Suicidal Behavior Characteristics And Suicide Risk Assessment Of Adolescent With Internet Addiction

Part one Epidemiological Characteristics and Influencing Factors of Internet AddictionObjective: To investigate the epidemiological characteristics and influencing factors of adolescents with internet addiction(IA).Method: A questionnaire survey was conducted among 27 599 adolescent students aged 15-20 years old in Chongqing and other areas by stratified cluster random sampling.Finally,26688 effective samples were investigated.The IA Scale(Young)was used to screen the students with IA.Quality of life scale,SCL-90,impulsivity,aggression,Eysenck personality scale were used to assess the influencing factors of IA.T test,chi square test and logistic regression were used for statistical description and analysis.In this study,P<0.05 was used as statistical significance.Results: The prevalence of IA among adolescents was 28.39%(7576 /26688).The prevalence of IA among male students was 32.61%,which was significantly higher than that of female students(24.37%)(P<0.01).The prevalence of IA among urban students was 36.85%,which was higher than that of rural students(23.39%)(P<0.01).However,there were no difference in the prevalence of IA among different regions and different school types(P>0.05).The incidence of IA was 44.93% in students with poor quality of life,which was higher than 22.00% in students with good quality of life(P < 0.01).IA has a great influence on students ‘mental health,learning status and the relationship between students and their families or others.The average score of SCL-90 self-rating scale of students with IA was higher than that of students without IA,and the score of IA was positively correlated with the score of SCL-90.This shows that the more serious the students’ IA,the worse their physical and mental health,suggesting that IA has affected the physical and mental health of adolescent students.The items scores and total scores of impulsivity and aggressive personality scale of students with IA were higher than those of students without IA,suggesting that IA students showed impulsive and aggressive tendencies to a certain extent.The IA assessment score was positively correlated with the impulsive and aggressive personality test scores,indicating that the more serious the students’ IA,the stronger their impulsiveness and aggression.The average scores of P and N of the Eysenck Personality Scale of students with IA were higher than those of students without IA,suggesting that students with IA had obvious psychotic and neurotic tendencies.On the contrary,the E-score of Eysenck personality traits of students with IA was lower than that of students without IA,indicating that students with IA showed introversion tendency.Internet dependence of adolescent students with IA was positively correlated with neuroticism and psychosis,and negatively correlated with extroversion.Students with IA are also accompanied by gambling games,smoking,drinking,staying up late and other unhealthy lifestyles.In the screening of risk factors for IA,it was found that "male","urban family","poor quality of life","mental health problems","gambling games","impulsive tendency","aggressive tendency","EPQ-P","EPQ-N"(neurotic tendency)were the risk factors of IA.But it was found that EPQ-E is the protective factor.Conclusion: The prevalence of Internet addiction among adolescents in Chongqing and other areas was 28.39%,which should be paid more attention by psychiatrists,family members,school and relevant departments.This study found that "male","urban family","poor quality of life","mental health problems","gambling games","impulsive tendency","aggressive tendency","EPQ-P","EPQ-N" were the risk factors of IA,and "EPQ-E" was the protective factor.The study also found that IA was related to smoking,drinking and staying up late,while IA was not related to region and school category.Part Two Study on Suicidal Characteristics and Influencing Factors of students with Internet AddictionObjective: To explore suicidal characteristics and influencing factors of students with IA.Method: A questionnaire survey was conducted among 27 599 adolescent students aged 15-20 years old in Chongqing and other areas by stratified cluster random sampling.Finally,26688 effective samples were investigated.The Scale for suicide ideation was used to screen the students with suicide attempt and suicidal ideation.Quality of life scale,SCL-90,impulsivity,aggression,Eysenck personality scale were used to assess the influencing factors of suicidal behavior.T test,chi square test and logistic regression were used for statistical description and analysis.In this study,P<0.05 was used as statistical significance.Results: The detection rate of suicide attempt among young students was 2.46%(657/26688).The detection rate of suicide attempt in IA group was 3.87% while that figure in non-IA group was 1.90%,suggesting a higher incidence of suicide attempt in students with IA.Compared with 268 male students attempting suicide(detection rate 2.06%),there were 389 female suicide attempters(detection rate 2.84%).The female students’ suicide attempt detection rate was significantly higher than that of male students(P< 0.01).The rate of suicide attempt of urban students was 2.93%,worse than 2.19% of rural students,suggesting a higher suicide risk among urban youth students(P<0.01).The incidence of suicide attempt in vocational middle school students was 3.10% higher than 2.36% in ordinary middle schools,and the difference was statistically significant(P<0.01),suggesting that students in vocational middle schools had higher suicide risk.There were no differences in the detection rate of adolescent suicide attempt between regions(P>0.05).The study found that the average number of student suicide attempt was 2.36±2.27,and the number of suicide attempt in the IA group(2.80±2.52)was higher than that in the non-IA group(2.00±1.98)(P<0.01).54.61% of students in the IA group had more than 2 times of suicide attempts higher than the non-IA group(38.19%)(P<0.01).In the last suicide,40.94% of total students wanted to die with the degree more than 50,51.88% of students in the IA group wanted to die with the degree more than 50,and 32.14% in the non-IA group wanted to die with the degree more than 50 points.The study found that the most common suicide pattern among adolescent students was taking poisons and therapeutic drugs,using tools,which included 330(50.23%)taking therapeutic drugs,125(19.03%)taking poisons and 82(12.48%)using tools.The main purposes of the last suicide were “to fight against reality”(40.94%),“being free from suffering”(15.98%),“reducing the burden of others”(12.79%)and “avoiding responsibility”(11.42%).The study found that the emotional problems caused by "family disputes","disputes with others","physical diseases" and "love affairs" are the main reasons for suicide among adolescent students.The order of suicidal reasons in the IA group and the non-IA