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Strain and Rural Young Suicide and Its Theoretical Model

Author: GaoZuo
Tutor: ZhangJie;JiangBaoFa
School: Shandong University
Course: Epidemiology and Biostatistics,
Keywords: Suicide Rural Youth Torque Theoretical model
CLC: B846
Type: PhD thesis
Year: 2011
Downloads: 187
Quote: 1
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Abstract


Background suicide or committed suicide (Completed Suicide), is the actors I fully understand or expectations of the fatal consequences of this action, in order to adopt a sense of self-destructive behavior leading to death. Around the world each year about 100 people die from suicide, attempted suicide suicide death of 10-fold compared to;, suicide is a cause of death in 15-34 year olds in our country, about 93% of suicides occur in rural areas . Suicide as a social phenomenon, is an important public health problem involving social, psychological, biological, medical and multidisciplinary. In Western society, the longer history of suicide, suicide risk factors have been found mainly include: mental illness, history of suicide attempts, physical illness, chronic or acute interpersonal problems, stressful life events, low socio-economic status, single unemployed. Mental illness is more important suicide risk factors, about 90% of suicide victims suffer from one or more mental illness. Compared to Western society, China's suicide research conducted quite late, according to some scholars of the epidemiological investigation, the suicide epidemic in China is mainly characterized by the status of the following three features: a female slightly higher than the male, female suicide rates 1.25 times that of men; rural areas than in urban Chinese rural suicide rate 3.27 times that of the city; Third, the overall bimodal age characteristics of suicide rates in China, a suicide peak aged 15-34, the second a peak for more than 60 years of age. Suicide epidemic of domestic change in recent years, mainly in the gender composition of the suicide tends to be male high female low suicide rate gap between urban and rural areas has been reduced, but it is accepted that the rural suicide rate is still much higher than the city, the suicide rate among 15-34 year-old age peak exists, suicide is a role of the social phenomenon caused by a number of factors. The study found two weeks before the suicide in China higher depression score, a history of suicide attempts, suicide acute stress intensity suicide a month before the poor quality of life, severe chronic psychological stress suicide the previous year, before committing suicide days of serious interpersonal conflict, people related by blood suicidal behavior, friends or acquaintances such as suicidal behavior is a major risk factor for suicide crowd. The past, the majority of suicide studies are simply looking for suicide risk factors from the perspective of sociology, psychology or psychiatry, it will eventually find a large number of risk factors, including the related events, social conditions, psychological or mental characteristics but only a few is not enough, these risk factors are likely to just people who committed suicide in before committing suicide, psychological and social conditions in some of the more intuitive surface reason for the next step of suicide prevention, and risk factors more bring multi-clue focus faults, we must explore the deeper reason hidden beneath these surface features, the correct interpretation of the root causes of suicide, which must have the correct theory as a guide. Western scholars on the basis of the study were made from the point of view of sociology, psychology and biology a lot about the suicide theory, mainly in the following three directions: First, the direction of sociology, Durkheim for, he considered suicide cause of individual social experience \), anomic suicide (Anomic Suicide) and fatalistic suicide (Fatalistic Suicide). , Psychology and social psychology direction, the direction of the main research directions in the theory of suicide, which depending on the focus of psychoanalytic theory, behavioral theory, poststructuralist theory, and cognitive theory. Psychoanalytic theory is that suicide is a failed response, such failure may result from excessive development of superego, the long-term psychological conflict, energy consumption, threatening raw power, resulting in the death of the upper hand; behaviorism that suicide is learned; cognitive theory that suicide is due to problems or setbacks in the cognitive processes internalization of negative emotions, caused long-term cognitive reduction will result in suicide. , Biology direction, including the study of the relationship of Neurobiology and Genetics and suicide. The researchers found that the content of serotonin may be the reasons of depression and suicide, especially the causes of suicide impulse. In recent years, it was found that some loci, such as the serotonin transporter gene, tryptophan hydroxylase gene correlation may exist and suicide gene and suicide Suicide Research in recent years new direction. Most of the above theoretical model is found in the field of social, psychological, physical or mental risk factors, a brief summary and integration, most complex, most of them based on the concept of sociology or psychology metaphysical reasoning, is more difficult to quantitative means of verification; these theories and more construction is based on psychological characteristics and social situation of the Westerners compared the distribution of the Chinese population and its distribution in Western society, under the influence of China's unique social and cultural background, suicide has its own peculiarities and differences, Western suicide theory model is not a good explanation of the psychological roots of suicide and suicide mode. For the above reasons Professor Zhang Jie Considering previous pressure theory of social and psychological factors, the researchers created a torsion theory to explain the root causes of suicide. The torque (Strain) that uncoordinated pressure, it is the pressure of two or more opposing ideas or social experience in individual psychology. Torque is different from the ordinary pressure, torque formation must have the presence of two or multiple pressure source, a total of four different sources torque: 1) different values ??conflict, when people of the two conflicting values ??of the same identity uncoordinated pressure experience; 2) desire and reality deviates from a wide gap between people's aspirations