University of St Andrews, UK.
Tayside Area Psychological Therapies Service, Dundee Health and Social Care Partnership, Dundee, Scotland.
Psychol Psychother. 2017 Dec;90(4):530-549. doi: 10.1111/papt.12123. Epub 2017 Mar 11.
Links between suicidality and depressed mood are well established. There is, however, little information about the emotional regulation processes that underlie the relationship between suicidality and current low mood, and how these processes differ between groups of never-suicidal (NS), suicidal ideators, and suicide attempters. As suicidality and depression are heterogeneous constructs, this study aimed to conduct within- and between-group comparisons of known suicide risk factors that are associated with emotion regulation (neuroticism, trait aggression, brooding, impulsivity, and overgeneral autobiographical memories).
Correlational design using between- and within-group comparisons from self-report measures.
Inter- and intragroup differences were identified using Pearson's correlation coefficients and tests of difference. An analysis of indirect effects was used to investigate whether the relationship between suicidality and current low mood was mediated by neuroticism, trait aggression, brooding, impulsivity, and overgeneral autobiographical memories, and if this relationship varied according to group type.
Brooding appeared to be a consistent feature of all three groups and was closely related to current low mood. Compared to the NS group, the relationship between suicide attempts and current low mood showed greater associations with brooding, trait aggression, and overgeneral autobiographical memories. Compared to the NS group, the suicidal ideation group showed stronger associations with neuroticism and impulsivity, but these factors did not correlate with low mood.
These results suggest a need for larger studies to focus on heterogeneity within suicidal populations and consider how different combinations of risk factors may heighten or reduce suicide risk.
It is well known that the severity and intensity of suicide and depressed presentations vary because of underlying dispositional and contextual factors (Fried & Nesse, ) which, in turn, affect how events are interpreted and responded to. Despite this, there is little research about how these mechanisms operate in different types of suicide groups, and their influence on the relationship between suicidality and current low mood. Understanding interrelationships that affect current low mood is of clinical significance because past suicidal history and deteriorations in already negative mood are linked to repeated suicide attempts and completion. Our findings show that ruminative brooding, defined as a tendency to repeatedly think about emotional aspects of an event, consistently correlates with current low mood across different types of suicidal groups (NS, suicidal ideators, and suicide attempters), and across analyses. Findings also show that suicidal ideation and attempt groups were associated with specific personality characteristics that increased the propensity of emotional responding and interpretation compared to the NS group. The relationship between suicide attempt and current low mood had a higher propensity to be influenced by trait aggression, brooding, and overgenerality compared to the NS group. In contrast, although the suicidal ideation group correlated more strongly with neuroticism and impulsivity, these factors did not influence current low mood. In terms of clinical practice, these findings imply that specific styles of interpretation and thinking may maintain the relationship between suicidality and current low mood. Given the cross-sectional nature of the study, however, it is not possible to imply causality. Nevertheless, the findings obtained provide some support for transdiagnostic models of cognitive-behavioural processes that could be developed further.
自杀意念与抑郁情绪之间存在明确关联。然而,目前对于导致自杀意念与当前心境低落之间关系的情绪调节过程,以及这些过程在从未有过自杀行为(NS)、有自杀意念和自杀企图的人群中如何不同,我们知之甚少。由于自杀意念和抑郁情绪是异质的构念,本研究旨在对与情绪调节相关的已知自杀风险因素(神经质、特质攻击性、沉思、冲动和非具体自传体记忆)进行组内和组间比较。
使用自我报告测量的组间和组内比较进行相关设计。
使用皮尔逊相关系数和差异检验来识别组间和组内差异。采用间接效应分析来探讨自杀意念与当前心境低落之间的关系是否由神经质、特质攻击性、沉思、冲动和非具体自传体记忆介导,以及这种关系是否因组类型而异。
沉思似乎是所有三组人群的共同特征,与当前心境低落密切相关。与 NS 组相比,自杀企图与当前心境低落之间的关系与沉思、特质攻击性和非具体自传体记忆的关联更大。与 NS 组相比,有自杀意念的组与神经质和冲动性的关联更强,但这些因素与心境低落无关。
这些结果表明,需要进行更大规模的研究,重点关注自杀人群中的异质性,并考虑不同风险因素组合如何加剧或降低自杀风险。
众所周知,自杀和抑郁表现的严重程度和强度因潜在的特质和情境因素而异(Fried & Nesse,),这些因素又反过来影响事件的解释和反应方式。尽管如此,关于这些机制在不同类型的自杀群体中是如何运作的,以及它们对自杀意念和当前心境低落之间关系的影响,研究甚少。了解影响当前心境低落的相互关系具有临床意义,因为过去的自杀史和已经消极的情绪恶化与重复自杀企图和完成有关。我们的研究结果表明,沉思,即反复思考事件的情感方面的倾向,在不同类型的自杀群体(NS、有自杀意念和自杀企图)中,以及在各种分析中,都与当前的心境低落一致相关。研究结果还表明,与 NS 组相比,有自杀意念和自杀企图的组与特定的人格特征有关,这些特征增加了情绪反应和解释的倾向。与 NS 组相比,自杀企图与当前心境低落之间的关系更容易受到特质攻击性、沉思和非具体性的影响。相比之下,尽管有自杀意念的组与神经质和冲动性的相关性更强,但这些因素并不影响当前的心境低落。就临床实践而言,这些发现意味着特定的解释和思维方式可能会维持自杀意念与当前心境低落之间的关系。然而,由于研究的横断面性质,不能推断因果关系。尽管如此,所获得的发现为进一步发展认知行为过程的跨诊断模型提供了一些支持。