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Predicting suicide risk in real-time crisis hotline chats integrating machine learning with psychological factors: Exploring the black box. 在实时危机热线聊天中预测自杀风险,将机器学习与心理因素相结合:探索黑匣子
IF 3.2 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-06-01 Epub Date: 2024-02-12 DOI: 10.1111/sltb.13056
Meytal Grimland, Joy Benatov, Hadas Yeshayahu, Daniel Izmaylov, Avi Segal, Kobi Gal, Yossi Levi-Belz

Background: This study addresses the suicide risk predicting challenge by exploring the predictive ability of machine learning (ML) models integrated with theory-driven psychological risk factors in real-time crisis hotline chats. More importantly, we aimed to understand the specific theory-driven factors contributing to the ML prediction of suicide risk.

Method: The dataset consisted of 17,654 crisis hotline chat sessions classified dichotomously as suicidal or not. We created a suicide risk factors-based lexicon (SRF), which encompasses language representations of key risk factors derived from the main suicide theories. The ML model (Suicide Risk-Bert; SR-BERT) was trained using natural language processing techniques incorporating the SRF lexicon.

Results: The results showed that SR-BERT outperformed the other models. Logistic regression analysis identified several theory-driven risk factors significantly associated with suicide risk, the prominent ones were hopelessness, history of suicide, self-harm, and thwarted belongingness.

Limitations: The lexicon is limited in its ability to fully encompass all theoretical concepts related to suicide risk, nor to all the language expressions of each concept. The classification of chats was determined by trained but non-professionals in metal health.

Conclusion: This study highlights the potential of how ML models combined with theory-driven knowledge can improve suicide risk prediction. Our study underscores the importance of hopelessness and thwarted belongingness in suicide risk and thus their role in suicide prevention and intervention.

研究背景本研究通过探索在实时危机热线聊天中整合了理论驱动的心理风险因素的机器学习(ML)模型的预测能力,来解决自杀风险预测难题。更重要的是,我们旨在了解有助于ML预测自杀风险的具体理论驱动因素:数据集由 17654 个危机热线聊天会话组成,这些会话被二分法归类为有自杀倾向或无自杀倾向。我们创建了一个基于自杀风险因素的词典(SRF),其中包含从主要自杀理论中得出的关键风险因素的语言表述。我们使用自然语言处理技术结合 SRF 词库对 ML 模型(Suicide Risk-Bert; SR-BERT)进行了训练:结果表明,SR-BERT 的表现优于其他模型。逻辑回归分析确定了几个与自杀风险显著相关的理论驱动风险因素,其中最突出的是绝望、自杀史、自残和归属感受挫:词汇表的能力有限,既不能完全涵盖与自杀风险相关的所有理论概念,也不能涵盖每个概念的所有语言表达。聊天记录的分类是由经过培训的金属健康非专业人员确定的:本研究强调了 ML 模型与理论知识相结合可以改善自杀风险预测的潜力。我们的研究强调了绝望和归属感受挫在自杀风险中的重要性,以及它们在自杀预防和干预中的作用。
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引用次数: 0
Suicide Crisis Syndrome: A systematic review. 自杀危机综合征:系统综述。
IF 3.2 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-06-01 Epub Date: 2024-02-27 DOI: 10.1111/sltb.13065
Laura Melzer, Thomas Forkmann, Tobias Teismann

Background: The objective of this systematic review is to describe the scientific evidence for the Suicide Crisis Syndrome (SCS), a presuicidal cognitive and affective state consisting of five symptomatic dimensions: entrapment, affective disturbance, loss of cognitive control, hyperarousal, and social withdrawal. The aim of this article is to summarize the emerging literature on the SCS and to assess the extent to which a uniform syndrome can be assumed.

Methods: A systematic literature search was conducted in three different databases (PubMed, PsycInfo, and Google Scholar) using the search terms "Suicide Crisis Inventory," "Suicide Crisis Syndrome," "Narrative Crisis Model of Suicide," and "Suicide Trigger State."

Results: In total, 37 articles from 2010 to 2022 were identified by search criteria. Twenty-one articles published between 2017 and 2022 were included in the systematic review. All but three studies were conducted in the United States and examined clinical samples of adult high-risk psychiatric in- and outpatients. Sample sizes ranged from N = 170 to 4846. The findings confirm the unidimensional structure of the proposed disorder and support the predictive validity for short-term suicidal behavior above and beyond suicidal ideation.

Conclusion: Despite the promising predictive validity of the SCS, a precise prediction of future suicidal behavior remains difficult.

