Department of Human Development, Cornell University, G78 Martha van Rensselaer Hall, Ithaca, NY 14853, United States.
J Affect Disord. 2018 Dec 1;241:499-504. doi: 10.1016/j.jad.2018.08.059. Epub 2018 Aug 14.
Informed by diathesis-stress models of suicide risk, this paper investigated the role of proximally-occurring stressful life events in the first transition from suicidal ideation to suicide attempt in adolescence. Interactions between stressful life events and psychiatric disorders in relation to this progression were also examined.
Data are from a subsample (N = 928) of adolescents with lifetime suicidal ideation from the National Comorbidity Survey-Adolescent Supplement. Logistic regression analyses compared adolescents who had transitioned to a first suicide attempt (n = 81) in the year prior to the study to adolescents with suicidal ideation only (n = 847).
Multivariate logistic regressions implicated increased risk for progression from suicidal ideation to a first suicide attempt in the presence of a recent romantic break-up as well as more recent stressful life events. However, among adolescents with suicidal ideation and either a recent romantic break-up or above-average recent stressors, neither a disruptive behavior disorder, mood disorder, nor a substance use disorder intensified the risk for progressing to a first suicide attempt.
Analyses are cross-sectional and therefore limit causal inferences.
Findings underscore the importance of comprehensive suicide risk evaluations that consider proximally-occurring interpersonal stressors which may influence the first transition from thinking about suicide to acting in adolescence.
本研究基于自杀风险的素质-应激模型，探讨了近发性应激性生活事件在青少年从自杀意念到自杀未遂的首次转变中的作用。还研究了这种进展与精神障碍之间的应激性生活事件相互作用。
数据来自国家共病调查-青少年补充研究中具有终生自杀意念的青少年的亚样本（N=928）。逻辑回归分析比较了在研究前一年从自杀意念转为首次自杀未遂的青少年（n=81）与仅具有自杀意念的青少年（n=847）。
多变量逻辑回归表明，在最近的恋爱关系破裂以及更近的应激性生活事件的情况下，从自杀意念进展到首次自杀未遂的风险增加。然而，在具有自杀意念且最近经历恋爱关系破裂或应激性生活事件较多的青少年中，破坏性行为障碍、心境障碍或物质使用障碍均未加剧进展为首次自杀未遂的风险。
分析是横断面的，因此限制了因果推断。
研究结果强调了全面的自杀风险评估的重要性，需要考虑可能影响青少年从自杀意念到自杀行为首次转变的近发性人际应激源。
