在评估自杀倾向时询问“你是否认为自己死了会更好？”这个问题有价值吗？一项案例研究。
Is There Value in Asking the Question "Do you think you would be better off dead?" in Assessing Suicidality? A Case Study.
作者信息
Giddens Jennifer M, Sheehan David V
机构信息
J. Giddens is the Co-founder of the Tampa Center for Research on Suicidality, Tampa, Florida; and Dr. Sheehan is Distinguished University Health Professor Emeritus, University of South Florida College of Medicine, Tampa, Florida.
出版信息
Innov Clin Neurosci. 2014 Sep;11(9-10):182-90.
OBJECTIVE
The author of the widely used suicidality scale, the Columbia-Suicide Severity Rating Scale, has repeatedly made the claim that asking the question, "Do you think you would be better off dead?" in suicidality assessment delivers false positive results. This case study investigates the value of this question as an immediate antecedent to impulsive suicidality and as a correlate of functional impairment.
METHOD
One subject with daily suicidality and frequent impulsive suicidality rated five passive suicidal ideation phenomena and impulsive suicidality daily on a 0 to 4 Likert scale and rated weekly functional impairment scores for 13 weeks on a 0 to 10 Discan metric.
RESULTS
Each of the five passive suicidal ideation phenomena studied frequently occurred at a different severity level, and the five phenomena did not move in synchrony. Most passive suicidal ideation phenomena were very low on dates of impulsive suicidality. Thoughts of being better off dead were a frequent antecedent to impulsive suicidality and were related to an increase in functional impairment.
CONCLUSION
The relationship to both functional impairment and impulsive suicidality suggest that it is potentially dangerous to ignore thoughts of being better off dead in suicidality assessment.
目的
广泛使用的自杀倾向量表——哥伦比亚自杀严重程度评定量表的作者多次声称，在自杀倾向评估中询问“你是否认为自己死了会更好？”这个问题会产生假阳性结果。本案例研究调查了这个问题作为冲动性自杀倾向的直接先兆以及与功能损害相关性的价值。
方法
一名每日有自杀倾向且频繁出现冲动性自杀倾向的受试者，每天使用0至4的李克特量表对五种被动自杀意念现象和冲动性自杀倾向进行评分，并在13周内每周使用0至10的迪坎量表对功能损害得分进行评分。
结果
所研究的五种被动自杀意念现象中的每一种都经常在不同的严重程度水平上出现，且这五种现象并非同步变化。在冲动性自杀倾向发生的日期，大多数被动自杀意念现象的程度非常低。认为死了会更好的想法是冲动性自杀倾向的常见先兆，并且与功能损害的增加有关。
结论
与功能损害和冲动性自杀倾向的关系表明，在自杀倾向评估中忽略认为死了会更好的想法可能具有危险性。
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