Beyond a dichotomous operationalization of suicide attempts.

IF 3.1 Q2 PSYCHIATRY Journal of psychopathology and clinical science Pub Date : 2024-10-01 Epub Date: 2024-06-20 DOI:10.1037/abn0000927
Ian H Stanley, Brian P Marx
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Abstract

Suicide attempts (SAs) are commonly assessed by asking patients and study participants face-valid questions about whether an individual has engaged in any self-injurious behavior with the intent to die within a given timeframe. Unfortunately, for most clinical and scientific endeavors, only information about the presence vs. absence of a SA is documented and analyzed. In this Viewpoint, we discuss how such a dichotomous operationalization of SAs obscures important heterogeneity among those who have attempted suicide. There are several facets of SAs, beyond the simple presence vs. absence, that are important to consider because they have implications regarding acute and long-term clinical outcomes. These facets include the level of intent to die, the means used and associated risk for death, the actual medical consequences of the attempt, and the chronicity of the behavior. We discuss how considering these SA facets-in theory testing and refinement, the design, analysis, and interpretation of research findings, and clinical practice-will improve the impact of scientific findings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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超越自杀未遂的二分法操作。
本文讨论了自杀未遂的二分法操作方法。每年,全世界都有数百万人试图自杀(SA)。由于自杀未遂的重要性不言而喻,临床医生和研究人员通常会通过询问一个人在特定时间段内是否有过以死亡为目的的自残行为来评估其自杀未遂史。回答选项通常是二分法(是/否),因此,如果一个人报告其行为与死亡意向非零相关,或者如果有其他暗示死亡意向的指标,则该人将被视为企图自杀。无论采用哪种确定方法,人们普遍认为患者和研究参与者要么有自杀史,要么没有。我们的目的并不是要表明,与不太严重的自杀行为相比,更严重的自杀行为--无论是从死亡意图的程度、使用的手段、实际的医疗后果还是慢性标准来看--更值得临床和科学界关注。相反,我们的目的是让更多的人意识到,在理论测试和完善、研究结果的设计、分析和解释以及临床实践中,应将可猝死行为视为在死亡意图、使用手段、实际医疗后果和慢性程度方面各不相同的多维行为。通过这样做,科学发现的临床影响将更容易辨别。(PsycInfo Database Record (c) 2024 APA, all rights reserved)。
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