FAMILY RISK FACTORS FOR ADOLESCENT SUICIDAL BEHAVIOR

拟议研究的目的是确定下列家庭危险因素 预示着反复发生的自杀企图和自杀念头 青少年自杀未遂后的两年时间 在精神病院住院。青春期自杀未遂 是一个值得关注的心理健康问题，既是因为 增加了完全自杀的风险，因为这可能会为 因为他持续的自毁行为。实证研究与临床 报告表明，家庭内部的骚乱，特别是 父母拒绝，家庭沟通和解决问题能力差，以及 父母的精神病态，可能是青少年自杀的重要危险因素 行为。然而，以前对家庭因素的研究一直只有 在记录这些因素可能导致的过程方面的价值有限 影响自杀行为，因为他们通常是交叉的 他们通常依赖于青少年自我报告数据，并且 他们还没有调查各种家庭危险因素的血统或 家庭和个人内部风险因素之间的关系。 将采用前瞻性的纵向设计来遵循90 青少年(13-18岁)在感染后立即住院 自杀未遂以及他们的父母。这些家庭将被评估 在住院期间和之后的六个月间隔 出院。此外，由60名住院青少年组成的对照组 没有自杀未遂的历史将被招募，连同他们的 父母。这些青少年将在人口统计和诊断方面进行匹配 招募的第一批60名自杀青年的特征，以及 这一对照组将仅在住院期间接受评估。 对青少年和家长的评估将集中在以下四个层面 潜在的风险变量被认为在 自杀行为发展和持续的过程：诱因 脆弱性，包括气质、父母的精神病态以及 童年压力；目前的适应指数，包括青年 精神病理学，年轻人对父母依恋的工作模式， 并观察和报告了当前亲子关系的指数 关系；目前的青年应对资源和压力；以及 对未来抱有希望。青年还将报告他们在#年的日常活动 在接下来的前四周进行了每周电话评估 出院了。反复自杀未遂的过程和 在后续的一段时间内的自杀意念将被分析使用 生存分析和纵向生长曲线。在多大程度上 风险变量以及风险变量随时间的变化是 随访期间自杀未遂和自杀意念的预测性 这段时间将被审查。一种假想的因果路径模型 这些因素在自杀行为的发展中将得到检验。

The purpose of the proposed study is to identify family risk factors that are predictive of recurrent suicide attempts and suicide ideation over a two-year period following a suicide attempt, among adolescents hospitalized in a psychiatric unit. Attempted suicide during adolescence is a mental health problem of significant concern, both because it increases the risk of completed suicide, and because it may set the stage for continued self-destructive behavior. Empirical research and clinical reports have indicated that disturbances within families, especially rejection by parents, poor family communication and problem-solving, and parental psychopathology, may be important risk factors for youth suicidal behavior. However, prior studies of family factors have been of only limited value in documenting the process by which these factors may influence suicidal behavior, because they have typically been cross- sectional, they have generally relied on adolescent self-report data, and they have not investigated lineages among various family risk factors or between family and intrapersonal risk factors. A prospective longitudinal design will be utilized to follow 90 adolescents (ages 13-18) who are hospitalized immediately following a suicide attempt, as well as their parents. These families will be assessed during the hospitalization, and at six-month intervals following discharge. In addition, a comparison group of 60 hospitalized adolescents with no history of a suicide attempt will be recruited, along with their parents. These adolescents will be matched on demographic and diagnostic characteristics with the first 60 suicidal youth who are recruited, and this comparison group will be assessed during their hospitalization, only. Assessment of adolescents and parents will focus on four levels of potential risk variables that are hypothesized to play a part in the process by which suicidal behavior develops and persists: predisposing vulnerabilities, including temperament, parental psychopathology, and childhood stresses; current indices of adjustment, including youth psychopathology, youth's working models of their attachment to parents, and observed as well as reported indices of the current parent-adolescent relationship; current youth coping resources and stresses; and indices of hope for the future. Youth will also report their daily activities in weekly telephone assessments conducted the first four weeks following discharge from the hospital. The course of repeated suicide attempts and of suicidal ideation over the follow-up period will be analyzed using survival analysis and longitudinal growth curves. The degree to which the risk variables, as well as changes in the risk variables over time, are predictive of suicide attempts and suicide ideation over the follow-up period will be examined. A hypothesized model of the causal pathways among these factors in the development of suicidal behavior will be tested.