or goals with reality difficult to achieve when experience the incongruous pressure; 3) relative deprivation, uncoordinated pressure when it was discovered that the same or similar people with their own background is with the plight of their superior experience; 4) crisis and the lack of capacity to respond when people crisis and the lack of appropriate response experience of the incongruous pressure. Torsion theory fully consider the individuals in the state of mind to accept the concept or situation when, comprehensive consideration of the mutual influence of social factors, individual psychological and spiritual factors. According to the definition of suicide, we believe that the various factors that affect suicide, the first and most fundamental factor is the psychological motives and motivation of the individual, is due to strong stimulation and influence of outside forces the individual for suicide ideation and suicide attempts, and eventually put into practice completed suicide. Better explain the power source of the suicide is torsion theory, Professor Zhang Jie torque theory, give full consideration to the cultural background and the traditional concept of combining social psychology and psychiatric factors to build out a suicide torque model . We believe that the torque root lead to suicide, the presence of torsion may be a direct result of people suicidal ideation or take a variety of means to commit suicide; torque may also lead to depression, schizophrenia and other serious mental disorders, leading to suicide, mental disorders may Torque point intermediate variables in the relationship and suicide; torque suicide point relationship may exist other psychosocial factors regulating the role of these factors in the relationship between the torque and suicide or play a collaborative role (risk factors), or plays antagonistic effect (protective factors), the lack of protective factors, strengthening the role of risk factors repeated individual torsion experience will eventually lead to suicide. Research purposes of measuring torque based on existing measurement tools; measure of the presence of the four sources in the rural aged 15-34 youth population torque by torque measurement and analysis, comparison of rural youth suicide crowd control The difference in the distribution of torque between the crowd. Study the relationship of the different types of torque and rural youth suicide measure of different sources torque suicide, to examine the relationship between the different types of torque. Relationship between psychosocial factors to study various types of torque with the level of education, social support, impulsivity and anxiety and mental illness, research torsion and other relevant factors exist in the case of rural youth suicide. To explore using structural equation modeling techniques and validation suicide torque model, comprehensive discussion of China's rural social, cultural and individual psychological aspects of suicide-related factors, and provide recommendations for suicide prevention. Methods This study uses a case-control study design, the use of the psychological autopsy method to collect information of the youth population aged 15-34 in rural China. We randomly selected in three provinces of Shandong, Liaoning and Hunan 16 counties or county-level cities, and then in the 16 counties through sequential sampling method to extract the suicide deaths between October 1, 2005 to 30 June 2008 15-34 year-old rural residents as the object of study, and randomly selected number of rural residents of the same age as the control of those who committed suicide were included in this study. Suicide death list from the county for Disease Prevention and Control Center Coroner's monitoring system. The survey total of 392 cases of suicide and 416 controls were effective. For each case of suicide, we have selected two more people understand the information of the deceased as a research object. First information generally for the families of the deceased, such as parents, siblings, spouses, the second information generally deceased friends or neighbors. For each control, we also select two information, information selection criteria are the same as the case of suicide. Reduce information bias in order to avoid information mourning reaction, we chose to interview two information people who committed suicide after the death of 2-6 months; avoid the attention of the local customs taboo day when the interview date is selected. A one-on-one, face-to-face interviews conducted a questionnaire survey. Related to the contents of the questionnaire interviews include: 1) In general, including gender, age, where they are residing, ethnicity, years of education, marital status, whether living alone, family size, employment status, household income, religious beliefs, physical illness , family suicide history, family psychiatric history, etc.: 2) information people semi-fixed-interview outline, mainly including suicide after a suicide before and after the occurrence of anything to stimulate target people suicide target people whether life is very disappointed, etc.; 3) Torque measurement scales, including the desire to achieve entry, the relative deprivation entry, capacity to respond scale (Coping Response Inventory, CRI,), male norms of Confucianism, Confucianism female norms, values ??Conflict Scale, the scale of the concept of gender equality ; 4) psychosocial questionnaire, including Life Event Scale, Social Support Scale, Impulsiveness Scale the (DickmanImpulsivity Inventory, DII), trait anxiety (State-Trait Anxiety Inventory, STAI), etc.; 5) Mental Status Questionnaire despair Scale (Beck Hopelessness Scale, BHS), Hamilton Depression Rating Scale (Hamilton Rating Scale for Depression, HAM-D), the DSM-IV clinical interview (Structured Clinical Interview for DSM-IV, SCID). Results 1. Measure torque eight variables in the distribution of the suicide and control groups have significant differences. In the suicide group, the relative deprivation of torque (3.62 ± 0.92), Confucianism female norms (2.98 ± 0.57) and desire with reality torque (2.90 ± 1.35) are the top three scores higher variable the same in the control group relatively deprived of torque (3.03 ± 0.58), Confucianism female norms (2.70 ± 0.56) and the desire and the reality of torque (2.55 ± 1.48) is higher variable top three scores. Torque experience score of the suicide group were significantly greater than the control group (P lt; 0.001 or P = 0.001). 