创伤后应激障碍对震后青少年自杀意念的影响：安全感的调节作用

为探讨创伤后应激障碍（PTSD）及其各个症状簇对震后青少年自杀意念的影响,并检验安全感在其中的调节作用,研究采用创伤暴露程度问卷、流调中心抑郁量表儿童版、DSM-5的PTSD症状核查表、安全感量表和儿童行为问题核查表对汶川地震8.5年后的1136名中学生进行调查。结果发现：PTSD、负性认知和情绪改变症状、警觉性增高症状分别正向预测自杀意念,侵入性症状和回避性症状对自杀意念的预测作用不显著;安全感在侵入性症状、负性认知和情绪改变症状、警觉性增高症状、PTSD与自杀意念之间起负向调节作用,在回避性症状与自杀意念之间不起调节作用。这表明PTSD各症状簇对震后青少年自杀意念的预测作用不同,且安全感在其中发挥的调节作用也不同。     

Exposure to violence and suicide risk in adolescents: a community study

The prevalence of violence exposure is relatively unexplored in adolescents in European communities, and reports on the association between exposure to community violence and suicidal behavior are rare. The aim of this study was to investigate (1) the prevalence of community violence in a European urban adolescent sample, (2) the relationship between exposure to community violence and suicidal ideation/deliberate self-harm, and (3) the influence of depressive symptoms and aggressive behavior on this relationship. Self-report surveys were administered to a representative school-based sample of 1509 adolescents in Antwerp (Belgium). The prevalence rate of violence exposure was still high but lower than that reported in U.S. communities. Suicidal ideation and deliberate self-harm were both related to violence exposure. The gender-specific influence of depressive symptomatology and aggressive behavior on the association between exposure to violence and suicidal behavior suggests the need for further research.     

论非正常死亡

“非正常死亡”概念带模糊性、悖论性、封闭性和诡辩性,并不科学。现实的死亡率千差万别。中国内地自杀死亡率16．78／10万,事故死亡率57．91／10万,他杀死亡率2．33／10万,自然死亡率535．9／10万,一切原因死亡率612／10万。一切原因死亡率较港澳高,自杀与事故死亡率较港澳低。澳门的一切原因死亡率特低(165．0／10万),自杀死亡率特高(40．9／10万)。     

Optimism, Pessimism, and Hope in Durkheim

In Book Two, Chapter (1), of The Division of Labor in Society (1984) entitled "The Progress of the Division of Labor and Happiness", Emile Durkheim (1858–1917) stages a provocative encounter between the attitudes of optimism and pessimism, an encounter that reveals certain problematic assumptions regarding the status of hope in relation to the project of binding oneself to life under conditions of anomie. Durkheim's theoretical assault on the utilitarian-based optimism of his day is accomplished against the backdrop of a critical pessimism that is shown to be equally untenable. However, his critique leaves the question of the status of hope in relation to the question of human happiness unclarified and ambiguously framed, even as Durkheim defends hope against the despair of pessimism. The essay concludes with a critical appraisal of Durkheim's partial critique of pessimism and a few observations regarding the links between memory, expectation, pessimism, suicide, hope, and happiness.     

Psychiatric chrono‐epidemiology: its relevance for the study of aggression

Chrono‐epidemiology is the study of the distribution of health events according to time. The time intervals taken into account have cyclic patterns and include circadian, weekly, seasonal, and circannual rhythms. In the behavioural field, chrono‐epidemiology can be and has been applied to studies concerning the causes of death (suicide and homicide), clinical events such as admissions to and contacts with mental healthcare services, and the seasonal distribution of crime involving the use of violence. Frequently reported findings include clear circadian and seasonal rhythms present in the phenomenon of suicide (rhythms more evident in the case of violent suicide); seasonal rhythms in the expression of aggression by patients hospitalised for mental illness; and a circannual recurrence of crimes with a violent component. The intrinsic circadian and seasonal rhythms of some neuronal systems, particularly those of serotonin, involved in the control of mood and impulses, are thought to favour the behavioural rhythms observed, although the contribution of socio‐environmental factors, such as the fluctuation of supportive networks according to time, is also acknowledged. By demonstrating non‐casual recurrence of certain behaviour and by exploring the socio‐biological basis of the rhythms beneath these recurrences, chrono‐epidemiology may offer important etiologic and preventive clues to the understanding of the biological and environmental correlates of aggressive behaviour. Aggr. Behav. 28:477–490, 2002. © 2002 Wiley‐Liss, Inc.     

