Rogers Megan L, Chiurliza Bruno, Hagan Christopher R, Tzoneva Mirela, Hames Jennifer L, Michaels Matthew S, Hitschfeld Mario J, Palmer Brian A, Lineberry Timothy W, Jobes David A, Joiner Thomas E
Florida State University, United States.
Florida State University, United States.
J Affect Disord. 2017 Mar 15;211:1-11. doi: 10.1016/j.jad.2016.12.057. Epub 2017 Jan 4.
A new clinical entity, Acute Suicidal Affective Disturbance (ASAD), was recently proposed to characterize rapid-onset, acute suicidality including the cardinal symptom of behavioral intent. This study examines the proposed ASAD criteria factor-analytically and in relation to correlates of suicidal behavior and existing psychiatric disorders in samples of psychiatric outpatients and inpatients.
Two samples of psychiatric outpatients (N=343, aged 18-71 years, 60.6% female, 74.9% White) and inpatients (N=7,698, aged 15-99 years, 57.2% female, 87.8% White) completed measures of their ASAD symptoms and psychological functioning.
Across both samples, results of a confirmatory factor analysis supported the unidimensional nature of the ASAD construct. Additionally, results provided evidence for the convergent and discriminant validity of ASAD, demonstrating its relation to, yet distinction from, other psychiatric disorders and correlates of suicide in expected ways. Importantly, ASAD symptoms differentiated multiple attempters, single attempters, and non-attempters, as well as attempters, ideators, and non-suicidal patients, and was an indicator of past suicide attempts above and beyond symptoms of depression and other psychiatric disorders.
This study utilized cross-sectional data and did not use a standardized measure of ASAD.
ASAD criteria formed a unidimensional construct that was associated with suicide-related variables and other psychiatric disorders in expected ways. If supported by future research, ASAD may fill a gap in the current diagnostic classification system (DSM-5) by characterizing and predicting acute suicide risk.
最近提出了一种新的临床实体——急性自杀性情感障碍（ASAD），用于描述快速发作的急性自杀行为，包括行为意图这一主要症状。本研究对所提出的ASAD标准进行了因素分析，并考察了其与精神科门诊患者和住院患者样本中自杀行为及现有精神障碍相关因素的关系。
两个样本，一个是精神科门诊患者（N = 343，年龄18 - 71岁，女性占60.6%，白人占74.9%），另一个是住院患者（N = 7698，年龄15 - 99岁，女性占57.2%，白人占87.8%），完成了ASAD症状和心理功能的测量。
在两个样本中，验证性因素分析结果支持ASAD结构的单维性质。此外，结果为ASAD的聚合效度和区分效度提供了证据，表明它与其他精神障碍及自杀相关因素以预期方式相关但又有区别。重要的是，ASAD症状区分了多次自杀未遂者、单次自杀未遂者和未自杀未遂者，以及自杀未遂者、有自杀意念者和无自杀倾向患者，并且是过去自杀未遂的一个指标，独立于抑郁症状和其他精神障碍症状。
本研究使用的是横断面数据，且未使用ASAD的标准化测量方法。
ASAD标准形成了一个单维结构，以预期方式与自杀相关变量和其他精神障碍相关。如果得到未来研究的支持，ASAD可能通过描述和预测急性自杀风险来填补当前诊断分类系统（DSM - 5）的空白。
