Department of Community Mental Health, University of Haifa, Haifa, Israel.
Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Suicide Life Threat Behav. 2024 Oct;54(5):878-887. doi: 10.1111/sltb.13118. Epub 2024 Jul 19.
Ambivalence in attitudes towards life and death are associated with suicide ideation (SI) among adolescents. However, previous research was mainly cross-sectional and did not examine through which psychopathological mechanisms (such as depression) attitudes towards life and death are associated with SI.
The current longitudinal study examined the mediating role of depression at follow-up in the association between attitudes towards life and death at baseline and SI at follow-up among at-risk adolescents referred to an outpatient psychiatric clinic.
129 adolescents aged 10-18 years (75.2% females) with a history of suicidal thoughts and behaviors were assessed at clinic intake and 1 month follow-up (80% retention rate at follow-up). All participants completed a questionnaire assessing attitudes towards life and death and SI severity at clinic intake, and depression and SI severity at 1 month follow-up.
While controlling for SI severity at intake, attraction towards life at baseline, rather than attraction and repulsion towards death at baseline, led to higher SI severity at follow-up, while depression at follow-up fully mediated this association.
Attitudes towards life, as well as depression play critical roles in the development of SI among adolescents. Interventions targeting reasons for living and promoting meaning of life may be beneficial in preventing depression and SI.
对生与死的态度矛盾与青少年的自杀意念（SI）有关。然而，以前的研究主要是横断面的，没有通过哪些心理病理机制（如抑郁）来检验对生与死的态度与 SI 之间的关系。
本纵向研究在门诊精神病诊所就诊的有自杀意念和行为史的高危青少年中，考察了随访时抑郁在基线时对生与死的态度与随访时 SI 之间的关联中的中介作用。
129 名 10-18 岁的青少年（75.2%为女性）有自杀意念和行为史，在诊所就诊时和 1 个月随访时（80%的随访率）进行评估。所有参与者在就诊时完成了一份问卷，评估对生与死的态度和 SI 的严重程度，以及在 1 个月随访时的抑郁和 SI 的严重程度。
在控制了就诊时 SI 的严重程度后，基线时对生活的吸引力，而不是对死亡的吸引力和排斥力，导致了随访时 SI 的严重程度更高，而随访时的抑郁完全中介了这种关联。
对生活的态度，以及抑郁，在青少年 SI 的发展中起着关键作用。针对生活意义和促进生活意义的干预措施可能有益于预防抑郁和 SI。
