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Antecedents and sex/gender differences in youth suicidal behavior

World Journal of Psychiatry 2014年第4期4卷 120-132页

作者： Anne E Rhodes Michael H Boyle Jeffrey A Bridge Mark Sinyor Paul S Links Lil Tonmyr Robin Skinner Jennifer M Bethell Corine Carlisle Sarah Goodday Travis Salway Hottes Amanda Newton Kathryn Bennett Purnima Sundar Amy H Cheung Peter Szatmari Institute for Clinical Evaluative Sciences Toronto M4N 3M5 Ontario Canada Department of Psychiatry University of Toronto Toronto M5T 1R8 Ontario Canada Suicide Studies Unit St. Michael’s Hospital Toronto M5B 1W8 Ontario Canada Dalla Lana School of Public Health University of Toronto Toronto M5T 3M7 Ontario Canada Department of Psychiatry and Behavioural Neurosciences Mc Master University Hamilton L8N 3K7 Ontario Canada The Offord Centre for Child Studies Hamilton L8S 4K1 Ontario Canada The research Institute at Nationwide Children’s Hospital Columbus OH 43205 United States The Ohio State University College of Medicine Columbus OH 43210 United States Sunnybrook Health Sciences Centre Toronto M4N 3M5 Ontario Canada Department of Psychiatry University of Western Ontario London N6A 5W9 Ontario Canada The Injury and Child Maltreatment Section Public Health Agency of Canada Ottawa K1A 0K9 Ontario Canada The Centre for Addiction and Mental Health Toronto M6J 1H4 Ontario Canada Department of Pediatrics University of Alberta Edmonton Alberta T6G 1C9 Canada The Department of Clinical epidemiology and Biostatistics Mc Master University Hamilton L8S 4K1 Ontario Canada The Ontario Centre of Excellence for Child and Youth Mental Health Ottawa K1G 0Z1 Ontario Canada The Hospital for Sick Children Toronto M5G 1X8 Ontario Canada

Suicide is the second leading cause of death in youth globally; however, there is uncertainty about how best to intervene. Suicide rates are typically higher in males than females, while the converse is true for suicide attempts. We review this "gender paradox" in youth, and in particular, the age-dependency of these sex/gender differences and the developmental mechanisms that may explain them. Epidemiologic, genetic,neurodevelopmental and psychopathological research have identified suicidal behaviour risks arising from genetic vulnerabilities and sex/gender differences in early adverse environments, neurodevelopment, mental disorder and their complex interconnections. Further, evolving sex-/gender-defined social expectations and norms have been thought to influence suicide risk. In particular, how youth perceive and cope with threats and losses(including conforming to others' or one's own expectations of sex/gender identity) and adapt to pain(through substance use and helpseeking behaviours). Taken together, considering brain plasticity over the lifespan, these proposed antecedents to youth suicide highlight the importance of interventions that alter early environment(s)(e.g., childhood maltreatment) and/or one's ability to adapt to them. Further, such interventions may have more enduring protective effects, for the individual and for future generations, if implemented in youth.

关键词： Suicide Attempted suicide Sex Gender Child Adolescent Review

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