A longitudinal examination of the interpersonal theory of suicide and effects of school-based suicide prevention interventions in a multinational study of adolescents
A longitudinal examination of the interpersonal theory of suicide and effects of school-based suicide prevention interventions in a multinational study of adolescents
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DOI：
10.1111/jcpp.13119
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发表时间：
2019-10-01
影响因子：
7.6
通讯作者：
Wasserman, Danuta
中科院分区：
文献类型：
--
作者：
Barzilay, Shira;Apter, Alan;Wasserman, Danuta
两种不同的模型对12个月以上自杀未遂（SA）的预测进行了比较，这两种模型受到特定的基于学校的自杀预防干预措施的不同影响。这些建议如下：（a）人际理论（IPTS）和（B）双路径模型，一条路径与外化症状和连续的自我伤害行为相关，另一条路径与内化症状相关。来自10个欧盟国家的11,110名高中生参加了拯救和赋权欧洲年轻生命（SEYLE）研究。基线测量包括感知负担，父母和同伴的阻挠，健康风险行为，自我伤害，自杀意念（SI）和企图（SA）。在12个月随访时重新评估SI和SA。每个模型对SI和SA组随时间的预测（即，在无干预/对照组中估计了重复SA、缓解SA、SA发作和无SA）。在干预组中估计了上级模型。结果人际关系理论与双路径模型的拟合效果较好。与IPTS的预测部分一致，父母的低忠诚度，但不是同伴的忠诚度或负担预测SI的可能性更大。在报告SI、自伤、危险行为，特别是SI和自伤的青少年中，重复SA的可能性高于没有SA的青少年。这三种干预措施都减弱了SI和自伤的综合效应。青年意识的心理健康计划（YAM）还降低了风险行为的影响，重复SA的可能性。结论人际关系理论的假设得到部分支持。知觉与父母的人际关系困难主要与SA相关，危险行为和自伤是SA的重要预测因子。自杀预防干预措施可能是有效的，通过减轻各种自伤行为的危险影响，并可能通过增加父母的参与进一步推进。
Background Predictions of two different models for suicide attempts (SA) over 12 months, as differentially impacted by specific school-based suicide prevention interventions, were compared. These were as follows: (a) interpersonal theory (IPTS) and (b) a two-pathway model, one path associated with externalizing symptoms and continuum of self-harm behaviors, and the other with internalizing symptoms. Methods Self-report questionnaires were completed by 11,110 high school students from ten EU countries enrolled in the Saving and Empowering Young Lives in Europe (SEYLE) study. Baseline measures included perceived burdensomeness, thwarted belongingness from parents and peers, health risk behaviors, self-injury, suicide ideation (SI), and attempts (SA). SI and SA were reassessed at 12-month follow-up. Each model's predictions of SI and SA groups over time (i.e., repeated SA, remitted SA, SA onset, and no SA) were estimated in the no intervention/control group. The superior model was estimated across intervention groups. Results Interpersonal theory showed better fit compared to the two-pathway model. In partial agreement with IPTS predictions, parental low belongingness but not peer belongingness or burdensomeness predicted greater likelihood of SI. The likelihood of repeated SA versus no SA was higher among adolescents who reported SI, self-injury, risk behaviors, and particularly both SI and self-injury. All three interventions attenuated the combined effect of SI and self-injury. Youth Aware of Mental Health Program (YAM) additionally decreased the effect of risk behaviors on the likelihood of repeated SA. Conclusions Interpersonal theory assumptions were partially supported. Perceived interpersonal difficulties with parents were primarily related with SI, and risk behaviors and self-injury were important predictors of SA. Suicide prevention interventions may be effective by mitigating the hazardous effect of varying self-harm behaviors and may be further advanced by increasing parental involvement.