Viktimizacija u detinjstvu kao faktor suicidnog rizika kod odraslih
Sažetak
Apstrakt
Uvod/Cilj. Postoje istraživanja o povezanosti između viktimizacije deteta i rizika od samoubilačkog ponašanja u ranoj adolescenciji, dok je značajno manje istraživanja koja pokazuju ovu povezanost kod odraslih osoba. Cilj našeg istraživanja je bio da se ispita da li viktimizacija u detinjstvu povećava rizik od pokušaja suicida kod odraslih osoba. Metode. Istraživanje je sprovedeno na grupi od 90 pacijenata, 71 žene i 19 muškaraca, prosečne životne dobi od 37,92 ± 11,04 godina, hospitalizovanih u Dnevnoj bolnici Klinike za psihijatriju Vojnomedicinske akademije, Beograd, Srbija. U istraživanju su korišteni: Upitnik viktimizacija (The Juvenile Victimization Questionnaire – JVQ), Upitnik mehanizama odbrane (Defense Style Questionnaire – DSQ-40) i Bekova skala depresije (Beck Depression Inventory – BDI). Ispitanici su bili podeljeni u dve grupe: grupa pacijenata koji su pokušali suicid (N = 50) i grupa pacijenata koji su bili na psihoterapijskom tretmanu zbog različitih životnih kriza koje nisu imale za posledicu pokušaj samoubistva (N = 40). Iz ispitivanja su isključeni pacijenti sa psihotičnim poremećajem (F20-F29, F30-31 i F 32.3), bolestima zavisnosti (F10-F19) i demencijom (F00-F09), prema Međunarodnoj klasifikaciji bolesti 10 verzija (ICD 10) (World Health Organization criteria). Ispitanici obe grupe su bili ujednačeni prema godinama života, obrazovanju i bračnom statusu. Za statističku obradu korišten je Studentov t-test za parametarsku i Mann-Whitney U test za neparametarsku analizu podataka. Rezultati. Pacijenti koji su pokušali suicid ispoljavali su depresiju umerenog stepena (19.76 ± 10.52) i koristili su nezrele mehanizme odbrane (p < 0.001). Upitnikom JVQ utvrđene su statistički značajne razlike na Ukupnom skoru viktimizacije (p < 0.005), kao i na dva modula: Vršnjačko zlostavljanje (p < 0.005) i Seksualno zlostavljanje (p < 0.005). Zaključak. Odrasle osobe koje su češće tokom života pokušale samoubistvo su bile žrtve vršnjačkog i seksualnog zlostavljanja u detinjstvu. Podaci o zlostavljanju u ranom detinjstvu pružaju mogućnosti rane detekcije osoba sa suicidnim rizikom što može pomoći u psihoterapijskom radu sa ovim osobama, kao i u prevenciji suicida u široj populaciji.
Reference
REFERENCES
Dedić G, Djurdjević S, Golubović B. Psychological assessment of persons following suicide attempt by self-poisoning. Vojnosa-nit Pregl 2010; 67(2): 151–8.
Roeger L, Allison S, Korossy-Horwood R, Eckert KA, Goldney RD. Is a history of school bullying victimization associated with adult suicidal ideation?: A South Australian population-based observational study. J Nerv Ment Dis 2010; 198(10): 728–33.
Meltzer H, Vostanis P, Ford T, Bebbington P, Dennis MS. Victims of bullying in childhood and suicide attempts in adulthood. Eur Psychiatry 2011; 26(8): 498–503.
Brunstein KA, Sourander A, Gould M. The association of suicide and bullying in childhood to young adulthood: A review of cross-sectional and longitudinal research findings. Can J Psy-chiatry 2010; 55(5): 282–8.
Lutz P, Almeida D, Fiori LM, Turecki G. Childhood maltreat-ment and stress-related psychopathology: The epigenetic memory hypothesis. Curr Pharm Design 2015; 21(11): 1413–7.
