Department of Psychology, Ohio University, Columbus, OH, USA.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
Suicide Life Threat Behav. 2019 Jun;49(3):826-837. doi: 10.1111/sltb.12480. Epub 2018 Jun 25.
Little is known about suicidal ideation stability, including whether stability is heterogeneous or homogeneous between individuals. Studies of this kind are necessary to understand the progression from suicidal ideation to action.
This study examined suicidal ideation trajectories, using growth mixture modeling, in a sample of 359 past/current military service members (M age = 32.1 years, SD = 7.7; 88.3% male). Self-reported suicidal ideation information was collected at baseline and follow-up sessions at months 1, 3, 6, and 12. Following extraction of the best-fitting solution, predictors of trajectory status were examined and trajectory status was used to predict suicidal behavior between baseline and month 12 assessments.
Results revealed four trajectories, Low-Stable (n = 125), Moderate-Stable (n = 101), High-Stable (n = 76), and High-Rapidly Declining (n = 57). In general, the High-Stable trajectory had the highest levels of perceived burdensomeness, thwarted belongingness, PTSD symptoms, and drug use. The High- and Moderate-Stable trajectories had the highest rates of suicidal behavior between baseline and month 12.
Suicidal ideation, even in individuals with elevated ideation, is not a homogeneous construct over time. Stability of suicidal ideation might be an important risk factor, even if ideation is only moderately elevated.
关于自杀意念的稳定性知之甚少，包括个体之间的稳定性是否具有异质性或同质性。这类研究对于理解从自杀意念到行动的进展是必要的。
本研究使用增长混合建模，在 359 名过去/现役军人样本中（M 年龄=32.1 岁，SD=7.7；88.3%为男性），考察了自杀意念轨迹。自杀意念的自我报告信息在基线和 1、3、6 和 12 个月的随访中收集。在提取最佳拟合解后，检查了轨迹状态的预测因素，并使用轨迹状态预测了基线和 12 个月评估之间的自杀行为。
结果显示了四种轨迹：低稳定（n=125）、中稳定（n=101）、高稳定（n=76）和高快速下降（n=57）。一般来说，高稳定轨迹的感知负担、归属感受挫、创伤后应激障碍症状和药物使用水平最高。高稳定和中稳定轨迹在基线和 12 个月之间的自杀行为发生率最高。
即使在有较高意念的个体中，自杀意念也不是一个随时间稳定的同质结构。自杀意念的稳定性可能是一个重要的风险因素，即使意念只是中等程度升高。
