Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
Department of Clinical Psychology, University of Duisburg-Essen, Duisburg, Germany.
Clin Psychol Psychother. 2022 Sep;29(5):1580-1586. doi: 10.1002/cpp.2741. Epub 2022 Apr 8.
Previous research provided preliminary support of a potential reinforcing effect of suicidal ideation demonstrating reduced negative affect and increased positive affect after thinking about suicide. The present study therefore sought to investigate the role of mood and affect as a proximal risk factor of suicidal ideation in a high-risk sample. Seventy-four psychiatric inpatients (72% female) with unipolar depression and current and/or lifetime suicidal ideation aged 18 to 85 years (M = 37.6, SD = 14.3) took part in an ecological momentary assessment (EMA) over 6 days. Multilevel analyses were calculated. Analyses revealed negative valence of mood and low positive affect to be predictors of subsequent intensity of suicidal ideation (active, passive) as well as predictors of change in suicidal ideation (active, passive) since the last measurement. High negative affect only predicted intensity of passive suicidal ideation. Suicidal ideation (active, passive) was prospectively associated with subsequent negative valence of mood and lower positive affect as well as with higher intensity of negative affect. Suicidal ideation (active, passive) also predicted the change in valence of mood, positive affect and negative affect since the last measurement. Mood and affect should be taken into account as important proximal risk factors of active and passive suicidal ideation. The results do not support the idea of a reinforcing effect of suicidal ideation. In fact, they show a pattern of reduced subsequent positive affect, negative valence of mood and increased negative affect. Replication studies with larger samples and longer EMA follow-ups are needed.
先前的研究提供了自杀意念潜在强化作用的初步支持，表明在思考自杀后，负性情绪会减少，正性情绪会增加。因此，本研究旨在调查情绪和情感作为有自杀意念的高风险样本的近端风险因素的作用。74 名年龄在 18 至 85 岁之间（M=37.6，SD=14.3）的单相抑郁且有当前和/或终生自杀意念的精神科住院患者参加了为期 6 天的生态瞬时评估（EMA）。计算了多层次分析。分析表明，情绪的负效价和低正性情绪是随后自杀意念强度（主动、被动）的预测因子，也是自杀意念变化（主动、被动）的预测因子。高负性情绪仅预测被动自杀意念的强度。自杀意念（主动、被动）与随后的情绪负效价和较低的正性情绪以及更高的负性情绪强度呈前瞻性相关。自杀意念（主动、被动）也预测了自上次测量以来情绪、正性情绪和负性情绪变化。情绪和情感应被视为主动和被动自杀意念的重要近端风险因素。研究结果不支持自杀意念的强化作用的观点。事实上，它们显示出随后正性情绪减少、情绪负效价增加和负性情绪增加的模式。需要进行更大样本和更长 EMA 随访的复制研究。
