Objective

Methamphetamine (METH) use and adverse childhood experiences (ACEs) has been associated with an increased risk of suicidal behaviour. However, whether METH use underlies the risk of suicide attributable to ACEs is unknown and warrants investigation to inform preventive interventions. In this study, we examined the mediating role of METH use in the relationship between attempted suicide and ACEs.

Method

METH users recruited from a mandatory detoxification center (n = 346) and healthy controls (n = 342) both completed a survey related to 9 types of ACE, which was based the Family Health Questionnaire. A lifetime history of attempted suicide was obtained using the Chinese version of the Composite International Diagnostic Interview. We conducted a bootstrapped mediation analysis to examine the mediating effect of METH use on the association between ACEs and attempted suicide.

Results

Female gender, METH use, and having multiple (≥3) ACEs were associated with an increased risk of attempted suicide. A dose–response relationship between the number of ACEs and suicide rate was observed among individuals with METH use. METH use significantly mediated the association between ACEs and attempted suicide in those with multiple (2 and 3 ACEs respectively with proportion mediated 0.16 and 0.42) and specific types of ACEs (physical abuse, witnessing maternal battering, household substance abuse, sexual abuse, and parental separation with proportion mediated 0.25, 0.35, 0.38, 0.48, 0.47 respectively).

Conclusion

Our study is the first to demonstrate that METH use partially mediates the association between ACEs and attempted suicide. Addressing METH use in people with ACEs could reduce their suicide risk.

中文翻译：

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探索甲基苯丙胺使用在不良童年经历和企图自杀之间的关系中的中介作用

客观的

甲基苯丙胺 (METH) 的使用和不良的童年经历 (ACE) 与自杀行为的风险增加有关。然而，METH 的使用是否是由 ACE 导致的自杀风险的基础尚不清楚，需要进行调查以告知预防干预措施。在这项研究中，我们研究了 METH 使用在企图自杀和 ACE 之间的关系中的中介作用。

方法

从强制戒毒中心（n = 346）和健康对照（n = 342）招募的 METH 用户都完成了与 9 种 ACE 相关的调查，该调查基于家庭健康问卷。使用综合国际诊断访谈的中文版获得了终生未遂自杀史。我们进行了自举中介分析，以检查 METH 使用对 ACE 和企图自杀之间关联的中介作用。

结果

女性、使用 METH 和多次 (≥3) ACE 与自杀未遂风险增加相关。在使用 METH 的个体中观察到 ACE 数量与自杀率之间存在剂量反应关系。METH 的使用显着介导了 ACE 和自杀未遂之间的关联，这些患者中有多个（分别为 2 和 3 个 ACE，比例介导为 0.16 和 0.42）和特定类型的 ACE（身体虐待、目睹母亲殴打、家庭药物滥用、性虐待和父母分离比例分别为 0.25、0.35、0.38、0.48、0.47）。

结论

我们的研究首次证明 METH 的使用在一定程度上介导了 ACE 与自杀未遂之间的关联。解决患有 ACE 的人使用 METH 可以降低他们的自杀风险。