Background: The literature has focused on explicit communications of suicidal ideation, although such communications are infrequent and less overt symptoms are comparable indicators of suicide risk. Aims: Our aim was to understand how clinicians consider inexplicit suicide risk factors in assessments of risk. Method: A national sample of 75 psychiatric crisis clinicians were provided with three vignettes, which varied in nine variables related to suicide risk. Clinicians rated imminent suicide risk and identified an appropriate level of care for each hypothetical patient. Results: Prior suicide attempt, intent to die, presence of a suicide plan, desire to die, hopelessness, burdensomeness, and passive suicidal ideation (defined as a combination of hopelessness, burdensomeness, desire to die, and anhedonia) significantly impacted risk perception while depression and anhedonia did not. Level of care was significantly associated with passive suicidal ideation, suicide plan, desire to die, and hopelessness. Limitations: Limitations of the study include its small sample size, experienced clinicians, and reliance on hypothetical patients. The study design did not allow for all variables to be compared against one another. Conclusion: Clinicians considered less overt risk factors for suicide when assessing risk. Future research should examine whether this knowledge is applied in real-life scenarios and if less experienced clinicians equally consider these risk factors.

中文翻译：

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临床医生如何将自杀风险因素纳入自杀风险评估。

背景：文献主要关注自杀意念的明确交流，尽管这种交流并不频繁，而且较不明显的症状是自杀风险的可比指标。目的：我们的目的是了解临床医生如何在风险评估中考虑不明确的自杀风险因素。方法：为 75 名精神危机临床医生的全国样本提供了三个小插曲，这些小插曲在与自杀风险相关的九个变量中有所不同。临床医生对即将发生的自杀风险进行评估，并为每个假设的患者确定适当的护理水平。结果：先前的自杀企图、死亡意图、存在自杀计划、死亡愿望、绝望、负担和消极的自杀意念（定义为绝望、负担、死亡愿望、和快感缺乏）显着影响风险感知，而抑郁和快感缺乏则没有。护理水平与被动自杀意念、自杀计划、死亡愿望和绝望显着相关。局限性：该研究的局限性包括样本量小、临床医生经验丰富以及对假设患者的依赖。研究设计不允许将所有变量相互比较。结论：临床医生在评估风险时考虑较少明显的自杀风险因素。未来的研究应该检查这些知识是否应用于现实生活中，以及经验不足的临床医生是否同样考虑这些风险因素。该研究的局限性包括样本量小、临床医生经验丰富以及对假设患者的依赖。研究设计不允许将所有变量相互比较。结论：临床医生在评估风险时考虑较少明显的自杀风险因素。未来的研究应该检查这些知识是否应用于现实生活中，以及经验不足的临床医生是否同样考虑这些风险因素。该研究的局限性包括样本量小、临床医生经验丰富以及对假设患者的依赖。研究设计不允许将所有变量相互比较。结论：临床医生在评估风险时考虑较少明显的自杀风险因素。未来的研究应该检查这些知识是否应用于现实生活中，以及经验不足的临床医生是否同样考虑这些风险因素。