Harford TC, Yi H, Grant BF. Associations between childhood abuse and interpersonal aggression and suicide attempt among U.S. adults in a national study. Child Abuse Negl 2014; 38(8): 1389–98.
Aho N, Gren-Landell M, Svedin CG. The Prevalence of Poten-tially Victimizing Events, Poly-Victimization, and Its Associa-tion to Sociodemographic Factors: A Swedish Youth Survey. J Interpers Violence 2016; 31(4): 620–51.
Spokas M, Wenzel A, Stirman SW, Brown GK, Beck AT. Suicide risk factors and mediators between childhood sexual abuse and suicide ideation among male and female suicide attempters. J Trauma Stress 2009; 22(5): 467–70.
Takizawa R, Maughan B, Arseneault L. Adult health outcomes of childhood bullying victimization: Evidence from a five-decade longitudinal British birth cohort. Am J Psychiatry 2014; 171(7): 777–84.
Witt A, Münzer A, Ganser HG, Fegert JM, Goldbeck L, Plener PL. Data on maltreatment profiles and psychopathology in children and adolescents. Data Brief 2016; 8: 1352–6.
Dedić GJ, Brown P. History of bullying preceding suicide at-tempt. Eur Psychiatry 2012; 27(Suppl 1): 1.
Dedić G. Victimization in childhood as a suicid risk factor in adulthood. Eur Psychiatry 2017; 441(Suppl 1): S291–S291.
World Health Organization. The ICD-10 Classification for men-tal and behavioural disorders. Diagnostic criteria for research. Geneva; World Health Organization; 1993.
Finkelhor D, Hamby SL, Ormrod R, Turner H. The Juvenile Vic-timization Questionnaire (JVQ): Reliability, validity, and na-tional norms. Child Abuse Negl 2005; 29(4): 383–412.
Andrews G, Singh M, Bond M. The Defense Style Questionnaire. J Nerv Ment Dis 1993; 181(4): 246–56.
Beck AT, Epstein N, Brown G, Steer RA. An inventory for mea-suring clinical anxiety: Psychometric properties. J Consult Clin Psychol 1988; 56(6): 893–7.
Schelbe L, Geiger JM. Intergenerational Transmission of Child Maltreatment. Springer Briefs in Social Work. .. New York, NY, US: Springer Publishing Co; 2017.
Datilio FM, Friman A. Cognitive-behavioral strategies in crisis interventions. Jastrebarsko: Naklada Slap; 2011. (Croatian)
Zalsman G. Genetics of Suicidal Behavior in Children and Adolescents. In: Dwivedi Y, editor. The Neurobiological Basis of Suicide. Boca Raton (FL): CRC Press/Taylor & Francis; 2012.
Cankaya B, Talbot NL, Ward EA, Duberstein PR. Parental sexual abuse and suicidal behaviour among women with major depressive disorder. Can J Psychiatry 2012; 57(1): 45–51.
Cuevas CA, Finkelhor D, Ormrod R, Turner H. Psychiatric diag-nosis as a risk marker for victimization in a national sample of children. J Interpers Violence 2009; 24(4): 636–52.
You S, Talbot NL, He H, Conner KR. Emotions and suicidal ideation among depressed women with childhood sexual abuse histories. Suicide Life Threat Behav 2012; 42(3): 244–54.
Klomek AB, Sourander A, Niemelä S, Kumpulainen K, Piha J, Tamminen T, et al. Childhood bullying behaviors as a risk for suicide attempts and completed suicides: A population-based birth cohort study. J Am Acad Child Adolesc Psychiatry 2009; 48(3): 254–61.
Játiva R, Cerezo AM. The mediating role of self-compassion in the relationship between victimization and psychological ma-ladjustment in a sample of adolescents. Child Abuse Negl 2014; 38(7): 1180–90.
