| Background:Suicide is the world’s major public health problem.Suicide attempt refers to a self-harming behavior for the purpose of death.Suicide attempters are the most risky.Suicidal ideation is a dynamic negative thought of an individual at a certain period.The suicidal ideation in a period of severe depression can reflect the degree of suicide risk of the individual.Therefore,the study of suicidal ideation in a period of severe depression of suicide attempters is more meaningful for preventing suicide.However,most of the current researches in this area are limited to the use of t-test,chi-square test and multi-factor logistic regression analysis.The defects are that the latent variables cannot be properly handled,the direct and indirect effects of the influencing factors cannot be analyzed,and the impact cannot be quantitatively evaluated.The magnitude of the factor action can not calculate the measurement error of the variable,but the structural equation modeling(SEM)analysis method can make up for these defects.And the results of the direct and indirect effects of the various influencing factors of suicidal ideation are also different.The stress-diathesis model theory believes that the factors affecting suicide risk are multifaceted,and suicide is the result of a combination of stress and susceptibility factors.Objective:Based on the theory of stress-diathesis model theory,this paper usesstructural equation modeling(SEM)to construct a structural equation model for therelationship between susceptible personality,negative life events,depression and suicidal ideation.The aim is to provide a scientific theoretical basis for the establishment of aneffective crisis intervention system and to prevent suicide attempts in suicide attempters.Methods:The study was conducted on 202 patients who had attempted suicide from the psychological clinic and emergency department of the First Affiliated Hospital of China Medical University.Self-edited sociodemographic and suicide-attempt characteristicsquestionnaire,Beck 19-item Scale for Suicidal Ideation(SSI),17-item HamiltonDepression Scale(HAMD-17),Eysenck Personality Questionnaire(EPQ),The 11th edition of Barratt Impulsiveness Scale(BIS-11)and Social Readjustment Rating Scale(SRRS)were used to conduct a questionnaire survey among the subjects.The Diagnostic and Statistical Manual of Mental Disorders(DSM-IV-TR)was as a diagnostic criteriaand the Chinese translation of the Structured Clinical Interview for DSM-IV Axis IDisorders,Patient Edition(SCID-I/P)was as a diagnostic tool to diagnose mental illness in the subjects.This study performed descriptive statistics,one-way ANOVA,t-test,correlation analysis,single factor and stepwise regression analysis using SPSS 22.0software.Structural equation modeling(SEM)and path analysis were performed using AMOS 22.0 software.Results:1.The prevalence of mental illness in suicide attempters was 85.2%.The score of intensity of suicidal ideation during a period of severe depression in SSI was 38.68±15.21,and the score of suicide risk during a period of severe depression in SSI was 40.43±13.67.2.The score of intensity of suicidal ideation and the score of suicide risk during a period of severe depression in SSI were significantly different in whether there were a history of attempted suicide,whether they thought more than 2 hours before suicideattempts,and whether there were mental illnesses.3.The results of regression analysisshowed that the intensity of suicidal ideation in a period of severe depression,depression,a history of attempted suicide,introverted personality and thinking more than 2 hoursbefore suicide attempts,which were risk factors for suicide risk in suicidal attempters.4.There was a significant positive correlation between depression and negative life events,neurotic personality,intensity of suicidal ideation and suicide risk in a period of severe depression(r=0.313,r=0.237,r=0.361,r=0.419,p<0.01);There was a significantpositive correlation between intensity of suicidal ideation and suicide risk(r=0.576,p<0.01).Impulsive personality was significantly positively correlated with psychoticpersonality and neurotic personality(r=0.226,r=0.209,p<0.01);There was a significant negative correlation between impulsive personality and depression,suicidal ideation in a period of severe depression(r=-0.167,r=-0.172,p<0.05).5.Attention impulsivity,motion impulsivity,and unplanned impulsivity were defined as three indicator variables of the exogenous latent variable,the impulsive personality,and the negative life events was defined as an exogenous measurable variable.The anxiety/somatization,weight,cognitive disturbance,retardation,sleep disruption were defined as five indicatorvariables of the exogenous latent variable,the depression,and the intensity of suicidal ideation,suicide risk during a period of severe depression were defined as two indicator variables of the exogenous latent variable,suicidal ideation.The relationship between negative life events,depression and suicidal ideation constructed a structural equation model.The model had a good fitting index:χ~2/df=2.253,RMSEA=0.079,TLI=0.909,NFI=0.902,CFI=0.942,GFI=0.937,AGFI=0.880,IFI=0.943.6.For susceptiblepersonality(impulsive personality,neurotic personality,psychiatric personality,internal personality),mental illness,depression,intensity of suicidal ideation and suicide risk in a period of severe depression,the study used a path analysis.The results showed that the intensity of suicidal ideation in a period of severe depression and the depression were the direct influencing factors on suicide risk,and the path coefficients were 0.488 and 0.243,respectively.At the same time,depression could also indirectly affect suicide risk through the intensity of suicidal ideation,and the path coefficient was 0.176.Impulsivepersonality and neurotic personality could indirectly affect suicide risk through mental illness,depression and the intensity of suicidal ideation,and the path coefficients were-0.036 and 0.028,respectively.Internal and external personality and neurotic personality could influence suicide risk indirectly through depression and the intensity of suicidal ideation,and the path coefficients were-0.132 and 0.101,respectively.The path model had a good fit index:χ~2/df=1.252,RMSEA=0.035,TLI=0.973,NFI=0.943,CFI=0.987,GFI=0.980,AGFI=0.945,IFI=0.988.Conclusion:Susceptible personality,negative life events and mental illness of suicide attempters all had an indirect effect on suicidal ideation and suicide risk in a period of severe depression.Depressive mood had the greatest impact on suicidal ideation and suicide risk in a period of severe depression,which was an important risk factor for suicidal ideation.The emergency department and clinical psychology department ofgeneral hospitals should strengthen the evaluation of depression and suicidal ideation in a period of severe depression of suicide attempters to prevent the occurrence of suicidalbehavior. |
PDF Full Text Request