Segal Daniel L, Gottschling Juliana, Marty Meghan, Meyer William J, Coolidge Frederick L
a Psychology Department , University of Colorado at Colorado Springs , Colorado Springs , CO , USA.
Aging Ment Health. 2015;19(12):1071-7. doi: 10.1080/13607863.2014.1003280. Epub 2015 Jan 26.
Suicide among older adults is a major public health problem in the USA. In our recent study, we examined relationships between the 10 standard DSM-5 personality disorders (PDs) and suicidal ideation, and found that the PD dimensions explained a majority (55%) of the variance in suicidal ideation. To extend this line of research, the purpose of the present follow-up study was to explore relationships between the four PDs that previously were included in prior versions of the DSM (depressive, passive-aggressive, sadistic, and self-defeating) with suicidal ideation and reasons for living.
Community-dwelling older adults (N = 109; age range = 60-95 years; 61% women; 88% European-American) completed anonymously the Coolidge Axis II Inventory, the Reasons for Living Inventory (RFL), and the Geriatric Suicide Ideation Scale (GSIS).
Correlational analyses revealed that simple relationships between PD scales with GSIS subscales were generally stronger than with RFL subscales. Regarding GSIS subscales, all four PD scales had medium-to-large positive relationships, with the exception of sadistic PD traits, which was unrelated to the death ideation subscale. Multiple regression analyses showed that the amount of explained variance for the GSIS (48%) was higher than for the RFL (11%), and this finding was attributable to the high predictive power of depressive PD.
These findings suggest that depressive PD features are strongly related to increased suicidal thinking and lowered resilience to suicide among older adults. Assessment of depressive PD features should also be especially included in the assessment of later-life suicidal risk.
在美国,老年人自杀是一个重大的公共卫生问题。在我们最近的研究中,我们考察了10种标准的《精神疾病诊断与统计手册》第5版(DSM-5)人格障碍与自杀意念之间的关系,发现人格障碍维度解释了自杀意念中大部分(55%)的变异。为了扩展这一研究方向,本随访研究的目的是探讨先前被纳入DSM早期版本的四种人格障碍(抑郁型、被动攻击型、施虐型和自我挫败型)与自杀意念及生存理由之间的关系。
社区居住的老年人(N = 109;年龄范围 = 60 - 95岁;61%为女性;88%为欧美裔)匿名完成了柯立芝轴II量表、生存理由量表(RFL)和老年自杀意念量表(GSIS)。
相关分析显示,人格障碍量表与GSIS分量表之间的简单关系通常比与RFL分量表之间的关系更强。关于GSIS分量表,除施虐型人格障碍特质与死亡意念分量表无关外,所有四种人格障碍量表均呈中等到较大的正相关。多元回归分析表明,GSIS的解释变异量(48%)高于RFL(11%),这一发现归因于抑郁型人格障碍的高预测力。
这些发现表明,抑郁型人格障碍特征与老年人自杀思维增加及对自杀的心理复原力降低密切相关。在评估晚年自杀风险时,也应特别纳入对抑郁型人格障碍特征的评估。