Horváthné Pató Irina, Szekeres Tamás, Kresznerits Szilvia, Perczel-Forintos Dóra
Klinikai Pszichológia Tanszék, Semmelweis Egyetem, Általános Orvostudomány Kar, Budapest, Hungary, E-mail:
Psychiatr Hung. 2023;38(3):203-217.
Suicide attempts and their consequences have been the leading causes of death among prisoners. Meta-analyses suggest that the main risk factors are current suicidal ideation, the presence of a mental disorder, high perceived stress levels, previous suicidal attempts or self-harm, and institutional and criminogenic variables. Empirical evidence is consistent with the integrated motivational-volitional model of suicidality, which also emphasizes the role of impulsivity in suicidal behaviour. The main objectives of our research are: (a) factor analysis of the Barratt Impulsiveness Scale-Brief-8 (BIS-R-8); (b) examination of the mental health status of prisoners, and the suicidal risk factors in our sample; (c) modeling the effect of mindfulness skills on the main risk factors.
In our cross-sectional survey, we matched a sample of inmates to a convenience sample according to gender and age (N=378). Based on our hypotheses, we examined the factor structure and reliability of the BIS-R-8. An independent sample t-test was used for comparison, and a two-step linear regression and mediation modeling were used to examine the risk of suicide.
Based on factor analysis, the BIS-R-8 can be used as a unidimensional scale. A two-factor structure with cognitive and behavioral impulsivity subscales has also been confirmed. However, the internal and external reliability of the one-factor structure proved to be better. Depression, hopelessness, perceived stress and impulsivity turned out to be of higher level in the prisoner sample; lower levels of coping skills, self-esteem, mindfulness skills and well-being were also confirmed. Depression and perceived stress level seems to be the main modifiable risk factors for suicidal thoughts in the total and prisoner's sample. Previous suicide attempts and non-suicidal self-harm are the main unmodifiable risk factors of suicidal thoughts. Low level of mindfulness skills directly and indirectly via perceived stress explains 50% of the heterogeneity in depression.
In correctional institutions BIS-8-R can be a suitable screening tool for measuring impulsivity as a suicide risk factor. Mindfulness-based interventions seem promising for improving the mental health status of prisoners and reducing the risk of suicide.
自杀未遂及其后果一直是囚犯死亡的主要原因。荟萃分析表明，主要风险因素包括当前的自杀意念、精神障碍的存在、高感知压力水平、既往自杀未遂或自我伤害，以及机构和犯罪成因变量。实证证据与自杀行为的综合动机 - 意志模型一致，该模型也强调冲动性在自杀行为中的作用。我们研究的主要目标是：（a）对巴雷特冲动性量表简版 -8（BIS-R-8）进行因素分析；（b）检查囚犯的心理健康状况以及我们样本中的自杀风险因素；（c）模拟正念技能对主要风险因素的影响。
在我们的横断面调查中，我们根据性别和年龄将一组囚犯样本与一个便利样本进行匹配（N = 378）。基于我们的假设，我们检查了BIS-R-8的因素结构和信度。使用独立样本t检验进行比较，并使用两步线性回归和中介模型来检查自杀风险。
基于因素分析，BIS-R-8可作为单维量表使用。一个具有认知和行为冲动性子量表的双因素结构也得到了证实。然而，单因素结构的内部和外部信度被证明更好。在囚犯样本中，抑郁、绝望、感知压力和冲动性水平较高；应对技能、自尊、正念技能和幸福感水平较低也得到了证实。抑郁和感知压力水平似乎是总体样本和囚犯样本中自杀念头的主要可改变风险因素。既往自杀未遂和非自杀性自我伤害是自杀念头的主要不可改变风险因素。正念技能水平低通过感知压力直接和间接地解释了抑郁中50%的异质性。
在惩教机构中，BIS-8-R可以作为一种合适的筛查工具，用于测量冲动性这一自杀风险因素。基于正念的干预措施似乎有望改善囚犯的心理健康状况并降低自杀风险。
