Kerr David C R, Washburn Jason J, Feingold Alan, Kramer Anne C, Ivey Asha Z, King Cheryl A
Oregon Social Learning Center, Eugene, OR, USA.
J Abnorm Child Psychol. 2007 Oct;35(5):817-30. doi: 10.1007/s10802-007-9132-5. Epub 2007 May 30.
The consequences of aggression on problem course and suicide risk were examined in 270 acutely suicidal adolescents (ages 12-17 years; 184 girls). Participants were assessed during psychiatric hospitalization (T1), 6-months post-hospitalization (T2), and 15 or more months post-hospitalization (T3). Study variables included self- and parent-reported aggression; self-reported internalizing symptoms, suicidal ideation, suicide attempt, and adverse events; and clinician-rated suicidal behavior. Aggression was not directly related to suicide attempt concurrently or prospectively. However, among more aggressive youth, internalizing symptoms were more predictive of T3 suicide attempt than among less aggressive youth. T1 aggression predicted aggressive incidents and the likelihood of incarceration prior to T3. Two-level hierarchical linear modeling indicated that self-reported aggression and internalizing problems were linked in terms of severity and rates of decline over time. Overall, parent-reported aggression was negatively associated with suicidal ideation. Findings highlight (a) the continuity and consequences of aggression, (b) a possible role of aggression in worsening suicide risk factors and potentiating suicide attempt, and (c) the importance of ongoing research on subtypes of suicidal adolescents.
对270名急性自杀倾向青少年（年龄在12至17岁之间；184名女孩）的攻击行为对问题病程和自杀风险的影响进行了研究。在精神科住院期间（T1）、出院后6个月（T2）以及出院后15个月或更长时间（T3）对参与者进行评估。研究变量包括自我报告和家长报告的攻击行为；自我报告的内化症状、自杀意念、自杀未遂及不良事件；以及临床医生评定的自杀行为。攻击行为与自杀未遂在同时期或前瞻性方面并无直接关联。然而，在攻击性更强的青少年中，内化症状比攻击性较弱的青少年更能预测T3期的自杀未遂情况。T1期的攻击行为可预测T3期之前的攻击事件及被监禁的可能性。二级分层线性模型表明，自我报告的攻击行为和内化问题在严重程度和随时间下降的速率方面存在关联。总体而言，家长报告的攻击行为与自杀意念呈负相关。研究结果凸显了（a）攻击行为的持续性及后果，（b）攻击行为在恶化自杀风险因素及增强自杀未遂可能性方面可能发挥的作用，以及（c）对自杀倾向青少年亚型进行持续研究的重要性。