Hahm HC, Lee Y, Ozonoff A, van Wert MJ. The impact of mul-tiple types of child maltreatment on subsequent risk behaviors among women during the transition from adolescence to young adulthood. J Youth Adolesc 2010; 39(5): 528–40.
Jeon HJ, Roh M, Kim K, Lee J, Lee D, Yoon SC, et al. Early trau-ma and lifetime suicidal behavior in a nationwide sample of Korean medical students. J Affect Disord 2009; 119(1–3): 210–4.
Frey LM, Fulginiti A. Talking about suicide may not be enough: Family reaction as a mediator between disclosure and interpersonal needs. J Ment Health 2017; 26(4): 366–72.
Glasser M, Kolvin I, Campbell D, Glasser A, Leitch I, Farrelly S. Cycle of child sexual abuse: links between being a victim and becoming a perpetrator. Br J Psychiatry 2001; 179: 482–94; discussion 495–7.
Nikić S, Dedić G. The phenomenon of "scapegoating" within the family. Vojnosanit Pregl 1992; 49(6): 578–83. (Serbian)
Smith CE, Pisetsky EM, Wonderlich SA, Crosby RD, Mitchell JE, Joiner TE, et al. Is childhood trauma associated with lifetime suicide attempts in women with bulimia nervosa? Eat Weight Disord 2016; 21(2): 199–204.
Pereda N, Guilera G, Abad J. Victimization and polyvictimiza-tion of Spanish children and youth: results from a community sample. Child Abuse Negl 2014; 38(4): 640–9.
Labonte B, Turecki G. The epigenetics of suicide: Explaining the biological effects of early life environmental adversity. Arch Suicide Res 2010; 14(4): 291–310.
Sachs-Ericsson NJ, Stanley IH, Sheffler JL, Selby E, Joiner TE. Non-violent and violent forms of childhood abuse in the prediction of suicide attempts: Direct or indirect effects through psychiatric disorders? J Affect Disord 2017; 215: 15–22.
Aho N, Proczkowska-Björklund M, Svedin CG. Victimization, po-lyvictimization, and health in Swedish adolescents. Adolesc Health Med Ther 2016; 7: 89–99.
Jokinen J, Forslund K, Ahnemark E, Gustavsson JP, Nordström P, Asberg M. Karolinska Interpersonal Violence Scale predicts suicide in suicide attempters. J Clin Psychiatry 2010; 71(8): 1025–32.
Soler L, Segura A, Kirchner T, Forns M. Polyvictimization and risk for suicidal phenomena in a community sample of Spanish adolescents. Violence Vict 2013; 28(5): 899–912.
Campbell-Sills L, Kessler RC, Ursano RJ, Rosellini AJ, Afifi TO, Colpe LJ, et al. Childhood Maltreatment and Lifetime Suicidal Behaviors Among New Soldiers in the US Army: Results From the Army Study to Assess Risk and Resilience in Servi-cemembers. J Clin Psychiatry 2017;. pii: 16m10900.
Barzilay S, Brunstein KA, Apter A, Carli V, Wasserman C, Had-laczky G, et al. Bullying Victimization and Suicide Ideation and Behavior Among Adolescents in Europe: A 10-Country Study. J Adoles Health 2017; 61(2): 179–86.
Dedić G. Psychosocial aspects of rape. Vojnosanit Pregl 1994; 51(6): 534–9. (Serbian)
McKibbin G, Humphreys C, Hamilton B. "Talking about child sexual abuse would have helped me": Young people who sex-ually abused reflect on preventing harmful sexual behavior. Child Abuse Negl 2017; 70(16): 210–21.
Dedić G. Model of psychotherapeutic crisis intervention following suicide attempt. Vojnosanit Pregl 2012; 69(7): 610–5.
Dedić G. Suicide-help, hope-psychotherapeutic intervention in crisis after suicide attempt. Belgrade: Medija centar Odbrana; 2011. (Serbia)