Abstract. Background: Worldwide, prisoners are at high risk of suicide. Research on near-lethal suicide attempts can provide important insights into risk and protective factors, and inform suicide prevention initiatives in prison. Aims: To synthesize findings of research on near-lethal attempts in prisons, and consider their implications for suicide prevention policies and practice, in the context of other research in custody and other settings. Method: We searched two bibliographic indexes for studies in any language on near-lethal and severe self-harm in prisoners, supplemented by targeted searches over the period 2000–2014. We extracted information on risk factors descriptively. Data were not meta-analyzed owing to heterogeneity of samples and methods. Results: We identified eight studies reporting associations between prisoner near-lethal attempts and specific factors. The latter included historical, prison-related, and clinical factors, including psychiatric morbidity and comorbidity, trauma, social isolation, and bullying. These factors were also identified as important in prisoners' own accounts of what may have contributed to their attempts (presented in four studies). Conclusion: Factors associated with prisoners' severe suicide attempts include a range of potentially modifiable clinical, psychosocial, and environmental factors. We make recommendations to address these factors in order to improve detection, management, and prevention of suicide risk in prisoners. PMID:27278569
Nock, Matthew K.; Borges, Guilherme; Bromet, Evelyn J.; Cha, Christine B.; Kessler, Ronald C.; Lee, Sing
Suicidal behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such behavior is important for policy-making and prevention. The authors reviewed government data on suicide and suicidal behavior and conducted a systematic review of studies on the epidemiology of suicide published from 1997 to 2007. The authors' aims were to examine the prevalence of, trends in, and risk and protective factors for suicidal behavior in the United States and cross-nationally. The data revealed significant cross-national variability in the prevalence of suicidal behavior but consistency in age of onset, transition probabilities, and key risk factors. Suicide is more prevalent among men, whereas nonfatal suicidal behaviors are more prevalent among women and persons who are young, are unmarried, or have a psychiatric disorder. Despite an increase in the treatment of suicidal persons over the past decade, incidence rates of suicidal behavior have remained largely unchanged. Most epidemiologic research on suicidal behavior has focused on patterns and correlates of prevalence. The next generation of studies must examine synergistic effects among modifiable risk and protective factors. New studies must incorporate recent advances in survey methods and clinical assessment. Results should be used in ongoing efforts to decrease the significant loss of life caused by suicidal behavior. PMID:18653727
Stanley, Barbara; Brown, Gregory; Brent, David A.; Wells, Karen; Poling, Kim; Curry, John; Kennard, Betsy D.; Wagner, Ann; Cwik, Mary F.; Klomek, Anat Brunstein; Goldstein, Tina; Vitiello, Benedetto; Barnett, Shannon; Daniel, Stephanie; Hughes, Jennifer
Objective: To describe the elements of a manual-based cognitive-behavioral therapy for suicide prevention (CBT-SP) and to report its feasibility in preventing the recurrence of suicidal behavior in adolescents who have recently attempted suicide. Method: The CBT-SP was developed using a risk reduction and relapse prevention approach and…
Full Text Available Suicide is a major public health problem in India, probably even bigger than in the West. Suicidal behavior is the best conceptualized as a multifaceted complex problem involving social factors and mental illnesses. Broadly, there are two approaches to suicide prevention; population preventive strategies and high-risk preventive strategies. Population preventive strategies include reducing availability of means for suicide, education of primary care physicians, influencing media portrayal of suicidal behavior, education of the public, telephone helplines, and addressing economic issues associated with suicidal behavior. High-risk preventive strategy includes identifying individuals with high risk of committing suicide, intensively treating mental illness if present, and providing psychosocial support. Thus, prevention requires a multipronged effort with collaboration from various sectors including mental health professionals, social justice department, and macroeconomic policy makers.
Betz, Marian E; Miller, Matthew; Barber, Catherine; Miller, Ivan; Sullivan, Ashley F; Camargo, Carlos A; Boudreaux, Edwin D
We sought to examine the beliefs and behaviors of emergency department (ED) providers related to preventing suicide by reducing suicidal patients' access to lethal methods (means restriction) and identify characteristics associated with asking patients about firearm access. Physicians and nurses at eight EDs completed a confidential, voluntary survey. The response rate was 79% (n = 631); 57% of respondents were females and 49% were nurses. Less than half believed, "most" or "all" suicides are preventable. More nurses (67%) than physicians (44%) thought "most" or "all" firearm suicide decedents would have died by another method had a firearm been unavailable (P suicidal patients about firearm access varied across five patient scenarios: suicidal with firearm suicide plan (64%), suicidal with no suicide plan (22%), suicidal with nonfirearm plan (21%), suicidal in past month but not today (16%), and overdosed but no longer suicidal (9%). In multivariable logistic regression, physicians were more likely than nurses to "almost always" or "often" ask about a firearm across all five scenarios, as were older providers and those who believed their own provider type was responsible for assessing firearm access. Many ED providers are skeptical about the preventability of suicide and the effectiveness of means restriction, and most do not assess suicidal patients' firearm access except when a patient has a firearm suicide plan. These findings suggest the need for targeted staff education concerning means restriction for suicide prevention. © 2013 Wiley Periodicals, Inc.
Franco-Martín, Manuel A; Muñoz-Sánchez, Juan Luis; Sainz-de-Abajo, Beatriz; Castillo-Sánchez, Gema; Hamrioui, Sofiane; de la Torre-Díez, Isabel
Suicide is the second cause of death in young people. The use of technologies as tools facilitates the detection of individuals at risk of suicide thus allowing early intervention and efficacy. Suicide can be prevented in many cases. Technology can help people at risk of suicide and their families. It could prevent situations of risk of suicide with the technological evolution that is increasing. This work is a systematic review of research papers published in the last ten years on technology for suicide prevention. In September 2017, the consultation was carried out in the scientific databases PubMed, ScienceDirect, PsycINFO, The Cochrane Library and Google Scholar. A general search was conducted with the terms "prevention" AND "suicide" AND "technology. More specific searches included technologies such as "Web", "mobile", "social networks", and others terms related to technologies. The number of articles found following the methodology proposed was 90, but only 30 are focused on the objective of this work. Most of them were Web technologies (51.61%), mobile solutions (22.58%), social networks (12.90%), machine learning (3.23%) and other technologies (9.68%). According to the results obtained, although there are technological solutions that help the prevention of suicide, much remains to be done in this field. Collaboration among technologists, psychiatrists, patients, and family members is key to advancing the development of new technology-based solutions that can help save lives.
The adolescent at risk for suicidal preoccupation and behavior has become an increasing concern for schools and communities. This paper presents some of the causes of teen suicide, things adults should know about adolescent suicide prevention, and what can be done to help such youth. The transition to adolescence is a complex time when many values…
Joiner, Thomas E., Jr.
The author has proposed a new theory of suicidal behavior--the interpersonal-psychological theory of suicidal behavior (Joiner, 2005)--which attempts to answer the question "Why do people die by suicide?" In this commentary, he briefly describes the theory, and then argues that the theory's constructs may allow a new level of focus and specificity…
Full Text Available Purpose: The present review summarizes the updated literature on the social aspects of suicidal behavior and prevention in adolescents. Recent findings: The predictive role of psychiatric disorders and past history are well recognized in adolescent suicide, but the role of social and cultural factors is less clear. Studies have focused on the importance of ethnicity, gender, family characteristics, and socioeconomic status. More recently, attention has been addressed to broader social risk factors, such as bullying in adolescents, suicide contagion, sexual orientation, and the popular media. Further empirical evidence is needed to advance our understanding of suicidal youth, develop better assessment tools, and formulate effective prevention and treatment programs. Summary: Suicidal behavior remains an important clinical problem and major cause of death in youth. Social factors may be at least as important as genetics. Advancing our understanding of underlying cultural and sociological issues in youth suicide will help clinicians achieve more efficient prediction, prevention and treatment.
Amitai, Maya; Apter, Alan
Purpose: The present review summarizes the updated literature on the social aspects of suicidal behavior and prevention in adolescents. Recent findings: The predictive role of psychiatric disorders and past history are well recognized in adolescent suicide, but the role of social and cultural factors is less clear. Studies have focused on the importance of ethnicity, gender, family characteristics, and socioeconomic status. More recently, attention has been addressed to broader social risk factors, such as bullying in adolescents, suicide contagion, sexual orientation, and the popular media. Further empirical evidence is needed to advance our understanding of suicidal youth, develop better assessment tools, and formulate effective prevention and treatment programs. Summary: Suicidal behavior remains an important clinical problem and major cause of death in youth. Social factors may be at least as important as genetics. Advancing our understanding of underlying cultural and sociological issues in youth suicide will help clinicians achieve more efficient prediction, prevention and treatment. PMID:22690178
Cash, Scottye J; Bridge, Jeffrey A
Suicide is the third leading cause of death among young people in the U.S. and represents a significant public health problem worldwide. This review focuses on recent developments in our understanding of the epidemiology and risk factors for adolescent suicide and suicidal behavior. The suicide rate among children and adolescents in the U.S. has increased dramatically in recent years and has been accompanied by substantial changes in the leading methods of youth suicide, especially among young girls. Much work is currently underway to elucidate the relationships between psychopathology, substance use, child abuse, bullying, internet use, and youth suicidal behavior. Recent evidence also suggests sex-specific and moderating roles of sex in influencing risk for suicide and suicidal behavior. Empirical research into the causal mechanisms underlying youth suicide and suicidal behavior is needed to inform early identification and prevention efforts.
Kuhlman, Shane T W; Walch, Susan E; Bauer, Kristina N; Glenn, April D
Gatekeeper training for suicide prevention was evaluated on a college campus to examine the impact of training on gatekeeper enactment of behaviors in support of suicide prevention and identify predictors of enactment of gatekeeper behaviors. Trained gatekeepers (N = 216) displayed greater perceived knowledge and self-efficacy for suicide prevention and reported higher rates of self-reported actual gatekeeper behaviors, including inquiring about suicidal ideation and referring for mental health treatment when they encountered someone in distress, compared to their untrained counterparts (N = 169). Consistent with the Theory of Planned Behavior, SEM results indicated that attitudes, self-efficacy, and perceived knowledge explained intentions to engage in gatekeeper behaviors, accounting for 59% of the variance in intentions to inquire about suicidal ideation and supporting the role of attitudes and perceived behavioral control in intentions to act. These intentions explained self-reported actual gatekeeper behaviors among participants who encountered someone in distress, with each one-point increase in intention associated with nearly twice the likelihood of both inquiring about suicidal ideation and referring someone for mental health care. On the other hand, self-reported situational barriers were associated with a decreased likelihood of referral behavior, indicating the role of actual behavioral control over volitional actions. Findings support the value of gatekeeper training for promoting factors that influence the likelihood of action on behalf of suicide prevention.
Bridge, Jeffrey A.; Goldstein, Tina R.; Brent, David A.
This review examines the descriptive epidemiology, and risk and protective factors for youth suicide and suicidal behavior. A model of youth suicidal behavior is articulated, whereby suicidal behavior ensues as a result of an interaction of socio-cultural, developmental, psychiatric, psychological, and family-environmental factors. On the basis of…
... remember the good times and develop a more positive outlook. ( Back to top. ) If You Are Feeling Suicidal If you have begun to think of suicide, it's important to recognize these thoughts for what they are: expressions of a treatable, ...
... Adults Podcast Series Q&A Peer Inspiration Life Unlimited Stories Life Unlimited Awards DBSA Honorary Advisory Board I'm Living ... suicide. As depression begins to lift, a person's energy and planning capabilities may return before the suicidal ...
King, Keith A.; Strunk, Catherine M.; Sorter, Michael T.
Background: Suicide ranks as the third leading cause of death among youth aged 15-24 years. Schools provide ideal opportunities for suicide prevention efforts. However, research is needed to identify programs that effectively impact youth suicidal ideation and behavior. This study examined the immediate and 3-month effect of Surviving the Teens[R]…
Kinchin, Irina; Doran, Christopher M
Suicide and non-fatal suicide behavior (NFSB) are significant problems faced by most countries. The objective of this research is to quantify the economic cost of suicide and NFSB in the Australian workforce and to examine the potential impact of introducing a workplace suicide prevention intervention to reduce this burden. The analysis used the best available suicide data, a well-established costing methodology, and a proven workplace intervention. In 2014, 903 workers died by suicide, 2303 workers harmed themselves resulting in full incapacity, and 11,242 workers harmed themselves resulting in a short absence from work. The present value of the economic cost of suicide and NFSB is estimated at $6.73 billion. Our analysis suggests the economic benefit of implementing a universal workplace strategy would considerably outweigh the cost of the strategy. For every one dollar invested, the benefits would be in excess of $1.50 ($1.11-$3.07), representing a positive economic investment. All variations of the key parameter hold the positive benefit-cost ratio. Rates of suicide and NFSB are far too high in Australia and elsewhere. More needs to be done to reduce this burden. Although workplace strategies are appropriate for those employed, these interventions must be used within a multifaceted approach that reflects the complex nature of self-harming behavior.
Britton, Peter C.; Patrick, Heather; Wenzel, Amy; Williams, Geoffrey C.
Cognitive behavioral therapy (CBT) has been found to be effective in preventing suicide-related behavior. However, it is often difficult to engage patients who are at-risk in treatment. Motivational Interviewing (MI) has been shown to increase treatment engagement and improve treatment outcomes when it is used to complement other treatments. As a…
Full Text Available The size of the elderly population is expected to increase dramatically in the next decades worldwide, also in Turkey. In accordance with these demographic changes, psychiatric disorders in late life, including suicide becomes much important. Elderly suicide is a very serious public health problem. Suicide rates in both males and females generally increase with age. However, the pattern is different in every nation. Suicidal behaviour in old age exists as a spectrum ranging from death wishes to completed suicide. Risk factors for suicide in old age are male sex, lower socioeconomic status, social isolation, having personality traits like hopelessness and dependency on others etc., the presence of psychiatric and physical disorders and previous suicidal behaviour. The most common cause for elderly suicide, as for all suicides, is untreated depression. Thus, elderly depression needs to be recognized and treated. The treatment of depressive disorder and other psychiatric diorders in late life, counselling in crisis situations and prevention of social isolation in elderly people are the major points for the prevention of suicide in old age. In this review article is to investigate the relationship between elderly and suicidal behavior. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(3.000: 294-309
Bridge, Jeffrey A.; Horowitz, Lisa M.; Fontanella, Cynthia A.; Grupp-Phelan, Jackie; Campo, John V.
The goal of the National Action Alliance for Suicide Prevention (Action Alliance) is to reduce suicide and suicide attempts in the U.S. by 40% in the next decade. In this paper, a public health approach is applied to suicide prevention to illustrate how reductions in youth suicide and suicidal behavior might be achieved by prioritizing research in two areas: (1) increasing access to primary care–based behavioral health interventions for depressed youth; and (2) improving continuity of care fo...
Suicide is a significant issue facing higher education institutions. Many campuses are involved in a variety of procedures, programs, and initiatives that seek to reduce or prevent suicide and the impact of suicide-related behavior. This article offers examples of campus prevention efforts, important resources on suicide prevention for college…
... Our Crisis Centers Stories of Hope and Recovery Mental Health & Suicide Prevention Glossary Get Involved Participate Our Crisis Centers Social Media Hub Promote National Suicide Prevention Month Providers & Professionals ...
... more likely to choose violent methods, such as shooting themselves. As a result, suicide attempts by men ... wanting to go out Suddenly having trouble in school or work Talking about death or suicide, or ...
Ruby, Eugene; Sher, Leo
Post-traumatic stress disorder (PTSD) is significantly associated with an increased risk for suicidal behavior among adolescents. Suicide is one of the top three causes of adolescent deaths worldwide. Despite the strong relationship between PTSD and suicidal behavior, precise causal pathways linking PTSD to suicide in adolescents remains unclear. A slew of mediating factors and variables commonly present themselves with both suicide and PTSD, including co-morbid psychiatric disorders, exposure to different forms of trauma and stressful life events, core neurobiological changes, and mental, emotional, and physiological states such as hyperarousal, impulsivity, and aggression. Because youth is such a critical stage of development, it is very important that at-risk adolescents are identified and referred for treatment. With many treatment challenges in these populations, effective implementation and use of prevention methods are of increasing importance. The most proven prevention methods include physician education, means restriction, and gatekeeper training. Other strategies that have received empirical support are public education campaigns and implementing guidelines for the media, including those for television, print media, and the Internet.
King, Keith A; Strunk, Catherine M; Sorter, Michael T
Suicide ranks as the third leading cause of death among youth aged 15-24 years. Schools provide ideal opportunities for suicide prevention efforts. However, research is needed to identify programs that effectively impact youth suicidal ideation and behavior. This study examined the immediate and 3-month effect of Surviving the Teens® Suicide Prevention and Depression Awareness Program on students' suicidality and perceived self-efficacy in performing help-seeking behaviors. High school students in Greater Cincinnati schools were administered a 3-page survey at pretest, immediate posttest, and 3-month follow-up. A total of 1030 students participated in the program, with 919 completing matched pretests and posttests (89.2%) and 416 completing matched pretests and 3-month follow-ups (40.4%). Students were significantly less likely at 3-month follow-up than at pretest to be currently considering suicide, to have made a suicidal plan or attempted suicide during the past 3 months, and to have stopped performing usual activities due to feeling sad and hopeless. Students' self-efficacy and behavioral intentions toward help-seeking behaviors increased from pretest to posttest and were maintained at 3-month follow-up. Students were also more likely at 3-month follow-up than at pretest to know an adult in school with whom they felt comfortable discussing their problems. Nine in 10 (87.3%) felt the program should be offered to all high school students. The findings of this study lend support for suicide prevention education in schools. The results may be useful to school professionals interested in implementing effective suicide prevention programming to their students. © 2011, American School Health Association.
Suicidal thoughts precede a suicide attempt. Knowing the people who are exposed to such thoughts enables prevention to be improved. The results of a study of the general population show that one in five French people claim to have already seriously considered committing suicide. This represents a particularly concerning public health issue. Copyright © 2017. Published by Elsevier Masson SAS.
Rao, V A
Suicide is an important mode of death. There are many psychiatrically ill patients in therapy running different degree of suicide risk. The risk of death by suicide is with almost all psychiatric illnesses, but it is found more with depressive disease, schizophrenia and personality disorder. Many studies have reported higher incidences of suicide attempts and suicide among alcoholics, which is often precipitated by family crises. Drug problems, low threshold for tolerance of day to day frustration, unemployement and poor parenting are major causes for youth suicide.There is biological evidence of suicidal behaviour. Fall in the level of serotonin and 5-HIAA in the CSF and in hind brain is found in subjects dying from suicide. Researchers have found decreased melatonin level in depression and suicide attempters. Long term therapy with antidepressants (Tricyclics), mood stabilizers (lithium and valproate) and new SSRIs prevent relapses and lessen suicide. It was concluded that general hospital doctors are in position of reducing suicide rates. Education of physician in detection of depression and suicide prevention will result in decline in number of suicides. The important measures include limiting the ability of methods of self-harm, antidepressants, paracetamol and insecticides.
Bridge, Jeffrey A; Horowitz, Lisa M; Fontanella, Cynthia A; Grupp-Phelan, Jackie; Campo, John V
The goal of the National Action Alliance for Suicide Prevention is to reduce suicide and suicide attempts in the U.S. by 40% in the next decade. In this paper, a public health approach is applied to suicide prevention to illustrate how reductions in youth suicide and suicidal behavior might be achieved by prioritizing research in two areas: (1) increasing access to primary care-based behavioral health interventions for depressed youth and (2) improving continuity of care for youth who present to emergency departments after a suicide attempt. Finally, some scientific, clinical, and methodologic breakthroughs needed to achieve rapid, substantial, and sustained reductions in youth suicide and suicidal behavior are discussed. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Virupaksha, H G; Muralidhar, Daliboyina; Ramakrishna, Jayashree
Suicide rate and suicidal tendencies among transgender persons are considerably high compared to general population. Hence, this review is an attempt to understand the issues around the suicide and suicidal behavior among transgender persons. The literature search conducted using three sources, i.e., electronic databases (PubMed, ProQuest, Google Scholar, PsycInfo), manual search (library catalog), and gray literature (consultation with experts). The suicide attempt rate among transgender persons ranges from 32% to 50% across the countries. Gender-based victimization, discrimination, bullying, violence, being rejected by the family, friends, and community; harassment by intimate partner, family members, police and public; discrimination and ill treatment at health-care system are the major risk factors that influence the suicidal behavior among transgender persons. In spite of facing a number of hardships in their day-to-day life, the transgender community holds a number of resiliency factors. Further, this community needs to be supported to strengthen their resiliency factors and draw culturally sensitive and transgender-inclusive suicide prevention strategies and increase protective factors to tackle this high rate of suicidality.
Seaburn, David; Gibbs, Danette; Schmeelk-Cone, Karen; White, Ann Marie; Caine, Eric D.
Suicide is the third leading cause of death among 10–24-year-olds and the target of school-based prevention efforts. Gatekeeper training, a broadly disseminated prevention strategy, has been found to enhance participant knowledge and attitudes about intervening with distressed youth. Although the goal of training is the development of gatekeeper skills to intervene with at-risk youth, the impact on skills and use of training is less known. Brief gatekeeper training programs are largely educational and do not employ active learning strategies such as behavioral rehearsal through role play practice to assist skill development. In this study, we compare gatekeeper training as usual with training plus brief behavioral rehearsal (i.e., role play practice) on a variety of learning outcomes after training and at follow-up for 91 school staff and 56 parents in a school community. We found few differences between school staff and parent participants. Both training conditions resulted in enhanced knowledge and attitudes, and almost all participants spread gatekeeper training information to others in their network. Rigorous standardized patient and observational methods showed behavioral rehearsal with role play practice resulted in higher total gatekeeper skill scores immediately after training and at follow-up. Both conditions, however, showed decrements at follow-up. Strategies to strengthen and maintain gatekeeper skills over time are discussed. PMID:21814869
Marzano, Lisa; Smith, Mark; Long, Matthew; Kisby, Charlotte; Hawton, Keith
Police officers are frequently the first responders to individuals in crisis, but generally receive little training for this role. We developed and evaluated training in suicide awareness and prevention for frontline rail police in the UK. To investigate the impact of training on officers' suicide prevention attitudes, confidence, and knowledge. Fifty-three participants completed a brief questionnaire before and after undertaking training. In addition, two focus groups were conducted with 10 officers to explore in greater depth their views and experiences of the training program and the perceived impact on practice. Baseline levels of suicide prevention attitudes, confidence, and knowledge were mixed but mostly positive and improved significantly after training. Such improvements were seemingly maintained over time, but there was insufficient power to test this statistically. Feedback on the course was generally excellent, notwithstanding some criticisms and suggestions for improvement. Training in suicide prevention appears to have been well received and to have had a beneficial impact on officers' attitudes, confidence, and knowledge. Further research is needed to assess its longer-term effects on police attitudes, skills, and interactions with suicidal individuals, and to establish its relative effectiveness in the context of multilevel interventions.
AAS 2011 Youth Suicidal Behavior Fact Sheet 4,822 youth age 15-24 died by suicide. i We want to change that. Su icid eRat ebyRace , age s 15-24, ... often the first to know their friend is suicidal, and we need to help them know where to ... 2011 Youth Risk and Behavior Survey found that in the previous 12 months ...
Cross, Wendi F.; Seaburn, David; Gibbs, Danette; Schmeelk-Cone, Karen; White, Ann Marie; Caine, Eric D.
Suicide is the third leading cause of death among 10-24-year-olds and the target of school-based prevention efforts. Gatekeeper training, a broadly disseminated prevention strategy, has been found to enhance participant knowledge and attitudes about intervening with distressed youth. Although the goal of training is the development of gatekeeper…
Williams, Caitlin L; Witte, Tracy K
We evaluated the effects of exposure to a suicide news article on a variety of outcome variables and whether adhering to one specific media guideline (i.e., including psychoeducational information and preventative resources) buffered any of the negative effects of exposure. Participants were randomly assigned to read one of three articles and then asked to complete a battery of self-report questionnaires. Overall, we found no effect of exposure to a suicide news article, regardless of the inclusion of resources and information, with a few minor exceptions. Although researchers have demonstrated the effectiveness of media guidelines in the aggregate at reducing imitative suicidal behavior, it remains unclear which guidelines in particular are responsible for this effect. © 2017 The American Association of Suicidology.
Strunk, Catherine M.; Sorter, Michael T.; Ossege, Julianne; King, Keith A.
Many school-based suicide prevention programs do not show a positive impact on help-seeking behaviors among emotionally troubled teens despite their being at high risk for suicide. This study is a secondary analysis of the Surviving the Teens® program evaluation to determine its effect on help-seeking behaviors among troubled youth. Results showed…
Draper, Brian M
Concerns about suicide risk in people with dementia have been increasing in recent years along with a discourse about rational suicide and assisted suicide. A systematic narrative literature review of suicidal behavior and assisted suicide in persons with dementia. Most studies that have examined the spectrum of suicidal ideation, attempted suicide and suicide in dementia have methodological limitations but the overall suicide risk does not appear to be increased. When suicidal behavior does occur, common themes include the presence of psychiatric comorbidity, mainly depression; occurrence early in the dementia course with preserved insight and capacity; and an increased risk in younger people. The emerging discourse on rational and assisted suicide has been spurred by early and pre-symptomatic diagnosis and poses a number of ethical challenges for clinicians including the role of proxy decision-makers. Although dementia might not confer a significant overall risk for suicidal behavior, clinicians still need to consider the potential for suicide in vulnerable individuals particularly early in the dementia course.
Johnson, R. Bradley; Oxendine, Symphony; Taub, Deborah J.; Robertson, Jason
Extensive media coverage of the suicide deaths of several gay and lesbian youth has highlighted lesbian, gay, bisexual, and transgender (LGBT) youth as a population at-risk for suicide. In addition, it has caused colleges and universities to address mental health and suicide behavior among this very diverse college population. One issue that…
Information to help teachers recognize the potential for suicide among hearing impaired and other students is presented. The "Suicide Decision Tree" emphasizes six important content areas (verbal signs, behavioral signs, stressors, past history, suicide plan, and resources) throughout a three-part process of monitoring, investigating, and…
Arun Kumar Agnihotri
Mar 5, 2016 ... suicide, family violence (including physical or sexual abuse), having guns or other firearms in the home, incarceration and exposure to others' suicidal behavior (such as that of family members, peers, or media figures). Research suggests that people who attempt suicide differ from others in many aspects of ...
Canino, Glorisa; Roberts, Robert E.
Reviews the scientific literature related to suicidal behavior among Latino youth. Discusses the conceptualizations of culture, and how culture may influence behavior and psychopathology, in particular, suicidal behavior. Reviews the literature that discusses rates of suicidal behavior, risk, and protective factors associated with this behavior…
Barzilay, S; Feldman, D; Snir, A; Apter, A; Carli, V; Hoven, C W; Wasserman, C; Sarchiapone, M; Wasserman, D
Joiner's interpersonal theory of suicide (IPTS) proposes that suicide results from the combination of a perception of burdening others, social alienation, and the capability for self-harm. The theory gained some empirical support, however the overall model has yet to be tested. This study aimed to test the main predictions of IPTS in a large community sample of Israeli adolescents. 1196 Israeli Jewish and Arab high-school pupils participating in the SEYLE project completed a self-report questionnaire measuring perceived burdensomeness, thwarted belongingness, health risk behaviors, and non-suicidal self-injury (risk variables), and suicidal ideation and suicide attempts (outcome measures). The data were tested in cross-sectional regression models. Consistent with IPTS, perceived burdensomeness was found to interact with thwarted belongingness, predicting suicidal ideation. Depression mediated most of the effect of thwarted belongingness and perceived burdensomeness on suicidal ideation. Acquired capability for self-harm, as measured by health risk behaviors and direct non-suicidal self-injurious behaviors, predicted suicide attempt. However, this mechanism operated independently from ideation rather than in interaction with it, at variance with IPTS-based predictions. The cross-sectional design precludes conclusions about causality and directionality. Proxy measures were used to test the interpersonal theory constructs. The findings support some of the IPTS predictions but not all, and imply two separate pathways for suicidal behavior in adolescents: one related to internalizing psychopathology and the other to self-harm behaviors. This conceptualization has clinical implications for the differential identification of adolescents at risk for suicidal behavior and for the development of prevention strategies. Copyright © 2015 Elsevier B.V. All rights reserved.
Rao, Venkoba A.
Suicide is an important mode of death. There are many psychiatrically ill patients in therapy running different degree of suicide risk. The risk of death by suicide is with almost all psychiatric illnesses, but it is found more with depressive disease, schizophrenia and personality disorder. Many studies have reported higher incidences of suicide attempts and suicide among alcoholics, which is often precipitated by family crises. Drug problems, low threshold for tolerance of day to day frustr...
Torok, Michelle; Calear, Alison; Shand, Fiona; Christensen, Helen
Mass media campaigns are increasingly seen as an important part of suicide prevention; however, despite their popularity, their efficacy is not well understood. The current review aimed to address key knowledge gaps regarding how mass media campaigns can be optimized to prevent suicide, by looking at their global efficacy, and mechanisms related to successful outcomes. A systematic review of the international literature examined studies which evaluated mass media campaigns targeted at suicide prevention, where suicide behaviors (mortality, attempts) or suicide literacy (knowledge, attitudes, help-seeking) was identified as a primary outcome. Thirteen articles describing 12 unique campaigns met eligibility criteria. For behavioral outcomes, mass media campaigns appear to be most effective when delivered as part of a multicomponent suicide prevention strategy, while "standalone campaigns" were modestly useful for increasing suicide literacy. Level of exposure, repeat exposure, and community engagement appeared to be fundamental to the success of these campaigns; however, these constructs were poorly adhered to in the development and implementation of campaigns. Overall, the mixed quality of the included studies highlights a need for increased quantity, consistency, and quality of evaluations to advance the evidence base. © 2016 The American Association of Suicidology.
de Groot, M.; Neeleman, J.; van der Meer, K.; Burger, H.
Grief interventions are more effective for high risk individuals. The presence of suicide ideation following suicide bereavement was examined to determine whether it indicates a high risk status. Using data from a randomized controlled trial (n =122) on the effectiveness of cognitive-behavior
Andriessen, Karl; Krysinska, Karolina
Belgium is a country with a high suicide rate (19.1/100,000 in 2004), and railway suicide poses a substantial safety and public health problem. This problem was addressed by the Suicide Prevention Unit of Infrabel (Manager of the Belgian Railway Infrastructure), which collects relevant data and implements a prevention program. To present data on fatal and nonfatal suicidal behavior on the Belgian railway network, including monthly and regional distribution and identification of hotspots; and to present the Infrabel suicide prevention program. Analysis of Infrabel data on railway suicide (1998-2009) and comparison with data on suicide in Belgium. A total of 1,092 railway suicides (1998-2009) and 557 suicide attempts (2003-2009) in Belgium (fatality rate of 54%) were studied. Monthly fluctuations were observed, with the majority of suicides occurring in Flanders, followed by Wallonia and Brussels. We identified 34 hotspots accounting for 35% of cases, mostly in Flanders. In 2004 railway suicide accounted for 5.3% of all suicides in Belgium (railway suicide rate of 1.03/100,000). Such a major human and economic loss warrants implementation of prevention measures. Infrabel has initiated a comprehensive suicide prevention program which focuses mainly on safeguarding the suicide hotspots.
Thapa, Priyata; Sung, Yoonhee; Klingbeil, David; Lee, Chih-Yuan; Klimes-Dougan, Bonnie
Understanding the context of suicidal behaviors is critical for effective suicide prevention strategies. Although suicide is an important topic for Asian Americans, there is limited information about what Asian Americans’ attitudes are towards suicide and their perceptions about the effectiveness of prevention efforts. These questions are critical to examine to provide foundational knowledge for determining how best to intervene. In this study, Asian American (n = 87) and White (n = 87)...
Stephens, Brady; Morley, Sybil; Thompson, Caitlin; Kemp, Janet; Bossarte, Robert M.
Objectives: The US Department of Veterans Affairs’ Suicide Prevention Applications Network (SPAN) is a national system for suicide event tracking and case management. The objective of this study was to assess data on suicide attempts among people using Veterans Health Administration (VHA) services. Methods: We assessed the degree of data overlap on suicide attempters reported in SPAN and the VHA’s medical records from October 1, 2010, to September 30, 2014—overall, by year, and by region. Data on suicide attempters in the VHA’s medical records consisted of diagnoses documented with E95 codes from the International Classification of Diseases, Ninth Revision. Results: Of 50 518 VHA patients who attempted suicide during the 4-year study period, data on fewer than half (41%) were reported in both SPAN and the medical records; nearly 65% of patients whose suicide attempt was recorded in SPAN had no data on attempted suicide in the VHA’s medical records. Conclusion: Evaluation of administrative data suggests that use of SPAN substantially increases the collection of data on suicide attempters as compared with the use of medical records alone, but neither SPAN nor the VHA’s medical records identify all suicide attempters. Further research is needed to better understand the strengths and limitations of both systems and how to best combine information across systems. PMID:28123228
Full Text Available Suicide associated mortality rates are notable for eating disorders. Crude mortality rate associated with suicide, varies between 0% and 5.3% in patients with eating disorders. Prominent risk factors for suicidal behavior among these patients are subtype of the eating disorders, comorbid psychiatric diagnosis (e.g. depression, alcohol and substance abuse, personality disorders, ultrarapid drug metabolism, history of childhood abuse and particular family dynamics. In this article, suicidal behavior and associated factors in eating disorders are briefly reviewed.
Robinson, Jo; Cox, Georgina; Malone, Aisling; Williamson, Michelle; Baldwin, Gabriel; Fletcher, Karen; O'Brien, Matt
Suicide, in particular among young people, is a major public health problem, although little is known regarding effective interventions for managing and preventing suicide-related behavior. To review the empirical literature pertaining to suicide postvention, prevention, and early intervention, specifically in school settings. MEDLINE, PsycINFO, and the Cochrane Central Register of Controlled Trials (CCRCT) as well as citation lists of relevant articles using terms related to suicide and schools were searched in July 2011. School-based programs targeting suicide, attempted suicide, suicidal ideation, and self-harm where intent is not specified were included. No exclusion was placed on trial design. All studies had to include a suicide-related outcome. A total of 412 potentially relevant studies were identified, 43 of which met the inclusion criteria, as well as three secondary publications: 15 universal awareness programs, 23 selective interventions, 3 targeted interventions, and 2 postvention trials. Overall, the evidence was limited and hampered by methodological concerns, particularly a lack of RCTs. The most promising interventions for schools appear to be gatekeeper training and screening programs. However, more research is needed.
Strunk, Catherine M; Sorter, Michael T; Ossege, Julianne; King, Keith A
Many school-based suicide prevention programs do not show a positive impact on help-seeking behaviors among emotionally troubled teens despite their being at high risk for suicide. This study is a secondary analysis of the Surviving the Teens(®) program evaluation to determine its effect on help-seeking behaviors among troubled youth. Results showed significant increases in mean scores of the Behavioral Intent to Communicate with Important Others Regarding Emotional Health Issues subscale (p Teens program has a positive effect on help-seeking behaviors in troubled youth. © The Author(s) 2013.
Pirkis, Jane E; Mok, Katherine; Robinson, Jo
This chapter explores the influence of the media on suicidal thoughts and behaviors. Until recently, the vast majority of studies in this area were concerned with traditional forms of media like newspapers and television and looked at the potential for irresponsible reporting of suicide to lead....... The recent proliferation of pro-suicide websites has led to concerns that contagion effects may operate in newer media like the Internet, particularly with the advent of Web 2.0. There are numerous suicide prevention websites, which include educational, interactive, and social networking content. A body...
King, Keith A.; Vidourek, Rebecca A.
Teen depression and suicidal behaviors are intricately intertwined, with untreated depression being a leading cause of adolescent suicide. Most depressed or suicidal teens tend to show warning signs and possess specific risk factors. A key component to preventing teen depression is for adults to remain aware of such warning signs and risk factors…
Conway, Paul Maurice; Erlangsen, Annette; Teasdale, Thomas William
on a sample of 85 adolescents (90.6% females) who participated at follow-up (85.9%) out of the 99 (49.7%) baseline respondents. All adolescents were recruited from a specialized suicide-prevention clinic in Denmark. Through multivariate logistic regression analyses, we examined whether baseline suicidal......Objectives: Using the Columbia-Suicide Severity Rating Scale (C-SSRS), we examined the predictive and incremental predictive validity of past-month suicidal behavior and ideation for short-term suicidal behavior among adolescents at a high risk of suicide. Methods: The study was conducted in 2014...... behavior predicted subsequent suicidal behavior (actual attempts and suicidal behavior of any type, including preparatory acts, aborted, interrupted and actual attempts; mean follow-up of 80.8 days, SD = 52.4). Furthermore, we examined whether suicidal ideation severity and intensity incrementally...
Full Text Available Understanding the context of suicidal behaviors is critical for effective suicide prevention strategies. Although suicide is an important topic for Asian Americans, there is limited information about what Asian Americans’ attitudes are towards suicide and their perceptions about the effectiveness of prevention efforts. These questions are critical to examine to provide foundational knowledge for determining how best to intervene. In this study, Asian American (n = 87 and White (n = 87 participants completed self-report indexes on their knowledge of depression and suicide (e.g., estimates of suicide rates, coping attitudes (e.g., help-seeking and suicide prevention attitudes (e.g., usefulness of PSAs. The results indicate that in comparison to Whites, Asian Americans perceived suicidal behavior to be more common, perceived a stronger link between depression and suicide, less frequently endorsed help-seeking strategies, and reported more concern or distress after viewing a suicide prevention PSA. These preliminary results also suggest the possibility of cultural differences in perceptions of suicide prevention messages. The implications of these findings are discussed with a focus on providing recommendations for exploring suicide prevention efforts for Asian Americans.
Benard, V; Geoffroy, P A; Bellivier, F
Suicidal behaviors are common in the general population and are so a major public health problem. In order to improve suicide prevention and to reduce the mortality by suicide, it appears essential to better identify suicide risk factors. Seasonality, circadian rhythms and sleep abnormalities have been already associated with numerous psychiatric disorders. This review aimed to characterize the associations between seasonality, circadian rhythms, sleep and suicidal behaviors including suicide attempts and completed suicides. We conducted a literature search between 1973 and 2015 in PubMed databases using the following terms: ("suicide" OR "suicidality" OR "suicide attempts" OR "suicidal behavior") AND ("circadian rhythms" OR "seasons" OR "sleep"). Many studies confirm a specific seasonality for suicide with a higher peak of suicides in spring for both sex and a lower peak in autumn especially for women. This distribution seems to correlate with depressive symptoms (especially for the autumn peak), gender and different types of suicide. Regarding gender and type of suicide differences, males more commonly commit violent suicide with a higher rate of suicides in spring. Suicide behaviors appear to be influenced by climatic and biological factors like sunshine, daylight cycles, temperature, air pollutants, viruses, parasites and aeroallergens. Circadian variations exist in suicide rates depending on age with a morning peak for elder and an evening peak for youth. In addition, completed suicide peak in early morning whereas suicide attempts peak rather in later afternoon. Several biomarkers dysregulation like melatonin, serotonin and cortisol may be implicated in suicide circadian variations. Furthermore, specific sleep disorders like insomnia, nightmares and sleep deprivation are common risk factors of suicide and possibly independently of the presence of depressive symptoms. Finally, the efficacy of chronotherapeutics (such as luminotherapy, dark therapy, sleep
Even though several youth fatal suicides have been linked with school victimization, there is lack of evidence on whether cyberbullying victimization causes students to adopt suicidal behaviors. To investigate this issue, I use exogenous state-year variation in cyberbullying laws and information on high school students from the Youth Risk Behavioral Survey within a bivariate probit framework, and complement these estimates with matching techniques. I find that cyberbullying has a strong impact on all suicidal behaviors: it increases suicidal thoughts by 14.5 percentage points and suicide attempts by 8.7 percentage points. Even if the focus is on statewide fatal suicide rates, cyberbullying still leads to significant increases in suicide mortality, with these effects being stronger for men than for women. Since cyberbullying laws have an effect on limiting cyberbullying, investing in cyberbullying-preventing strategies can improve individual health by decreasing suicide attempts, and increase the aggregate health stock by decreasing suicide rates. Copyright © 2017 Elsevier B.V. All rights reserved.
