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北京大学学报（医学版） ›› 2026, Vol. 58 ›› Issue (3): 606-615. doi: 10.19723/j.issn.1671-167X.2026.03.022

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家庭创伤、校园霸凌与青少年自杀行为的关系：DRD2基因多态性的调节作用

白红娟1, 陈洋2, 王琨3, 徐学兵4,*()   

  1. 1. 宁夏回族自治区宁安医院儿童青少年精神科, 银川 750021
    2. 宁夏回族自治区宁安医院药剂科, 银川 750021
    3. 宁夏回族自治区工伤康复鉴定指导中心, 银川 750021
    4. 宁夏回族自治区宁安医院精神科, 银川 750021
  • 收稿日期:2025-06-19 出版日期:2026-06-18 发布日期:2026-04-09
  • 通讯作者: 徐学兵
  • 基金资助:
    宁夏回族自治区卫生健康科研项目(2025-NWZC-A019)

Relationship between family trauma, school bullying and suicidal behavior in adolescents: Regulatory effect of DRD2 gene polymorphism

Hongjuan BAI1, Yang CHEN2, Kun WANG3, Xuebing XU4,*()   

  1. 1. Department of Child and Adolescent Psychiatry, Ningxia Hui Autonomous Region, Yinchuan 750021, China
    2. Department of Pharmacy, Ningan Hospital, Ningxia Hui Autonomous Region, Yinchuan 750021, China
    3. Department of Occupational Injury Rehabilitation Evaluation and Guidance Center, Ningxia Hui Autonomous Region, Yinchuan 750021, China
    4. Department of Psychiatry, Ningan Hospital, Ningxia Hui Autonomous Region, Yinchuan 750021, China
  • Received:2025-06-19 Online:2026-06-18 Published:2026-04-09
  • Contact: Xuebing XU
  • Supported by:
    the Health Research Project of Ningxia Hui Autonomous Region(2025-NWZC-A019)

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摘要：

目的: 探究家庭创伤、校园霸凌与青少年自杀行为的关系，以及DRD2基因多态性的调节作用。方法: 连续选择2022年6月—2024年6月于宁夏回族自治区宁安医院就诊的确诊为青少年抑郁障碍患者98例，根据就诊前6个月是否有自杀行为和对自杀行为态度得分分为非自杀组(n=62)和自杀倾向组(n=36)。比较两组患者一般资料。分析各基因型与自杀行为的关系、自杀行为的影响因素、家庭创伤和校园霸凌对自杀行为的交互作用。分析基因多态性对抑郁障碍可能存在的调节效应。结果: 与非自杀组比较，自杀倾向组病程、非自杀性自伤行为、家庭创伤、校园霸凌、焦虑、抑郁评分增加，生命意义评分降低(P＜0.05)。基因型A2A2较A1A1可增加自杀行为风险(P＜0.05)。隐性模式中，基因型A2A2较A1A1和A1A2增加自杀行为风险(P＜0.05)；加性遗传模式中，基因型A1A1、A1A2、A2A2与自杀行为之间均有重要关联(P＜0.05)。非自杀性自伤行为、家庭创伤、校园霸凌、抑郁障碍以及A2A2基因型是自杀行为的独立危险因素，生命意义是独立保护因素。家庭创伤＞54.78分和校园霸凌＞10.37分对青少年自杀行为存在相乘(OR=6.585，95%CI：5.478~7.367)及相加(OR=7.849，95%CI：7.231~8.294)的交互作用。抑郁障碍在家庭创伤(β=0.092，95%CI：0.084~0.103)、校园霸凌(β=0.090，95%CI：0.081~0.098)与自杀行为间发挥调节效应。加性遗传模式下，TaqⅠA基因在携带A1A2 / A2A2分型的青少年中对“家庭创伤、校园霸凌→抑郁障碍→自杀行为”的调节效应显著。结论: 家庭创伤和校园霸凌同时存在时青少年自杀行为风险更高，抑郁障碍在其中发挥调节效应，DRD2基因TaqⅠA位点多态性对携带A2等位基因的青少年具有显著的调节效应。

关键词: 家庭创伤, 校园霸凌, 自杀行为, DRD2基因多态性, 调节作用

Abstract:

