Abstract：
BACKGROUND: Suicide is a significant global public health concern. However, previous studies have predominantly focused on individual-level risk factors. Against this backdrop, microsystem suicide propinquity, which encompasses suicidal thoughts and behaviors (STB) within families and peer groups, is significant in elucidating the development and perpetuation of STB in adolescents.
METHODS: This study utilized data from the National Longitudinal Study of Adolescent to Adult Health (Add Health, 1994-2018). Adolescents who reported instances of suicide attempts among their friends and family members during Wave 1 were selected (N = 4826). Generalized estimation equations (GEE) and structural equation models (SEM) were employed.
RESULTS: GEE analyses indicated that individuals with friends who had attempted suicide exhibited higher risks for suicidal ideation (OR [95 % CI] = 2.57 [2.13, 3.11]) and suicide attempts (OR [95 % CI] = 2.47 [1.78, 3.42]). Also, individuals with family members who had attempted suicide exhibited higher risks for suicidal ideation (OR [95 % CI] = 2.37 [1.62, 3.46]) and attempts (OR [95 % CI] = 2.27 [1.17, 4.41]). However, friends\' and family members\' suicide attempts failed to show significant interactive effect. Besides, SEM analyses indicated that friends\' and family members\' suicide attempts were associated with one\'s long-term suicidal ideation and attempts via depressive symptoms.
CONCLUSIONS: Suicide attempts of friends and family during adolescence were long-term risk factors for suicidal ideation and attempts from adolescence to young adulthood. Moreover, depressive symptoms served as long-term mechanisms in these associations.
METHODS: This study utilized data from the National Longitudinal Study of Adolescent to Adult Health (Add Health, 1994-2018). Adolescents who reported instances of suicide attempts among their friends and family members during Wave 1 were selected (N = 4826). Generalized estimation equations (GEE) and structural equation models (SEM) were employed.
RESULTS: GEE analyses indicated that individuals with friends who had attempted suicide exhibited higher risks for suicidal ideation (OR [95 % CI] = 2.57 [2.13, 3.11]) and suicide attempts (OR [95 % CI] = 2.47 [1.78, 3.42]). Also, individuals with family members who had attempted suicide exhibited higher risks for suicidal ideation (OR [95 % CI] = 2.37 [1.62, 3.46]) and attempts (OR [95 % CI] = 2.27 [1.17, 4.41]). However, friends\' and family members\' suicide attempts failed to show significant interactive effect. Besides, SEM analyses indicated that friends\' and family members\' suicide attempts were associated with one\'s long-term suicidal ideation and attempts via depressive symptoms.
CONCLUSIONS: Suicide attempts of friends and family during adolescence were long-term risk factors for suicidal ideation and attempts from adolescence to young adulthood. Moreover, depressive symptoms served as long-term mechanisms in these associations.
摘要：
背景：自杀是一个重要的全球公共卫生问题。然而,以往的研究主要集中在个体层面的危险因素上.在这种背景下,微系统自杀倾向，包括家庭和同龄人群体中的自杀想法和行为（STB），对于阐明青少年STB的发展和延续具有重要意义。
方法：这项研究利用了全国青少年对成人健康纵向研究的数据（添加健康，1994-2018)。选择了在第1波中报告其朋友和家人之间自杀未遂的青少年（N=4826）。采用广义估计方程(GEE)和结构方程模型(SEM)。
结果：GEE分析表明，有朋友自杀未遂的个体出现自杀意念（OR[95%CI]=2.57[2.13,3.11]）和自杀未遂（OR[95%CI]=2.47[1.78,3.42]）的风险较高。此外，有家庭成员尝试自杀的个体出现自杀意念(OR[95%CI]=2.37[1.62,3.46])和尝试自杀(OR[95%CI]=2.27[1.17,4.41])的风险较高.然而,朋友\'和家人\'自杀企图未能显示出显著的互动效果。此外,SEM分析表明，朋友和家庭成员的自杀未遂与一个人的长期自杀意念和通过抑郁症状的企图有关。
结论：青少年时期朋友和家人的自杀未遂是自杀意念的长期危险因素，也是青少年时期到青少年时期的自杀未遂。此外，抑郁症状是这些关联的长期机制.
方法：这项研究利用了全国青少年对成人健康纵向研究的数据（添加健康，1994-2018)。选择了在第1波中报告其朋友和家人之间自杀未遂的青少年（N=4826）。采用广义估计方程(GEE)和结构方程模型(SEM)。
结果：GEE分析表明，有朋友自杀未遂的个体出现自杀意念（OR[95%CI]=2.57[2.13,3.11]）和自杀未遂（OR[95%CI]=2.47[1.78,3.42]）的风险较高。此外，有家庭成员尝试自杀的个体出现自杀意念(OR[95%CI]=2.37[1.62,3.46])和尝试自杀(OR[95%CI]=2.27[1.17,4.41])的风险较高.然而,朋友\'和家人\'自杀企图未能显示出显著的互动效果。此外,SEM分析表明，朋友和家庭成员的自杀未遂与一个人的长期自杀意念和通过抑郁症状的企图有关。
结论：青少年时期朋友和家人的自杀未遂是自杀意念的长期危险因素，也是青少年时期到青少年时期的自杀未遂。此外，抑郁症状是这些关联的长期机制.
