Association Between Childhood Trauma And Suicide Risk Among Middle School Students:the Mediating Role Of Insomnia

Objective:Adolescent suicide is a serious public health problem that seriously threatens the life safety of suicidal persons and social stability.Therefore,it is necessary to explore the risk factors related to adolescent suicide and its occurrence and development mechanism to provide more evidence for the prevention of adolescent suicide.This study investigated the relationship between childhood trauma,insomnia and suicide risk among middle school students,with the following objectives:1.Analysis of childhood trauma,insomnia and suicide risk among adolescents under the new coronavirus pneumonia epidemic.2.To analyze the degree of association between childhood trauma and suicide risk and insomnia among middle school students.3.Analysis of the mediating role of insomnia between childhood trauma and suicide risk in middle school students.Methods:In May 2021,using the general demographics questionnaire,Childhood Trauma Questionnaire,Insomnia Severity Index,Suicidal Behavior Questionnaire-Revised,Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 items to make a questionnaire survey was conducted among students in 3 middle schools in a city in Guangxi.SPSSAU 21.0 online statistical software was used for data analysis.The enumeration data is expressed as[n(%)],and the comparison between groups is by the chi-square test.The measurement data were approximated to a normal distribution by the normality test and were represented by x ± s.The comparison between groups was performed by analysis of variance and the LSD test was used for post-hoc multiple comparisons.Pearson correlation was used to analyze the correlation between variables.Multivariate Logistic regression analysis was used to analyze the influencing factors of suicide risk and insomnia of the survey subjects.The mediation effect was tested by Bootstrap method.P<0.05 was considered to be statistically significant.Results:(1)Among the 3442 middle school students,the detection rates of childhood trauma,insomnia and high suicide risk were 49.27%,49.54%and 37.01%.(2)Detection rate of childhood trauma among middle school students was significantly different in 7 aspects of gender,household registration,left-behind,parental relationship,parental education level,and family economy(P<0.05).There were statistically significant differences in the detection rate of insomnia among middle school students in eight aspects:grade,gender,household registration,whether left-behind,parents’ marital status,parental relationship,mother’s education level,and family economy(P<0.05).There were statistically significant differences in the detection rate of high suicide risk among middle school students in four aspects:gender,left-behind status,parental marital status,and parental relationship(P<0.05).(3)There were significant differences in the scores of suicide risk and insomnia among middle school students under different types of childhood trauma P<0.05),3 or more childhood traumas>2 childhood traumas>1 childhood trauma>middle school students without childhood trauma.(4)Pearson correlation analysis showed that the total score of childhood trauma and each subscale score was significantly positively correlated with the suicide risk score(r=0.135-0.467,P<0.01),and the total score of childhood trauma and each subscale score was significantly correlated with the total score of insomnia(r=0.1 19-0.306,P<0.01),and the total score of insomnia was significantly positively correlated with the suicide risk score(r=0.399,P<0.01).(5)Multivariate Logistic regression analysis showed that the risk of insomnia among middle school students with 2,3 or more childhood traumas was 1.643 times and 2.335 times higher than that of non-trauma middle school students(all P<0.01).Middle school students with 1,2,3 or more types of childhood trauma are 1.384 times,2.558 times,and 3.736 times more likely to have a high suicide risk than those without trauma(all P<0.01).Middle school students with mild,moderate and severe insomnia were 1.449 times,2.481 times,and 2.428 times more likely to have high suicide risk than those without insomnia(all P<0.01).(6)The mediating effect test showed that the mediating effect of insomnia between childhood trauma and suicide risk was 0.036(95%CI:0.0302-0.434),and the mediation effect accounted for 21.82%of the total effect.After controlling for general demographic data,anxiety,and depression,the mediating effect of insomnia between childhood trauma and suicide risk was 0.011(95%CI:0.008-0.015),and the mediating effect accounted for 9.48%of the total effect.Conclusion:Childhood trauma,insomnia and high suicide risk are common psychobehavioral problems in middle school students,and childhood trauma experience in middle school students is associated with both suicide risk and insomnia.Childhood trauma in middle school students can increase their suicide risk,and insomnia can aggravate the effect of childhood trauma on their suicide risk.Taking interventions to control or reduce the occurrence of childhood trauma and insomnia can help control and reduce suicide risk among middle school students.