Abstract：
Behavioral warning signs (WS) are near-term changes within individuals, which aid in determining imminent risk for suicide attempts. However, those who attempt suicide differ in their engagement of WS, and it is unclear if these differences relate to future risk of suicidal behavior. Using a sample of 132 adults presenting to a hospital following a suicide attempt, the current study sought to determine if differences in engagement in WS for the index attempt prospectively predicted suicide attempt, frequency of ideation, and intensity of suicide ideation 12 months post discharge. Latent class analyses (LCAs) conducted on 6 behaviors (i.e., alcohol use, nightmares, interpersonal negative life events, suicide communication, risky behavior, low sleep, and high sleep) found a 5-class solution optimally fit the data. One identified class, characterized by engagement in risky behaviors the hours before an attempt differed from other identified classes in terms of risk for future suicidal ideation and behaviors. More specifically, participants in \"High Risky Behavior\" class had higher rates of 12-month suicide reattempt, significantly more frequent suicide ideation, and significantly worse intensity of suicide ideation during the 12 months following their index attempt compared to participants endorsing typical patterns of WS. These results held when adjusting for various traditional baseline covariates (e.g., depressive symptoms). The current study demonstrates that patterns of behavioral WS may be utilized as their own prognostic indicator of future suicidal ideation and behaviors among high-risk individuals reporting a recent suicide attempt, which can inform post-discharge clinical intervention and prevention efforts.
摘要：
行为警告信号(WS)是个体内部的近期变化，这有助于确定自杀企图的迫在眉睫的风险。然而,那些试图自杀的人对WS的参与不同，目前尚不清楚这些差异是否与未来的自杀行为风险有关。使用132名自杀未遂后到医院就诊的成年人的样本，当前的研究试图确定在WS中参与指数尝试的差异是否可以前瞻性地预测自杀企图，频率的想法，以及出院后12个月自杀意念的强度。对6种行为进行的潜在类别分析(LCA)(即，酒精使用,噩梦,人际负面生活事件，自杀通讯,危险行为,低睡眠,和高睡眠）找到了5级解决方案，最佳地适合数据。一个确定的班级，其特征是在尝试前几个小时参与危险行为，在未来自杀意念和行为的风险方面与其他确定的类别不同。更具体地说,“高风险行为”类的参与者有更高的12个月自杀再尝试率，自杀意念明显更频繁，与支持典型WS模式的参与者相比，在他们的索引尝试后的12个月内，自杀意念的强度明显更差。这些结果在调整各种传统基线协变量时保持不变(例如，抑郁症状)。当前的研究表明，行为WS的模式可以用作他们自己的预后指标，以预测报告最近自杀未遂的高危个体的未来自杀意念和行为。这可以为出院后的临床干预和预防工作提供信息。
