Social Rejection and Suicidal Ideation and Attempts among Adolescents Following Hospitalization: a Prospective Study
Social Rejection and Suicidal Ideation and Attempts among Adolescents Following Hospitalization: a Prospective Study
复制标题
DOI：
10.1007/s10802-019-00580-z
复制
发表时间：
2020-01-01
影响因子：
3.6
通讯作者：
Liu, Richard T.
中科院分区：
文献类型：
--
作者：
Cheek, Shayna M.;Goldston, David B.;Liu, Richard T.
尽管研究表明，应激性生活事件与随后的自杀意念和行为有关，但关于特定类型的生活事件是否与自杀意念和自杀企图有不同的关系尚不清楚。目前的前瞻性研究在一个临床急性的青少年样本中检验了与社会排斥相关的生活事件是否与SI和自杀企图有直接关系。对219名12~18岁的青少年在出院后进行6个月的跟踪调查。在指标入院和6个月的随访期间，对应激性生活事件进行了情境威胁访谈。参与者还在基线和6个月的随访中接受了目前的SI和自杀企图的评估。多元线性回归模型的结果表明，即使在控制了基线抑郁症状、研究开始时的SI、性别、年龄和非社会拒绝应激源的数量之后，社会拒绝应激源的数量和SI之间也存在显著的前瞻性关联。采用Anderson-Gill重复性事件模型来检验SR应激源与自杀企图之间的关系。结果表明，一个主要的社会排斥应激源之后的31天与未来自杀企图的高风险相关。然而，与非社会拒绝应激源相比，社会拒绝应激源与自杀未遂风险的相关性并不强。这些发现有助于澄清社会排斥作为自杀危机诱因的作用，并有可能为更准确、有针对性的风险评估提供信息。
Despite research indicating that stressful life events are associated with subsequent suicidal ideation (SI) and behavior, there is a lack of clarity regarding whether specific types of life events are differentially related to SI and attempts. The current prospective study examines whether social rejection related life events are proximally related to SI and suicide attempts in a clinically acute sample of adolescents. Adolescents aged 12 to 18 (n = 219) were followed for 6 months after discharge from inpatient hospitalization. A contextual threat interview of stressful life events between index admission and 6-month follow-up was administered. Participants were also assessed for current SI and suicide attempts at baseline and 6-month follow-up. Results from a multiple linear regression model indicated a significant prospective association between number of social rejection stressors and SI, even after controlling for baseline depressive symptoms, SI at study entry, gender, age, and number of non-social rejections stressors. An Anderson-Gill recurrent events model was conducted to examine the relationship between SR stressors and suicide attempts. Results demonstrated that the 31 days following a major social rejection stressor were associated with heightened risk for prospective suicide attempts. However, social rejection stressors were not more strongly related to risk for suicide attempt than non-social rejection stressors. These findings help clarify the role of social rejection as a precipitant of suicidal crises and have potential to inform more accurate, targeted risk assessment.