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Những trải nghiệm tiêu cực trong thời thơ ấu: một nghiên cứu hồi cứu để hiểu mối liên hệ của chúng với chẩn đoán sức khỏe tâm thần suốt đời, hành vi tự hại hoặc cố gắng tự tử, và tình trạng sức khỏe tâm thần kém hiện tại trong quần thể nam phạm nhân ở Wales
Tóm tắt
Các phạm nhân có nguy cơ cao mắc các vấn đề sức khỏe tâm thần và hành vi tự hại, với tự tử là nguyên nhân tử vong hàng đầu trong trại giam. Những trải nghiệm tiêu cực trong thời thơ ấu (ACEs) như việc trẻ em bị lạm dụng là những yếu tố dự đoán mạnh mẽ cho sức khỏe tâm thần và sự ổn định, tuy nhiên, mặc dù có mức độ ACEs cao trong các quần thể phạm nhân, tương đối ít nghiên cứu đã khám phá mối quan hệ giữa ACEs và sức khỏe tâm thần cũng như sự ổn định của phạm nhân. Chúng tôi đã thực hiện một khảo sát ACE với 468 phạm nhân nam trưởng thành tại một nhà tù ở Wales, những người không bị xem là có nguy cơ tự hại và tự tử, và đã khám phá các mối quan hệ giữa ACEs, chẩn đoán bệnh tâm thần trong suốt đời, hành vi tự hại (suốt đời và trong tù) hoặc cố gắng tự tử (suốt đời và trong tù), và tình trạng sức khỏe tâm thần kém hiện tại. Phần lớn người tham gia (84,2%) đã trải qua ít nhất một ACE và 45,5% đã trải qua ≥4 ACEs. Tỷ lệ chẩn đoán bệnh tâm thần suốt đời, hành vi tự hại (suốt đời và trong tù) hoặc cố gắng tự tử (suốt đời và trong tù), và tình trạng sức khỏe tâm thần kém hiện tại gia tăng với mức độ tiếp xúc với ACEs. Ví dụ, 2,7% những người không có ACEs đã báo cáo hành vi tự hại hoặc cố gắng tự tử trong tù so với 31,0% (hành vi tự hại trong tù) và 18,3% (cố gắng tự tử trong tù) của những người đã trải qua ≥4 ACEs. So với những người tham gia không có ACEs, những người có ≥4 ACEs có khả năng báo cáo chẩn đoán bệnh tâm thần suốt đời và cố gắng tự tử cao gấp bốn lần, và cao hơn 10 lần khả năng báo cáo hành vi tự hại suốt đời so với những người không có ACEs. Không phụ thuộc vào chẩn đoán bệnh tâm thần suốt đời, hành vi tự hại hoặc cố gắng tự tử, những người tham gia có ≥4 ACEs có khả năng có tình trạng sức khỏe tâm thần kém hiện tại cao gấp gần ba lần so với những người không có ACEs. Các phạm nhân nam đã chịu đựng nhiều ACEs có khả năng cao hơn đáng kể về chẩn đoán bệnh tâm thần suốt đời, hành vi tự hại hoặc cố gắng tự tử, và tình trạng sức khỏe tâm thần kém hiện tại khi ở trong tù. Những phát hiện này gợi ý rằng cần có những cách tiếp cận dựa trên trải nghiệm chấn thương trong các nhà tù để hỗ trợ sức khỏe tâm thần và sự ổn định của phạm nhân.
Từ khóa
#trao đổi #ACEs #sức khỏe tâm thần #tự hại #cố gắng tự tử #phạm nhânTài liệu tham khảo
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