Keefe Kristy M, Hetzel-Riggin Melanie D, Sunami Naoyuki
Western Illinois University, Macomb, USA.
Penn State Behrend, Erie, USA.
J Interpers Violence. 2020 Apr;35(7-8):1635-1653. doi: 10.1177/0886260517698282. Epub 2017 Mar 20.
Sexual assault and suicide are two serious public health concerns. Research has documented the relationship between sexual assault and suicidal thinking and attempts; however, limited research explores the more multifaceted relationships between posttraumatic stress reactions and suicidal ideation in college students through unsuccessful modulation of emotion. The authors hypothesized a mediation model where the relationship between sexual assault and suicidal ideation is mediated by dissociation and hostility. In total, 1,677 undergraduate students were administered modified versions of the Traumatic Life Events Questionnaire (TLEQ), Symptom Checklist-90-Revised (SCL-90-R), and Peritraumatic Dissociative Experiences Questionnaire (PDEQ). The results revealed both significant partial but equal mediators of hostility and dissociation. However, a portion of the direct effect between sexual assault and suicidal ideation remained unaccounted for by indirect effects. The current model supports previous work on dialectical behavior therapy that says either side of the dialectic between extreme expression and suppression of hostility increases the likelihood of suicidal thinking after sexual assault. With sexual assault survivors, practitioners should use strategies that emphasize both anger expression and healthy avoidance as a way to modulate emotion to potentially reduce suicidal thoughts. Future research should focus on different gender models, additional possible mediators such as alcohol use and guilt, and different forms of sexual assault. Limitations of the correlational, cross-sectional methodology are discussed.
性侵犯和自杀是两个严重的公共卫生问题。研究已记录了性侵犯与自杀念头及自杀企图之间的关系；然而，通过情绪调节失败来探索大学生创伤后应激反应与自杀意念之间更具多面性的关系的研究有限。作者假设了一个中介模型，其中性侵犯与自杀意念之间的关系由解离和敌意介导。共有1677名本科生接受了创伤性生活事件问卷（TLEQ）、症状自评量表90修订版（SCL-90-R）和创伤性解离体验问卷（PDEQ）的修订版测试。结果显示，敌意和解离都是显著的部分中介因素，但二者作用相当。然而，性侵犯与自杀意念之间的部分直接效应仍无法通过间接效应来解释。当前模型支持先前关于辩证行为疗法的研究，该研究表明，在极端表达与抑制敌意之间的辩证关系中，任何一方都会增加性侵犯后自杀念头出现的可能性。对于性侵犯幸存者，从业者应采用强调愤怒表达和健康回避的策略，以此调节情绪，从而有可能减少自杀念头。未来的研究应聚焦于不同的性别模型、诸如饮酒和内疚等其他可能的中介因素，以及不同形式的性侵犯。文中讨论了相关横断面研究方法的局限性。
