La Salle University, Philadelphia, Pennsylvania 19141, United States.
J Affect Disord. 2012 Feb;136(3):1121-5. doi: 10.1016/j.jad.2011.10.034. Epub 2011 Nov 25.
Previous research has identified only a few variables that have been associated with making an impulsive suicide attempt. The aim of the current study was to compare individuals who made an impulsive suicide attempt with those who made a premeditated attempt on both previously examined and novel characteristics.
Participants were classified as making an impulsive or premeditated attempt based on the Suicide Intent Scale (Beck et al., 1974a) and were compared on a number of characteristics relevant to suicidality, psychiatric history, and demographics.
Individuals who made an impulsive attempt expected that their attempts would be less lethal; yet the actual lethality of both groups' attempts was similar. Those who made an impulsive attempt were less depressed and hopeless than those who made a premeditated attempt. Participants who made an impulsive attempt were less likely to report a history of childhood sexual abuse and more likely to be diagnosed with an alcohol use disorder than those who made a premeditated attempt.
Although the sample size was adequate for bivariate statistics, future studies using larger sample sizes will allow for multivariate analyses of characteristics that differentiate individuals who make impulsive and premeditated attempts.
Clinicians should not minimize the significance of impulsive attempts, as they are associated with a similar level of lethality as premeditated attempts. Focusing mainly on depression and hopelessness as indicators of suicide risk has the potential to under-identify those who are at risk for making impulsive attempts.
先前的研究仅确定了一些与冲动性自杀企图相关的变量。本研究的目的是比较冲动性自杀尝试者和预谋性自杀尝试者在先前研究和新特征方面的个体差异。
根据自杀意念量表(Beck 等人,1974a),参与者被分为冲动性或预谋性自杀尝试者,并在与自杀相关的多个特征、精神病史和人口统计学方面进行了比较。
冲动性自杀尝试者预计他们的尝试不会那么致命;然而,两组尝试的实际致命性相似。与预谋性自杀尝试者相比,冲动性自杀尝试者的抑郁和绝望程度较低。与预谋性自杀尝试者相比,冲动性自杀尝试者报告童年性虐待史的可能性较小,更有可能被诊断为酒精使用障碍。
尽管样本量对于双变量统计来说足够大,但未来使用更大样本量的研究将允许对区分冲动性和预谋性尝试者的特征进行多变量分析。
临床医生不应该低估冲动性尝试的重要性,因为它们与预谋性尝试具有相似的致命性。将抑郁和绝望主要作为自杀风险的指标有可能会低估那些有冲动性自杀风险的人。