Del Carpio Laura, Rasmussen Susan, Paul Sally
School of Psychological Sciences & Health, University of Strathclyde, Glasgow, United Kingdom.
School of Social Work & Social Policy, University of Strathclyde, Glasgow, United Kingdom.
Front Psychol. 2020 Jun 3;11:1153. doi: 10.3389/fpsyg.2020.01153. eCollection 2020.
Research has demonstrated that exposure to suicide can lead to increased vulnerability for self-harm or suicide. As a result, ideation-to-action models of suicide (e.g., the Integrated Motivational-Volitional Model of Suicide; IMV) recognise exposure as a significant risk factor which may be implicated in the translation of thoughts into actions. However, few studies have tested this theoretical link explicitly within an adolescent population, and examined how it compares to other types of bereavements.
A 6-month prospective questionnaire study was conducted with 185 Scottish adolescents aged 11-17 (113 adolescents also completed the questionnaire at follow-up). The questionnaire included measures on experiences with bereavement and lifetime engagement in self-harm, as well as measures of defeat, entrapment, social support, coping, and other psychological variables.
At baseline, 12% of young people reported exposure to a suicide death, and 61% to a non-suicide death. In addition, 21% of pupils reported ever engaging in self-harm, while 23% had experienced self-harm ideation without engaging in it. Cross-sectional multivariate logistic regressions showed that family social support, glorifying/normalising beliefs about suicide, and family self-harm were significantly associated with self-harm group membership (control, ideation, or enactment groups). At follow-up, 10% of pupils reported exposure to a suicide death and 16% to a non-suicide death for the first time. A total of 26% of the sample reported self-harm at T2 (11% of participants for the first time), and 24% reported self-harm ideation without engaging in it. Multivariate analyses found that self-harm ideation and family self-harm at baseline were the only variables to predict self-harm group membership prospectively, in the expected directions. Bereavement experiences, whether by suicide or non-suicide, did not predict self-harm group status at baseline nor at follow-up.
This study provides support for the validity of a theoretical model of suicide, even though predictive ability over the 6-months period was limited. Although difficulties with recruitment may have limited the statistical power, this study provides insight into the prevalence and experiences of suicide bereavement among adolescents and the factors related to the onset and maintenance of self-harm.
研究表明，接触自杀事件会导致自我伤害或自杀的易感性增加。因此，自杀的意念到行动模型（例如，自杀综合动机 - 意志模型；IMV）将接触视为一个重要的风险因素，它可能与将想法转化为行动有关。然而，很少有研究在青少年人群中明确检验这种理论联系，也没有研究它与其他类型的丧亲之痛相比情况如何。
对185名年龄在11 - 17岁的苏格兰青少年进行了为期6个月的前瞻性问卷调查研究（113名青少年在随访时也完成了问卷）。问卷包括关于丧亲经历和终身自我伤害情况的测量，以及挫败感、陷入困境、社会支持、应对方式和其他心理变量的测量。
在基线时，12%的年轻人报告接触过自杀死亡事件，61%报告接触过非自杀死亡事件。此外，21%的学生报告曾有过自我伤害行为，23%有过自我伤害意念但未付诸行动。横断面多变量逻辑回归显示，家庭社会支持、对自杀的美化/正常化信念以及家庭中的自我伤害行为与自我伤害分组（对照组、意念组或行为组）显著相关。在随访时，10%的学生首次报告接触过自杀死亡事件，16%首次报告接触过非自杀死亡事件。共有26%的样本在T2时报告有自我伤害行为（11%的参与者是首次出现），24%报告有自我伤害意念但未付诸行动。多变量分析发现，基线时的自我伤害意念和家庭中的自我伤害行为是仅有的能按预期方向前瞻性预测自我伤害分组的变量。丧亲经历，无论是因自杀还是非自杀导致的，在基线时和随访时都不能预测自我伤害分组情况。
本研究为自杀理论模型的有效性提供了支持，尽管6个月期间的预测能力有限。尽管招募方面的困难可能限制了统计效力，但本研究深入了解了青少年中自杀丧亲的发生率和经历，以及与自我伤害的发生和持续相关的因素。
