University of Rochester, Rochester, NY, USA.
Harvard University, Cambridge, MA, USA.
J Child Psychol Psychiatry. 2017 Dec;58(12):1319-1329. doi: 10.1111/jcpp.12769. Epub 2017 Jul 4.
Suicidal thoughts and behaviors are major public health concerns in youth. Unfortunately, knowledge of reliable predictors of suicide risk in adolescents is limited. Promising research using a death stimuli version of the Implicit Association Test (Death IAT) indicates that stronger identification with death differs between adults with and without a history of suicidal thoughts and behaviors and uniquely predicts suicide ideation and behavior. However, research in adolescents is lacking and existing findings have been mixed. This study extends previous research by testing whether implicit identification with death predicts changes in suicide ideation during psychiatric treatment in adolescents.
Participants included 276 adolescents, ages 13-19, admitted to a short-term residential treatment program. At hospital admission and discharge, adolescents completed the Death IAT and measures of recent suicidal thoughts.
At admission, implicit identification with death was associated with recent suicide ideation, but did not differ between those who engaged in prior suicidal behavior and those who did not. Prospectively, adolescents' implicit identification with death at admission significantly predicted their suicide ideation severity at discharge, above and beyond explicit suicide ideation. However, this effect only was significant for adolescents with longer treatment stays (i.e., more than 13 days).
Implicit identification with death predicts suicidal thinking among adolescents in psychiatric treatment. Findings clarify over what period of time implicit cognition about death may predict suicide risk in adolescents.
自杀念头和行为是青少年的主要公共卫生关注点。遗憾的是，人们对预测青少年自杀风险的可靠因素知之甚少。一项使用死亡刺激版内隐联想测验（Death IAT）的有前途的研究表明，具有自杀念头和行为史的成年人与没有自杀念头和行为史的成年人相比，对死亡的认同程度更强，且这种认同程度可以独特地预测自杀意念和行为。然而，针对青少年的研究还很缺乏，且现有的研究结果也存在差异。本研究通过测试内隐的死亡认同是否能预测青少年在精神科治疗期间自杀意念的变化，扩展了之前的研究。
参与者包括 276 名 13-19 岁的青少年，他们被收入短期住院治疗项目。在入院和出院时，青少年完成了 Death IAT 和近期自杀意念的测量。
入院时，对死亡的内隐认同与近期的自杀意念有关，但在有过自杀行为和没有自杀行为的青少年中没有差异。前瞻性地，入院时青少年对死亡的内隐认同显著预测了他们在出院时的自杀意念严重程度，这超过了外显的自杀意念。然而，这种影响仅在治疗时间较长（即超过 13 天）的青少年中显著。
对死亡的内隐认同预测了精神科治疗中的青少年自杀思维。这些发现阐明了在多长时间内，对死亡的内隐认知可能预测青少年的自杀风险。
