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[“脑海中的年龄歧视”作为老年人自杀意念的一个风险因素]

[Ageism "in the mind" as a risk factor for suicidal ideation in old age].

作者信息

Kessler Eva-Marie

机构信息

Universitäres Department Psychologie, MSB Medical School Berlin - Hochschule für Gesundheit und Medizin, Rüdesheimer Straße 50, 14197, Berlin, Deutschland.

出版信息

Z Gerontol Geriatr. 2025 Feb;58(1):10-16. doi: 10.1007/s00391-024-02396-z. Epub 2025 Jan 23.

Abstract

This article systematically analyzes suicidal ideation in old age from the perspective of traditional age-related ideas, evaluations and expectations. The synthesis of empirical evidence from different research areas provides preliminary evidence that ageism "in the mind" reduces the will to live in old age and thus represents a suicide risk for the individual. This effect is caused by a culturally deeply rooted social climate of old age, according to which life in old age tends to be seen as a phase of deficit and lack of productivity, and according to which older people tend to be expected to socially withdraw and not become a burden. If healthcare professionals are not sufficiently qualified in gerontology, they are guided in their work by this age bias, which, in the worst case, is expressed in ignorance and passivity towards suicidal crises in older people. A relevant risk factor is that in old age the ageism internalized by individuals over the course of their lives is directed against themselves. The analysis underlines a contextualist understanding of suicidal ideation beyond a widespread, oversimplistic view as an understandable reaction to "old age" or a narrow psychiatric assessment as "old age depression". At the same time, ageist tendencies in the public discourse are questioned, according to which suicidal ideation in old age is a rational phenomenon that is justified in view of the horrors of old age and is also a less serious phenomenon for the social environment. The rhetoric of assisted suicide as an act of self-determination and self-decision in favor of society is also questioned.

摘要

本文从传统的与年龄相关的观念、评价和期望的角度,系统地分析了老年人的自杀意念。不同研究领域的实证证据综合提供了初步证据,表明“内心的年龄歧视”会降低老年人的生存意愿,从而对个体构成自杀风险。这种影响是由一种文化上根深蒂固的老年社会氛围造成的,根据这种氛围,老年生活往往被视为一个缺乏和生产力低下的阶段,并且人们往往期望老年人从社会中退出,不成为负担。如果医疗保健专业人员在老年医学方面没有足够的资质,他们在工作中就会受到这种年龄偏见的引导,在最坏的情况下,表现为对老年人自杀危机的无知和消极态度。一个相关的风险因素是,在老年时,个体在其一生中内化的年龄歧视会针对他们自己。该分析强调了对自杀意念的情境主义理解,超越了一种普遍的、过于简单化的观点,即把自杀意念视为对“老年”的一种可理解的反应,或者一种狭隘的精神病学评估,即“老年抑郁症”。与此同时,公共话语中的年龄歧视倾向也受到质疑,根据这种倾向,老年人的自杀意念是一种理性现象,鉴于老年的种种可怕之处是合理的,而且对社会环境来说也是一种不太严重的现象。协助自杀作为一种有利于社会的自我决定和自我决策行为的言辞也受到质疑。

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