Department of Psychiatry and Behavioral Health, Mount Sinai Beth Israel Medical Center, New York City, NY, USA.
Division of Clinical Science, Department of Psychology, Florida International University, Miami, FL, USA.
Suicide Life Threat Behav. 2021 Aug;51(4):684-695. doi: 10.1111/sltb.12730. Epub 2021 Jan 23.
Clinicians' negative emotional responses to suicidal patients are predictive of near-term suicidality. This study aimed to explore the underlying pathway of this association by investigating the potential relationship between clinicians' emotional responses and the Narrative Crisis Model of suicide, which comprises long-term risk factors (LTRF) of suicidal thoughts and behaviors, Suicidal Narrative, and the Suicide Crisis Syndrome (SCS), a presuicidal affective state.
One thousand and One patient participants and 169 clinician participants were recruited. Patients' Suicidal Narrative, SCS, and LTRF were assessed at intake using the Suicidal Narrative Inventory (SNI), the Suicide Crisis Inventory, and a composite score of three separate scales, respectively. Clinicians' emotional responses were measured immediately after patient intake using the Therapist Response Questionnaire-Suicide Form (TRQ-SF).
Multilevel regression analyses, which controlled for clinician differences, found that only patients' SNI total score and perceived burdensomeness subscale score were significantly associated with clinicians' TRQ-SF total score. Furthermore, a higher SNI total score was significantly related to higher distress and lower affiliation scores among clinicians.
Clinicians appear to respond emotionally to patients' Suicidal Narrative, and thus, future investigation of Suicidal Narrative and its potential to improve imminent suicide risk assessment is warranted.
临床医生对自杀患者的负面情绪反应可预测近期的自杀倾向。本研究旨在通过调查临床医生的情绪反应与自杀的叙事危机模型之间的潜在关系来探索这种关联的潜在途径，该模型包括自杀思维和行为的长期风险因素 (LTRF)、自杀叙事和自杀危机综合征 (SCS)，这是一种自杀前的情感状态。
共招募了 101 名患者参与者和 169 名临床医生参与者。使用自杀叙事量表 (SNI)、自杀危机量表和三个独立量表的综合评分分别在入组时评估患者的自杀叙事、SCS 和 LTRF。使用治疗师反应问卷-自杀量表 (TRQ-SF) 在患者入组后立即测量临床医生的情绪反应。
控制了临床医生差异的多层次回归分析发现，只有患者的 SNI 总分和感知负担子量表得分与临床医生的 TRQ-SF 总分显著相关。此外，SNI 总分越高，临床医生的痛苦得分越高，而联系得分越低。
临床医生似乎对患者的自杀叙事做出了情绪反应，因此，有必要进一步研究自杀叙事及其对改善即时自杀风险评估的潜在作用。
