The Three-Step Theory (3ST): A New Theory of Suicide Rooted in the "Ideation-to-Action" Framework
The Three-Step Theory (3ST): A New Theory of Suicide Rooted in the "Ideation-to-Action" Framework
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DOI：
10.1521/ijct.2015.8.2.114
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发表时间：
2015-06-01
影响因子：
2.6
通讯作者：
May, Alexis M.
中科院分区：
文献类型：
--
作者：
Klonsky, E. David;May, Alexis M.
Klonsky 和 May（2014）认为，“从想法到行动”的框架应该指导自杀理论、研究和预防。从这个角度来看，（a）自杀意念的发展和（b）从意念到自杀企图的进展是具有不同解释的不同过程。本文介绍了一种植根于观念到行动框架的具体自杀理论：三步理论（3ST）。首先，该理论假设自杀意念是痛苦（通常是心理痛苦）和绝望的结合的结果。其次，对于那些同时经历痛苦和绝望的人来说，联系是防止想法升级的关键保护因素。第三，该理论认为，从意念到自杀尝试的过程是由性格、后天和实际因素对自杀企图的能力所促进的。为了检验这一理论，作者利用亚马逊的 Mechanical Turk（对构思和尝试历史进行过采样）对 910 名美国成年人进行了自我报告测量。结果支持了该理论的中心原则。首先，痛苦和绝望的交互模型解释了自杀意念的巨大差异。这一结果在男性和女性以及各个年龄段（即 18-25 岁、26-35 岁和 36-70 岁）中都得到了重复。同样正如预测的那样，对于那些同时承受痛苦和绝望的人来说，连通性最能保护他们免受意念的影响。最后，自杀能力的性格、后天和实际方面都预测了自杀企图历史，超过了当前和一生的自杀意念。这些初步发现支持 3ST。讨论了自杀预防和未来研究的意义。
Klonsky and May (2014) argued that an "ideation-to-action" framework should guide suicide theory, research, and prevention. From this perspective, (a) the development of suicide ideation and (b) the progression from ideation to suicide attempts are distinct processes with distinct explanations. The present article introduces a specific theory of suicide rooted in the ideation-to-action framework: the Three-Step Theory (3ST). First, the theory hypothesizes that suicide ideation results from the combination of pain (usually psychological pain) and hopelessness. Second, among those experiencing both pain and hopelessness, connectedness is a key protective factor against escalating ideation. Third, the theory views the progression from ideation to attempts as facilitated by dispositional, acquired, and practical contributors to the capacity to attempt suicide. To examine the theory, the authors administered self-report measures to 910 U.S. adults utilizing Amazon's Mechanical Turk (oversampling for ideation and attempt histories). Results supported the theory's central tenets. First, an interactive model of pain and hopelessness accounted for substantial variance in suicide ideation. This result replicated in both men and women, and across age groups (i.e., 18-25, 26-35, and 36-70). Also as predicted, connectedness was most protective against ideation in those high on both pain and hopelessness. Finally, dispositional, acquired, and practical aspects of suicide capacity each predicted suicide attempt history over and above current and lifetime suicidal ideation. These initial findings support the 3ST. Implications for suicide prevention and future research are discussed.