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目的 探讨预防自我伤害的家庭安全计划干预对青少年抑郁症患者的抑郁程度、自杀意念、自我伤害程度、家庭支持程度的影响，为改善青少年抑郁症患者的自我伤害行为提供参考。方法 采用便利抽样法选取98例青少年抑郁症患者随机分为观察组和对照组各49例，观察组接受预防自我伤害的家庭安全计划干预，对照组接受常规治疗管理。干预2周后，采用汉密尔顿抑郁量表-24(HAMD-24)、Beck自杀意念量表(BSI-CV)、青少年自我伤害问卷、父母心理控制量表、父母自主支持量表评价并比较研究对象的抑郁程度、自杀相关想法及行为、家庭支持程度方面的差异。结果 共86例患者完成本次研究。干预后，观察组和对照组的HAMD-24得分分别为(9.00±6.35)分、(12.46±5.98)分，最近一周自杀意念总分得分分别为(5.74±4.82)分、(11.81±6.87)分，2组间差异均有统计学意义(均P<0.05)。干预后，观察组青少年自我伤害问卷得分为(2.76±5.04)分，父母心理控制量表和父母自主支持量表得分为(28.41±9.94)分、(54.90±13.58)分，对照组分别为(8.86±13.60)分、(33.58±8.92)分、(46.86±12.02)分; 2组间差异均有统计学意义(均P<0.05)。结论 预防自我伤害的家庭安全计划干预能有效降低具有自我伤害行为的青少年抑郁症患者的抑郁水平，减轻其自杀意念，降低其自我伤害程度并提高家庭支持程度。
Abstract：Objective To evaluate the impact of a family safety planning intervention on depressive symptoms,suicidal ideation,self-harm severity,and family support in adolescents with depression,in order to provide reference for reducing self-harm behaviors in this population. Methods Using a convenience sampling method,98 adolescents with depression were enrolled and randomly divided into the intervention group(n = 49) and the control group(n = 49). The intervention group received a family safety planning intervention for preventing self-harm,while the control group received routine treatment and care. After the 2-week intervention,participants were assessed using the Hamilton depression rating scale-24(HAMD-24),the Beck scale for suicide ideation-Chinese version(BSI-CV),the adolescent self-harm inventory,the parental psychological control scale,and the parental autonomy support scale. The differences in depression severity,suicide-related thoughts and behaviors,and levels of family support between the two groups were compared. Results A total of 86 participants completed the study. After the intervention,the intervention group demonstrated significantly lower scores compared to the control group on the HAMD-24(9. 00±6. 35 vs. 12. 46±5. 98) and on the BSI-CV total score for recent suicidal ideation(5. 74±4. 82 vs. 11. 81± 6. 87),all P< 0. 05. Similarly,post-intervention scores favored the intervention group on the adolescent self-harm inventory(2. 76 ± 5. 04 vs. 8. 86 ± 13. 60),the parental psychological control scale(28. 41±9. 94 vs. 33. 58±8. 92),and the parental autonomy support scale(54. 90±13. 58 vs. 46. 86±12. 02),all P<0. 05.Conclusions A family safety planning intervention for self-harm prevention effectively reduces the depressive symptoms,suicidal ideation,and self-harm severity,while improving perceived family support in adolescents with depression.
[1]FERGUSSON D M,HORWOOD L J. The christchurch health and development study:review of findings on child and adolescent mental health[J].Aust N Z J Psychiatry,2001,35(3):287-296.
[2]MCGEE R,FEEHAN M,WILLIAMS S,et al. DSM-III disorders in a large sample of adolescents[J].J Am Acad Child Adolesc Psychiatry,1990,29(4):611-619.
[3]BACHMANN S.Epidemiology of suicide and the psychiatric perspective[J].Int J Environ Res Public Health,2018,15(7):1425.
[4]MUEHLENKAMP J J,XHUNGA N,BRAUSCH A M. Self-injury age of onset:a risk factor for NSSI severity and suicidal behavior[J].Arch Suicide Res,2019,23(4):551-563.
[5]韩阿珠，徐耿，苏普玉．中国大陆中学生非自杀性自伤流行特征的Meta分析[J]．中国学校卫生，2017,38(11):1665-1670.
[6]World Health Organization. Practice manual for establishing and maintaining surveillance systems for suicide attempts and self-harm[M].Geneva:World Health Organization,2016.
[7]周晶晶，王小平，方贻儒，等．精神科医生对伴有自杀意念和自杀未遂抑郁症患者的诊疗现况调查[J]．神经疾病与精神卫生，2023,23(9):626-634.
[8]徐家玥，周云飞．导致自杀行为的高危因素[J]．国际精神病学杂志，2023,50(4):616-619.
[9]陈祉妍，郭菲，方圆．2022年国民心理健康调查报告:现状、影响因素与服务状况[M]//傅小兰，张侃，陈雪峰，等．中国国民心理健康发展报告(2021—2022)．北京:社会科学文献出版社，2023:1-29.
[10]DOUPNIK S K,RUDD B,SCHMUTTE T,et al. Association of suicide prevention interventions with subsequent suicide attempts,linkage to follow-up care,and depression symptoms for acute care settings:a systematic review and meta-analysis[J].JAMA Psychiatry,2020,77(10):1021.
[11]ASARNOW J R,BERK M S,BARAFF L J. Family intervention for suicide prevention:a specialized emergency department intervention for suicidal youths[J]. Prof Psychol Res Pract,2009,40(2):118-125.