Objective: To explore the relationship between family trauma, school bullying and adolescent suicidal behavior, and the regulatory role of DRD2 gene polymorphism. Methods: A total of 98 adolescent patients with depressive disorders who visited our hospital from June 2022 to June 2024 were selected. They were divided into the non-suicide group (n=62) and the suicide group (n=36) based on their suicide behavior in the previous 6 months and their attitudes towards suicide behavior. The general data of the two groups were compared. The relationship between each genotype and suicide behavior, the influencing factors of suicide behavior, the interaction between family trauma and school bullying on suicide behavior, and the regulatory effects of depression and genetic polymorphisms were analyzed. The possible regulatory effects of depression and genetic polymorphisms were also investigated. Results: Compared with the non-suicide group, the duration of illness, non-suicidal self-harm behavior, family trauma, school bullying, anxiety, depression scores in the suicide group increased, while the life meaning score decreased (P < 0.05). The genotype A2A2 was associated with an increased risk of suicidal behavior compared to genotype A1A1 (P < 0.05). In the recessive model, the genotype A2A2 was associated with an increased risk of suicidal behavior compared to genotype A1A1 and A1A2 (P < 0.05); in the additive model, there were significant associations between the genotypes A1A1, A1A2, A2A2 and suicidal behavior (P < 0.05). Non-suicidal self-harm behavior, family trauma, school bullying, depression, and the A2A2 genotype were independent risk factors for suicidal behavior, while life meaning was an independent protective factor. Family trauma > 54.78 points and school bullying > 10.37 points had a multiplicative (OR=6.585, 95%CI: 5.478-7.367) and additive (OR=7.849, 95%CI: 7.231-8.294) interaction effect on adolescent suicidal behavior. Depression exerted a regulatory effect between family trauma (β=0.092, 95%CI: 0.084-0.103), school bullying (β=0.090, 95%CI: 0.081-0.098) and suicidal behavior. In the additive genetic model, the TaqⅠA gene had a significant regulatory effect on "family trauma, school bullying → depression → suicidal behavior" in adolescents with the A1A2/ A2A2 genotype. Conclusion: The risk of suicidal behavior is higher in adolescents with both family trauma and school bullying, and depression plays a part of the mediating effect. The TaqⅠA polymorphism of DRD2 gene has a significant regulatory effect on adolescents carrying A2 allele.

Key words: Family trauma, School bullying, Suicidal behavior, DRD2 gene polymorphism, Regulating effect

中图分类号: 

  • B846

表1

DRD2基因多态性检测引物序列"

Site Primer type Primer sequence(5′ to 3′) Primer length/bp
rs1800497 PCR upstream primer GCTTAGAACCACCCAGAGTG 21
PCR downstream primer TGTCCACGCCCGCAA 16
Single-base extension primer CAGCACTTTGAGGATGGCTGGGCTGGAC 28
rs2283265 PCR upstream primer ACGTGGTGCTGGTGCTGAT 19
PCR downstream primer GCCGCTGGTGTTGGTGTA 18
Single-base extension primer GCTGGTGTTGGTGTAGCCGCTGGTG 27

表2

非自杀组与自杀倾向组一般资料比较"

Items Non-suicide group (n=62) Suicide group (n=36) χ2/t P
Gender 0.170 0.680
  Male 37 (59.68) 23 (63.89)
  Female 25 (40.32) 13 (36.11)
Age/years 15.34±2.62 15.03±2.48 0.576 0.566
Disease duration/years 3.16±0.43 3.51±0.67 3.150 0.002
Years of education 12.32±1.51 11.84±1.25 1.612 0.110
Living area 0.283 0.595
  Urban 38 (61.29) 24 (66.67)
  Rural 24 (38.71) 12 (33.33)
Father’s education level 0.151 0.697
  High school and above 42 (67.74) 23 (63.89)
  Junior high school and below 20 (32.26) 13 (36.11)
Mother’s education level 0.214 0.644
  High school and above 34 (54.84) 18 (50.00)
  Junior high school and below 28 (45.16) 18 (50.00)
Family structure 0.170 0.680
  Nuclear family 25 (40.32) 13 (36.11)
  Non-nuclear family 37 (59.68) 23 (63.89)
The only child 0.088 0.767
  Yes 26 (41.94) 14 (38.89)
  No 36 (58.06) 22 (61.11)
Experience of staying behind 0.074 0.785
  Yes 14 (22.58) 9 (25.00)
  No 48 (77.42) 27 (75.00)
Conditions of boarding 0.033 0.856
  Yes 35 (56.45) 21 (58.33)
  No 27 (43.55) 15 (41.67)
Non-suicidal self-injury 35.61±4.08 44.94±5.32 9.741 ＜0.001
Meaning of life 45.61±5.84 34.12±5.12 9.812 ＜0.001
Family trauma 49.34±5.21 64.16±7.21 11.755 ＜0.001
School bullying/points 8.69±1.76 13.26±2.28 11.096 ＜0.001
Anxiety/score 56.16±6.31 68.91±7.02 9.251 ＜0.001
Depression/score 58.32±5.87 72.64±6.65 11.084 ＜0.001

表3

Hardy-Weinberg遗传平衡检验"

