Negron R, Piacentini J, Graae F, Davies M, Shaffer D
Disruptive Behaviors Disorders Clinic, East Ridge Health Systems, Martinsburg, WV 25401, USA.
J Am Acad Child Adolesc Psychiatry. 1997 Nov;36(11):1512-9. doi: 10.1016/S0890-8567(09)66559-X.
To compare psychological and event-related contingencies that characterize and differentiate adolescent suicidal ideation and attempts.
Thirty-five ideators and 32 attempters (aged 12 to 17 years) consecutively referred to the suicide disorders clinic were evaluated with a semistructured interview about current and past emotional, cognitive, and behavioral states.
Before the precipitant stressor (baseline), attempters reported significantly more hopelessness than ideators (odds ratio [OR] = 4.2, p < .05). During the suicidal episode, attempters, relative to ideators, spent more time ideating (OR = 4.3, p < .05), were more likely to isolate themselves (OR = 5.8, p < .01), and were less likely to tell anyone what they were thinking (OR = 4.5, p < .05). In contrast, ideators reported significantly more residual anger after the episode than did attempters (OR = 4.0, p < .05). All the episodes of ideation and attempts were preceded by a stress event. No differences were found between the groups on Beck Depression inventory scores.
Preexisting hopelessness, a tendency toward isolation, not talking about ideation, and longer length of time ideating during suicidal episodes discriminated suicide attempters from suicide ideators. Knowledge of these factors may be helpful in preventive and treatment efforts with suicidal adolescents.
比较能够表征和区分青少年自杀意念及自杀未遂行为的心理及事件相关的意外情况。
对连续转诊至自杀障碍门诊的35名有自杀意念者和32名自杀未遂者（年龄在12至17岁之间）进行了关于当前及过去情绪、认知和行为状态的半结构化访谈评估。
在促发应激源出现之前（基线时），自杀未遂者报告的绝望感显著多于有自杀意念者（优势比[OR]=4.2，p<.05）。在自杀发作期间，与有自杀意念者相比，自杀未遂者花费更多时间进行自杀意念思考（OR=4.3，p<.05），更有可能自我孤立（OR=5.8，p<.01），且不太可能告诉任何人他们在想什么（OR=4.5，p<.05）。相比之下，有自杀意念者在发作后报告的残留愤怒情绪显著多于自杀未遂者（OR=4.0，p<.05）。所有自杀意念及自杀未遂事件之前均有一个应激事件。两组在贝克抑郁量表得分上未发现差异。
预先存在的绝望感、自我孤立倾向、不谈论自杀意念以及在自杀发作期间较长时间的自杀意念思考，将自杀未遂者与有自杀意念者区分开来。了解这些因素可能有助于对有自杀倾向的青少年进行预防和治疗。
