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首页> 外文期刊>Psychotherapy >Suicide risk assessment in clinical practice: pragmatic guidelines for imperfect assessments.
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Suicide risk assessment in clinical practice: pragmatic guidelines for imperfect assessments.

机译：临床实践中的自杀风险评估：不完善评估的实用指南。

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摘要

This practice review focuses on the challenges of conducting sensitive and accurate assessments of the relative risk for suicide attempts and completed suicides. Suicide and suicide attempts are a frequently encountered clinical crisis, and the assessment, management, and treatment of suicidal patients is one of the most stressful tasks for clinicians. An array of risk factors, warning signs, and protective factors associated with suicide risk are reviewed; however, we are not yet in possession of evidence-based diagnostic tests that can accurately predict suicide risk on an individual level without also creating an inordinate number of false-positive predictions. Given the current limitations of assessment strategies, clinicians are advised to keep in mind that patients contemplating suicide are under enormous psychological distress, requiring sensitive and thoughtful engagement during the assessment process. An overarching goal of these assessments should be conducted within the therapeutic frame, in which efforts are made to enhance the therapeutic alliance by negotiating a collaborative approach to assessing risk and understanding why thoughts of suicide are so compelling. Within this treatment heuristic, the Suicide Assessment Five-step Evaluation and Triage (SAFE-T) is recommended as a pragmatic multidimensional assessment protocol incorporating the best known risk and protective factors.
机译：本实践回顾着重于对自杀未遂和完成自杀的相对风险进行敏感而准确的评估所面临的挑战。自杀和自杀未遂是经常遇到的临床危机，对自杀患者的评估，管理和治疗是临床医生最紧张的任务之一。审查了一系列与自杀风险相关的风险因素，警告信号和保护因素;但是，我们还没有基于证据的诊断测试，可以准确地预测个体自杀风险，而又不会产生过多的假阳性预测。考虑到当前评估策略的局限性，建议临床医生记住打算自杀的患者承受着巨大的心理困扰，在评估过程中需要敏感而周到的参与。这些评估的总体目标应在治疗框架内进行，在此框架内，应通过协商评估风险的协作方法并理解为何自杀念头如此引人注目的努力来增强治疗联盟。在这种治疗试探法中，建议将自杀评估五步评估和分类（SAFE-T）作为实用的多维评估方案，结合最广为人知的风险和保护因素。

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