Examining the Course of Suicidal and Nonsuicidal Self-Injurious Thoughts and Behaviors in Outpatient and Inpatient Adolescents
Examining the Course of Suicidal and Nonsuicidal Self-Injurious Thoughts and Behaviors in Outpatient and Inpatient Adolescents
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DOI：
10.1007/s10802-016-0214-0
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发表时间：
2017-07-01
影响因子：
3.6
通讯作者：
Auerbach, Randy P.
中科院分区：
文献类型：
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作者：
Glenn, Catherine R.;Lanzillo, Elizabeth C.;Auerbach, Randy P.
青少年的自杀性和非自杀性自残想法和行为 (SITB) 是主要的公共卫生问题。尽管越来越多的研究关注非自杀性自残和自杀性自残之间的复杂关联，但这两类行为之间的时间关系尚不清楚。目前的研究通过检查接受门诊（N = 106；82.1% 女性）和住院（N = 174；75.9% 女性）治疗的青少年的 SITB 病程来解决这一经验差距。通过经过充分验证的结构化访谈，在单一时间点对 SITB（同时发生、发病年龄和 SITB 之间的时间间隔）和主要精神疾病进行评估。两个临床样本中的青少年都报告了 SITB 的高并发率：大多数青少年报告了终生非自杀性自伤 (NSSI) 和自杀念头。两个样本中报告了类似的 SITB 时间模式：NSSI 思想和自杀意念的发病年龄最早，其次是 NSSI 行为、自杀计划和自杀企图。然而，住院患者样本中每种 SITB 的发病年龄均低于门诊样本。就 SITB 之间的时间滞后而言，自杀意念平均发生在最初参与 NSSI 之前，这表明 NSSI 和自杀行为的途径可能同时发生，而不是从非自杀性自伤到自杀性自伤连续发生。结果还表明，SITB之间的过渡时间相对较快，干预和预防的关键时期是自杀念头出现后的前6-12个月。总而言之，这些发现对于理解非自杀性和自杀性自残之间的时滞关系具有重要意义。
Suicidal and nonsuicidal self-injurious thoughts and behaviors (SITBs) among youth are major public health concerns. Although a growing body of research has focused on the complex association between nonsuicidal and suicidal self-injury, the temporal relationship between these two classes of behaviors is unclear. The current study addresses this empirical gap by examining the course of SITBs in adolescents receiving outpatient (N = 106; 82.1 % female) and inpatient (N = 174; 75.9 % female) treatment. SITBs (co-occurrence, age-of-onset, and time lag between SITBs) and major psychiatric disorders were assessed at a single time point with well-validated structured interviews. Adolescents in both clinical samples reported high co-occurrence of SITBs: most adolescents reported both lifetime nonsuicidal self-injury (NSSI) and suicidal thoughts. A similar temporal pattern of SITBs was reported in the two samples: thoughts of NSSI and suicide ideation had the earliest age-of-onset, followed by NSSI behaviors, suicide plans, and suicide attempts. However, the age-of-onset for each SITB was younger in the inpatient sample than in the outpatient sample. In terms of time lag between SITBs, suicide ideation occurred on average before initial engagement in NSSI, suggesting that pathways to NSSI and suicidal behavior may occur simultaneously rather than in succession from nonsuicidal to suicidal self-injury. Results also indicated that the time to transition between SITBs was relatively fast, and that a key period for intervention and prevention is within the first 6-12 months after the onset of suicidal thinking. Taken together, these findings have important implications for understanding the time-lagged relationship between nonsuicidal and suicidal self-injury.