Thornton Keely E, Wiggs Kelsey K, Epstein Jeffery N, Tamm Leanne, Becker Stephen P
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 10006, Cincinnati, OH, 45229-3039, USA.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Eur Child Adolesc Psychiatry. 2025 Mar;34(3):1195-1206. doi: 10.1007/s00787-024-02556-x. Epub 2024 Sep 5.
The current study examined attention-deficit/hyperactivity disorder (ADHD) dimensions and cognitive disengagement syndrome (CDS) symptoms in relation to self-injurious thoughts and behaviors (SITBs) in an early adolescent sample. Participants were 341 adolescents ages 10-12 years (52.2% female; 37.8% people of color) recruited from the community. Caregivers reported on CDS and ADHD symptoms. Adolescents completed a rating scale and were administered an interview assessing SITBs. We estimated associations using logistic regression in a stepped fashion: (1) no adjustment, (2) adjustment for sex, race, family income, and psychotropic medication use, and (3) further adjustment for depressive symptoms. In this early adolescent community sample, 22.9% reported a history of suicidal ideation, 8.2% reported a history of a suicide plan, 6.2% reported a history of non-suicidal self-injury (NSSI), and 16.4% met a clinical cutoff for current suicide risk. Across most analyses using rating scale or interview methods, higher mean CDS scores were related to endorsement of suicidal ideation and planning. ADHD inattentive (IN) and hyperactive-impulsive (HI) symptoms were associated with endorsement of NSSI, and ADHD-IN symptoms were associated with thoughts of suicide and/or plan measured via questionnaire, though effects were less robust and not significant, potentially due to low base rates impacting statistical power. This study adds to a growing body of research highlighting the importance of screening for CDS symptoms among individuals with and without ADHD. More research, especially longitudinal work, is needed that examines possible differential pathways to SITBs by ADHD and CDS symptoms to advance SITB prevention, early detection, and intervention.
本研究在一个青少年早期样本中，考察了注意力缺陷/多动障碍（ADHD）维度及认知脱离综合征（CDS）症状与自我伤害性想法和行为（SITBs）之间的关系。参与者为从社区招募的341名10至12岁的青少年（52.2%为女性；37.8%为有色人种）。照料者报告了CDS和ADHD症状。青少年完成了一份评定量表，并接受了一项评估SITBs的访谈。我们采用逐步逻辑回归估计关联：（1）不调整，（2）调整性别、种族、家庭收入和精神药物使用情况，（3）进一步调整抑郁症状。在这个青少年早期社区样本中，22.9%的人报告有自杀意念史，8.2%的人报告有自杀计划史，6.2%的人报告有非自杀性自伤（NSSI）史，16.4%的人达到当前自杀风险的临床临界值。在使用评定量表或访谈方法的大多数分析中，较高的平均CDS得分与自杀意念和计划的认可相关。ADHD注意力不集中（IN）和多动冲动（HI）症状与NSSI的认可相关，ADHD-IN症状与通过问卷测量的自杀想法和/或计划相关，尽管效果不太显著且不具有统计学意义，这可能是由于低发生率影响了统计效力。本研究为越来越多的研究增添了内容，强调了在有无ADHD的个体中筛查CDS症状的重要性。需要更多的研究，尤其是纵向研究，来考察ADHD和CDS症状导致SITBs的可能不同途径，以推进SITB的预防、早期检测和干预。
