School of Medicine,King's College London,London,UK.
Department of Psychological Medicine,King's College London,London,UK.
Psychol Med. 2014 Dec;44(16):3361-3. doi: 10.1017/S0033291714001299. Epub 2014 Jul 7.
There is a commonly held perception in psychology that enquiring about suicidality, either in research or clinical settings, can increase suicidal tendencies. While the potential vulnerability of participants involved in psychological research must be addressed, apprehensions about conducting studies of suicidality create a Catch-22 situation for researchers. Ethics committees require evidence that proposed studies will not cause distress or suicidal ideation, yet a lack of published research can mean allaying these fears is difficult. Concerns also exist in psychiatric settings where risk assessments are important for ensuring patient safety. But are these concerns based on evidence? We conducted a review of the published literature examining whether enquiring about suicide induces suicidal ideation in adults and adolescents, and general and at-risk populations. None found a statistically significant increase in suicidal ideation among participants asked about suicidal thoughts. Our findings suggest acknowledging and talking about suicide may in fact reduce, rather than increase suicidal ideation, and may lead to improvements in mental health in treatment-seeking populations. Recurring ethical concerns about asking about suicidality could be relaxed to encourage and improve research into suicidal ideation and related behaviours without negatively affecting the well-being of participants.
在心理学中,有一种普遍的观点认为,无论是在研究还是临床环境中询问自杀倾向,都可能增加自杀倾向。虽然必须关注参与心理研究的参与者的潜在脆弱性,但对进行自杀研究的担忧为研究人员制造了一个两难境地。伦理委员会要求有证据表明拟议的研究不会引起痛苦或自杀意念,但缺乏已发表的研究意味着减轻这些担忧是困难的。在精神病学环境中也存在关注,在这些环境中,风险评估对于确保患者安全很重要。但这些担忧有依据吗?我们对已发表的文献进行了回顾,以检查询问自杀是否会在成年人和青少年以及一般人群和高危人群中引起自杀意念。没有发现询问自杀想法的参与者中自杀意念有统计学意义的增加。我们的研究结果表明,承认和谈论自杀实际上可能会减少而不是增加自杀意念,并可能导致寻求治疗的人群的心理健康得到改善。反复出现的关于询问自杀倾向的伦理问题可以得到放松,以鼓励和改善自杀意念和相关行为的研究,而不会对参与者的福祉产生负面影响。