University of Rochester School of Medicine, Department of Psychiatry, Rochester, NY, USA.
Depress Anxiety. 2010 Sep;27(9):871-7. doi: 10.1002/da.20701.
The Interpersonal Theory of Suicide states that to make a serious or lethal suicide attempt, a person must experience reductions in fear and pain sensitivity sufficient to overcome self preservation reflexes (i.e., the acquired capability for suicide). The purpose of this study was to examine the fearlessness component of the acquired capability for suicide using self-report assessment instruments and an objective measure of aversion (the affectively modulated startle reflex task).
Depressed suicide ideators (n=15), depressed suicide attempters (n=15), and a group of control participants (n=14) were compared on their self-report of acquired capability and painful and provocative life events, and completed the affectively modulated startle reflex task. This task compared electromyography recordings of participants' eye-blink response to a startle probe while viewing pictures of varying hedonic valence (neutral, positive, negative, and suicide-related).
Suicide attempters reported the highest levels of fearlessness and pain insensitivity and a greater history of painful and provocative life events. Although no group differences were found on the psychophysiology data, participants reacted to suicide-related images with less aversion compared to neutral images with no differences between suicide-related and positive images.
Self-reported fearlessness and pain insensitivity can differentiate suicide attempters and suicide ideators. Results suggest that one's self-perception (i.e., cognitions regarding fear and pain tolerance) are more functionally related to suicide attempts than psychophysiological reactivity to suicide-related stimuli.
人际理论的自杀状态，以作出严重或致命自杀企图，一个人必须经历减少恐惧和疼痛的敏感性足以克服自我保护反射（即，获得自杀能力）。本研究的目的是探讨使用自我报告评估工具和厌恶的客观测量（情感调制的惊跳反射任务）获得自杀能力的无所畏惧的组成部分。
抑郁自杀意念者（n=15），抑郁自杀企图者（n=15）和一组对照组参与者（n=14）在获得能力和痛苦和挑衅性生活事件的自我报告中进行了比较，并完成了情感调制的惊跳反射任务。该任务比较了参与者的眼跳反应的肌电图记录，以在观看不同愉悦值的图片（中性，阳性，阴性和自杀相关）时探测惊跳探针。
自杀企图者报告了最高水平的无所畏惧和疼痛不敏感，以及更多的痛苦和挑衅性生活事件史。尽管在心理生理学数据上没有发现组间差异，但与中性图像相比，参与者对自杀相关图像的反应较少厌恶，而自杀相关图像与阳性图像之间没有差异。
自我报告的无所畏惧和疼痛不敏感可以区分自杀企图者和自杀意念者。结果表明，一个人的自我认知（即，关于恐惧和疼痛耐受性的认知）与自杀企图的功能相关性大于对自杀相关刺激的心理生理学反应。
