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情绪失调作为一种将创伤后应激障碍与住院精神科出院后随后的自杀念头和行为相联系的机制。

Emotion dysregulation as a mechanism linking posttraumatic stress disorder to subsequent suicidal thoughts and behaviors following inpatient psychiatric discharge.

作者信息

Raudales Alexa M, Carosa Catarina L, Weiss Nicole H, Schatten Heather T, Armey Michael F

机构信息

Department of Psychology, University of Rhode Island, Kingston, RI, USA.

Butler Hospital, Providence, RI, USA.

出版信息

J Psychiatr Res. 2023 May;161:34-39. doi: 10.1016/j.jpsychires.2023.03.002. Epub 2023 Mar 3.

Abstract

Posttraumatic stress disorder (PTSD) is a well-known risk factor for suicidal thoughts and behaviors (STBs). However, there is a scarcity of longitudinal studies exploring underlying pathways. This study sought to examine the mechanistic role of emotion dysregulation in the relations between PTSD and STBs following discharge from psychiatric inpatient treatment, a particularly high-risk period for suicide. Participants were 362 trauma-exposed psychiatric inpatients (45% female, 77% white, M = 40.37). PTSD was assessed via a clinical interview (Columbia Suicide Severity Rating Scale) during hospitalization, emotion dysregulation was assessed via self-report 3-weeks post-discharge, and STBs were assessed via a clinical interview 6-months post-discharge. St'1ructural equation modeling showed that emotion dysregulation significantly mediated the relation between PTSD and suicidal thoughts (β = 0.10, SE = 0.04, p = .01, 95%CI [0.04, 0.39]) but not suicide attempts (β = 0.04, SE = 0.04, p = .29, 95%CI [-0.03, 0.12]) post-discharge. Findings highlight a potential clinical utility of targeting emotion dysregulation among individuals with PTSD to prevent suicidal thoughts following discharge from psychiatric inpatient treatment.

摘要

创伤后应激障碍(PTSD)是自杀念头和行为(STB)的一个众所周知的风险因素。然而,探索潜在途径的纵向研究却很匮乏。本研究旨在探讨情绪调节障碍在精神科住院治疗出院后PTSD与STB之间关系中的作用机制,这是一个自杀风险特别高的时期。研究对象为362名有创伤经历的精神科住院患者(45%为女性,77%为白人,平均年龄M = 40.37岁)。住院期间通过临床访谈(哥伦比亚自杀严重程度评定量表)评估PTSD,出院后3周通过自我报告评估情绪调节障碍,出院后6个月通过临床访谈评估STB。结构方程模型显示,情绪调节障碍在出院后显著介导了PTSD与自杀念头之间的关系(β = 0.10,标准误SE = 0.04,p = 0.01,95%置信区间[0.04, 0.39]),但未介导自杀未遂(β = 0.04,标准误SE = 0.04,p = 0.29,95%置信区间[-0.03, 0.12])。研究结果凸显了针对PTSD患者的情绪调节障碍进行干预,以预防精神科住院治疗出院后自杀念头的潜在临床效用。

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