Identifying person-specific coping responses to suicidal urges: A case series analysis and illustration of the idiographic method.
Identifying person-specific coping responses to suicidal urges: A case series analysis and illustration of the idiographic method.
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DOI：
10.1111/sltb.12841
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发表时间：
2022-06
影响因子：
3.2
通讯作者：
King, Cheryl A.
中科院分区：
文献类型：
--
作者：
Kuehn, Kevin S.;Foster, Katherine T.;Czyz, Ewa K.;King, Cheryl A.
关键词：
自杀是导致死亡的主要原因。预防工作面临的一个挑战是自杀冲动、想法和行为在高危个体中的广泛现象学异质性。尽管存在这种异质性，但大多数自杀研究估计群体水平的影响是通过将人们平均起来，就好像他们是一样的，从而阻止了对可能调节风险的个人特定因素的检测，而这些因素是有效预防的关键。本研究的目的是说明具体（即，个人特定）的方法，并强调其在自杀研究中的效用。我们采用了一种病例系列方法，使用了来自精神病住院青少年亚组的三个病例，这些病例提供了自杀未遂出院后日常冲动和应对行为的密集纵向数据。为了说明，自杀冲动和应对行为之间的个人特定的双向联系在一系列案例中使用向量自回归方法进行建模。自杀冲动和应对之间的关系在三个个体之间有所不同，他们在存在/不存在和影响程度上表现出这种可变性的范围。报告自杀风险水平相似的个体可能以个性化的方式应对自杀冲动（例如，使用不同的应对策略），需要个性化的评估和治疗。我们讨论了对未来自杀研究的影响。
Suicide is a leading cause of death. One challenge to prevention efforts is the wide phenomenological heterogeneity in suicidal urges, thoughts, and behaviors across individuals at risk. Despite this heterogeneity, most suicide research estimates group-level effects by averaging across people as if they were the same, preventing detection of person-specific factors that may modulate risk and be key to effective prevention. The goal of the present study is to illustrate the idiographic (i.e., person-specific) approach and highlight its utility for suicide research. We implemented a case series approach using three cases from a sub-set of psychiatrically hospitalized adolescents who provided intensive longitudinal data on daily urges and coping behavior after discharge following a suicide attempt. For illustration, person-specific, bidirectional links between suicidal urges and coping behavior were modeled across a series of cases using a vector autoregression approach. The relationship between suicidal urges and coping differed across the three individuals, who were presented to exhibit the range of this variability in the presence/absence and magnitude of effects. Individuals who report similar suicidal risk levels likely respond in individualized ways to suicidal urges (e.g., use different coping strategies), necessitating personalized assessment and treatment. We discuss implications for future suicide research.
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