Waisman Center & Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA.
Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.
J Abnorm Child Psychol. 2019 Feb;47(2):333-344. doi: 10.1007/s10802-018-0435-5.
Although suicide remains a leading cause of death for adolescents, risk factors beyond diagnoses and suicide attempt history remain unclear. We examined whether cognitive style and temperament impact risk for an early, yet still clinically relevant and distressing, form of suicidality: active suicidal ideation. We used binary logistic regression to test whether brooding, inattention, and impulsivity predicted significantly increased risk for suicidal ideation in a sample of 134 twins, 46 of whom endorsed active suicidal ideation (i.e., probands), as well as probands' cotwins and matched controls. When comparing probands with controls and controlling for depression diagnoses, brooding (B = 0.73, Odds Ratio [OR] = 2.07, p = 0.021), inattention (B = 1.09, OR = 2.98, p < 0.001), and impulsivity (B = 0.91, OR = 2.47, p = 0.001) differentiated probands from controls, individually. We compared probands with their cotwins using the same approach, which allowed us to account for variance in suicidal ideation risk related to twins' shared, familial characteristics (e.g., prenatal environment, neighborhood); inattention was the only significant predictor of suicidal ideation risk (B = 0.66, OR = 1.93, p = 0.020). We then fit a logistic regression model that included all three predictors. Only inattention predicted significantly increased likelihood of suicidal ideation in proband versus controls and proband versus cotwin comparisons (B = 0.88, OR = 2.40, p = 0.024 and B = 0.67, OR = 1.96, p = 0.045, respectively). These results highlight the potential utility of examining novel, more proximal risk factors for suicidal ideation in addition to more established distal factors, like suicide attempt history and psychiatric diagnoses.
尽管自杀仍然是青少年的主要死因,但风险因素超出了诊断和自杀企图史仍不清楚。我们研究了认知风格和气质是否会影响早期但仍然具有临床相关性和令人痛苦的自杀形式的风险:主动自杀意念。我们使用二元逻辑回归来测试在 134 对双胞胎样本中,沉思、注意力不集中和冲动是否会显著增加自杀意念的风险,其中 46 人(即先证者)、先证者的同卵双胞胎和匹配的对照者都有自杀意念。当将先证者与对照者进行比较并控制抑郁诊断时,沉思(B=0.73,优势比[OR]=2.07,p=0.021)、注意力不集中(B=1.09,OR=2.98,p<0.001)和冲动(B=0.91,OR=2.47,p=0.001)分别将先证者与对照者区分开来。我们使用相同的方法将先证者与其同卵双胞胎进行比较,这使我们能够解释与双胞胎共同的、家族特征相关的自杀意念风险的差异(例如,产前环境、邻里);注意力不集中是唯一显著预测自杀意念风险的因素(B=0.66,OR=1.93,p=0.020)。然后,我们拟合了一个包含所有三个预测因子的逻辑回归模型。只有注意力不集中在先证者与对照者和先证者与同卵双胞胎的比较中预测自杀意念的可能性显著增加(B=0.88,OR=2.40,p=0.024 和 B=0.67,OR=1.96,p=0.045)。这些结果强调了除了更确定的自杀企图史和精神诊断等远端因素外,研究新的、更接近的自杀意念风险因素的潜在效用。