Prinstein Mitchell J, Nock Matthew K, Simon Valerie, Aikins Julie Wargo, Cheah Charissa S L, Spirito Anthony
Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3270, USA.
J Consult Clin Psychol. 2008 Feb;76(1):92-103. doi: 10.1037/0022-006X.76.1.92.
Remarkably little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor. A sample of 143 adolescents 12-15 years old was assessed during psychiatric inpatient hospitalization and again at 3, 6, 9, 15, and 18 months postdischarge through a series of structured interviews and parent- and adolescent-reported instruments. Symptoms of depression, posttraumatic stress disorder, externalizing psychopathology, hopelessness, and engagement in several forms of self-injurious/suicidal behaviors (i.e., suicide threats/gestures, plans, nonsuicidal self-injury [NSSI]) were assessed. Latent growth curve analyses revealed a period of suicidal ideation remission between baseline and 6 months following discharge, as well as a subtle period of suicidal ideation reemergence between 9 and 18 months postdischarge. Changes in suicidal ideation predicted suicide attempts. After accounting for the effects of suicidal ideation, baseline suicide threats/gestures also predicted future suicide attempts. Higher adolescent-reported depressive symptoms, lower parent-reported externalizing symptoms, and higher frequencies of NSSI predicted weaker suicidal ideation remission slopes. Findings underscore the need for more longitudinal research on the course of adolescent suicidality.
令人惊讶的是，对于青少年自杀意念和行为的时间进程、根据自杀意念的变化预测自杀未遂，以及将自杀意念作为预测因素考虑后对自杀未遂的预测，我们所知甚少。对143名12至15岁的青少年样本在精神科住院期间进行了评估，并在出院后的3、6、9、15和18个月通过一系列结构化访谈以及家长和青少年报告的工具再次进行评估。评估了抑郁症状、创伤后应激障碍症状、外化精神病理学症状、绝望感以及参与几种形式的自我伤害/自杀行为（即自杀威胁/姿态、计划、非自杀性自我伤害[NSSI]）的情况。潜在增长曲线分析显示，在基线和出院后6个月之间存在一段自杀意念缓解期，以及在出院后9至18个月之间存在一段自杀意念再次出现的微妙时期。自杀意念的变化可预测自杀未遂。在考虑了自杀意念的影响后，基线自杀威胁/姿态也可预测未来的自杀未遂。青少年报告的较高抑郁症状、家长报告的较低外化症状以及较高频率的NSSI预测自杀意念缓解斜率较弱。研究结果强调了对青少年自杀行为进程进行更多纵向研究的必要性。