背景:自杀危机综合征(SCS)是一种自杀前的认知和情感状态,由五个症状维度组成:禁锢、情感障碍、认知失控、过度焦虑和社会退缩。本文旨在总结有关 SCS 的新兴文献,并评估在多大程度上可以假设存在统一的综合征:方法:使用 "自杀危机量表"、"自杀危机综合征"、"自杀危机叙事模型 "和 "自杀触发状态 "等检索词,在三个不同的数据库(PubMed、PsycInfo 和 Google Scholar)中进行了系统的文献检索:根据搜索标准,共找到 2010 年至 2022 年间的 37 篇文章。2017年至2022年间发表的21篇文章被纳入系统综述。除三项研究外,其他研究均在美国进行,研究对象为成人高危精神病住院和门诊患者的临床样本。样本量从 N = 170 到 4846 不等。研究结果证实了所提出的障碍的单维结构,并支持对自杀意念之外的短期自杀行为的预测有效性:尽管SCS的预测有效性很有希望,但要精确预测未来的自杀行为仍然很困难。
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引用次数: 0
Fearlessness about death and suicidal ideation: Religious identity matters. 对死亡和自杀念头的恐惧:宗教身份很重要。
IF 3.2 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-06-01 Epub Date: 2024-02-27 DOI: 10.1111/sltb.13069
Frances G Hart, Jeremy G Stewart, Chloe C Hudson, Kailyn Fan, Thröstur Björgvinsson, Courtney Beard

Introduction: Religion is a salient aspect of patient background in treatment (The psychology of religion and coping: Theory, research, practice; Guilford Press). However, research investigating the role of religion in suicide is lacking and inconsistent (Journal of Religion and Health, 57, 2478-2499). The current study (1) clarifies the association between religious identity and fearlessness about death in a psychiatric sample and (2) tests whether religious identity moderates the association between fearlessness about death and suicidal ideation.

Methods: Participants were 155 patients seeking treatment in a partial hospital program. Religious identity was assessed using the Identities in Treatment Scale (The Behavior Therapist). Fearlessness about death was assessed with two relevant items from the acquired capability with rehearsal for suicide scale (Psychological Assessment, 28, 1452-1464), as in prior studies (Suicide & Le-Threatening Behavior, 50, 1230-1240; Journal of Affective Disorders Reports, 12, 100492).

Results: Fearlessness about death interacted with religious identity to predict suicidal ideation, b = 0.47, 95% C.I. [0.02, 0.91], p = 0.042. Conditional effects showed that greater fearlessness about death was associated with greater suicidal ideation among non-religious patients, b = -0.56, 95% C.I. [-0.88, -0.24], p = 0.001, but not in religious patients, b = -0.09, 95% C.I. [-0.41, 0.22], p = 0.559.

Conclusions: Our results suggest that fearlessness about death is a risk factor for suicidal ideation, but only among those who do not identify as religious. Results from this study inform theories of suicide and elucidate the influence of religious identity on links among suicide risk factors and suicide-related outcomes.

导言:宗教是治疗中病人背景的一个突出方面(《宗教与应对心理学》:理论、研究、实践;吉尔福德出版社)。然而,有关宗教在自杀中的作用的研究却很缺乏,而且研究结果也不一致(《宗教与健康杂志》,57,2478-2499)。本研究(1)澄清了精神病样本中宗教身份与对死亡的无畏之间的关联,(2)检验了宗教身份是否调节了对死亡的无畏与自杀意念之间的关联:方法:155 名患者在部分医院项目中寻求治疗。方法:155 名患者在部分医院项目中寻求治疗,他们使用治疗中的身份量表(行为治疗师)对宗教身份进行评估。与之前的研究(《自杀与自我威胁行为》,50,1230-1240;《情感障碍报告期刊》,12,100492)一样,通过自杀预演量表(《心理评估》,28,1452-1464)中的两个相关项目来评估对死亡的恐惧:结果:对死亡的恐惧与宗教认同相互作用,预测自杀意念,b = 0.47,95% C.I. [0.02, 0.91],p = 0.042。条件效应显示,在非宗教患者中,对死亡的恐惧感越强,自杀意念越强,b = -0.56,95% C.I. [-0.88,-0.24],p = 0.001;而在宗教患者中,对死亡的恐惧感越强,自杀意念越强,b = -0.09,95% C.I. [-0.41,0.22],p = 0.559:我们的研究结果表明,对死亡的恐惧是自杀意念的一个风险因素,但仅限于那些不信教的人。这项研究的结果为自杀理论提供了参考,并阐明了宗教身份对自杀风险因素和自杀相关结果之间联系的影响。
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引用次数: 0
Do measures of social support and social distress share general factors associated with suicidal ideation and attempts? 社会支持和社会困扰的衡量标准是否与自杀意念和自杀未遂相关的一般因素相同?
IF 3.2 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-05-30 DOI: 10.1111/sltb.13097
K G Saulnier, C A King, M A Ilgen, D Ganoczy, J Jagusch, J Garlick, K M Abraham, A Lapidos, H M Kim, E Vega, B K Ahmedani, P N Pfeiffer

Introduction: Aspects of social relationships have variably been associated with suicidal ideation (SI) and suicide attempts (SAs). This study assessed whether social support and social distress measures have general factors versus measure-specific factors that are associated with suicide risk.

