Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
Neurosci Biobehav Rev. 2023 Oct;153:105361. doi: 10.1016/j.neubiorev.2023.105361. Epub 2023 Aug 16.
Although suicide is a leading cause of preventable death worldwide, current prevention efforts have failed to substantively mitigate suicide risk. Suicide research has traditionally relied on subjective reports that may not accurately differentiate those at high versus minimal risk. This narrative review supports the inclusion of objective task-based measures in suicide research to complement existing subjective batteries. The article: 1) outlines risk factors proposed by contemporary theories of suicide and highlights recent empirical findings supporting these theories; 2) discusses ongoing challenges associated with current risk assessment tools and their ability to accurately evaluate risk factors; and 3) analyzes objective laboratory measures that can be implemented alongside traditional measures to enhance the precision of risk assessment. To illustrate the potential of these methods to improve our understanding of suicide risk, the article reviews how acute stress responses in a laboratory setting can be modeled, given that stress is a major precipitant for suicidal behavior. More precise risk assessment strategies can emerge if objective measures are implemented in conjunction with traditional subjective measures.
尽管自杀是全球可预防死亡的主要原因，但当前的预防工作未能实质性降低自杀风险。自杀研究传统上依赖于可能无法准确区分高风险和低风险人群的主观报告。本综述性文章支持在自杀研究中纳入基于客观任务的测量方法，以补充现有的主观测试。本文：1）概述了当代自杀理论提出的风险因素，并强调了支持这些理论的最新实证发现；2）讨论了与当前风险评估工具相关的持续挑战及其准确评估风险因素的能力；3）分析了可以与传统测量方法结合使用的客观实验室测量方法，以提高风险评估的精度。为了说明这些方法在提高我们对自杀风险理解方面的潜力，本文综述了如何在实验室环境中模拟急性应激反应，因为应激是自杀行为的一个主要促发因素。如果客观测量与传统主观测量相结合实施，更精确的风险评估策略可能会出现。