Hogan, Michael F; Grumet, Julie Goldstein
Suicide is a significant public health problem. It is the tenth leading cause of death in the United States, and the rate has risen in recent years. Many suicide deaths are among people recently seen or currently under care in clinical settings, but suicide prevention has not been a core priority in health care. In recent years, new treatment and management strategies have been developed, tested, and implemented in some organizations, but they are not yet widely used. This article examines the feasibility of improving suicide prevention in health care settings. In particular, we consider Zero Suicide, a model for better identification and treatment of patients at risk for suicide. The approach incorporates new tools for screening, treatment, and support; it has been deployed with promising results in behavioral health programs and primary care settings. Broader adoption of improved suicide prevention care may be an effective strategy for reducing deaths by suicide. Project HOPE—The People-to-People Health Foundation, Inc.
Garland, A F; Zigler, E
The rate of adolescent suicide has increased dramatically in the past few decades, prompting several interventions to curb the increase. Unfortunately, many of the intervention efforts have not benefited from current research findings because the communication between researchers and those who develop the interventions is inadequate. Of specific concern are the increasingly popular curriculum-based suicide prevention programs, which have not demonstrated effectiveness and may contain potentially deleterious components. This article reviews the current epidemiological research in adolescent suicide and suggests how this knowledge could be used more effectively to reduce the rate of adolescent suicide. Recommendations include support for integrated primary prevention efforts; suicide prevention education for professionals; education and policies on firearm management; education for the media about adolescent suicide; more efficient identification and treatment of at-risk youth, including those exposed to suicidal behavior; crisis intervention; and treatment for suicide attempters.
Wu, Kevin Chien-Chang; Chen, Ying-Yeh; Yip, Paul S. F.
As the largest continent in the World, Asia accounts for about 60% of World suicides. Preventing suicide by restricting access to suicide methods is one of the few evidence-based suicide prevention strategies. However, there has been a lack of systematic exploration of suicide methods in Asian countries. To amend this shortage, the current review examines the leading suicide methods in different Asian countries, their trend, their age- and sex- specific characteristics, and their implications for suicide prevention. In total, 42 articles with leading suicide methods data in 17 Asian countries/regions were retrieved. The epidemiologic characteristics and recent trends of common suicide methods reflect specific socio-cultural, economic, and religious situations in the region. Common suicide methods shift with the introduction of technologies and constructions, and have specific age- or sex-characteristics that may render the restriction of suicide methods not equally effective for all sex and age sub-groups. Charcoal burning, pesticide poisoning, native plant poisoning, self-immolation, and jumping are all prominent examples. In the information society, suicide prevention that focuses on suicide methods must monitor and control the innovation and spread of knowledge and practices of suicide “technologies”. It may be more cost-effective to design safety into technologies as a way of suicide prevention while there is no rash of suicides yet by the new technologies. Further research on suicide methods is important for public health approaches to suicide prevention with sensitivity to socio-cultural, economic, and religious factors in different countries. PMID:22690187
Paul S. F. Yip
Full Text Available As the largest continent in the World, Asia accounts for about 60% of World suicides. Preventing suicide by restricting access to suicide methods is one of the few evidence-based suicide prevention strategies. However, there has been a lack of systematic exploration of suicide methods in Asian countries. To amend this shortage, the current review examines the leading suicide methods in different Asian countries, their trend, their age- and sex- specific characteristics, and their implications for suicide prevention. In total, 42 articles with leading suicide methods data in 17 Asian countries/regions were retrieved. The epidemiologic characteristics and recent trends of common suicide methods reflect specific socio-cultural, economic, and religious situations in the region. Common suicide methods shift with the introduction of technologies and constructions, and have specific age- or sex-characteristics that may render the restriction of suicide methods not equally effective for all sex and age sub-groups. Charcoal burning, pesticide poisoning, native plant poisoning, self-immolation, and jumping are all prominent examples. In the information society, suicide prevention that focuses on suicide methods must monitor and control the innovation and spread of knowledge and practices of suicide “technologies”. It may be more cost-effective to design safety into technologies as a way of suicide prevention while there is no rash of suicides yet by the new technologies. Further research on suicide methods is important for public health approaches to suicide prevention with sensitivity to socio-cultural, economic, and religious factors in different countries.
Katz, Cara; Bolton, Shay-Lee; Katz, Laurence Y; Isaak, Corinne; Tilston-Jones, Toni; Sareen, Jitender
Suicide is one of the leading causes of death among youth today. Schools are a cost-effective way to reach youth, yet there is no conclusive evidence regarding the most effective prevention strategy. We conducted a systematic review of the empirical literature on school-based suicide prevention programs. Studies were identified through MEDLINE and Scopus searches, using keywords such as "suicide, education, prevention and program evaluation." Additional studies were identified with a manual search of relevant reference lists. Individual studies were rated for level of evidence, and the programs were given a grade of recommendation. Five reviewers rated all studies independently and disagreements were resolved through discussion. Sixteen programs were identified. Few programs have been evaluated for their effectiveness in reducing suicide attempts. Most studies evaluated the programs' abilities to improve students' and school staffs' knowledge and attitudes toward suicide. Signs of Suicide and the Good Behavior Game were the only programs found to reduce suicide attempts. Several other programs were found to reduce suicidal ideation, improve general life skills, and change gatekeeper behaviors. There are few evidence-based, school-based suicide prevention programs, a combination of which may be effective. It would be useful to evaluate the effectiveness of general mental health promotion programs on the outcome of suicide. The grades assigned in this review are reflective of the available literature, demonstrating a lack of randomized controlled trials. Further evaluation of programs examining suicidal behavior outcomes in randomized controlled trials is warranted. © 2013 Wiley Periodicals, Inc.
Borges, Guilherme; Orozco, Ricardo; Benjet, Corina; Medina-Mora, Maria Elena
To summarize the epidemiology of completed suicide and suicidal behavior in Mexico. National data registries on mortality from the year 1970 to 2007 and cross-sectional surveys were used to analyze suicide mortality and suicidal behavior. The suicide rate grew 275% from 1970 to 2007. Suicide has been increasing among Mexicans 15-29 years old since 1970. In adults aged 18-29 years the lifetime prevalence of ideation was 9.7%, and attempt 3.8%. About 6,601,210 Mexicans had suicidal thoughts, 593,600 attempted suicide and 99,731 used some sort of medical service as a direct consequence of the latter in the year prior to the survey. Suicide and suicide-related behaviors are significant public health problems and, as such, actions are urgently required to identify and treat persons with suicidal thoughts, assess suicidal risk in patients with psychiatric disorders and implement population interventions.
Full Text Available Research was reviewed on whether self-report measures of religiosity were a protective factor against suicidal behaviors. It was found that scores on Francis’s measure of religiosity was negatively associated with non-lethal suicidal behavior (ideation and attempts, a protective effect. Similarly, it was found that intrinsic religiosity (but not extrinsic religiosity was negatively associated with non-lethal suicidal behaviors. However, these associations were weak. Research is needed on the issue whether counselors can use their patients’ religiosity to reduce the risk of dying by suicide.
Lynch, Frances L
Suicide is a leading cause of death in the U.S. and results in immense suffering and significant cost. Effective suicide prevention interventions could reduce this burden, but policy makers need estimates of health outcomes achieved by alternative interventions to focus implementation efforts. To illustrate the utility of health outcome models to help in achieving goals defined by the National Action Alliance for Suicide Prevention's Research Prioritization Task Force. The approach is illustrated specifically with psychotherapeutic interventions to prevent suicide reattempt in emergency department settings. A health outcome model using decision analysis with secondary data was applied to estimate suicide attempts and deaths averted from evidence-based interventions. Under optimal conditions, the model estimated that over 1 year, implementing evidence-based psychotherapeutic interventions in emergency departments could decrease the number of suicide attempts by 18,737, and if offered over 5 years, it could avert 109,306 attempts. Over 1 year, the model estimated 2,498 fewer deaths from suicide, and over 5 years, about 13,928 fewer suicide deaths. Health outcome models could aid in suicide prevention policy by helping focus implementation efforts. Further research developing more sophisticated models of the impact of suicide prevention interventions that include a more complex understanding of suicidal behavior, longer time frames, and inclusion of additional outcomes that capture the full benefits and costs of interventions would be helpful next steps. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.
Miller, David N.
Meeting a crucial need, this book distills the best current knowledge on child and adolescent suicide prevention into comprehensive guidelines for school-based practitioners. The author draws on extensive research and clinical experience to provide best-practice recommendations for developing schoolwide prevention programs, conducting risk…
Okamura, Tsuyoshi; Ito, Kae; Morikawa, Suimei; Awata, Shuichi
The purpose of this study is to investigate the frequency and correlates of suicidal behavior among homeless people in Japan. A face-to-face survey was conducted in two districts of Tokyo, Japan, with 423 subjects who resided on streets and riversides and in urban parks and stations (street homeless) or who were residents of shelters, cheap hotels, or welfare homes for homeless people (sheltered homeless). When questioned about suicidal ideation in the previous 2 weeks, 51 subjects (12.2% of valid responses) had a recurring wish to die, 29 (6.9%) had frequent thoughts of suicide, and 22 (5.3%) had made suicide plans. In addition, 11 (2.9%) subjects had attempted suicide in the previous 2 weeks and 74 (17.7%) reported that they had ever attempted suicide. In univariate logistic regression analyses, street homelessness, lack of perceived emotional social support, poor subjective health perception, visual impairment, pain, insomnia, poor mental well-being, and current depression were significantly associated with recurrent thoughts of suicide in the previous 2 weeks. Among these, current depression had the greatest significance. In multivariate logistic regression analyses after controlling for depression, street homelessness and lack of perceived emotional social support were significantly associated with recurrent thoughts of suicide in the previous 2 weeks. Comprehensive interventions including housing and social support as well as mental health services might be crucial as effective strategies for suicide prevention among homeless people.
Robinson, Jo; Rodrigues, Maria; Fisher, Steve; Bailey, Eleanor; Herrman, Helen
Suicide is a leading cause of death, particularly among young adults. The rapid growth of social media and its heavy use by young adults presents new challenges and opportunities for suicide prevention. Social media sites are commonly used for communicating about suicide-related behavior with others, which raises the possibility of using social media to help prevent suicide. However, the use of social media varies widely between different suicide prevention advocates. The role this type of intervention should play in a community's overall suicide prevention strategy remains a matter of debate. Explore the ways in which stakeholders use social media for suicide prevention and assess their views about the potential utility of social media as a suicide prevention tool. A 12-week stakeholder consultation that involved the online administration and completion of surveys by 10 individuals who conduct research about suicide and social media, 13 organizations that use social media for suicide prevention purposes, and 64 users of social media. Social media was seen as a useful means of delivering a range of suicide prevention activities. Respondents reported that the key benefits of social media were the opportunity to obtain emotional support from others, to express one's feelings, to talk to others with similar problems, and to provide help to others. The social media site believed to hold most potential for delivering suicide prevention activities was Facebook. There were concerns about potential risks of social media, but respondents felt the potential benefits outweighed the risks. Social media was recognized by different types of stakeholders as holding potential for delivering suicide prevention activities. More research is required to establish the efficacy and safety of potential social media-based interventions and ethical standards and protocols to ensure that such interventions are delivered safely need to be developed and implemented.
Beurs, D. de; Kirtley, O.; Kerkhof, A.; Portzky, G.; O'Connor, R.C.
In this editorial, we discuss how mobile phone technology has the potential to move the field forward in terms of understanding suicide risk as well as laying foundations for the development of effective treatments/interventions. We have focused on mobile health technology given the rapid growth of
Shadick, Richard; Akhter, Sarah
Because of a dearth of experience in preventing suicide in diverse student populations, Pace University developed a multicultural suicide prevention kit. This article details the process used to develop the kit. The rationale for approaching suicide prevention in a culturally competent manner is presented, and methods used to gain culture-specific…
Kalist, David E; Molinari, Noelle-Angelique M; Siahaan, Freddy
Little is known about the labor market outcomes of people who have attempted suicide or thought about suicide. We used micro-level data from the first wave of the National Epidemiologic Survey on Alcohol and Related Conditions 2001-2002 to examine the effects of suicidal behavior on income and employment. The data provide a representative sample of the U.S. population, with its primary purpose to provide information on alcohol use disorders for the civilian non-institutionalized population aged 18 and over. The data include employment, income, and other socioeconomic and demographic information on respondents. Since the survey included 43,093 people, the data include a large number of respondents who attempted suicide or thought about committing suicide. We estimated earnings regressions and logit and ordered logit employment regressions. We used methods of IV estimation as well as two stage linear probability models to address potential endogeneity of suicidal behavior while estimating regressions separately by sex, since there are significant differences in suicide rates, suicide attempts, and suicidal ideation between men and women. We find that suicide attempts and suicidal ideation are negatively related to personal income and the probability of employment. The effects differ by sex. Men and women who attempted suicide had mean earnings lower by 16 and 13 percent, respectively. This amount reflects the combined effect of suicidal behavior and mental illness. With instrumental variable regression, the magnitude of the effects becomes larger-for example, as much as 50 percent decrease in the income of males who attempted suicide. Thoughts of suicide negatively affect income but to a smaller extent. Logit and ordered logit regressions indicate that attempted suicide reduces the probability of fulltime employment by over 20 percentage points for men and approximately 17 percentage points for women. People who engaged in suicidal behavior reported significantly
Cha, Christine; Najmi, Sadia; Park, Jennifer; Finn, Christine; Nock, Matthew K.
A long-standing challenge for scientific and clinical work on suicidal behavior is that people often are motivated to deny or conceal suicidal thoughts. We proposed that people considering suicide would possess an objectively measurable attentional bias toward suicide-related stimuli, and that this bias would predict future suicidal behavior. Participants were 124 adults presenting to a psychiatric emergency department who were administered a modified emotional Stroop task and followed for si...
Wilcox, Holly C; Wyman, Peter A
Suicide is a public health problem that accounts for more than 1 million deaths annually worldwide. This article addresses evidence-based and promising youth suicide prevention approaches at the primary, secondary, and tertiary levels. Coordinated, developmentally timed, evidence-based suicide prevention approaches at all intervention levels are likely to reduce youth suicide. For most youth who die by suicide, there are opportunities for intervention before imminent risk develops. Current research in suicide prevention points to the value of investing in "upstream" universal interventions that build skills and resilience as well as policies that enable access to care and protection from lethal means. Copyright © 2016 Elsevier Inc. All rights reserved.
Nebhinani, Naresh; Mamta; Gaikwad, Achla D.; Tamphasana, L.
Background: Preventing suicide depends upon different health professionals’ knowledge regarding suicide, attitude toward suicide attempters, skills to assess and manage suicidal risk. Objectives: This study was aimed to assess the attitude of nursing students toward suicide prevention. Materials and Methods: 308 nursing students were recruited from the two institutions through total enumeration method. Attitude toward suicide prevention scale was administered. Study design was cross-sectional. Results: Majority were single females, from urban locality, who were pursuing BSc Nursing with the mean age of 20 years. Only minority had previous exposure to suicide prevention programs or workshops. Nearly half of the subjects had positive attitude toward working with suicidal patients. Again half of the subjects considered unemployment and poverty as main causes of suicide and were quite hopeless about it and they also perceived that most of the suicidal people would not reveal their suicidal plans to others. Conclusions: Merely half of the students had positive attitude toward working with suicidal patients. Hence, there is strong need to organize more educational and training programs on suicide prevention so that these budding health professionals could be more equipped and trained to manage these suicidal patients. PMID:25013311
Nebhinani, Naresh; Mamta; Gaikwad, Achla D; Tamphasana, L
Preventing suicide depends upon different health professionals' knowledge regarding suicide, attitude toward suicide attempters, skills to assess and manage suicidal risk. This study was aimed to assess the attitude of nursing students toward suicide prevention. 308 nursing students were recruited from the two institutions through total enumeration method. Attitude toward suicide prevention scale was administered. Study design was cross-sectional. Majority were single females, from urban locality, who were pursuing BSc Nursing with the mean age of 20 years. Only minority had previous exposure to suicide prevention programs or workshops. Nearly half of the subjects had positive attitude toward working with suicidal patients. Again half of the subjects considered unemployment and poverty as main causes of suicide and were quite hopeless about it and they also perceived that most of the suicidal people would not reveal their suicidal plans to others. Merely half of the students had positive attitude toward working with suicidal patients. Hence, there is strong need to organize more educational and training programs on suicide prevention so that these budding health professionals could be more equipped and trained to manage these suicidal patients.
Foo, Xiang Yi; Alwi, Muhd Najib Mohd; Ismail, Siti Irma Fadhillah; Ibrahim, Normala; Osman, Zubaidah Jamil
The variation in suicide patterns across ethnic groups with different religious background is a puzzling social phenomenon. This study sought to examine the impact of religious commitment and attitudes toward suicide on suicidal behaviors of college students across major ethnic and religious groups in a multicultural society of Malaysia. A total of 139 college students completed Religious Commitment Inventory-10, Attitudes Toward Suicide Scale, and Suicidal Behavior Questionnaire-Revised. Findings showed significant discrepancies in attitudes toward suicide, but not suicidal behaviors across ethnic and religious groups. Suicide acceptance significantly affected suicidal behaviors as well. Although religious commitment is not associated with suicidal behaviors, its deviation is reflected in students' acceptance of suicide. Additionally, college students' suicide risk, lifetime, and recent suicide ideation, as well as their likelihood of future suicide attempt can be associated with their acceptance of suicide. The influence of attitudes toward suicide and religion, therefore, should be taken into consideration while implementing suicide prevention programs as it helps shape the norms about suicide among youths.
Grossman, Arnold H.; Park, Jung Yeon; Russell, Stephen T.
The interpersonal psychological theory of suicide (IPTS) was used to examine suicidal thoughts and behaviors among 129 transgender and gender nonconforming (TGNC) youth. Youth were categorized according to their gender identities: female-to-male (FTM), male-to-female (MTF), female-to-different-gender (FTDG), and male-to-different gender (MTDG). Higher percentages of suicidal ideation were reported by FTDG and FTM youth; and higher percentages of suicide attempts by FTDG and MTDG youth. Perceived burdensomeness and thwarted belongingness were significantly related to suicidal ideation and/or suicide attempts. Experiences of painful, provocative and harmful events and acquired capability significantly predicted suicide attempts. The findings support IPTS in explaining suicidal behaviors among TGNC youth. Implications for prevention and intervention efforts are discussed. PMID:28344728
Jacob, Nina; Scourfield, Jonathan; Evans, Rhiannon
While concerns abound regarding the impact of the Internet on suicidal behaviors, its role as a medium for suicide prevention remains underexplored. The study examines what is currently known about the operation and effectiveness of Internet programs for suicide and self-harm prevention that are run by professionals. Systematic searches of scholarly databases and suicide-related academic journals yielded 15 studies that presented online prevention strategies. No professional programs with a sole focus on nonsuicidal self-harm were identified, thus all studies reviewed focused on suicide prevention. Studies were predominantly descriptive and summarized the nature of the strategy and the target audience. There was no formal evaluation of program effectiveness in preventing suicide. Studies either presented strategies that supported individuals at risk of suicide (n = 8), supported professionals working with those at risk (n = 6), or attempted to improve website quality (n = 1). Although the Internet increasingly serves as an important medium for suicidal individuals, and there is concern about websites that both promote and encourage suicidal activity, there is lack of published evidence about online prevention strategies. More attention is needed in the development and evaluation of such preventative approaches.
... Settings Behavioral Health Care Inpatient Mental Health Outpatient Mental Health Substance Abuse Treatment ... Emergency Departments Primary Care Justice System Adult Justice System Juvenile Justice ...
Bryan, Craig J.; Dhillon-Davis, Luther E.; Dhillon-Davis, Kieran K.
In light of continuing concerns about iatrogenic effects associated with suicide prevention efforts utilizing video-based media, the impact of emotionally-charged videos on two vulnerable subgroups--suicidal viewers and suicide survivors--was explored. Following participation in routine suicide education as a part of the U.S. Air Force Suicide…
Ways of conceptualizing suicide prevention are reviewed briefly, and the preventive model: Universal, Selected, and Indicated prevention (USI) is chosen as the structure for the literature review, and the discussion. Universal preventive interventions are directed toward entire population; select...
Lahoz, Titia; Hvid, Marianne; Wang, August G
BACKGROUND: The Amager Project was initiated as a quasi-experimental study in 2005, based on an active outreach suicide preventive intervention inspired by the Norwegian Baerum Model. A 1-year follow-up study was conducted as a randomized controlled trial showing that this kind of active outreach...... to suicide attempters had a significant preventive effect on the prevalence of suicide attempts and significantly reduced the number of patients repeating a suicide attempt. AIMS: In this 5-year RCT follow-up the aim was to investigate the sustainability of the suicide preventive effect shown in a 1-year...... follow-up study. METHOD: One hundred and thirty-three suicide attempters were included at this 5-year follow-up RCT study at Copenhagen University Hospital, Amager, and randomized to a rapid outreach suicide preventive intervention (OPAC) or TAU. RESULTS: Offering OPAC intervention to patients after...
Draper, Brian M
Despite a general decline in late life suicide rates over the last 30 years, older people have the highest rates of suicide in most countries. In contrast, non-fatal suicidal behaviour declines with age and more closely resembles suicide than in younger age groups. There are difficulties in the detection and determination of pathological suicidal ideation in older people. Multiple factors increase suicide risk ranging from distal early and mid-life issues such as child abuse, parental death, substance misuse and traumatic life experiences to proximal precipitants in late life such as social isolation and health-related concerns. Clinical depression is the most frequently identified proximal mental health concern and in many cases is a first episode of major depression. Recent studies have identified changes on neuroimaging and neurocognitive factors that might distinguish suicidal from non-suicidal depression in older people. Strategies for suicide prevention need to be 'whole of life' and, as no single prevention strategy is likely to be successful alone, a multi-faceted, multi-layered approach is required. This should include optimal detection and management of depression and of high risk individuals as available evidence indicates that this can reduce suicidal behaviour. How best to improve the quality of depression management in primary and secondary care requires further research. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Boonstra, T.W.; Larsen, M.E.; Cummins, N.; O'Dea, B.; Tighe, J.; Nicholas, J.; Shand, F.; Epps, J.; Christensen, H.
Suicide is one of the leading causes of death globally, and is notably a significant cause of death amongst young people. A suicide outcome is a complex combination of personal, social, and health factors, and therefore suicide prevention is a challenge, requiring a systems approach incorporating
After her son died by suicide, Theodora Schiro vowed to raise awareness and teach others about depression and suicide. In this article, Schiro (a former teacher and principal) explains how educators can detect warning signs, devise preventative programs, and fight the stigma associated with suicide.
on restrictions in firearms and carbon monoxide gas. At the selective prevention level, a review of risk of suicide in homelessness and schizophrenia and risk factors for suicide in schizophrenia is conducted and possible interventions are mentioned together with the evidence for their effect. Suicide rate...
Pirruccello, Linda M
Suicide is the third leading cause of death for adolescents and young people in the United States. The etiology of suicide in this population has eluded policy makers, researchers, and communities. Although many suicide prevention programs have been developed and implemented, few are evidence-based in their effectiveness in decreasing suicide rates. In one northern California community, adolescent suicide has risen above the state's average. Two nurses led an effort to develop and implement an innovative grassroots community suicide prevention project targeted at eliminating any further teen suicide. The project consisted of a Teen Resource Card, a community resource brochure targeted at teens, and education for the public and school officials to raise awareness about this issue. This article describes this project for other communities to use as a model. Risk and protective factors are described, and a comprehensive background of adolescent suicide is provided.
Erlangsen, Annette; Nordentoft, Merete; Conwell, Yeates
BACKGROUND: The number of older adults is growing rapidly. This fact, combined with the high rates of suicide in later life, indicates that many more older adults will die by their own hands before rigorous trials can be conducted to fully understand the best approaches to prevent late life suicide....... AIMS: To disseminate key considerations for interventions addressing senior suicidal behavior. METHODS: An international expert panel has reviewed and discussed key considerations for interventions against suicide in older adults based on existing evidence, where available, and expert opinion. RESULTS...
Robinson, M; Braybrook, D; Robertson, S
Purpose – The purpose of this paper is to report findings from a formative evaluation of a suicide prevention public awareness campaign – Choose Life, North Lanarkshire. The focus is on preventing male suicide. The paper explores how the public campaign supports a co-ordinated and community-based direction for suicide prevention work, and examines how good practice can be identified, spread, and sustained. Design/methodology/approach – The paper draws on data collected from March to November ...
Larsen, Mark E; Cummins, Nicholas; Boonstra, Tjeerd W; O'Dea, Bridianne; Tighe, Joe; Nicholas, Jennifer; Shand, Fiona; Epps, Julien; Christensen, Helen
Suicide is one of the leading causes of death globally, and is notably a significant cause of death amongst young people. A suicide outcome is a complex combination of personal, social, and health factors, and therefore suicide prevention is a challenge, requiring a systems approach incorporating public health strategies, screening at-risk individuals, targeted interventions, and follow-up for suicide survivors and those bereaved by suicide. Engineering practice has been implicated in the hindrance of the adoption of suicide prevention strategies, such as installing safety barriers at the Golden Gate Bridge, however technological developments offer new opportunities in suicide prevention, and the potential to reduce the number of deaths by suicide. We present an overview of current technological developments which are facilitating research in the field of suicide prevention, including multiple modes of screening such as network analysis of mobile-phone collected connectivity data, automatic detection of suicidality from social media content, and crisis detection from acoustic variability in speech patterns. The current field of mhealth apps for suicide prevention is assessed, and an innovative app for an Indigenous population is presented. From this overview, future challenges - technical and ethical - are discussed.
Department of Veterans Affairs — The VA's Veteran Health Administration, in support of the Open Data Initiative, is providing the Veterans Affairs Suicide Prevention Synthetic Dataset (VASPSD). The...
A comprehensive approach to suicide prevention is needed to effectively address the problem of teen suicide. This article describes three levels of prevention (primary prevention, intervention, and postvention) and provides practical strategies that community, mental, and social health professionals can use within each level to help prevent…
Fredriksen, Kristin J; Schoeyen, Helle K; Johannessen, Jan O; Walby, Fredrik A; Davidson, Larry; Schaufel, Margrethe A
This study investigated how severely depressed individuals experienced the relationship between psychotic symptoms and suicidal ideation and behavior. Semi-structured qualitative interviews were conducted with a purposive sample of nine inpatients from a psychiatric university hospital between September 2012 and May 2013 fulfilling diagnostic criteria for a psychotic depressive episode as part of a unipolar or bipolar disorder. Analysis was conducted using systematic text condensation. Participants experienced (1) being directed to perform impulsive potentially fatal actions, (2) feeling hounded to death, (3) becoming trapped in an inescapable darkness, and (4) being left bereft of mental control. They described how impulsivity directed by delusions and hallucinations resulted in unpredictable actions with only moments from decision to conduct. Suicide was seen as an escape not only from life problems but also from psychotic experiences and intense anxiety. Participants reported being in a chaotic state, unable to think rationally or anticipate the consequences of their actions. Their ability to identify and communicate psychotic symptoms and suicidal ideation and behavior was compromised, leaving them to struggle alone with these terrifying experiences. Suicide risk assessments based on verbal reports from individuals with psychotic depression may not always be valid due to potential impulsivity and underreporting of suicidal ideation. It may be important for clinicians to explore the delusional content of such patients' experiences to assess the possibility of suicide as a result of shame, guilt, remorse, or altruistic intentions to save others from harm.
Conejero, Ismael; Lopez-Castroman, Jorge; Giner, Lucas; Baca-Garcia, Enrique
Suicidal behavior and its prevention constitute a major public health issue. Etiology of suicidal behavior is multifactorial. Whereas current research is mostly focused on clinical and biological risk factors, the sociodemographic risk factors for suicidal behavior, first highlighted by Durkheim, have received less attention. Besides the well-known impact of age and gender, sociodemographic variables such as marital and parental status, education, occupation, income, employment status, religion, migration or minority status, and sexual orientation are repeatedly reported to play an important role in suicidal behavior. This narrative review aimed to summarize recent research on sociodemographic risk factors for suicidal behavior and to elicit possible implications for suicide prevention.
; selective interventions are directed toward individuals who are at greater risk for suicidal behaviour; and indicated preventions are targeted at individuals who have already begun self-destructive behaviour. On the universal prevention level, an overview of the literature is presented with focus...... on restrictions in firearms and carbon monoxide gas. At the selective prevention level, a review of risk of suicide in homelessness and schizophrenia and risk factors for suicide in schizophrenia is conducted and possible interventions are mentioned together with the evidence for their effect. Suicide rate......Ways of conceptualizing suicide prevention are reviewed briefly, and the preventive model: Universal, Selected, and Indicated prevention (USI) is chosen as the structure for the literature review, and the discussion. Universal preventive interventions are directed toward entire population...
Benard, V; Vaiva, G; Masson, M; Geoffroy, P A
Bipolar disorder (BD) is a severe and recurrent psychiatric disorder. The severity of prognosis in BD is mainly linked to the high rate of suicide in this population. Indeed, patients with BD commit suicide 20 to 30 times more frequently than the general population, and half of the BD population with an early age of onset have a history of suicide attempt. International therapeutic guidelines recommend lithium (Li) as the first-line treatment in BD for its prophylactic action on depressive or manic episodes. In addition, Li is the only mood stabilizer that has demonstrated efficacy in suicide prevention. This effect of Li is unfortunately often unknown to psychiatrists. Thus, this review aims to highlight evidence about the preventive action of Li on suicide in BD populations. We conducted a literature search between April 1968 and August 2014 in PubMed database using the following terms: "lithium" AND "suicide" OR "suicidality" OR "suicide attempt". As confirmed by a recent meta-analysis, many studies show that Li has a significant effect on the reduction of suicide attempts and deaths by suicide in comparison to antidepressants or other mood-stabilisers in BD populations. Studies have demonstrated that long-term treatment with Li reduces suicide attempts by about 10% and deaths by suicide by about 20%. The combination of Li and an antidepressant could reduce suicidal behaviours by reducing suicidal ideation prior to depressive symptoms. It appears crucial for Li efficacy in suicide prevention to maintain the Li blood concentrations in the efficient therapeutic zone and to instate long-term Li treatment. The "impulsive-aggressive" endophenotype is associated with suicide in BD. The specific action of Li on the 5-HT serotoninergic system could explain the specific anti-suicidal effects of Li via the modulation of impulsiveness and aggressiveness. Furthermore, genetic variants of the glycogen synthase kinase 3α/β (GSK3α and β; proteins inhibited by Li) seem to
Keller, Sarah N; Wilkinson, Tim
This study examined whether a community-based suicide prevention project could increase willingness to seek professional help for suicidal ideation among eastern Montana youth. Online surveys were administered at baseline (N = 224) and six months post-test (N = 217) consisting of the Risk Behavior Diagnosis Scale (RBD), self-report questions on suicidality, willingness to engage with suicide prevention resources, and willingness to communicate with peers, family members, teachers or counselors about suicide. A comparison of means within groups from pre- to post-test showed increases in self-efficacy for communicating about suicidal concerns with a teacher, school counselor or social worker; increases in self-efficacy for helping others; and increases in response-efficacy of interpersonal communication about suicide with a teacher, school counselor or social worker. Young adults need to be willing and able to intervene in life-threatening situations affecting their peers. In step with narrative empowerment education, personal experiences can be used to communicatively reduce peer resistance to behavior change. Health communicators tend to rely on overly didactic education and awareness-raising when addressing suicide prevention. This research shows the importance of direct and personal forms of influence advocated by social marketing professionals.
Beth S. Brodsky
Full Text Available Suicide is reaching epidemic proportions, with over 44,000 deaths by suicide in the US, and 800,000 worldwide in 2015. This, despite research and development of evidence-based interventions that target suicidal behavior directly. Suicide prevention efforts need a comprehensive approach, and research must lead to effective implementation across public and mental health systems. A 10-year systematic review of evidence-based findings in suicide prevention summarized the areas necessary for translating research into practice. These include risk assessment, means restriction, evidence-based treatments, population screening combined with chain of care, monitoring, and follow-up. In this article, we review how suicide prevention research informs implementation in clinical settings where those most at risk present for care. Evidence-based and best practices address the fluctuating nature of suicide risk, which requires ongoing risk assessment, direct intervention and monitoring. In the US, the National Action Alliance for Suicide Prevention has put forth the Zero Suicide (ZS Model, a framework to coordinate a multilevel approach to implementing evidence-based practices. We present the Assess, Intervene and Monitor for Suicide Prevention model (AIM-SP as a guide for implementation of ZS evidence-based and best practices in clinical settings. Ten basic steps for clinical management model will be described and illustrated through case vignette. These steps are designed to be easily incorporated into standard clinical practice to enhance suicide risk assessment, brief interventions to increase safety and teach coping strategies and to improve ongoing contact and monitoring of high-risk individuals during transitions in care and high risk periods.
Harris, Keith M; Starcevic, Vladan; Ma, Jing; Zhang, Wei; Aboujaoude, Elias
This study investigated whether several psychopathology variables, including suicidality, could predict the time people spend using the internet (hours online). Next, we examined a specific at-risk population (suicidal individuals) by their online behaviors, comparing suicidal individuals who went online for suicide-related purposes with suicidal individuals who did not go online for suicide-related purposes. An anonymous online sample of 713 (aged 18-71) reported hours online, psychiatric histories, and completed several standardized scales. After accounting for age and education, hierarchical regression modeling showed that the assessed psychopathology variables, including suicidality, did not explain significant variance in hours online. Hours online were better predicted by younger age, greater willingness to develop online relationships, higher perceived social support, higher curiosity, and lower extraversion. Suicidal participants, who did or did not go online for suicide-related purposes, did not differ on hours online. Multiple regression modeling showed that those who went online for suicide-related purposes were likely to be younger, more suicidal, and more willing to seek help from online mental health professionals. These findings revealed that hours online are not a valid indicator of psychopathology. However, studying online behaviors of specific at-risk groups could be informative and useful, including for suicide prevention efforts. Copyright © 2017. Published by Elsevier B.V.
Mokkenstorm, Jan K; Eikelenboom, Merijn; Huisman, Annemiek; Wiebenga, Jasper; Gilissen, Renske; Kerkhof, Ad J F M; Smit, Johannes H
Recognizing the importance of digital communication, major suicide prevention helplines have started offering crisis intervention by chat. To date there is little evidence supporting the effectiveness of crisis chat services. To evaluate the reach and outcomes of the 113Online volunteer-operated crisis chat service, 526 crisis chat logs were studied, replicating the use of measures that were developed to study telephone crisis calls. Reaching a relatively young population of predominantly females with severe suicidality and (mental) health problems, chat outcomes for this group were found to be comparable to those found for crisis calls to U.S. Lifeline Centers in 2003-2004, with similar but not identical associations with specific helpers' styles and attitudes. Our findings support a positive effect of the 113Online chat service, to be enhanced by practice standards addressing an apparent lack of focus on the central issue of suicidality during chats, as well as by the development of best practices specific for online crisis intervention. © 2016 The American Association of Suicidology.
Rihmer, Zoltán; Kántor, Zsuzsa; Rihmer, Annamária; Seregi, Krisztina
Since suicide is a very complex, multicausal human behaviour, its prevention should also be complex. The prediction of suicide is very difficult at the level of the general population, but it is much easier among patients with certain mental disorders, because most persons who kill themselves have diagnosable and treatable psychiatric disorders. This article reviews the most important biological and non-biological suicide prevention strategies.
Full Text Available Abstract Background Suicide is a leading cause of death for children and youth in the United States. Although school based programs have been the principal vehicle for youth suicide prevention efforts for over two decades, few have been systematically evaluated. This study examined the effectiveness of the Signs of Suicide (SOS prevention program in reducing suicidal behavior. Methods 4133 students in 9 high schools in Columbus, Georgia, western Massachusetts, and Hartford, Connecticut were randomly assigned to intervention and control groups during the 2001–02 and 2002–03 school years. Self-administered questionnaires were completed by students in both groups approximately 3 months after program implementation. Results Significantly lower rates of suicide attempts and greater knowledge and more adaptive attitudes about depression and suicide were observed among students in the intervention group. Students' race/ethnicity, grade, and gender did not alter the impact of the intervention on any of the outcomes assessed in this analysis. Conclusion This study has confirmed preliminary analysis of Year 1 data with a larger and more racially and socio-economically diverse sample. SOS continues to be the only universal school-based suicide prevention program to demonstrate significant effects of self-reported suicide attempts in a study utilizing a randomized experimental design. Moreover, the beneficial effects of SOS were observed among high school-aged youth from diverse racial/ethnic backgrounds, highlighting the program's utility as a universal prevention program. Trial registration clinicaltrials.gov NCT000387855.
Glenn, Catherine R; Nock, Matthew K
Aspirational Goal 3 of the National Action Alliance for Suicide Prevention's Research Prioritization Task Force is to predict who is at risk for attempting suicide in the near future. Despite decades of research devoted to the study of risk and protective factors for suicide and suicidal behavior, surprisingly little is known about the short-term prediction of these behaviors. In this paper, we propose several questions that, if answered, could improve the identification of short-term, or imminent, risk for suicidal behavior. First, what factors predict the transition from suicidal thoughts to attempts? Second, what factors are particularly strong predictors of making this transition over the next hours, days, or weeks? Third, what are the most important objective markers of short-term risk for suicidal behavior? And fourth, what method of combining information about risk and protective factors yields the best prediction? We propose that the next generation of research on the assessment and prediction of suicidal behavior should shift, from cross-sectional studies of bivariate risk and protective factors, to prospective studies aimed at identifying multivariate, short-term prediction indices, examining methods of synthesizing this information, and testing the ability to predict and prevent suicidal events. Copyright © 2014. Published by Elsevier Inc.
Harris, Keith M; McLean, John P; Sheffield, Jeanie
To assist suicide prevention we need a better understanding of how suicidal individuals act in their environment, and the online world offers an ideal opportunity to examine daily behaviors. This anonymous survey (N = 1,016) provides first-of-its-kind empirical evidence demonstrating suicide-risk people (n = 290) are unique in their online behaviors. Suicidal users reported more time online, greater likelihood of developing online personal relationships, and greater use of online forums. In addition, suicide-risk women reported more time browsing/surfing and social networking. The authors conclude that suicide prevention efforts should respond to suicide-risk users' greater demands for online interpersonal communications.
Diagle, M.S.; Daniel, A.E.; Dear, G.E.; Frottier, P.; Hayes, H.M.; Kerkhof, A.J.F.M.; Konrad, N.; Liebling, A.; Sarchiapone, M.
The International Association for Suicide Prevention created a Task Force on Suicide in Prisons to better disseminate the information in this domain. One of its objectives was to summarize suicide-prevention activities in the prison systems. This study of the Task Force uncovered many differences
Wong, Paul W. C.; Liu, Patricia M. Y.; Chan, Wincy S. C.; Law, Y. W.; Law, Steven C. K.; Fu, King-Wa; Li, Hana S. H.; Tso, M. K.; Beautrais, Annette L.; Yip, Paul S. F.
An integrative suicide prevention program was implemented to tackle an outbreak of visitor charcoal burning suicides in Cheung Chau, an island in Hong Kong, in 2002. This study evaluated the effectiveness of the program. The numbers of visitor suicides reduced from 37 deaths in the 51 months prior to program implementation to 6 deaths in the 42…
Konrad, N.; Daigle, M.S.; Daniel, A.E.; Dear, G.E.; Frottier, P.; Hayes, L.M.; Kerkhof, A.J.F.M.; Liebling, A.; Sarchiapone, M.
