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生活压力事件模式:区分自杀意念者与自杀未遂者。

Patterns of stressful life events: distinguishing suicide ideators from suicide attempters.

机构信息

School of Psychology and Psychology Research Institute, University of Ulster at Magee, BT48 5JL, Northern Ireland.

School of Psychology and Psychology Research Institute, University of Ulster at Magee, BT48 5JL, Northern Ireland.

出版信息

J Affect Disord. 2015 Apr 1;175:192-8. doi: 10.1016/j.jad.2014.12.034. Epub 2014 Dec 19.

Abstract

BACKGROUND

Suicidal ideation is an important indicator for subsequent suicidal behaviour, yet only a proportion of ideators transit from thought to action. This has led to interest surrounding the factors that distinguish ideators who attempt from non-attempters. The study aimed to identify distinct classes of life event categories amongst a sample of ideators and assess the ability of the classes to predict the risk of a suicide attempt.

METHODS

A subsample of ideators was extracted based on responses to the suicidality section of the Adult Psychiatric Morbidity Survey (N=7403). Fifteen stressful life events (SLEs) were grouped into six broad categories.

RESULTS

Using Latent Class Analysis (LCA), three distinct classes emerged; class 1 had a high probability of encountering interpersonal conflict, class 2 reported a low probability of experiencing any of the SLE categories with the exception of minor life stressors, whereas class 3 had a high probability of endorsing multiple SLE categories. The Odds Ratio for attempted suicide were highest among members of Class 3.

LIMITATIONS

The use of broad event categories as opposed to discrete life events may have led to an underestimation of the true exposure to SLEs.

CONCLUSIONS

The findings suggest the experience of multiple types of SLEs may predict the risk of transitioning towards suicidal behaviour for those individuals who have contemplated suicide. In application, this re-emphasises the need for a routine appraisal of risk amongst this vulnerable group and an assessment of the variety of events which may signal the individuals who may be at immediate risk.

摘要

背景

自杀意念是随后自杀行为的一个重要指标,但只有一部分意念者会从想法转变为行动。这导致人们对区分有自杀意念但未尝试自杀者和有自杀意念且尝试自杀者的因素产生了兴趣。本研究旨在确定意念者样本中不同类别的生活事件类别,并评估这些类别预测自杀企图风险的能力。

方法

从成人精神发病率调查的自杀意念部分中提取了一个意念者的亚样本(N=7403)。将 15 种应激性生活事件(SLEs)分为六类。

结果

使用潜在类别分析(LCA),出现了三个不同的类别;第 1 类遇到人际冲突的可能性很高,第 2 类报告除了轻微生活压力外,经历任何 SLE 类别的可能性都很低,而第 3 类则极有可能认可多种 SLE 类别。尝试自杀的几率在第 3 类成员中最高。

局限性

使用广泛的事件类别而不是离散的生活事件可能导致对 SLE 实际暴露的低估。

结论

研究结果表明,对于那些考虑过自杀的人来说,经历多种类型的 SLEs 可能预示着向自杀行为转变的风险。在实际应用中,这再次强调了需要对这一弱势群体进行常规风险评估,并评估可能表明个体处于立即风险中的各种事件。

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