Daily prediction of nonsuicidal self-injury among inpatients: The roles of suicidal thoughts, interpersonal difficulties, hopelessness, and affect.

IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL
Michael J Kyron, Geoff R Hooke, Craig J Bryan, Glenn Kiekens, Wai Chen, Penelope Hasking, Andrew C Page
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Abstract

Objective: Nonsuicidal self-injury (NSSI) is a major public health issue. Despite increased research efforts in clinical samples, we still have little understanding of the short-term correlates, predictors, and targets of NSSI among treatment-seeking individuals. The present study was designed to (a) evaluate how suicidal thoughts, interpersonal difficulties, hopelessness, and affective states are associated with same-day and next-day NSSI; (b) identify which factors may be effective targets in treatment through network modeling.

Method: Data from 1,265 psychiatric inpatients who self-injured throughout their visit to a psychiatric hospital self-reported their suicidal ideation, negative affect, and positive affect on a daily basis (in total 36,345 prospective reports). An additional 632 patients were also surveyed regarding feelings of hopelessness, wish to live, and interpersonal difficulties. Using multilevel structural equation modeling, we examined contemporaneous and time-lagged associations with NSSI. Multilevel network analyses assessed interconnectedness of daily predictors and were compared with a matched sample of 1,265 patients who did not self-injure during their stay.

Results: Increases in suicidal ideation were associated with increased probability of same-day and next-day self-injury, and an inverse relationship was observed for wish to live. Increases in positive affect were also significantly associated with decreased probability of next-day self-injury. Perceived burdensomeness had high centrality in network models, particularly among patients who self-injured, indicating it is susceptible to activation and directly associated with all predictors.

Conclusions: Routine monitoring may improve prediction of when a patient is at short-term risk to self-injure and provides person-specific data that can assist in targeting risk and protective factors during treatment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

住院病人非自杀性自伤的日常预测:自杀念头、人际关系困难、绝望和情感的作用。
目的:非自杀性自伤(NSSI)是一个重大的公共卫生问题。尽管在临床样本中进行了更多的研究,但我们对寻求治疗的个体中自伤的短期相关性、预测因素和目标仍然知之甚少。本研究旨在(a)评估自杀念头、人际关系困难、绝望和情感状态与当日和次日自伤的关系;(b)通过网络建模确定哪些因素可能是治疗的有效目标。方法:来自1265名在精神病院自残的精神病住院患者的数据,这些患者每天自我报告他们的自杀意念、消极影响和积极影响(共36345份前瞻性报告)。另外对632名患者进行了关于绝望感、生存愿望和人际关系困难的调查。使用多层结构方程模型,我们研究了与自伤的同期和滞后关联。多层网络分析评估了每日预测指标的相互关联性,并与1265名住院期间没有自残的患者的匹配样本进行了比较。结果:自杀意念的增加与当日自伤和次日自伤的可能性增加相关,与生存意愿呈反比关系。积极情绪的增加也与第二天自伤概率的降低显著相关。感知负担在网络模型中具有很高的中心性,特别是在自残患者中,这表明它容易被激活,并与所有预测因子直接相关。结论:常规监测可以提高对患者短期自伤风险的预测,并提供个人特异性数据,有助于在治疗过程中针对风险和保护因素。(PsycInfo数据库记录(c) 2023 APA,版权所有)。
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
CiteScore
9.00
自引率
3.40%
发文量
94
期刊介绍: The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.
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