2 suicide group and control group, the proportion of male desire to achieve significantly smaller than female. Suicide group, the relative deprivation torque of men and women score higher in men than women and there are significant differences (the 3.73 vs.3.49, P = 0.01), Confucianism norms of women score higher in men than women and there is a significant difference (3.05 vs.2.89 , P = 0.008), weak concept of gender equality score in men than women and there is a significant difference (1.79 vs.1.63, P lt; 0.001); men and women in the control group only in the weak concept of gender equality score significant difference (1.67 vs.1.56, P = 0.007). Considering torque, social, psychological and mental condition factor, our sample overall multivariate logistic regression analysis, 12 variables ultimately included in the equation, torque the experience variables have been included in equation 2, are weak and actively respond to ( OR = 5.020), the values ??conflict (OR = 0.538); seven variables were included in the final equation psychosocial factors are marital status (OR = 0.336), caucus relationship (OR = 0.408), family history of suicide (OR = 3.317 ), family status (OR = 0.571), negative life events (OR = 1.376), years of education (OR = 0.844), non-functional impulse (OR = 1.176); mental factors three variables are included in equation, including the sense of desperation (OR = 2.339), depression (OR = 9.141) and mental illness (OR = 4.787). 10 variables for the male group eventually included in the equation, Torque experience variables have been included in equation 4 are relatively deprived of torque (OR = 1.767), the strong negative response (OR = 2.646), weak positive response (OR = 3.772) , values ??conflict (OR = 0.399); psychosocial factors three variables to be included in the final equation, respectively, is with the parents of the relationship (OR = 1.924), by education year number (OR = 0.715), non-functional impulse (OR = 1.162 ); mental factors three variables are included in the equation, including a sense of desperation (OR = 1.113), depression (OR = 37.871) and mental illness (OR = 8.385). There are nine variables ultimately included in the equation for the female group, torque an experience variables are included in equation, is a weak positive response (OR = 7.337); social and psychological factors five variables are included in the equation, marital status (OR = 0.213), caucus relationship (OR = 0.192), family status (OR = 0.315), negative life events (OR = 1.624), non-functional impulses (OR = 1.213); mental factors three variables are included in the equation, including the sense of desperation (OR = 1.150), depression (OR = 11.123) and mental illness (OR = 3.833). Considering torque, social, psychological and mental condition factor, we build structural equation model of rural youth suicide, at the point of suicide risk factors, mental factors path coefficient was 0.73 Second torque experience its path coefficients 0.67, and psychosocial factors in its path coefficient 0.66; the torsion factors and psychosocial factors related to sex strong correlation coefficient of 0.84, path coefficient of torque factors and psychosocial factors on the mental factors of 0.62 and 0.52, respectively. Conclusions of significance. Whether suicide crowd or the normal population, relative poverty is still the main problem faced by the people, want to be able to affluent still is the most urgent desire of the people's minds, people are more likely to experience relative poverty torque, while the the types of Torque experience account for a large proportion of people experience various types of torque; ability to achieve the aspirations of the rural population or limited, many difficulties hinder the desire to achieve in reality, it is generally easy to experience desire and reality torque. Among the women, the suicide and control groups strongly negative coping, values, conflict and weak concept of gender equality in three variables score minimum and no significant differences suicide women with control populations in the face of crisis, take the wrong negative coping ability may be at a level, and are relatively small relative to men; women generally agree that the concept of gender equality, brought on by its smaller torque experience. Men may be more easily feel the the torque relative deprivation; men more likely to experience the Promotion of Women, as well as gender equality popularity of the concept of the psychological torque. After considering various factors, psychological factors for the population as a whole still is the most important risk factors for suicide, the risk factors for the lack of correct positive response capacity is also very important in the face of a crisis. By comparison of male and female suicide risk factors, we may infer of torque factors on male suicide larger than females; torque experience relative deprivation for men, may be more profound impact on male suicide, men may be more susceptible to the impact of the real problem of the economy or substances lead to suicide; men and women will be because of the lack of positive response in the face of crisis and lead to suicide, but the male's ability to withstand the crisis may be weaker than women, because men will not only because of the lack of a positive response capacity suicide, and error, a negative response measures will be taken in the face of crisis, which may take suicide the most extreme way to escape. By the obtained models, we can infer torque is Chinese rural youth suicide important dangerous factors; torque factors psychological factors also have an important impact, torsion may be able to affect the individual spirit condition which lead individuals to commit suicide; psychosocial factors and torque there is a strong interaction between the factors, psychosocial factors can lead to suicide, may through the individual torque experience and lead to suicide. 4 of this study is more comprehensive study torque distribution experience in China's rural youth, build eight variables to measure torque and for rural youth suicide and control groups to compare more comprehensive measure of the torque factors in rural China impact in youth suicide; epidemiological methods and the theory of social psychology to explore the theoretical model of the Chinese rural youth suicide risk factors and suicide; torque theoretical model using structural equation modeling techniques to explore the suicide, for the first time more comprehensive a quantitative method to verify the theoretical model of suicide.

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