group was basically the same,but the contributing factors were quite different.The IA students had a higher proportion of interpersonal relationships problems and economic difficulties while the emotional reasons of non-IA students such as love affairs accounted the majority.The study found that low quality of life of adolescent students was closely related to their suicide attempt and well reflected in the main causes of suicide(interpersonal relationship disorder,physical health,emotional problems,economic difficulties).The results of this survey showed that the rate of attempt suicide students with physical and mental disabilities was as high as 5.78% much higher than that of normal students(1.64%)(P<0.01).Students in IA and non-IA groups accompanied by physical and mental disabilities had a higher rate of suicide attempt.The study found that the personality of suicide attempters revealed different degrees of defects.Suicide attempters had higher scores of impulsive and aggressive personality than those of non-suicidal students displaying more impulsive,aggressive and extroverted personality traits,and the students with IA demonstrate more prominently(P<0.01).The study also found that students with unhealthy lifestyles(smoking,alcoholism,playing gambling games,staying up late),regardless of with or without IA,had higher rates of attempt suicide than those without unhealthy lifestyles(P<0.01).The study also found that the incidence of suicide attempt(5.81%)was significantly higher in students with suicidal ideation than in students without suicidal ideation(1.49%).The incidence of suicide attempt in IA group was a prominent 7.22% high(P<0.01),which showed that suicidal ideation was an important predictor of suicide attempt.The degree of IA was closely related to suicide attempt and suicidal ideation.The more serious the student’s IA,the higher the risk of suicide.Conclusion: The rate of suicide attempt among adolescents with IA was higher,accompanied by higher repeat suicide.The rate of suicide attempt especially for female students with IA was higher with repeated suicide more serious,which shall be paid great attention by the school,family and education administrations.Effective measures must be taken early to prevent the occurrence of suicidal behavior and reduce the incidence of suicide and mortality.IA with poor quality of life,physical and mental health problems significantly increases the risk of suicide among adolescents.Suicidal attempted students with IA are often accompanied by serious personality defects showing obvious impulsiveness,aggressiveness tendency,poor emotional behavior,and introverted personality.Suicidal ideation has a strong synergy with IA,which significantly enhances the suicide risk among students.The unhealthy lifestyle of young students also contributes to the risk of suicidal behavior.The severity of IA has a great impact on suicidal ideation and suicide attempt.The more serious the student’s IA,the higher the risk of suicide.Part Three Study on Suicide Risk Prediction of Adolescent Students with Internet AddictionObjective: To establish a logistic regression analysis predictive model to explore the risk factors of suicide attempt with internet addiction and to predict the risk of suicide.Method: This part targeted a high-risk group of suicide attempt,7576 adolescent students with IA as the study object.Logistic regression model was established with Y(1 = suicide group(SA),0 = non-suicide group(NSA)as dependent variable,and the risk factors screened as independent variable X.P<0.05 was used as statistical significance.Results: This study showed that 10 variables entered the multivariate logistic regression predictive model among which “suicidal ideation”,“poor quality of life”,“physical and mental health problems”,“smoking”,“drinking”,“staying up late”,“aggressive tendency”,“psychic tendency” and "extroverted personality" were risk factors for suicide attempt while "male" was protective factors for suicide attempt.There were 10 variables were included in the Logistic regression prediction model eventually through stepwise regression analysis of 14 variables,which simplified the prediction index system of suicide attempt,and provided a reference for rapid screening of high-risk groups of suicide.And through the establishment of suicide risk prediction and evaluation model,can screen high-risk groups of suicide,improve the effectiveness and pertinence of suicide intervention.The predictive model with AUC=0.784 established in this study had certain suicide risk predictive ability.Conclusion: Suicidal ideation was the strongest predictor of attempted suicide,followed by neuroticism,alcohol consumption,smoking and quality of life,while "male" was the protective factor.The result of model evaluation showed that the fitting effect of the model was excellent,and the predictive ability of suicide attempt can reach 78.40%,which has a good practical value for suicide prevention and intervention.Part Four Brain Function Imaging Changes in Suicide Attempter with Internet AddictionObjective: Adolescent students with IAT scores greater than or equal to 40 were selected as the research subjects,and students with attempted suicide and those without suicide were screened out.20 students with attempted suicide were selected as the suicide group and 20 students without suicide as the control group.ALFF analysis was used to assess the synchronous changes in regional brain activity in Internet addicts who attempted suicide.P<0.05 showed statistical significance.Method: The z ALFF electroencephalogram of suicide group and control group were analyzed by double-sample t-test.The results showed that there were significant differences in frontal_Inf_Oper_R and frontal_Inf_Tri_R of right trigone between the two groups(P < 0.05).Voxel-wise-based post-hoc test was performed in both groups.The results showed that the activity of the suicide group in the right inferior frontal gyrus and the right inferior frontal gyrus of the trigone was significantly increased compared with the control group(P < 0.05).Results: A two-sample T-test was used to analyze the z ALFF brain map between the suicide group and the control group.The results showed that there were significant differences between the areas of Frontal_Inf_Oper_R and Frontal_Inf_Tri_R(P<0.05)(see Figure 4-1 for details).A two-sample T-test was performed on voxel-wise post-hoc in the two groups.Compared with the control group,the suicide group had enhanced activities in the Frontal_Inf_Oper_R and the Frontal_Inf_Tri_R.(P < 0.05).Conclusion: There are obvious functional abnormalities in the prefrontal cortex of young students with IA and suicide attempt.According to the specific changes of brain function imaging,combined with suicide prediction model,it is helpful to improve the ability of suicide risk assessment and reduce the occurrence of suicide behavior,and provides a scientific reference for suicide risk assessment and early intervention.