In 2000 the Department of Mental Health of the World Health Organization (WHO) published a guide named Preventing Suicide. A Resource for Prison Officers as part of the WHO worldwide initiative for the prevention of suicide. In 2007 there are new epidemiological data on prison suicide, a more
Predicting and preventing suicide represent very difficult challenges for clinicians. The awareness of adolescent suicide as a major social and medical problem has increased over the past years. However, many health care professionals who have frequent contact with adolescents are not sufficiently trained in suicide evaluation techniques and approaches to adolescents with suicidal behavior. Suicide prevention efforts among adolescents are restricted by the fact that there are five key problems related to the evaluation and management of suicidality in adolescents: 1. Many clinicians underestimate the importance of the problem of adolescent suicidal behavior and underestimate its prevalence. 2. There is a misconception that direct questioning of adolescents about suicidality is sufficient to evaluate suicide risk. 3. Another misconception is that adolescents with non-psychiatric illnesses do not need to be evaluated for suicidality. 4. Many clinicians do not know about or underestimate the role of contagion in adolescent suicidal behavior. 5. There is a mistaken belief that adolescent males are at lower suicide risk than adolescent females. Educating medical professionals and trainees about the warning signs and symptoms of adolescent suicide and providing them with tools to recognize, evaluate, and manage suicidal patients represent a promising approach to adolescent suicide prevention.
Robert, Anna; Suelves, Josep Maria; Armayones, Manuel; Ashley, Sivakamy
Suicidal behavior is a common and severe health problem around the world. Internet use has been related to an increase in suicidal behaviors, but few studies have focused on the potential benefits of Internet use for preventing self-harm and suicide. We reviewed the existing literature on the relationship between suicide and Internet use. The accessibility of suicide-related information on the Internet seems to have an impact on the incidence of suicide behaviors. However, the Internet is useful for linking people who feel lonely or isolated, and it provides access to suicide prevention information and resources. The Internet can influence vulnerable people to attempt suicide, but it can also be used to prevent self-harm and suicide. We propose some efforts that can be made in this preventive line.
Despite a large volume of research literature on suicide, the approach to suicide prevention is still firmly based on a medical model. Recently, the Chief Coroner in New Zealand expressed the view that current techniques have failed to reduce the suicide rate and a new approach is needed. However, the call for a new approach is often interpreted as disparities in access to mental health services so resources are directed to increase public access to them. Current evidence suggests that persis...
Abrutyn, Seth; Mueller, Anna S.
Though Durkheim argued that strong social relationships protect individuals from suicide, we posit that these relationships have the potential to increase individuals’ vulnerability when they expose them to suicidality. Using three waves of data from the National Longitudinal Study of Adolescent Health, we evaluate whether new suicidal thoughts and attempts are in part responses to exposure to the suicide attempts of role models, specifically friends and family. We find that the suicide attempts of role models do in fact trigger new suicidal thoughts and in some cases attempts, even after significant controls are introduced. Moreover, we find that these effects fade with time, that girls are more vulnerable to them than boys, and that the relationship to the role model—for teenagers at least—matters. Friends appear to be more salient role models for both boys and girls. Our findings suggest that exposure to suicidal behaviors in significant others may teach individuals new ways to deal with emotional distress, namely by becoming suicidal. This reinforces the idea that the structure – and content – of social networks conditions their role in preventing suicidality. Specifically, social ties can be conduits of not just social support, but also anti-social behaviors, like suicidality. PMID:26069341
Abrutyn, Seth; Mueller, Anna S
Though Durkheim argued that strong social relationships protect individuals from suicide, we posit that these relationships have the potential to increase individuals' vulnerability when they expose them to suicidality. Using three waves of data from the National Longitudinal Study of Adolescent Health, we evaluate whether new suicidal thoughts and attempts are in part responses to exposure to the suicide attempts of role models, specifically friends and family. We find that the suicide attempts of role models do in fact trigger new suicidal thoughts and in some cases attempts, even after significant controls are introduced. Moreover, we find that these effects fade with time, that girls are more vulnerable to them than boys, and that the relationship to the role model-for teenagers at least-matters. Friends appear to be more salient role models for both boys and girls. Our findings suggest that exposure to suicidal behaviors in significant others may teach individuals new ways to deal with emotional distress, namely by becoming suicidal. This reinforces the idea that the structure - and content - of social networks conditions their role in preventing suicidality. Specifically, social ties can be conduits of not just social support, but also anti-social behaviors, like suicidality.
Michael A. Dawes
Full Text Available Adolescent suicidal behaviors and substance use are disturbingly common. Research suggests overlap of some of the etiological mechanisms for both adolescent suicidal behavior and substance use, yet clear understanding of the complex relations between these behaviors and their causal underpinnings is lacking. A growing body of evidence and a diathesis model (Mann et al. 1999; Mann, 2003 highlight the importance of impulse control as a proximal risk factor for adolescent suicidal and substance use behaviors. This literature review extends current theory on the relationships between adolescent suicidal behavior and substance use by: (1 examining how, when, and to what extent adolescent development is affected by poor impulse control, stressful life events, substance use behavior, and biological factors; (2 presenting proposed causal mechanisms by which these risk factors interact to increase risk for suicidal behaviors and substance use; and (3 proposing specific new hypotheses to extend the diathesis model to adolescents at risk for suicide and substance use. More specifically, new hypotheses are presented that predict bidirectional relationships between stressful life events and genetic markers of 5-HT dysregulation; substance use behavior and impulsivity; and substance use behavior and suicide attempts. The importance of distinguishing between different developmental trajectories of suicidal and substance use behaviors, and the effects of specific risk and protective mechanisms are discussed. Use of new statistical approaches that provide for the comparison of latent growth curves and latent class models is recommended to identify differences in developmental trajectories of suicidal behavior and substance use. Knowledge gained from these prospective longitudinal methods should lead to greater understanding on the timing, duration, and extent to which specific risk and protective factors influence the outcomes of suicidal behavior and substance
Full Text Available Soo-Hyun Joo, Jong-Hyun Jeong, Seung-Chul HongDepartment of Psychiatry, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, KoreaAbstract: Abnormalities in thyroid function are associated with many psychiatric symptoms. We present a report of a 15-year-old girl who was admitted to the psychiatry inpatient unit with symptoms of suicidal behavior, irritability, and impulsivity. One year previously, she had become more short-tempered, and had started to cut her wrists impulsively. Laboratory tests revealed subclinical hyperthyroidism. She was treated with anxiolytic and antithyroid drugs, and her suicidal ideation and irritability resolved. This case demonstrates that subclinical hyperthyroidism can be associated with suicidal behavior as well as overt hyperthyroidism. Early intervention is required to prevent suicidal behavior in patients with subclinical hyperthyroidism.Keywords: suicidal behavior, subclinical hyperthyroidism, anxiolytics
Oquendo, Maria A; Dragatsi, Dianna; Harkavy-Friedman, Jill; Dervic, Kanita; Currier, Dianne; Burke, Ainsley Keller; Grunebaum, Michael F; Mann, J John
Latinos appear to be relatively protected against suicidal behavior, but the factors that mediate this effect are not known. Some protective factors may be related to cultural constructs that provide a buffer against suicidal behavior in the face of psychiatric illness. We sought to determine whether the Reasons for Living Inventory (RFLI) might capture protective factors against suicidal behavior in Latinos and non-Latinos. Patients with major depression, bipolar disorder, or schizophrenia were interviewed regarding their depressive symptomatology and lifetime history of suicidal behavior. The RFLI, which measures protective factors against suicidal acts, was also administered. Multivariate analyses were used to assess the relationship between suicide measures, ethnicity, and selected clinical and demographic variables. Although Latinos and non-Latinos did not differ significantly in attempter status (attempter/nonattempter), number of attempts, or suicide intent, Latinos reported significantly less suicidal ideation and made less lethal attempts. On the RFLI, Latinos scored significantly higher on subscales regarding survival and coping beliefs, responsibility to family, and moral objections to suicide, possibly reflective of cultural norms endorsed by Latino groups. Multivariate analyses suggested that although being Latino was independently associated with less suicidal ideation, other suicidal behaviors held a stronger relationship to moral objections to suicide and survival and coping skills than to ethnicity. Self-identification as Latino may be associated with espousing cultural constructs that mediate protective effects against suicidal behavior. Constructs identified in the RFLI may protect Latinos from acting on suicidal thoughts, affecting moral objections to suicide and survival and coping beliefs. Further studies to elucidate the impact of these factors on suicidal behavior and their relationship to specific cultural constructs would be of interest.
Full Text Available Abstract Background To respond to the rapid surge in the incidence of suicide in Japan, which appears to be an ongoing trend, the Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP have launched a multimodal community-based suicide prevention program, NOCOMIT-J. The primary aim of this study is to examine whether NOCOMIT-J is effective in reducing suicidal behavior in the community. Methods/DesignThis study is a community intervention trial involving seven intervention regions with accompanying control regions, all with populations of statistically sufficient size. The program focuses on building social support networks in the public health system for suicide prevention and mental health promotion, intending to reinforce human relationships in the community. The intervention program components includes a primary prevention measures of awareness campaign for the public and key personnel, secondary prevention measures for screening of, and assisting, high-risk individuals, after-care for individuals bereaved by suicide, and other measures. The intervention started in July 2006, and will continue for 3.5 years. Participants are Japanese and foreign residents living in the intervention and control regions (a total of population of 2,120,000 individuals. Discussion The present study is designed to evaluate the effectiveness of the community-based suicide prevention program in the seven participating areas. Trial registration UMIN Clinical Trials Registry (UMIN-CTR UMIN000000460.
Krysinska, Karolina; Lester, David; Lyke, Jennifer; Corveleyn, Jozef
Despite the progress of positive psychology, current knowledge regarding suicide protective factors is limited. Trait gratitude (a tendency to experience gratitude in daily life) may protect against suicidal ideation and behavior. The study tested a model of causal effects among gratitude, religiosity, reasons for living, coping, and social support as predictors of suicidal ideation, suicide threats, and suicide attempts after controlling for depression and stressful life events. A sample of 165 college students were administered measures of gratitude, religiosity, reasons for living, social support, coping skills, stress, and depression. The study assessed lifetime and current suicidal ideation as well as lifetime suicide threat and attempt. Both gratitude and religiosity, along with social support, coping skills, and reasons for living, correlated negatively with prior suicidal ideation, but not with prior attempted suicide. After controlling for risk factor (depression and stress), the impact of gratitude and religiosity was no longer statistically significant. Further research could help understand the role of positive emotions and human strengths, such as gratitude, in preventing and alleviating suicidal ideation and behavior.
Pearson, Veronica; Phillips, Michael R.; He, Fengsheng; Ji, Huiyu
Reports on a sample of 147 young women living in rural areas in China who had attempted suicide. The women's suicidal behavior was characterized by high levels of impulsivity and low rates of mental illness, including depression. Detailed suggestions are made about ways to implement suicide prevention strategies within the particular social and…
Blaauw, E.; Winkel, F.W.; Kerkhof, A.J.F.M.
Relationships between bullying features and suicidal behavior of inmates were examined. The files of 95 suicide victims in jails and prisons in the Netherlands were examined for reports of bullying. In addition, 221 nonsuicidal jail inmates and 53 suicidal jail inmates were interviewed. The files of
Goldston, David B.; Molock, Sherry Davis; Whitbeck, Leslie B.; Murakami, Jessica L.; Zayas, Luis H.; Hall, Gordon C. Nagayama
Ethnic groups differ in rates of suicidal behaviors among youths, the context within which suicidal behavior occurs (e.g., different precipitants, vulnerability and protective factors, and reactions to suicidal behaviors), and patterns of help-seeking. In this article, the authors discuss the cultural context of suicidal behavior among African…
Greening, Leilani; Stoppelbein, Laura; Luebbe, Aaron
Given that parenting practices have been linked to suicidal behavior in adolescence, examining the moderating effect of parenting styles on suicidal behavior early in development could offer potential insight into possible buffers as well as directions for suicide prevention and intervention later in adolescence. Hence, the moderating effects of…
In Japan, a national countermeasure has been forwarded since the enactment of the Basic Act on Suicide Countermeasures in 2006 and the Comprehensive Suicide Prevention Initiative in 2007. The distinctive policy of the Japanese countermeasure is expressed as the word, "comprehensive," which means that suicide prevention may not only be carried out only by mental health measures but also by comprehensive measures including chance of administrative practices. This policy is proper, although mental health measures appear to be too simple inclining to psychiatric treatments for the classic type of "depression" by a pharmacotherapy. The authors have insisted that mental health measures including psychiatric treatments are also required to be more comprehensive. This paper describes that benzodiazepine (BZ)-abuse problems including overdosing by suicidal intents have got worse recently as psychiatric clinics have increased and most of BZ abusers obtain the abused drugs form psychiatrists. This current situation indicates that pharmacists need to monitor psychiatrists' prescribing behavior and qualities of psychiatric treatment is required to be refined, suggesting pharmacists may be one of the "Gate Keeper," as supporting resources for suicide prevention. Additionally, this paper explained that basic attitudes and responses acquired by pharmacists as a supporter for suicide prevention.
Full Text Available Despite a large volume of research literature on suicide, the approach to suicide prevention is still firmly based on a medical model. Recently, the Chief Coroner in New Zealand expressed the view that current techniques have failed to reduce the suicide rate and a new approach is needed. However, the call for a new approach is often interpreted as disparities in access to mental health services so resources are directed to increase public access to them. Current evidence suggests that persisting with depression and mental illness as a rationale for suicide prevention is unwise and is highly politicised. For example, over the last decade or so, despite a sustained awareness campaign on depression and mental illness and the doubling of prescriptions for anti-depressants, suicide rates maintained an increasing trend over the same period. It is argued that a new approach must redefine the suicide prevention problem holistically so that the whole community may share ownership of the problem. This paper argues that in order to move forward with a new approach, suicide prevention must be de-politicised – and describes a grassroots approach to de-politicisation. Initial results suggest that with the grassroots approach there is potential to save lives, and it is cost-effective and sustainable.
Holt, Melissa K.; Vivolo-Kantor, Alana M.; Polanin, Joshua R.; Holland, Kristin M.; DeGue, Sarah; Matjasko, Jennifer L.; Wolfe, Misty; Reid, Gerald
BACKGROUND AND OBJECTIVES Over the last decade there has been increased attention to the association between bullying involvement (as a victim, perpetrator, or bully-victim) and suicidal ideation/behaviors. We conducted a meta-analysis to estimate the association between bullying involvement and suicidal ideation and behaviors. METHODS We searched multiple online databases and reviewed reference sections of articles derived from searches to identify cross-sectional studies published through July 2013. Using search terms associated with bullying, suicide, and youth, 47 studies (38.3% from the United States, 61.7% in non-US samples) met inclusion criteria. Seven observers independently coded studies and met in pairs to reach consensus. RESULTS Six different meta-analyses were conducted by using 3 predictors (bullying victimization, bullying perpetration, and bully/victim status) and 2 outcomes (suicidal ideation and suicidal behaviors). A total of 280 effect sizes were extracted and multilevel, random effects meta-analyses were performed. Results indicated that each of the predictors were associated with risk for suicidal ideation and behavior (range, 2.12 [95% confidence interval (CI), 1.67–2.69] to 4.02 [95% CI, 2.39–6.76]). Significant heterogeneity remained across each analysis. The bullying perpetration and suicidal behavior effect sizes were moderated by the study’s country of origin; the bully/victim status and suicidal ideation results were moderated by bullying assessment method. CONCLUSIONS Findings demonstrated that involvement in bullying in any capacity is associated with suicidal ideation and behavior. Future research should address mental health implications of bullying involvement to prevent suicidal ideation/behavior. PMID:25560447
Holt, Melissa K; Vivolo-Kantor, Alana M; Polanin, Joshua R; Holland, Kristin M; DeGue, Sarah; Matjasko, Jennifer L; Wolfe, Misty; Reid, Gerald
Over the last decade there has been increased attention to the association between bullying involvement (as a victim, perpetrator, or bully-victim) and suicidal ideation/behaviors. We conducted a meta-analysis to estimate the association between bullying involvement and suicidal ideation and behaviors. We searched multiple online databases and reviewed reference sections of articles derived from searches to identify cross-sectional studies published through July 2013. Using search terms associated with bullying, suicide, and youth, 47 studies (38.3% from the United States, 61.7% in non-US samples) met inclusion criteria. Seven observers independently coded studies and met in pairs to reach consensus. Six different meta-analyses were conducted by using 3 predictors (bullying victimization, bullying perpetration, and bully/victim status) and 2 outcomes (suicidal ideation and suicidal behaviors). A total of 280 effect sizes were extracted and multilevel, random effects meta-analyses were performed. Results indicated that each of the predictors were associated with risk for suicidal ideation and behavior (range, 2.12 [95% confidence interval (CI), 1.67-2.69] to 4.02 [95% CI, 2.39-6.76]). Significant heterogeneity remained across each analysis. The bullying perpetration and suicidal behavior effect sizes were moderated by the study's country of origin; the bully/victim status and suicidal ideation results were moderated by bullying assessment method. Findings demonstrated that involvement in bullying in any capacity is associated with suicidal ideation and behavior. Future research should address mental health implications of bullying involvement to prevent suicidal ideation/behavior. Copyright © 2015 by the American Academy of Pediatrics.
Knipe, Duleeka W.; Chang, Shu-Sen; Dawson, Andrew
Objective: To investigate the effect of 3-year phased bans of the pesticides dimethoate and fenthion in 2008–2010, and paraquat in 2009–2011, on suicide mortality in Sri Lanka. Methods: Age-standardised overall, sex-specific, and method-specific suicide rates were calculated using Sri Lankan police...... data (1989–2015). Using negative binomial regression models, we estimated the change in the rate and number of suicide deaths in post-ban years (2011–15) compared to those expected based on pre-ban trends (2001–10). Findings: Overall suicide mortality dropped by 21% between 2011 and 2015, from 18.......3 to 14.3 per 100,000. The decline in pesticide suicides during this same period was larger than for overall suicides: from 8.5 to 4.2 per 100,000, a 50% reduction. This was accompanied by a smaller concurrent rise in non-pesticide suicide mortality with a 2% increase (9.9 to 10.1 per 100,000). In 2015...
Rihmer, Zoltán; Németh, Attila; Kurimay, Tamás; Perczel-Forintos, Dóra; Purebl, György; Döme, Péter
Suicide is a major public health problem everywhere in the world and in the WHO European Region suicide accounts for over 120,000 deaths per year. 1. Recognition and diagnosis: An underlying psychiatric disorder is present in up to 90% of people who completed suicide. Comorbidity with depression, anxiety, substance abuse and personality disorders is high. In order to achieve successful prevention of suicidality, adequate diagnostic procedures and appropriate treatment for the underlying disorder are essential. 2. Treatment and care: Acute intervention should start immediately in order to keep the patient alive. Existing evidence supports the efficacy of pharmacological treatment and cognitive behavioural therapy (including dialectical behavior therapy and problem-solving therapy) in preventing suicidal behaviour. Some other psychological treatments are promising, but the supporting evidence is currently insufficient. Studies show that antidepressant and mood stabilizer treatments decrease the risk for suicidality among responders in mood disorder patients. However, the risk of suicidal behaviour in depressed patients treated with antidepressants exists during the first 10-14 days of treatment, which requires careful monitoring. Short-term supplementary medication with anxiolytics and hypnotics in the case of anxiety and insomnia is recommended. Treatment with antidepressants of children and adolescents should only be given under supervision of a specialist. Long-term treatment with lithium has been shown to be very effective in preventing both suicide and attempted suicide in patients with unipolar and bipolar depression. Treatment with clozapine is effective in reducing suicidal behaviour in patients with schizophrenia. Other atypical antipsychotics are promising but more evidence is required. 3. Family and social support: The suicidal person should always be motivated to involve family in the treatment. Psychosocial treatment and support is recommended, as the
The medical profession represents one of the groups of people who are not reached by the present help system for suicidal behaviour. The suicide rate of male physicians is slightly higher than that of the general population, while that of their female colleagues is clearly higher. This tendency is most pronounced in female psychiatrists and anaesthetists. In addition to the usual preventive measures such as the treatment of depression and addiction, the necessity of a qualified, professional treatment especially for doctors must be recognized because there is often a penchant for ineffective self-treatment. The symptoms are played down and even in acute crisis situations the urgently needed help is not enlisted.
Slaven, Janine; Kisely, Stephen
Suicide has been a major community concern in Esperance, a geographically isolated port on the south coast of Western Australia. To evaluate the effect of three evidence-based initiatives for the primary prevention of suicide: (i) providing suicide awareness sessions for staff members in health, education and social services; (ii) limiting the sale of over the counter analgesics (aspirin and paracetamol) to packets containing less than the minimum lethal dose; and (iii) implementing Commonwealth media guidelines in the reporting of suicides by media. Changes in knowledge, awareness, attitudes, comfort and use, before and after each intervention were assessed using standardized instruments and pro forma derived from previous work, such as the Youth Suicide Prevention Training Manual and Suicide Intervention Beliefs Scale. Percentage changes in the number of retail outlets selling over the counter analgesics to less than potentially lethal quantities (less than 8 g of paracetamol or aspirin) were also measured. Media representatives were interviewed to gain their perceptions of Commonwealth Guidelines for the reporting of suicide, and encouraged to consult the project team before reporting suicide related issues. The baseline survey illustrated that mental health staff and general practitioners were more aware of suicide issues, risk factors for suicide and awareness of professional and ethical responses than staff from other services, and were more willing to raise the issue with a person at risk. Thirty-three subjects participated in suicide awareness training of whom 21 (66%) returned questionnaires. There were significant increases in awareness of suicide-related issues and risk factors, as well as reported levels of knowledge of professional and ethical responses and comfort, competence and confidence levels when assisting a person at risk. Only three media representatives were aware of the Commonwealth Health Department Guidelines for reporting suicide and only
Disayavanish, Chamlong; Disayavanish, Primprao
The majority of the Thai population is Buddhists and Buddhism has a great deal of influence on their mind, character, way of life, and health, particularly mental health. According to the Four Noble Truths (Cattări ariyasaccani), suicide is a form of suffering that is originated from craving (Tanhă). Therefore, human beings cannot avoid suffering by taking their own lives, nor do they escape from "the wheel of suffering" by doing so. Moreover, the consequence of suicide is a rebirth in the woeful planes of existence, and hence further suffering endlessly. From the present study, the Buddhist approach to suicide prevention can be considered in the following areas: 1) Buddhist attitude toward suicide, 2) faith and confidence in life after death, 3) providing monks with general knowledge and understanding about suicide and life after death, 4) early identification of mental disorders, persons at risk of suicide and prompt referral to appropriate mental health professionals, 5) control of access to instruments of suicide, 6) control of alcohol and drug abuse, 7) prevention of HIV infection, 8) responsible media reporting and 9) practice of meditation.
Suicide is a complex but preventable public health problem globally. For every suicide death, there are generally between eight and twenty five attempted suicides. Although the causes of suicide are multidimentional and multifaceted, cost effective preventive strategies are readily available even in resource constrained ...
Miller, David N.; Eckert, Tanya L.
Youth suicidal behavior continues to be a significant national problem in need of urgent attention by school personnel. The purpose of this introductory article to the special series is to provide an overview of youth suicidal behavior, including research-based information on demographic data; risk factors and warning signs; and where, when, and…
Rathus, Jill H.; Miller, Alec L.
Reports on the preliminary study of a time-limited, out-patient treatment for suicidal adolescents designed to reduce suicidal behavior and psychiatric inpatient admissions along with drop-out rates. Dialectical Behavior Therapy (DBT) for adolescents seems to be effective in keeping them out of hospital and in treatment. DBT appears to be a…
Robinson, Jo; Calear, Alison L; Bailey, Eleanor
Youth suicide rates are unacceptably high. Schools have long been accepted as an appropriate setting for suicide prevention activities. This review aims to synthesise the evidence for all types of suicide prevention interventions across educational settings. The review draws on two previous reviews conducted by the authors. In order to be included, studies had to test a specific suicide prevention intervention in an educational setting, have a suicide-related outcome and target young people. A totally of 21 studies were included: 17 were conducted in school settings and four in universities. Seven of the school-based studies (41%) and one of the university studies (25%) were randomised controlled trials. Overall, the trials conducted in schools reported positive effects, as did four of the non- randomised controlled trials. Two of the university-based studies reported positive effects. Both universal and indicated interventions showed positive results; no iatrogenic effects were reported. School-based studies can have a positive impact on suicide-related behaviour and, overall, do not appear to cause harm. Study quality is variable, and the number of studies conducted in school settings far exceed those conducted in universities. These gaps need to be addressed by future research.
Full Text Available In Western countries the general rule is that caregivers do everything possible to prevent suicide. The aim of this essay is to critically reflect on that position along three questions: is there an unconditional obligation to live, how far does the duty reach to safeguard life, and how does one deal with the tension between suicide prevention and euthanasia? The study material consists of Christian theological and ethical literature and relevant legislation, while the method is a religious ethical reflection, clarified by means of a case study. We consider suicide as an expression of an existential search for meaning and interwoven with psychiatric problems. After discussing the three ethical arguments against suicide, we conclude that the inviolability of life is a generally recognized and fundamental value, but that there is no unconditional obligation to live. Nevertheless, there is a legal duty to safeguard life. In practice however, restriction of freedom and coercion are counterproductive in the search for meaning and require a proportional assessment between inviolability of life and autonomy. Finally, the legal possibility of euthanasia in mental suffering or medically assisted suicide brings caregivers in a confusing situation. Good companionship of the euthanasia request may help finding a new life perspective and hence may contribute to suicide prevention.
Dorji, Gampo; Choki, Sonam; Jamphel, Kinga; Wangdi, Yeshi; Chogyel, Tandin; Dorji, Chencho; Nirola, Damber Kumar
Suicide and mental disorders are a growing public health issue in Bhutan, due in part to a rapidly transitioning society. The burden of suicide has been recognized by the Royal Government of Bhutan and, as a result, it introduced the country's first ever national suicide-prevention plan in 2015. The 3-year action plan takes a holistic approach to making suicide-prevention services a top social priority, through strengthening suicide-prevention policies, promoting socially protective measures, mitigating risk factors and reaching out to individuals who are at risk of suicide or affected by incidents of suicide. This article documents Bhutan's policy and governance for addressing depression and suicide within the context of its national suicide-prevention strategy, examines progress and highlights lessons for future directions in suicide prevention. Since the endorsement of the 3-year action plan by the prime minister's cabinet, the implementation of suicide-prevention measures has been accelerated through a high-level national steering committee. Activities include suicide-prevention actions by sectors such as health, education, monastic communities and police; building capacity of gatekeepers; and improving the suicide information system to inform policies and decision-making. Suicide-prevention activities have become the responsibility of local governments, paving the way for suicide prevention as an integral mandate across sectors and at grass-root levels in the Kingdom of Bhutan.
Full Text Available Objective: Suicide is a complex phenomenon associated with pyschological, biological and social factors. Suicide has been reported as the second or third most common cause of death in children and adolescents worldwide. Suicidal behaviour in children and adolescents will be discussed in the frame of motivational definition. Method: Published research studies and reviews on children and adolescent suicides have been reviewed. Furthermore, classical papers have been searched to obtain knowledge about suicide behavior. Results: It is reported that firearms have been the most important effect in adolescent suicide. Both fatal and nonfatal suicidal behaviors have been linked consistently to negative parent-child relationships, depression, substance use, overall number of life stressors, gender and impulsive behaviors. Discussion: Future efforts to investigate suicidal behavior should use new research methodologies that may lead to identification of the interactions between environmental factors and constitutional and biological factors that are associated with risk for suicidal behavior. [TAF Prev Med Bull 2005; 4(2.000: 88-97
Pease, James L; Forster, Jeri E; Davidson, Collin L; Holliman, Brooke Dorsey; Genco, Emma; Brenner, Lisa A
This cross-sectional study was designed to examine the suicide risk assessment practices of Suicide Prevention Coordinators (SPCs) within the Veterans Health Administration. Specifically, this study sought to (1) identify factors SPCs consider most important in assessing risk and patient priority; (2) measure the level of consistency and agreement between SPCs in assessing suicide risk and prioritizing cases; and (3) measure individual SPC consistency between cases. SPCs (n = 63) responded to online survey questions about imminent and prolonged risk for suicide in response to 30 fictional vignettes. Combinations of 12 acute and chronic suicide risk factors were systematically distributed throughout the 30 vignettes using the Fedorov () procedure. The SPCs were also asked to identify the level of priority for further assessment both disregarding and assuming current caseloads. Data were analysed using clinical judgement analysis. Suicidal plan, β = 1.64; 95% CI (1.45, 1.82), and preparatory behaviour, β = 1.40; 95% CI (1.23, 1.57), were considered the most important acute or imminent risk factors by the SPCs. There was less variability across clinicians in the assessment of risk when alcohol use (p = 0.02) and hopelessness (p = 0.03) were present. When considering acute or imminent risk factors, there was considerable variability between clinicians on a vignette-by-vignette basis, median SD = 0.86 (range = 0.47, 1.13), and within individual clinicians across vignettes, median R 2 = 0.80 (0.49, 0.95). These findings provide insight into how this group of providers think about acute and chronic risk factors contributing to imminent suicide risk in Veterans. Copyright © 2016 John Wiley & Sons, Ltd. Identifies factors that practitioners consider most important in suicide risk assessment Discusses how to distinguish between chronic and acute risk for suicide Identifies factors that lead to more consistent clinical judgments. Copyright
Christoffersen, Mogens; DePanfilis, Diane
The purpose of the present paper is to shed light on the questions: Do children, who are exposed to psychological maltreatment, have an increased risk for suicide attempts or contemplation? Will children’s suicidal behavior diminish when psychological maltreatment is reduced? Suicidal behavior...... as well as child abuse and neglect were analyzed on the basis of standardized questionnaires addressed to caseworkers assigned to these cases (N=1,055). Half of the children were exposed to abuse and neglect. More than one third of the children were exposed to psychological maltreatment. These children...... showed higher rates of suicidal tendencies, compared to those children who were not exposed to psychological maltreatment....
Department of Health (Ireland)
National Office of Suicide Prevention Annual Report 2006 Suicidal behaviour is a major public health problem in Ireland. In particular it is a significant cause of death among young men aged 18 Ã¢?" 35, while overall suicide rates in Ireland are lower than the EU average, youth suicide rates are fifth highest. Risk factors for suicide include depression, schizophrenia and alcohol but suicide trends over time in many countries are influenced by major social changes especially those which re...
Tsai, Jack; Trevisan, Louis; Huang, Minda; Pietrzak, Robert H
The U.S. Department of Veterans Affairs (VA) is shifting its focus from ending veteran homelessness to preventing veteran suicides. With supporting data, this Open Forum argues that VA homelessness services also help address veteran suicides. Analysis of a nationally representative survey of U.S. veterans in 2015 shows that veterans with a history of homelessness attempted suicide in the previous two years at a rate >5.0 times higher compared with veterans without a history of homelessness (6.9% versus 1.2%), and their rates of two-week suicidal ideation were 2.5 times higher (19.8% versus 7.4%). Because the majority of veterans who die by suicide are not engaged in VA care, VA services for the homeless that include outreach efforts to engage new veterans may be reaching some of these veterans. Thus continued federal support for VA homelessness services not only may help address homelessness but also may help prevent suicide of veterans.
Ftanou, Maria; Cox, Georgina; Nicholas, Angela; Spittal, Matthew J; Machlin, Anna; Robinson, Jo; Pirkis, Jane
Media campaigns have received increased attention as an intervention for combating suicide. Suicide prevention campaigns involving public service announcements (PSAs) have not been well described and have been subject to minimal evaluation. This study aimed to identify suicide prevention PSAs from around the world and analyze and describe their content. We searched the Internet for short, English-language PSAs that had been screened as part of suicide prevention campaigns and identified 35. Most commonly, these PSAs focused on the general population and/or people who might be at risk of suicide, and had a particular emphasis on young people. Almost 60% promoted open discussion about suicide, around 50% indicated that the life of a suicidal person was important, about 40% acknowledged the suffering associated with suicidal thoughts and feelings, about 25% stressed that suicide is preventable, and about 20% focused on the devastating impact of suicide for those left behind. Most PSAs promoted some sort of support for people at risk of suicide, usually a helpline or website. Although these messages appeared appropriate and practical there is a lack of research on the impact that they may have on people with varying degrees of suicide risk. Further work is needed to ensure that they are consistent with theories of behavior change, and that they are having their desired impacts.
Pettit, Jeremy W.; Green, Kelly L.; Grover, Kelly E.; Schatte, Dawnelle J.; Morgan, Sharon T.
Little is known about the role of chronic stress in youth suicidal behaviors. This study examined the relations between specific domains of chronic stress and suicidal behaviors among 131 inpatient youth (M age = 15.02 years) who completed measures of stress, suicidal ideation, suicide attempt, and suicide intent. After controlling for…
Coleman, Daniel; Del Quest, Aisling
As part of an evaluation component of a youth suicide prevention, a quasi-experimental repeated measures design tested hypotheses about two brief suicide prevention gatekeeper trainings (Question, Persuade, Refer [QPR] and RESPONSE) and one longer suicide intervention skills training (Applied Suicide Intervention Skills Training [ASIST]). All three trainings showed large changes in prevention attitudes and self-efficacy, largely maintained at follow-up. ASIST trainees had large increases in asking at-risk youth about suicide at follow-up. Convergent with other research, modeling and role-play in training are crucial to increased prevention behaviors. Practice and research implications are discussed, including social work roles in suicide prevention and research.
Notredame, C-E; Pauwels, N; Vaiva, G; Danel, T; Walter, M
After more than 50 years of dedicated research, media coverage of suicide is now well known to have a significant influence on the suicide epidemiology. This influence is supposed to result from two opposite effects. The Werther effect (WE) refers to the robust increase of suicide rates following the publication of a suicide story. This specific kind of mass cluster implies a suggestion process, i.e. imitation of the depicted death by vulnerable persons. In contract, the preventive potential of medias has been labeled the "Papageno effect" (PE). Although more recently discovered and far less known, PE predicts that journalists can help prevent suicidal behaviors beyond a simple WE reduction. Because PE and WE directly bridge journalistic productions to suicidal events, several national and international health organisms (including the World Health Organization) started to see the media as new prevention opportunities. In this paper, we intend to assess the extent to which journalists can be considered as public health actors in the specific field of suicide prevention. Based on a critical review of the so-called Media effect studies, we explore the opportunities, limits and constraints of collaborating with media professionals for public health actions. For that purpose, we focus on the main strategy employed so far, namely providing recommendations for more cautious coverage of suicide. An overview of the efficacy of these recommendations serves not only as a starting point for understanding how public health and journalistic perspectives can confront, but also how they can be combined in a fertile way. Numerous suicide prevention organisms developed strategies in order to assist journalists in reporting suicide stories in a safer way. As a formal support to these strategies, around 30 national or international guides have been produced around the word, with the shared aim of reducing WE and, eventually, promoting PE. The recommendations about articles' style
Full Text Available Suicide is today in the Western world one of the leading causes of death and most people have had suicidal ideation at some time during their life. In the population of persons with intellectual disability some researchers have thought that impaired intellectual capacity could act as a buffer to suicidal behavior, but the fact is that the few studies conducted in that population contest this assumption and showed that the characteristics of suicidality in this population are very similar to persons without intellectual disability. This paper reviews the studies conducted and describe the symptomatology in this population. Professionals working with this population should therefore be aware of and assess for this behavior. Sadness or depression are symptoms that could indicate later suicidal behavior.
Dockhorn, Carolina Neumann de Barros Falcão; PUCRS; Werlang, Blanca Susana Guevara; PUCRS
Suicidal behavior has been increasing in numbers becoming a public health issue. Due to this reality it is of extreme importance that preventive measures with the purpose of reducing outrages numbers of suicide attempts and consummated suicides. Within the prevention programs there is the resource of hotlines on which has its presence in Brazil by the CVV agencies executors of CVV Suicide Prevention Program and members of the “Centro de Valorização da Vida”. With volunteer workers, CVV offers...
school-based suicide prevention programs. Five other reviews were found again of youth , adolescent and school-based programs, while 45 clinical...Health Organizations Health Evidence Network identified only one report of strategies for suicide prevention, again for youth and adolescents . The...Coping and Support Training) Columbia University TeenScreen Emergency Room Intervention for Adolescent Females PROSPECT (Prevention of Suicide
Full Text Available Louise Mewton,1 Gavin Andrews2 1National Health and Medical Research Council Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 2Clinical Research Unit for Anxiety and Depression (CRUfAD, St Vincent's Hospital, Sydney, NSW, Australia Abstract: This systematic review provides an overview of the effectiveness of cognitive behavioral therapy (CBT in reducing suicidal cognitions and behavior in the adult population. We identified 15 randomized controlled trials of CBT for adults (aged 18 years and older that included suicide-related cognitions or behaviors as an outcome measure. The studies were identified from PsycINFO searches, reference lists, and a publicly available database of psychosocial interventions for suicidal behaviors. This review identified some evidence of the use of CBT in the reduction of both suicidal cognitions and behaviors. There was not enough evidence from clinical trials to suggest that CBT focusing on mental illness reduces suicidal cognitions and behaviors. On the other hand, CBT focusing on suicidal cognitions and behaviors was found to be effective. Given the current evidence, clinicians should be trained in CBT techniques focusing on suicidal cognitions and behaviors that are independent of the treatment of mental illness. Keywords: suicidal behaviors, suicidal cognitions, CBT
Shelef, L; Tatsa-Laur, L; Derazne, E; Mann, J J; Fruchter, E
To evaluate the effectiveness of the IDF Suicide Prevention Program, implemented since 2006. Quasi-experimental (before and after) cohort study. Two cohorts of IDF mandatory service soldiers: the first inducted prior to (1992-2005, n=766,107) and the second subsequent to (2006-2012, n=405,252) the launching of the intervention program. The IDF Suicide Prevention Program is a population-based program, incorporating: reducing weapon availability, de-stigmatizing help-seeking behavior, integrating mental health officers into service units, and training commanders and soldiers to recognize suicide risk factors and warning signs. Suicide rate and time to suicide in cohorts before and after exposure to the Suicide Prevention Program. Trend analysis showed lower suicide rates in the cohort after intervention. The hazard ratio for the intervention effect on time to suicide was 0.44 (95% CI=0.34-0.56, Psuicide rate following the administration of the IDF Suicide Prevention Program. The effect of the intervention appears to be related to use of a weapon, and being able to benefit from improved help-seeking and de-stigmatization. Future efforts should seek to extend the program's prevention reach to other demographic groups of soldiers. The success of the IDF program may inform suicide prevention in other military organizations and in the civilian sector. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Shadick, Richard; Akhter, Sarah
As the college population in the United States rapidly diversifies, leaders of successful campus suicide prevention programs are recognizing the importance of targeting specific groups of students. Recent estimates from the National Center for Education Statistics indicated that in 2008 more than one-third (36.7 percent) of college students…
Wallack, Cory; Servaty-Seib, Heather L.; Taub, Deborah J.
Gatekeeper training is one of the most commonly employed methods for identifying and intervening with at-risk students (Davidson and Locke, 2010). Within the context of campus suicide prevention, a gatekeeper is broadly defined as any individual who has the potential to come into contact with at-risk students (Davidson and Locke, 2010). Although…
Huisman, A.; Pirkis, J; Robinson, J.
Background: Despite the growing strength of the field of suicidology, various commentators have recently noted that insufficient effort is being put into intervention research, and that this is limiting our knowledge of which suicide prevention strategies might be the most effective. Aims: To
Reidenberg, Dan; Berman, Alan L
It is axiomatic that the goal of suicide prevention is the prevention of suicide. Yet in spite of significant efforts to this end since the middle of the last century, and most notably in the last decade, the rate of suicide in the U.S. has not declined; rather, it has increased. To address this issue, Suicide Awareness Voices of Education (SAVE) brought together leading prevention specialists from other public health problems where successes have been achieved, representatives from countries where suicide rates have declined, and U.S. based suicide prevention researchers and program directors, to "think outside the box" and propose innovative, scalable approaches that might better drive success in achieving desired results from U.S. suicide prevention efforts. The recommendations should challenge our preconceptions and force us outside our own mental constraints to broaden our perspectives and suggest catalysts for real change in suicide prevention. © 2016 The American Association of Suicidology.
