BackgroundPrevious studies demonstrate a link between irritability and suicidal thoughts and behaviors (STBs) in youth samples. However, they have mostly assessed irritability in community samples and as a largely dispositional (i.e. trait‐like) construct. Thus, it remains unclear to what extent links between irritability and STBs reflect within‐person processes of elevated risk in clinically meaningful time periods.MethodsThe present study used clinical data from 689 adolescents aged 12–19 years attending a total of 6,128 visits at a specialty Intensive Outpatient Program for depressed and suicidal youth to examine patterns in weekly assessments of irritability and STBs throughout treatment, including associations among trends and fluctuations departing from these trends via multilevel structural equation modeling. Youth completed self‐report measures of irritability, depression, and STBs weekly as part of standard IOP clinical care.ResultsOverall, two‐thirds of variance in weekly irritable mood was accounted for by between‐person differences and the remaining portion by weekly fluctuations. After controlling for depression, during weeks when youth were more irritable they experienced increased STBs. Rates of change in irritability and STBs tended to track together at early stages of treatment, but these effects were generally accounted for by depression severity.ConclusionsOur results suggest that although changes in STBs are best accounted for by depression, irritability can be understood as a specific, proximal risk factor for youth STBs that exacerbates youth STBs in clinically informative timeframes above and beyond depression.

中文翻译：

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高危青少年的烦躁与自杀想法和行为之间的每周联系

背景先前的研究表明，青少年样本中的烦躁与自杀想法和行为（STB）之间存在联系。然而，他们主要评估了社区样本中的易怒性，并将其作为一种主要的性格（即特质）结构。因此，目前尚不清楚烦躁与 STB 之间的联系在多大程度上反映了在临床上有意义的时间段内人体内风险升高的过程。 方法本研究使用了 689 名 12-19 岁青少年的临床数据，共在专科就诊 6,128 次针对抑郁和自杀青少年的强化门诊计划，旨在检查整个治疗期间每周评估的烦躁和 STB 的模式，包括通过多级结构方程模型得出的趋势和偏离这些趋势的波动之间的关联。作为标准 IOP 临床护理的一部分，青少年每周完成烦躁、抑郁和 STB 的自我报告测量。结果总体而言，每周烦躁情绪的三分之二的差异是由人与人之间的差异造成的，其余部分是由每周​​的波动造成的。在控制抑郁症后，在年轻人更加烦躁的几周内，他们的 STB 会增加。在治疗的早期阶段，烦躁性和 STB 的变化率往往会同时出现，但这些影响通常是由抑郁的严重程度来解释的。结论我们的结果表明，虽然 STB 的变化最好由抑郁来解释，但烦躁性可以被理解为一种特定的症状。 ，青年 STB 的近端危险因素，在临床信息丰富的时间范围内加剧青年 STB 的程度高于抑郁症。