Suicide Risk in Older Adults: Evaluating Models of Risk and Predicting Excess Zeros in a Primary Care Sample
Suicide Risk in Older Adults: Evaluating Models of Risk and Predicting Excess Zeros in a Primary Care Sample
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DOI：
10.1037/a0034953
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发表时间：
2013-11-01
影响因子：
4.6
通讯作者：
Williams, Ryan B.
中科院分区：
文献类型：
--
作者：
Cukrowicz, Kelly C.;Jahn, Danielle R.;Williams, Ryan B.
需要进行研究，以探讨老年人自杀的基于理论的风险因素。自杀的人际关系理论（乔伊纳，2005年;货车奥登等人，2010）提供了关于有助于死亡意念和自杀意念的发展和变化的变量的具体假设;然而，数据表明，老年人即使在经历自杀意念时，也可能不会在研究环境中或向治疗提供者报告自杀意念（Heisel等人，2006年）。本研究的目的是测试基于理论的预测变量，有助于死亡意念（即，消极的死亡愿望）和老年人的自杀意念。本文介绍了零膨胀负二项回归（ZINB）在自杀行为研究中的应用。ZINB被用来测试基于理论的预测，同时也测试了一个假设，该假设与那些赞同与自杀风险相关的风险因素的参与者中否认自杀意念相关的变量有关。参与者包括239名60岁及以上的成年人，他们从初级保健诊所招募，完成了各种自我报告工具。本研究结果显示，知觉负担感与绝望感与死亡意念的变异性有显著相关。其他结果表明，挫折归属感，感知负担和绝望之间的相互作用，挫折归属感和感知负担之间的相互作用分数升高与参与者是自杀意念者的概率显着降低。这些结果为自杀的人际关系理论提供了实质性的支持。这些研究结果的影响进行了讨论。
Research is needed that examines theory-based risk factors for suicide in older adults. The interpersonal theory of suicide (Joiner, 2005; Van Orden et al., 2010) provides specific hypotheses regarding variables that contribute to the development and variability in death ideation and suicide ideation; however, data suggest that older adults may not report suicide ideation in research settings or to treatment providers even when they experience it (Heisel et al., 2006). The purpose of this study was to test theory-based predictions regarding variables that contribute to death ideation (i.e., a passive wish to die) and suicide ideation in older adults. This study introduces the application of zero-inflated negative binomial regression (ZINB) to the study of suicidal behavior. ZINB was used to test theory-based predictions, while also testing a hypothesis regarding variables associated with denial of suicide ideation among participants who endorsed risk factors associated with suicide risk. Participants included 239 adults aged 60 and older recruited from primary care clinics who completed a variety of self-report instruments. The results of this study indicated that perceived burdensomeness and hopelessness were significantly associated with variability in death ideation. Additional results indicated that elevated scores on thwarted belonging, the interaction between perceived burdensomeness and hopelessness, and the interaction between thwarted belonging and perceived burdensomeness were associated with a significant reduction in the probability of a participant being a suicide ideator. These results offer substantial support for the interpersonal theory of suicide. The implications of these findings are discussed.