监狱中反复自杀的桥梁评估和治疗:开发和验证一个风险模型
Seena Fazel1,2, Leanne Heathcote3, Leen Farouki4
1Department of Psychiatry, University of Oxford, Oxford, UK seena.fazel@psych.ox.ac.uk.
BMJ mental health
|February 28, 2025
概括
一个新的模型,即监狱中自伤自杀风险人群的风险评估 (RAPSS),有效地分层监禁人员反复自杀的风险. 这种工具有助于更好地分配资源用于监狱中预防自杀.
科学领域:
- 法医精神病学 法医精神病学
- 公共卫生 公共卫生
- 临床心理学 临床心理学
背景情况:
- 自杀的想法和行为在监狱人口中很普遍,导致诸如自杀和自我伤害等不良健康结果.
- 有效的风险分层对于及时干预和改善惩戒设施内患者护理至关重要.
研究的目的:
- 开发和验证一个预测模型来分层监狱中个体重复自杀的风险.
- 确定关键的社会人口统计学,临床和与监狱相关的因素,与在3个月的时间范围内重复自杀相关.
主要方法:
- 一个多变量模型是使用7个英格兰监狱中754个被确定为自伤或自杀高风险的人的数据开发的.
- 该模型结合了例行收集的数据,并使用Cox比例危险模型进行了测试.
- 对13所监狱的390名个人进行了前性验证,以评估该模型的性能.
主要成果:
- 最终的模型包括9个因素,如性别,年龄和最近的自杀行为,预测了1144名参与者的22%的重复自杀倾向.
- 监狱中有自伤自杀风险的人的风险评估 (RAPSS) 工具在开发和验证样本中展示了类似的校准和歧视.
- 外部验证显示c-统计值为0.66,具有58%的灵敏度和72%的特异性,风险切线为25%.
结论:
- 开发的RAPSS工具提供了一种新的,基于证据的方法来分层监狱人口中重复自杀风险.
- 这种风险评估模型可以改善在惩戒机构中预防和管理自杀的资源分配.
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