764~0.925)
客观支持-0.1640.03917.994<0.0010.848(0.786~0.915)
支持利用度-0.1270.0438.5190.0040.881(0.809~0.959)
), ArticleFig(id=1241759353481528148, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327422316551, language=CN, label=表5, caption=

青少年早期自杀意念发展轨迹潜在类别的多元logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目回归系数标准误Wald
χ2值		P值OR值（95%CI）
中风险-稳定型
常量0.4780.6840.4890.484-
性别-1.0780.25517.927<0.0010.340(0.207~0.560)
留守状态0.5800.4082.0240.1551.786(0.803~3.971)
是否独生0.8130.2689.2130.0022.255(1.334~3.812)
主观支持-0.0670.0363.4770.0620.935(0.871~1.003)
客观支持-0.0030.0280.0140.9050.997(0.943~1.053)
支持利用度-0.0550.0313.1780.0750.946(0.891~1.006)
中风险-恶化型
常量0.4710.7530.3920.531-
性别-0.5830.2684.7460.0290.558(0.331~0.943)
留守状态1.3470.35914.043<0.0013.844(1.901~7.774)
是否独生0.7410.3045.9460.0152.098(1.156~3.805)
主观支持-0.0340.0420.6820.4090.966(0.890~1.048)
客观支持-0.0750.0325.4260.0200.928(0.871~0.988)
支持利用度-0.0300.0360.6980.4030.970(0.903~1.042)
高风险-稳定型
常量5.6780.89939.937<0.001-
性别-1.6910.38119.707<0.0010.184(0.087~0.389)
留守状态1.4010.42111.0960.0014.059(1.780~9.257)
是否独生0.5050.3921.6640.1971.657(0.769~3.571)
主观支持-0.1730.04912.559<0.0010.841(0.764~0.925)
客观支持-0.1640.03917.994<0.0010.848(0.786~0.915)
支持利用度-0.1270.0438.5190.0040.881(0.809~0.959)
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青少年早期自杀意念的发展轨迹：基于潜变量混合增长模型分析
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陈子逸 , 张天成 , 张福兰 , 周县委 , 王澳伦 , 郭淑媛
现代预防医学 | 儿少卫生与妇幼保健 2024,51(18): 3314-3319
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现代预防医学 | 儿少卫生与妇幼保健 2024, 51(18): 3314-3319
青少年早期自杀意念的发展轨迹：基于潜变量混合增长模型分析
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陈子逸, 张天成 , 张福兰, 周县委, 王澳伦, 郭淑媛
作者信息
  • 吉首大学体育科学学院，湖南 吉首 416000

    • 陈子逸(2000— )，男，硕士在读，研究方向：青少年体质健康促进研究

通讯作者:

张天成，E-mail:
The developmental trajectory of early suicidal ideation in adolescents: an analysis based on latent variable mixed growth model
Zi-yi CHEN, Tian-cheng ZHANG , Fu-lan ZHANG, Xian-wei ZHOU, Ao-lun WANG, Shu-yuan GUO
Affiliations
  • College of Sports Science, Jishou University, Jishou, Hunan 416000, China
出版时间: 2024-09-25 doi: 10.20043/j.cnki.MPM.202406431
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摘要
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目的

考察青少年早期自杀意念的动态发展轨迹，以及性别、留守状态、是否独生、走读情况和社会支持等对自杀意念发展轨迹的影响。

方法

采取整群抽样法，于2023年3～12月选取湖南省某城区中学989名在校7年级学生进行3次追踪调查，使用青少年自杀意念量表(PANSI)与青少年社会支持量表(CASSS)进行问卷调查，采用LGMM模型分析探究青少年早期自杀意念的不同类别。

结果

青少年早期自杀意念的发展轨迹存在4个潜在类别，分别是C1组定义为“高风险—稳定型”（7.2%）、C2组定义为“中风险—恶化型”（8.8%）、C3组定义为“中风险—稳定型”（11.1%）以及C4组定义为“低风险—稳定型”（72.9%）。女生、留守、独生是青少年早期自杀意念发展轨迹的危险因素（均P<0.05），社会支持是发展轨迹的保护因素。

结论

青少年早期自杀意念的发展轨迹具有显著的群体异质性与个体差异性。

青少年  /  自杀意念  /  发展轨迹  /  潜变量混合增长模型
Objective

To investigate the dynamic developmental trajectories of early suicidal ideation among adolescents, and the influence of factors such as gender, left-behind status, only-child status, boarding status, and social support on the trajectories of suicidal ideation development.

