Psychological Factors Protecting Against Suicidality in Older Adults: A Systematic Review

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL Clinical psychology & psychotherapy Pub Date : 2024-08-13 DOI:10.1002/cpp.3029

Hannah Maynard, James D. Gregory, Andrea Davies, John Fox

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Abstract

Objective

Suicide rates in older adults are often the highest of any age group, particularly among high income countries. However, there is a limited understanding of the factors that could protect against suicidality in older age. This systematic review aimed to identify and evaluate the psychological factors that protect against suicidality in older age.

Method

An a priori protocol was established and registered on PROSPERO (CRD42022343694). EMBASE, MEDLINE, PsycINFO, Web of Science and Scopus were searched. Papers were quality assessed using the Quality Assessment with Diverse Studies (QuADSs) tool. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Seventeen papers were included and narratively synthesised.

Results

The initial searches identified 10,673 records, resulting in the screening of 5441 records after the removal of duplicates. The protective factors identified were (1) meaning/purpose in life, (2) reasons for living, (3) coping styles, (4) psychological wellbeing, (5) life satisfaction, (6) personality factors, (7) cognitive functioning, and (8) sense of belonging. The factors with the most empirical support were meaning in life, followed by psychological wellbeing and coping responses, such as primary control strategies, and personality traits, such as positive affect and agency. There was also evidence to suggest that the influence of some protective factors, for example meaning in life, may depend upon stage in older life and gender.

Conclusion

This review identified several psychological factors that have been found to protect against suicidal ideation in older adults, representing potential treatment targets for reducing suicide in older adults. Recommendations for future research includes greater use of longitudinal and case–control designs, measuring outcomes across the continuum of suicidality and using samples that allow comparison between younger and older adults and within the spectrum of old age.

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防止老年人自杀的心理因素：系统回顾

目的：老年人的自杀率往往是所有年龄组中最高的，尤其是在高收入国家。然而，人们对防止老年人自杀的因素了解有限。本系统综述旨在确定和评估可预防老年人自杀的心理因素：方法：制定先验方案并在 PROSPERO（CRD42022343694）上注册。检索了 EMBASE、MEDLINE、PsycINFO、Web of Science 和 Scopus。采用多元化研究质量评估（QuADSs）工具对论文进行质量评估。同时还遵循了《系统综述和元分析首选报告项目》（PRISMA）指南。共纳入 17 篇论文并进行了叙述性综合：初步检索共发现 10,673 条记录，去除重复后筛选出 5441 条记录。确定的保护因素包括：(1) 生活意义/目的；(2) 生活理由；(3) 应对方式；(4) 心理健康；(5) 生活满意度；(6) 个性因素；(7) 认知功能；(8) 归属感。获得最多实证支持的因素是生活意义，其次是心理健康和应对方式，如主要控制策略，以及人格特质，如积极情绪和能动性。还有证据表明，一些保护性因素（如人生意义）的影响可能取决于老年生活的阶段和性别：本综述确定了几种可防止老年人产生自杀意念的心理因素，它们是减少老年人自杀的潜在治疗目标。对未来研究的建议包括：更多地使用纵向和病例对照设计，测量整个自杀倾向的结果，以及使用允许在年轻人和老年人之间以及在老年阶段内进行比较的样本。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.