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前瞻性应对方式与精神科急诊患者抑郁和自杀风险的相关性研究。

Prospective Associations of Coping Styles With Depression and Suicide Risk Among Psychiatric Emergency Patients.

机构信息

University of Michigan.

University of Michigan.

出版信息

Behav Ther. 2018 Mar;49(2):225-236. doi: 10.1016/j.beth.2017.07.010. Epub 2017 Aug 3.

DOI:10.1016/j.beth.2017.07.010
PMID:29530261
Abstract

Suicide is the second leading cause of death for those ages 13-25 in the United States. Coping is a mediator between stressful life events and adverse outcomes, and coping skills have been incorporated into interventions (e.g., cognitive-behavioral therapy, dialectical behavior therapy, safety-planning interventions) for suicidal populations. However, longitudinal research has not directly examined the prospective associations between multiple coping styles and suicide-related outcomes in high-risk samples. This study identified cross-sectional and 4-month longitudinal associations of coping styles with suicide risk factors (i.e., depression, suicidal ideation, suicidal behavior) in a sample of 286 adolescent and young adult psychiatric emergency patients. Positive reframing was the coping style most consistently associated with positive outcomes, whereas self-blame and disengagement were consistently associated with negative outcomes. Active coping protected against suicidal behavior for males, but not for females. This was the first study to examine longitudinal relationships between coping and suicide-related outcomes in a high-risk clinical sample. Findings suggest that clinical interventions with suicidal adolescents and young adults may benefit from a specific focus on increasing positive reframing and reducing self-blame.

摘要

在美国,自杀是 13 至 25 岁人群的第二大主要死因。应对是压力生活事件和不良后果之间的中介因素,应对技能已被纳入自杀人群的干预措施(例如认知行为疗法、辩证行为疗法、安全规划干预措施)中。然而,纵向研究尚未直接检查在高风险样本中,多种应对方式与自杀相关结果之间的前瞻性关联。本研究在 286 名青少年和青年精神科急诊患者的样本中,确定了应对方式与自杀风险因素(即抑郁、自杀意念、自杀行为)的横断面和 4 个月纵向关联。积极重新构建是与积极结果最一致相关的应对方式,而自责和脱离接触则与消极结果一致相关。积极应对可预防男性自杀行为,但对女性无效。这是第一项在高风险临床样本中检查应对与自杀相关结果之间的纵向关系的研究。研究结果表明,对有自杀倾向的青少年和年轻人进行的临床干预可能会受益于特别关注增加积极重新构建和减少自责。

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