Department of Nursing, Medical University of South Carolina, Charleston, SC, USA; Department of Clinical Psychology, Seattle Pacific University, Seattle, WA, USA.
Department of Psychology, Ohio University, Athens, OH, USA.
Psychiatry Res. 2019 Apr;274:12-19. doi: 10.1016/j.psychres.2019.02.004. Epub 2019 Feb 3.
This study sought to examine the effect of general PTSD symptoms as well as specific PTSD symptom clusters on suicidal ideation and suicidal attempts. We first compared a correlated factors solution consistent with the DSM-5 symptom clusters for PTSD with a bifactor solution comprising a General PTSD factor and orthogonal specific factors. Using the best fitting model (i.e., bifactor solution), we then investigated the effect of specific PTSD symptom clusters on severity of suicidal ideation and suicide attempts above and beyond the effect of general PTSD symptoms. A sample of 773 veterans who have never sought professional mental health treatment were screened for suicidal ideation within the past two weeks. One month after the baseline measurement, the participants completed a follow-up assessment, again by telephone. A bi-factor solution was used to account for a general PTSD factor as well as the specific DSM-5 PTSD symptom clusters. After controlling for baseline suicidal ideation and behavior, it appeared that the Anxious Arousal factor was predictive of changes in the magnitude of severity of suicidal ideation and the General PTSD factor was predictive of the onset of new suicidal behavior at the one-month follow-up. Additionally, the Re-experiencing factor of PTSD also significantly predicted new suicidal behavior at the one-month follow-up. These results suggest that it may beneficial for clinicians, who are assessing individuals with PTSD for suicidality, to be aware of the frequency, duration, and content of their clients' repetitive, intrusive thoughts as these thoughts may increase their capability to inflict non-lethal or lethal forms of self-injury.
本研究旨在探讨广泛性创伤后应激障碍（PTSD）症状以及特定 PTSD 症状群对自杀意念和自杀企图的影响。我们首先比较了与 DSM-5 PTSD 症状群一致的相关因素解决方案和包含一般 PTSD 因素和正交特定因素的双因素解决方案。使用最佳拟合模型（即双因素解决方案），我们进一步调查了特定 PTSD 症状群对自杀意念和自杀企图严重程度的影响，这些影响超出了一般 PTSD 症状的影响。一项从未寻求过专业心理健康治疗的 773 名退伍军人样本在过去两周内接受了自杀意念筛查。在基线测量一个月后，参与者通过电话再次完成了随访评估。使用双因素解决方案来解释一般 PTSD 因素和特定的 DSM-5 PTSD 症状群。在控制基线自杀意念和行为后，焦虑唤醒因子似乎可以预测自杀意念严重程度的变化幅度，而一般 PTSD 因子则可以预测一个月随访时新的自杀行为的发生。此外，PTSD 的再体验因子也显著预测了一个月随访时的新自杀行为。这些结果表明，对于评估 PTSD 患者自杀风险的临床医生来说，了解其患者重复、侵入性思维的频率、持续时间和内容可能是有益的，因为这些思维可能会增加他们实施非致命或致命形式的自我伤害的能力。