Methods: Adults (N = 455, 60.0% female), admitted to psychiatric inpatient units following a recent suicide attempt or active SI, completed assessments of social support (emotional support, instrumental support, friendship, perceived support from significant others, friends, family) and social distress (loneliness, perceived rejection, perceived burdensomeness, thwarted belongingness). Bifactor modeling examined general and specific factors of social support and distress in relation to SI (week prior to hospitalization, via the Beck Scale for SI) and SAs (past 30 days, via the Columbia Suicide Severity Rating Scale).

Results: SI was significantly associated with the general social support (B = -1.51), the general social distress (B = 1.67), and the specific perceived burdensomeness (B = 1.57) factors. SAs were significantly associated with the specific Perceived Rejection (OR = 1.05) and Thwarted Belongingness (OR = 0.91) factors.

Conclusion: General social support and social distress were associated with SI but not recent SAs. Specific social distress factors were also related to SI and SAs controlling for general social distress, suggesting areas for future interventions.

简介社会关系的各个方面与自杀意念(SI)和自杀企图(SA)有不同程度的关联。本研究评估了社会支持和社会困扰测量是否具有与自杀风险相关的一般因素和测量特异性因素:最近自杀未遂或主动 SI 后入住精神科住院病房的成年人(N = 455,60.0% 为女性)完成了社会支持(情感支持、工具支持、友谊、感知到的来自重要他人、朋友和家人的支持)和社会困扰(孤独、感知到的排斥、感知到的负担、归属感受挫)的评估。双因素模型研究了社会支持和痛苦的一般因素和特殊因素与SI(住院前一周,通过贝克SI量表)和SAs(过去30天,通过哥伦比亚自杀严重程度评定量表)的关系:SI与一般社会支持(B=-1.51)、一般社会痛苦(B=1.67)和特定感知负担(B=1.57)因素有明显关联。SA与特定的 "感知到的拒绝"(OR = 1.05)和 "归属感受挫"(OR = 0.91)因素明显相关:结论:一般社会支持和社会困扰与 SI 相关,但与最近的 SAs 无关。具体的社会困扰因素也与SI和SA有关,但与一般社会困扰无关,这表明了未来干预的领域。
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引用次数: 0
Perceived burdensomeness and thwarted belongingness as mediators of the relation between anxiety and suicidal ideation among adolescents. 感知到的负担和受挫的归属感是青少年焦虑与自杀意念之间关系的中介。
IF 3.2 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-05-22 DOI: 10.1111/sltb.13094
Lauren Seibel, Katherine M Harris, Roberto López, Jennifer Wolff, Anthony Spirito, Christianne Esposito-Smythers

Introduction: Anxiety and suicidal ideation have been shown to be positively related in adolescents. However, less is known about the strength of this association across different types of anxiety or the mechanisms through which this relation exists. Joiner's interpersonal theory of suicide suggests that thwarted belongingness (TB) and perceived burdensomeness (PB) lead to suicidal ideation; these constructs may explain a pathway through which anxiety and suicidal ideation are related. It was hypothesized that TB would mediate the relation between social anxiety disorder (SAD) symptoms and suicidal ideation, and PB would mediate the relation between generalized anxiety disorder (GAD) symptoms and suicidal ideation.

Methods: These longitudinal mediation models were assessed using data collected from 147 depressed adolescents, who were recently hospitalized for suicidal ideation or behavior, enrolled in a randomized controlled trial (RCT).

Results: Consistent with study hypotheses, PB mediated the relation between GAD symptoms and suicidal ideation severity. However, TB did not mediate the relation between SAD symptoms and suicidal ideation severity.

Conclusion: These results suggest that screening for and addressing PB among youth with GAD may help reduce risk for suicidal behavior.