Annor, Francis B; Clayton, Heather B; Gilbert, Leah K; Ivey-Stephenson, Asha Z; Irving, Shalon M; David-Ferdon, Corinne; Kann, Laura K
Studies among adults have documented association between sexual orientation discordance and some suicide risk factors. However, studies examining sexual orientation discordance and nonfatal suicidal behaviors in youth are rare. This study examines the association between sexual orientation discordance and suicidal ideation/suicide attempts among a nationally representative sample of U.S. high school students. Using sexual identity and sex of sexual contact measures from the 2015 national Youth Risk Behavior Survey (n=6,790), a sexual orientation discordance variable was constructed describing concordance and discordance (agreement and disagreement, respectively, between sexual identity and sex of sexual contacts). Three suicide-related questions (seriously considered attempting suicide, making a plan about how they would attempt suicide, and attempting suicide) were combined to create a two-level nonfatal suicide risk variable. Analyses were restricted to students who identified as heterosexual or gay/lesbian, who had sexual contact, and who had no missing data for sex or suicide variables. The association between sexual orientation discordance and nonfatal suicide risk was assessed using logistic regression. Analyses were performed in 2017. Approximately 4.0% of students experienced sexual orientation discordance. High suicide risk was significantly more common among discordant students compared with concordant students (46.3% vs 22.4%, porientation discordance was associated with increased likelihood of nonfatal suicidal behaviors. Discordant adolescents may experience unique stressors that should be considered when developing and implementing suicide prevention programs. Published by Elsevier Inc.
Krarup, Gertrud; Nielsen, Bent; Rask, P
The aim of this study was to elucidate the influence of various events in childhood on suicidal behavior in adult age. For this purpose, 99 patients admitted to the Department of Psychiatry of Odense University Hospital after making a suicide attempt were followed for 5 years, to register repeate......: the suicidal act is perceived--and learned--as way to solve problems.......The aim of this study was to elucidate the influence of various events in childhood on suicidal behavior in adult age. For this purpose, 99 patients admitted to the Department of Psychiatry of Odense University Hospital after making a suicide attempt were followed for 5 years, to register repeated......, and the first-evers on average were past the age of 40. Somewhat unexpectedly, significantly more repeaters than first-evers had grown up with both their parents. However, the results also showed that significantly more repeaters than first-evers had had an unhappy childhood. This indicates...
Zeller, Meg H; Reiter-Purtill, Jennifer; Jenkins, Todd M; Ratcliff, Megan B
Relative suicidal behavioral risks (ideation, attempts) for overweight, obese, and extremely obese adolescents (vs. healthy weight) and who did/did not accurately perceive themselves as overweight were examined in this study. A new variable (weight status/accuracy) was computed that combined actual weight status (based on BMI) with weight perception accuracy. To evaluate the effect of weight status/accuracy on each suicidal risk behavior, logistic regression was performed to calculate odds-ratios and 95% confidence intervals (CI). Potential model covariates included gender, age, race, survey year, and whether they had felt sad/hopeless. Weight perception accuracy increased as the degree of excess weight increased. Relative to healthy weight, being obese or extremely obese (but not overweight) was associated with significantly greater risk for adolescent engagement in suicidal ideation, but was unrelated to suicide attempts. Adolescents in all excess weight categories who were accurate in their weight perception were at significantly greater odds of suicidal ideation, whereas those who were inaccurate were of no greater odds of suicidal ideation than healthy weight youth who accurately perceived their weight. Findings regarding suicide attempts varied based on actual weight/weight perception accuracy and race/ethnicity. The present findings are both important and clinically relevant. While widely accepted that there are multiple pathways to suicide, our understanding of adolescent suicidal behavior risks and accordingly, prevention efforts, will be informed by comprehensive prospective studies that should also, from here forward, consider categorization of the entire weight spectrum (e.g., extreme obesity). Copyright © 2012 The Obesity Society.
McBee-Strayer, Sandra M.; Rogers James R.
Surveys 162 self-identified lesbian, gay, and bisexual (LGB) individuals with regard to suicidal behaviors, suicide risk factors, and reasons for living. Approximately 41% of the respondents indicated a serious consideration of suicide including the identification of a specific suicide plan or a past suicide attempt with significant intent to die.…
Goldston, David B.; Walrath, Christine M.; McKeon, Richard; Puddy, Richard W.; Lubell, Keri M.; Potter, Lloyd B.; Rodi, Michael S.
In response to calls for greater efforts to reduce youth suicide, the Garrett Lee Smith (GLS) Memorial Act has provided funding for 68 state, territory, and tribal community grants, and 74 college campus grants for suicide prevention efforts. Suicide prevention activities supported by GLS grantees have included education, training programs…
Zhou, Xue Mei; Jia, Shu Hua
Recognizing suicidal communication from the distressful catharsis in a high-risk group with suicidal tendencies is essential for suicide prevention. This study analyzes whether suicidal communication can indicate the severity of suicidal intent. Various types of suicidal communication are defined, and their clinical significance is further explored. A comprehensive analysis of the psychological autopsy data of 200 victims of completed suicide, including their general socio-demographic status, suicidal communication methods, previous suicide attempts, mental disorders, and psychosocial situation. Our results showed that 39.5% of all the subjects were suicidal communicators, 23.0% had previously attempted suicide, and 14.0% left suicide notes; 32.4% of 142 subjects free of physical disease suffered from mental disorders. Suicidal communication included verbal communication, behavioral communication, and suicidal notes. Younger people with a higher level of education were more inclined to communicate their suicidal intent by leaving a suicide note. Suicide notes, but not previous suicide attempts or psychosocial situation, were significantly correlated with suicidal intent. Suicidal communicators showed higher depression scores than non-communicators. Those who suffered from mood disorders with higher levels of both depression and suicidal intent were more likely to expose their intent through behavioral communication. The present study provides strong evidence that suicidal communication can indicate the severity of suicidal intent. Current findings help interpret high-risk, self-destructive behavior and consequently provide the theoretical basis for a feasible suicide prevention program.
... Share 10 Things Parents Can Do to Prevent Suicide Page Content As children grow into teenagers, it ... Your Teen . 3. Never shrug off threats of suicide as typical teenage melodrama. Any written or verbal ...
Abil, Yerkin A.; Kim, Natalia P.; Baymuhambetova, Botagoz Sh.; Mamiyev, Nurlan B.; Li, Yelena D.; Shumeyko, Tatyana S.
Aim of research: to develop complex of psychology-pedagogical conditions, directed on prevention of suicidal tendencies among teenagers. On analysis basis of scientific literature authors disclose main causes of suicidal behavior in adolescence. To confirm science veracity of advanced theoretic assumptions, describes experiment, conducted on basis…
Kindrick, Clint; Gathright, Molly; Cisler, Josh M; Messias, Erick
We used the 2011 Arkansas Youth Risk Behavior Survey to estimate the prevalence of risky sexual behavior and sexual assault and to measure its association with teen suicidality. In Arkansas, 50.3% of students reported ever having sexual intercourse, 26% onset at 14 or younger, 36 % having had more than one partner, and 10.2% having been physically forced to have sex. "Being forced to have sex" was a risk factor for depression and all components of the suicide continuum. Additionally, early onset of sexual activity and having more than one partner increased the risk for depression, suicidal ideation, plan, and attempt. Suicide is a grievous and preventable tragedy, sadly standing among the leading causes of death for teens.' In this series, we examine risk factors for suicidality among Arkansas high school students; in this installment, we examine sexual behavior. A previous study utilizing the Rhode Island Youth Risk Behavior Survey (YRBS) found an association between having forced sexual intercourse and suicide. Furthermore, an association between psychiatric disorders and risky sexual behaviors, including both early onset and number of partners was found in a birth cohort study revealed. We hypothesize that Arkansas' teens reporting risky sexual behavior and sexual assault are at higher risk of depression and suicidality as well.
Samuel, Diana; Sher, Leo
Suicide is both a public and mental health problem, and is a leading cause of deaths, especially among adolescents. Two factors that contribute to the decision of adolescents to commit suicide are having a primary mood disorder and/or substance use. In the Indian culture, the family unit has both a positive and negative impact on suicide. The family serves as a protective factor that provides a strong support for the individual, but alternately creates an inseparable individual when seeking mental health care, which often complicates the situation. Due to the stigma, Indians typically perceive having a mental illness as shameful. Religion is integral to the Indian culture so much so that individuals often use herbal remedies, seek help from religious leaders, and attend religious establishments prior to obtaining a mental health evaluation in those that are subsequently deemed as mentally ill. Despite the fact that suicides are underreported and misdiagnosed in India, it is known that the highest rates are among those immigrating, Indians tend to switch the methods they use to commit suicide from ingestion of poison to hanging, which may reflect a lack of available poisonous substances or the influence of the host culture. Considering the high suicide rates in adolescents, the importance of providing psychoeducation, restricting access to lethal means, and promoting social integration in immigrants are various ways by which suicides in Indian adolescents can be avoided.
Langhinrichsen-Rohling, Jennifer; Lamis, Dorian A.
Youth recently assigned to probation (n = 233) were assessed for current suicide proneness, depression, and hopelessness, as well as for recent suicide ideation, previous suicide ideation, or suicide attempt(s). The Life Attitudes Schedule-Short Form (LAS-SF) was used to assess suicide proneness. As per the LAS-SF, suicide proneness was defined…
Ohnishi, Masaru; Koyama, Shihomi; Senoo, Akiko; Kawahara, Hiroko; Shimizu, Yukito
According to the nationwide survey of the National University students in Japan, the annual suicide rate in 2012 was 15.7 per 100,000 undergraduate students. In many universities, suicide prevention is an important issue regarding mental health measures, and each university is actively examining this. The current situation concerning measures for suicide prevention in the Japanese National Universities was investigated in 2009. In 2010, the "college student's suicide prevention measures guideline, 2010" was established based on the results of this investigation. This guideline refers to the basic philosophy of suicide prevention in Chapter 1, risk factors for suicide in Chapter 2, and systems and activities for suicide prevention in Chapter 3. The Health Service Center, Okayama University plays central roles in mental health and suicide prevention measures on the Medical Campus. The primary prevention includes a mini-lecture on mental health, classes on mental health, and periodic workshops and lectures for freshmen. The secondary prevention includes interviews with students with mental health disorders by a psychiatrist during periodic health check-ups and introducing them to a hospital outside the university. The tertiary prevention includes support for students taking a leave of absence to return to school, periodic consultation with such students with mental disorders, and postvention following a suicide. We believe that for mental health measures on the university campus, it is important to efficiently make use of limited resources, and that these efforts will eventually lead to suicide prevention.
... public through various media such as radio, television, advertisements, newspapers, magazines, and billboards. Public Health Approach – the ... used for an injury that is unplanned; in many settings these are termed accidental injuries. Universal preventive ...
Vahabzadeh, Arshya; Sahin, Ned; Kalali, Amir
Suicide continues to be a leading cause of death and has been recognized as a significant public health issue. Rapid advances in data science can provide us with useful tools for suicide prevention, and help to dynamically assess suicide risk in quantitative data-driven ways. In this article, the authors highlight the most current international research in digital suicide prevention, including the use of machine learning, smartphone applications, and wearable sensor driven systems. The authors also discuss future opportunities for digital suicide prevention, and propose a novel Sensor-driven Mental State Assessment System.
Soloff, Paul H; Chiappetta, Laurel
Course and outcome of Borderline Personality Disorder (BPD) are favorable for the vast majority of patients; however, up to 10% die by suicide. This discrepancy begs the question of whether there is a high lethality subtype in BPD, defined by recurrent suicidal behavior and increasing attempt lethality over time. In a prospective, longitudinal study, we sought predictors of high lethality among repeat attempters, and defined clinical subtypes by applying trajectory analysis to consecutive lethality scores. Criteria-defined subjects with BPD were assessed using standardized instruments and followed longitudinally. Suicidal behavior was assessed on the Columbia Suicide History, Lethality Rating Scale, and Suicide Intent Scale. Variables discriminating single and repeat attempters were entered into logistic regression models to define predictors of high and low lethality attempts. Trajectory analysis using three attempt and five attempt models identified discrete patterns of Lethality Rating Scale scores. A high lethality trajectory was associated with inpatient recruitment, and poor psychosocial function, a low lethality trajectory with greater Negativism, Substance Use Disorders, Histrionic and/or Narcissistic PD co-morbidity. Illness severity, older age, and poor psychosocial function are characteristics of a poor prognosis subtype related to suicidal behavior.
Gould, T D; Georgiou, P; Brenner, L A; Brundin, L; Can, A; Courtet, P; Donaldson, Z R; Dwivedi, Y; Guillaume, S; Gottesman, I I; Kanekar, S; Lowry, C A; Renshaw, P F; Rujescu, D; Smith, E G; Turecki, G; Zanos, P; Zarate, C A; Zunszain, P A; Postolache, T T
Worldwide, suicide is a leading cause of death. Although a sizable proportion of deaths by suicide may be preventable, it is well documented that despite major governmental and international investments in research, education and clinical practice suicide rates have not diminished and are even increasing among several at-risk populations. Although nonhuman animals do not engage in suicidal behavior amenable to translational studies, we argue that animal model systems are necessary to investigate candidate endophenotypes of suicidal behavior and the neurobiology underlying these endophenotypes. Animal models are similarly a critical resource to help delineate treatment targets and pharmacological means to improve our ability to manage the risk of suicide. In particular, certain pathophysiological pathways to suicidal behavior, including stress and hypothalamic-pituitary-adrenal axis dysfunction, neurotransmitter system abnormalities, endocrine and neuroimmune changes, aggression, impulsivity and decision-making deficits, as well as the role of critical interactions between genetic and epigenetic factors, development and environmental risk factors can be modeled in laboratory animals. We broadly describe human biological findings, as well as protective effects of medications such as lithium, clozapine, and ketamine associated with modifying risk of engaging in suicidal behavior that are readily translatable to animal models. Endophenotypes of suicidal behavior, studied in animal models, are further useful for moving observed associations with harmful environmental factors (for example, childhood adversity, mechanical trauma aeroallergens, pathogens, inflammation triggers) from association to causation, and developing preventative strategies. Further study in animals will contribute to a more informed, comprehensive, accelerated and ultimately impactful suicide research portfolio.
Nordentoft, Merete; Qin, Ping; Helweg-Larsen, Karin
Restriction of means for suicide is an important part of suicide preventive strategies in different countries. The effect on method-specific suicide rate and overall suicide rate of restrictions on availability of carbon monoxide, barbiturates, and dextropropoxyphene was examined. From 1970 to 2000......, overall suicide mortality and method-specific suicide mortality in Denmark were compared with official information about availability of barbiturates and analgesics and carbon monoxide in vehicle exhaust and household gas. Restrictions on availability of household gas with carbon monoxide content...... and barbiturates was associated with a decline in the number of suicides and suicides by self-poisoning with these compounds after controlling for the effect of calender year. Restricted access occurred concomittantly with a 55 percent decrease in suicide rate....
Ganz, D; Sher, L
Depression, alcohol abuse and suicidality each continue to threaten adolescent populations throughout the world. The comorbidity between these diseases has been found to be up to 73% with consistent positive correlations between adolescent drinking, depression and suicidality. Alcohol abuse, depression and suicidal behavior in adolescents have also been found to have biochemical and genetic correlates. This article explores the contributing and causative factors and directional models underlying such prevalent comorbidities. Alcohol use is shown to be both a distal and proximal cause of suicide attempts in adolescent populations. Individuals with both alcoholism and depression who attempt or complete suicide often present with significantly high levels of aggression and impulsivity. These factors may be caused or nuanced by poor or underdeveloped coping skills as well as other comorbid psychiatric conditions. Such behaviors, alone or in comorbidity, may be a consequence of childhood abuse, social pressures, low self-esteem and/or delinquency- all of which may be particularly salient among adolescent populations. Such adolescent stressors are implicated as the cause for the self-medication model. Some studies suggest that depression encourages alcohol use as self-medication and then leads to suicidality, while others imply that the initial alcohol consumption is responsible for increasing depressive and suicidal symptoms in adolescents. This article discusses the social stigma associated with alcoholism, depression and suicidality, and how that may serve to enhance these disorders in adolescent populations. Many directional models are presented based on past research and as suggestions for future research. There is a lot that can be done by clinicians, legal and educational professionals and society at large that may help to prevent and treat such problems.
Inuit in Canada have among the highest suicide rates in the world, and it is primarily among their youth. Risk factors include known ones such as depression, substance use, a history of abuse, and knowing others who have made attempts or have killed themselves, however of importance are the negative effects of colonialism. This took place for Inuit primarily during the government era starting in the 1950s, when Inuit were moved from their family-based land camps to crowded settlements run by white men, and children were removed from their parents and placed into residential or day schools. This caused more disorganization than reorganization. The most negative effect of this colonialism/imperialism for Inuit has been on their family and sexual relationships. Many Inuit youth feel alone and rejected. Suicide prevention has been taking place, the most successful being community-driven programs developed and run by Inuit. Mental health factors for Indigenous peoples are often cultural. It is recommended that practitioners work with the community and with Inuit organizations. Empowered communities can be healing. PMID:27738249
Kok, Jin Kuan; van Schalkwyk, Gertina J.; Chan, Andrea Huan Wen
The suicide rate among youths in Malaysia has increased over the years, giving rise to considerable public concern. The purpose of this study was to explore and describe potential stressors of suicide and suicide prevention strategies as perceived by youths in Malaysia aged 15-25 years. A qualitative approach was adopted and 625 students from…
Platt, Belinda; Hawton, Keith; Simkin, Sue; Dean, Rachel; Mellanby, Richard J
Suicide rates are elevated in the veterinary profession in several countries, yet little is known about possible contributory and preventive factors. To obtain information from veterinarians with a history of suicidal ideation or behavior about the factors associated with suicidality in their profession. We conducted a mixed-methods interview study with 21 UK veterinarians who had attempted suicide or reported recent suicidal ideation. Interview topics included work and nonwork contributory factors, coping mechanisms, and preventive factors. Self-poisoning was the most common method used or considered by participants. Common contributory factors were workplace relationships, career concerns, patient issues, number of hours and volume of work, and responsibility, although two-thirds of participants reported co-occurring difficult life events. Around half had received a psychiatric diagnosis following their suicidal behavior. Several possible preventive measures were suggested by participants. Several work- and non-work-related contributory factors to suicidality in the veterinary profession were identified. Future preventive measures may involve better promotion of support services, formal support for recent graduates, and improving employers' attitudes toward work-life balance.
Levitt, Aaron J.; Lorenzo, Julie; Yu, Van; Wean, Caren; Miller-Solarino, Sophie
Social workers and paraprofessionals serve psychiatric populations at high risk for suicide, but may receive little training related to suicidality. This study evaluated a suicide awareness and prevention training workshop for providers working with mentally ill homeless and previously homeless adults. Trainees attended a half day of training, and…
Calear, A.L.; Christensen, H.; Freeman, A.; Fenton, K.; Grant, J.B.; van Spijker, B.; Donker, T.
Youth suicide is a significant public health problem. A systematic review was conducted to examine the effectiveness of school, community and healthcare-based interventions in reducing and preventing suicidal ideation, suicide attempts and deliberate self-harm in young people aged 12–25 years.
Miller, Alec L.; Rathus, Jill H.; Linehan, Marsha M.
Filling a tremendous need, this highly practical book adapts the proven techniques of dialectical behavior therapy (DBT) to treatment of multiproblem adolescents at highest risk for suicidal behavior and self-injury. The authors are master clinicians who take the reader step by step through understanding and assessing severe emotional…
Poma, Stefano Zanone; Vicentini, Silvia; Siviero, Francesca; Grossi, Antonello; Toniolo, Emanuele; Baldo, Vincenzo; De Leo, Diego
A survey about opinions on end-of-life issues of a population represented by 1,171 people in the waiting room of general practitioners' surgeries was conducted in a province of northern Italy. Most subjects did not consider suicide as a reasonable option even in cases of a serious and incurable disease. Moreover, subjects did not consider euthanasia as a possible option either; however, they did express an opposite attitude when considering euthanasia in a third-person perspective. People with a personal history of suicidal behavior appear to present as a different population, overall expressing more open attitudes. © 2014 The American Association of Suicidology.
Lapierre, Sylvie; Erlangsen, Annette; Waern, Margda
BACKGROUND: Suicide rates are highest among the elderly, yet research on suicide prevention in old age remains a much-neglected area. AIMS: We carried out a systematic review to examine the results of interventions aimed at suicidal elderly persons and to identify successful strategies and areas ......, engage family and community gatekeepers, use telecommunications to reach vulnerable older adult, and evaluate the effects of means restriction and physicians education on elderly suicide....
Butler, Louise; Phelan, Jim
This paper examines perceptions regarding rural male suicide and the preventative services available in Co. Kilkenny to combat the problem. For every four male suicides, there is one female suicide. The problem is becoming a rural rather than an urban one. The research set out to identify gaps in services and existing policies in addressing suicide among young rural men. Data were obtained from interview with the service providers and also from focus group discussions with young rural Kilkenn...
Full Text Available The purpose of this study is to examine American and Japanese clergy’s perception of their role in the prevention of suicide. The research questions are as follows: (a How do clergy in the United States and Japan perceive suicide? (b Do they see suicide differently? and (c How do they envision the role of suicide prevention? The hypotheses are as follows: (a Christian clergy think that suicide is an unacceptable “sin”; (b Buddhist clergy are more accepting of suicide than Christian clergy; (c there are role differences related to suicide prevention in the Japanese and American religious communities; and (d American and Japanese religious leaders have a different view of their obligations related to suicide prevention. The investigator sent 400 anonymous mail surveys, respectively, to New York and Tokyo. The surveys asked about the clergy’s personal beliefs and the Church’s role in suicide prevention. The investigator analyzed the responses using both quantitative and qualitative methods. The major findings are that many American Christian clergy consider suicide to be a sin, but that “God’s love is available for people who committed suicide.” Many Japanese Buddhist clergy think how one dies is not the most important issue.
Mallick, Faryal; McCullumsmith, Cheryl B
Ketamine, an NMDA receptor antagonist with efficacy as a rapid anti-depressant, has early evidence for action to reduce suicidal ideation. This review will explore several important questions that arise from these studies. First, how do we measure reductions in suicidal ideation that occur over minutes to hours? Second, are the reductions in suicidal ideation after ketamine treatment solely a result of its rapid anti-depressant effect? Third, is ketamine only effective in reducing suicidal ideation in patients with mood disorders? Fourth, could ketamine's action lead us to a greater understanding of the neurobiology of suicidal processes? Last, do the reductions in depression and suicidal ideation after ketamine treatment translate into decreased risk for suicidal behavior? Our review concludes that ketamine treatment can be seen as a double-edged sword, clinically to help provide treatment for acutely suicidal patients and experimentally to explore the neurobiological nature of suicidal ideation and suicidal behavior.
Vriniotis, Mary; Barber, Catherine; Frank, Elaine; Demicco, Ralph
A spate of suicides involving a just-purchased firearm led a statewide coalition of firearm dealers, firearm rights advocates, and suicide prevention professionals to discuss the role of gun shops in preventing suicide. The group developed and mailed materials for (1) firearm retailers on avoiding sales to suicidal customers and (2) their customers on suicide and firearm safety. All storefront retailers were identified (n = 65), visited unannounced 6 months after receiving materials, and asked to complete a survey. Nearly half (48%) had at least one campaign product on display. Belief that reducing a suicidal person's access to firearms might save a life was associated with displaying materials (69% vs. 41%, p = .06). Public health and gun groups can successfully collaborate on suicide prevention activities. © 2014 The American Association of Suicidology.
Bean, Gretchen; Baber, Kristine M.
Youth suicide prevention is an important public health issue. However, few prevention programs are theory driven or systematically evaluated. This study evaluated Connect, a community-based youth suicide prevention program. Analysis of pre and posttraining questionnaires from 648 adults and 204 high school students revealed significant changes in…
Arendt, Florian; Scherr, Sebastian
Search engines are increasingly used to seek suicide-related information online, which can serve both harmful and helpful purposes. Google acknowledges this fact and presents a suicide-prevention result for particular search terms. Unfortunately, the result is only presented to a limited number of visitors. Hence, Google is missing the opportunity to provide help to vulnerable people. We propose a two-step approach to a tailored optimization: First, research will identify the risk factors. Second, search engines will reweight algorithms according to the risk factors. In this study, we show that the query share of the search term "poisoning" on Google shows substantial peaks corresponding to peaks in actual suicidal behavior. Accordingly, thresholds for showing the suicide-prevention result should be set to the lowest levels during the spring, on Sundays and Mondays, on New Year's Day, and on Saturdays following Thanksgiving. Search engines can help to save lives globally by utilizing a more tailored approach to suicide prevention.
Cluver, Lucie; Orkin, Mark; Boyes, Mark E; Sherr, Lorraine
This is the first known prospective study of child suicidal behavior in sub-Saharan Africa. Aims were to determine whether (1) cumulative exposure to adverse childhood experiences (ACEs) predicts later suicidality and (2) heightened risks are mediated by mental health disorder and drug/alcohol misuse. Longitudinal repeated interviews were conducted 1 year apart (97% retention) with 3,515 adolescents aged 10-18 years in South Africa (56% female; areas from urban/rural sites within two provinces and door-to-door sampling included all homes with a resident adolescent. Measures included past-month suicide attempts, planning, and ideation, mental health disorders, drug/alcohol use, and ACE, for example, parental death by AIDS or homicide, abuse, and exposure to community violence. Analyses included multivariate logistic regression and multiple mediation tests. Past-month suicidality rates were 3.2% of adolescents attempting, 5.8% planning, and 7.2% reporting ideation. After controlling for baseline suicidality and sociodemographics, a strong, graded relationship was shown between cumulative ACE and all suicide behaviors 1 year later. Baseline mental health, but not drug/alcohol misuse, mediated relationships between ACE and subsequent suicidality. Suicide attempts rose from 1.9% among adolescents with no ACE to 6.3% among adolescents with >5 ACEs (cumulative odds ratio [OR], 2.46; confidence interval [CI], 1.00-6.05); for suicide planning, from 2.4% to 12.5% (cumulative OR, 4.40; CI, 2.08-9.29); and for suicide ideation, from 4.2% to 15.6% (cumulative OR, 2.99; CI, 1.68-5.53). Preventing and mitigating childhood adversities have the potential to reduce suicidality. Among adolescents already exposed to adversities, effective mental health services may buffer against future suicidality. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Mouaffak, Fayçal; Marchand, Arnaud; Castaigne, Emmanuelle; Arnoux, Armelle; Hardy, Patrick
Attempted suicide is a strong risk factor for subsequent suicidal behavior. In recent years, a particular interest has been given to follow-up interventions as a potential effective strategy in preventing recurrent suicidal behavior. We developed a follow-up intervention program called OSTA (organization of a suitable monitoring for suicide attempters) aimed at addressing this issue and tested its effectiveness in a 1-year randomized controlled trial. Individuals who attempted suicide and were admitted to the emergency department (ED) of Bicêtre Hospital (n=320) were randomly allocated to receive either the OSTA program or a control treatment. On an intention to treat basis, the proportion of patients who reattempted suicide did not differ significantly between the interventional group (IG) 14.5% (22/152) and the control group (CG) 14% (21/150). There were also no significant differences, between the two arms, in the number of suicide attempts. Although no significant difference has been found between the OSTA program and the control treatment concerning the rate of suicide reattempts, we believe that further studies should be conducted to test the effectiveness of more standardized follow-up studies in suicide prevention. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Lewitzka, U; Severus, E; Bauer, R; Ritter, P; Müller-Oerlinghausen, B; Bauer, M
The management and treatment of patients with suicidal behavior is one of the most challenging tasks for health-care professionals. Patients with affective disorders are at high risk for suicidal behavior, therefore, should be a target for prevention. Numerous international studies of lithium use have documented anti-suicidal effects since the 1970s. Despite the unambiguous evidence of lithium's anti-suicidal effects and recommendations in national and international guidelines for its use in acute and maintenance therapy of affective disorders, the use of lithium is still underrepresented. The following article provides a comprehensive review of studies investigating the anti-suicidal effect of lithium in patients with affective disorders.
Suicide Event Report ASIST Applied Suicide Intervention Skills Training ASPP Army Suicide Prevention Program ASPTF Army Suicide Prevention Task Force BUMED... Virtual Experience Immersive Learning Simulation VHA Veterans Health Administration WAQ Warrior Adventure Quest WRAIR Walter Reed Army Institute of...Applied Suicide Intervention Skills Training ( ASIST ) (Eggert, Randell, et al., 2007) and Suicide, Options, Awareness, and Relief Best Practices for
Manning, Jessica; VanDeusen, Karen
Western Michigan University's Suicide Prevention Program utilizes multiple technological components, including an online training course, a Web site, and 2 social networking Web site profiles, as integral aspects of a comprehensive program. This article discusses the development, maintenance, use, and impact of the technological aspects of this…
Rice, Timothy R; Sher, Leo
The Germanwings 9525 incident drew significant attention to the 'plane-assisted suicide' construct, yet little scientific literature exists on this topic. This paper reviews the available literature and applies lessons from the suicide-homicide and men's mental health literature to better understand this construct from a scientific perspective. A systematic review of the relevant clinical literature was undertaken. Multiple lines of evidence suggests the applicability and relevance of suicide-homicide research and men's mental health to the plane-assisted suicide phenomenon. Plane-assisted suicides occur within an overwhelmingly male, middle aged population who, in addition to suicide, commit large scale acts of murder. Issues of divorce, separation, and threats to masculinity appear integral to an effective prevention program. Further research in the understanding of plane-assisted suicide as a product of neuropsychiatric disorder may advance such prevention efforts and have the opportunity to reduce the loss of life in future tragedies.
Wang, Liang-Jen; Wu, Ya-Wen; Chen, Chih-Ken
Case management services have been implemented in suicide prevention programs. To investigate whether case management is an effective strategy for reducing the risks of repeated suicide attempts and completed suicides in a city with high suicide rates in northern Taiwan. The Suicide Prevention Center of Keelung City (KSPC) was established in April 2005. Subjects included a consecutive sample of individuals (N = 2,496) registered in KSPC databases between January 1, 2006, and December 31, 2011, with at least one episode of nonfatal self-harm. Subjects were tracked for the duration of the study. Of all the subjects, 1,013 (40.6%) received case management services; 416 (16.7%) had at least one other deliberate self-harm episode and 52 (2.1%) eventually died by suicide. No significant differences were found in the risks of repeated self-harm and completed suicides between suicide survivors who received case management and those who refused the services. However, a significant reduction in suicide rates was found after KSPC was established. Findings suggest that case management services might not reduce the risks of suicide repetition among suicide survivors during long-term follow-up. Future investigation is warranted to determine factors impacting the downward trend of suicide rates.
Full Text Available It is known in the literature that the incidence and prevalence of suicide and attempted suicide in psychiatric patients is significantly higher than in the general population. The paper examined risk factors for suicidal behavior in the category of admitted patients hospitalized with the diagnosis of sleep disorders and affective (Unipolar resp. Bipolar depression. Study activated by 80 patients, 40 in both diagnostic groups received treatment at the Special Psychiatric Hospital in Gornja Toponica near Nis. The work methodology used are: psychiatric interview, Hamilton Depression Rating Scale (HAMD, and the C-SSRS (Columbia-Suicide Severity Rating Scale- assessment tool that assesses suicidal ideation and behavior. The study results show that there is a relationship between suicidal behavior (suicide attempts and suicidal ideation and the diagnosis of bipolar affective disorder, positive history of previous suicide attempts, so that these factors are stronger, to the degree of suicidality higher. On this sample, clearly suicidal behavior, with the same purpose, intensity of suicidal thoughts and medical impairment after suicide attempts were significantly more frequent in patients with Bipolar Affective Disorder in the depressive phase of the illness. Patients with a previous suicide attempt, and poor personal and social circumstances had a higher rate of attempted suicide.
Full Text Available Background: There are well-documented gender differences in adolescent suicidal behavior; death by suicide is more common in males, while nonfatal suicide attempts are more common among females. Over the past three decades, researchers have documented the effectiveness of a myriad of suicide prevention initiatives. However, there has been insufficient attention to which types of suicide prevention interventions are effective in changing attitudes and behaviors for young males and females. In this review of the literature, we consider common examples of primarily universal suicide prevention programs from three implementation settings: school-based, community-based, and healthcare-based. Our purpose is to delineate how the potential gender bias in such strategies may translate into youth suicide prevention efforts. Methods: Research in which gender was found to moderate program success was retrieved through online databases. Results: The results that feature programming effects for both males and females are provocative, suggesting that when gender differences are evident, in almost all cases, females seem to be more likely than males to benefit from existing prevention programming. Conclusions: We conclude by considering recommendations that may benefit males more directly. Implications for adolescent suicide prevention in particular are discussed. Personalization of suicide intervention is presented as a promising solution to reduce suicide rates.
Hamilton, Emma; Klimes-Dougan, Bonnie
There are well-documented gender differences in adolescent suicidal behavior; death by suicide is more common in males, while nonfatal suicide attempts are more common among females. Over the past three decades, researchers have documented the effectiveness of a myriad of suicide prevention initiatives. However, there has been insufficient attention to which types of suicide prevention interventions are effective in changing attitudes and behaviors for young males and females. In this review of the literature, we consider common examples of primarily universal suicide prevention programs from three implementation settings: school-based, community-based, and healthcare-based. Our purpose is to delineate how the potential gender bias in such strategies may translate into youth suicide prevention efforts. Research in which gender was found to moderate program success was retrieved through online databases. The results that feature programming effects for both males and females are provocative, suggesting that when gender differences are evident, in almost all cases, females seem to be more likely than males to benefit from existing prevention programming. We conclude by considering recommendations that may benefit males more directly. Implications for adolescent suicide prevention in particular are discussed. Personalization of suicide intervention is presented as a promising solution to reduce suicide rates.
Chen, Paul C Y; Lee, Lai Kah; Wong, Kam Cheong; Kaur, Jagmohni
This study was undertaken to examine factors relating to adolescent suicide behavior. This was a cross-sectional school survey of 4,500 adolescent students based on a structured questionnaire. Data were collected using the supervised self-administered questionnaire (modified version of the Youth Risk Behavior Surveillance in the Malaysian National Language, Bahasa Malaysia). Seven percent (312 of 4,454) of the adolescent students had seriously considered attempting suicide. Among the adolescents, 4.6% had attempted suicide at least once during the 12 months preceding the survey. Female adolescents were more likely to put their suicidal thoughts into suicidal action than were male adolescents. Malay and Indian people are more likely than the Chinese to respond, "Felt sad and hopeless." However, Malay adolescents had the lowest rate of attempted suicide. Based on multiple logistic regression, factors significantly related to urban adolescents' suicide behavior are "Felt sad or hopeless," "Number of days felt unsafe to go to school," "Riding with a driver who had been drinking alcohol," "Physical fight," and "Number of days absent from school." In comparison, factors relating to rural adolescents' suicide behavior are "Felt sad or hopeless," "Physical fight," "Physical fight resulting in injury," and "Drive a vehicle after drinking alcohol." Adolescent suicide behavior should be viewed as a serious problem. Measures can be taken to prevent suicide by looking at the factors significantly linked to suicidal behavior among adolescents. Steps can then be taken to identify adolescents who have serious suicidal ideation so that intervention can be taken to reduce the suicidal rate.
Clare M. Roberts
Full Text Available The efficacy of an enhanced version of the Aussie Optimism Program (AOP was investigated in a cluster randomized controlled trial. Grade 6 students aged 10–11 years of age (N = 2288 from 63 government primary schools in Perth, Western Australia, participated in the pre, post, and follow-up study. Schools were randomly assigned to one of three conditions: Aussie Optimism with teacher training, Aussie Optimism with teacher training plus coaching, or a usual care condition that received the regular Western Australian Health Education Curriculum. Students in the Aussie Optimism conditions received 20, 1-h lessons relating to social and interpersonal skills and optimistic thinking skills over the last 2 years of primary school. Parents in the active conditions received a parent information booklet each year, plus a self-directed program in Grade 7. Students and parents completed the Extended Strengths and Difficulties Questionnaire. Students who scored in the clinical range on the Emotional Symptoms Scale were given The Diagnostic Interview for Children and Adolescents IV, to assess suicidal ideation and behavior, and depressive and anxiety disorders. Results indicated that Aussie Optimism with teacher training plus coaching was associated with the best outcomes: a significant increase in student-reported pro-social behavior from pre-test to post-test 1 (maintained at post-test 2 and significantly lower incidence rates from suicidal ideation at post-test 2 and follow-up. No significant intervention effects on anxiety and depressive disorders, and total difficulties were reported. These findings suggest that the AOP with teacher training along with coaching may have the potential to positively impact on suicidality and pro-social behavior in the pre-adolescent years.
Full Text Available AimMental Health workers bear responsibility for preventing suicide in their client group. Survey studies have indicated that staff can be seriously adversely affected when a client suicides. The aim of the current study is to describe and evaluate the effects on mental health (MH workers of their ongoing role in managing suicidal behaviours and to identify the thoughts and feelings associated with this role.MethodA survey was administered to 135 MH workers via an on-line self-report vehicle. The survey comprised standardised measures of anxiety and burnout as well as a questionnaire developed for this study concerning perceptions and attitudes to suicide and suicide prevention.ResultsFactor analysis of 12 retained items of the questionnaire identified three factors: 1 preventability beliefs (beliefs about suicide being always and/or permanently preventable; 2 associated distress (stress/anxiety about managing suicidal behaviour; and 3 the prevention role (covering views about personal roles and responsibilities in preventing suicidal behaviours. Analysis of these factors found that many MH workers experience an elevation of stress/anxiety in relation to their role in managing suicidal behaviours. This distress was associated with the emotional exhaustion component of burnout. Measures showed adverse responses were higher for outpatient than inpatient workers; for those who had received generic training in suicide prevention: and for those who had experienced a workplace related client suicide.ConclusionThere is a need for the development of appropriate self-care strategies to alleviate stress in MH workers exposed to suicide.
Garland, A; Shaffer, D; Whittle, B
A national survey of suicide prevention programs was conducted to determine the number, distribution and content of school-based, curriculum programs for adolescents. One hundred fifteen programs were identified. The total number of students and schools targeted for prevention efforts more than doubled during the academic years 1984/1985 to 1986/1987. Content of the programs was similar, with nearly all including information on suicide warning signs and other facts, as well as on accessing community mental health resources. Most included a separate component for school staff and parents. Ninety-five percent subscribed to the view that suicide is most commonly a response to extreme stress or pressure and could happen to anyone. Possible negative implications of this "stress model" of suicide were discussed. While this survey plays an important first step in providing a description of these programs, more evaluative research is needed to determine what effect, if any, these programs have on suicidal behavior.
Spencer-Thomas, Sally; Jahn, Danielle R.
Suicidology and suicide prevention are relatively new fields of study in the United States, but they have made significant progress since their beginnings. This study aimed to identify the most impactful theories in the history of science and suicidology and the most impactful events in the suicide prevention movement. These theories and events…
Krarup, Gertrud; Nielsen, Bent; Rask, P
. It is commonly agreed that the experience in childhood of suicidal behavior among family members or other persons in the close environment is of importance in future suicidal risk. The results of this study indicate that the predictive value of this factor mainly applies to attempts with no fatal outcome...... that the psychological climate of the home may be more important than the rupture of early home life. It is noteworthy that the group of repeaters, as against the first-evers, could be characterized by personality disorders and abuse, especially of alcohol: disorders known to be precipitated by a discordant childhood...
