Developmental Trajectories of Suicidal Thoughts and Behaviors From Adolescence Through Adulthood
Developmental Trajectories of Suicidal Thoughts and Behaviors From Adolescence Through Adulthood
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DOI：
10.1016/j.jaac.2016.02.010
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发表时间：
2016-05-01
影响因子：
13.3
通讯作者：
Doyle, Otima
中科院分区：
文献类型：
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作者：
Goldston, David B.;Erkanli, Alaattin;Doyle, Otima
目的：自杀念头和行为（STBs）的长期过程中的个人模式知之甚少。本研究的目的是确定发展轨迹的STB从青春期到青年期，以及风险和保护协变量，和非自杀的结果与这些trajectors.Method：共180名青少年（年龄12-18岁的招聘）进行了反复评估，平均13.6年（2,273评估），因为他们的精神病住院治疗。轨迹基于每次评估时STB的评级。协变量包括精神病风险因素（成年期精神障碍、绝望、特质焦虑、冲动和攻击性、性虐待和身体虐待、父母自杀行为史的发作时间比例），保护因素（生存和应对信念，成年后的社会支持，父母身份）和非自杀结局结果：使用贝叶斯群体轨迹模型，我们确定了4种STBs的轨迹：增加风险类（11%）;最高的总体风险类别（12%）;降低风险类别（33%）;和低风险类别（44%）。4类与风险和保护因素和非自杀outcomes.Conclusion：青少年和年轻人有异质性的发展轨迹的STB的相关性的不同模式。这些轨迹及其协变量可以为预测STB和针对自杀行为风险个体的干预措施提供信息。
Objective: Little is known about the patterns among individuals in the long-term course of suicidal thoughts and behaviors (STBs). The objective of this study was to identify developmental trajectories of STBs from adolescence through young adulthood, as well as risk and protective covariates, and nonsuicidal outcomes associated with these trajectories.Method: A total of 180 adolescents (ages 12-18 years at recruitment) were repeatedly assessed over an average of 13.6 years (2,273 assessments) since their psychiatric hospitalization. Trajectories were based on ratings of STBs at each assessment. Covariates included psychiatric risk factors (proportion of time in episodes of psychiatric disorders, hopelessness, trait anxiety, impulsivity, and aggression in adulthood, sexual and physical abuse, parental history of suicidal behavior), protective factors (survival and coping beliefs, social support in adulthood, parenthood), and nonsuicidal outcomes (social adjustment and functional impairment in adulthood, school drop-out, incarcerations).Results: Using a Bayesian group-based trajectory model, 4 trajectories of STBs were identified: an increasing risk class (11%); a highest overall risk class (12%); a decreasing risk class (33%); and a low risk class (44%). The 4 classes were associated with distinct patterns of correlates in risk and protective factors and nonsuicidal outcomes.Conclusion: Adolescents and young adults have heterogeneous developmental trajectories of STBs. These trajectories and their covariates may inform strategies for predicting STBs and targeting interventions for individuals at risk for suicidal behavior.