Ambulatory assessment of suicidal ambivalence: The temporal variability of the wish to live and the wish to die and their relevance in the concurrent and prospective prediction of suicidal desire.

IF 2.7 3区医学 Q2 PSYCHIATRY

Suicide and Life-Threatening Behavior Pub Date : 2024-10-01 Epub Date: 2024-08-03 DOI:10.1111/sltb.13120

Mareike Ernst, Theresa J Gemke, L Julian Olivi, Rory C O'Connor

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引用次数: 0

Abstract

Introduction: Suicidal ambivalence is increasingly understood as the result of the interplay of two conflicting motivational orientations, the wish to die (WTD) and wish to live (WTL). However, research is scarce regarding the nature of their relationship, their temporal structure, and their relevance in predicting suicidal desire.

Methods: Fifty psychosomatic/psychiatric inpatients (17 reporting suicide attempts) took part in an intensive longitudinal design with 10 signal-contingent prompts per day over 10 days; assessing WTD, WTL, and suicidal desire. We calculated mean values and variability of WTD, WTL, suicidal ambivalence, and suicidal desire and tested mixed-effects models of suicidal desire.

Results: The mean number of answered prompts was 40.98 (SD = 21.68). Repeated-measures correlation of WTD and WTL was r = -0.60. Patients with a history of suicide attempts reported higher WTD, lower WTL, more suicidal ambivalence, stronger suicidal desire, and showed higher variability in all constructs. At the same assessment, WTD was the strongest statistical predictor of suicidal desire. Only WTL and the interaction of WTD and WTL predicted suicidal desire prospectively.

Conclusion: Wish to die and WTL are likely two distinct (although correlated) constructs that should not be reduced to a single ambivalence score. A stronger focus on WTL holds potential for suicide research and practice.

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自杀矛盾心理的非卧床评估：求生愿望和求死愿望的时间可变性及其在同时和前瞻性预测自杀愿望中的相关性。

简介自杀的矛盾心理越来越多地被理解为两种相互冲突的动机取向--想死（WTD）和想活（WTL）--相互作用的结果。然而，有关它们之间关系的性质、时间结构以及它们在预测自杀欲望方面的相关性的研究却很少：50名心身/精神科住院病人（17人曾报告自杀未遂）参加了一项强化纵向设计，在10天内每天进行10次信号相关提示；评估WTD、WTL和自杀欲望。我们计算了WTD、WTL、自杀矛盾感和自杀欲望的平均值和变异性，并对自杀欲望的混合效应模型进行了测试：结果：回答提示的平均次数为 40.98（SD = 21.68）。WTD和WTL的重复测量相关性为r = -0.60。有自杀未遂史的患者WTD更高、WTL更低、自杀矛盾感更强、自杀欲望更强烈，并且在所有构念中表现出更高的变异性。在同一次评估中，WTD 是预测自杀欲望最强的统计指标。只有WTL以及WTD和WTL的交互作用可以预测自杀欲望的前景：结论：死亡愿望和WTL可能是两个不同的（尽管相关）概念，不应简化为一个单一的矛盾评分。加强对WTL的关注将为自杀研究和实践带来潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Suicide and Life-Threatening Behavior Medicine-Public Health, Environmental and Occupational Health

CiteScore

5.40

自引率

3.10%

发文量

期刊介绍： An excellent resource for researchers as well as students, Social Cognition features reports on empirical research, self-perception, self-concept, social neuroscience, person-memory integration, social schemata, the development of social cognition, and the role of affect in memory and perception. Three broad concerns define the scope of the journal: - The processes underlying the perception, memory, and judgment of social stimuli - The effects of social, cultural, and affective factors on the processing of information - The behavioral and interpersonal consequences of cognitive processes.