University Psychiatric Centre (UPC-KUL), University of Leuven, Leuven, Belgium.
University of Central Lancashire, Preston, UK.
Int J Geriatr Psychiatry. 2017 Jun;32(6):685-691. doi: 10.1002/gps.4511. Epub 2016 May 29.
The "Internal Struggle Hypothesis" (Kovacs and Beck, ) suggests that suicidal persons may have both a wish to live (WTL) and a wish to die (WTD). The current study investigates whether the three-group typology - "WTL", "ambivalent (AMB)", and "WTD" - is determined by common correlates of suicidality and whether these groups can be ordinally ranked.
The sample comprised 113 older inpatients. Discriminant analysis was used to create two functions (combining social, psychiatric, psychological, and somatic variables) to predict the assignment of older inpatients into the groups WTL, AMB, and WTD.
The functions "Subjective Well-being" and "Social Support" allowed us to assign patients into these three distinct groups with good accuracy (66.1%). "Subjective Well-being" contrasted the groups WTD and WTL and "Social Support" discriminated between the groups WTD and AMB. "Social Support" was highest in the AMB group.
Our results suggest a simultaneous presence of a WTL and a WTD in older inpatients, and also that the balance between them is determined by "Subjective Well-being" and "Social Support". Unexpectedly, the AMB group showed the highest scores on "Social Support". We hypothesize that higher social support might function as an important determinant of a remaining WTL when a WTD is present because of a lower sense of well-being. The study suggests that the groups WTL-AMB-WTD can not situated on a one-dimensional continuum. Copyright © 2016 John Wiley & Sons, Ltd.
“内心斗争假说”（Kovacs 和 Beck，）认为自杀者可能既有生存的愿望（WTL）又有死亡的愿望（WTD）。本研究调查了三群组类型学——“WTL”、“矛盾（AMB）”和“WTD”——是否由自杀的共同相关因素决定，以及这些群体是否可以进行有序排列。
样本包括 113 名老年住院患者。判别分析用于创建两个函数（结合社会、精神、心理和躯体变量），以预测老年住院患者分配到 WTL、AMB 和 WTD 组。
“主观幸福感”和“社会支持”这两个函数可以准确地（66.1%）将患者分配到这三个不同的组中。“主观幸福感”对比了 WTD 和 WTL 组，而“社会支持”则区分了 WTD 和 AMB 组。AMB 组的“社会支持”最高。
我们的结果表明，老年住院患者同时存在 WTL 和 WTD，它们之间的平衡由“主观幸福感”和“社会支持”决定。出乎意料的是，AMB 组在“社会支持”方面的得分最高。我们假设，由于幸福感较低，当存在 WTD 时，更高的社会支持可能作为仍然存在 WTL 的重要决定因素。研究表明，WTL-AMB-WTD 组不能位于一维连续体上。
