Behavioral Medicine Program, Health and Behavior Research Branch, National Institute of Mental Health, 20857, Rockville, Maryland.
J Youth Adolesc. 1988 Feb;17(1):1-23. doi: 10.1007/BF01538721.
Suicidal behavior represents a major public health problem requiring the development and implementation of early detection and treatment strategies. This paper integrates a proposed model of risk factors with a multithreshold level of early detection in youth suicide. These riskfactor domains include psychiatric diagnosis, personality traits, psychosocial factors, life events and chronic medical illness, biological factors, and family history and genetics. The three levels of early detection are detection awareness, major problem awareness, and major psychiatric disorders. Each of these levels are described in detail with examples, followed by a review of intervention and treatment strategies for each level. Detection awareness requires a strong component of education and public health interventions. Major problem awareness requires a level of active intervention and treatment in dealing with behavior problems, personality issues, or specific life events. The final level deals not exclusively but primarily with the treatment of psychiatric disorders since it is proposed that treatment of specific psychiatric syndromes plays a major role in preventing suicide. The primary purpose of this paper is to outline a new approach to early detection and intervention for the prevention of youth suicide.
自杀行为是一个重大的公共卫生问题,需要制定和实施早期发现和治疗策略。本文将提出的风险因素模型与青少年自杀的多阈值早期检测相结合。这些风险因素包括精神科诊断、人格特质、心理社会因素、生活事件和慢性躯体疾病、生物学因素、家族史和遗传学。早期检测的三个层次是检测意识、主要问题意识和主要精神障碍。每个层次都有详细的描述和例子,后面是每个层次的干预和治疗策略的回顾。检测意识需要强大的教育和公共卫生干预措施。主要问题意识需要积极干预和治疗行为问题、人格问题或特定的生活事件。最后一个层次主要处理精神障碍的治疗,因为提出治疗特定的精神综合征在预防自杀方面起着主要作用。本文的主要目的是概述一种新的早期发现和干预方法,以预防青少年自杀。