OBJECTIVE Psychotic experiences, including auditory hallucinatory experiences (HEs), are strongly associated with both suicidal thoughts and behaviour. This study examined their role in the ideation-to-attempt transition in adolescents, including their direct and indirect effect via potential mediators. METHODS Participants were from an Australian prospective longitudinal cohort of 1669 adolescents (12-17 years); of which a subsample endorsing baseline suicidal ideation (n=216) was the focus of most analyses. Suicidal thoughts and behaviours were measured using the Self-Harm Behaviour Questionnaire. Diagnostic Interview Schedule for Children was used to assess auditory HEs. Potential mediators of interest were psychological distress and Interpersonal Theory of Suicide (IPTS) constructs. RESULTS Among adolescents reporting suicidal ideation at baseline (n=216), 6.5% had attempted suicide during follow-up. The size of auditory HEs' univariate effect suggests a possible strong relationship with increased risk of incident suicide attempts (OR=2.40; 95%CI=0.76-7.56); however, there was inadequate statistical power to produce a precise estimate. When HEs were accompanied by distress there was a nine-fold increased risk of acting on suicidal thoughts. Distress was independently associated with risk of attempt transition (OR=4.09), whereas IPTS constructs were poor explanatory variables in most models. CONCLUSION Adolescents with psychological distress and auditory HEs are at high risk of incident suicide attempts. Further investigations on the role of negative/distressing content of hallucinations in the ideation-to-attempt transition are warranted.

中文翻译：

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幻觉体验在从自杀念头到企图转变的过程中的作用：一种检验关联的理论和数据驱动方法

目标精神病体验，包括幻听体验 (HE)，与自杀念头和行为密切相关。本研究检查了它们在青少年从观念到尝试转变中的作用，包括它们通过潜在中介的直接和间接影响。方法 参与者来自澳大利亚前瞻性纵向队列，该队列由 1669 名青少年（12-17 岁）组成；其中支持基线自杀意念的子样本（n = 216）是大多数分析的重点。使用自残行为问卷测量自杀想法和行为。儿童诊断访谈时间表用于评估听觉 HE。感兴趣的潜在中介是心理困扰和人际自杀理论 (IPTS) 结构。结果 在基线时报告有自杀意念的青少年 (n=216) 中，6.5% 在随访期间曾尝试自杀。听觉 HE 单变量效应的大小表明可能与自杀未遂事件风险增加密切相关（OR=2.40；95%CI=0.76-7.56）；然而，统计能力不足，无法做出准确的估计。当 HE 伴随着痛苦时，产生自杀念头的风险会增加 9 倍。苦恼与尝试转变的风险独立相关 (OR=4.09)，而 IPTS 结构在大多数模型中是较差的解释变量。结论 有心理困扰和听觉 HE 的青少年发生自杀未遂事件的风险很高。