Giner, Lucas; Blasco-Fontecilla, Hilario; De La Vega, Diego; Courtet, Philippe
Suicide is one of the leading causes of violent death in many countries and its prevention is included in worldwide health objectives. Currently, the DSM-5 considers suicidal behavior as an entity that requires further study. Among the three validators required for considering a psychiatric disorder, there is one based on psychological correlates, biological markers, and patterns of comorbidity. This review includes the most important and recent studies on psychological factors: cognitive, emotional, temperament, and personality correlates (unrelated to diagnostic criteria). We included classic factors related to suicidal behavior such as cognitive, inflexibility, problem-solving, coping, rumination, thought suppression, decision-making, autobiographical memory, working memory, language fluency, burdensomeness, belongingness, fearless, pain insensitivity, impulsiveness, aggressiveness, and hopelessness. The personality correlates reported are mainly based on the personality theories of Cloninger, Costa and McCrae, and Eysenck. Moreover, it explores conceptual links to other new pathways in psychological factors, emptiness, and psychological pain as a possible origin and common end path for a portion of suicidal behaviors.
Campbell, Anita; Chapman, Murray; McHugh, Cate; Sng, Adelln; Balaratnasingam, Sivasankaran
This audit examined the demographics of Indigenous Australians dying by suicide in the Kimberley region of Western Australia during the period 2005-2014. This is a de-identified retrospective audit of reported suicide deaths provided to Kimberley Mental Health and Drug Service during the period 2005-2014. Variables such as age, sex, method of suicide, previous engagement with mental health services, locality and ethnicity were assessed. Indigenous suicide rates in the Kimberley region have dramatically increased in the last decade. There is also an overall trend upwards in Indigenous youth suicide and Indigenous female suicides. These findings highlight the need for culturally informed, and youth focussed, suicide prevention interventions within the Kimberley region. © The Royal Australian and New Zealand College of Psychiatrists 2016.
Ramberg, Inga-Lill; Di Lucca, Maria Anna; Hadlaczky, Gergö
Suicide-preventive training has shown to influence attitudes. This study aimed at investigating what impact other factors than knowledge might have on attitudes towards work with suicidal patients and suicide prevention. In 2007, 500 health-care staff working in a psychiatric clinic in Stockholm received a questionnaire with items concerning work with suicidal patients to which 358 (71.6%) responded. A set of attitude items were tested using structural equation modelling (LISREL). Three models were found to be satisfactory valid and reliable: Job clarity, Job confidence and Attitudes towards prevention. These were then used in regression analyses as dependent variables with predictors such as experience of work with suicidal patients, perceived sufficient training, age and gender. Perceived sufficient training was consistently the most important predictor for all three attitude concepts (p prevention). Age was another significant predictor for Job clarity (p suicide for Job confidence (p suicide preventive education is likely to improve attitudes towards the prevention of suicide, clarity and confidence regarding their role in the care for suicidal patients. These improvements may contribute to the prevention of suicide in health care settings.
Miller, Matthew; Barber, Catherine; White, Richard A; Azrael, Deborah
On an average day in the United States, more than 100 Americans die by suicide; half of these suicides involve the use of firearms. In this ecological study, we used linear regression techniques and recently available state-level measures of suicide attempt rates to assess whether, and if so, to what extent, the well-established relationship between household firearm ownership rates and suicide mortality persists after accounting for rates of underlying suicidal behavior. After controlling for state-level suicide attempt rates (2008-2009), higher rates of firearm ownership (assessed in 2004) were strongly associated with higher rates of overall suicide and firearm suicide, but not with nonfirearm suicide (2008-2009). Furthermore, suicide attempt rates were not significantly related to gun ownership levels. These findings suggest that firearm ownership rates, independent of underlying rates of suicidal behavior, largely determine variations in suicide mortality across the 50 states. Our results support the hypothesis that firearms in the home impose suicide risk above and beyond the baseline risk and help explain why, year after year, several thousand more Americans die by suicide in states with higher than average household firearm ownership compared with states with lower than average firearm ownership.
Di Napoli, Wilma Angela; Della Rosa, Alberto
The World Health Organization identifies suicide among the top 10 causes of death in many countries with an overall mortality rate of 16 per 100,000 inhabitants. Furthermore suicide attempts present a frequency 4-10 times greater than the suicidal events, representing also one of the main risk factors to lead to recurrent attempts of suicide. In 2008 the Autonomous Province of Trento launched a suicide prevention pogram called "Invitation to Life" which includes various interventions intended to counter the phenomenon of suicide in the region. Actually the epidemiological research upon the phenomenon of suicide in Trentino region is one of the main pillars of the project: it represents a fundamental requirement to identify risk and protective factors in the population in order to adopt more specific and effective preventive strategies. This article aims to present methods and instruments for epidemiological monitoring of suicide and attempted suicide which are applied in Trentino and to describe results after seven years from the beginning of the local prevention program "Invitation to life".
Harrod, Curtis S; Goss, Cynthia W; Stallones, Lorann; DiGuiseppi, Carolyn
Suicide is a leading cause of death among post-secondary students worldwide. Suicidal thoughts and planning are common among post-secondary students. Previous reviews have examined the effectiveness of interventions for symptomatic individuals; however, many students at high risk of suicide are undiagnosed and untreated. We evaluated the effect on suicide and suicide-related outcomes of primary suicide prevention interventions that targeted students within the post-secondary setting. We searched the following sources up to June 2011: Specialised Registers of two Cochrane Groups, Cochrane Central Register of Controlled Trials, and nine other databases, trial registers, conference proceedings, and websites of national and international organizations. We screened reference lists and contacted authors of included studies to identify additional studies. We updated the search in November 2013; we will include these results in the review's next update. We included studies that tested an intervention for the primary prevention of suicide using a randomized controlled trial (RCT), controlled before-and-after (CBA), controlled interrupted time series (CITS), or interrupted time series (ITS) study design. Interventions targeted students within the post-secondary setting (i.e. college, university, academy, vocational, or any other post-secondary educational institution) without known mental illness, previous suicide attempt or self-harm, or suicidal ideation. Outcomes included suicides, suicide attempts, suicidal ideation, changes in suicide-related knowledge, attitudes and behavior, and availability of means of suicide. We used standardized electronic forms for data extraction, risk of bias and quality of evidence determination, and analysis. We estimated standardised mean differences (SMD) with 95% confidence intervals (CIs). We analysed studies by intervention type and study design. We summarized RCT effect sizes using random-effects models meta-analyses; and analysed
The article reviews the evidence on the role of childhood adversities, family structure, and parenting in youth suicidal behavior, and suggests that future suicide research could benefit from investigating how parenting can protect against suicidal behavior in young people at risk. It discusses how empirical studies have moved from routinely including various operationalizations of "non-optimal" parenting as a "risk factor" for adolescent suicidal behavior to identifying pathways of influence and buffer effects. It argues that measures (both at the micro and the macro level) that target vulnerable populations such as parents with weak material and social resources, low social and emotional support, mental health problems and few networks, and high-risk children might be beneficial in preventing youth suicidal behaviors.
Greening, Leilani; Stoppelbein, Laura; Luebbe, Aaron
Given that parenting practices have been linked to suicidal behavior in adolescence, examining the moderating effect of parenting styles on suicidal behavior early in development could offer potential insight into possible buffers as well as directions for suicide prevention and intervention later in adolescence. Hence, the moderating effects of parenting styles, including authoritarian, permissive, and features of authoritative parenting, on depressed and aggressive children's suicidal behavior, including ideation and attempts, were evaluated with young children (N = 172; 72% male, 28% female) ranging from 6 to 12 years of age. African American (69%) and Caucasian (31%) children admitted for acute psychiatric inpatient care completed standardized measures of suicidal behavior, depressive symptoms, and proactive and reaction aggression. Their parents also completed standardized measures of parental distress and parenting style. Hierarchical regression analyses revealed that, while statistically controlling for age and gender, children who endorsed more depressive symptoms or reactive aggression reported more current and past suicidal behavior than children who endorsed fewer depressive or aggressive symptoms. The significant positive relationship observed between depressive symptoms and childhood suicidal behavior, however, was attenuated by parental use of authoritarian parenting practices for African-American and older children but not for younger and Caucasian children. The ethnic/racial difference observed for the buffering effect of authoritarian parenting practices offers potential theoretical and clinical implications for conceptualizing the moderating effects of parenting styles on African-American and Caucasian children's suicidal behavior.
Ma, Jing; Zhang, Wei; Harris, Keith; Chen, Qiang; Xu, Xiaolin
Social media and online environments are becoming increasingly popular and integral to modern lives. The online presentation of suicidal behaviors is an example of the importance of communication technologies, and the need for professionals to respond to a changing world. These types of behaviors, however, have rarely been scientifically analyzed. This study aimed to examine the behaviors of both suicide broadcasters and their audience, with attention on prevention/crisis opportunities. Multiple case studies were employed to explore live-broadcast suicide by Chinese emerging adults (aged 18-25 years). Six cases were selected (four males, two females; aged 19-24, M = 21.60, SD = 2.25), retrieved from 190 public documents (case range = 5 to 32; M = 11.50, SD = 10.37). A qualitative study based on grounded theory was adopted. Information on case background, stages, participants and their behaviors were collected. (1) Five stages of blogcast suicide incidents were revealed, including: Signaling, Initial reactions, Live blogcast of suicide attempts, Crisis responses, and Final outcomes. (2) Common behavioral trends (e.g., comforting, verbal abuse) were identified from the blogcast participants (e.g., active audience, peers, parents and police). (3) Suicide blogcasters exhibited tendencies to communicated signs of pain and cries for help. This multi-case study found live presentations of suicidal behaviors offered unique opportunities to respond to suicidal crises, and also to learn more about the relationships between suicidal people and potential help sources. Findings showed many audience members wanted to be helpful but lacked appropriate skills or knowledge. Others engaged in suicide cyberbullying. The social media is an environment in the making. This study revealed that increasing knowledge and skills for crisis response and suicide prevention is needed. Such efforts could lead to empowered netizens and a more hospitable online world.
Full Text Available Abstract Background Social media and online environments are becoming increasingly popular and integral to modern lives. The online presentation of suicidal behaviors is an example of the importance of communication technologies, and the need for professionals to respond to a changing world. These types of behaviors, however, have rarely been scientifically analyzed. This study aimed to examine the behaviors of both suicide broadcasters and their audience, with attention on prevention/crisis opportunities. Methods Multiple case studies were employed to explore live-broadcast suicide by Chinese emerging adults (aged 18-25 years. Six cases were selected (four males, two females; aged 19-24, M = 21.60, SD = 2.25, retrieved from 190 public documents (case range = 5 to 32; M = 11.50, SD = 10.37. A qualitative study based on grounded theory was adopted. Information on case background, stages, participants and their behaviors were collected. Results (1 Five stages of blogcast suicide incidents were revealed, including: Signaling, Initial reactions, Live blogcast of suicide attempts, Crisis responses, and Final outcomes. (2 Common behavioral trends (e.g., comforting, verbal abuse were identified from the blogcast participants (e.g., active audience, peers, parents and police. (3 Suicide blogcasters exhibited tendencies to communicated signs of pain and cries for help. Conclusions This multi-case study found live presentations of suicidal behaviors offered unique opportunities to respond to suicidal crises, and also to learn more about the relationships between suicidal people and potential help sources. Findings showed many audience members wanted to be helpful but lacked appropriate skills or knowledge. Others engaged in suicide cyberbullying. The social media is an environment in the making. This study revealed that increasing knowledge and skills for crisis response and suicide prevention is needed. Such efforts could lead to
Lutz, Julie; Fiske, Amy
Middle-aged and older adults have elevated rates of suicide around the globe, but there is a paucity of knowledge about risk factors for suicide in these age groups. One possible risk factor may be functional disability, which is more common at later ages. The current systematic critical review examined findings regarding the associations between functional disability and suicidal behavior (suicidal ideation, suicide attempts, and death by suicide) in middle-aged and older adults (i.e. age 50 and older). Forty-five studies were found that examined these associations. The majority of studies supported a significant association between functional disability and suicidal ideation. In addition, findings to date strongly suggest that depression serves as a mediator of the association between functional disability and suicidal ideation, though most studies did not directly test for mediation. Firm conclusions regarding suicide attempts and death by suicide, as well as mediation, cannot be drawn due to a relative lack of research in these areas. The association between functional disability and suicidal behavior suggests an important area for prevention and intervention among middle-aged and older adults, but additional research is necessary to clarify the specifics of these associations and examine appropriate intervention strategies. Important future directions for research in this area include the direct comparison of associations of risk factors with different types of suicidal behavior, greater use of longitudinal data with multiple time points, and further examination of potential mediators and moderators of the association between functional disability and suicidal behavior. Copyright © 2017 Elsevier B.V. All rights reserved.
Bauer, Rebecca L; Chesin, Megan S; Jeglic, Elizabeth L
Liu (2004) investigated the interaction between delinquency and depression among adolescents and found that delinquency moderated the relationship between depression and suicidal behaviors. This study also explored the relationship between depression, delinquency, and suicidal behaviors, although delinquency was expected to mediate, as opposed to moderate, the relationship between depression and suicidal behaviors. The participants comprised 354 college students. The students completed a series of questionnaires measuring delinquent behavior, depressive symptoms, and suicidal thoughts and behaviors. Contrary to Liu's (2004) findings, delinquency was found not to moderate but rather to partially mediate the relationship between depression and suicidal behaviors. The findings suggest that for some college students, depression is associated with delinquent behaviors, which, in turn, are associated with suicidal behaviors.
Talib, Mansor Abu; Abdollahi, Abbas
Suicide is an important public health problem for adolescents, and it is essential to increase our knowledge concerning the etiology of suicide among adolescent students. Therefore, this study was designed to examine the associations between hopelessness, depression, spirituality, and suicidal behavior, and to examine spirituality as a moderator between hopelessness, depression, and suicidal behavior among 1376 Malaysian adolescent students. The participants completed measures of depression, hopelessness, daily spiritual experience, and suicidal behavior. Structural equation modeling indicated that adolescent students high in hopelessness and depression, but also high in spirituality, had less suicidal behavior than others. These findings reinforce the importance of spirituality as a protective factor against hopelessness, depression, and suicidal behavior among Malaysian adolescent students.
Meerwijk, Esther L; Weiss, Sandra J
Among people with suicide ideation most do not attempt suicide or die by suicide. In this online study of adult US Facebook users (n = 219), we examined capability for suicide, operationalized as fearlessness about death, and tolerance for psychological pain as potential variables that may explain why some people move from suicide ideation to suicidal behavior. Tolerance for psychological pain was significantly higher for participants who had never attempted suicide. Fearlessness about death was higher in participants who had attempted suicide, but not significantly. At high levels of psychological pain, one's belief in the ability to cope with psychological pain, a dimension of tolerance for psychological pain, was lower in participants with a history of suicide attempt than in participants who had never attempted suicide. The odds of suicidal desire were almost cut in half with each unit increase in participants' belief in their coping ability, whereas for each unit increase in fearlessness about death, the odds of suicidal desire increased by 65%. The Pearson correlation between tolerance for psychological pain and fearlessness about death was negligible. Our findings support a role for both tolerance for psychological pain and capability for suicide/fearlessness about death in the ideation-to-action framework of suicide. Copyright © 2018 Elsevier B.V. All rights reserved.
Marutani, Miki; Yamamoto-Mitani, Noriko; Kodama, Shimpei
Suicide is a major health issue worldwide, including in Japan. Japanese public health nurses (PHNs) play a distinctive role in suicide prevention, although few studies have delineated this role. The purpose of this study was to develop a conceptual framework that elucidates PHNs' activities for suicide prevention. Semi-structured interviews were conducted in 2012-2013 with 15 PHNs who worked in Tokyo metropolitan regions. Data were analyzed qualitatively using grounded theory, and a conceptual framework with seven categories was developed. Three phases that depict the PHNs' suicide prevention activities emerged. Phase I, Pursuing to understand suicide cases, included two categories: tracing back individual suicide cases and raising consciousness among the general public. Phase II, Spreading a web of care, included three categories: knitting a caring network, weaving regular programs into the web, and continuing to be a member of the web. Phase III, Maintaining motivation and commitment, included two categories: legitimatizing suicide prevention and cultivating continued commitment in the community. The activities of suicide prevention by PHNs included a process of developing a caring network that lead to the enhancement of the caring capacity of the community as a whole. © 2016 Wiley Periodicals, Inc.
Tang, Fang; Byrne, Majella; Qin, Ping
Psychological distress and suicidal behavior are important mental health problems among university students and warrant research to inform strategies for effective prevention in this young population. The present study aimed to assess psychological distress and suicidal behavior and to unravel their associations among university students. A total of 5972 undergraduate students, randomly selected from six universities in central China, comprised the sample. The Chinese version of the Symptom Checklist-90-revised (SCL-90-R) was used to assess various psychological symptoms. Logistic regression analysis was used to examine the relationship between psychological distress and risk for suicidal behavior. 40.7% of the university students reported positive in a least one of the 9 psychological symptom dimensions assessed by the SCL-90-R. 7.6% of the students reported suicidal behavior in the previous twelve months. The risk of suicidal behavior was significantly associated with psychological symptoms of all types, but there were notable differences by sex. For male students, depression and phobic anxiety increased the risk of suicidal behavior. Meanwhile, depression and obsessive-compulsiveness were positively associated with suicidal behavior in female students. Furthermore, increasing risk of suicidal behavior was associated with increasing positive symptom total (PST) score and a statistically significant trend was observed. Data collected from a cross-sectional survey does not allow any examination of causal inference. Psychological distress and suicidal behavior were both common among university students; and psychological distress was highly associated with suicidal behavior. The findings underscore the importance of mental health care for university students. Copyright © 2017 Elsevier B.V. All rights reserved.
Zalsman, Gil; Hawton, Keith; Wasserman, Danuta; van Heeringen, Kees; Arensman, Ella; Sarchiapone, Marco; Carli, Vladimir; Höschl, Cyril; Barzilay, Ran; Balazs, Judit; Purebl, György; Kahn, Jean Pierre; Sáiz, Pilar Alejandra; Lipsicas, Cendrine Bursztein; Bobes, Julio; Cozman, Doina; Hegerl, Ulrich; Zohar, Joseph
Many countries are developing suicide prevention strategies for which up-to-date, high-quality evidence is required. We present updated evidence for the effectiveness of suicide prevention interventions since 2005. We searched PubMed and the Cochrane Library using multiple terms related to suicide prevention for studies published between Jan 1, 2005, and Dec 31, 2014. We assessed seven interventions: public and physician education, media strategies, screening, restricting access to suicide means, treatments, and internet or hotline support. Data were extracted on primary outcomes of interest, namely suicidal behaviour (suicide, attempt, or ideation), and intermediate or secondary outcomes (treatment-seeking, identification of at-risk individuals, antidepressant prescription or use rates, or referrals). 18 suicide prevention experts from 13 European countries reviewed all articles and rated the strength of evidence using the Oxford criteria. Because the heterogeneity of populations and methodology did not permit formal meta-analysis, we present a narrative analysis. We identified 1797 studies, including 23 systematic reviews, 12 meta-analyses, 40 randomised controlled trials (RCTs), 67 cohort trials, and 22 ecological or population-based investigations. Evidence for restricting access to lethal means in prevention of suicide has strengthened since 2005, especially with regard to control of analgesics (overall decrease of 43% since 2005) and hot-spots for suicide by jumping (reduction of 86% since 2005, 79% to 91%). School-based awareness programmes have been shown to reduce suicide attempts (odds ratio [OR] 0·45, 95% CI 0·24-0·85; p=0·014) and suicidal ideation (0·5, 0·27-0·92; p=0·025). The anti-suicidal effects of clozapine and lithium have been substantiated, but might be less specific than previously thought. Effective pharmacological and psychological treatments of depression are important in prevention. Insufficient evidence exists to assess the
Gould, Madelyn S.; Munfakh, Jimmie L. H.; Kleinman, Marjorie; Lake, Alison M.
Linking at-risk callers to ongoing mental health care is a key goal of crisis hotline interventions that has not often been addressed in evaluations of hotlines' effectiveness. We conducted telephone interviews with 376 suicidal and 278 nonsuicidal crisis callers to the National Suicide Prevention Lifeline (Lifeline) to assess rates of mental…
Caine, Eric D
Suicide prevention must be transformed by integrating injury prevention and mental health perspectives to develop a mosaic of common risk public health interventions that address the diversity of populations and individuals whose mortality and morbidity contribute to the burdens of suicide and attempted suicide. Emphasizing distal preventive interventions, strategies must focus on people and places--and on related interpersonal factors and social contexts--to alter the life trajectories of people before they become suicidal. Attention also must be paid to those in the middle years--the age with the greatest overall burden. We need scientific and social processes that define priorities and assess their potential for reducing what has been a steadily increasing rate of suicide during the past decade.
Burke, Ainsley K.; Galfalvy, Hanga; Everett, Benjamin; Currier, Dianne; Zelazny, Jamie; Oquendo, Maria A.; Melhem, Nadine M.; Kolko, David; Harkavy-Friedman, Jill M.; Birmaher, Boris; Stanley, Barbara; Mann, J. John; Brent, David A.
Objective: Exposure to suicidal behavior in peers and relatives is thought to increase risk for suicidal behavior in vulnerable individuals, possibly as a result of imitation or modeling. This study examines exposure to suicidal behavior and likelihood of suicide attempt in a high-risk cohort of offspring of a depressed parent. Method: A total of…
Hoffmire, Claire; Stephens, Brady; Morley, Sybil; Thompson, Caitlin; Kemp, Janet; Bossarte, Robert M
The US Department of Veterans Affairs' Suicide Prevention Applications Network (SPAN) is a national system for suicide event tracking and case management. The objective of this study was to assess data on suicide attempts among people using Veterans Health Administration (VHA) services. We assessed the degree of data overlap on suicide attempters reported in SPAN and the VHA's medical records from October 1, 2010, to September 30, 2014-overall, by year, and by region. Data on suicide attempters in the VHA's medical records consisted of diagnoses documented with E95 codes from the International Classification of Diseases, Ninth Revision . Of 50 518 VHA patients who attempted suicide during the 4-year study period, data on fewer than half (41%) were reported in both SPAN and the medical records; nearly 65% of patients whose suicide attempt was recorded in SPAN had no data on attempted suicide in the VHA's medical records. Evaluation of administrative data suggests that use of SPAN substantially increases the collection of data on suicide attempters as compared with the use of medical records alone, but neither SPAN nor the VHA's medical records identify all suicide attempters. Further research is needed to better understand the strengths and limitations of both systems and how to best combine information across systems.
Liu, Richard T; Miller, Ivan
Despite the sustained theoretical and empirical interest over the past 40years in the association between life events and suicidal ideation and behavior, the literature in this area has yet to be systematically reviewed. The current article provides a comprehensive review of the empirical literature pertaining to life events in relation to at least one aspect of suicidal ideation and behavior (i.e., suicidal ideation, plans, attempts, degree of suicidal intent, medical severity of attempt, repeat versus first lifetime attempt status, and death by suicide). A total of 95 articles meeting inclusion criteria were identified by a literature search using Medline and PsycINFO. Evidence for an association between negative life events and suicidal ideation and behavior was generally consistent, with strongest support found for more severe than with less severe forms of suicidal ideation and behavior. Support for an inverse relation between positive events and suicidal ideation and behavior was generally lacking. Although there is general support for life stressors as a risk factor for suicidal ideation and behavior, interpretation of these findings is constrained by methodological limitations prevalent in much of the literature, particularly in the case of suicidal ideation and suicide plans. Recommendations for future research are provided. Copyright © 2014 Elsevier Ltd. All rights reserved.
Suicide prevention for people with schizophrenia or bipolar disorder warrants an evidence-based approach to service design as well as clinical practice. The issue of personal responsibility (diminished when mental capacity is impaired) contributing to reduction of suicide risk has, arguably, been neglected. © The Royal College of Psychiatrists 2015.
Methods: The present study is an analysis of 63 essays written by secondary school learners on the subject of suicide prevention. Results: Just over two-thirds of the essays revealed reasonable knowledge without serious inaccuracies, with over half the sample citing conflict with parents as precipitants to suicidal behaviour.
Suicidal behaviour is an important public health problem globally and in Africa. A brief overview of the nature and severity of the problem is provided, but the primary aim of this paper is to identify priorities and prevention strategies for reducing suicidal behaviour in South Africa by discussing a framework for a proposed ...
Franks, Rebecca; Burnett, Donna O.; Evans, Retta R.
Suicide is a preventable public health concern affecting the nation as the 10th leading cause of death. The prevalence of suicide among the elderly is higher than any other group. Risk factors attributed to this phenomenon are depression, social isolation, substance abuse, poor physical health or function, financial stress, and access to lethal…
Robinson, Jo; Cox, Georgina; Bailey, Eleanor; Hetrick, Sarah; Rodrigues, Maria; Fisher, Steve; Herrman, Helen
Social media platforms are commonly used for the expression of suicidal thoughts and feelings, particularly by young people. Despite this, little is known about the ways in which social media can be used for suicide prevention. The aim of this study was to conduct a systematic review to identify current evidence pertaining to the ways in which social media are currently used as a tool for suicide prevention. Medline, PsycInfo, Embase, CINHAL and the Cochrane Library were searched for articles published between 1991 and April 2014. English language articles with a focus on suicide-related behaviour and social media were included. No exclusion was placed on study design. Thirty studies were included; 4 described the development of social media sites designed for suicide prevention, 6 examined the potential of social media in terms of its ability to reach or identify people at risk of suicide, 15 examined the ways in which people used social media for suicide prevention-related purposes, and 5 examined the experiences of people who had used social media sites for suicide prevention purposes. No intervention studies were identified. Social media platforms can reach large numbers of otherwise hard-to-engage individuals, may allow others to intervene following an expression of suicidal ideation online, and provide an anonymous, accessible and non-judgmental forum for sharing experiences. Challenges include difficulties controlling user behaviour and accurately assessing risk, issues relating to privacy and confidentiality and the possibility of contagion. Social media appears to hold significant potential for suicide prevention; however, additional research into its safety and efficacy is required. © 2015 Wiley Publishing Asia Pty Ltd.
Miller, Ivan W; Camargo, Carlos A; Arias, Sarah A; Sullivan, Ashley F; Allen, Michael H; Goldstein, Amy B; Manton, Anne P; Espinola, Janice A; Jones, Richard; Hasegawa, Kohei; Boudreaux, Edwin D
Suicide is a leading cause of deaths in the United States. Although the emergency department (ED) is an opportune setting for initiating suicide prevention efforts, ED-initiated suicide prevention interventions remain underdeveloped. To determine whether an ED-initiated intervention reduces subsequent suicidal behavior. This multicenter study of 8 EDs in the United States enrolled adults with a recent suicide attempt or ideation and was composed of 3 sequential phases: (1) a treatment as usual (TAU) phase from August 2010 to December 2011, (2) a universal screening (screening) phase from September 2011 to December 2012, and (3) a universal screening plus intervention (intervention) phase from July 2012 to November 2013. Screening consisted of universal suicide risk screening. The intervention phase consisted of universal screening plus an intervention, which included secondary suicide risk screening by the ED physician, discharge resources, and post-ED telephone calls focused on reducing suicide risk. The primary outcome was suicide attempts (nonfatal and fatal) over the 52-week follow-up period. The proportion and total number of attempts were analyzed. A total of 1376 participants were recruited, including 769 females (55.9%) with a median (interquartile range) age of 37 (26-47) years. A total of 288 participants (20.9%) made at least 1 suicide attempt, and there were 548 total suicide attempts among participants. There were no significant differences in risk reduction between the TAU and screening phases (23% vs 22%, respectively). However, compared with the TAU phase, patients in the intervention phase showed a 5% absolute reduction in suicide attempt risk (23% vs 18%), with a relative risk reduction of 20%. Participants in the intervention phase had 30% fewer total suicide attempts than participants in the TAU phase. Negative binomial regression analysis indicated that the participants in the intervention phase had significantly fewer total suicide attempts
Flynn, Alexandra; Zackula, Rosalee; Klaus, Nicole M; McGinness, Liz; Carr, Susan; Macaluso, Matthew
Yellow Ribbon is a gatekeeper-type suicide prevention program that is widely used in public schools. However, data on its effectiveness are limited. The purpose of our study was to evaluate self-reported changes in knowledge and comfort level communicating about suicide following Yellow Ribbon training for a large, representative sample of students from a public school system in the midwestern United States. The program was administered to students within the same school district during 2006 through 2009. A pre-post survey using a 4-point Likert scale was administered to rate students' knowledge of risk factors and available resources, comfort level communicating about suicide, estimate of friends at risk for suicide, and behavioral intent toward help-seeking. Aggregate responses from 3,257 students, aged 11 to 18 years, were collected by the schools; 51% were female, 33% were Hispanic, and 30% were white. Suicide-related knowledge of risk factors, where to go for help, and resources, along with comfort level in asking for help, all significantly improved following program participation (Cramer's V = 0.243 to 0.376, P suicide prevention program appears to be beneficial for students in the midwestern United States. We observed significant improvement in knowledge, comfort level, and behavioral intent for help-seeking if suicidal thoughts occur. Findings also suggested that Yellow Ribbon training administered during middle school may be especially helpful for males.
Nock, Matthew K; Green, Jennifer Greif; Hwang, Irving; McLaughlin, Katie A; Sampson, Nancy A; Zaslavsky, Alan M; Kessler, Ronald C
Although suicide is the third leading cause of death among US adolescents, little is known about the prevalence, correlates, or treatment of its immediate precursors, adolescent suicidal behaviors (ie, suicide ideation, plans, and attempts). To estimate the lifetime prevalence of suicidal behaviors among US adolescents and the associations of retrospectively reported, temporally primary DSM-IV disorders with the subsequent onset of suicidal behaviors. Dual-frame national sample of adolescents from the National Comorbidity Survey Replication Adolescent Supplement. Face-to-face household interviews with adolescents and questionnaires for parents. A total of 6483 adolescents 13 to 18 years of age and their parents. Lifetime suicide ideation, plans, and attempts. The estimated lifetime prevalences of suicide ideation, plans, and attempts among the respondents are 12.1%, 4.0%, and 4.1%, respectively. The vast majority of adolescents with these behaviors meet lifetime criteria for at least one DSM-IV mental disorder assessed in the survey. Most temporally primary (based on retrospective age-of-onset reports) fear/anger, distress, disruptive behavior, and substance disorders significantly predict elevated odds of subsequent suicidal behaviors in bivariate models. The most consistently significant associations of these disorders are with suicide ideation, although a number of disorders are also predictors of plans and both planned and unplanned attempts among ideators. Most suicidal adolescents (>80%) receive some form of mental health treatment. In most cases (>55%), treatment starts prior to onset of suicidal behaviors but fails to prevent these behaviors from occurring. Suicidal behaviors are common among US adolescents, with rates that approach those of adults. The vast majority of youth with suicidal behaviors have preexisting mental disorders. The disorders most powerfully predicting ideation, though, are different from those most powerfully predicting conditional
Paraschakis, Antonios; Michopoulos, Ioannis; Christodoulou, Christos; Koutsaftis, Filippos; Douzenis, Athanassios
Frequency and gender differences of psychiatric medication intake in a sample of suicide victims from the Athens Greater Area were investigated with a particular focus on the implications for suicide prevention. Data were collected from the toxicological analyses of the suicide cases of the period November 2007-October 2009. Information was available for 262 individuals, 196 men (74.8%) and 66 women (25.2%); 109 of these (41.6%) were receiving psychiatric medication(s). Women were statistically more frequently under treatment: antidepressants (32.8% vs. 11.3%, p suicides. More thoughtful choice of psychiatric medication could possibly already prevent a number of female suicides. © 2016 American Academy of Forensic Sciences.
Full Text Available Background: This study examined the tendency and suicidal behavior rates of Chinese adult inpatients with different types of mental disorders from 2010 to 2015. The aim was to provide some interesting clues for further studies. Methods: Adult patients with mental disorders who were hospitalized in Beijing Anding hospital from 1 January 2010 to 31 December 2015 were included. Chi-square tests were used to compare the difference among inpatients with mental disorders by gender and year. Frequency, trend and suicidal behavior rates of inpatients with mental disorders were graphed. Results: A total of 17,244 psychiatric adult inpatients were included in our study. About 53.2% of the inpatients had mood disorders, followed by schizophrenia, which accounted for 34.6%. The proportion of female inpatients with mental disorders was larger than that of males (52.6% to 47.4%. Of the total, 3296 psychiatric inpatients were recognized as having suicidal behaviors. The rate of suicidal behavior among all inpatients was 19.1%, and it varied over the years. The suicidal behavior rate of female inpatients with mood disorders was much higher than that of the corresponding male inpatients. Conclusions: The presence of suicidal behavior varied among people with different types of mental disorders. For each type of mental illness, identifying the risk of specific suicide behavior would help tailor-make preventive efforts accordingly.
Skerrett, Delaney M; Kõlves, Kairi; De Leo, Diego
The aim of this article is to review the Australian literature about suicidality in minority sexual identity and/or behavior groups in order to determine the evidence base for their reported higher vulnerability to suicidal behaviors than heterosexual and non-transgendered individuals in the Australian context, as well as to identify the factors that are predictive of suicidal behaviors in these groups in Australia. A literature search for all available years (until the end of 2012) was conducted using the databases Scopus, Medline, and Proquest for articles published in English in peer-reviewed academic journals. All peer-reviewed publications that provided empirical evidence for prevalence and predictive factors of suicidal behaviors among LGBT individuals (or a subset thereof) in Australia were included. Reference lists were also scrutinized to identify "gray" literature for inclusion. The results revealed that there is only limited research from Australia. Nevertheless, although no population-based studies have been published, research indicates that sexual minorities are indeed at a higher risk for suicidal behaviors. In order to further the understanding of suicidal behaviors and potential prevention among LGBT groups in the Australia, further research is needed, particularly on fatal suicidal behaviors.
The suicide rates in Denmark have been declining during the last two decades. The decline was relatively larger among women than among men. All age groups experienced a decline except the very young with stable rates and the very old with increasing rates. The Universal, Selective, Indicated (USI) model recommended by Institute of Medicine was used as a framework for the thesis. Universal preventive interventions are directed toward the entire population; selective interventions are directed toward individuals who are at greater risk for suicidal behaviour; and indicated preventions are targeted at individuals who have already begun self-destructive behaviour. At the universal level, a review was carried out to highlight the association between availability of methods for suicide and suicide rate. There were mostly studies of firearms, and the conclusion of the review was that there was clear indication of restricted access to lethal means was associated with decline in suicide with that specific method, and in many cases also with overall suicide mortality. Restricting access is especially important for methods with high case fatality rate. Our own study indicated a beneficial effect on suicide rates of restrictions in access to barbiturates, dextropropoxyphen, domestic gas and car exhaust with high content of carbon monoxide. Although a range of other factors in the society might also be of importance, it was concluded that restrictions in access to dangerous means for suicide were likely to play an important role in reducing suicide rates in Denmark, especially for women. At the selective level, there are several important risk groups such as psychiatric patients, persons with alcohol and drug abuse, persons with newly diagnosed severe physical illness, all who previously attempted suicide, and groups of homeless, institutionalized, prisoners and other socially excluded persons. The thesis focused on homeless persons and psychiatric patients, especially patients
Redvers, Jennifer; Bjerregaard, Peter; Eriksen, Heidi
, families and communities. The persistence of suicide has made it clear that more needs to be done. OBJECTIVE: Our aim was to undertake a scoping review of the peer-reviewed literature on suicide prevention and interventions in Indigenous communities across the circumpolar north. Our objective...... Indigenous populations; 19 articles discussed specific suicide-related interventions and 7 of these described program evaluation methods and results in detail. The majority of publications on specific interventions were found in North American countries. The majority of prevention or intervention......BACKGROUND: Suicide is a serious public health challenge in circumpolar regions, especially among Indigenous youth. Indigenous communities, government agencies and health care providers are making concerted efforts to reduce the burden of suicide and strengthen protective factors for individuals...
Alexander J Millner
Full Text Available Suicide is a leading cause of death worldwide. Although research has made strides in better defining suicidal behaviors, there has been less focus on accurate measurement. Currently, the widespread use of self-report, single-item questions to assess suicide ideation, plans and attempts may contribute to measurement problems and misclassification. We examined the validity of single-item measurement and the potential for statistical errors. Over 1,500 participants completed an online survey containing single-item questions regarding a history of suicidal behaviors, followed by questions with more precise language, multiple response options and narrative responses to examine the validity of single-item questions. We also conducted simulations to test whether common statistical tests are robust against the degree of misclassification produced by the use of single-items. We found that 11.3% of participants that endorsed a single-item suicide attempt measure engaged in behavior that would not meet the standard definition of a suicide attempt. Similarly, 8.8% of those who endorsed a single-item measure of suicide ideation endorsed thoughts that would not meet standard definitions of suicide ideation. Statistical simulations revealed that this level of misclassification substantially decreases statistical power and increases the likelihood of false conclusions from statistical tests. Providing a wider range of response options for each item reduced the misclassification rate by approximately half. Overall, the use of single-item, self-report questions to assess the presence of suicidal behaviors leads to misclassification, increasing the likelihood of statistical decision errors. Improving the measurement of suicidal behaviors is critical to increase understanding and prevention of suicide.
Pratt, Daniel; Gooding, Patricia; Awenat, Yvonne; Eccles, Steve; Tarrier, Nicholas
Suicide is a serious public health problem but a problem that is preventable. This complex and challenging problem is particularly prevalent amongst prisoners; associated with a five-fold increase in risk compared to the general community. Being in prison can lead people to experience fear, distrust, lack of control, isolation, and shame, which is often experienced as overwhelming and intolerable with some choosing suicide as a way to escape. Few effective psychological interventions exist to prevent suicide although cognitive behaviour therapies appear to offer some promise. Offering cognitive behaviour suicide prevention (CBSP) therapy to high risk prisoners may help to reduce the likelihood of preventable self-inflicted deaths. In this paper we present three cases drawn from a randomised controlled trial designed to investigate the feasibility of CBSP for male prisoners. Implications of the current findings for future research and clinical practice are considered.
Kõlves, Kairi; Barker, Emma; De Leo, Diego
Allergies are among the most common chronic conditions. In addition to physical and social impacts, a number of studies have consistently linked allergies to poor psychological outcomes, including depression and anxiety. The aim of the present systematic literature review was to analyze the existing literature about the relationship between allergies and fatal and nonfatal suicidal behaviors. Data sources include articles retrieved from Scopus, PubMed, ProQuest, and Web of Knowledge. Search terms: "suicid* and (allerg* or hay fever or atop* or eczema or aeroallergen*)" in English-language peer-reviewed journals between 1990 and 2014. Original research articles that provide empiric evidence about the potential link between allergies and suicidal behaviors. The initial search identified a total of 769 articles with 17 original research articles that present empiric evidence. Nine articles analyzed the relationship between allergies and fatal suicidal behavior, and nine analyzed nonfatal suicidal behaviors (one article included both). There currently is little research into the relationship between allergies and suicidal behavior. The review was restricted to English-language articles published within the chosen time period; other limitations included the small number of articles that involve suicide mortality, and the fact that the majority of articles originated from the United States and Scandinavia. Analysis of the results indicates a link between allergies and suicidality, particularly suicide mortality; however, results for nonfatal suicidal behaviors are mixed. It is important that further research by using more rigorous study designs be carried out to lend strength to these findings.
This article studies the statistical relationship between the search propensity of suicide-related terms on Google and the number of suicides. Suicide mortality data from all American states from January 2006 to November 2014 (n = 5372) and data on Google search intensity for the same period was collected. Regression analysis with dynamic components was performed to determine the relationship between search intensity and the number of suicides. First, this article finds a positive simultaneous correlation between search intensity and the number of suicides. The magnitude of this relationship has grown from 2006 to 2014 suggesting an increased reliance on the internet for suicide-related information. Second, search propensity is a significant predictor for the number of suicides for youth and for males. Suicide prevention websites should therefore be designed knowing that at-risk individuals in both groups are probably more prone to look for suicide-related information online. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Hirsch, Jameson K; Chang, Edward C; Jeglic, Elizabeth L
The objective of this study was to examine the combined moderating effects of life stress and loneliness on the association between social problem solving ability (SPS) and suicidal behaviors. We assessed SPS, suicidal behavior, loneliness, and stressful life events in a sample of 385 ethnically diverse college students. Overall, only loneliness moderated the association between SPS and suicidal behaviors. Across ethnic groups, loneliness moderated the association between SPS and suicidal behavior for Blacks, Whites, and Asians; life stress was a moderator for Hispanics. For most individuals, loneliness increases the strength of the association between poor problem-solving and suicidal behaviors. For Hispanics, life stress exacerbates this relationship. Ethnically-specific prevention strategies targeting loneliness and life stress may promote effective problem-solving, reducing suicide risk.
