Department of Psychiatry and Biobehavioral Sciences, University of California.
Division of Child and Adolescent Psychiatry, Massachusetts General Hospital.
J Clin Child Adolesc Psychol. 2024 Nov-Dec;53(6):944-957. doi: 10.1080/15374416.2024.2344735. Epub 2024 May 1.
Although life stress has been linked to adolescent suicidal ideation, most past research has been cross-sectional, and potential processes characterizing this relation remain unclear. One possibility may be a lack of emotional clarity. Informed by stress generation, the current study examined prospective relations between episodic life stress, lack of emotional clarity, and suicidal ideation in an adolescent clinical sample.
The sample consisted of 180 youths ( = 14.89; = 1.35; 71.7% female; 78.9% White; 43.0% sexual minority) recruited from a psychiatric inpatient facility. Suicidal ideation severity was assessed at baseline and 18-month follow-up. Lack of emotional clarity and life stress were assessed at baseline, as well as 6-, and 12-month follow-ups. Two random-intercepts cross-lagged panel models were created to estimate within-person relations for variables of interest.
At the within-person level, lack of emotional clarity at baseline predicted greater 6-month impact of interpersonal dependent stressors (b = 0.29, = .012, 95% CI [0.07, 0.52]), which subsequently predicted a greater 12-month lack of emotional clarity (b = 0.41, = .005, 95% CI [0.12, 0.70]). Next, a 12-month lack of emotional clarity but not interpersonal dependent stress, predicted greater 18-month suicidal ideation (b = 0.81, = .006, 95% CI [0.23, 1.30]; = .24, < .001). No significant relations were found for the lack of emotional clarity and independent stress.
Results support the stress generation hypothesis and suggest that future research should be conducted evaluating whether bolstering youth's understanding of their emotional experiences may reduce subsequent suicidal ideation.
尽管生活压力与青少年自杀意念有关,但大多数既往研究都是横断面研究,这一关系的潜在过程尚不清楚。一种可能是缺乏情绪清晰度。本研究根据应激产生理论,考察了青少年临床样本中偶发生活压力、情绪清晰度缺失与自杀意念之间的前瞻性关系。
该样本包括 180 名青少年(平均年龄=14.89;标准差=1.35;71.7%为女性;78.9%为白人;43.0%为性少数群体),他们来自一家精神病住院机构。自杀意念严重程度在基线和 18 个月随访时进行评估。情绪清晰度缺失和生活压力在基线时以及 6 个月和 12 个月随访时进行评估。创建了两个随机截距交叉滞后面板模型,以估计感兴趣变量的个体内关系。
在个体内水平上,基线时的情绪清晰度缺失预测了 6 个月时人际依赖性压力源的更大影响(b=0.29, = .012,95%置信区间[0.07,0.52]),这随后预测了 12 个月时更大的情绪清晰度缺失(b=0.41, = .005,95%置信区间[0.12,0.70])。接下来,12 个月时的情绪清晰度缺失而不是人际依赖性压力,预测了 18 个月时更大的自杀意念(b=0.81, = .006,95%置信区间[0.23,1.30]; = .24, < .001)。情绪清晰度缺失与独立压力之间没有发现显著关系。
研究结果支持应激产生假说,并表明未来的研究应评估增强青少年对自身情绪体验的理解是否可以降低随后的自杀意念。