SNP locus Genotype Non-suicide group (n=62) Suicide group (n=36)
Actual value Theoretical value χ2 P Actual value Theoretical value χ2 P
TaqⅠA A1A1 29 28.615 0.006 0.997 6 6.215 0.007 0.996
A1A2 23 23.154 8 7.761
A2A2 10 10.231 22 22.024

表4

两组DRD2基因(TaqⅠA)遗传模式分析"

DRD2 gene (TaqⅠA) Non-suicide group (n=62) Suicide group (n=36) OR (95%CI) P
A1A1 29(46.77) 6(16.67)
A1A2 23(37.10) 8(22.22) 1.125(0.846-1.432) 0.154
A2A2 10(16.13) 22(61.11) 1.874(1.496-2.328) ＜0.001
Explicit mode A1A1 vs. (A1A2+A2A2) 29(46.77)/33(53.23) 6(16.67)/30(83.33) 1.231(0.892-1.476) 0.106
Implicit mode(A1A1+A1A2) vs. A2A2 52(83.87)/10(16.13) 14(38.89)/22(61.11) 1.695(1.326-2.021) ＜0.001
Additive mode A1A1 vs. A1A2 vs. A2A2 29(46.77)/23(37.10)/10(16.13) 6(16.67)/8(22.22)/22(61.11) 0.008

表5

多因素Logistic回归分析"

Variables β SE Wald χ2 OR(95%CI) P
Course of disease 0.210 0.216 0.948 1.234 (0.911-1.485) 0.062
Non-suicidal self-injury 0.623 0.284 4.808 1.864 (1.549-2.297) 0.012
Meaning of life -0.481 0.305 2.490 0.618 (0.405-0.859) 0.018
Family trauma 0.853 0.264 10.433 2.346 (2.031-2.695) 0.006
School bullying 0.709 0.281 6.358 2.031 (1.745-2.397) 0.010
Anxiety 0.193 0.225 0.737 1.213 (0.846-1.594) 0.058
Depression 0.948 0.269 12.424 2.581 (2.169-2.882) 0.005
A2A2 genotype of DRD2 gene (TaqⅠA) 0.772 0.247 9.768 2.164 (1.793-2.455) 0.009

表6

家庭创伤和校园霸凌对青少年自杀行为的交互作用"

Factors 1 Factors 2 Suicidal behavior OR (95%CI) OR (95%CI)a
Family trauma School bullying No/Yes
≤54.78 ≤10.37 27/2 1.000 1.000
≤54.78 ＞10.37 13/7 2.864 (2.249-3.516) 3.161 (2.794-3.857)
＞54.78 ≤10.37 14/6 1.593 (1.194-1.932) 1.895 (1.329-2.363)
＞54.78 ＞10.37 8/21 7.596 (7.031-7.917) 7.849 (7.231-8.294)
Interactions Additive model RERI=4.122 (95%CI：-1.845-5.638)，P＞0.05
AP=0.854 (95%CI：0.436-1.425)，P＜0.05
S=4.832 (95%CI：0.931-13.524)，P＞0.05
Multiplication model OR=6.585 (95%CI：5.478-7.367)，P＜0.05

图1

抑郁障碍在家庭创伤、校园霸凌与青少年自杀行为之间的调节效应"

表7

加性遗传模式下TaqⅠA调节家庭创伤、校园霸凌对自杀行为影响的回归分析"

Items Equation 1 criterion: Depression Equation 2 criterion: Suicidal behavior
β SE t 95%CI β SE t 95%CI
Family trauma 0.068 0.042 1.619 -0.043-0.112 0.059 0.045 1.311 -0.061-0.091
TaqⅠA 0.051 0.051 1.000 -0.065-0.128 0.044 0.055 0.800 -0.058-0.112
Family trauma×TaqⅠA 0.174 0.050 3.480 0.123-0.228 0.134 0.053 2.528 -0.049-0.105
School bullying 0.061 0.043 1.419 -0.068-0.135 0.055 0.050 1.100 -0.052-0.128
School bullying×TaqⅠA 0.152 0.048 3.167 0.108-0.211 0.128 0.048 2.667 -0.087-0.184
Depression 0.298 0.046 6.478 0.231-0.348
Depression×TaqⅠA 0.071 0.044 1.614 0.044-0.102
Control variables
Non-suicidal self-injury 0.097 0.043 2.256 -0.055-0.159 0.072 0.038 1.895 -0.033-0.064
Meaning of life -0.069 0.051 -1.353 -0.123-0.074 -0.051 0.040 -1.275 -0.098-0.031
R2 0.135 0.197
F 20.614 21.623
P ＜0.001 ＜0.001

图2

加性遗传模式下TaqⅠA在家庭创伤、校园霸凌与自杀行为之间的调节作用图"

图3

加性遗传模式下TaqⅠA在抑郁障碍与自杀行为之间的调节作用图"

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ISSN 1671-167X
CN 11-4691/R
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