Functional domains as correlates of suicidality among psychiatric inpatients.
Functional domains as correlates of suicidality among psychiatric inpatients.
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DOI：
10.1016/j.jad.2016.05.066
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发表时间：
2016-10
影响因子：
6.6
通讯作者：
Gabbay V
中科院分区：
文献类型：
--
作者：
Yaseen ZS;Galynker II;Briggs J;Freed RD;Gabbay V
人们对自杀仍然知之甚少，也无法预测。为了应对这一挑战，这项研究考察了几个研究领域标准(RDoC)结构与急性自杀风险住院患者自杀行为的独立贡献。具体地说，我们考察了快感缺失、焦虑/陷阱和依恋障碍，它们分别反映了奖励过程、负价系统和社交过程中的障碍。对135名因自杀住院的成年人进行了快感缺乏、焦虑、诱捕和恐惧依恋的定量评估。用哥伦比亚自杀严重程度评定量表评估目前的自杀倾向和自杀史。双变量分析(显著性阈值为p<；0.01)和多变量模型检验了症状维度和自杀意念严重性之间的关系。我们还评估了有自杀未遂史的患者和那些只表现出自杀意念的患者之间的差异。经双变量分析，除恐惧依恋外，其余症状与SI呈显著正相关(r=0.37-0.50，p<；0.001)。然而，当使用多变量分析时，在整个样本中，只有快感缺乏(β=0.28，p=0.01)和诱捕(β=0.19，p=0.03)与SI独立相关。在有自杀未遂史的患者和仅有意念的患者之间，没有不同的功能领域测量。对自我报告数据和横断面设计的依赖。在这一高自杀风险队列中，奖赏和威胁处理的干扰可能是自杀意念发展的独立因素。未来的研究应该评估它们作为风险因素的作用。
Suicide remains poorly understood and unpredictable. Addressing this challenge, this study examined the independent contributions of several research domain criteria (RDoC) constructs in relation to suicidality in patients hospitalized for acute suicide risk. Specifically, we examined anhedonia, anxiety/entrapment, and attachment disturbances, reflecting disturbances in reward processes, negative valence systems, and social processes, respectively. Anhedonia, anxiety, entrapment, and fearful attachment, were assessed quantitatively in 135 adults hospitalized for suicidality. Current suicidality and suicidal history were assessed with the Columbia Suicide Severity Rating Scale. Bivariate analyses (with significance threshold of p < 0.01 to account for multiple comparisons) and multivariate models examined relationships between symptom dimensions and severity of suicidal ideation (SI). We also assessed differences between patients with a history of suicide attempt and those who exhibited only suicidal ideations. Using bivariate analyses all symptoms except for fearful attachment correlated robustly with SI (r = 0.37–0.50, p < 0.001). However, when using multivariate analyses, only anhedonia (β = 0.28, p = 0.01) and entrapment (β = 0.19, p = 0.03) were independently associated with SI across the entire sample. No functional domain measures differed between patients with history of suicide attempt versus ideation only. The reliance on self-report data and a cross-sectional design. Disturbances in reward and threat processing may represent independent factors in the development of suicidal ideation in this high suicide risk cohort. Future studies should assess their role as risk factors.