[12]ASARNOW J R,BARAFF L J,BERK M,et al. An emergency department intervention for linking pediatric suicidal patients to follow-up mental health treatment[J]. Psychiatr Serv,2011,62(11):1303-1309.
[13]李金澄．基于情绪管理的团体辅导对青少年自伤的干预研究[D]．长沙:湖南师范大学，2016.
[14]GYSIN-MAILLART A,SCHWAB S,SORAVIA L,et al. A novel brief therapy for patients who attempt suicide:a 24-months followup randomized controlled study of the attempted suicide short intervention program(ASSIP)[J].PLoS Med,2016,13(3):e1001968.
[15]BECK A T,STEER R A,CARBIN M G.Psychometric properties of the Beck Depression Inventory:twenty-five years of evaluation[J].Clin Psychol Rev,1988,8(1):77-100.
[16]杨文辉，刘绍亮，周烃，等．贝克抑郁量表第2版中文版在青少年中的信效度[J]．中国临床心理学杂志，2014,22(2):240-245.
[17]王黎明，申彦丽，梁执群，等．Beck自杀意念量表中文版评价抑郁症患者的信、效度[J]．中国健康心理学杂志，2012,20(1):159-160.
[18]郑莺．武汉市中学生自我伤害行为流行学调查及其功能模型[D]．武汉:华中师范大学，2006.
[19]冯玉．青少年自我伤害行为与个体情绪因素和家庭环境因素的关系[D]．武汉:华中师范大学，2008.
[20]SHEK D T L,LEE T Y.Perceived parental behavioral control,psychological control,and parent-child relational qualities in Chinese adolescents in Hong Kong[M]//KANE M J. Contemporary issues in parenting.New York:Nova Science,2005:47-63.
[21]SHEK D T L.Perceived parental control based on indigenous Chinese parental control concepts in adolescents in Hong Kong[J].Am J Fam Ther,2007,35(2):123-137.
[22]MAGEAU G A,RANGER F,JOUSSEMET M,et al.Validation of the perceived parental autonomy support scale(P-PASS)[J]. Can J Behav Sci,2015,47(3):251-262.
[23]聂苗卉．父母心理控制及自主支持与大学生未来规划:双元自主的中介作用[D]．上海:华东师范大学，2018.
[24]刘嘉．绘画团体辅导在有自伤行为高职生群体中的干预研究[J]．科教导刊，2021(10):158-160.
[25]林妮娜．结合舞动治疗的团体辅导在减少中学生自伤行为中的作用[D]．南昌:江西师范大学，2018.
[26]王宇飞．元认知干预技术对青少年自伤行为干预效果的研究[D]．大连:辽宁师范大学，2020.
[27]ZHOU X Y,TENG T,ZHANG Y Q,et al. Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder:a systematic review and network meta-analysis[J].Lancet Psychiatry,2020,7(7):581-601.
[28]《自杀风险患者评估和管理临床实践指南》编写背景和使用事项[J]．中国心理卫生杂志，2015,29(S1):2-11.
[29]B部分:对自杀风险患者的初步干预[J]．中国心理卫生杂志，2015,29(S1):41-61.
[30]苗莹莹，徐晖，李旻玥．安全计划干预在预防患者自杀中的应用进展[J]．中华护理杂志，2023,58(17):2166-2170.
[31]张素贞，慕永刚．安全干预计划对大学生非自杀性自伤行为干预的研究[J]．养生保健指南，2019(49):283-283.
[32]STANLEY B,MARTÍNEZ-ALÉS G,GRATCH I,et al. Coping strategies that reduce suicidal ideation:an ecological momentary assessment study[J].J Psychiatr Res,2021,133:32-37.
[33]缪群芳，李静依，彭岸舒，等．伴自杀意念的青少年抑郁症患者心理体验的质性研究[J]．中华现代护理杂志，2023,29(28):3829-3835.
[34]MADSEN T,ERLANGSEN A,EGILSDOTTIR E,et al. The effect of the SAFE intervention on post-discharge suicidal behavior:a quasi-experimental study using propensity score matching[J]. Soc Psychiatry Psychiatr Epidemiol,2024,59(6):1053-1061.
[35]韩燕，徐彬，蒋慧珠，等．伴非自杀性自伤行为青少年抑郁症患者与其父母互动需求的质性研究[J]．中华现代护理杂志，2024,30(27):3707-3712.
[36]叶铭惠，胡颖颖，何春雷，等．青少年服毒自杀患者心理体验的质性研究[J]．中华护理杂志，2021,56(2):250-254.
[37]BALASA R,LIGHTFOOT S,CLEVERLEY K,et al. Effectiveness of emergency department-based and initiated youth suicide prevention interventions:a systematic review[J]. PLoS One,2023,18(12):e0289035.
[38]蒲睿，戴丽帆，罗鹏，等．大学生父母心理控制与健康危险行为的关联[J]．中国学校卫生，2020,41(6):863-866.
[39]黄垣成，赵清玲，李彩娜．青少年早期抑郁和自伤的联合发展轨迹:人际因素的作用[J]．心理学报，2021,53(5):515-526.
基本信息:
DOI：10.19890/j.cnki.issn1674-6449.2026.02.007
中图分类号:R749.4
引用信息:
[1]谢文茹,孔彩虹,朱小英,等.预防自我伤害的家庭安全计划干预对青少年抑郁症患者的影响[J].健康研究,2026,46(02):160-167+179.DOI:10.19890/j.cnki.issn1674-6449.2026.02.007.
基金信息:
杭州市医药卫生科技项目(A20220126)
2026-04-15
2026-04-15