Social behavior, interaction appraisals, and suicidal ideation in schizophrenia: The dangers of being alone.
Social behavior, interaction appraisals, and suicidal ideation in schizophrenia: The dangers of being alone.
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DOI：
10.1016/j.schres.2016.02.028
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发表时间：
2016-04
影响因子：
4.5
通讯作者：
Granholm EL
中科院分区：
文献类型：
--
作者：
Depp CA;Moore RC;Perivoliotis D;Holden JL;Swendsen J;Granholm EL
尽管自杀风险中的社会评价越来越受到关注，但精神分裂症患者自杀念头和行为之间的人际关系还没有得到很好的理解。生态瞬时评估可以揭示有自杀意念的精神分裂症患者是否存在功能失调的社会评价和行为。93名确诊为有自杀意念的精神分裂症患者(n=18，19%)和无自杀意念的患者(n=75，81%)参加了为期一周的通过移动设备进行的每日密集监测，生成关于社会互动的数量和对他们的评价的实时报告，以及关于同时发生的情感和症状的信息。自杀意念的存在与社交互动的数量或独处时间无关，但与对独处的预期以及独处时更多的负面和更少的积极影响有关。尽管有这种令人厌恶的独处经历，但有自杀意念的人报告说，他们对最近和潜在的社交活动的价值持负面评价。这些发现表明，精神分裂症患者的自杀意念可能与社交互动的数量无关，而是与对社交互动质量的负面期望以及对孤独的厌恶经历有关。认知疗法干预解决了对社会互动的负面期望和快乐，特别是当独自一人时，可能会减少自杀念头。
Despite the increasing attention to social appraisals in suicide risk, the interpersonal correlates of suicidal thoughts and behavior in schizophrenia are not well understood. Ecological momentary assessment could reveal whether dysfunctional social appraisals and behavior are evident in people with schizophrenia with suicidal ideation. A total of 93 outpatients with diagnoses of schizophrenia with (n = 18, 19%) and without (N = 75; 81%) suicidal ideation participated in one week of intensive daily monitoring via mobile devices, generating real-time reports on the quantity of social interactions and appraisals about them, as well as information concerning concurrent affect and symptoms. The presence of suicidal ideation was not associated with the quantity of social interactions or time spent alone, but it was associated with the anticipation of being alone as well as greater negative and lower positive affect when alone. Despite this aversive experience of being alone, people with suicidal ideation reported negative appraisals about the value of recent and potential social interactions. These findings suggest that suicidal ideation in schizophrenia may not be associated with the quantity of social interactions, but with negative expectations about the quality of social interactions coupled with an aversive experience of being alone. Cognitive therapy interventions that address negative expectations and pleasure about social interactions, especially when alone, may reduce suicidal ideation.