Short-term associations between nonsuicidal and suicidal thoughts and behaviors: A daily diary study with high-risk adolescents.
Short-term associations between nonsuicidal and suicidal thoughts and behaviors: A daily diary study with high-risk adolescents.
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DOI：
10.1016/j.jad.2021.05.104
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发表时间：
2021-09-01
影响因子：
6.6
通讯作者：
King CA
中科院分区：
文献类型：
--
作者：
Czyz EK;Glenn CR;Arango A;Koo HJ;King CA
在这项针对自杀风险升高的青少年的日常研究中，我们研究了非自杀性自伤（NSSI）与自杀想法和行为之间的近端关联。我们还调查了突出的反自杀功能的基本NSSI的参与，相对于个人和人际动机。78名因自杀风险住院的青少年（67.9%为女性;年龄13-17岁）在出院后4周内完成了评估NSSI和自杀想法的每日调查（n=1621次观察）。在1个月随访时评估自杀行为（实际、流产、中断的自杀企图）。在一生的NSSI中，通常经历更持久（OR=2.54，p=<.001）和强烈（OR=1.87，p=.002）自杀意念的青少年更有可能在某一天参与NSSI。此外，当青少年相对于他们的典型水平经历更持久（OR=1.99，p<0.001）和更强烈（OR=1.66，p<0.001）的想法时，NSSI的可能性增加。这种模式与最近的NSSI一致。NSSI的抗自杀功能在住院时和每天发生NSSI时（65.6%的时间）经常得到认可，同时还有个人内部的负面动机（以避免厌恶状态）。探索性分析表明，在出院后一个月内有自杀行为的青少年在同一时期每天报告的NSSI水平较高（Hedge g=1.26，p=<.001）。日常水平的协会同时进行了检查，结果的普遍性是有限的样本特征。NSSI和自杀想法和行为之间的显着的近端关联，以及反自杀功能的突出性，指出针对这些交叉现象的干预工作的重要性在青少年自杀风险升高。
In this daily dairy study of adolescents at elevated suicide risk, we examined proximal associations between nonsuicidal self-injury (NSSI) and suicidal thoughts as well as behaviors. We also investigated the prominence of the anti-suicide function underlying NSSI engagement, relative to intrapersonal and interpersonal motives. Seventy-eight adolescents (67.9% female; ages 13-17) hospitalized due to suicide risk completed daily surveys assessing NSSI and suicidal thoughts for four weeks after discharge (n=1621 observations). Suicidal behavior (actual, aborted, interrupted suicide attempts) was assessed at 1-month follow-up. Over and above lifetime NSSI, adolescents who generally experienced more enduring (OR=2.54, p=<.001) and intense (OR=1.87, p=.002) suicidal ideation were more likely to engage in NSSI on a given day. Moreover, NSSI likelihood increased when adolescents experienced more enduring (OR=1.99, p<.001) and intense (OR=1.66, p<.001) ideation relative to their typical levels. This pattern was consistent for those with recent NSSI. The anti-suicide function of NSSI was frequently endorsed at hospitalization and when NSSI occurred daily (65.6% of the time), alongside the intrapersonal-negative motive (to avoid aversive states). Exploratory analyses suggest adolescents with suicidal behavior within the month after discharge experienced higher NSSI levels reported daily over the same period (Hedge’s g=1.26, p=<.001). Daily-level associations were examined concurrently and generalizability of results is limited by sample characteristics. The notable proximal associations between NSSI and suicidal thoughts and behaviors, as well as the prominence of the anti-suicide function, point to the importance of intervention efforts targeting these intersecting phenomena among adolescents at elevated suicide risk.
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影响因子：
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