简介研究表明,在青少年中,焦虑与自杀倾向呈正相关。然而,人们对不同类型的焦虑与自杀意念之间的关系强度或这种关系存在的机制却知之甚少。乔伊纳的自杀人际关系理论认为,挫败的归属感(TB)和感知到的负担(PB)会导致自杀意念;这些概念可以解释焦虑和自杀意念之间的关系。研究假设 TB 将调解社交焦虑症(SAD)症状与自杀意念之间的关系,PB 将调解广泛性焦虑症(GAD)症状与自杀意念之间的关系:这些纵向中介模型是利用从 147 名抑郁青少年收集的数据进行评估的,这些青少年最近因自杀意念或行为住院,并参加了一项随机对照试验(RCT):与研究假设一致,PB 在 GAD 症状与自杀意念严重程度之间起中介作用。然而,TB并不能调节SAD症状与自杀意念严重程度之间的关系:这些结果表明,在患有 GAD 的青少年中筛查并解决 PB 问题可能有助于降低自杀行为的风险。
{"title":"Perceived burdensomeness and thwarted belongingness as mediators of the relation between anxiety and suicidal ideation among adolescents.","authors":"Lauren Seibel, Katherine M Harris, Roberto López, Jennifer Wolff, Anthony Spirito, Christianne Esposito-Smythers","doi":"10.1111/sltb.13094","DOIUrl":"https://doi.org/10.1111/sltb.13094","url":null,"abstract":"<p><strong>Introduction: </strong>Anxiety and suicidal ideation have been shown to be positively related in adolescents. However, less is known about the strength of this association across different types of anxiety or the mechanisms through which this relation exists. Joiner's interpersonal theory of suicide suggests that thwarted belongingness (TB) and perceived burdensomeness (PB) lead to suicidal ideation; these constructs may explain a pathway through which anxiety and suicidal ideation are related. It was hypothesized that TB would mediate the relation between social anxiety disorder (SAD) symptoms and suicidal ideation, and PB would mediate the relation between generalized anxiety disorder (GAD) symptoms and suicidal ideation.</p><p><strong>Methods: </strong>These longitudinal mediation models were assessed using data collected from 147 depressed adolescents, who were recently hospitalized for suicidal ideation or behavior, enrolled in a randomized controlled trial (RCT).</p><p><strong>Results: </strong>Consistent with study hypotheses, PB mediated the relation between GAD symptoms and suicidal ideation severity. However, TB did not mediate the relation between SAD symptoms and suicidal ideation severity.</p><p><strong>Conclusion: </strong>These results suggest that screening for and addressing PB among youth with GAD may help reduce risk for suicidal behavior.</p>","PeriodicalId":39684,"journal":{"name":"Suicide and Life-Threatening Behavior","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Suicidal thoughts and behaviors among gender and sexual minorities: Adults ages 18-24 show highest rates of past month suicidal thoughts. 性别和性少数群体中的自杀想法和行为:18-24 岁的成年人上个月有自杀念头的比例最高。
IF 3.2 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-05-21 DOI: 10.1111/sltb.13093
M E Manges, C Bryan, A Bryan, C R Bauder, H M Wastler

Introduction: Sexual and gender minority (SGM) people are at increased risk for suicidal thoughts and behaviors relative to their cisgender heterosexual peers. However, most research in this area has focused on youth, limiting our understanding of suicide risk among SGM adults.

Methods: To address this gap in the literature, the present study examined suicidal thoughts and behaviors among SGM adults across different age groups using a sample of 10,620 US adults.

Results: Consistent with the literature on youth, SGM adults showed higher rates of suicidal thoughts and behaviors than cisgender heterosexual adults. When examining prevalence rates across various age groups, young adults (18-24) showed greater lifetime and past month suicidal thoughts and behaviors relative to adults ages 45+. Adults ages 18-24 also showed greater past month suicidal ideation than adults ages 25-44; however, there were no group differences in lifetime suicidal thoughts and behaviors and past month suicidal behavior between adults ages 18-24 and 25-44.

Conclusions: Although suicidal thoughts and behaviors are most common among young SGM adults, other age groups do still show concerning rates of suicidal thoughts and behaviors, suggesting that this risk might extend to later years of life. Additional resources for SGM adults that are not only tailored toward youth and young adults are warranted.

