Joiner T E, Rudd M D, Rouleau M R, Wagner K D
Department of Psychology, Florida State University, Tallahassee 32306-1270, USA.
J Am Acad Child Adolesc Psychiatry. 2000 Jul;39(7):876-80. doi: 10.1097/00004583-200007000-00016.
Although suicidal crises demand an enormous amount of clinical attention, surprisingly little empirical research has been conducted on the parameters of suicidal crises in general, and in children and adolescents in particular. On the basis of past conceptual work on the unique characteristics of multiple suicide attempters, as well as work on the effect of previous suicidal and depressive experience on later functioning, the authors developed predictions regarding the intensity and duration of suicidal crises in youths presenting to inpatient psychiatry units. Specifically, it was hypothesized that multiple attempt status would relate significantly to intensity of suicidal crises and would relate more strongly to intensity than to duration of crises.
Data on past suicide history and self-rated symptoms were collected for 50 suicidal patients, all of whom were available at follow-up.
Findings conformed to prediction: Multiple attempters experienced more intense but not more long-lasting crises; the relation between multiple attempt status and crisis intensity exceeded that between multiple attempt status and crisis duration.
Previous suicidal experience may alter the parameters of current suicidal crises. Implications of these findings for suicide risk and clinical assessment and management are discussed.
尽管自杀危机需要大量临床关注,但令人惊讶的是,总体上针对自杀危机参数的实证研究很少,尤其是针对儿童和青少年的自杀危机参数。基于以往关于多次自杀未遂者独特特征的概念性研究,以及以往自杀和抑郁经历对后续功能影响的研究,作者对入住精神病科病房的青少年自杀危机的强度和持续时间进行了预测。具体而言,研究假设多次自杀未遂状态与自杀危机强度显著相关,且与危机强度的关联比与危机持续时间的关联更强。
收集了50名自杀患者过去的自杀史和自评症状数据,所有患者在随访时均能获取相关信息。
研究结果符合预测:多次自杀未遂者经历的危机更为强烈,但持续时间并不更长;多次自杀未遂状态与危机强度之间的关联超过了多次自杀未遂状态与危机持续时间之间的关联。
既往自杀经历可能会改变当前自杀危机的参数。本文讨论了这些研究结果对自杀风险以及临床评估和管理的意义。