Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States of America.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States of America; Division of Psychology, University of Texas Southwestern Medical Center, Dallas, TX, United States of America; Department of Psychiatry, Children's Health Children's Medical Center, Dallas, TX, United States of America.
J Affect Disord. 2022 Aug 15;311:515-522. doi: 10.1016/j.jad.2022.05.083. Epub 2022 May 24.
Suicide is a notable risk for individuals with features of borderline personality disorder. Given the centrality of interpersonal difficulties in this disorder, we proposed that the negative interpersonal cognitions (perceived burdensomeness and thwarted belongingness) identified by the Interpersonal Theory of Suicide (IPTS) may explain the associations between suicidal ideation and borderline personality features.
Participants were 322 suicidal youth (74% girls) aged 11-18 years (M, SD = 14.74, 1.6) in an intensive outpatient program in the southwest United States. Youth completed measures assessing borderline personality features at program entry, and suicidal ideation and IPTS variables at entry and exit.
Borderline personality features did not moderate associations of IPTS variables and suicidal ideation. For the entire sample, changes in suicidal ideation from entry to discharge occurred in tandem with changes in perceived burdensomeness and depressive symptoms, but not thwarted belongingness. Youth with elevated borderline personality features entered with greater suicidal ideation, but improved more from treatment entry to exit. Regardless of level of borderline personality features, changes in negative interpersonal cognitions over treatment were associated with changes in suicidal ideation.
Self-report measures and lack of sample diversity are study limitations.
This research highlights the clinical utility of the IPTS variables and the importance of promoting competence and interpersonal connectedness when treating this population. Findings indicate that the IPTS variables carry the same fundamental information for contributing to suicidal ideation, regardless of level of borderline personality features.
具有边缘型人格障碍特征的个体自杀风险显著。鉴于该障碍的人际困难核心地位，我们提出，自杀的人际理论（IPT）所确定的消极人际认知（感知负担和归属感受挫）可能解释了自杀意念和边缘型人格特征之间的关联。
研究参与者为美国西南部一个强化门诊项目中的 322 名有自杀意念的青少年（74%为女孩，年龄 11-18 岁，M，SD=14.74，1.6）。青少年在项目开始时完成了评估边缘型人格特征的测量，以及自杀意念和 IPT 变量的测量。
边缘型人格特征并不能调节 IPT 变量与自杀意念之间的关系。对于整个样本，从进入到出院期间自杀意念的变化与感知负担和抑郁症状的变化一致，但与归属感受挫无关。具有较高边缘型人格特征的青少年自杀意念更强烈，但从治疗开始到结束时，他们的改善更多。无论边缘型人格特征水平如何，治疗过程中消极人际认知的变化都与自杀意念的变化有关。
本研究的局限性在于自我报告的测量和样本多样性的缺乏。
这项研究突出了 IPT 变量的临床实用性，以及在治疗这一人群时促进能力和人际联系的重要性。研究结果表明，无论边缘型人格特征水平如何，IPT 变量对于产生自杀意念都具有相同的基本信息。
