FAMILY RISK FACTORS FOR ADOLESCENT SUICIDAL BEHAVIOR

这项拟议研究的目的是确定家庭风险因素， 是预测复发性自杀企图和自杀意念超过 青少年自杀未遂后两年 在精神科住院青春期自杀未遂 是一个值得关注的心理健康问题，因为它 增加了自杀的风险，因为它可能会为自杀创造条件， 持续的自我毁灭行为实证研究与临床 报告指出，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， 父母精神病理学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仅限于 记录这些因素可能 影响自杀行为，因为他们通常是交叉的- 部分，他们通常依赖于青少年自我报告的数据， 他们没有调查各种家庭风险因素中的谱系， 家庭和个人因素之间的联系 前瞻性纵向设计将用于跟踪90 青少年（13-18岁）在接受治疗后立即住院， 自杀未遂，以及他们的父母。这些家庭将被评估 在住院期间，并在六个月的间隔后， 放电此外，60名住院青少年的对照组 没有自杀企图的历史将被招募，沿着他们的 父母 这些青少年将在人口统计学和诊断学方面进行匹配 前60名被招募的自杀青少年的特征，以及 该对照组将仅在其住院期间进行评估。 对青少年和家长的评估将侧重于四个层面， 潜在的风险变量，假设在 自杀行为发展和持续的过程：诱发 脆弱性，包括气质，父母的精神病理学， 童年压力;目前的调整指数，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父母-青少年的指数， 关系;当前青年应对资源和压力;以及 对未来的希望 青年还将报告他们的日常活动， 每周进行电话评估， 出院反复的自杀企图， 将使用以下方法分析随访期间自杀意念的发生率 存活分析和纵向生长曲线。的程度 风险变量以及风险变量随时间的变化， 预测随访期间的自杀企图和自杀意念 期间将进行检查。一个假设模型的因果途径之间 这些因素在自杀行为的发展将被测试。

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.