There are gaps in our knowledge of the role attitudes toward suicide play in determining people's willingness to participate (WTP) for suicide prevention. We conducted a large nationwide cross-sectional study with the aim of clarifying the relationship between WTP for reducing suicide risk and attitudes toward suicide. Ordinal logistic regression analyses (n = 1771) showed that there were significant associations of WTP for suicide prevention with 'Suicide as a right' (β = -.15, 95% CI: -.25 to -.04, p = .006), 'Preventability/readiness to help' (β = .81, 95% CI: .69-.94, p suicide prevention is more likely to be achieved through provision of information that increases endorsement of 'preventability/readiness to help' and 'common occurrence' factors, and decreases 'suicide as a right' scores.
du Roscoät, E; Beck, F
This review focuses on interventions to prevent suicide. It excludes psychotherapy evaluations and pharmaceutical clinical trials. The aim of this article is to provide useful input to the reflection on and the development of actions for professionals who may be concerned by suicide prevention. This research is based on 41 published evaluation studies presenting results on at least one of the three following outcomes: completed suicides, suicide attempts, and suicidal ideations. These studies have been classified into seven categories of preventive action. According to data from the literature selected for our analysis, the three most efficient categories of intervention seem to be the limitation of access to lethal means, the preservation of contact with the patients hospitalized for a suicide attempt after hospitalization, and the implementation of emergency call centers. The four other categories of intervention examined in this study - the training of general practitioners, the reorganization of care, programs in schools, and information campaigns - have not yet shown sufficient proof of their efficacy. Nevertheless, these interventions, under certain conditions, can also contribute significantly to the prevention of suicide. The majority of effective interventions minister to people already suffering from psychological disorders, but health promotion initiatives prior to situations of psychological disorders also deserve to be considered, in particular the implementation of services for the isolated elderly. Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Kaplan, M S; Adamek, M E; Rhoades, J A
Physicians have a unique role to play in the prevention of elder suicide, yet they may not be sufficiently attentive to the prominence of firearms in the rising trend in suicide by elder persons. This study sought to examine the extent to which physicians inquired about firearms with their depressed and suicidal elderly patients and further identified factors associated with physicians' likelihood of asking about firearms. A probability sample of 300 primary care physicians in Illinois was drawn from the American Medical Association Physician Masterfile. Physicians were chosen from the specialties most likely to be involved with elderly persons: internal medicine and family practice. A mailed questionnaire yielded a 63% response rate. Although they were treating depressed and suicidal older patients, a sizable proportion of the respondents (42%) reported that they did not ask such patients or their family members whether they had access to a firearm. Several factors distinguished physicians who assessed for firearms from those who did not. The most salient predictors were: continuing medical education training in suicide risk assessment, expertise in geriatric mental health, confidence in diagnosing depression, having a patient mention suicide in the past year, and indicating patient reluctance as a barrier to mental health treatment. Physicians working with depressed and suicidal elderly persons need to be informed about the prevalence of elder suicide and about the likelihood of elderly persons using firearms as a method of suicide. Effective suicide prevention will require physician training that directly addresses geriatric mental health and firearm suicide, in particular, at the student, residency, and continuing education levels.
Lapierre, Sylvie; Erlangsen, Annette; Waern, Margda; De Leo, Diego; Oyama, Hirofumi; Scocco, Paolo; Gallo, Joseph; Szanto, Katalin; Conwell, Yeates; Draper, Brian; Quinnett, Paul
Background Suicide rates are highest among the elderly, yet research on suicide prevention in old age remains a much-neglected area. Aims We carried out a systematic review to examine the results of interventions aimed at suicidal elderly persons and to identify successful strategies and areas needing further exploration. Methods Searches through various electronic databases yielded 19 studies with an empirical evaluation of a suicide prevention or intervention program designed especially for adults aged 60 years and older. Results Most studies were centered on the reduction of risk factors (depression screening and treatment, and decreasing isolation), but when gender was considered, programs were mostly efficient for women. The empirical evaluations of programs attending to the needs of high-risk older adults seemed positive; most studies showed a reduction in the level of suicidal ideation of patients or in the suicide rate of the participating communities. However, not all studies used measures of suicidality to evaluate the outcome of the intervention, and rarely did they aim at improving protective factors. Conclusions Innovative strategies should improve resilience and positive aging, engage family and community gatekeepers, use telecommunications to reach vulnerable older adult, and evaluate the effects of means restriction and physicians education on elderly suicide. PMID:21602163
Anneberg, Inger; Madsen, Bente Hjorth
In most countries men have a higher suicide rate than women. In Denmark suicide among men is almost three times as frequent as among women. For this reason we wanted to ask the following question: Is there any way to facilitate mens' access to help, when they are in a crisis? Could men be better...
Christensen, Helen; Batterham, Philip J; O'Dea, Bridianne
Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or to deliver proactive interventions in response to individuals' posts on social media. In this article, we examine research studies which focus on these three aspects of suicide and the internet: the use of online screening for suicide, the effectiveness of e-health interventions aimed to manage suicidal thoughts, and newer studies which aim to proactively intervene when individuals at risk of suicide are identified by their social media postings. We conclude that online screening may have a role, although there is a need for additional robust controlled research to establish whether suicide screening can effectively reduce suicide-related outcomes, and in what settings online screening might be most effective. The effectiveness of Internet interventions may be increased if these interventions are designed to specifically target suicidal thoughts, rather than associated conditions such as depression. The evidence for the use of intervention practices using social media is possible, although validity, feasibility and implementation remains highly uncertain.
Explored relationship between the extent of gun ownership and the strictness of gun control laws to suicide and homicide rates in the nine major geographic regions of the United States. Found gun ownership, rather than the strictness of gun control laws, was the strongest correlate of the rates of suicide and homicide by guns. (Author)
Indelicato, Natalie Arce; Mirsu-Paun, Anca; Griffin, Wayne D.
A university-wide suicide prevention program was implemented to provide students, faculty, and staff tools to identify, assist, and refer distressed and suicidal individuals. The study examined participant self-reports of suicide-related knowledge and prevention skills, group differences in suicide prevention knowledge and skills, group…
Skerrett, Delaney Michael; Mars, Michelle
The purpose of this article is to describe and assess-as well as identify and rectify gaps in-intervention and prevention initiatives that specifically address poor mental health outcomes and suicidal behaviors in lesbian, gay, bisexual, transgender, and intersex (LGBTI) populations in Australia. It begins with an overview of the evidence base for heightened vulnerability to suicidal behaviors among LGBTI people in Australia. It then provides a discussion on the public health implications for LGBTI-targeted mental health initiatives and the prevention of and timely intervention in LGBTI suicidal behaviors. We conclude that the literature supports an increased risk for poorer mental health outcomes and suicidal behaviors in LGBTI populations in the Australian context. Psychological distress and suicidal behaviors in LGBTI people in Australia have social determinants that can and have been addressed through the provision of interventions with a strong evidence base in reducing these outcomes, implemented at a nationwide level, including training of health professionals and gatekeepers to mental health services and the general public. We conclude that the current Australian focus appears to address many of the social determinants of suicidal behaviors and poor mental health in LGBTI people but requires sustained and uniform government support if it is to continue and to produce measurable results.
Madhav P Bhatta
Full Text Available PURPOSE: The purpose of this study was to assess the influence of multiple adverse life experiences (sexual abuse, homelessness, running away, and substance abuse in the family on suicide ideation and suicide attempt among adolescents at an urban juvenile detention facility in the United States. MATERIALS AND METHODS: The study sample included a total of 3,156 adolescents processed at a juvenile detention facility in an urban area in Ohio between 2003 and 2007. The participants, interacting anonymously with a voice enabled computer, self-administered a questionnaire with 100 items related to health risk behaviors. RESULTS: Overall 19.0% reported ever having thought about suicide (suicide ideation and 11.9% reported ever having attempted suicide (suicide attempt. In the multivariable logistic regression analysis those reporting sexual abuse (Odds Ratio = 2.75; 95% confidence interval = 2.08-3.63 and homelessness (1.51; 1.17-1.94 were associated with increased odds of suicide ideation, while sexual abuse (3.01; 2.22-4.08, homelessness (1.49; 1.12-1.98, and running away from home (1.38; 1.06-1.81 were associated with increased odds of a suicide attempt. Those experiencing all four adverse events were 7.81 times more likely (2.41-25.37 to report having ever attempted suicide than those who experienced none of the adverse events. CONCLUSIONS: Considering the high prevalence of adverse life experiences and their association with suicidal behaviors in detained adolescents, these factors should not only be included in the suicide screening tools at the intake and during detention, but should also be used for the intervention programming for suicide prevention.
Teo, Alan R; Andrea, Sarah B; Sakakibara, Rae; Motohara, Satoko; Matthieu, Monica M; Fetters, Michael D
Suicide is a critical public health problem around the globe. Asian populations are characterized by elevated suicide rates and a tendency to seek social support from family and friends over mental health professionals. Gatekeeper training programs have been developed to train frontline individuals in behaviors that assist at-risk individuals in obtaining mental health treatment. The purpose of this study is to assess the efficacy of a brief, multi-component gatekeeper intervention in promoting suicide prevention in a high-risk Asian community in the United States. We adapted an evidence-based gatekeeper training into a two-hour, multi-modal and interactive event for Japanese-Americans and related stakeholders. Then we evaluated the intervention compared to an attention control using mixed methods. A sample of 106 community members participated in the study. Intervention participants (n = 85) showed significant increases in all three types of intended gatekeeper behavior, all four measures of self-efficacy, and both measures of social norms relevant to suicide prevention, while the control group (n = 48) showed no significant improvements. Additional results showed significantly higher satisfaction and no adverse experiences associated with the gatekeeper training. The separate collection of qualitative data, and integration with the quantitative survey constructs confirmed and expanded understanding about the benefits of the intervention. A brief, multi-modal gatekeeper training is efficacious in promoting positive gatekeeper behaviors and self-efficacy for suicide prevention in an at-risk ethnic minority population of Japanese Americans.
Lai, Mee Huong; Maniam, Thambu; Ravindran, Arun V
Background Suicide is a serious and increasing problem worldwide. The emergence of the digital world has had a tremendous impact on people’s lives, both negative and positive, including an impact on suicidal behaviors. Objective Our aim was to perform a review of the published literature on Web-based suicide prevention strategies, focusing on their efficacy, benefits, and challenges. Methods The EBSCOhost (Medline, PsycINFO, CINAHL), OvidSP, the Cochrane Library, and ScienceDirect databases were searched for literature regarding Web-based suicide prevention strategies from 1997 to 2013 according to the modified PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The selected articles were subjected to quality rating and data extraction. Results Good quality literature was surprisingly sparse, with only 15 fulfilling criteria for inclusion in the review, and most were rated as being medium to low quality. Internet-based cognitive behavior therapy (iCBT) reduced suicidal ideation in the general population in two randomized controlled trial (effect sizes, d=0.04-0.45) and in a clinical audit of depressed primary care patients. Descriptive studies reported improved accessibility and reduced barriers to treatment with Internet among students. Besides automated iCBT, preventive strategies were mainly interactive (email communication, online individual or supervised group support) or information-based (website postings). The benefits and potential challenges of accessibility, anonymity, and text-based communication as key components for Web-based suicide prevention strategies were emphasized. Conclusions There is preliminary evidence that suggests the probable benefit of Web-based strategies in suicide prevention. Future larger systematic research is needed to confirm the effectiveness and risk benefit ratio of such strategies. PMID:24472876
Steinbüchel, Toni Andreas; Herpertz, Stephan; Külpmann, Ina; Kehyayan, Aram; Dieris-Hirche, Jan; Te Wildt, Bert Theodor
Background Internet addiction (IA) is associated with a high rate of co-morbid mental disorders, especially depression, anxiety disorders, ADHD and personality disorders and a considerable level of psychological strain. In terms of risk assessment, the present work investigates the current research literature on suicidal behavior and non-suicidal self-injurious behavior (NSSI). Methods We performed a systematic literature search in 14 databases on title and abstract level for the most common keywords for IA, NSSI and suicidality. After deduction of multiple items, 2334 articles remained. They were filtered per inclusion and exclusion criteria. We identified studies that examined the relationship between IA, NSSI and suicidality, which were assessed by validated psychometric instruments. This allowed a total of 15 studies to be included. Results The relationship between IA and suicidality was examined in 10 studies, four studies examined the relationship of IA, suicidality, and NSSI, and one study exclusively focused on IA and NSSHB. All studies showed higher prevalence for NSSI and respectively suicidality of the subjects with an IA compared to subjects without IA, with point prevalence varying considerably between 1.6-18.7%. Discussion The results of the included publications suggest that Internet dependency is associated with an increased rate of non-suicidal self-harming behavior and increased suicidality, with suicidal ideation being more closely related to IA than suicidal actions. In order to develop a better understanding of causal relationships between IA, NSSI and suicidality, further longitudinal studies are required. Conclusion Against the background of the presented studies NSSHB and suicidality need to be explicitly addressed within the assessment and treatment of IA patients. © Georg Thieme Verlag KG Stuttgart · New York.
Ingram, Ellen; Ellis, Jon B.
College students (n=228) completed a suicide ideation questionnaire and read one of 4 scenarios: cancer, AIDS, schizophrenia, and depression. People in the cancer and AIDS scenario were viewed as the most justified in committing suicide. Suicide ideators saw the people in the scenarios as justified in committing suicide more often than did…
Masood A. Shaikh
Full Text Available Abstract Background Suicide is among the top causes of adolescent mortality worldwide. While correlates of suicidal behavior are better understood and delineated in upper-income countries, epidemiologic knowledge of suicidal behavior in low-income countries remains scant, particularly in the African continent. The present study sought to add to the epidemiologic literature on suicidal behavior in Africa by examining the behavioral correlates of suicide attempts among Malawi adolescents. Methods A cross-sectional study using a nationally-representative sample extracted from publically-available data was conducted. Bivariate and multivariate analyses were performed to discern associations between suicide attempts and a host of behavioral variables. 2225 records were included in the study. Results At the multivariate level, suicide attempters had significantly higher odds of being anxious, being physically bullied, having sustained a serious injury and having a greater number of lifetime sexual partners. Alcohol use (at an early age and within the past 30 days was also associated with suicide attempts. Conclusions These findings have the potential to guide public health interventions geared toward suicide prevention in Africa and other, similar regions, as well as provide the impetus for future epidemiologic studies on suicidal behavior in low-income countries.
Callahan, S Todd; Fuchs, D Catherine; Shelton, Richard C; Balmer, Leanne S; Dudley, Judith A; Gideon, Patricia S; Deranieri, Michelle M; Stratton, Shannon M; Williams, Candice L; Ray, Wayne A; Cooper, William O
To assess the safety of psychotropic medication use in children and adolescents, it is critical to be able to identify suicidal behaviors from medical claims data and distinguish them from other injuries. The purpose of this study was to develop an algorithm using administrative claims data to identify medically treated suicidal behavior in a cohort of children and adolescents. The cohort included 80,183 youth (6-18 years) enrolled in Tennessee's Medicaid program from 1995-2006 who were prescribed antidepressants. Potential episodes of suicidal behavior were identified using external cause-of-injury codes (E-codes) and ICD-9-CM codes corresponding to the potential mechanisms of or injuries resulting from suicidal behavior. For each identified episode, medical records were reviewed to determine if the injury was self-inflicted and if intent to die was explicitly stated or could be inferred. Medical records were reviewed for 2676 episodes of potential self-harm identified through claims data. Among 1162 episodes that were classified as suicidal behavior, 1117 (96%) had a claim for suicide and self-inflicted injury, poisoning by drugs, or both. The positive predictive value of code groups to predict suicidal behavior ranged from 0-88% and improved when there was a concomitant hospitalization but with the limitation of excluding some episodes of confirmed suicidal behavior. Nearly all episodes of confirmed suicidal behavior in this cohort of youth included an ICD-9-CM code for suicide or poisoning by drugs. An algorithm combining these ICD-9-CM codes and hospital stay greatly improved the positive predictive value for identifying medically treated suicidal behavior. Copyright © 2013 John Wiley & Sons, Ltd.
Thorlindsson, Thorolfur; Bernburg, Jon Gunnar
The current study examines the contextual effects of community structural characteristics, as well as the mediating role of key social mechanisms, on youth suicidal behavior in Iceland. We argue that the contextual influence of community structural instability on youth suicidal behavior should be mediated by weak attachment to social norms and…
Brownson, Chris; Becker, Martin Swanbrow; Shadick, Richard; Jaggars, Shanna S.; Nitkin-Kaner, Yael
Suicidal and help-seeking behaviors of students of color remain a significant problem on college campuses. Self-reported suicidal experiences and help-seeking behavior of diverse students are examined on the basis of results from a national survey of college student mental health. The results suggest significant differences in the expression of…
Brown, David R.; Blanton, Curtis J.
Used data from the 1995 National College Health Risk Behavior Survey to evaluate the relationship between physical activity, sports participation, and suicide among college students. Overall, selected physical activity patterns were associated in a non-systematic manner with decreased or increased odds of suicidal behavior among male and female…
Ahmedani, Brian K; Vannoy, Steven
In 2012, the National Action Alliance for Suicide Prevention's Research Prioritization Task Force (RPTF) released a series of Aspirational Goals (AGs) to decrease suicide deaths and attempts. The RPTF asked experts to summarize what was known about particular AGs and to propose research pathways that would help reach them. This manuscript describes what is known about the benefits of access to health care (AG8) and continuity of care (AG9) for individuals at risk for suicide. Research pathways are proposed to address limitations in current knowledge, particularly in U.S. healthcare-based research. Using a three-step process, the expert panel reviewed available literature from electronic databases. For two AGs, the experts summarized the current state of knowledge, determined breakthroughs needed to advance the field, and developed a series of research pathways to achieve prevention goals. Several components of healthcare provision have been found to be associated with reduced suicide ideation, and in some cases they mitigated suicide deaths. Randomized trials are needed to provide more definitive evidence. Breakthroughs that support more comprehensive patient data collection (e.g., real-time surveillance, death record linkage, and patient registries) would facilitate the steps needed to establish research infrastructure so that various interventions could be tested efficiently within various systems of care. Short-term research should examine strategies within the current healthcare systems, and long-term research should investigate models that redesign the health system to prioritize suicide prevention. Evidence exists to support optimism regarding future suicide prevention, but knowledge is limited. Future research is needed on U.S. healthcare services and system enhancements to determine which of these approaches can provide empirical evidence for reducing suicide. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights
Klomek, Anat Brunstein; Sourander, Andre; Niemelä, Solja; Kumpulainen, Kirsti; Piha, Jorma; Tamminen, Tuula; Almqvist, Fredrik; Gould, Madelyn S
There are no previous studies about the association of childhood bullying behavior with later suicide attempts and completed suicides among both sexes. The aim was to study associations between childhood bullying behaviors at age 8 years and suicide attempts and completed suicides up to age 25 years in a large representative population-based birth cohort. The sample includes 5,302 Finnish children born in 1981. Information about bullying was gathered at age 8 years from self-report, as well as parent and teacher reports. Information about suicide attempts requiring hospital admission and completed suicides was gathered from three different Finnish registries until the study participants were 25 years old. Regression analyses were conducted to determine whether children who experience childhood bullying behaviors are at risk for later suicide attempts and completed suicides after controlling for baseline conduct and depression symptoms. The association between bullying behavior at age 8 years and later suicide attempts and completed suicides varies by sex. Among boys, frequent bullying and victimization are associated with later suicide attempts and completed suicides but not after controlling for conduct and depression symptoms; frequent victimization among girls is associated with later suicide attempts and completed suicides, even after controlling for conduct and depression symptoms. When examining childhood bullying behavior as a risk factor for later suicide attempts and completed suicides, each sex has a different risk profile.
Melia, Ruth; Francis, Kady; Duggan, Jim; Bogue, John; O'Sullivan, Mary; Chambers, Derek; Young, Karen
Previous research has reported that two of the major barriers to help-seeking for individuals at risk of suicide are stigma and geographical isolation. Mobile technology offers a potential means of delivering evidence-based interventions with greater specificity to the individual, and at the time that it is needed. Despite documented motivation by at-risk individuals to use mobile technology to track mental health and to support psychological interventions, there is a shortfall of outcomes data on the efficacy of mobile health (mHealth) technology on suicide-specific outcomes. The objective of this study is to develop a protocol for a systematic review and meta-analysis that aims to evaluate the effectiveness of mobile technology-based interventions for suicide prevention. The search includes the Cochrane Central Register of Controlled Trials (CENTRAL: The Cochrane Library), MEDLINE, Embase, PsycINFO, CRESP and relevant sources of gray literature. Studies that have evaluated psychological or nonpsychological interventions delivered via mobile computing and communication technology, and have suicidality as an outcome measure will be included. Two authors will independently extract data and assess the study suitability in accordance with the Cochrane Collaboration Risk of Bias Tool. Studies will be included if they measure at least one suicide outcome variable (ie, suicidal ideation, suicidal intent, nonsuicidal self-injurious behavior, suicidal behavior). Secondary outcomes will be measures of symptoms of depression. Where studies are sufficiently homogenous and reported outcomes are amenable for pooled synthesis, meta-analysis will be performed. A narrative synthesis will be conducted if the data is unsuitable for a meta-analysis. The review is in progress, with findings expected by summer 2018. To date, evaluations of mobile technology-based interventions in suicide prevention have focused on evaluating content as opposed to efficacy. Indeed, previous research has
Preti, A; Miotto, P
To compare well established antecedents and correlates of completed suicide with the motives and the mechanics reported in Greek mythology. A well-known collection of Greek myths, the Book of fables by Hyginus, was explored to investigate the mechanics driving an individual to imagine, design and carry out a suicide attempt. Females outnumber males in the mythographer's list, their favourite methods to die being drowning, hanging, self-burning and throwing themselves down from on high. Some kind of familial recurrence of suicide was accounted for, and a large percentage of these suicides was connected to incest. Shame, sense of guilt and grief for the death of a loved one are the most frequently reported psychological correlates of the act, whereas defeat, failure or a catastrophic change in living conditions and, among females, an unfortunate love affair figure as the main antecedents of suicide. Negative life events and emotional reactions to the severing of social ties frequently occur as antecedents of suicide in Greek mythology. Copyright Blackwell Munksgaard 2005.
Virginia Ross; Anoop Sankaranarayanan; Terry J. Lewin; Mick Hunter
AimMental Health workers bear responsibility for preventing suicide in their client group. Survey studies have indicated that staff can be seriously adversely affected when a client suicides. The aim of the current study is to describe and evaluate the effects on mental health (MH) workers of their ongoing role in managing suicidal behaviours and to identify the thoughts and feelings associated with this role.MethodA survey was administered to 135 MH workers via an on-line self-report vehicle...
Schilling, Elizabeth A; Aseltine, Robert H; James, Amy
This study replicated and extended previous evaluations of the Signs of Suicide (SOS) prevention program in a high school population using a more rigorous pre-test post-test randomized control design than used in previous SOS evaluations in high schools (Aseltine and DeMartino 2004; Aseltine et al. 2007). SOS was presented to an ethnically diverse group of ninth grade students in technical high schools in Connecticut. After controlling for the pre-test reports of suicide behaviors, exposure to the SOS program was associated with significantly fewer self-reported suicide attempts in the 3 months following the program. Ninth grade students in the intervention group were approximately 64% less likely to report a suicide attempt in the past 3 months compared with students in the control group. Similarly, exposure to the SOS program resulted in greater knowledge of depression and suicide and more favorable attitudes toward (1) intervening with friends who may be exhibiting signs of suicidal intent and (2) getting help for themselves if they were depressed or suicidal. In addition, high-risk SOS participants, defined as those with a lifetime history of suicide attempt, were significantly less likely to report planning a suicide in the 3 months following the program compared to lower-risk participants. Differential attrition is the most serious limitation of the study; participants in the intervention group who reported a suicide attempt in the previous 3 months at baseline were more likely to be missing at post-test than their counterparts in the control group.
Sacharewicz, A; Maciorkowska, E
Suicide, taking one's own life, seems to be in contradiction with the will to live. However, it is not so obvious, as there is not the same patterns of behavior for all people. People differ from one another as far as reactions, behavior, and actions are concerned. Some are mobilized, others are discouraged by failures. It is often thought that suicidal behavior occurs due to a mental disorder. The purpose of the study was to check the knowledge of IV-year-students of Pedagogy and Psychology of The University in Bialystok concerning suicidal behavior. Danger of suicidal phenomenon among young people was also to be noticed and discussed. The examination was conducted in the group of 50 students of the IV year of Pedagogy and Psychology of The University in Bialystok in 2002. Students, 21-25 years of age, comprised the most numerous group. Women were the majority (84%) while men were 16%. The examination tool was the questionnaire of 29 open and closed questions. The analysis of the results points to the fact that making a decision of suicide is a result of long reflections expanded in time. Personal and family problems are most common causes of suicidal behavior given by the responders. Social isolation and bad mental condition were behaviors indicating the will to commit suicide. Lonely people, chronically ill, emotionally immature and the young people were those of the high risk groups. According to the examined students, pain connected with physical suffering may influence suicidal behavior.
Pratt, Daniel; Gooding, Patricia; Awenat, Yvonne; Eccles, Steve; Tarrier, Nicholas
Suicide is a serious public health problem but a problem that is preventable. This complex and challenging problem is particularly prevalent amongst prisoners; associated with a five-fold increase in risk compared to the general community. Being in prison can lead people to experience fear, distrust, lack of control, isolation, and shame, which is often experienced as overwhelming and intolerable with some choosing suicide as a way to escape. Few effective psychological interventions exist to...
Wright, Nate; Roesler, Jon; Heinen, Melissa
Minnesota's suicide rate has been increasing for more than 10 years. This article describes the demographic groups at highest risk for suicide and suicide attempts in the state. It also highlights prevention strategies outlined in the Minnesota State Suicide Prevention Plan 2015-2020.
Larsen, Mark Erik; Nicholas, Jennifer; Christensen, Helen
Suicide is a leading cause of death globally, and there has been a rapid growth in the use of new technologies such as mobile health applications (apps) to help identify and support those at risk. However, it is not known whether these apps are evidence-based, or indeed contain potentially harmful content. This review examines the concordance of features in publicly available apps with current scientific evidence of effective suicide prevention strategies. Apps referring to suicide or deliberate self-harm (DSH) were identified on the Android and iOS app stores. Systematic review methodology was employed to screen and review app content. App features were labelled using a coding scheme that reflected the broad range of evidence-based medical and population-based suicide prevention interventions. Best-practice for suicide prevention was based upon a World Health Organization report and supplemented by other reviews of the literature. One hundred and twenty-three apps referring to suicide were identified and downloaded for full review, 49 of which were found to contain at least one interactive suicide prevention feature. Most apps focused on obtaining support from friends and family (n = 27) and safety planning (n = 14). Of the different suicide prevention strategies contained within the apps, the strongest evidence in the literature was found for facilitating access to crisis support (n = 13). All reviewed apps contained at least one strategy that was broadly consistent with the evidence base or best-practice guidelines. Apps tended to focus on a single suicide prevention strategy (mean = 1.1), although safety plan apps provided the opportunity to provide a greater number of techniques (mean = 3.9). Potentially harmful content, such as listing lethal access to means or encouraging risky behaviour in a crisis, was also identified. Many suicide prevention apps are available, some of which provide elements of best practice, but none that provide comprehensive evidence
Mark Erik Larsen
Full Text Available Suicide is a leading cause of death globally, and there has been a rapid growth in the use of new technologies such as mobile health applications (apps to help identify and support those at risk. However, it is not known whether these apps are evidence-based, or indeed contain potentially harmful content. This review examines the concordance of features in publicly available apps with current scientific evidence of effective suicide prevention strategies.Apps referring to suicide or deliberate self-harm (DSH were identified on the Android and iOS app stores. Systematic review methodology was employed to screen and review app content. App features were labelled using a coding scheme that reflected the broad range of evidence-based medical and population-based suicide prevention interventions. Best-practice for suicide prevention was based upon a World Health Organization report and supplemented by other reviews of the literature.One hundred and twenty-three apps referring to suicide were identified and downloaded for full review, 49 of which were found to contain at least one interactive suicide prevention feature. Most apps focused on obtaining support from friends and family (n = 27 and safety planning (n = 14. Of the different suicide prevention strategies contained within the apps, the strongest evidence in the literature was found for facilitating access to crisis support (n = 13. All reviewed apps contained at least one strategy that was broadly consistent with the evidence base or best-practice guidelines. Apps tended to focus on a single suicide prevention strategy (mean = 1.1, although safety plan apps provided the opportunity to provide a greater number of techniques (mean = 3.9. Potentially harmful content, such as listing lethal access to means or encouraging risky behaviour in a crisis, was also identified.Many suicide prevention apps are available, some of which provide elements of best practice, but none that provide comprehensive
Larsen, Mark Erik; Nicholas, Jennifer; Christensen, Helen
Background Suicide is a leading cause of death globally, and there has been a rapid growth in the use of new technologies such as mobile health applications (apps) to help identify and support those at risk. However, it is not known whether these apps are evidence-based, or indeed contain potentially harmful content. This review examines the concordance of features in publicly available apps with current scientific evidence of effective suicide prevention strategies. Methods Apps referring to suicide or deliberate self-harm (DSH) were identified on the Android and iOS app stores. Systematic review methodology was employed to screen and review app content. App features were labelled using a coding scheme that reflected the broad range of evidence-based medical and population-based suicide prevention interventions. Best-practice for suicide prevention was based upon a World Health Organization report and supplemented by other reviews of the literature. Results One hundred and twenty-three apps referring to suicide were identified and downloaded for full review, 49 of which were found to contain at least one interactive suicide prevention feature. Most apps focused on obtaining support from friends and family (n = 27) and safety planning (n = 14). Of the different suicide prevention strategies contained within the apps, the strongest evidence in the literature was found for facilitating access to crisis support (n = 13). All reviewed apps contained at least one strategy that was broadly consistent with the evidence base or best-practice guidelines. Apps tended to focus on a single suicide prevention strategy (mean = 1.1), although safety plan apps provided the opportunity to provide a greater number of techniques (mean = 3.9). Potentially harmful content, such as listing lethal access to means or encouraging risky behaviour in a crisis, was also identified. Discussion Many suicide prevention apps are available, some of which provide elements of best practice, but none
Soltaninejad, Abdollah; Fathi-Ashtiani, Ali; Ahmadi, Khodabakhsh; Mirsharafoddini, Hediye Sadat; Nikmorad, Alireza; Pilevarzadeh, Motahare
Suicidal behavior is one the most significant mental health problems in the military. Militaries are closed systems that operate in particular situations. Military service is associated with certain stressful conditions. On this basis, there is likely of trauma in the military environment. Measures of suicidal behavior are pathologically complex. A range of biological, psychological, social, and institutional factors are involved in the incidence and prevalence of these behaviors. One of the underlying factors in suicidal behavior is individuals' personality. The study population comprised of the Iranian Armed Forces. To recruit the sample of the research, 1659 soldiers were selected by multistage sampling. Data were collected using the Beck Scale for Suicide Ideation (BSSI) and NEO-Five Factor Inventory. There was a significant positive correlation (r = 0.323) between neuroticism and suicide ideation; however, significant negative correlations existed between three other personality traits --extraversion [r = -0.306], agreeableness [r = -0.227], and conscientiousness [r = -0.271] and suicidal ideation. Unlike neuroticism, extraversion and conscientiousness personality factors could reduce significantly (as much 14% as are predicted) levels of suicidal ideation. Based on these results, neuroticism might increase suicide, but extraversion and conscientiousness personality traits are associated with a reduced risk of suicide.
Fässberg, Madeleine Mellqvist; van Orden, Kimberly A; Duberstein, Paul
individuals aged 65 and older. Our search identified only 16 articles (across 14 independent samples) that met inclusion criteria. The limited number of studies points to the need for further research. Included studies were conducted in Canada (n = 2), Germany (n = 1), Hong Kong (n = 1), Japan (n = 1...... indicated that at least in industrialized countries, limited social connectedness is associated with suicidal ideation, non-fatal suicidal behavior, and suicide in later life. Primary prevention programs designed to enhance social connections as well as a sense of community could potentially decrease...
Fitzgerald, Caris T; Messias, Erick; Buysse, Daniel J
Suicide in the adolescent population is a tragic and preventable cause of death. Previous studies have confirmed both long and short total sleep times (TSTs) are associated with suicidal ideation in the adult population. We hypothesized that both long and short TSTs are risk factors for serious suicide attempt in the adolescent population as well. We tested this hypothesis using the Youth Risk Behavior Surveys from 2007 and 2009, which consist of school-based, nationally representative samples (N = 12,154 for 2007, N = 14,782 for 2009). Logistic regression models were used to assess the relationship between suicidality and sleep after adjusting for confounders including age, sex, race/ethnicity, feelings of sadness, and substance abuse. Of the total sample, roughly 15% reported suicidal ideation, 10% planned suicide, 5% attempted and 2% reported an attempt requiring treatment. Teens who reported sleeping ≤ 5 or ≥ 10 h had a significantly higher risk for suicidality compared to those with a TST of 8 h. The largest odds ratios were found among the most severe forms of suicidality (attempt requiring treatment) with an odds ratio of 5.9 for a TST ≤ 4 h and 4.7 for a TST ≥ 10 h. Both short and long TSTs are risk factors for suicidality among teens and extremes in TST may indicate more serious suicidality. Self-reported sleep duration may be a useful screening question for suicide risk. Future studies should examine whether sleep duration is a causal and/or modifiable risk factor for suicidality in teens.
Spirito, Anthony; Esposito-Smythers, Christianne; Wolff, Jennifer; Uhl, Kristen
CBT has emerged as a well-established treatment for depression in children and adolescents but treatment trials for adolescents with suicidality are few in number, and their efficacy to date is rather limited. Although a definitive treatment for adolescent suicide attempters has yet to be established, the limited literature suggests that suicidal thoughts and behavior should be directly addressed for optimal treatment outcome. This chapter reviews the rationale underlying the use of CBT for t...
Takeshima, Tadashi; Yamauchi, Takashi; Inagaki, Masatoshi; Kodaka, Manami; Matsumoto, Toshihiko; Kawano, Kenji; Katsumata, Yotaro; Fujimori, Maiko; Hisanaga, Ayaka; Takahashi, Yoshitomo
Suicide is a global public health problem and solutions to it can be found only through a global dialog. The suicide rate in Japan has been alarming, but Japan has made substantial efforts to reduce this rate, making prevention a high priority. This report reviews the developmental stages of a comprehensive policy of suicide prevention in Japan from 1998 to 2013. Our review suggests that suicide prevention activities were facilitated by the 2006 Basic Act for Suicide Prevention and the 2007 General Principles of Suicide Prevention Policy. Along with the establishment of a Special Fund program for local governments, the Basic Act and General Principles led to the development of a comprehensive and multi-sector approach to suicide prevention. Suicide rates in Japan, especially among middle-aged men, decreased consistently after 2009, suggesting that the initiatives were effective. Continuous monitoring is needed to evaluate Japan's suicide prevention policy.
a major cause of suicide, as expressed by an individual who suffered from it to the extent that he made a compulsive decision that almost cost him...Has the US Army Suicide Prevention Program changed the rate (either increased or decreased) of suicide in terms of more “ buy in” from senior leadership
Bryan, Craig J.; Steiner-Pappalardo, Nicole; Rudd, M. David
The incremental impact of adding a mnemonic to remember suicide warning signs to the Air Force Suicide Prevention Program (AFSPP) community awareness briefing was investigated with a sample of young, junior-enlisted airmen. Participants in the standard briefing significantly increased their ability to list suicide warning signs and improved…
Cheng, Qijin; Fu, King-wa; Caine, Eric; Yip, Paul S. F.
Background The Hong Kong news media report suicide-related events more frequently and sensationally than Western countries. Little is known about Hong Kong media professionals’ experiences and thoughts about such reporting. Aims To understand Hong Kong media professionals’ experiences and perceptions of suicide reporting and whether the news media can be better engaged into suicide prevention. Method We conducted three focus groups of journalists from both the Cantonese and English language news media. Data were analyzed using grounded theory methods. Results We discerned three rationales from participants regarding their intense coverage of suicide-related events: (1) satisfying commercial competitiveness, (2) addressing social problems, and (3) responding to readers’ interests. The first rationale was a dominant and vigorous motivating factor, and often influenced suicide reporting among local Cantonese media. Media professionals recommended engagement strategies targeted at frontline journalists, media managers, and general media consumers. Conclusion We see potential to involve news media professionals in Hong Kong as working partners in suicide prevention. To succeed, this effort requires engagement in a proactive, consistent, and sustained fashion. PMID:24322824
Bakst, Shelly; Rabinowitz, Jonathan; Bromet, Evelyn J
Persons with psychotic illnesses have an increased risk for suicide, especially early in the illness. Sufficient knowledge allowing for early recognition is lacking. To describe suicide behaviors before and during the 4 years following first psychiatric hospitalization, examine associations of demographic and psychiatric risk factors, and develop a suicide risk index. Data came from the Suffolk County Mental Health Project, a first-admission cohort (n = 529). Cox regression was used to study associations of risk factors to suicide behaviors; a summary suicide behavior risk index was also tested. Prior to first admission, 28.0% (n = 148) of the cohort had attempted suicide. During the 4-year follow-up, 13.6% (n = 72) of the cohort attempted suicide (29.7% of those with previous attempts and 7.3% making their first attempt) and 3 respondents died of suicide. The significant predictors at index admission of subsequent attempts were prior attempts or ideation, severity of depressive symptoms and thought disorder, lifetime substance abuse, and younger age. Suicide ideation was predicted by the same variables with the addition of insight into illness and with the exception of age at admission. A 3-category risk index was created; 61.1% of those who made a suicide attempt were in the highest risk group (n = 44/72). The current study confirms and extends previous research showing that risk factors early in the course of illness are predictive of subsequent ideation and attempts. The risk index may be a useful adjunct in identifying individuals likely to benefit from preventive interventions.
Quigley, Jody; Rasmussen, Susan; McAlaney, John
Social influences-including the suicidal and self-harming behaviors of others-have been highlighted as a risk factor for suicidal and self-harming behavior in young people, but synthesis of the evidence is lacking. A systematic review of 86 relevant papers was conducted. Considerable published evidence was obtained for positive associations between young people's suicidal and self-harming behavior and that of people they know, with those reporting knowing people who had engaged in suicidal or self-harming behaviors more likely to report engaging in similar behaviors themselves. Findings are discussed in relation to a number of methodological and measurement issues-including the role of normative perceptions-and implications for the prevention of suicidal and self-harming behavior are considered.
Restrepo-Bernal, Diana; Bonfante-Olivares, Laura; Torres de Galvis, Yolanda; Berbesi-Fernández, Dedsy; Sierra-Hincapié, Gloria
Suicide is a public health problem. In Colombia, teenagers are considered a group at high risk for suicidal behavior. To explore the possible association between suicidal behavior and attention deficit hyperactivity disorder in adolescents of Medellin. Observational, cross-sectional, analytical study. The Composite International Diagnostic Interview was applied to a total of 447 adolescents and the sociodemographic, clinical, familiar, and life event variables of interest were analyzed. The descriptive analysis of qualitative variables are presented as absolute values and frequencies, and the age was described with median [interquartile range]. A logistic regression model was constructed with explanatory variables that showed statistical association. Data were analyzed with SPSS® software version 21.0. Of the total, 59.1% were female, and the median age was 16 [14-18] years. Suicidal behavior was presented in 31% of females and 23% of males. Attention deficit was present in 6.3% of adolescents. The logistic regression analysis showed that the variables that best explained the suicidal behavior of adolescents were: female sex, post-traumatic stress disorder, panic disorder, and cocaine use. The diagnosis and early intervention of attention deficit hyperactivity disorder in children may be a useful strategy in the prevention of suicidal behavior in adolescents. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Gulbas, Lauren E.; Hausmann-Stabile, Carolina; De Luca, Susan M.; Tyler, Tee R.; Zayas, Luis H.