导言:与同性异性同龄人相比,性与性别少数群体(SGM)的自杀想法和行为的风险更高。然而,这方面的研究大多集中在青少年身上,限制了我们对 SGM 成年人自杀风险的了解:为了填补这一文献空白,本研究以 10,620 名美国成年人为样本,调查了不同年龄组的 SGM 成年人的自杀想法和行为:与有关青少年的文献一致,SGM 成人的自杀想法和行为发生率高于同性异性恋成人。在研究各年龄组的发病率时,相对于 45 岁以上的成年人,年轻成年人(18-24 岁)的终生和上个月的自杀想法和行为更多。与 25-44 岁的成年人相比,18-24 岁的成年人在过去一个月中也表现出更强的自杀念头;但是,18-24 岁和 25-44 岁的成年人在一生中的自杀念头和行为以及过去一个月中的自杀行为方面没有群体差异:尽管自杀念头和行为在年轻的SGM成年人中最为常见,但其他年龄组的自杀念头和行为发生率仍令人担忧,这表明这种风险可能会延续到晚年。有必要为 SGM 成年人提供更多的资源,而不仅仅是针对青少年和年轻人。
{"title":"Suicidal thoughts and behaviors among gender and sexual minorities: Adults ages 18-24 show highest rates of past month suicidal thoughts.","authors":"M E Manges, C Bryan, A Bryan, C R Bauder, H M Wastler","doi":"10.1111/sltb.13093","DOIUrl":"https://doi.org/10.1111/sltb.13093","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual and gender minority (SGM) people are at increased risk for suicidal thoughts and behaviors relative to their cisgender heterosexual peers. However, most research in this area has focused on youth, limiting our understanding of suicide risk among SGM adults.</p><p><strong>Methods: </strong>To address this gap in the literature, the present study examined suicidal thoughts and behaviors among SGM adults across different age groups using a sample of 10,620 US adults.</p><p><strong>Results: </strong>Consistent with the literature on youth, SGM adults showed higher rates of suicidal thoughts and behaviors than cisgender heterosexual adults. When examining prevalence rates across various age groups, young adults (18-24) showed greater lifetime and past month suicidal thoughts and behaviors relative to adults ages 45+. Adults ages 18-24 also showed greater past month suicidal ideation than adults ages 25-44; however, there were no group differences in lifetime suicidal thoughts and behaviors and past month suicidal behavior between adults ages 18-24 and 25-44.</p><p><strong>Conclusions: </strong>Although suicidal thoughts and behaviors are most common among young SGM adults, other age groups do still show concerning rates of suicidal thoughts and behaviors, suggesting that this risk might extend to later years of life. Additional resources for SGM adults that are not only tailored toward youth and young adults are warranted.</p>","PeriodicalId":39684,"journal":{"name":"Suicide and Life-Threatening Behavior","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Structural adverse childhood experiences associated with suicidal ideation, suicide attempts, and repetitive nonsuicidal self-injury among racially and ethnically minoritized youth. 在少数种族和族裔青少年中,与自杀意念、自杀未遂和重复性非自杀性自伤有关的结构性不良童年经历。
IF 3.2 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-04-23 DOI: 10.1111/sltb.13084
Patricia I Jewett, Lindsay A Taliaferro, Iris W Borowsky, Michelle A Mathiason, Eunice M Areba

Introduction: High rates of suicidal ideation (SI), suicide attempts (SA), and repetitive nonsuicidal self-injury (NSSI) among some ethnoracially minoritized United States youth populations may be related to adverse childhood experiences (ACEs) with structural roots.

Methods: Using the 2013-2019 Minnesota Student Surveys, we assessed associations of student-reported structural ACEs (parental incarceration, housing instability, food insecurity, and foster care involvement) with SI, SA, and repetitive NSSI within the past 12 months using multilevel logistic regression stratified by ethnoracial group (American Indian/Alaskan Native [AIAN], Hmong, other Asian, Black Latino, other Latino, Somali, other Black/African American [AA], Native Hawaiian/Pacific Islander [NHPI], and multiracial), and adjusted for sex, grade, ACEs experienced within one's household, mental health treatment, and perceived safety.

Results: Structural ACEs were strongly associated with increasing SI, SA, and NSSI. At ≥2 structural ACEs, repetitive NSSI rates ranged from 7% to 29% (female), 8% to 20% (male); SA rates ranged from 13% to 35% (female), 10% to 22% (male); and SI rates ranged from 31% to 50% (female), 20% to 32% (male). Black Latino, NHPI, AIAN, and Black/AA students most often reported structural ACE exposures.

Conclusion: Reducing structural ACEs may reduce SI, SA, and repetitive NSSI among ethnoracially minoritized youth populations. Disaggregating diverse youth groups revealed variations in these outcomes that remain hidden when subpopulations are aggregated.

导言:在美国一些少数民族青少年群体中,自杀意念(SI)、自杀未遂(SA)和重复性非自杀性自伤(NSSI)的高发率可能与具有结构性根源的不良童年经历(ACEs)有关:我们使用 2013-2019 年明尼苏达州学生调查,评估了学生报告的结构性 ACE(父母入狱、住房不稳定、食品不安全和寄养)与过去 12 个月内的 SI、SA 和重复性 NSSI 的关联,并使用多层次逻辑回归对种族群体进行分层(美国印第安人/阿拉斯加原住民 [AIAN]、苗族、其他亚裔、黑人和其他亚裔)、苗族、其他亚裔、黑人拉丁裔、其他拉丁裔、索马里人、其他黑人/非洲裔美国人 [AA]、夏威夷原住民/太平洋岛民 [NHPI] 和多种族)进行分层,并根据性别、年级、家庭中的 ACE、心理健康治疗和安全感进行调整。结果显示结构性 ACE 与 SI、SA 和 NSSI 的增加密切相关。当结构性 ACE ≥2 时,重复性 NSSI 率为 7%至 29%(女性),8%至 20%(男性);SA 率为 13%至 35%(女性),10%至 22%(男性);SI 率为 31%至 50%(女性),20%至 32%(男性)。拉丁裔黑人、非华裔印度人、亚裔美国人和黑人/非裔美国人学生最常报告结构性 ACE 暴露:结论:减少结构性 ACE 可减少少数民族青少年群体中的 SI、SA 和重复性 NSSI。对不同的青少年群体进行分类,发现了这些结果中的差异,而这些差异在对亚群体进行汇总时仍然是隐性的。
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引用次数: 0
Efficacy of mentalization-based therapy in treating self-harm: A systematic review and meta-analysis. 以心理治疗为基础的自我伤害疗法的疗效:系统回顾和荟萃分析。
IF 2.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-04-01 Epub Date: 2024-01-27 DOI: 10.1111/sltb.13044
Carola Hajek Gross, Sofia-Marie Oehlke, Karin Prillinger, Andreas Goreis, Paul L Plener, Oswald D Kothgassner

