Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA.
Department of Psychology, Adelphi University, Garden City, NY, USA.
Suicide Life Threat Behav. 2019 Apr;49(2):413-422. doi: 10.1111/sltb.12439. Epub 2018 Feb 4.
In this study, we introduce the construct of the suicidal narrative, a hypothetical personal narrative linked to imminent suicide, and explore its relationship to near-term suicidal risk and the suicide crisis syndrome (SCS). Psychiatric outpatients (N = 289) were administered the Columbia Suicide-Severity Rating Scale (C-SSRS), Suicide Crisis Inventory (SCI), and Suicide Narrative Inventory (SNI), a novel instrument combining the documented risk factors of Thwarted Belongingness, Perceived Burdensomeness, Humiliation, Social Defeat, Goal Disengagement, and Goal Reengagement. Dimensional measures of past month, lifetime, and past suicidal phenomena, incorporating ideation and behavior, were calculated from the C-SSRS. Structural equation modeling was used to explore the interaction among variables. Factor analysis of the SNI yielded two orthogonal factors, termed Interpersonal and Goal Orientation. The former factor was comprised of Perceived Burdensomeness, Social Defeat, Humiliation, and Thwarted Belongingness, the latter of Goal Disengagement and Goal Reengagement. The Interpersonal factor correlated with both SCS severity and suicidal phenomena in each time frame and the Goal Orientation factor with no other variable. As hypothesized, the proposed model was significant for the past month only. Our findings support the construct of the suicidal narrative and its function as a near-term suicidal risk factor.
在这项研究中，我们引入了自杀叙述的结构，这是一种与即将发生的自杀相关的假设性个人叙述，并探讨了它与近期自杀风险和自杀危机综合征（SCS）的关系。对 289 名精神科门诊患者进行了哥伦比亚自杀严重程度评定量表（C-SSRS）、自杀危机量表（SCI）和自杀叙述量表（SNI）的评估，SNI 是一种将挫败归属感、感知负担、羞辱、社会挫败、目标脱离和目标重新参与等已有风险因素结合在一起的新工具。从 C-SSRS 中计算了过去一个月、终生和过去自杀现象的维度测量值，包括意念和行为。使用结构方程模型来探讨变量之间的相互作用。SNI 的因子分析产生了两个正交因子，分别称为人际关系和目标取向。前者由感知负担、社会挫败、羞辱和挫败归属感组成，后者由目标脱离和目标重新参与组成。人际关系因素与每个时间框架的 SCS 严重程度和自杀现象都相关，而目标取向因素与其他变量都不相关。正如假设的那样，过去一个月的模型是显著的。我们的研究结果支持自杀叙述的结构及其作为近期自杀风险因素的功能。
