Stewart Jeremy G, Glenn Catherine R, Esposito Erika C, Cha Christine B, Nock Matthew K, Auerbach Randy P
McLean Hospital, 115 Mill St, Mailstop 331, de Marneffe Building, Room 239, Belmont, MA 02478-9106.
Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA.
J Clin Psychiatry. 2017 Jun;78(6):e614-e621. doi: 10.4088/JCP.16m10647.
Mental illness and suicidal ideation are among the strongest correlates of suicidal behaviors, but few adolescents with these risk factors make a suicide attempt. Therefore, it is critical to identify factors associated with the transition from suicide ideation to attempts. The present study tested whether deficits in cognitive control in the context of suicide-relevant stimuli (ie, suicide interference) reliably differentiated adolescent ideators and attempters.
Adolescents (n = 99; 71 girls) aged 13-18 years (mean = 15.53, SD = 1.34) with recent suicide ideation (n = 60) or a recent suicide attempt (n = 39) were recruited from an acute residential treatment facility between August 2012 and December 2013. We measured interference to suicide-related, negative, and positive words using the Suicide Stroop Task (SST).
When stimuli were analyzed separately, suicide attempters showed greater interference for suicide (t₉₇ = 2.04, P = .044, d = 0.41) and positive (t₉₇ = 2.63, P = .010, d = 0.53) stimuli compared to suicide ideators. An additional omnibus interference (suicide, negative, positive) x group (suicide ideator, suicide attempter) analysis of variance revealed a main effect of group (F₁,₉₇ = 4.31, P = .041, ηp² = 0.04) but no interaction (P = .166), indicating that attempters showed greater interference for emotional stimuli, regardless of valence. Multiple attempters drove this effect; single attempters and ideators did not differ in SST performance (P = .608).
General deficits in cognitive control in the context of emotional stimuli may be a marker of adolescent suicide risk.
精神疾病和自杀意念是自杀行为最密切的相关因素，但很少有具有这些风险因素的青少年会尝试自杀。因此，识别与从自杀意念转变为自杀企图相关的因素至关重要。本研究测试了在与自杀相关的刺激（即自杀干扰）背景下认知控制缺陷是否能可靠地区分有自杀意念的青少年和自杀未遂者。
2012年8月至2013年12月期间，从一家急性住院治疗机构招募了13 - 18岁（平均 = 15.53，标准差 = 1.34）的青少年（n = 99；71名女孩），他们近期有自杀意念（n = 60）或近期有过自杀未遂行为（n = 39）。我们使用自杀斯特鲁普任务（SST）测量对与自杀相关、消极和积极词汇的干扰。
当分别分析刺激时，与有自杀意念者相比，自杀未遂者对自杀（t₉₇ = 2.04，P = .044，d = 0.41）和积极（t₉₇ = 2.63，P = .010，d = 0.53）刺激表现出更大的干扰。另外一项综合干扰（自杀、消极、积极）×组（有自杀意念者、自杀未遂者）方差分析显示有组的主效应（F₁,₉₇ = 4.31，P = .041，ηp² = 0.04）但无交互作用（P = .166），表明无论效价如何，自杀未遂者对情绪刺激表现出更大的干扰。多次自杀未遂者导致了这种效应；单次自杀未遂者和有自杀意念者在SST表现上没有差异（P = .608）。
在情绪刺激背景下认知控制的普遍缺陷可能是青少年自杀风险的一个标志。
