ABSTRACT

The recent rise in suicide rates among children and adolescents has made suicide prevention in youth a major focus of government agencies and mental health organizations. In 2012, Nock presented future directions in the study of self-injurious thoughts and behavior (SITBs), highlighting the need to better examine which risk factors are associated with “each part of the pathway” to suicidal and non-suicidal self-injury in order to inform prevention and intervention efforts. Over the past decade, we have made important advances in understanding the development of SITBs and effective interventions. However, there are still major gaps of knowledge in our understanding of how to prevent suicide. Researchers have recently called for more studies focusing particularly on the pathway from suicidal ideation to suicidal behavior. However, we caution against prioritizing only a part of the suicide risk continuum (e.g., the transition from suicidal ideation to suicidal behavior) while minimizing research focusing on earlier developmental points of the pathway to suicide (e.g., the first development of suicidal ideation). We emphasize that childhood and adolescence represent a critical opportunity to intervene and prevent SITBs by altering developmental trajectories toward persistent and escalating SITBs over time. We advocate for integrating a developmental psychopathology perspective into future youth suicide research that focuses on how and when risk for SITBs first emerges and develops across childhood into emerging adulthood. This research is critical for informing interventions aimed at bending developmental pathways away from all SITBs. Here, we describe the need for future research that integrates key developmental psychopathology principles on 1) the identification of the continuum from developmentally typical to atypical as SITBs first emerge and develop, particularly among young children in early to middle childhood, 2) the way in which expressions of and risk for SITBs change across development, 3) how SITBs dynamically move along a continuum from typical to atypical over time, and 4) suicide prevention efforts. We also offer recommendations for future directions that focus on identifying disparities in SITBs occurring among minoritized youth within a developmental psychopathology perspective.

 抽象的

最近儿童和青少年自杀率的上升使得青少年自杀预防成为政府机构和心理健康组织的主要关注点。 2012年，诺克提出了自残思想和行为（SITB）研究的未来方向，强调需要更好地研究哪些风险因素与自杀和非自杀自残的“路径的每个部分”相关。以便为预防和干预工作提供信息。在过去的十年中，我们在了解 SITB 的发展和有效干预措施方面取得了重要进展。然而，我们对如何预防自杀的理解仍然存在重大知识空白。研究人员最近呼吁进行更多研究，特别关注从自杀意念到自杀行为的途径。然而，我们警告不要仅优先考虑自杀风险连续体的一部分（例如，从自杀意念到自杀行为的转变），同时尽量减少关注自杀途径早期发展点（例如，自杀意念的首次发展）的研究。我们强调，儿童期和青春期是干预和预防 SITB 的关键机会，随着时间的推移，可以改变 SITB 的持续和升级的发展轨迹。我们主张将发展精神病理学观点纳入未来的青少年自杀研究中，重点关注 SITB 风险如何以及何时首次出现并从儿童期发展到成年期。这项研究对于为旨在改变所有 SITB 发展途径的干预措施提供信息至关重要。 在此，我们描述了未来研究的必要性，该研究整合了以下方面的关键发展精神病理学原理：1）识别 SITB 首次出现和发展时从典型发育到非典型的连续统一体，特别是在儿童早期到中期的幼儿中，2） SITB 的哪些表现形式和风险会随着发展而变化，3) SITB 如何随着时间的推移从典型到非典型动态变化，以及 4) 自杀预防工作。我们还为未来的方向提供了建议，重点是从发展精神病理学的角度确定少数民族青年中发生的 SITB 差异。