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精神分裂症患者对自杀念头和行为产生心理复原力的因素:定性研究

Factors that contribute to psychological resilience to suicidal thoughts and behaviours in people with schizophrenia diagnoses: qualitative study.

作者信息

Harris Kamelia, Gooding Patricia, Haddock Gillian, Peters Sarah

机构信息

PhD candidate, Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK.

Lecturer, Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK.

出版信息

BJPsych Open. 2019 Sep 9;5(5):e79. doi: 10.1192/bjo.2019.63.

Abstract

BACKGROUND

Suicide is a leading cause of premature death in people with a diagnosis of schizophrenia. Although exposure to stressors can play a part in the pathways to death by suicide, there is evidence that some people with a diagnosis of schizophrenia can be resilient to the impact of suicide triggers.

AIMS

To investigate factors that contribute to psychological resilience to suicidal thoughts and behaviours from the perspectives of people with a diagnosis of schizophrenia.

METHOD

A qualitative design was used, involving semi-structured, face-to-face interviews. Twenty individuals with non-affective psychosis or schizophrenia diagnoses who had experience of suicide thoughts and behaviours participated in the study. The interviews were audio-recorded, transcribed verbatim and examined using inductive thematic analysis.

RESULTS

Participants reported that psychological resilience to suicidal thoughts and behaviours involved ongoing effort. This ongoing effort encompassed: (a) understanding experiences (including reconciliation to mental health experiences and seeking reasons to live), (b) active behaviours (including talking to people and keeping occupied), and (c) relationship dynamics (including feeling supported by significant others and mental health professionals).

CONCLUSIONS

Psychological resilience was described as a dynamic process that developed over time through the experiences of psychosis and the concomitant suicidal experiences. Psychological resilience can be understood using a multicomponential, dynamic approach that integrates buffering, recovery and maintenance resilience models. In order to nurture psychological resilience, interventions should focus on supporting the understanding and management of psychosis symptoms and concomitant suicidal experiences.

DECLARATION OF INTEREST

None.

摘要

背景

自杀是精神分裂症患者过早死亡的主要原因。尽管暴露于应激源可能在自杀死亡途径中起作用,但有证据表明,一些精神分裂症患者能够对自杀诱因的影响具有复原力。

目的

从精神分裂症患者的角度调查有助于对自杀念头和行为产生心理复原力的因素。

方法

采用定性设计,包括半结构化面对面访谈。20名有自杀念头和行为经历的非情感性精神病或精神分裂症患者参与了研究。访谈进行了录音,逐字转录,并采用归纳主题分析法进行分析。

结果

参与者报告说,对自杀念头和行为的心理复原力需要持续努力。这种持续努力包括:(a) 理解经历(包括接受心理健康经历并寻找活下去的理由),(b) 积极行为(包括与人交谈和保持忙碌),以及 (c) 人际关系动态(包括感受到重要他人和心理健康专业人员的支持)。

结论

心理复原力被描述为一个动态过程,随着时间的推移,通过精神病经历和随之而来的自杀经历而发展。心理复原力可以通过一种多成分、动态的方法来理解,这种方法整合了缓冲、恢复和维持复原力模型。为了培养心理复原力,干预措施应侧重于支持对精神病症状和随之而来的自杀经历的理解和管理。

利益声明

无。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d116/6737512/d4e2b2d65b69/S2056472419000632_fig1.jpg

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