The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer 4025000, Israel.
Clinical Psychology M.A. Program, Ruppin Academic Center, Emek Hefer 4025000, Israel.
Int J Environ Res Public Health. 2022 Dec 9;19(24):16561. doi: 10.3390/ijerph192416561.
Suicide is not only a tragic end of life but also may be the beginning of a very challenging life for those left behind. Suicide-loss survivors (SLSs) are individuals who were exposed to the suicide of a close family member or a friend and endure highly emotional distress. The psychological stance and reactions of SLS are deeply colored by painful, intense emotions that are expressed through different psychiatric symptoms, including depression and suicide ideation (SI). The present study investigated the long-term effects of interpersonal factors such as social support, self-disclosure, thwarted belongingness, and perceived burdensomeness on depression and suicidal ideation among SLS. One hundred fifty-two Israeli SLS, aged 20-72, participated in this longitudinal study, during which their suicide ideation and depression levels were assessed at four points over six years (T1-baseline, and two (T2), four (T3), and six (T4) years after baseline). At the last time point, interpersonal factors were also assessed. SLSs' interpersonal variables significantly predicted depression and SI levels beyond their usual trajectories over the years. Significant correlations were found between both perceived burdensomeness and thwarted belongingness and depression levels at all measurement points. Moreover, thwarted belongingness was found to be a significant moderator of the relationship between former and current depression levels, as the contribution of depression-T3 to depression-T4 was lower among SLSs with low thwarted belongingness (b = 0.14, CI = 0.05-0.34) compared with SLSs with high thwarted belongingness (b = 0.25, CI = 0.22-0.45). These findings emphasize the vital healing role of interpersonal factors such as belongingness, as they may attenuate depression and SI symptoms over time. Hence, clinicians should focus on therapies that boost interpersonal interactions and belongingness, as they seem to be crucial stepping stones on the way to recovery. Moreover, national programs should be implemented to offer SLSs targeted interventions to reduce distress and depression in the aftermath of suicide loss.
自杀不仅是生命的悲惨终结，也可能是留下的人开始面临极具挑战的生活。自杀幸存者（SLS）是指那些暴露于近亲或朋友自杀事件下并承受高度情绪困扰的个体。SLS 的心理立场和反应深受痛苦、强烈情绪的影响，这些情绪通过不同的精神症状表现出来，包括抑郁和自杀意念（SI）。本研究调查了人际关系因素（如社会支持、自我表露、归属感受挫和被认为是负担）对 SLS 抑郁和自杀意念的长期影响。152 名年龄在 20-72 岁的以色列 SLS 参加了这项纵向研究，在六年内（T1-基线，以及两年（T2）、四年（T3）和六年（T4）后）四次评估他们的自杀意念和抑郁水平。在最后一次时间点，还评估了人际关系因素。SLS 的人际关系变量显著预测了他们多年来的抑郁和 SI 水平的变化轨迹。在所有测量点都发现了两者之间的显著相关性，即被认为是负担和归属感受挫与抑郁水平之间的相关性。此外，归属感受挫被发现是前和当前抑郁水平之间关系的一个显著调节因素，因为在归属感受挫较低的 SLS 中，抑郁-T3 对抑郁-T4 的贡献较低（b=0.14，CI=0.05-0.34），而在归属感受挫较高的 SLS 中，抑郁-T3 对抑郁-T4 的贡献较高（b=0.25，CI=0.22-0.45）。这些发现强调了人际关系因素（如归属感）的重要治疗作用，因为它们可能随着时间的推移减轻抑郁和 SI 症状。因此，临床医生应该关注增强人际互动和归属感的治疗方法，因为它们似乎是康复之路上的关键步骤。此外，应实施国家计划，为 SLS 提供有针对性的干预措施，以减轻自杀后遗留的痛苦和抑郁。
