Carballo Juan J, Oquendo Maria A, Giner Lucas, Zalsman Gil, Roche Ansley M, Sher Leo
Clinica Puerta de Hierro Hospital, Universidad Autonoma de Madrid, Madrid, Spain.
Int J Adolesc Med Health. 2006 Jan-Mar;18(1):15-9. doi: 10.1515/ijamh.2006.18.1.15.
Suicidal behavior and alcohol use disorders among adolescents and young adults are serious public health problems. In the study of suicidal behavior among young people with alcoholism, it has been shown that aggression and impulsivity are higher among those who attempted suicide. Impulsivity has been related to suicidal and self-destructive behaviors within different psychiatric conditions, i.e. alcohol and substance use disorders, mood disorders, conduct disorder, impulse control disorders, antisocial personality disorder, and borderline personality disorder. The term impulsivity has been used to define different constructs such as (1) personality trait or cognitive style in which disinhibition is the core characteristic, (2) a tendency to act immediately in response to external or internal stimuli, and (3) a group of psychiatric disorders with behavioral dyscontrol. Among adolescents suicidal behavior is transmitted in families independently of psychiatric conditions, but not independently of impulsivity/aggression. Two causal links between impulsiveness and alcoholism have been proposed: (1) adolescents who develop alcoholism possess higher premorbid levels of impulsiveness than those who do not develop alcoholism, and (2) levels of impulsiveness differentiate both populations only after the development of alcoholism, with higher levels of impulsiveness among those adolescents who developed alcoholism. Cognitive behavioral techniques have shown promising results in the treatment of adolescents with alcohol and substance use disorder and suicidality. The relative frequency of suicidal behavior among adolescents and young adults suffering from alcoholism and its subsequent devastating effects on individuals, families and society merits further research and development of prevention strategies.
青少年和青年中的自杀行为及酒精使用障碍是严重的公共卫生问题。在对酗酒青少年的自杀行为研究中发现,自杀未遂者的攻击性和冲动性更强。在不同的精神疾病中,如酒精和物质使用障碍、情绪障碍、品行障碍、冲动控制障碍、反社会人格障碍和边缘型人格障碍,冲动性都与自杀和自我毁灭行为有关。冲动性这一术语被用来定义不同的概念,如:(1)以去抑制为核心特征的人格特质或认知风格;(2)对外部或内部刺激立即做出反应的倾向;(3)一组存在行为失控的精神疾病。在青少年中,自杀行为在家庭中传播,与精神疾病无关,但与冲动性/攻击性有关。关于冲动性和酗酒之间的因果关系,已提出两种观点:(1)患酗酒症的青少年病前冲动性水平高于未患酗酒症的青少年;(2)只有在酗酒症发展之后,冲动性水平才会区分这两类人群,患酗酒症的青少年冲动性水平更高。认知行为技术在治疗患有酒精和物质使用障碍及自杀倾向的青少年方面已显示出有前景的结果。酗酒的青少年和青年中自杀行为的相对发生率及其随后对个人、家庭和社会造成的毁灭性影响值得进一步研究并制定预防策略。