Methods

A cluster sampling method was employed to conduct three follow-up surveys among 989 7th-grade students in a certain urban middle school in Hunan Province from March to December 2023. The adolescent suicidal ideation scale (PANSI) and adolescent social support scale (CASSS) were used for questionnaire surveys. A latent growth mixture model (LGMM) was utilized to analyze and explore different categories of early suicidal ideation among adolescents.

Results

Four potential categories of developmental trajectories of early suicidal ideation among adolescents were identified, labeled as C1 group "high-risk-stable" (7.2%), C2 group "medium-risk-worsening" (8.8%), C3 group "medium-risk-stable" (11.1%) and C4 group "low-risk-stable" (72.9%). Being female, left-behind, and only-child were identified as risk factors for the developmental trajectories of early suicidal ideation (all P<0.05), while social support was identified as a protective factor for these trajectories.

Conclusion

The developmental trajectories of early suicidal ideation among adolescents exhibit significant heterogeneity among groups and individual differences.

Adolescents  /  Suicidal ideation  /  Development trajectories  /  Latent growth mixture model
陈子逸, 张天成, 张福兰, 周县委, 王澳伦, 郭淑媛. 青少年早期自杀意念的发展轨迹：基于潜变量混合增长模型分析. 现代预防医学, 2024 , 51 (18) : 3314 -3319 . DOI: 10.20043/j.cnki.MPM.202406431
Zi-yi CHEN, Tian-cheng ZHANG, Fu-lan ZHANG, Xian-wei ZHOU, Ao-lun WANG, Shu-yuan GUO. The developmental trajectory of early suicidal ideation in adolescents: an analysis based on latent variable mixed growth model[J]. Modern Preventive Medicine, 2024 , 51 (18) : 3314 -3319 . DOI: 10.20043/j.cnki.MPM.202406431
正文
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自杀意念往往被视为自杀的前兆或自杀者的早期心理活动，是指个体已有明确想要结束自己生命的想法，但尚未付诸行动[1]。相关研究显示，近年来我国青少年自杀意念的检出率从17.7%~31.3%均有汇报，总体形势不容乐观[2-3]。有研究指出，青少年早期是自杀意念发展的关键期，这一阶段的个体通常刚进入初一阶段，面临学业压力增大、社交环境变迁等诸多适应性问题[4]。倘若不能及时展开精准干预，可能促使这一时期个体产生不同程度的自杀意念，甚至实施极端行为，对当事家庭与周围人群造成强烈的心理冲击，导致不良社会影响[5]。先前研究对青少年自杀意念的发展现状、影响机制等进行了诸多有益的探索，但较少关注青少年期自杀意念的发展轨迹及其类别间的异质性[6]。因此，基于纵向视角分析青少年早期自杀意念的发展轨迹及其潜在类别，对提升青少年早期心理健康水平，改善其生命质量具有重要意义。
