Wagner K D, Rouleau M, Joiner T
Department of Psychiatry and Behavioral Sciences, Medical Branch, University of Texas, Galveston 77555-0425, USA.
Am J Psychiatry. 2000 Dec;157(12):2017-21. doi: 10.1176/appi.ajp.157.12.2017.
This study was conducted to determine whether there are changes in the cognitive factors of attributional style, hopelessness, and self-esteem when suicidal ideation fades in psychiatrically hospitalized children and adolescents.
The cognitive factors of attributional style, hopelessness, and self-esteem were assessed in subjects aged 7-17 years (50 with and 50 without suicidal ideation) at admission and discharge from a psychiatric hospital.
For subjects with suicidal ideation, attributional style became significantly more positive and hopelessness was decreased from admission to discharge, by which time suicidal ideation had faded. There was no association between self-esteem and suicidal ideation after control for depression. These changes in cognitive factors were not seen in the group without suicidal ideation. There were no significant differences between children and adolescents in the pattern of results.
Change in attributional style was shown to be a factor significantly related to the resolution of suicidal ideation in children and adolescents. This cognitive style could be specifically addressed in psychotherapy with depressed children and adolescents as a means of reducing suicidal ideation. These results may have an implication for reducing the length of psychiatric inpatient stays.
本研究旨在确定精神科住院儿童和青少年自杀意念消退时，归因方式、绝望感和自尊等认知因素是否存在变化。
对7至17岁的受试者（50名有自杀意念者和50名无自杀意念者）在精神病院入院时和出院时评估其归因方式、绝望感和自尊等认知因素。
对于有自杀意念的受试者，从入院到出院，归因方式显著变得更加积极，绝望感降低，此时自杀意念已经消退。在控制抑郁后，自尊与自杀意念之间没有关联。在无自杀意念的组中未观察到这些认知因素的变化。儿童和青少年在结果模式上没有显著差异。
归因方式的改变被证明是与儿童和青少年自杀意念消退显著相关的一个因素。在对抑郁儿童和青少年进行心理治疗时，可以专门针对这种认知方式，作为减少自杀意念的一种手段。这些结果可能对缩短精神科住院时间有启示。
