Predicting Future Suicide Attempts Among Adolescent and Emerging Adult Psychiatric Emergency Patients.
Predicting Future Suicide Attempts Among Adolescent and Emerging Adult Psychiatric Emergency Patients.
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DOI：
10.1080/15374416.2014.910789
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
King CA
中科院分区：
文献类型：
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作者：
Horwitz AG;Czyz EK;King CA
本研究的目的是纵向研究自杀意念的具体特征，结合自杀企图和非自杀性自伤（NSSI）的历史，以最好地评估高危青少年和新兴成年人未来企图的风险。这项回顾性病历审查研究的参与者为473例（53%女性; 69%白人）连续患者，年龄15-24岁（M = 19.4岁），在9个月期间接受精神科急诊（PE）服务。这些患者的医疗记录，包括临床医生管理的哥伦比亚自杀严重程度评定量表，在索引访问和未来18个月内发生的未来访问时进行编码。逻辑回归模型被用来预测在此期间的自杀企图。SES，自杀意念严重程度（即，意图，方法），自杀意念强度（即，自杀未遂的终生史和NSSI的终生史是未来自杀未遂的重要独立预测因素。自杀意念增加了预测未来自杀企图的增量有效性，超出了过去自杀企图的影响，而一生的NSSI史没有。性别调节自杀想法的持续时间和未来尝试之间的关系（男性预测，但不是女性）。结果表明，将过去的行为和当前的想法纳入自杀风险制定的价值。此外，自杀意念持续时间需要额外的检查，作为筛选评估高风险样本（特别是男性）自杀风险的潜在关键因素。
The purpose of this study was to longitudinally examine specific characteristics of suicidal ideation in combination with histories of suicide attempts and non-suicidal self-injury (NSSI) to best evaluate risk for a future attempt among high-risk adolescents and emerging adults. Participants in this retrospective medical record review study were 473 (53% female; 69% Caucasian) consecutive patients, ages 15–24 years (M = 19.4 years) who presented for psychiatric emergency (PE) services during a 9-month period. These patients’ medical records, including a clinician-administered Columbia-Suicide Severity Rating Scale, were coded at the index visit and at future visits occurring within the next 18 months. Logistic regression models were used to predict suicide attempts during this period. SES, suicidal ideation severity (i.e., intent, method), suicidal ideation intensity (i.e., frequency, controllability), a lifetime history of suicide attempt, and a lifetime history of NSSI were significant independent predictors of a future suicide attempt. Suicidal ideation added incremental validity to the prediction of future suicide attempts above and beyond the influence of a past suicide attempt, whereas a lifetime history of NSSI did not. Sex moderated the relationship between the duration of suicidal thoughts and future attempts (predictive for males, but not females). Results suggest value in incorporating both past behaviors and current thoughts into suicide risk formulation. Furthermore, suicidal ideation duration warrants additional examination as a potential critical factor for screening assessments evaluating suicide risk among high-risk samples, particularly for males.