University of North Carolina at Chapel Hill, Department of Psychology, Chapel Hill, NC 27599-3270, USA.
J Consult Clin Psychol. 2012 Oct;80(5):842-9. doi: 10.1037/a0029429. Epub 2012 Jul 30.
Longitudinal data on adolescent self-injury are rare. Little is known regarding the associations between various forms of self-injurious thoughts and behaviors over time, particularly within community samples that are most relevant for prevention efforts. This study examined nonsuicidal self-injury (NSSI) as a time-invariant, prospective predictor of adolescent suicide ideation, threats or gestures, and attempts over a 2.5-year interval.
A diverse (55% female; 51% non-White) adolescent community sample (n = 399) reported depressive symptoms, frequency of NSSI, suicide ideation, threats or gestures, and attempts in 9th grade (i.e., baseline) and at 4 subsequent time points. Generalized estimating equations and logistic regressions were conducted to reveal the associations between baseline NSSI and the likelihood of each suicidal self-injury outcome postbaseline while controlling for depressive symptoms and related indices of suicidal self-injury as competing predictors.
Baseline NSSI was significantly, prospectively associated with elevated levels of suicide ideation and suicide attempts, but not threats or gestures. Neither gender nor ethnicity moderated results.
Above and beyond established risk factors such as depressive symptoms and previous suicidality, adolescent NSSI may be an especially important factor to assess when determining risk for later suicidality.
青少年自残的纵向数据较为罕见。目前尚不清楚各种形式的自残思想和行为随时间的变化而发生的关联，特别是在最有利于预防工作的社区样本中。本研究考察了非自杀性自伤（NSSI）作为一个时不变的、青少年自杀意念、威胁或姿势以及尝试自杀的前瞻性预测因子，时间跨度为 2.5 年。
一个多样化的（55%女性；51%非白人）青少年社区样本（n=399）在 9 年级（即基线）和之后的 4 个时间点报告了抑郁症状、NSSI 的频率、自杀意念、威胁或姿势以及尝试自杀的情况。采用广义估计方程和逻辑回归来揭示基线 NSSI 与基线后每种自杀性自残结果的可能性之间的关联，同时控制抑郁症状和与自杀性自残相关的指标作为竞争预测因子。
基线 NSSI 与自杀意念和自杀企图的水平升高显著相关，但与威胁或姿势无关。性别和种族均未调节结果。
除了抑郁症状和以前的自杀性等既定风险因素外，青少年 NSSI 可能是在确定以后自杀风险时需要评估的一个特别重要的因素。
