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老年人自杀行为中沉思、反省和愤怒反刍。

Brooding, reflection, and anger rumination in late life suicidal behavior.

机构信息

Department of Psychology, Louisiana State University, Baton Rouge, LA, USA.

Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

出版信息

J Affect Disord. 2025 Jan 15;369:963-969. doi: 10.1016/j.jad.2024.10.093. Epub 2024 Oct 22.

Abstract

BACKGROUND

Current literature on age-specific risk factors for suicide in older adulthood is lacking. One risk factor for younger-life suicide, rumination, has not been extensively studied in older adults, but from prior research, may be more relevant to late-life vs. early life suicide. The current study investigated how multiple subtypes of rumination (i.e., brooding, reflection, and anger rumination) relate to suicidal ideation and recent suicidal behavior in late life.

METHODS

378 participants aged 50-90 (mean age 63.4, SD 7.5) were recruited into a case-control study examining suicide in older adults. Participants were recruited into three groups: 1) depressed adults who had made a recent (past two years) suicide attempt, 2) those with depression but no suicide attempt, and 3) a healthy comparison group. Among depressed groups, we examined relationships between rumination types, trait anger, depression, and suicidal ideation. Then, we conducted logistic regression to test which variables were related to having made a suicide attempt in the past two years among those with current suicidal ideation.

RESULTS

All forms of rumination were related to depression. Brooding was related to ideation severity, but only depression severity related to presence of ideation. Anger rumination and ideation severity each contributed unique variance in their prediction of recent suicide attempts.

LIMITATIONS

Our cross-section design does not allow for causal claims; future studies should consider using ecological momentary assessment approaches.

CONCLUSIONS

Treatments to decrease rumination without an intense cognitive component should be considered for late-life patients.

摘要

背景

目前关于老年期特定自杀风险因素的文献尚缺乏。一种与年轻人群自杀相关的风险因素——反刍思维,在老年人中尚未得到广泛研究,但根据先前的研究,它可能与生命晚期自杀更为相关,而不是生命早期自杀。本研究探讨了多种反刍思维亚型(即沉思、反省和愤怒反刍)与生命晚期自杀意念和近期自杀行为的关系。

方法

378 名年龄在 50-90 岁(平均年龄 63.4,标准差 7.5)的参与者被纳入一项关于老年人自杀的病例对照研究中。参与者被分为三组:1)近期(过去两年内)有自杀企图的抑郁成年人,2)有抑郁但无自杀企图的成年人,3)健康对照组。在抑郁组中,我们检验了反刍思维类型、特质愤怒、抑郁与自杀意念之间的关系。然后,我们进行了逻辑回归,以检验在有当前自杀意念的人中,哪些变量与过去两年内有自杀企图有关。

结果

所有形式的反刍都与抑郁有关。沉思与意念严重程度有关,但只有抑郁严重程度与意念存在有关。愤怒反刍和意念严重程度都对预测最近的自杀企图有独特的贡献。

局限性

我们的横断面设计不允许做出因果推断;未来的研究应考虑使用生态瞬时评估方法。

结论

对于生命晚期的患者,应考虑采用减少反刍但没有强烈认知成分的治疗方法。

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