Introduction: Mentalization-based therapy (MBT) and its adapted version for adolescents (MBT-A) are repeatedly highlighted as promising treatments for reducing self-harm, particularly in borderline personality disorder (BPD). Despite the availability of publications providing evidence of their efficacy in reducing self-harm, recent meta-analyses have yielded mixed results. To inform best-practice clinical decision-making, we conducted a systematic review and meta-analysis. We aimed to disentangle findings for both adolescents and adults on the efficacy of MBT(-A) in reducing self-harm (primary outcome) and symptoms of BPD and depression (secondary outcomes).

Methods: Web of Science, Scopus, Embase, PubMed/Medline, and Cochrane Review Database were searched for eligible studies published until September 2022. In total, 14 studies were identified, comprising 612 participants from nine MBT studies (six pre-post, three RCTs) and five MBT-A studies (two pre-post, three RCTs). Aggregated effect sizes were estimated using random-effects models. Meta-regressions were conducted to assess the effect of moderator variables (treatment duration, drop-out rates, and age) on effect sizes.

Results: Overall, both MBT and MBT-A demonstrated promising effects in reducing self-harm (g = -0.82, 95% CI -1.15 to -0.50), borderline personality disorder (g = -1.08, 95% CI -1.38 to -0.77), and depression (g = -1.1, 95% CI -1.52 to -0.68) symptoms. However, when compared to control interventions (TAU, SCM), MBT(-A) did not prove to be more efficacious, with the exception of MBT showing superior effects on BPD symptoms in adults (g = -0.56, 95% CI -0.88 to -0.24).

Conclusion: Although the pre-post evaluations seem promising, this analysis, including RCTs, showed no superiority of MBT(-A) to control conditions, so that prioritizing the application of MBT (-A) for the treatment of self-harm is not supported. Possible explanations and further implications are discussed.