To date, there is little research to validate empirically differences between non-suicidal self-injurious behavior (NSSI) and attempted suicide among Latina adolescents. Understanding the characteristics and contextual features of self-harmful behaviors among Latina teens is a critical public health and social justice matter given the disproportionate rates of attempted suicide and anticipated population growth of this vulnerable group. In this article, we draw on an ecodevelopmental model to focus attention on factors in the sociocultural environment that shape suicidal and non-suicidal self-injurious behaviors. Through analysis of qualitative interviews conducted with girls who used NSSI (n = 18), attempted suicide (n = 29), used NSSI and attempted suicide (n = 8,) and had no reported lifetime history of self-harm (n = 28), we describe the sociocultural factors that shaped psychosocial vulnerabilities and gave rise to decisions to use NSSI or attempt suicide. Our analysis revealed that adolescents who engaged in NSSI perceived their negative feelings as something that could be controlled through self-injurious acts, whereas powerlessness was a theme underlying the emotional states of girls who attempted suicide. When NSSI ceased to function as a mechanism for control, girls came to sudden decisions to attempt suicide. Most teens identified specific, and often multiple, situations that induced these intense affective states and shaped decisions to inflict self-harm. Two situational experiences emerged as particularly salient and promising for subsequent studies on self-harmful behaviors among Latina adolescents: transnational stress and bullying. We describe each of these and offer suggestions for future research and practice. PMID:26052816
Beck-Cross, Cathy; Cooper, Robyn
Suicide is the third leading cause of death among young people ages 15 to 19 years, with male adolescents four times more likely to die than their female peers. This study used Bronfenbrenner's bioecological model to examine micro- and macrosystems as predictors of suicidal behaviors through responses by male adolescents (N = 9,910) to a statewide…
Klein, Dena A; Miller, Alec L
Although research to date on dialectical behavior therapy (DBT) for adolescents has its limitations, growing evidence suggests that DBT is a promising treatment for adolescents with a range of problematic behaviors, including but not limited to suicidal and nonsuicidal self-injury. This article introduces dialectical behavior therapy's theoretical underpinnings, describes its adaptation for suicidal adolescents, and provides a brief review of the empirical literature evaluating DBT with adolescents. Copyright © 2011 Elsevier Inc. All rights reserved.
BACKGROUND: In modern psychiatry, there is a movement to understand mental health, not solely based on behaviors and subjective report, but also based on objective markers of illness. Several studies have focused on a relationship between serum cholesterol levels and aggressive behaviors including suicide. AIM: To identify a potential link between cholesterol and suicidal behavior. MATERIAL AND METHODS: 150 patients with psychiatry diagnosis were divided into three equal g...
Fekete, S; Balkó Mácsai, E; Kóczán, G; Ozsváth, K; Benkö, A
The authors analyse the modelling effect of the suicide of the first Hungarian beauty queen. After the publication of a book, a film and the newspapers about her suicide increased significantly the number of suicides committed by young females by the same method (Lidocain pill). During this period the consumption of Lidocain pills decreased in Hungary. The monthly and seasonal fluctuation of suicides committed by other methods is different from these changes. The suicide of celebrities mediated by the mass media can become modell through identification for a people in crisis situation.
Full Text Available Jana Kocourkova, Iva Dudova, Jiri Koutek Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic Abstract: Asperger syndrome hinders adaptation to developmental challenges during childhood and adolescence, particularly with regard to interpersonal relationships. Individuals with Asperger syndrome display lack of empathy and limited ability to understand social and emotional exchanges with other people. Individuals with Asperger syndrome are significantly exposed to the risk of suicidal behavior, especially during adolescence. The authors describe cases of suicidal behavior in two adolescent boys with Asperger syndrome. Keywords: Asperger syndrome, suicidal behavior, adolescence
Full Text Available Suicide is a major public health issue. In Japan, local governments are responsible for suicide prevention, and local government officers are therefore expected to act as gatekeepers for suicide prevention. In this study, through a questionnaire survey, the authors examined the current knowledge and attitudes concerning suicide prevention among local government officers and healthcare and welfare professionals, and the effects of providing suicide prevention education on their knowledge of and attitudes toward suicide and its prevention. One hundred eighty-three local government officers and 432 healthcare/welfare professionals completed the survey before and after a single education session. Before the session, the local government officers and healthcare/welfare professionals showed mainly positive attitudes toward suicide prevention efforts, with little difference between the two groups. After the training, knowledge and attitudes were further improved for most questionnaire items. Respondents with one or more experiences of suicide prevention training showed significantly more knowledge and positive attitudes before the training than those with no such experience. Moreover, knowledge of depression and having a sympathetic attitude were found to be especially associated with the overall attitude that “suicide can be prevented”. Training in suicide prevention was shown to be effective in promoting appropriate knowledge and attitudes among local government officers and healthcare/welfare professionals who are gatekeepers for preventing suicide. Our findings confirm the importance of suicide prevention education, and will contribute to creating a standard educational program on suicide prevention in Japan.
Moreno-Montoya, José; Palacios-Espinosa, Ximena; Gracia-Ruiz, Jennifer
Whereas most studies have focused on how the religious beliefs positively interfere with the presence or execution of suicidal behaviors, few have identified differences among religious beliefs and how these can not only be consider as a protective factor for suicide, but also as a variable that influences the expression of the suicidal related behaviors. To provide evidence about the effect of religious practices and beliefs on suicidal behavior in cancer patients in Colombia. This is a hospital-based cross-sectional study with a sample of 132 patients with cancer. Socio-demographic data were measured, in which the religious affiliation was included. The instruments used include the Scale of Suicidal Ideation (SSI), the item 9 of Beck Depression Scale (BDI-IA) and the Beck Hopelessness Inventory (BHS). In our study, 93% of the patients had advanced stages of cancer, where 51.52% of them were in stage IV. Cancer patients who reported non-Catholic Christians were 3 and 4 times more likely to have some manifestation of suicidal behavior. It is recognized in non-Catholic Christians patients a greater chance to express suicidal ideation, which could be related to their level of suicide acceptability. It is considered that religion and their perception of death affects the expression and acceptance of suicidal ideation, reason why it is necessary more research on the effect of different religions on suicidal behavior, in order to include these aspects in the patient intervention. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Rowe, Catherine A; Walker, Kristin L; Britton, Peter C; Hirsch, Jameson K
Individuals who experience negative life events may be at increased risk for suicidal behavior. Intrapersonal characteristics, such as basic psychological needs, however, may buffer this association. To assess the potential moderating role of overall basic psychological needs, and the separate components of autonomy, competence, and relatedness, on the association between negative life events and suicidal behavior. Our sample of 439 college students (311 females, 71%) completed the following self-report surveys: Life Events Scale, Basic Psychological Needs Scale, Beck Depression Inventory - II, and the Suicide Behaviors Questionnaire-Revised. In support of our hypotheses, negative life events were associated with greater levels of suicidal ideation and attempts, and satisfaction of basic psychological needs, including autonomy, relatedness, and competence, significantly moderated this relationship, over and above the effects of the covariates of age, sex, and depressive symptoms. Suicidal behavior associated with the experience of negative life events is not inevitable. Therapeutically bolstering competence, autonomy, and relatedness may be an important suicide prevention strategy for individuals experiencing life stressors.
Skinner, Kayla D; Rojas, Sasha M; Veilleux, Jennifer C
Individuals with eating pathology, particularly those with diagnosed eating disorders, are at high risk for suicide. It is less clear whether undiagnosed eating pathology and subsyndromal eating disorders carry the same risk and, if so, what mechanisms may explain why higher levels of eating pathology yield greater risk for engaging in suicidal behaviors. The indirect relationship between disordered eating and risk for suicidal behaviors via facets of experiential avoidance was tested using a multiple-mediator model. The model was tested using bootstrapping estimates of indirect effects in a sample of 218 noncollege student adults (Mage = 32.33, 66.1% women) with a history of suicidal attempt and/or history of nonsuicidal self-injury (NSSI). Results revealed that disordered eating indirectly predicted risk for suicidal behaviors, distress aversion (i.e., negative attitudes or dislike of distress), and procrastination (i.e., delaying engagement with distressing activities). Results suggest that targeting experiential avoidance and helping those who have a history of engaging in suicidal behaviors and/or NSSI develop regulation strategies to use during times of distress may be of utmost importance for treatment and prevention of eating pathology. © 2016 The American Association of Suicidology.
Dobry, Yuriy; Braquehais, María Dolores; Sher, Leo
Bullying is a highly prevalent behavior which carries a significant social, medical and financial cost for its victims and perpetrators, with powerful and long-lasting psychological and social impact. Bullying has been defined as a specific form of intentional, repeated aggression, that involves a disparity of power between the victim(s) and perpetrator(s). The aggression can take physical, verbal or gestural forms. The behavior of bullying crosses sociodemographic categories of age, gender, ethnicity, level of academic achievement and professional environment. It has been abundantly observed by teachers and parents in elementary schools, but has also shown its negative presence in corporate boardrooms. The direct outcome of bullying, for both victims and perpetrators, is an increased risk of psychiatric disorders including depression, post-traumatic stress disorder, anxiety disorders, substance abuse and suicidal behavior. Cruelty (and bullying, as one of its manifestations) breaks the basis of morality. Mental health professionals usually treat the victims of those actions unfortunately long after they have been exposed to the harm. The evidence does not support the idea that the majority of cruel actions are intrinsically "pathological", in the sense of being motivated by "mental disorders". Therefore, only moral rules and legal actions - but not psychiatric or psychological interventions - may dissuade humans from this form of cruelty.
Houle, J; Guillou-Ouellette, C
In Montréal, the characteristics of suicide cases may vary between different areas. The information collected by coroners during their investigations of suicides could be used to support local suicide-prevention planning actions. This study analyzes all coroners' records on suicide in Montréal from 2007 to 2009 to (1) determine the usefulness of the data available; (2) develop a profile of cases; (3) examine local differences by comparing two areas, one with the highest suicide rate and the other with the lowest. The data collected revealed the lack of a systematic, standardized procedure for recording information about deaths by suicide. The rates of missing data varied, but were very high for antecedents of suicide attempts and recent events that could have precipitated the suicide. We observed differences in the characteristics of suicide cases according to area of residence. By adopting a standardized procedure for collecting information on cases of suicide, coroners could provide local decision makers with a more accurate portrait of the people who die by suicide in their area. Local adjustments may improve suicide prevention strategies.
Osteen, Philip J.; Jacobson, Jodi M.; Sharpe, Tanya L.
The prevalence of suicide suggests social workers will encounter clients at risk for suicide, but research shows social workers receive little to no training on suicide and suicide prevention and feel unprepared to work effectively with clients at risk. Baseline results from a randomized intervention study of the Question, Persuade, and Refer…
Plener, Paul L; Kapusta, Nestor D; Brunner, Romuald; Kaess, Michael
Non-Suicidal Self-Injury (NSSI) and Suicidal Behavior Disorder (SBD) were included as diagnostic categories in Section 3 of the 5th edition of the Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association (APA). Thus, these diagnostic entities were not recognized as formal clinical diagnoses, but rather for the first time clearly defined in a classificatory system to standardize further research in this field. This paper introduces both concepts and addresses the discussion about NSSI and suicidal behavior disorder based on a selective review of the literature. First studies using the new definitions are introduced. In Germany the prevalence of NSSI is estimated to lie at about 4 %, of SBD at about 9 %. It can be expected that in the future the new definitions will lead to a better comparability of study outcomes with regards to NSSI and suicidal behavior disorder.
... Collection Activity (Veteran Suicide Prevention Online Quantitative Surveys) Under OMB Review AGENCY.... Abstract: VA's top priority is the prevention of Veterans suicide. It is imperative to reach these at-risk... families' awareness of VA's suicide prevention and mental health support services. In addition, the surveys...
... Collection (Veteran Suicide Prevention Online Quantitative Surveys) Activity: Comment Request AGENCY... prevention of suicide among Veterans and their families. DATES: Written comments and recommendations on the.... Abstract: VA's top priority is the prevention of Veterans suicide. It is imperative to reach these at-risk...
Full Text Available Dynamic simulation modelling is increasingly being recognised as a valuable decision-support tool to help guide investments and actions to address complex public health issues such as suicide. In particular, participatory system dynamics (SD modelling provides a useful tool for asking high-level ‘what if’ questions, and testing the likely impacts of different combinations of policies and interventions at an aggregate level before they are implemented in the real world. We developed an SD model for suicide prevention in Australia, and investigated the hypothesised impacts over the next 10 years (2015–2025 of a combination of current intervention strategies proposed for population interventions in Australia: 1 general practitioner (GP training, 2 coordinated aftercare in those who have attempted suicide, 3 school-based mental health literacy programs, 4 brief-contact interventions in hospital settings, and 5 psychosocial treatment approaches. Findings suggest that the largest reductions in suicide were associated with GP training (6% and coordinated aftercare approaches (4%, with total reductions of 12% for all interventions combined. This paper highlights the value of dynamic modelling methods for managing complexity and uncertainty, and demonstrates their potential use as a decision-support tool for policy makers and program planners for community suicide prevention actions.
Rodziński, Paweł; Rutkowski, Krzysztof; Ostachowska, Anna
In clinical practice suicidal ideation (SI) is one of the most commonly encountered symptoms in patients with mental disorders. Such encounter calls for diligent evaluation of suicidal risk. Although the risk factors are widely known, accurate estimation of suicidal risk remains one of the most difficult and most important tasks that clinicians face - especially considering recently collected data showing increase in suicide prevalence in Poland. More thorough estimation of suicidal risk in patients with SI requires taking under consideration not only suicidal risk factors but also factors that are more specific for progression of SI to suicidal behaviors (SB). The review presented in this paper consists of a range of suicidological theories that allow to select a number of groups of factors and mechanisms that are most specific for progression of SI to SB. These groups include: (1) transgression of fear of causing harm and pain to oneself, as well as disintegration of other protective barriers such as (2) decline of social integration with others, feeling of being alienated or abandoned, decline of sense of belongingness, lack of social support, (3) resignation from family and social obligations, (4) dismissing cultural or religious norms, (5) rejection of life goals, values and aspirations that were appreciated earlier, (6) narrowing down in perceived alternatives for suicide, i.e., "tunnel vision", feelings of helplessness and powerlessness, (7) devising in details and accepting simple suicidal plan, especially when such plan is being consolidated through rehearsals and as if "automatized", (8) impulsiveness, (9) accumulation of aggression that may be vented out as suicide, and finally (10) accessibility of means to commit suicide.
with a predisposition for suicidal behavior. Suicide prevention in war veterans with PTMD should focus on (1) improvement in recognition of PTMD; (2) treating symptoms of PTMD; (3) preventing a relapse when the patient is in remission; (4) treating suicidal ideation; (5) treating comorbid psychiatric conditions including alcohol and drug abuse; (6) treating medical and neurological disorders including traumatic brain injury; and (7) social support. It is extremely important to understand PTMD, to optimize assessment and treatment for people with PTMD, and to identify processes that facilitate recovery from exposure to traumatic events. Every nation, every generation, faces traumas that cause suicide. The world needs to deal with this and it is one thing that the world can come together on.
Neuner, Tanja; Hubner-Liebermann, Bettina; Hausner, Helmut; Hajak, Goran; Wolfersdorf, Manfred; Spiessl, Hermann
Our study investigated the association of aggression and suicidal behavior in schizophrenic inpatients. Eight thousand nine hundred one admissions for schizophrenia (1998-2007) to a psychiatric university hospital were included. Schizophrenic suicides (n = 7)/suicide attempters (n = 40) were compared to suicides (n = 30)/suicide attempters (n =…
Ilakkuvan, Vinu; Snyder, Melanie G.; Wiggins, Jane
Students on a college campus are involved in each other's lives in ways that are pervasive and consequential, including during times of distress. A comprehensive campus based suicide prevention plan includes strategies to promote peer involvement that are both safe and effective. Careful program planning, careful training and careful messaging are…
Pedersen, Cecilia Petrine; Larsen, Christina Viskum Lytken
Konference rapport fra seminaret "Hope and Resilience in Suicide Prevention", der blev afholdt i Nuuk, november 2009. Rapporten beskriver baggrunden for seminaret og indeholder referater af oplæg fra seminaret givet af forskere, praktikere og unge. Et væsentligt indhold i rapporten er desuden...
Kocourkova, Jana; Dudova, Iva; Koutek, Jiri
Asperger syndrome hinders adaptation to developmental challenges during childhood and adolescence, particularly with regard to interpersonal relationships. Individuals with Asperger syndrome display lack of empathy and limited ability to understand social and emotional exchanges with other people. Individuals with Asperger syndrome are significantly exposed to the risk of suicidal behavior, especially during adolescence. The authors describe cases of suicidal behavior in two adolescent boys with Asperger syndrome.
Christofferson, Dana E; Hamlett-Berry, Kim; Augustson, Erik
Automated mobile health (mHealth) programs deliver effective smoking cessation interventions through text message platforms. Smoking is an independent risk factor for suicide, so the Department of Veterans Affairs incorporated information about the Veterans Crisis Line into its SmokefreeVET smoking cessation text messaging program. Almost 7% of all SmokefreeVET enrollees have accessed this information. Because of the reach and automated nature of this and similar programs, we recommend including a referral to a suicide prevention hotline for all smoking cessation mHealth interventions.
Robinson, Jo; Bailey, Eleanor; Hetrick, Sarah; Paix, Steve; O'Donnell, Matt; Cox, Georgina; Ftanou, Maria; Skehan, Jaelea
Social media is increasingly being used by young people for health-related issues, including communicating about suicide. Due to the concerns about causing distress or inducing suicidal thoughts or behaviors, to date young people neither have been engaged in the development of social media-based suicide prevention interventions nor have interventions focused on educating young people about safe ways to communicate about suicide online. Given the potential that social media holds to deliver messages to vast numbers of people across space and time and the fact that young people often prefer to seek help from their friends and peers, safely educating and engaging young people to develop suicide prevention messages that can be delivered via social media is an obvious next step. The objectives of this study were to (1) provide education to a small number of secondary school students about safe ways to communicate about suicide via social media; (2) engage the same young people in the development of a suite of social media-based suicide prevention multimedia messages; (3) assess the impact of this on participants; and (4) assess the acceptability and safety of the messages developed. This study involved two phases. In phase 1, 20 participants recruited from two schools took part in an 8- to 10-week program during which they were provided with psychoeducation about mental health and suicide, including how to talk safely about suicide online, and they were then supported to design and develop their own media messages. These participants completed an evaluation questionnaire at the conclusion of the program. In phase 2, a larger group of participants (n=69), recruited via an opt-in process, viewed the media messages and completed a short questionnaire about each one. Participants in phase 1 enjoyed the program and reported that they learned new skills, such as how to talk safely about suicide online, and felt more able to provide emotional support to others (16/20, 80%). No
Blasco-Fontecilla, Hilario; Fernández-Fernández, Roberto; Colino, Laura; Fajardo, Lourdes; Perteguer-Barrio, Rosa; de Leon, Jose
Behavioral addictions such as gambling, sun-tanning, shopping, Internet use, work, exercise, or even love and sex are frequent, and share many characteristics and common neurobiological and genetic underpinnings with substance addictions (i.e., tolerance, withdrawal, and relapse). Recent literature suggests that both non-suicidal self-injury (NSSI) and suicidal behavior (SB) can also be conceptualized as addictions. The major aim of this mini review is to review the literature and explore the neurobiological and psychological mechanisms underlying the addiction to self-harming behaviors. This is a narrative review. The authors performed literature searches in PubMed and Google for suicidal behavior, self-harming, addiction, and "major repeaters." Given the scarce literature on the topic, a subset of the most closely related studies was selected. The authors also focused on three empirical studies testing the hypothesis that major repeaters (individuals with ≥5 lifetime suicide attempts) represent a distinctive suicidal phenotype and are the individuals at risk of developing an addiction to SB. The authors reviewed the concept of behavioral addictions and major repeaters, current empirical evidence testing concerning whether or not NSSI and SB can be understood as "addictions," and the putative mechanisms underlying them. Our review suggests that both NSSI and SB can be conceptualized as addictions. This is relevant because if some individual's self-harming behaviors are better conceptualized as an addiction, treatment approaches could be tailored to this addiction.
Full Text Available Introduction: Behavioral addictions such as gambling, sun-tanning, shopping, internet use, work, exercise, or even love and sex are frequent, and share many characteristics and common neurobiological and genetic underpinnings with substance addictions (i.e., tolerance, withdrawal, and relapse. Recent literature suggests that both non-suicidal self-injury (NSSI and suicidal behavior (SB can also be conceptualized as addictions. The major aim of this mini review is to review the literature and explore the neurobiological and psychological mechanisms underlying the addiction to self-harming behaviors.Method: This is a narrative review. The authors performed literature searches on PubMed and Google for suicidal behavior, self-harming, addiction, and major repeaters. Given the scarce literature on the topic, a subset of the most closely related studies was selected. The authors also focused on three empirical studies testing the hypothesis that major repeaters (individuals with ≥5 lifetime suicide attempts represent a distinctive suicidal phenotype, and are the individuals at risk of developing an addiction to SB. Results: The authors reviewed the concept of behavioral addictions and major repeaters, current empirical evidence testing concerning whether or not NSSI and SB can be understood as addictions, and the putative mechanisms underlying them.Conclusion: Our review suggests that both NSSI and SB can be conceptualized as addictions. This is relevant because if some individual’s self-harming behaviors are better conceptualized as an addiction, treatment approaches could be tailored to this addiction.
Qiao, Nan; Bell, Teresa Maria
The study sought to examine indigenous adolescents' suicidal behaviors and risk factors in a nationally representative sample and explore potential causes of disparities. The study analyzed the 1991-2013 Youth Risk Behavior Survey National Combined Datasets. Suicidal behavior outcomes included suicide consideration, planning, and attempts during the past 12 months. Logit regressions were used to estimate the effects of potential suicide risk factors on these suicidal behaviors. The results showed that a high percentage of indigenous adolescents exhibited suicidal behaviors (consideration: 24.6 %; planning: 20.7 %; attempts: 16.2 %). After adjusting for risk factors, indigenous adolescents were no more likely than other adolescents to consider or plan for suicide (consideration: OR 1.18, CI 0.96-1.45, p = 0.125; planning: OR 1.16, CI 0.95-1.42, p = 0.156); however, they remained significantly more likely to have made suicide attempts (OR 1.73, CI 1.32-2.26, p suicidal behaviors could be explained by the heterogeneous prevalence of suicidal risk factors across different races/ethnicities.
Garcia-Williams, Amanda G; Moffitt, Lauren; Kaslow, Nadine J
The objective of this paper is to describe the mental health and service utilization of graduate students at a large southeastern university and identify psychological factors associated with their student suicidal behavior. E-mail invitations to complete the Interactive Screening Program, an online anonymous mental health questionnaire, were sent to graduate students. The questionnaire included the Patient Health Questionnaire (PHQ-9) as well as items assessing suicide behavior, anxiety, negative emotion, substance use, eating behavior, and service utilization. A total of 301 graduate students responded to the questionnaires between 14 July 2010 and 24 January 2012. With regards to suicide, 7.3 % of the sample reported thoughts of suicide, 2.3 % reported having plans for suicide, and 1.7 % had hurt themselves in the past 2 weeks; while 9.9 % had ever made a suicide attempt in their lifetime. Graduate students had PHQ-9 scores indicating mild depression, and more than half endorsed feeling nervous, irritable, stressed, anxious, lonely, or having fights/arguments. In terms of service utilization, 22.2 % of the sample was currently taking some type of medication, and 18.5 % currently in counseling/therapy are females and those with higher PHQ-9 scores more likely to be using services. Those endorsing suicidal behavior in the past 2 weeks had significantly higher depression scores than those without such behavior and were characterized by more anxiety, negative emotions (such as loneliness, anger, hopelessness, desperation, and being out of control), substance use, and eating problems. Graduate students experience significant amounts of stress and anxiety, and their suicidal behavior is strongly characterized by depression, hopelessness, desperation, lack of control, and eating problems. Future work with this population should focus on the development and evaluation of mental health and wellness interventions and on ways to promote help-seeking, especially among male
Marek S. Kopacz
Full Text Available In recent years, identifying ways to mitigate the risk of suicidal behavior in Veteran populations has become a major public health challenge of special significance. This has included identifying support options that can be used by Veterans in times of distress or crisis. For example, Veterans at increased risk of suicide will sometimes voice complaints indicative of a need for spiritual and pastoral care support. At U.S. Department of Veterans Affairs Medical Centers, such support is provided to Veterans by clinical chaplains. This discussion paper aims to present the contextual framework in which chaplaincy services are provided to Veterans at increased risk of suicide, better conceptualize the spiritual and pastoral care needs of at-risk Veterans who request chaplaincy services, and offer practical suggestions for framing the provision of spiritual and pastoral care services.
Wagner, Birgit; Klinitzke, Grit; Brähler, Elmar; Kersting, Anette
A number of studies have revealed that the number of completed suicides decreases with increasing body mass index (BMI). However, only few studies have evaluated the association between suicidal behavior, suicide attempts, and the various BMI categories. The aim of this study was to determine whether obesity is positively associated with increased suicide attempts and suicidal behavior with consideration of gender differences. In a representative German population-based sample (N = 2436), interviews were conducted in 2011 to examine the prevalence of suicide attempts and suicidal behavior in participants in the different BMI categories. Logistic regression analyses were conducted for suicidal behavior and suicide attempts to examine the association between obesity status and suicidality, controlling for confounding variables. Suicidal behavior was assessed by the Suicidal Behaviors Questionnaire-Revised (SBQ-R), which is a four-item self-report measure of suicidal thoughts and past attempts. BMI was calculated from participants' self-reported height and weight. Analyses revealed that extremely obese participants (BMI ≥ 40.0) had a prevalence rate of suicidal behavior of 33% for female respondents and 13% for male respondents and rates for suicide attempts of 27% for female and 13% for male respondents. No significant gender differences could be found for any of the weight categories. Furthermore, adjusted odd ratios (AOR) showed a significant difference in suicidal behavior in class I obesity (OR, 3.02 [1.50-6.08] and class III obesity (OR, 21.22 [6.51-69.20]. AORs for suicide attempts showed significantly greater odds for class I obesity (OR, 3.49 [1.76-6.90] and class III obesity (OR, 12.43 [3.87-39.86] compared to the normal weight group. These results support a positive relationship between suicidal behavior, suicide attempts, and obesity. However contrary to previous findings, no gender differences were found. The findings support the introduction of
Full Text Available Throughout history, the social convictions and norms have influenced the recognition and presence of suicidal behaviour in different ways. However, previous research findings regarding the connection between suicidal behaviour and attitudes towards suicide have not arrived at a clear conclusion. The present research explores adolescents' attitudes toward suicide. The aim was to examine the relation between the permissive attitude toward suicide on one side and certain suicide risk factors and satisfaction in different domains of psychical functioning on the other side. Data was collected on 423high school students in three Slovenian cities, chosen on the basis of different regional suicide rates, with an Attitudes towards Suicide Questionnaire ATTS, Psychological Well-Being Scales PWBS, and questions about suicidal behaviour of adolescents and their surroundings. The results showed that the acceptance of suicide is proportional to the suicide rates of different regions. We concluded that permissive attitudes towards suicide could potentially lead to the increased risk of suicidal behaviour. Furthermore, the acceptance of suicide was, inter alia, significantly positively related to the self-reported probability of committing suicide, the presence of suicidal behaviour of the adolescent and his/her friends or other people he/she knows, while the connection with the subjective life satisfaction was negative. Considering the fact that there has been a trend of growing permissiveness towards suicide in society in the last few decades, the findings raise a question regarding the positive effects of such tolerance on suicide rates and support the justification of restrictive attitudes towards suicide as a protective factor of suicidal behaviour.
Kaslow, Nadine J.; Garcia-Williams, Amanda; Moffitt, Lauren; McLeod, Mark; Zesiger, Heather; Ammirati, Rachel; Berg, John P.; McIntosh, Belinda J.
Preventing suicide is a commonly shared priority among college administrators, faculty, staff, students, and family members. Coalitions are popular health promotion mechanisms for solving community-wide problems and are valuable in campus-wide suicide prevention efforts. This article provides an example of an effective suicide prevention…
Mishara, Brian L.; Weisstub, David N.
The ethical basis of suicide prevention is illustrated by contrasting helpline emergency rescue policies of the Samaritans and the AAS and the U.S. National Suicide Prevention Lifeline network. We contrast moralist, relativist, and libertarian ethical premises and question whether suicide can be rational. Samaritans respect a caller's right to…
Ran, Mao-Sheng; Wu, Qiu-Hua; Conwell, Yeates; Chen, Eric Yu-Hai; Chan, Cecilia Lai-Wan
This study evaluated the characteristics of suicidal behavior (suicide attempt or suicidal ideation) among 230 consecutively admitted inpatients with schizophrenia and mood disorders in a university hospital in China. The rate of lifetime suicidal behavior was found to be significantly higher in patients with mood disorders (62.4%) than in…
Fernández Rodríguez, María Del C; Huertas, Ivonne Bayron
Described by Durkheim (1966) as the crudest expression of the social phenomena, suicide is of interest to clinicians, academics and researchers. Within the academic context, this issue has to be addressed and prevented. We are interested in sharing the process of participative action that led to the creation of a Suicide Prevention Program (SPP) for college students. Based on knowledge that was generated through a collaborative effort among all sectors of the academic community, we developed a prevention campaign that is culturally sensitive to our university's environment. This campaign is directed towards overcoming the stigma of seeking help and is characterized by promoting a sense of wellbeing in a holistic manner, paying attention not only to the individual, but also to elements of their sociocultural environment.
of Religion/Spirituality in the Prevention of Suicide Psychological and Psychiatric Studies Sigmund Freud , a critic of religion, believed religion...youth ministry. 47 Sigmund Freud , Civilization and its Discontents (1930) trans. James Strachey, Standard Addition of the Psychological Works of... Sigmund Freud , (London: Hogarth Press, 1962), 25, quoted in Harold G. Koenig, "Religion and Medicine II: Religion, Mental Health, and Related Behaviors
Frank, M L; Lester, D; Wexler, A
A national sample of 500 members of Gamblers Anonymous was surveyed by mail in order to gather information on suicidal history. One hundred sixty two usable surveys were returned representing 32.4% of the original sample. Compulsive gamblers who had a history of suicidal preoccupation began gambling at an earlier age than nonsuicidal gamblers and were more likely to have stolen to support their gambling. They also tended to have addicted relatives and children more than nonsuicidal gamblers did. The data suggest that those gamblers who had been suicidal tend to be more serious gamblers than nonsuicidal respondents.
Gilissen, Renske; De Beurs, Derek; Mokkenstorm, Jan; Mérelle, Saskia; Donker, Gé; Terpstra, Sanne; Derijck, Carla; Franx, Gerdien
The European Alliance against Depression (EAAD) program is to be introduced in The Netherlands from 2017 onwards. This program to combat suicide consists of interventions on four levels: (1) increasing the awareness of suicide by local media campaigns; (2) training local gatekeepers, such as teachers or police officers; (3) targeting high-risk persons in the community; and (4) training and support of professionals in primary care settings. The implementation starts in seven Dutch pilot regions. Each region is designated as a Suicide Prevention Action NETwork (SUPRANET). This paper describes the SUPRANET program components and the evaluation of its feasibility and impact. The findings will be used to facilitate the national implementation of EAAD in The Netherlands and to add new findings to the existing literature on EAAD.
Kim, Dong-Sik; Kim, Hyun-Sun
This study examined the association between early initiation of problem behaviors (alcohol drinking, cigarette smoking, and sexual intercourse) and suicidal behaviors (suicidal ideation and suicide attempts), and explored the effect of concurrent participation in these problem behaviors on suicidal behaviors among Korean adolescent males and females. Data were obtained from the 2006 Korean Youth Risk Behavior Survey, a nationally representative sample of middle and high school students (32,417 males and 31,467 females) in grades seven through twelve. Bivariate and multivariate logistic analyses were conducted. Several important covariates, such as age, family living structure, household economic status, academic performance, current alcohol drinking, current cigarette smoking, current butane gas or glue sniffing, perceived body weight, unhealthy weight control behaviors, subjective sleep evaluation, and depressed mood were included in the analyses. Both male and female preteen initiators of each problem behavior were at greater risk for suicidal behaviors than non-initiators, even after controlling for covariates. More numerous concurrent problematic behaviors were correlated with greater likelihood of seriously considering or attempting suicide among both males and females. This pattern was more clearly observed in preteen than in teen initiators although the former and latter were engaged in the same frequency of problem behavior. Early initiation of alcohol drinking, cigarette smoking, and sexual intercourse, particularly among preteens, represented an important predictor of later suicidal ideation and suicide attempts in both genders. Thus, early preventive intervention programs should be developed and may reduce the potential risks for subsequent suicidal behaviors.
Full Text Available Background: Suicide is a serious public health challenge in circumpolar regions, especially among Indigenous youth. Indigenous communities, government agencies and health care providers are making concerted efforts to reduce the burden of suicide and strengthen protective factors for individuals, families and communities. The persistence of suicide has made it clear that more needs to be done. Objective: Our aim was to undertake a scoping review of the peer-reviewed literature on suicide prevention and interventions in Indigenous communities across the circumpolar north. Our objective was to determine the extent and types of interventions that have been reported during past decade. We want to use this knowledge to support community initiative and inform intervention development and evaluation. Design: We conducted a scoping review of online databases to identify studies published between 2004 and 2014. We included articles that described interventions in differentiated circumpolar Indigenous populations and provided evaluation data. We retained grey literature publications for comparative reference. Results: Our search identified 95 articles that focused on suicide in distinct circumpolar Indigenous populations; 19 articles discussed specific suicide-related interventions and 7 of these described program evaluation methods and results in detail. The majority of publications on specific interventions were found in North American countries. The majority of prevention or intervention documentation was found in supporting grey literature sources. Conclusion: Despite widespread concern about suicide in the circumpolar world and active community efforts to promote resilience and mental well-being, we found few recorded programs or initiatives documented in the peer-reviewed literature, and even fewer focusing specifically on youth intervention. The interventions described in the studies we found had diverse program designs and content, and used varied
Redvers, Jennifer; Bjerregaard, Peter; Eriksen, Heidi; Fanian, Sahar; Healey, Gwen; Hiratsuka, Vanessa; Jong, Michael; Larsen, Christina Viskum Lytken; Linton, Janice; Pollock, Nathaniel; Silviken, Anne; Stoor, Petter; Chatwood, Susan
Suicide is a serious public health challenge in circumpolar regions, especially among Indigenous youth. Indigenous communities, government agencies and health care providers are making concerted efforts to reduce the burden of suicide and strengthen protective factors for individuals, families and communities. The persistence of suicide has made it clear that more needs to be done. Our aim was to undertake a scoping review of the peer-reviewed literature on suicide prevention and interventions in Indigenous communities across the circumpolar north. Our objective was to determine the extent and types of interventions that have been reported during past decade. We want to use this knowledge to support community initiative and inform intervention development and evaluation. We conducted a scoping review of online databases to identify studies published between 2004 and 2014. We included articles that described interventions in differentiated circumpolar Indigenous populations and provided evaluation data. We retained grey literature publications for comparative reference. Our search identified 95 articles that focused on suicide in distinct circumpolar Indigenous populations; 19 articles discussed specific suicide-related interventions and 7 of these described program evaluation methods and results in detail. The majority of publications on specific interventions were found in North American countries. The majority of prevention or intervention documentation was found in supporting grey literature sources. Despite widespread concern about suicide in the circumpolar world and active community efforts to promote resilience and mental well-being, we found few recorded programs or initiatives documented in the peer-reviewed literature, and even fewer focusing specifically on youth intervention. The interventions described in the studies we found had diverse program designs and content, and used varied evaluation methods and outcomes. The studies we included consistently
Full Text Available It has been assumed that impaired intellectual capacity could act as a buffer to suicidality in the population of children and adolescents with intellectual disability. The few studies that have been conducted contest this assumption, and in fact, the findings showed that the characteristics of suicidality in the population of children and adolescents with intellectual disability are very similar to other adolescents without intellectual disability. This paper reviews the few studies conducted and describe the symptomatology in this population.
Barzilay, Shira; Brunstein Klomek, Anat; Apter, Alan; Carli, Vladimir; Wasserman, Camilla; Hadlaczky, Gergö; Hoven, Christina W; Sarchiapone, Marco; Balazs, Judit; Kereszteny, Agnes; Brunner, Romuald; Kaess, Michael; Bobes, Julio; Saiz, Pilar; Cosman, Doina; Haring, Christian; Banzer, Raphaela; Corcoran, Paul; Kahn, Jean-Pierre; Postuvan, Vita; Podlogar, Tina; Sisask, Merike; Varnik, Airi; Wasserman, Danuta
To examine risk and protective factors moderating the associations between three types of bullying victimization (physical, verbal, and relational bullying) with suicide ideation/attempts in a large representative sample of European adolescents. We analyzed cross-sectional data on 11,110 students (mean age = 14.9, standard deviation = .89) recruited from 168 schools in 10 European Union countries involved in the Saving and Empowering Young Lives in Europe study. A self-report questionnaire was used to measure victimization types, depression, anxiety, parental and peer support, and suicide ideation and attempts. For each outcome, we applied hierarchical nonlinear models controlling for sociodemographics. Prevalence of victimization was 9.4% physical, 36.1% verbal, and 33.0% relational. Boys were more likely to be physically and verbally victimized, whereas girls were more prone to relational victimization. Physical victimization was associated with suicide ideation, and relational victimization was associated with suicide attempts. Other associations between victimization and suicidality (ideation/attempts) were identified through analysis of interactions with additional risk and protective factors. Specifically, verbal victimization was associated with suicide ideation among adolescents with depression who perceived low parental support. Similarly, low peer support increased the associations between verbal victimization and suicide ideation. Verbal victimization was associated with suicide attempts among adolescents with anxiety who perceived low parental support. Findings support the development of prevention strategies for adolescent victims of bullying who may be at elevated risk for suicide ideation/behavior, by taking into account gender, the type of bullying, symptomatology, and availability of interpersonal support. Copyright © 2017. Published by Elsevier Inc.
Juliana Lourenço Araújo Veras
Full Text Available Objective: This paper offers a systematic review of the literature on eating disorders and the relationship with suicidal behavior. Methods: Searches were performed in the Medline, Lilacs, Adolec and Pubmed databases for articles published between 2003 and 2014. Results: Anorexia nervosa was the most often cited eating disorder in the articles selected. In cases of bulimia nervosa, suicide attempts and self-aggression were more frequent among those who use multiple compensation behaviors. Behavior disorders, emotional disorders and chemical dependency were described as risk factors in all publications. Conclusion: Despite the small number of studies performing an in-depth investigation into the relationship between eating disorder and suicidal behavior, the concomitant presence of these conditions places the health of patients at greater risk.
Kelliher Rabon, Jessica; Sirois, Fuschia M.; Hirsch, Jameson K.
Objective: College students may be at heightened risk for suicide and suicidal behavior due to maladaptive cognitive-emotional factors and failure to practice basic health behaviors. However, self-compassion and wellness behaviors may protect against risk. The relation between self-compassion and suicidal behavior and the contributing roles of…
Lanzillo, Elizabeth C.; Esposito, Erika C.; Santee, Angela C.; Nock, Matthew K.; Auerbach, Randy P.
