Werbart Törnblom Annelie, Sorjonen Kimmo, Runeson Bo, Rydelius Per-Anders
Department of Women's and Children's Health, Centre for Psychiatry Research, Karolinska Institutet, Stockholm County Council, Stockholm, Sweden.
Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Front Psychiatry. 2021 Aug 27;12:670246. doi: 10.3389/fpsyt.2021.670246. eCollection 2021.
Most empirically anchored psychological models of suicide focus either on the perceived situational stress or on vulnerability factors and coping deficits. The interaction between life stressors and vulnerability factors is less explored. This case-control study examines interactions between life events and coping strategies in three groups of young people: cases of suicide, cases of other sudden violent death (SVD), and control cases. Four coping strategies, two more adaptive and two more maladaptive, were identified. Distinctive of the suicide and the SVD group was significantly less Planful Problem-Solving, and more Escape-Avoidance and Confrontive Coping than among the controls. Furthermore, Confrontive Coping had significantly higher level in the SVD group than in the suicide group. Between-group differences were partly accounted for differences in negative life events, early and late in life. Both target groups experienced significantly more adverse childhood experiences and recent stressful life events than the controls-the suicide group being more exposed to recent stressful life events even in comparison with the SVD group. This might indicate that adverse childhood experiences are a risk factor for both causes of death, whereas proximal stressful life events are a risk factor for death by suicide to a higher degree than for SVD. Improved understanding of the interplay between life events, both in the far past and present, and coping styles, may facilitate the identification of young people at risk of suicide and violent death.
大多数基于实证的自杀心理模型要么关注感知到的情境压力，要么关注易感性因素和应对缺陷。生活压力源与易感性因素之间的相互作用较少被探讨。这项病例对照研究考察了三组年轻人中生活事件与应对策略之间的相互作用：自杀案例、其他突然暴力死亡（SVD）案例和对照案例。确定了四种应对策略，其中两种更具适应性，两种更具适应不良性。自杀组和SVD组的特点是，与对照组相比，有计划地解决问题的能力明显较低，逃避和对抗性应对更多。此外，对抗性应对在SVD组中的水平明显高于自杀组。组间差异部分归因于早年和晚年负面生活事件的差异。两个目标组经历的童年不良经历和近期压力性生活事件都明显多于对照组——与SVD组相比，自杀组甚至更易遭受近期压力性生活事件。这可能表明童年不良经历是这两种死因的风险因素，而近期压力性生活事件对自杀死亡的风险因素程度高于对SVD的影响。更好地理解过去和现在生活事件与应对方式之间的相互作用，可能有助于识别有自杀和暴力死亡风险的年轻人。
