Robison Morgan, Janakiraman Roshni, Wilson-Lemoine Emma, Rogers Megan L, Duffy Alan, Rienecke Renee D, Le Grange Daniel, Blalock Dan V, Mehler Philip S, Joiner Thomas E
Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306-4301, USA.
Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Int J Cogn Behav Ther. 2025 Feb 26. doi: 10.1007/s41811-025-00250-7.
Suicide risk is elevated among vulnerable populations. We examined two forms of internalization (i.e., self-blame, self-disgust) and externalization (i.e., other-blame, societal-disgust) and their associations with suicidal ideation (SI) in two studies. In Study 1 ( = 967), participants with mood and/or anxiety disorders completed self-report measures at admission and discharge on self-blame, other-blame, and SI. Study 2 ( = 295) investigated similar constructs among a sexual minority sample, with the addition of covariates including internalized homophobia, homophobia experiences, perceived burdensomeness, and thwarted belongingness. In Study 1, self-blame at admission and discharge, but not other-blame at admission or discharge, was significantly associated with SI. Furthermore, their interaction at discharge was significant such that SI was highest for those high in self-blame and low in other-blame. Longitudinally, neither form of blame at admission was associated with SI at discharge, nor was their interaction. In Study 2, self-disgust, societal-disgust, and their interaction were significantly associated with SI beyond self-blame and other covariates. Contrary to Study 1, the form of the interaction was such that SI was highest for those high in both self-disgust and societal-disgust. Significant findings were cross-sectional; thus, future research should longitudinally test brief intervals (e.g., hours to days) to better understand these associations. These studies provide some evidence that self-blame and self-disgust, more so than otherblame and societal-disgust, may be risk factors for SI in clinical and sexual minority groups.
自杀风险在弱势群体中有所升高。我们在两项研究中考察了内化的两种形式（即自责、自我厌恶）和外化的两种形式（即归咎他人、社会厌恶）及其与自杀意念（SI）的关联。在研究1（n = 967）中，患有情绪和/或焦虑症的参与者在入院和出院时完成了关于自责、归咎他人和自杀意念的自我报告测量。研究2（n = 295）在一个性少数群体样本中调查了类似的构念，并增加了协变量，包括内化的恐同症、恐同经历、感知到的负担感和归属感缺失。在研究1中，入院和出院时的自责，但不是入院或出院时的归咎他人，与自杀意念显著相关。此外，它们在出院时的交互作用显著，即自责程度高且归咎他人程度低的人自杀意念最高。纵向来看，入院时的两种归咎形式均与出院时的自杀意念无关，它们的交互作用也无关。在研究2中，自我厌恶、社会厌恶及其交互作用在控制了自责和其他协变量后与自杀意念显著相关。与研究1相反，交互作用的形式是自我厌恶和社会厌恶程度都高的人自杀意念最高。显著发现是横断面的；因此，未来研究应纵向测试较短的时间间隔（如数小时至数天），以更好地理解这些关联。这些研究提供了一些证据，表明与归咎他人和社会厌恶相比，自责和自我厌恶可能是临床群体和性少数群体中自杀意念的风险因素。