社会支持作为青少年早期心理问题的重要缓冲因素，是指个体与社会各方面（家人、朋友等社会人或社会组织）在精神与物质上的联结程度，以及对于来自社会网络的支持资源的利用程度[7]。相关研究显示，低社会支持的个体往往有着较为消极、封闭的社交关系，这可能会促使负性情绪的产生，进一步加深自身的自杀意念，甚至实施自伤、自杀等故意伤害行为[8]。考虑到以往研究少有从变化发展的角度对该主题进行较为深刻的分析与探讨，因此，有必要考察社会支持与青少年早期自杀意念发展轨迹的关系。
综上所述，本研究拟构建潜变量混合增长模型（Latent Growth Mixture Model, LGMM），分析青少年早期自杀意念的多种发展轨迹，并探究部分人口学因素与社会支持等对自杀意念的影响，以期为自杀意念的预防及干预提供循证依据。
1　方法
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1.1　研究对象
选取湖南省某城区4所公立中学所有无认知障碍、能独立完成问卷的3 231名7年级学生作为研究对象。本实验已通过吉首大学生物医学伦理委员会审批（批号：JSDX-2023-0034），并取得所调查学校的许可和调查对象及家长的知情同意，追踪调查的数据仅用于学术性分析研究。
1.2　抽样方法
采取随机整群抽样法，每所学校随机抽取5个班级，以20个班级的989名学生作为追踪调研样本。于2023年3月、6月和12月进行3次施测，剔除有缺失值或随意填写的无效问卷后，以全部完成3次施测且问卷编码对应一致的775份数据作为最终有效研究样本。x2/t检验结果显示，流失被试和完成3次调查的被试在性别、留守状态、是否独生、走读情况以及首次施测的自杀意念与社会支持得分上的差异均无统计学意义（均P>0.05），即被试不存在结构性流失。
1.3　调查工具及内容
采用调查问卷收集研究对象的基本信息，包括性别、留守状态、是否独生、走读情况等。
采用青少年自杀意念量表（Positive and Negative Suicide Ideation, PANSI）测量青少年早期自杀意念[9]。该量表共14个条目，采用Likert 5级记分法，从“1=从未如此”到“5=经常如此”，研究对象根据近两周的感受对每个条目进行评分，包括两个维度：积极自杀意念（6个条目）与消极自杀意念（8个条目）。积极自杀意念采取反向记分，各条目得分相加即为总得分，总得分越高表示个体的自杀意念越重。本研究中，3次测量的Cronbach α系数为0.88、0.90、0.89。
采用青少年社会支持量表（CASSS）[10]测量社会支持水平，量表共17个条目，采用Likert 5级计分法，用于测试青少年的社会支持资源以及对已有资源的利用程度，包括主观支持（5个条目）、客观支持（6个条目）与支持利用度（6个条目）三个维度。将三次数据各维度加权平均作为社会支持相应维度的得分，得分越高代表个体社会支持水平越高，本研究中，该量表3次测量的Cronbach α系数为0.89、0.94、0.96。
1.4　质量控制
被试以班级为单位进行施测，通过线下发放实体问卷进行填写与收集。由经过培训的团队成员担任主试，组织班级学生在指定时间进行集体测评。在测评之前，主试详细说明测评目的，并承诺对被试的内容进行保密。
1.5　统计学方法
采用Mplus 8.3进行LGMM模型分析，依次选取1～5个类别进行分析。本研究中LGMM模型的拟合指数的评估标准为：CFI>0.90，TLI>0.90，RMSEA<0.08，SRMR<0.08[11]。使用SPSS27.0进行统计学分析，计量资料以均数和标准差进行统计描述，采用方差分析进行比较；计数资料以例数和百分比进行统计描述，采用卡方检验进行组间比较。以潜在类别作为因变量，进行单因素和多元logistic回归分析，检验水准α=0.05。
2　结果
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2.1　调查对象不同时间点自杀意念得分
