Impulsive-aggressive behaviours and completed suicide across the life cycle: a predisposition for younger age of suicide
Impulsive-aggressive behaviours and completed suicide across the life cycle: a predisposition for younger age of suicide
复制标题
DOI：
10.1017/s0033291707001419
复制
发表时间：
2008-03-01
影响因子：
6.9
通讯作者：
Turecki, G.
中科院分区：
文献类型：
--
作者：
McGirr, A.;Renaud, J.;Turecki, G.
背景资料。目前尚不清楚冲动性攻击行为与自杀之间的关联是否存在于不同年龄段。通过心理尸检，我们共检查了645名11-87岁自杀死亡的受试者。使用SCID-I和SCID-II或K-SADS访谈以及一系列行为和人格特质评估进行了基于代理的访谈。其次，对246名活体对照进行了类似的评估。较高的冲动、终生攻击史和寻求新奇与自杀死亡的年龄较小有关，而避免伤害的水平增加与自杀年龄的增加有关。这一效应是在考虑了与年龄相关的精神病理学(当前和终身抑郁障碍、终身焦虑障碍、当前和终身药物滥用障碍、精神障碍和B群人格障碍)后观察到的。年龄效应不是由于告密者的特征造成的，在活着的对照组中也没有观察到这种影响。当直接控制主要精神疾病时，年龄、冲动水平、攻击性和寻求新颖性之间的交互作用预测自杀状态，同时控制年龄和这些行为的独立贡献。更高水平的冲动-攻击性特征在年轻人自杀事件中起着更大的作用，随着年龄的增长，其重要性逐渐下降。
Background. It is unclear whether the association between impulsive-aggressive behaviours and suicide exists across different ages.Method. Via psychological autopsy, we examined a total of 645 subjects aged 11-87 years who died by suicide. Proxy-based interviews were conducted using the SCID-I & SCID-II or K-SADS interviews and a series of behavioural and personality-trait assessments. Secondarily, 246 living controls were similarly assessed.Results. Higher levels of impulsivity, lifetime history of aggression, and novelty seeking were associated with younger age of death by suicide, while increasing levels of harm avoidance were associated with increasing age of suicide. This effect was observed after accounting for age-related psychopathology (current and lifetime depressive disorders, lifetime anxiety disorders, current and lifetime substance abuse disorders, psychotic disorders and cluster B personality disorders). Age effects were not due to the characteristics of informants, and such effects were not observed among living controls. When directly controlling for major psychopathology, the interaction between age, levels of impulsivity, aggression and novelty seeking predicted suicide status while controlling for the independent contributions of age and these traits.Conclusions. Higher levels of impulsive-aggressive traits play a greater role in suicide occurring among younger individuals, with decreasing importance with increasing age.