Wilson Keith G, Heenan Adam, Kowal John, Henderson Peter R, McWilliams Lachlan A, Castillo Dyana
*Department of Psychology, The Ottawa Hospital †Clinical Epidemiology Program, The Ottawa Hospital Research Institute Departments of ‡Medicine §Psychology ¶Anaesthesiology, University of Ottawa, Ottawa ∥Department of Psychology, Queen's University, Kingston, ON #Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada.
Clin J Pain. 2017 Aug;33(8):699-706. doi: 10.1097/AJP.0000000000000451.
The interpersonal theory of suicide offers a conceptual framework for understanding suicidal ideation (SI) that may be applicable to individuals with chronic pain. The theory emphasizes the importance of 2 interpersonal constructs as precursors to SI: perceived burdensomeness (the belief that one has become a burden to others) and thwarted belongingness (a lack of social integration or connection). Our objective was to test the interpersonal theory of suicide in people with chronic pain.
Hierarchical regression analysis was used in a cross-sectional study of 282 patients of an interdisciplinary pain clinic. The Beck Scale for Suicide Ideation was the criterion measure of SI, and independent variables included both general and pain-specific predictors.
After adjusting for other known or putative risk factors related to pain and mental health, perceived burdensomeness significantly predicted SI, whereas thwarted belongingness did not. As expected according to theory, the interaction between perceived burdensomeness and thwarted belongingness was also significant; perceived burdensomeness was a strong predictor of SI at high levels of thwarted belongingness, but only marginally at low levels. Other independent predictors were male sex, number of prior suicide attempts, and hopelessness.
These findings are in line with some, but not all, of the major predictions of the interpersonal theory of suicide. In general, however, they support the relevance of the theory for individuals with chronic pain.
自杀人际理论提供了一个概念框架，用于理解可能适用于慢性疼痛患者的自杀意念（SI）。该理论强调两种人际结构作为自杀意念先兆的重要性：感知到的负担感（认为自己已成为他人负担的信念）和归属感受挫（缺乏社会融合或联系）。我们的目的是在慢性疼痛患者中检验自杀人际理论。
在一项对一家跨学科疼痛诊所的282名患者进行的横断面研究中，采用了分层回归分析。贝克自杀意念量表是自杀意念的标准测量指标，自变量包括一般预测因素和疼痛特异性预测因素。
在对与疼痛和心理健康相关的其他已知或假定风险因素进行调整后，感知到的负担感显著预测了自杀意念，而归属感受挫则不然。正如理论所预期的，感知到的负担感和归属感受挫之间的相互作用也很显著；在归属感受挫程度较高时，感知到的负担感是自杀意念的一个强有力预测因素，但在程度较低时只是略有预测作用。其他独立预测因素为男性、既往自杀未遂次数和绝望感。
这些发现与自杀人际理论的一些主要预测相符，但并非全部。然而，总体而言，它们支持该理论对慢性疼痛患者的相关性。