被试在3个时间点自杀意念得分见表1。不同施测时间点自杀意念得分两两呈现显著正相关（P<0.001）,不同维度社会支持与3次施测时间点的自杀意念呈显著负相关（P<0.001）。
2.2　LGMM模型分析结果
2.2.1　模型拟合信息
从初始模型开始，分别抽取1至5个潜在类别的LGMM模型进行模型拟合优度分析，具体拟合结果见表2。其中，除5类别分类外，LMR与BLRT值均达到显著水平（P<0.01）。保留4个类别时，LOG（L）、AIC、BIC、以及aBIC的数值小于前3个类别，Entropy值为0.929，综合以上多个检验指标，最终选择自杀意念的4个潜在类别为最终模型。4个类别的归属概率矩阵见表3，各类别中的被试归属于每个潜在类别的平均概率从91%到100%，表明4类别模型的结果是可信的。
2.2.2　青少年早期自杀意念在各潜在类别的发展轨迹
通过LGMM模型获取4个潜在类别截距和斜率的均值。截距的均值分别为C1：47.253（SE=0.555;t=85.112；P<0.01）；C2：32.058（SE=0.355;t=90.256；P<0.01）；C3：29.251（SE=0.190;t=153.700；P<0.01）；C4：22.119（SE=0.165;t=134.107；P<0.01）。通过数据可看出C1组青少年早期自杀意念初始得分较高，C4组较低，C2、C3组得分接近且处于中间水平。斜率的均值分别为C1：0.844（SE=0.223;t=3.784；P<0.01）；C2：4.549（SE=0.170;t=26.766；P<0.01）；C3：0.312（SE=0.089;t=3.519；P<0.01）；C4：-0.561（SE=0.060;t=-9.269；P<0.01）。其中，除C2组随时间发展产生明显的上升趋势，其余组变化趋势趋于平缓。
根据截距和斜率特征，分别定义4个潜在类别的名称：C1组“高风险—稳定型”（7.2%）、C2组“中风险—恶化型”（8.8%）、C3组“中风险—稳定型”（11.1%）、C4组“低风险—稳定型”（72.9%）。各潜在类别的估计值和增长轨迹见图1。
2.2.3　青少年早期自杀意念发展轨迹潜在类别的单因素分析
单因素分析结果中性别、留守状态、是否独生、主观支持、客观支持以及支持利用度对于青少年早期自杀意念的发展轨迹潜在类别具有预测作用，差异均具有统计学意义（P<0.05），见表4。
2.2.4　青少年早期自杀意念发展轨迹潜在类别的多元logistic回归分析结果
将单因素分析中具有统计学意义的人口学变量作为协变量，以社会支持的不同维度作为自变量，青少年早期自杀意念发展轨迹的4个潜在类别为因变量，低风险—稳定型为参照组，进行多元logistic回归分析。其中，连续变量以原值纳入分析，分类变量赋值方式如下：男生=1，女生=2；留守=1，非留守=2；独生=1，非独生=2。
回归结果显示，相较于女生，男生归属于中风险—稳定型、中风险—恶化型、高风险—稳定型的概率更低；相较于非留守个体，留守青少年归属于中风险—恶化型、高风险—稳定型的概率更高；相较于非独生个体，独生青少年归属于中风险—稳定型、中风险—恶化型的概率更高。此外，高主观支持与高风险—稳定型呈负相关；高客观支持与中风险—恶化型、高风险—稳定型呈负相关；高支持利用度与中风险—稳定型、高风险—稳定型呈负相关。因此，女生、留守、独生是青少年早期自杀意念发展的危险因素，男生、非留守、非独生、社会支持是青少年早期自杀意念发展的保护因素。
3　讨论
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本研究通过LGMM模型分析发现，青少年早期自杀意念的发展轨迹存在4个异质性的潜在类别，分别是：低风险—稳定型、中风险—稳定型、中风险—恶化型与高风险—稳定型。其中，低风险—稳定型表现为被试自杀意念的初始水平最低，整体占总样本的72.9%，这与以往横断面研究的类别结果相一致[12]，也提示有近三成青少年自杀意念的发展轨迹为中高风险，对于青少年早期自杀意念的关注与干预迫在眉睫。中风险—恶化型与中风险—稳定型分别占总样本的8.8%与11.1%。值得注意的是，中风险—恶化型呈现显著上升趋势，这可能受个体间的认知差异的影响，自杀认知模型指出，认知偏差严重的青少年，更易受到自杀意念的影响，并产生抑郁、焦虑、绝望等诸多心理健康问题[13-14]。而这些问题相互交织，又形成了更为复杂的心理健康困境，使其陷入“认知偏差——自杀意念加剧”的恶性循环，并呈现出“中风险—恶化型”的类别特征。高风险—稳定型，占总样本数的7.2%，是学校亟需关注、识别，并实施干预的重点亚群体，依据自杀的素质-应激理论，长期处于不利的环境中的青少年，压力性事件的持续影响可能会让个体形成低自尊和低自我价值感，并引发抑郁、绝望等负性情绪，随着这类情绪的积累，可能进一步导致高水平且难以消退的自杀意念[15]。此外，相关研究提示，压力性事件可能源于家庭问题（家庭矛盾、成员变故）、同伴关系（同伴欺凌、同伴疏离）等诸多因素，在后续研究中有必要思考不同应激源对青少年早期自杀意念水平与发展轨迹的影响[16-17]。
