Personality Disorder Risk Factors for Suicide Attempts Over 10 Years of Follow-Up
Personality Disorder Risk Factors for Suicide Attempts Over 10 Years of Follow-Up
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DOI：
10.1037/per0000089
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发表时间：
2015-04-01
影响因子：
2.8
通讯作者：
Grilo, Carlos M.
中科院分区：
文献类型：
--
作者：
Ansell, Emily B.;Wright, Aidan G. C.;Grilo, Carlos M.
识别自杀企图的人格障碍（PD）风险因素是研究和临床护理的重要考虑因素。然而，大多数先前的研究都集中在单一PD或分类PD诊断，而没有考虑不同PD或PD标准严重程度（总和）对自杀相关结局风险的独特影响。这通常是通过横断面或回顾性评估方法进行的。很少有三维模型的PD检查纵向，自然的前瞻性设计。此外，重要的是要考虑不同的风险因素在预测的风险曾经作出自杀企图与风险作出越来越多的企图在同一模型。这项研究调查了431名参与者，他们在合作纵向人格障碍研究中被跟踪了10年。人格障碍标准的基线评估总结为人格病理学的维度计数，并在整个10年随访期间的年度访谈中作为自杀企图的预测因素进行检查。我们使用单变量和多变量零膨胀泊松回归模型，同时评估PD的危险因素，曾经试图自杀，并为越来越多的企图自杀者。与先前的研究一致，边缘性PD与曾经尝试过的行为唯一相关。然而，只有自恋型PD与越来越多的尝试唯一相关。这些发现突出了边缘型和自恋型人格病理学作为自杀相关结果的独特贡献者的相关性。
Identifying personality disorder (PD) risk factors for suicide attempts is an important consideration for research and clinical care alike. However, most prior research has focused on single PDs or categorical PD diagnoses without considering unique influences of different PDs or of severity (sum) of PD criteria on the risk for suicide-related outcomes. This has usually been done with cross-sectional or retrospective assessment methods. Rarely are dimensional models of PDs examined in longitudinal, naturalistic prospective designs. In addition, it is important to consider divergent risk factors in predicting the risk of ever making a suicide attempt versus the risk of making an increasing number of attempts within the same model. This study examined 431 participants who were followed for 10 years in the Collaborative Longitudinal Personality Disorders Study. Baseline assessments of personality disorder criteria were summed as dimensional counts of personality pathology and examined as predictors of suicide attempts reported at annual interviews throughout the 10-year follow-up period. We used univariate and multivariate zero-inflated Poisson regression models to simultaneously evaluate PD risk factors for ever attempting suicide and for increasing numbers of attempts among attempters. Consistent with prior research, borderline PD was uniquely associated with ever attempting. However, only narcissistic PD was uniquely associated with an increasing number of attempts. These findings highlight the relevance of both borderline and narcissistic personality pathology as unique contributors to suicide-related outcomes.