St. John's University, Queens, New York, USA.
Mount Sinai Beth Israel, New York, New York, USA.
Fam Process. 2024 Sep;63(3):1429-1445. doi: 10.1111/famp.12922. Epub 2023 Aug 7.
No study to date has examined the moderating effect of parenthood on suicidal states and outcomes using a conditional process model. The Narrative Crisis Model, a multi-stage model from interpersonal distress to suicidal outcomes mediated by Suicide Crisis Syndrome severity, was assessed (H1). The present study tested whether (H2) parenthood moderates the indirect association between interpersonal distress and suicidality to reduce suicide risk. Psychiatric outpatients (N = 466) completed measures assessing the severity of interpersonal distress and Suicide Crisis Syndrome, as well as a clinical interview of suicidal thoughts and behaviors. The sample was predominantly female (65.7%), with ages ranging from 18 to 84 years. Mediation was conducted on the total sample (H1) and a conditional process analysis compared parents (n = 170) and non-parents (H2). Suicide Crisis Syndrome severity mediated the relationship between interpersonal distress and suicidal outcomes. Parenthood moderated the indirect relationship between interpersonal distress and suicidal outcomes through Suicide Crisis Syndrome such that parents had a significantly higher suicide risk than non-parents (index = 0.058; 95% CI [0.005, 0.139]). In the context of an outpatient population, parents appear to be more at risk for developing a suicidal crisis and engaging in suicidal thoughts and behaviors than non-parents. Parenthood may act as a pile-up stressor for this population, outweighing the protective effects of having children. In this way, the Narrative Crisis Model is a theoretical model suitable for the examination of complex factors impacting risk for near-term suicidal thoughts and behaviors.
迄今尚无研究使用条件过程模型来检验父母身份对自杀状态和结果的调节作用。本研究评估了叙事危机模型（Narrative Crisis Model），这是一种多阶段模型，其中人际困扰通过自杀危机综合征严重程度介导自杀结局（假设 1）。本研究检验了父母身份是否（假设 2）调节人际困扰与自杀之间的间接关联，以降低自杀风险。精神科门诊患者（N=466）完成了评估人际困扰和自杀危机综合征严重程度的量表，以及对自杀想法和行为的临床访谈。该样本主要为女性（65.7%），年龄从 18 岁到 84 岁不等。在总样本中进行了中介分析（假设 1），并对父母（n=170）和非父母（假设 2）进行了条件过程分析。自杀危机综合征严重程度介导了人际困扰与自杀结果之间的关系。父母身份通过自杀危机综合征调节了人际困扰与自杀结果之间的间接关系，父母的自杀风险显著高于非父母（指标=0.058；95%CI[0.005,0.139]）。在门诊人群的背景下，父母似乎比非父母更有可能出现自杀危机并产生自杀想法和行为。父母身份可能对该人群构成堆积压力源，超过了有子女的保护作用。在这种情况下，叙事危机模型是一种适合检验影响近期自杀想法和行为风险的复杂因素的理论模型。
