Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27705, USA.
Department of Psychiatry and Behavioral Sciences, Duke University Medical School, Durham, NC, USA.
J Abnorm Child Psychol. 2020 Jan;48(1):123-133. doi: 10.1007/s10802-019-00580-z.
Despite research indicating that stressful life events are associated with subsequent suicidal ideation (SI) and behavior, there is a lack of clarity regarding whether specific types of life events are differentially related to SI and attempts. The current prospective study examines whether social rejection related life events are proximally related to SI and suicide attempts in a clinically acute sample of adolescents. Adolescents aged 12 to 18 (n = 219) were followed for 6 months after discharge from inpatient hospitalization. A contextual threat interview of stressful life events between index admission and 6-month follow-up was administered. Participants were also assessed for current SI and suicide attempts at baseline and 6-month follow-up. Results from a multiple linear regression model indicated a significant prospective association between number of social rejection stressors and SI, even after controlling for baseline depressive symptoms, SI at study entry, gender, age, and number of non-social rejections stressors. An Anderson-Gill recurrent events model was conducted to examine the relationship between SR stressors and suicide attempts. Results demonstrated that the 31 days following a major social rejection stressor were associated with heightened risk for prospective suicide attempts. However, social rejection stressors were not more strongly related to risk for suicide attempt than non-social rejection stressors. These findings help clarify the role of social rejection as a precipitant of suicidal crises and have potential to inform more accurate, targeted risk assessment.
尽管研究表明生活压力事件与随后的自杀意念（SI）和行为有关，但对于特定类型的生活事件是否与 SI 和自杀企图有差异关联仍存在不明确性。目前的前瞻性研究检查了在临床急性青少年样本中，与社会排斥相关的生活事件是否与 SI 和自杀企图有直接关联。12 至 18 岁的青少年（n=219）在从住院治疗出院后 6 个月内进行了随访。在指数住院和 6 个月随访期间，对生活压力事件进行了情境威胁访谈。在基线和 6 个月随访时，还评估了参与者当前的 SI 和自杀企图。多线性回归模型的结果表明，即使在控制基线抑郁症状、研究开始时的 SI、性别、年龄和非社会排斥压力源数量后，社会排斥压力源的数量与 SI 之间存在显著的前瞻性关联。进行了安德森-吉尔复发性事件模型来检验 SR 压力源与自杀企图之间的关系。结果表明，在主要社会排斥压力源后的 31 天内，与未来自杀企图的风险增加有关。然而，与非社会排斥压力源相比，社会排斥压力源与自杀企图的风险没有更强的关联。这些发现有助于澄清社会排斥作为自杀危机诱发因素的作用，并有可能为更准确、有针对性的风险评估提供信息。