本研究发现，部分人口学因素影响青少年早期自杀意念发展轨迹。首先，女生自杀意念在发展轨迹上为中高风险组的可能性更高，其原因可能是青春期早期女生本身在情感、认知上的易感性特点，且相比男生承受着更多来自生理发育（如身体发育、月经初潮等）的压力，导致女生容易出现情绪问题以及自杀意念的产生[18-19]。其次，留守个体自杀意念发展轨迹为中高风险的可能性更高，根据家庭系统理论，留守作为典型的家庭风险因素，家庭功能的弱化和亲子关系的缺失更易激活青少年负性的认知情感结构，进而引发更为强烈的自杀意念[20-21]。再者，独生子女自杀意念的发展轨迹更易处于中高风险组，这一现象可能是由于独生子女缺乏与兄弟姐妹之间的相互交流与支持，个体其必须独自承载着家庭的期望与压力[22]，导致他们面临着更大的心理压力，加速了自杀意念的发展。
本研究还发现，社会支持是青少年早期自杀意念水平及发展轨迹的保护因素。过往研究发现，不同维度的社会支持均能够负向预测个体自杀意念的产生，同时社会支持的综合得分越高，个体自杀意念水平越低，与本研究的结果较为相似[23]。社会支持理论提出，高社会支持的青少年在应对挫折与压力时，能够更清晰的感知与利用社会支持所带来的心理资源与物质资源，提升生命质量以及社会资源的汲取能力，进而有效减少负性情绪（孤独感、抑郁、焦虑等）对心理健康发展的不良影响[24]，降低青少年早期自杀意念的风险。因此，在后续研究中应从同伴关系、家庭、学校等多方面入手，加强不同来源社会支持对青少年早期自杀意念的预防与干预作用。
综上，本研究采用纵向追踪设计考察了青少年早期自杀意念的发展轨迹，发现青少年早期自杀意念的发展轨迹存在4个具有异质性的潜在类别，并探讨了部分人口学因素及社会支持对发展轨迹的影响，为青少年心理健康问题的识别与干预提供了一定的循证依据。但本研究仍有一定局限性，首先，本研究样本选自湖南省某城市的公立初中，样本代表性有限，后续研究中可进一步扩大样本量，使研究结论更具推广性；其次，同伴、家庭等因素在青少年早期自杀意念发展过程中的影响同样不可忽视，未来研究可进一步考察其他因素的预测作用，为降低青少年自杀意念，提升心理健康水平提供精准干预。
基金
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  • 教育部规划基金项目(22YJ880086)
  • 湖南省教育厅重点项目(21A0346)
  • 吉首大学研究生科研创新项目(JGY2023009)
文献
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2024年第51卷第18期
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doi: 10.20043/j.cnki.MPM.202406431
  • 接收时间：2024-06-26
  • 首发时间：2026-03-20
  • 出版时间：2024-09-25
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  • 收稿日期：2024-06-26
基金
教育部规划基金项目(22YJ880086)
湖南省教育厅重点项目(21A0346)
吉首大学研究生科研创新项目(JGY2023009)
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    吉首大学体育科学学院，湖南 吉首 416000

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张天成，E-mail:
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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