导言:心理治疗(MBT)及其针对青少年的改良版(MBT-A)被反复强调为减少自残(尤其是边缘型人格障碍(BPD))的有效治疗方法。尽管有出版物提供了这些疗法在减少自残方面的疗效证据,但最近的荟萃分析却得出了好坏参半的结果。为了给最佳临床决策提供参考,我们进行了一项系统性回顾和荟萃分析。我们的目的是将青少年和成年人的研究结果区分开来,以了解 MBT(-A)在减少自残(主要结果)以及 BPD 和抑郁症状(次要结果)方面的疗效:方法:在 Web of Science、Scopus、Embase、PubMed/Medline 和 Cochrane Review Database 中检索了 2022 年 9 月之前发表的符合条件的研究。总共确定了 14 项研究,包括来自 9 项 MBT 研究(6 项事后研究,3 项研究性临床试验)和 5 项 MBT-A 研究(2 项事后研究,3 项研究性临床试验)的 612 名参与者。使用随机效应模型估算了综合效应大小。进行了元回归以评估调节变量(治疗持续时间、辍学率和年龄)对效应大小的影响:总体而言,MBT 和 MBT-A 在减少自残(g = -0.82,95% CI -1.15 至 -0.50)、边缘型人格障碍(g =-1.08,95% CI -1.38 至 -0.77)和抑郁症(g =-1.1,95% CI -1.52 至 -0.68)症状方面均表现出良好的效果。然而,与对照干预(TAU、SCM)相比,MBT(-A)并未被证明更有效,但MBT对成人BPD症状(g = -0.56,95% CI -0.88至-0.24)的效果更佳:结论:尽管前后评价似乎很有希望,但包括研究性试验在内的这项分析表明,MBT(-A)并不优于对照条件,因此不支持优先应用MBT(-A)治疗自残。本文讨论了可能的解释和进一步的影响。
{"title":"Efficacy of mentalization-based therapy in treating self-harm: A systematic review and meta-analysis.","authors":"Carola Hajek Gross, Sofia-Marie Oehlke, Karin Prillinger, Andreas Goreis, Paul L Plener, Oswald D Kothgassner","doi":"10.1111/sltb.13044","DOIUrl":"10.1111/sltb.13044","url":null,"abstract":"<p><strong>Introduction: </strong>Mentalization-based therapy (MBT) and its adapted version for adolescents (MBT-A) are repeatedly highlighted as promising treatments for reducing self-harm, particularly in borderline personality disorder (BPD). Despite the availability of publications providing evidence of their efficacy in reducing self-harm, recent meta-analyses have yielded mixed results. To inform best-practice clinical decision-making, we conducted a systematic review and meta-analysis. We aimed to disentangle findings for both adolescents and adults on the efficacy of MBT(-A) in reducing self-harm (primary outcome) and symptoms of BPD and depression (secondary outcomes).</p><p><strong>Methods: </strong>Web of Science, Scopus, Embase, PubMed/Medline, and Cochrane Review Database were searched for eligible studies published until September 2022. In total, 14 studies were identified, comprising 612 participants from nine MBT studies (six pre-post, three RCTs) and five MBT-A studies (two pre-post, three RCTs). Aggregated effect sizes were estimated using random-effects models. Meta-regressions were conducted to assess the effect of moderator variables (treatment duration, drop-out rates, and age) on effect sizes.</p><p><strong>Results: </strong>Overall, both MBT and MBT-A demonstrated promising effects in reducing self-harm (g = -0.82, 95% CI -1.15 to -0.50), borderline personality disorder (g = -1.08, 95% CI -1.38 to -0.77), and depression (g = -1.1, 95% CI -1.52 to -0.68) symptoms. However, when compared to control interventions (TAU, SCM), MBT(-A) did not prove to be more efficacious, with the exception of MBT showing superior effects on BPD symptoms in adults (g = -0.56, 95% CI -0.88 to -0.24).</p><p><strong>Conclusion: </strong>Although the pre-post evaluations seem promising, this analysis, including RCTs, showed no superiority of MBT(-A) to control conditions, so that prioritizing the application of MBT (-A) for the treatment of self-harm is not supported. Possible explanations and further implications are discussed.</p>","PeriodicalId":39684,"journal":{"name":"Suicide and Life-Threatening Behavior","volume":" ","pages":"317-337"},"PeriodicalIF":2.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139567461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relations between discrimination, rejection sensitivity, negative affect, and decrements in problem-solving ability following social rejection: An experimental investigation. 歧视、拒绝敏感性、消极情绪与社交拒绝后解决问题能力下降之间的关系:一项实验研究。
IF 3.2 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-04-01 Epub Date: 2024-01-05 DOI: 10.1111/sltb.13036
Roberto López, Christianne Esposito-Smythers, Annamarie B Defayette, Katherine M Harris, Lauren Seibel, Emma D Whitmyre

Introduction: While negative affect and problem-solving deficits have been consistently linked to suicidal thoughts and behaviors, the latter are often conceptualized and studied as time- and/or context-invariant. Though requiring additional empirical support, theory suggests that discrimination may strengthen the relation between rejection sensitivity and increases in negative affect as well as declines in problem-solving abilities following rejection. The aim of the current study was to test this claim using a social rejection paradigm (i.e., Cyberball) with young adults experiencing past-month suicidal ideation.

Methods: The sample consisted of 50 participants. Lifetime discrimination and rejection sensitivity were assessed prior to Cyberball. Negative affect and problem-solving abilities were assessed pre- and post-Cyberball. SPSS and the PROCESS macro were used to test relations among variables of interest.

Results: Rejection sensitivity predicted greater problem-solving decrements, but not negative affect, following rejection among individuals who had experienced higher (vs. lower) levels of lifetime discrimination.

Conclusion: Addressing rejection sensitivity and sources of discrimination within the context of treatment may reduce the impact of social rejection on problem-solving abilities among young adults at risk for suicide.

