Morrissey R F, Dicker R, Abikoff H, Alvir J M, DeMarco A, Koplewicz H S
Division of Child and Adolescent Psychiatry, Long Island Jewish Medical Center, New Hyde Park, NY, USA.
J Am Acad Child Adolesc Psychiatry. 1995 Jul;34(7):902-11. doi: 10.1097/00004583-199507000-00014.
The primary purpose of this research is to investigate the criteria used by child and adolescent clinicians in determining the appropriateness of hospitalization for suicidal adolescents.
A questionnaire containing 64 vignettes describing adolescent suicide attempters was completed by a sample of 36 child and adolescent clinicians. Six variables known to relate to lethality of attempt were systematically varied within the vignettes: gender, depression, conduct disorder/substance abuse, previous attempts, suicidal relative, and family supports. Respondents were asked to judge the appropriateness of hospitalization for each vignette.
Hospitalization preference was found to be inversely related to professional experience and was significantly predicted by all risk factors except gender. Configural cue utilization added substantially to the efficacy of a linear model in predicting preference to hospitalize.
Experienced clinicians use known risk factors for adolescent suicide in making recommendations to hospitalize, but results also suggest ongoing needs for education and training in adolescent suicidality.
本研究的主要目的是调查儿童和青少年临床医生在确定自杀青少年住院的适宜性时所使用的标准。
36名儿童和青少年临床医生完成了一份包含64个描述青少年自杀未遂者的 vignette（病例描述）的问卷。在 vignette 中系统地改变了六个已知与未遂致死性相关的变量：性别、抑郁、品行障碍/物质滥用、既往未遂史、自杀亲属和家庭支持。要求受访者判断每个 vignette 住院的适宜性。
发现住院偏好与专业经验呈负相关，除性别外，所有风险因素均能显著预测住院偏好。构型线索利用在预测住院偏好的线性模型有效性方面有显著提升。
经验丰富的临床医生在提出住院建议时会使用已知的青少年自杀风险因素，但结果也表明在青少年自杀问题上持续存在教育和培训需求。
