Department of Psychiatry, McLean Hospital/Harvard Medical School, Boston, USA.
Department of Psychiatry & Human Behavior, Division of Clinical Psychology, Brown University, Providence, USA.
Res Child Adolesc Psychopathol. 2021 Mar;49(3):393-399. doi: 10.1007/s10802-020-00750-4. Epub 2021 Jan 6.
Suicide is the second leading cause of death in adolescents and suicide rates in this population have increased in recent years. A critical step in preventing suicide is improving the accuracy of suicide risk assessment. Measurement of suicidal cognitions typically emphasizes assessment of verbal thoughts about suicide. Recent research suggests, however, that suicidal mental imagery, or mentally imagining suicide-related content, may be even more strongly associated with suicidal behavior. No research has evaluated suicidal mental imagery in adolescents, however. The present study evaluated suicidal mental imagery and suicidal verbal thoughts in a sample of adolescents (N = 159) admitted to an adolescent psychiatric inpatient unit. Of those adolescents who reported suicidal cognitions, 63.73% reported suicidal mental imagery. Adolescents who reported suicidal mental imagery had 2.40 greater odds of having made a suicide attempt, after accounting for history of suicidal verbal thoughts and relevant covariates. Findings suggest that suicidal mental imagery should be directly assessed when evaluating suicide risk, and that treatments may be optimized by targeting both suicidal verbal thoughts and suicidal mental imagery.
自杀是青少年人群的第二大死因，近年来自杀率呈上升趋势。预防自杀的关键步骤是提高自杀风险评估的准确性。自杀认知的衡量通常侧重于评估关于自杀的口头想法。然而，最近的研究表明，自杀的心理意象，即想象与自杀相关的内容，可能与自杀行为的关联更紧密。然而，目前还没有研究评估青少年的自杀心理意象。本研究在一个青少年精神科住院病房的样本（N=159）中评估了自杀心理意象和自杀口头想法。在报告自杀认知的青少年中，有 63.73%报告了自杀心理意象。在考虑了自杀口头想法和相关协变量的情况下，报告自杀心理意象的青少年自杀未遂的可能性增加了 2.40 倍。研究结果表明，在评估自杀风险时，应直接评估自杀心理意象，并且通过针对自杀口头想法和自杀心理意象，治疗可能会得到优化。
