有过自杀未遂的重性抑郁障碍患者的气质、性格和决策特点。
Temperament, character and decision-making characteristics of patients with major depressive disorder following a suicide attempt.
机构信息
Department of Psychiatry, Faculty of Medicine, University of Szeged, Szeged, Hungary.
出版信息
PLoS One. 2021 May 20;16(5):e0251935. doi: 10.1371/journal.pone.0251935. eCollection 2021.
BACKGROUND
Multiple psychological factors of suicidal behaviour have been identified so far; however, little is known about state-dependent alterations and the interplay of the most prominent components in a suicidal crisis. Thus, the combined effect of particular personality characteristics and decision-making performance was observed within individuals who recently attempted suicide during a major depressive episode.
METHODS
Fifty-nine medication-free major depressed patients with a recent suicide attempt (within 72 h) and forty-five healthy control individuals were enrolled in this cross-sectional study. Temperament and character factors, impulsivity and decision-making performance were assessed. Statistical analyses aimed to explore between-group differences and the most powerful contributors to suicidal behaviour during a depressive episode.
RESULTS
Decision-making and personality differences (i.e. impulsivity, harm avoidance, self-directedness, cooperativeness and transcendence) were observed between the patient and the control group. Among these variables, decision-making, harm avoidance and self-directedness were shown to have the strongest impact on a recent suicide attempt of individuals with a diagnosis of major depressive disorder according to the results of the binary logistic regression analysis. The model was significant, adequately fitted the data and correctly classified 79.8% of the cases.
CONCLUSIONS
The relevance of deficient decision-making, high harm avoidance and low self-directedness was modelled in the case of major depressed participants with a recent suicide attempt; meaning that these individuals can be described with the myopia for future consequences, a pessimistic, anxious temperament; and a character component resulting in the experience of aimlessness and helplessness. Further studies that use a within-subject design should identify and confirm additional characteristics specific to the suicidal mind.
背景
迄今为止，已经确定了多种与自杀行为相关的心理因素；然而，对于在自杀危机中最突出的因素的状态依赖性改变及其相互作用知之甚少。因此，在经历重度抑郁发作并近期自杀未遂的个体中，观察到了特定人格特征和决策表现的综合影响。
方法
本横断面研究纳入了 59 名近期（72 小时内）有自杀未遂经历的未经药物治疗的重度抑郁患者和 45 名健康对照者。评估了气质和性格因素、冲动性和决策表现。统计分析旨在探索组间差异以及在重度抑郁发作期间对自杀行为影响最大的因素。
结果
在患者组和对照组之间观察到了决策和人格差异（即冲动性、回避伤害、自我导向、合作性和超越性）。在这些变量中，根据二元逻辑回归分析的结果，决策、回避伤害和自我导向被证明对被诊断为重度抑郁症的个体最近的自杀企图具有最强的影响。该模型具有统计学意义，能充分拟合数据，并正确分类了 79.8%的病例。
结论
在近期有自杀未遂经历的重度抑郁参与者中，决策能力不足、回避伤害高和自我导向低的相关性得到了建模；这意味着这些个体可以被描述为对未来后果的短视、悲观、焦虑的气质；以及导致漫无目的和无助感的性格特征。进一步使用个体内设计的研究应该确定并确认自杀思维特有的其他特征。
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