Boone Kiran, Balzen Kennedy M, Sharp Carla
Department of Psychology, University of Houston, Texas.
Res Psychother. 2025 Feb 3;27(3):814. doi: 10.4081/ripppo.2024.814.
Interpersonal factors and depression are believed to be some of the main drivers of suicidal thoughts and behaviors, but other factors may be equally or more important. Drawing on psychodynamic (mentalization) theory, we propose that personality functioning, in particular an incoherent sense of self, may be an important driver of suicidal thoughts and behaviors over and above factors of interpersonal functioning and depression. To evaluate this, we examined associations between personality functioning and suicidal ideation and suicide attempt in young adults. Participants (N=153; Mage=20.93) were recruited from a college sample (N=90) and a clinical sample with borderline personality disorder (N=63). Personality functioning (self and interpersonal components) was measured with the Level of Personality Functioning Scale - Brief Form 2.0. Suicidal ideation was measured with the Personality Assessment Inventory. Suicide attempt history was assessed with the Columbia-Suicide Severity Rating Scale. Depression symptoms were measured with the Symptom Checklist 90. Regressions examined relationships between personality functioning, depression symptoms, and suicidal ideation or attempt while controlling for age and gender. Overall personality functioning was significantly associated with suicidal ideation (β=.584, p<.001) and suicide attempt (β=.384, p<.001). Overall personality functioning was a stronger predictor than depression symptoms, age, and gender when included in the same model predicting suicidal ideation or attempt. Both the self and interpersonal components of personality functioning were significantly associated with suicidal ideation and attempt, with larger effect sizes for self-functioning. Findings underscore the importance of considering personality functioning, especially self-functioning, in suicide risk assessment and treatment.
人际因素和抑郁被认为是自杀念头和行为的一些主要驱动因素，但其他因素可能同样重要或更重要。借鉴心理动力学（心理化）理论，我们提出人格功能，特别是自我的不连贯感，可能是人际功能和抑郁因素之外自杀念头和行为的重要驱动因素。为了评估这一点，我们研究了年轻成人的人格功能与自杀意念及自杀未遂之间的关联。参与者（N = 153；年龄中位数 = 20.93）来自一个大学样本（N = 90）和一个患有边缘性人格障碍的临床样本（N = 63）。人格功能（自我和人际成分）用《人格功能水平量表简表2.0》进行测量。自杀意念用《人格评估量表》进行测量。自杀未遂史用《哥伦比亚自杀严重程度评定量表》进行评估。抑郁症状用《症状自评量表90》进行测量。回归分析在控制年龄和性别的同时，研究了人格功能、抑郁症状与自杀意念或自杀未遂之间的关系。总体人格功能与自杀意念（β = 0.584，p < 0.001）和自杀未遂（β = 0.384，p < 0.001）显著相关。在预测自杀意念或自杀未遂的同一模型中，总体人格功能比抑郁症状、年龄和性别是更强的预测因素。人格功能的自我和人际成分均与自杀意念和自杀未遂显著相关，自我功能的效应量更大。研究结果强调了在自杀风险评估和治疗中考虑人格功能，尤其是自我功能的重要性。