导言虽然消极情绪和解决问题能力的缺失一直与自杀想法和行为有关,但后者通常被概念化并被研究为与时间和/或环境无关。尽管还需要更多的实证支持,但理论表明,歧视可能会加强拒绝敏感性与消极情绪增加以及拒绝后问题解决能力下降之间的关系。本研究的目的是使用社交拒绝范式(即网络球),对过去一个月有自杀倾向的年轻人进行测试:方法:样本由 50 名参与者组成。方法:样本由 50 名参与者组成,在玩网络球之前对他们的终生辨别力和拒绝敏感度进行了评估。消极情绪和解决问题的能力则在玩网络球前后进行评估。使用 SPSS 和 PROCESS 宏检验相关变量之间的关系:结果:在一生中遭受过较高(与较低)程度歧视的人中,拒绝敏感性预示着被拒绝后解决问题的能力会下降,而消极情绪则不会:结论:在治疗过程中解决拒绝敏感性和歧视来源问题,可以减少社会拒绝对有自杀风险的年轻人解决问题能力的影响。
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引用次数: 0
A profound absence of counseling interventions for suicide prevention among youth in Africa: A call to action based on an empty scoping review. 非洲青少年自杀预防咨询干预措施严重缺失:基于空白范围审查的行动呼吁。
IF 3.2 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-04-01 Epub Date: 2024-01-12 DOI: 10.1111/sltb.13041
Brandon A Knettel, Armstrong Obale, Hamza Iqbal, Mela C Fotabong, Ngaha N Philippe, Margaret Graton, Leila Ledbetter

Objective: One-third of all global suicide deaths occur among adolescents and young adults, making suicide the second leading cause of death among young people. Nearly 80% of suicide deaths occur in low- and middle-income countries, and many African nations have higher rates of suicide than global averages. However, interventions are scarce. We conducted a scoping review of counseling interventions for suicide prevention among youth in Africa.

Method: We performed structured searches of the Medline, Embase, PyscINFO, African Index Medicus, Global Heath Database, and Proquest Dissertations and Theses Global databases. Studies were eligible for inclusion if they described a counseling intervention conducted in Africa, focused on participants under age 22, and included a suicide-related outcome.

Results: After removal of duplicates, 1808 titles and abstracts were screened and 10 studies were identified for full-text review. Of these, six included adult participants and did not disaggregate results for youth, two did not describe an intervention, and two did not include a relevant outcome. Thus, no studies were eligible for inclusion.

Conclusions: This empty review highlights the striking absence of published research on a life-threatening public health challenge, representing a distinct call to action for improved efforts in adolescent suicide prevention in Africa.

目的:全球三分之一的自杀死亡病例发生在青少年和年轻人身上,自杀已成为年轻人的第二大死因。近 80% 的自杀死亡发生在中低收入国家,许多非洲国家的自杀率高于全球平均水平。然而,干预措施却很少。我们对预防非洲青少年自杀的咨询干预措施进行了范围界定:我们对 Medline、Embase、PyscINFO、African Index Medicus、Global Heath Database 和 Proquest Dissertations and Theses Global 数据库进行了结构化检索。只要研究描述了在非洲进行的咨询干预,以 22 岁以下的参与者为研究对象,并包含与自杀相关的结果,就符合纳入条件:去除重复内容后,共筛选出 1808 篇标题和摘要,并确定了 10 篇研究进行全文审阅。其中,6 项研究包括成年参与者,但未对青少年的结果进行分类,2 项研究未对干预措施进行描述,2 项研究未包含相关结果。因此,没有研究符合纳入条件:这篇空洞的综述突出表明,对于这一威胁生命的公共卫生挑战,公开发表的研究成果明显不足,这也是对改进非洲青少年自杀预防工作的明确要求。
{"title":"A profound absence of counseling interventions for suicide prevention among youth in Africa: A call to action based on an empty scoping review.","authors":"Brandon A Knettel, Armstrong Obale, Hamza Iqbal, Mela C Fotabong, Ngaha N Philippe, Margaret Graton, Leila Ledbetter","doi":"10.1111/sltb.13041","DOIUrl":"10.1111/sltb.13041","url":null,"abstract":"<p><strong>Objective: </strong>One-third of all global suicide deaths occur among adolescents and young adults, making suicide the second leading cause of death among young people. Nearly 80% of suicide deaths occur in low- and middle-income countries, and many African nations have higher rates of suicide than global averages. However, interventions are scarce. We conducted a scoping review of counseling interventions for suicide prevention among youth in Africa.</p><p><strong>Method: </strong>We performed structured searches of the Medline, Embase, PyscINFO, African Index Medicus, Global Heath Database, and Proquest Dissertations and Theses Global databases. Studies were eligible for inclusion if they described a counseling intervention conducted in Africa, focused on participants under age 22, and included a suicide-related outcome.</p><p><strong>Results: </strong>After removal of duplicates, 1808 titles and abstracts were screened and 10 studies were identified for full-text review. Of these, six included adult participants and did not disaggregate results for youth, two did not describe an intervention, and two did not include a relevant outcome. Thus, no studies were eligible for inclusion.</p><p><strong>Conclusions: </strong>This empty review highlights the striking absence of published research on a life-threatening public health challenge, representing a distinct call to action for improved efforts in adolescent suicide prevention in Africa.</p>","PeriodicalId":39684,"journal":{"name":"Suicide and Life-Threatening Behavior","volume":" ","pages":"296-301"},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11021152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Suicide and Life-Threatening Behavior
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