Kleiman Evan M, Turner Brianna J, Fedor Szymon, Beale Eleanor E, Huffman Jeff C, Nock Matthew K
Department of Psychology, Harvard University.
Department of Psychology, University of Victoria.
J Abnorm Psychol. 2017 Aug;126(6):726-738. doi: 10.1037/abn0000273. Epub 2017 May 8.
Two studies examined 2 important but previously unanswered questions about the experience of suicidal ideation: (a) How does suicidal ideation vary over short periods of time?, and (b) To what degree do risk factors for suicidal ideation vary over short periods and are such changes associated with changes in suicidal ideation? Participants in Study 1 were 54 adults who had attempted suicide in the previous year and completed 28 days of ecological momentary assessment (EMA; average of 2.51 assessments per day; 2,891 unique assessments). Participants in Study 2 were 36 adult psychiatric inpatients admitted for suicide risk who completed EMA throughout their time in the hospital (average stay of 10.32 days; average 2.48 assessments per day; 649 unique assessments). These studies revealed 2 key findings: (a) For nearly all participants, suicidal ideation varied dramatically over the course of most days: more than 1-quarter (Study 1 = 29%; Study 2 = 28%) of all ratings of suicidal ideation were a standard deviation above or below the previous response from a few hours earlier and nearly all (Study 1 = 94.1%; Study 2 = 100%) participants had at least 1 instance of intensity of suicidal ideation changing by a standard deviation or more from 1 response to the next. (b) Across both studies, well-known risk factors for suicidal ideation such as hopelessness, burdensomeness, and loneliness also varied considerably over just a few hours and correlated with suicidal ideation, but were limited in predicting short-term change in suicidal ideation. These studies represent the most fine-grained examination of suicidal ideation ever conducted. The results advance the understanding of how suicidal ideation changes over short periods and provide a novel method of improving the short-term prediction of suicidal ideation. (PsycINFO Database Record
（a）自杀意念在短时间内如何变化？以及（b）自杀意念的风险因素在短时间内变化的程度如何，以及这些变化是否与自杀意念的变化相关？研究1的参与者是54名在前一年曾尝试自杀的成年人，他们完成了28天的生态瞬时评估（EMA；平均每天2.51次评估；2891次独特评估）。研究2的参与者是36名因自杀风险入院的成年精神科住院患者，他们在住院期间完成了EMA（平均住院10.32天；平均每天2.48次评估；649次独特评估）。这些研究揭示了两个关键发现：（a）对于几乎所有参与者来说，自杀意念在大多数日子里都有显著变化：所有自杀意念评分中超过四分之一（研究1 = 29%；研究2 = 28%）比几小时前的前一次反应高出或低出一个标准差，几乎所有（研究1 = 94.1%；研究2 = 100%）参与者至少有一次自杀意念强度从一次反应到下一次反应变化一个标准差或更多。（b）在两项研究中，自杀意念的知名风险因素，如绝望、负担感和孤独感，在短短几个小时内也有很大变化，并与自杀意念相关，但在预测自杀意念的短期变化方面有限。这些研究是有史以来对自杀意念进行的最精细的检查。研究结果推进了对自杀意念在短时间内如何变化的理解，并提供了一种改进自杀意念短期预测的新方法。（PsycINFO数据库记录
