Personality of late- and early-onset elderly suicide attempters
Personality of late- and early-onset elderly suicide attempters
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DOI：
10.1002/gps.5254
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发表时间：
2020-01-07
影响因子：
4
通讯作者：
Dombrovski, Alexandre Y.
中科院分区：
文献类型：
--
作者：
Szuecs, Anna;Szanto, Katalin;Dombrovski, Alexandre Y.
目的自杀行为通常表现在青春期和成年期早期，一些人在晚年首次尝试自杀，往往具有显著的致命意图和决心。考虑到这些人在生命早期的适应能力更强，他们可能具有阻碍适应衰老的特征，如高度尽责，而不是与年轻人的自杀行为相关的冲动-攻击性特征。方法对50岁(平均65岁)的老年人进行横断面病例对照研究，分为早发和晚发未遂者(首次尝试年龄分别为50岁和61岁)、自杀意念者以及非自杀的抑郁症和健康对照组。人格评定采用五因素模型(FFM，n=200)，5种DSM人格障碍在特质水平上分析为连续得分(PDs，n=160)。鉴于我们对迟发性尝试者的假设，FFM维度的尽责性在子成分水平上得到了进一步的检验。结果所有临床组均表现出比健康受试者更多的适应不良。与抑郁对照组相比，自杀意念者和早发性未遂者都表现出更高的神经质和边缘特征，而只有早发性未遂者表现出更低的外向性和更高的反社会特征。在大多数指标上，晚发的尝试者与抑郁的对照组相似，但在有序性方面得分更高，这是责任心的一个组成部分。结论虽然神经质、内向和B簇特征在早发性自杀行为中显著，但迟发性病例通常缺乏这些特征。相比之下，晚发性自杀行为中较高的有序程度与年龄选择性失调假说是一致的。要点老年初试者的个性在早发和晚发的初试者中有所不同。早发性自杀未遂者具有在年轻自杀人群中普遍存在的人格特征(高神经质、低外向、反社会和临界性帕金森病特征)，支持一些人的体质自杀风险因素持续到晚年。迟发性自杀未遂者比没有自杀倾向的抑郁症参与者有更高的秩序性水平，这表明这种普遍的适应性特征可能会促进部分抑郁症老年人的自杀行为。
Objectives While suicidal behavior often manifests in adolescence and early adulthood, some people first attempt suicide in late life, often with remarkable lethal intent and determination. Given these individuals' more adaptive functioning earlier in life, they may possess traits that hinder adjustment to aging, such as high conscientiousness, rather than impulsive-aggressive traits associated with suicidal behavior in younger adults. Methods A cross-sectional case-control study was conducted in older adults aged >= 50 (mean: 65), divided into early- and late-onset attempters (age at first attempt 50, mean: 31 vs 61), suicide ideators as well as non-suicidal depressed and healthy controls. Personality was assessed in terms of the five-factor model (FFM, n = 200) and five DSM personality disorders analyzed on the trait level as continuous scores (PDs, n = 160). Given our starting hypothesis about late-onset attempters, the FFM dimension conscientiousness was further tested on the subcomponent level. Results All clinical groups displayed more maladaptive profiles than healthy subjects. Compared to depressed controls, higher neuroticism, and borderline traits characterized both suicide ideators and early-onset attempters, while only early-onset attempters further displayed lower extraversion and higher antisocial traits. Late-onset attempters were similar to depressed controls on most measures, but scored higher than them on orderliness, a conscientiousness subcomponent. Conclusions While neuroticism, introversion, and cluster B traits are prominent in early-onset suicidal behavior, late-onset cases generally lack these features. In contrast, higher levels of orderliness in late-onset suicidal behavior are compatible with the age-selective maladjustment hypothesis. Key pointsPersonality of elderly attempters differed between those with early- and late-onset first attempts. Early-onset attempters possessed personality traits generally found in younger suicidal populations (high neuroticism, low extraversion, antisocial, and borderline PD traits), supporting that constitutional suicide risk factors persist into late life in some individuals. Late-onset suicide attempters had higher levels of orderliness than non-suicidal depressed participants, suggesting that this generally adaptive trait may facilitate suicidal behavior in a subset of depressed elderly.