Department of Psychology, Rutgers University, 53 Avenue E., Piscataway, NJ 08854-8040, USA.
J Clin Child Adolesc Psychol. 2013;42(4):481-95. doi: 10.1080/15374416.2012.736356. Epub 2012 Nov 13.
Suicidal ideation (SI) and thoughts of death are often experienced as fluctuating; therefore a dynamic representation of this highly important indicator of suicide risk is warranted. Theoretical accounts have suggested that affective, behavioral, and interpersonal factors may influence the experience of thoughts of death/SI. This study aimed to examine the prospective and dynamic impact of these constructs in relation to thoughts of death and SI. We assessed adolescents with a recent hospitalization for elevated suicide risk over 6 months. Using the methodology of the Longitudinal Interval Follow-Up Evaluation, weekly ratings for SI, course of depressive illness, affect sensitivity, negative affect intensity, behavioral dysregulation, peer invalidation, and family invalidation were obtained. Using multilevel modeling, results indicated that (a) same-week ratings between these constructs and SI were highly correlated at baseline and throughout follow-up; (b) baseline ratings of affect sensitivity, behavioral dysregulation, and peer invalidation were positive prospective predictors of SI at any week of follow-up; (c) weekly ratings of each of these constructs had significant associations with next-week ratings of SI; and (d) ratings of SI had positive significant associations with next-week ratings on each of the constructs. These results suggest that affective sensitivity, behavioral dysregulation, peer invalidation, and SI are highly associated with SI levels both chronically (over months) and acutely (one week to the next), whereas depression, negative affect intensity, and family invalidation were more acutely predictive of SI. Elevated SI may then aggravate all these factors in a reciprocal manner.
自杀意念（SI）和死亡念头常常表现出波动；因此，有必要对自杀风险的这一重要指标进行动态表示。理论解释表明，情感、行为和人际关系因素可能会影响对死亡念头/SI 的体验。本研究旨在考察这些结构与死亡念头和 SI 之间的前瞻性和动态影响。我们在 6 个月的时间内对最近因自杀风险升高而住院的青少年进行了评估。使用纵向间隔随访评估的方法，每周评估 SI、抑郁疾病的病程、情感敏感性、负性情绪强度、行为失调、同伴否定和家庭否定。使用多层模型，结果表明：（a）这些结构和 SI 之间的同周评分在基线和整个随访过程中高度相关；（b）情感敏感性、行为失调和同伴否定的基线评分是随访中任何一周 SI 的积极前瞻性预测因素；（c）这些结构的每周评分与 SI 的下一周评分具有显著关联；（d）SI 的评分与每个结构的下一周评分均呈显著正相关。这些结果表明，情感敏感性、行为失调、同伴否定和 SI 与 SI 水平具有高度相关性，无论是在慢性（数月）还是急性（一周到下一周）方面，而抑郁、负性情绪强度和家庭否定则更能预测 SI。升高的 SI 可能会以互惠的方式加剧所有这些因素。
