ABSTRACT

Objective

Interpersonal negative life events (NLEs) have been linked to risk for suicidal thoughts and behaviors. However, little is known about how this risk is conferred over the short term and the mechanisms linking interpersonal NLEs to suicide risk, particularly in adolescents. This study used an intensive longitudinal design to examine thwarted belongingness with family and friends as potential mechanisms linking interpersonal NLEs to suicidal thoughts.

Method

Forty-eight adolescents (M_age = 14.96 years; 64.6% female, 77.1% White), who recently received acute psychiatric care for suicide risk, were followed intensely for 28 days after discharge. Smartphone-based ecological momentary assessment was used to measure presence of interpersonal NLEs at the day level, fluctuations in thwarted belongingness with family and friends (separately) within day, and fluctuations in suicidal thoughts within day. A multi-level structural equation model was utilized to examine family thwarted belongingness and friend thwarted belongingness as parallel mediators in the relationship between interpersonal NLEs and next-day suicidal thoughts.

Results

Significant direct effects were observed between interpersonal NLEs and family thwarted belongingness, family thwarted belongingness and suicidal thoughts, and friend thwarted belongingness and suicidal thoughts. In addition, family, but not friend, thwarted belongingness significantly mediated the association between interpersonal NLEs and next-day suicidal thoughts.

Conclusions

Interpersonal NLEs predicted greater suicidal thoughts over the short term (next day) in high-risk adolescents. Findings suggest how interpersonal NLEs may confer risk for suicidal thoughts – by reducing feelings of family belongingness. Future research is needed to examine how modifying belongingness may reduce suicide risk in adolescents.

中文翻译：

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受挫的归属感介导人际压力和自杀念头：一项针对高危青少年的深入纵向研究

摘要

客观的

人际关系负面生活事件 (NLE) 与自杀念头和行为的风险有关。然而，关于这种风险在短期内是如何产生的，以及人际 NLE 与自杀风险之间的联系机制，尤其是在青少年中，人们知之甚少。本研究使用密集的纵向设计来检查受挫的与家人和朋友的归属感作为将人际 NLE 与自杀念头联系起来的潜在机制。

方法

48 名青少年（M_年龄 = 14.96 岁；64.6% 为女性，77.1% 为白人）最近因自杀风险接受了急性精神病治疗，在出院后进行了 28 天的密切随访。基于智能手机的生态瞬时评估用于测量白天人际 NLE 的存在、一天内与家人和朋友（分别）受挫的归属感的波动，以及一天内自杀念头的波动。利用多层次结构方程模型来检验家庭受挫归属感和朋友受挫归属感作为人际 NLE 与次日自杀念头之间关系的平行中介。

结果

在人际 NLE 与家庭受挫的归属感、家庭受挫的归属感和自杀念头以及朋友受挫的归属感和自杀念头之间观察到显着的直接影响。此外，家庭而非朋友阻碍了归属感显着调节人际 NLE 与次日自杀念头之间的关联。

结论

人际 NLE 预测高危青少年在短期内（第二天）有更大的自杀念头。研究结果表明人际关系 NLE 如何通过降低家庭归属感来增加自杀念头的风险。未来的研究需要检验改变归属感如何降低青少年的自杀风险。