大学生的冲动性特质与自杀意念的关系:一个有调节的中介模型

以应激-易感模型为依据考察冲动性特质与自杀意念的关系,并在此基础上提出一个有调节的中介模型,探讨负性生活事件影响的中介作用以及家庭环境的调节作用。采用巴瑞特冲动性量表、青少年生活事件量表、家庭环境量表、贝克自杀意念量表对902名大学生进行集体施测,旨在考察负性生活事件的影响对大学生冲动性特质与自杀意念的中介作用以及家庭环境的调节作用,结果表明:(1)冲动性特质和负性生活事件的影响能正向预测大学生的自杀意念;(2)负性生活事件的影响在冲动性特质和自杀意念之间起中介作用;(3)负性生活事件影响的中介作用和冲动性特质的直接作用受家庭环境的调节。这些结果对于综合解释环境与个体因素对自杀意念的作用与机制具有重要意义。     

Implementing and Adapting the SAFETY Treatment for Suicidal Youth: The Incubator Model,Telehealth, and the Covid-19 Pandemic

The Safe Alternatives for Teens and Youth (SAFETY) treatment was developed to decrease the risk of repeat suicidal and self-harm behavior in youth presenting with elevated suicide risk. This paper uses case illustrations to demonstrate the SAFETY treatment, building upon the companion paper describing our “incubator” treatment development model and process (Asarnow et al., 2022). As illustrated in the second case illustration, the incubator model approach was particularly useful during the COVID-19 pandemic switch to telehealth. SAFETY specifically targets suicide and self-harm risk reduction using an individually tailored principle-guided approach, grounded in a case conceptualization that identifies cognitive-behavioral processes and reactions that contribute to increased suicide attempt risk and explains the youth’s suicidal/self-harm behavior within the context of his or her broader social systems. The SAFETY treatment has been tested in two treatment development trials, and results support the efficacy of SAFETY for preventing suicide attempts in adolescents presenting with recent self-harm.     

Written Exposure Therapy for Suicide in a Psychiatric Inpatient Unit: A Case Series

Patients with posttraumatic stress disorder (PTSD) are at an elevated risk of suicide. For patients hospitalized for suicide risk, psychosocial treatment and stabilization are routinely offered; however, the availability of evidence-based, manualized therapeutic interventions for PTSD is sparse. Typically, the short duration of hospitalization makes it difficult to accommodate evidence-based, trauma-focused treatments. This article presents the clinical course of four active-duty service members with PTSD who were hospitalized in a psychiatric inpatient unit for acute suicide risk and treated with Written Exposure Therapy for Suicide (WET-S). WET-S is a brief, five-session therapy based upon Written Exposure Therapy and augmented with Crisis Response Planning for Suicide Prevention. Both posttraumatic stress symptoms and suicidal ideation were reduced from pre- to posttreatment for three of the four patients treated. WET-S shows promise as a manualized therapeutic intervention that can be delivered on an inpatient psychiatric unit.     

The Incubator Treatment Development Model: The SAFETY Treatment for Suicidal/Self-Harming Youth

Youths who make suicide attempts or engage in repetitive self-harm are at risk for future suicide attempts and death by suicide or self-harm. This treatment development report focuses on the Safe Alternatives for Teens and Youth (SAFETY) treatment. SAFETY is a 12-week outpatient child and family-centered cognitive-behavioral treatment, informed by dialectical-behavior therapy, and designed to promote safety following a suicide attempt or repeated episodes of self-harm. Previous reports have described results of small open and randomized treatment development trials. Here, we describe our “incubator” treatment development model. Combining scientific rigor with attention to the community context in which treatment is delivered, the incubator model emphasizes laboratory-based treatment development trials and quantitative and qualitative data generated through partnerships with community treatment sites and youth and parent consumers of care. Aims of this approach are to: (1) integrate information from our partners throughout the treatment development process; (2) create a more feasible and easily transportable “youth” and “family” centered treatment; and (3) accelerate the pace with which laboratory-based treatment advances can be incorporated into improvements in community care. We describe our incubator treatment development model and how data generated through our treatment development process and interactions between the laboratory and community teams contributed to the development of the SAFETY treatment.