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从构想到行动:在一项针对青年成年人的全国性研究中区分那些有自杀想法的人和那些试图自杀的人。

From ideation to action: Differentiating between those who think about suicide and those who attempt suicide in a national study of young adults.

机构信息

Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow G12 0XH, UK.

Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow G12 0XH, UK.

出版信息

J Affect Disord. 2018 Dec 1;241:475-483. doi: 10.1016/j.jad.2018.07.074. Epub 2018 Jul 27.

Abstract

BACKGROUND

Although many suicide risk factors have been identified, there is still relatively little known about the factors that differentiate those who think about suicide from those who make a suicide attempt.

AIMS

Using the integrated motivational-volitional model (IMV) of suicidal behaviour as a framework, this study hypothesised that (i) motivational and volitional phase factors would differentiate non-suicidal controls from those who had a history of suicidal ideation or suicide attempts, and (ii) within a multivariable model only volitional phase factors would differentiate between those who had a history of suicidal ideation and those who had attempted suicide.

METHOD

The Scottish Wellbeing Study (n = 3508) is a nationally representative study of young people (18-34 years) recruited throughout Scotland. Using multinomial regression analysis, three groups (non-suicidal control (n = 2534), lifetime suicide ideation (n = 498) and lifetime suicide attempt (n = 403) groups) were compared on motivational and volitional phase variables.

RESULTS

Consistent with the IMV model, motivational and volitional phase variables differentiated the control group from both the ideation and attempt groups. Only volitional phase variables differentiated between the suicide attempt group and the suicidal ideation group in the multivariable model; with those reporting a suicide attempt being higher on acquired capability, mental imagery about death, impulsivity, and being more likely to know a friend who had made a suicide attempt. Having a family member or friend die by suicide or a family member attempt suicide did not differentiate between the groups.

LIMITATIONS

The findings were based on cross-sectional data derived from self-report measures.

CONCLUSIONS

These findings provide further support for the IMV model, and highlight potential targets for clinical intervention.

摘要

背景

尽管已经确定了许多自杀风险因素,但对于那些有自杀念头的人与那些试图自杀的人之间的区别因素,人们的了解仍然相对较少。

目的

本研究以自杀行为的综合动机-意志模型(IMV)为框架,假设(i)动机和意志阶段因素将区分无自杀意念对照组与有自杀意念或自杀未遂史者,(ii)在多变量模型中,只有意志阶段因素才能区分有自杀意念史者和有自杀未遂史者。

方法

苏格兰幸福感研究(n=3508)是一项在苏格兰各地招募的年轻人(18-34 岁)的全国代表性研究。采用多项回归分析,将三组(无自杀对照组(n=2534)、终生自杀意念组(n=498)和终生自杀未遂组(n=403))在动机和意志阶段变量上进行比较。

结果

与 IMV 模型一致,动机和意志阶段变量将对照组与有自杀意念组和自杀未遂组区分开来。只有意志阶段变量在多变量模型中区分了自杀未遂组和自杀意念组;报告有自杀未遂的人在习得能力、关于死亡的心理意象、冲动性以及更有可能认识一个有自杀未遂的朋友方面得分更高。有家庭成员或朋友自杀或企图自杀并不能区分这些群体。

局限性

研究结果基于来自自我报告测量的横断面数据。

结论

这些发现进一步支持了 IMV 模型,并强调了临床干预的潜在目标。

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