Suicidal and nonsuicidal self-injurious thoughts and behaviors (SITBs) among youth are major public health concerns. Although a growing body of research has focused on the complex association between nonsuicidal and suicidal self-injury, the temporal relationship between these two classes of behaviors is unclear. The current study addresses this empirical gap by examining the course of SITBs in adolescents receiving outpatient (N = 106; 82.1 % female) and inpatient (N = 174; 75.9 % female) treatment. SITBs (co-occurrence, age-of-onset, and time lag between SITBs) and major psychiatric disorders were assessed at a single time point with well-validated structured interviews. Adolescents in both clinical samples reported high co-occurrence of SITBs: most adolescents reported both lifetime nonsuicidal self-injury (NSSI) and suicidal thoughts. A similar temporal pattern of SITBs was reported in the two samples: thoughts of NSSI and suicide ideation had the earliest age-of-onset, followed by NSSI behaviors, suicide plans, and suicide attempts. However, the age-of-onset for each SITB was younger in the inpatient sample than in the outpatient sample. In terms of time lag between SITBs, suicide ideation occurred on average before initial engagement in NSSI, suggesting that pathways to NSSI and suicidal behavior may occur simultaneously rather than in succession from nonsuicidal to suicidal self-injury. Results also indicated that the time to transition between SITBs was relatively fast, and that a key period for intervention and prevention is within the first 6–12 months after the onset of suicidal thinking. Taken together, these findings have important implications for understanding the time-lagged relationship between nonsuicidal and suicidal self-injury. PMID:27761783
Full Text Available Investigating the factors related to suicide is crucial for suicide prevention. Psychiatric disorders, gender, socioeconomic status, and catastrophic illnesses are associated with increased risk of suicide. Most studies have typically focused on the separate influences of physiological or psychological factors on suicide-related behaviors, and have rarely used national data records to examine and compare the effects of major physical illnesses, psychiatric disorders, and socioeconomic status on the risk of suicide-related behaviors.To identify the characteristics of people who exhibited suicide-related behaviors and the multiple factors associated with repeated suicide-related behaviors and deaths by suicide by examining national data records.This is a cohort study of Taiwan's national data records of hospitalized patients with suicide-related behaviors from January 1, 1997, to December 31, 2010.The study population included all people in Taiwan who were hospitalized with a code indicating suicide or self-inflicted injury (E950-E959 according to the International Classification of Disease, Ninth Revision, Clinical Modification.Self-poisoning was the most common method of self-inflicted injury among hospitalized patients with suicide-related behaviors who used a single method. Those who were female, had been hospitalized for suicide-related behaviors at a younger age, had a low income, had a psychiatric disorder (i.e., personality disorder, major depressive disorder, bipolar disorder, schizophrenia, alcohol-related disorder, or adjustment disorder, had a catastrophic illness, or had been hospitalized for suicide-related behaviors that involved two methods of self-inflicted injury had a higher risk of hospitalization for repeated suicide-related behaviors. Those who were male, had been hospitalized for suicide-related behaviors at an older age, had low income, had schizophrenia, showed repeated suicide-related behaviors, had a catastrophic illness
Lin, Yu-Wen; Huang, Hui-Chuan; Lin, Mei-Feng; Shyu, Meei-Ling; Tsai, Po-Li; Chang, Hsiu-Ju
Background Investigating the factors related to suicide is crucial for suicide prevention. Psychiatric disorders, gender, socioeconomic status, and catastrophic illnesses are associated with increased risk of suicide. Most studies have typically focused on the separate influences of physiological or psychological factors on suicide-related behaviors, and have rarely used national data records to examine and compare the effects of major physical illnesses, psychiatric disorders, and socioeconomic status on the risk of suicide-related behaviors. Objectives To identify the characteristics of people who exhibited suicide-related behaviors and the multiple factors associated with repeated suicide-related behaviors and deaths by suicide by examining national data records. Design This is a cohort study of Taiwan’s national data records of hospitalized patients with suicide-related behaviors from January 1, 1997, to December 31, 2010. Participants The study population included all people in Taiwan who were hospitalized with a code indicating suicide or self-inflicted injury (E950–E959) according to the International Classification of Disease, Ninth Revision, Clinical Modification. Results Self-poisoning was the most common method of self-inflicted injury among hospitalized patients with suicide-related behaviors who used a single method. Those who were female, had been hospitalized for suicide-related behaviors at a younger age, had a low income, had a psychiatric disorder (i.e., personality disorder, major depressive disorder, bipolar disorder, schizophrenia, alcohol-related disorder, or adjustment disorder), had a catastrophic illness, or had been hospitalized for suicide-related behaviors that involved two methods of self-inflicted injury had a higher risk of hospitalization for repeated suicide-related behaviors. Those who were male, had been hospitalized for suicide-related behaviors at an older age, had low income, had schizophrenia, showed repeated suicide
Fite, Paula J; Poquiz, Jonathan; Frazer, Andrew L; Reiter, Nicholas
This study examined associations between reactive and proactive functions of aggression and suicidal behavior in a sample of outpatient treatment seeking youth (n = 111, 60.5% male) ranging from 6 to 17 years of age (Mean age = 10.57 years). Additionally, hope was evaluated as a moderator of these associations. Child reports of measures were used to evaluate associations. When also considering the variance associated with child depressive symptoms and hope, reactive, but not proactive, aggression was uniquely associated with suicidal behavior. Moreover, hope moderated this association, such that reactive aggression was only positively associated with suicidal behavior when levels of hope were low. Findings and their implications for targeting hope with aggressive youth for the prevention of suicidal behavior are discussed.
Heilbron, Nicole; Goldston, David; Walrath, Christine; Rodi, Michael; McKeon, Richard
Several agencies have emphasized the importance of establishing clear protocols or procedures to address the needs of youths who are identified as suicidal through suicide prevention programs or in emergency department settings. What constitutes optimal guidelines for developing and implementing such protocols, however, is unclear. At the request…
Roth, Kimberly B; Borges, Guilherme; Medina-Mora, Maria-Elena; Orozco, Ricardo; Ouéda, Christiane; Wilcox, Holly C
Suicide rates in Mexico have been rising steadily for several decades. This study examined the relationship of depressed mood and antisocial behavior problems with thoughts of death, suicide plans and attempts. Data from 22,966 individuals who participated in a population-based nationally-representative survey in Mexico were analyzed. After adjusting for covariates, all odds ratios for thoughts of death and suicidal behaviors were statistically significant in relation to antisocial behavior problems and depressed mood, both moderate and severe. Multiplicative effects of depressed mood and antisocial problems were found, with comorbid individuals showing increased risk of thoughts of death and suicidal plans and attempts, compared to individuals displaying none. Possible explanations, particularly for the multiplicative effect of both mood and problem behaviors on suicide-related behaviors, are discussed in the context of prior findings and directions for future research. Copyright © 2010 Elsevier Ltd. All rights reserved.
Ruder, Thomas D; Hatch, Gary M; Ampanozi, Garyfalia; Thali, Michael J; Fischer, Nadja
The media and the Internet may be having an influence on suicidal behavior. Online social networks such as Facebook represent a new facet of global information transfer. The impact of these online social networks on suicidal behavior has not yet been evaluated. To discuss potential effects of suicide notes on Facebook on suicide prevention and copycat suicides, and to create awareness among health care professionals. We present a case involving a suicide note on Facebook and discuss potential consequences of this phenomenon based on literature found searching PubMed and Google. There are numerous reports of suicide notes on Facebook in the popular press, but none in the professional literature. Online social network users attempted to prevent planned suicides in several reported cases. To date there is no documented evidence of a copycat suicide, directly emulating a suicide announced on Facebook. Suicide notes on online social networks may allow for suicide prevention via the immediate intervention of other network users. But it is not yet clear to what extent suicide notes on online social networks actually induce copycat suicides. These effects deserve future evaluation and research.
Crepeau-Hobson, Franci; Leech, Nancy L.
This study examined the association between various types of peer-directed violence and suicidal thoughts and behaviors among adolescents. A nationally representative sample of 15,425 high school students completed the 2011 Youth Risk Behavior Survey. All types of peer victimization (bullying, physical violence, and dating violence) were found to…
Shtivelband, Annette; Aloise-Young, Patricia A; Chen, Peter Y
Background: Gatekeeper training is a promising suicide prevention strategy that is growing in popularity. Although gatekeeper training programs have been found to improve trainee knowledge, self-efficacy, and perceived skills, researchers have found that the benefit of gatekeeper training may not last over time. Aims: The purpose of this study was to identify strategies for strengthening the long-term effects of suicide prevention gatekeeper training. Method: In-depth interviews and focus groups were conducted with gatekeepers (N = 44) and data were analyzed using a qualitative research approach. Results: The results of this study suggest that posttraining interventions may be more effective if they include the following seven themes: (a) social network - connecting with other gatekeepers; (b) continued learning - further education; (c) community outreach - building awareness; (d) accessibility - convenience; (e) reminders - ongoing communication; (f) program improvement -- enhancing previous training; and (g) certification - accreditation. Conclusion: Posttraining interventions that incorporate the themes from this study offer a promising direction in which to sustain the effects of gatekeeper suicide prevention training.
Matthieu, Monica M; Gardiner, Giovanina; Ziegemeier, Ellen; Buxton, Miranda; Han, Lu; Cross, Wendi
Community-dwelling veterans at risk for suicide may be in contact with a variety of providers in agency-based settings that offer health and human services. The study aim is to describe the perspective of agency-based clinical and community providers who may come into contact with veterans in need of suicide prevention services and to examine the nature of their personal and professional relationships to individuals at risk for suicide among this sample. This study reports on qualitative data from a sample of Veterans' Affairs (VA) and community providers serving veterans and military families in one Midwestern state ( N = 70). Providers completed a survey assessing exposure to suicide, including contact with and relationship to someone suicidal, and organizational characteristics of the providers' employing agencies. Semi-structured interview questions probed for the nature of how they would react with suicidal individuals. Most providers (94%) had some prior contact with someone who was suicidal, and nearly three quarters (77%) knew someone who had died by suicide. Providers reported powerful emotional responses of sadness and remorse to suicidal experiences. While these providers interact with veterans and military families as part of their jobs, they may have their own history of being exposed to suicide, both professionally and personally.
Bryan, Craig J; David Rudd, M; Wertenberger, Evelyn; Etienne, Neysa; Ray-Sannerud, Bobbie N; Morrow, Chad E; Peterson, Alan L; Young-McCaughon, Stacey
Newer approaches for understanding suicidal behavior suggest the assessment of suicide-specific beliefs and cognitions may improve the detection and prediction of suicidal thoughts and behaviors. The Suicide Cognitions Scale (SCS) was developed to measure suicide-specific beliefs, but it has not been tested in a military setting. Data were analyzed from two separate studies conducted at three military mental health clinics (one U.S. Army, two U.S. Air Force). Participants included 175 active duty Army personnel with acute suicidal ideation and/or a recent suicide attempt referred for a treatment study (Sample 1) and 151 active duty Air Force personnel receiving routine outpatient mental health care (Sample 2). In both samples, participants completed self-report measures and clinician-administered interviews. Follow-up suicide attempts were assessed via clinician-administered interview for Sample 1. Statistical analyses included confirmatory factor analysis, between-group comparisons by history of suicidality, and generalized regression modeling. Two latent factors were confirmed for the SCS: Unloveability and Unbearability. Each demonstrated good internal consistency, convergent validity, and divergent validity. Both scales significantly predicted current suicidal ideation (βs >0.316, ps 1.07, ps <0.050) better than other risk factors. Self-report methodology, small sample sizes, predominantly male samples. The SCS is a reliable and valid measure that predicts suicidal ideation and suicide attempts among military personnel better than other well-established risk factors. Copyright © 2014 Elsevier B.V. All rights reserved.
Bouris, Alida; Everett, Bethany G; Heath, Ryan D; Elsaesser, Caitlin E; Neilands, Torsten B
Sexual minority youth (SMY) are at higher risk for victimization and suicide than are heterosexual youth (HY). Relatively little research has examined which types of victimization are most closely linked to suicide, which is necessary to develop targeted prevention interventions. The present study was conducted to address this deficit. The data come from the 2011 Chicago Youth Risk Behavior Survey (n = 1,907). Structural equation modeling (SEM) in Mplus evaluated the direct, indirect, and total effects of sexual orientation on a latent indicator of suicidal ideation and behaviors via seven types of victimization. Four indicators of victimization were school-specific (e.g., harassment due to sexual orientation or gender identity (SO/GID), bullying, threatened or injured with a weapon, and skipping school due to safety concerns), and three indicators assessed other types of victimization (e.g., electronic bullying, intimate partner violence, and sexual abuse). Thirteen percent of youth were classified as SMY. Significantly more SMY than HY reported suicidal ideation (27.95% vs. 13.64%), a suicide plan (22.78% vs. 12.36%), and at least one suicide attempt (29.92% vs. 12.43%) in the past year (all P harassment, skipping school, electronic bullying, and sexual abuse. Sexual orientation was not directly related to suicidal ideation and behaviors in SEM. Rather, SMY's elevated risk of suicidality functioned indirectly through two forms of school-based victimization: being threatened or injured with a weapon (B = .19, SE = .09, P ≤ .05) and experiencing SO/GID-specific harassment (B = .40, SE = .15, P ≤ .01). There also was a trend for SMY to skip school as a strategy to reduce suicide risk. Although SMY experience higher rates of victimization than do HY, school-based victimization that involves weapons or is due to one's SO/GID appear to be the most deleterious. That SMY may skip school to reduce their risk of suicidal ideation and
Cheng, Andrew T A; Hawton, Keith; Chen, Tony H H; Yen, Amy M F; Chang, Jung-Chen; Chong, Mian-Yoon; Liu, Chia-Yih; Lee, Yu; Teng, Po-Ren; Chen, Lin-Chen
Few studies have directly assessed the impact of a specific media report in vulnerable people. This study investigates possible influences of media reporting of a celebrity suicide on subsequent suicidal behaviors and associated risk factors among depressive patients. Depressive patients (N=461) were assessed through a structured interview soon after extensive media reporting of a celebrity suicide. Among 438 depressive patients exposed to the media report, 38.8% reported an influence on subsequent suicidal behaviors, including 24 (5.5%) with a suicide attempt. The risk of such influence was highest among patients in a severe depressive state just prior to the media report (adjusted OR 7.81, 95% CI 3.28-18.59). Such influence on a subsequent suicide attempt was highest in patients with a most recent suicide attempt within one month prior to the media reports (adjusted hazard ratio 11.91, 95% CI 3.76-37.72). Our finding of the significant media influence may reflect adverse thoughts among more suicidal and depressed individuals. The possible influence of other factors on the findings cannot be ruled out. This study has provided more convincing evidence suggesting negative influences of media reporting of a celebrity suicide on subsequent suicidal behaviors among depressive patients. Particular attention in terms of potential negative media influences should be paid to patients who are younger and currently depressed and have made a recent suicide attempt.
Price, James H; Khubchandani, Jagdish
Suicidal ideation and suicide attempts are more common in Latina adolescents than White or African-American adolescents. Several health risk behaviors have been identified as being associated with Latina adolescent suicides. However, to date, no study has identified the consistency and stability of these risk behaviors over time. This study utilized the national Youth Risk Behaviors Survey from 2001 to 2013 to estimate the prevalence of suicidal ideation, suicide attempts, and health risk behaviors associated with suicidal behaviors in Latina adolescents. Our analysis found the prevalence of suicidal ideation and suicide attempts varied significantly over the 13-year study span, decreasing from 2001 to 2009 and increased from 2011 to 2013. The analyses found 11 health risk behaviors that were significantly associated with both suicidal ideation and suicide attempts that did not vary over time. The stability of these 11 health risk behaviors associated with suicidal behaviors could be useful to school personnel to identify early at risk Latina adolescents who may benefit from school and community mental health resources.
Jun, Won Hee; Lee, Eun Ju; Park, Jeong Soon
To investigate the effects of a suicide prevention programme on the levels of depression, self-esteem, suicidal ideation and spirituality in patients with mental illness. Instances of suicide have significant correlations with depression, low self-esteem, suicidal ideation and a low level of spirituality in the victims. Therefore, addressing depression, low self-esteem and suicidal ideation as suicide risk factors and increasing levels of spirituality can constitute an effective programme to prevent suicide among patients with mental illness. The study was a quasi-experimental study with a nonequivalent control group, nonsynchronised design. The study sample consisted of 45 patients with mental illness who had been admitted to the psychiatric unit in a university hospital in South Korea. The patients were assigned to control and experimental groups of 23 and 22 members, respectively. The suicide prevention programme was conducted with the experimental group over four weeks and included eight sessions (two per week). The control group received only routine treatments in the hospital. The experimental group that participated in the programme had significantly decreased mean scores for depression and suicidal ideation compared with the control group. However, there were no significant differences in the mean scores for self-esteem and spirituality between the groups. The suicide prevention programme might be usefully applied as a nursing intervention for patients hospitalised in psychiatric wards or clinics where the goals are to decrease depression and suicidal ideation. Typical treatments for hospitalised patients with mental illness are not enough to prevent suicide. Intervention for suicide prevention needs to apply an integrated approach. The suicide prevention programme using an integrated approach is more effective in reducing depression and suicidal ideation in patients with mental illness than applying routine treatments in the hospital. © 2013 John Wiley
Bennett, Kathryn; Rhodes, Anne E; Duda, Stephanie; Cheung, Amy H; Manassis, Katharina; Links, Paul; Mushquash, Christopher; Braunberger, Peter; Newton, Amanda S; Kutcher, Stanley; Bridge, Jeffrey A; Santos, Robert G; Manion, Ian G; Mclennan, John D; Bagnell, Alexa; Lipman, Ellen; Rice, Maureen; Szatmari, Peter
We conducted an expedited knowledge synthesis (EKS) to facilitate evidence-informed decision making concerning youth suicide prevention, specifically school-based strategies and nonschool-based interventions designed to prevent repeat attempts. Systematic review of review methods were applied. Inclusion criteria were as follows: systematic review or meta-analysis; prevention in youth 0 to 24 years; peer-reviewed English literature. Review quality was determined with AMSTAR (a measurement tool to assess systematic reviews). Nominal group methods quantified consensus on recommendations derived from the findings. No included review addressing school-based prevention (n = 7) reported decreased suicide death rates based on randomized controlled trials (RCTs) or controlled cohort studies (CCSs), but reduced suicide attempts, suicidal ideation, and proxy measures of suicide risk were reported (based on RCTs and CCSs). Included reviews addressing prevention of repeat suicide attempts (n = 14) found the following: emergency department transition programs may reduce suicide deaths, hospitalizations, and treatment nonadherence (based on RCTs and CCSs); training primary care providers in depression treatment may reduce repeated attempts (based on one RCT); antidepressants may increase short-term suicide risk in some patients (based on RCTs and meta-analyses); this increase is offset by overall population-based reductions in suicide associated with antidepressant treatment of youth depression (based on observational studies); and prevention with psychosocial interventions requires further evaluation. No review addressed sex or gender differences systematically, Aboriginal youth as a special population, harm, or cost-effectiveness. Consensus on 6 recommendations ranged from 73% to 100%. Our EKS facilitates decision maker access to what is known about effective youth suicide prevention interventions. A national research-to-practice network that links researchers and decision
DeBastiani, Summer; De Santis, Joseph P
Suicide is a significant health problem internationally. Those who complete suicide may have different behaviors and risk factors than those who attempt a non-fatal suicide. The purpose of this article is to analyze the concept of suicide lethality and propose a clear definition of the concept through the identification of antecedents, attributes, and consequences. A literature search for articles published in the English language between 1970 and 2016 was conducted using MEDLINE, the Cochrane Library, Pubmed, Psychlit, Ovid, PsycINFO, and Proquest. The bibliographies of all included studies were also reviewed to identify additional relevant citations. A concept analysis was conducted on the literature findings using six stages of Walker and Avant's method. The concept analysis differentiated between suicide, lethality, suicidal behavior, and suicide lethality. Presence of a suicide plan or a written suicide note was not found to be associated with the majority of completed suicides included in the definition of suicide lethality. There are a few scales that measure the lethality of a suicide attempt, but none that attempt to measure the concept of suicide lethality as described in this analysis. Clarifying the concept of suicide lethality encourages awareness of the possibility of different suicidal behaviors associated with different suicide outcomes and will inform the development of future nursing interventions. A clearer definition of the concept of suicide lethality will guide clinical practice, research, and policy development aimed at suicide prevention.
Fish, Jessica N; Rice, Cara E; Lanza, Stephanie T; Russell, Stephen T
The developmental timing of suicide-related disparities between heterosexuals and sexual minorities (i.e., lesbian/gay and bisexual (LGB) people) is an understudied area that has critical prevention implications. In addition to developmentally situated experiences that shape risk for suicidality in the general population, sexual minorities also experience unique social stressors (e.g., anti-LGB stigma) that may alter their risk for suicidal behavior at different ages. Using a nationally representative US sample of adults, we assessed age-varying rates of suicidal behavior among heterosexuals and sexual minorities ages 18 to 60 and the age-varying association between anti-LGB discrimination and suicidal behavior. We also tested whether these age-varying prevalences and associations differed for men and women and for sexual minorities who did and did not endorse a sexual minority identity. Results indicate a critical period for suicide behavior risk for sexual minorities during young adulthood, with the highest rates of risk at age 18 followed by a steady decline until the early 40s. Disparities were particularly robust for sexual minorities who identified as lesbian, gay, or bisexual. This pattern was present for both men and women, though sexual minority women in their 30s were more likely to report suicidal behavior than heterosexuals and sexual minority men. Sexual minorities who experienced anti-LGB discrimination were more likely to report suicidal behavior, but the significance of this association was limited to those under 30. The effect of discrimination on suicidal behavior was stronger among young adult sexual minority men, relative to sexual minority women, but was present for a wider age range for sexual minority women (until age 30) relative to sexual minority men (until age 25).
Tresno, Fiona; Ito, Yoshimi; Mearns, Jack
This study reports the prevalence of self-injurious behavior and suicide attempts among college students in Indonesia and examines risk factors distinguishing between 3 groups: self-injury with suicide attempt, non-suicidal self-injury, and non-self-injury. Self-report questionnaires measuring self-injury and suicide attempts, negative mood…
Price, Sian; Weightman, Alison Lesley; Morgan, Helen Elizabeth; Mann, Mala K.; Thomas, S.
This document has been produced by the Vulnerable Groups Team of the Public Health\\ud Wales NHS Trust in conjunction with the Support Unit for Research Evidence at Cardiff\\ud University. It updates the document originally published by the National Public Health\\ud Service for Wales in 2007. This document brings together evidence relevant to the\\ud prevention of suicide and self harm. It adopts a public health approach to prevention and\\ud the evidence is presented at four levels. The document...
Washburn, Cheryl A.; Mandrusiak, Michael
Findings from biannual American College Health Association-National College Health Assessment surveys have highlighted the prevalence of depression, suicidal ideation, and attempted suicides on Canadian university campuses and the need for comprehensive suicide prevention programs. This article explores how one large western Canadian university…
Becker, Martin A. Swanbrow; Drum, David J.
This study explored the mental health influence on resident assistants associated with their training in suicide prevention and their subsequent role as campus mental health gatekeepers. Despite considerable prior personal experience with their own suicidal thinking as well as with others who have thoughts of suicide, a multiple regression…
Bagley, Steven C.; Munjas, Brett; Shekelle, Paul
Military personnel and veterans have important suicide risk factors. After a systematic review of the literature on suicide prevention, seven (five in the U.S.) studies of military personnel were identified containing interventions that may reduce the risk of suicide. The effectiveness of the individual components was not assessed, and problems in…
van Ballegooijen, W.; Spijker, B.A.J.; Kerkhof, A.J.F.M.
BACKGROUND: The internet can provide valuable support for persons with suicidal tendencies. By means of the Google search engine we found and categorised 153 Dutch websites dealing with suicide. The websites relating to suicide prevention (n = 23) were scored for quality against a list of 17 quality
Hooven, Carole; Herting, Jerald R.; Snedker, Karen A.
Objectives: To provide a long-term look at suicide risk from adolescence to young adulthood for former participants in Promoting CARE, an indicated suicide prevention program. Methods: Five hundred ninety-three suicide-vulnerable high school youth were involved in a long-term follow-up study. Latent class growth models identify patterns of change…
Logan, Joseph E; Vagi, Kevin J; Gorman-Smith, Deborah
Youth reporting combined histories of nonfatal violence, suicidal ideation/behavior, and gun-carrying (VSG) are at risk for perpetrating fatal interpersonal violence and self-harm. We characterized these youth to inform prevention efforts. We analyzed 2004 data from 3,931 seventh-, ninth-, and 11-12th-grade youth and compared VSG youth (n = 66) with non-gun carrying youth who either had no histories of violence or suicidal thoughts/behavior (n = 1,839), histories of violence (n = 884), histories of suicidal thoughts/behaviors (n = 552), or both (n = 590). We compared groups based on demographic factors, risk factors (i.e., friends who engage in delinquency, peer-violence victimization, depressive symptoms, illicit substance use), and protective factors (i.e., school connectedness, parental care and supervision). Regression models identified factors associated with VSG youth. Illicit substance use and having friends who engage in delinquency were more common among VSG youth in all comparisons; almost all VSG youth had high levels of these factors. Depressive symptoms were positively associated with VSG youth versus youth without either violent or suicide-related histories and youth with violent histories alone. School connectedness and parental supervision were negatively associated with VSG youth in most comparisons. Family-focused and school-based interventions that increase connectedness while reducing delinquency and substance use might prevent these violent tendencies.
Pan, Lisa A.; Batezati-Alves, Silvia C.; Almeida, Jorge R. C.; Segreti, AnnaMaria; Akkal, Dalila; Hassel, Stefanie; Lakdawala, Sara; Brent, David A.; Phillips, Mary L.
Objectives: Impaired attentional control and behavioral control are implicated in adult suicidal behavior. Little is known about the functional integrity of neural circuitry supporting these processes in suicidal behavior in adolescence. Method: Functional magnetic resonance imaging was used in 15 adolescent suicide attempters with a history of…
Dale, Rosanna; Power, Kevin; Kane, Scott; Stewart, Alex Mitchell; Murray, Lindsey
The current study examined the role of perceived parental bonding and early maladaptive schemas in suicidal behavior. Participants completed measures of perceived parental bonding; schemas; risk of repeating suicidal behavior; anxiety; and depression following their presentation at Accident and Emergency with suicidal behavior. A suicidal behavior group (n = 60) differed from a comparison clinical (n = 46) and non-clinical (n = 48) group on measures of early maladaptive schemas, anxiety, and depression. No significant difference was noted between the suicidal behavior group and the comparison clinical group on a measure of parental bonding. Within the suicidal behavior group, significant associations were indicated between perceived parental bonding and risk of repetition of suicidal behavior; and early maladaptive schemas and risk of repetition of suicidal behavior. Early maladaptive schemas were found to mediate the relationship between perceived parental bonding and risk of repetition of suicidal behavior, with schemas of Social Alienation and Defectiveness/Shame offering mediator roles. The findings of the current study emphasize the complexities of suicidal behavior and factors that are associated with suicidal behavior. Although causality cannot be assumed, the findings highlight the importance and inter-relationships of not only perceived early experiences, but of underlying schemas in relation to suicidal behavior.
Zarrouq, Btissame; Bendaou, B; Elkinany, S; Rammouz, I; Aalouane, R; Lyoussi, B; Khelafa, S; Bout, A; Berhili, N; Hlal, H; Nejjari, C; El Rhazi, K
Suicidal behavior is a major cause of injury and death worldwide, especially among adolescents and young adults. Few studies have tackled this issue in the Arab world. The present study investigated the prevalence and the risk factors of suicidal behaviors among Moroccan school students. From April 2012 to November 2013, a cross-sectional study was conducted in the North-Centre region of Morocco among students in public secondary schools selected using stratified cluster random sampling. The data were collected via anonymous self-administered questionnaires. The Mini International Neuropsychiatric Interview was used in its Moroccan Colloquial Arabic version to assess suicidality according to the DSM-IV criteria. A total of 3020 students (53 % boys) aged 11-23 years (average age = 16 ± 2.1 years) were included in the study. The prevalence of suicide ideation, suicide planning and suicide attempts during the last month were 15.7, 6.3, and 6.5 % respectively. Univariate analyses demonstrated that suicidal behaviors followed different epidemiological patterns. According to the multivariate analyses, the risk factors for all suicidal behaviors among Moroccan school students were the female gender, middle school level, urban locations, low family income, parents' divorce, tobacco consumption and psychoactive substances (alcohol and cannabis) use. The intervention of preventive programs has become an emergency to overcome the issue of suicidality in Morocco. Further researches on adolescents' suicidal behaviors are suggested to update temporal data and assess the effectiveness of potential interventions.
Russell, Stephen T; Pollitt, Amanda M; Li, Gu; Grossman, Arnold H
This study aimed to examine the relation between chosen name use, as a proxy for youths' gender affirmation in various contexts, and mental health among transgender youth. Data come from a community cohort sample of 129 transgender and gender nonconforming youth from three U.S. cities. We assessed chosen name use across multiple contexts and examined its association with depression, suicidal ideation, and suicidal behavior. After adjusting for personal characteristics and social support, chosen name use in more contexts was associated with lower depression, suicidal ideation, and suicidal behavior. Depression, suicidal ideation, and suicidal behavior were lowest when chosen names could be used in all four contexts. For transgender youth who choose a name different from the one given at birth, use of their chosen name in multiple contexts affirms their gender identity and reduces mental health risks known to be high in this group. Copyright © 2018 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Radeloff, Daniel; Lempp, Thomas; Rauf, Amna; Bennefeld-Kersten, Katharina; Kettner, Mattias; Freitag, Christine M
Following accidents, suicide is the second leading cause of death in adolescence. This stage of life has the most suicide attempts of all age groups. In addition to mentally ill juveniles, adolescent delinquents represent a high-risk group for suicidal behavior and completed suicide. In particular, the population of detainees, an extreme form of juvenile delinquency, have a 16- to 18-fold higher risk of suicidal behavior and suicide compared to the general population. Because the composition of juvenile detainees differs greatly from that of detained adults, age-specific scientific approaches and prevention programs are needed. This task cannot be addressed by juvenile detention staff alone, but rather demands close cooperation between adolescent psychiatrists, psychologists, prison medical staff, legal experts and prison officers to use the opportunity for suicide prevention in juvenile detention facilities.
Panagioti, M; Gooding, P A; Taylor, P J; Tarrier, N
A growing body of research has highlighted the importance of identifying resilience factors against suicidal behavior. However, no previous study has investigated potential resilience factors among individuals with Posttraumatic Stress Disorder (PTSD). The aim of this study was to examine whether perceived social support buffered the impact of PTSD symptoms on suicidal behavior. Fifty-six individuals who had previously been exposed to a traumatic event and reported PTSD symptoms in the past month (n = 34, 60.7% participants met the full criteria for a current PTSD diagnosis) completed a range of self-report measures assessing PTSD symptoms, perceived social support and suicidal behavior. Hierarchical regression analyses were conducted to examine whether perceived social support moderates the effects of PTSD symptoms on suicidal behavior. The results showed that perceived social support moderated the impact of the number and severity of PTSD symptoms on suicidal behavior. For those who perceived themselves as having high levels of social support, an increased number and severity of PTSD symptoms were less likely to lead to suicidal behavior. The current findings suggest that perceived social support might confer resilience to individuals with PTSD and counter the development of suicidal thoughts and behaviors. The milieu of social support potentially provides an area of further research and an important aspect to incorporate into clinical interventions for suicidal behavior in PTSD or trauma populations. © 2013.
Gould, Madelyn S; Lake, Alison M; Munfakh, Jimmie Lou; Galfalvy, Hanga; Kleinman, Marjorie; Williams, Caitlin; Glass, Andrew; McKeon, Richard
Crisis lines are settings where identifying individuals at imminent risk of suicidal behavior and intervening to keep them safe are critical activities. We examined clinical characteristics of crisis callers assessed by telephone crisis helpers as being at imminent risk of suicide, and the interventions implemented with these callers. Data were derived from 491 call reports completed by 132 helpers at eight crisis centers in the National Suicide Prevention Lifeline network. Helpers actively engaged the callers in collaborating to keep themselves safe on 76.4% of calls and sent emergency services without the callers' collaboration on 24.6% of calls. Four different profiles of imminent risk calls emerged. Caller profiles and some helper characteristics were associated with intervention type. Our findings provide a first step toward an empirical formulation of imminent risk warning signs and recommended interventions. © 2015 The American Association of Suicidology.
Scott J Fitzpatrick
Full Text Available Suicide is a significant public health concern. Continued high suicide rates, coupled with emerging international evidence, have led to the development of a ‘systems’ approach to suicide prevention, which is now being trialled as part of a proposed Suicide Prevention Framework for NSW (New South Wales, Australia. The Framework replicates successful international approaches. It is organised around nine components, ranging from individual to population-level approaches, to improve coordination and integration of existing services. If implemented fully, the Framework may lead to a significant reduction in suicide. However, to ensure its long-term success, we must attend to underlying structures within the system and their interrelationships. Such an approach will also ensure that policy makers and local suicide prevention action groups, particularly in rural areas, are able to respond to local challenges and incorporate multiple perspectives into their practice, including evidence for the broader social determinants of suicide.
González-Forteza, Catalina; Juárez-López, Carlos E; Jiménez, Alberto; Montejo-León, Liliana; Rodríguez-Santisbón, Ulises R; Wagner, Fernando A
Suicide is an important public health problem that requires a preventive approach. The present study aimed at assessing suicidal behaviors and their relations with other psychosocial factors in Campeche, Mexico, in order to inform the design of potential preventive interventions. A multistage probability sample of 2386 students representative of all middle schools of the state of Campeche, Mexico, took a standardized, paper-and-pencil survey covering selected psychosocial constructs including suicide behavior, depression, drug use, familial relationships, locus of control, impulsivity, and self-esteem, among others. Latent classes were identified and multinomial logistic regression was used to analyze associations between class membership and psychosocial covariates. An estimated 8% of the middle school population in Campeche had three or more psychosocial problems in the past month including drug use, major depression episode symptoms, as well as suicidal problems like attempts and self-inflicted injuries. Four latent classes were identified, one with lowest risk and three with varying characteristics in terms of binge alcohol and other drug use, depression, and suicide behaviors. Associations between psychosocial covariates and latent class were observed, as predicted based on a multi-dimensional theoretical framework. Heterogeneity across "High-Risk" groups and their potential determinants highlight the need for differentiated, specialized efforts ranging from universal to indicated interventions. Given the high level of risk factors in this population, universal preventive interventions should aim at building resiliency among youth by helping them develop an array of coping resources, as well as by creating a more nurturing psychosocial environment. Copyright © 2017 Elsevier Inc. All rights reserved.
Nakanishi, Miharu; Yamauchi, Takashi; Takeshima, Tadashi
In Japan, the Cabinet Office released the 'General Principles of Suicide Prevention Policy' in 2007 and suggested nine initiatives. In 2009, a national fund was launched to help prefectures (the administrative divisions of Japan) and local authorities implement five categories of suicide-prevention programs. This paper examines the impact of the national fund on the establishment of the systems for suicide prevention and the implementation of these initiatives among local authorities. The present study included 1385 local authorities (79.5%) from all 47 prefectures that responded to the cross-sectional questionnaire survey. Improved suicide-prevention systems and the implementation of nine initiatives in April 2013 were observed among 265 local authorities (19.1%) that implemented 'Training of community service providers' and 'Public awareness campaigns'; 178 local authorities (12.9%) that implemented 'Face-to-face counseling', 'Training of community service providers' and 'Public awareness campaigns'; and 324 local authorities (23.4%) that implemented 'Trauma-informed policies and practices'. There was no significant difference in suicide-prevention systems and the implementation of nine initiatives between 203 local authorities (14.7%) that implemented only 'Public awareness campaigns' and 231 local authorities (16.7%) that did not implement any suicide-prevention programs. The results of our study suggest that the national fund promoted the establishment of community systems for suicide prevention and helped implement initiatives among local authorities. The national suicide-prevention strategy in Japan should explore a standard package of programs to guide community suicide-prevention efforts with a sustained workforce among local authorities. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.
Sansone, Randy A; Wiederman, Michael W
The relationships between religiosity/spirituality (RS) and self-harm behavior, including non-suicidal self-harm behavior (NS-SHB) and suicide attempts/completions, remain of keen interest. Whereas the majority of studies strongly suggest that RS protects against suicide attempts/completions, relationships between RS and NS-SHB have been rarely studied. In this study, we examined RS in relationship to both NS-SHB (six explicit behaviors) and past history of suicide attempts. In a cross-sectional sample of 306 consecutive primary care outpatients, we administered four self-report assessments for RS (extent participant considered self a religious person, extent participant considered self a spiritual person, extent religion is involved in understanding/dealing with stressful situations, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp-12)) as well as examined seven items on the Self-Harm Inventory: six items reflecting NS-SHB and one item reflecting a past suicide attempt. While two RS items yielded no significant findings (extent participant considered self a spiritual person, extent religion is involved in understanding/dealing with stressful situations), the remaining two items were associated with a lowered risk of self-harm behavior, particularly the FACIT-Sp-12. Some but not all aspects of RS are associated with lowered risk for self-harm. In this study, considering oneself a religious person and reporting a general sense of RS well-being offered the most protective effect to participants, particularly the latter. © The Author(s) 2015.
The DiaS trial: dialectical behavior therapy versus collaborative assessment and management of suicidality on self-harm in patients with a recent suicide attempt and borderline personality disorder traits - study protocol for a randomized controlled trial.
Andreasson, Kate; Krogh, Jesper; Rosenbaum, Bent; Gluud, Christian; Jobes, David A; Nordentoft, Merete
In Denmark 8,000 to 10,000 people will attempt suicide each year. The Centre of Excellence in Suicide Prevention in the Capital Region of Denmark is treating patients with suicidal behavior, and a recent survey has shown that 30% of the patients are suffering from borderline personality disorder. The majority of patients (70% to 75%) with borderline personality disorder have a history of deliberate self-harm and 10% have a lifetime risk to die by suicide. The DiaS trial is comparing dialectical behavior therapy with collaborative assessment and management of suicidality-informed supportive psychotherapy, for the risk of repetition of deliberate self-harm in patients with a recent suicide attempt and personality traits within the spectrum of borderline personality disorder. Both treatments have previously shown effects in this group of patients on suicide ideation and self-harm compared with treatment as usual. The trial is designed as a single-center, two-armed, parallel-group observer-blinded randomized clinical superiority trial. We will recruit 160 participants with a recent suicide attempt and at least two traits of the borderline personality disorder from the Centre of Excellence in Suicide Prevention, Capital Region of Denmark. Randomization will be performed though a centralized and computer-generated approach that conceals the randomization sequence. The interventions that are offered are a modified version of a dialectical behavior therapy program lasting 16 weeks versus collaborative assessment and management of suicidality-informed supportive psychotherapy, where the duration treatment will vary in accordance with established methods up to 16 weeks. The primary outcome measure is the ratio of deliberate self-harming acts including suicide attempts measured at week 28. Other exploratory outcomes are included such as severity of symptoms, suicide intention and ideation, depression, hopelessness, self-esteem, impulsivity, anger, and duration of respective
Kao, Yu-Chen; Liu, Yia-Ping
The purpose of the present study was to explore the relationship between suicidal behavior and socio-demographic and clinical factors, including insight into illness, in patients with schizophrenia spectrum disorders. We evaluated 104 inpatients using the Self-Appraisal of Illness Questionnaire (SAIQ) for insight assessment, several Beck-related symptoms rating scales, and the Positive and Negative Syndrome Scale (PANSS) for psychopathology. These patients were also evaluated for suicidal behavior and risk using the critical items of the Scale for Suicide Ideation (SSI) and lifetime suicide attempts. Patients with suicidal behavior generally had greater insight into illness than those who were non-suicidal. After controlling for depressive symptoms, the association of insight into illness with current suicidal ideation remained significant, whereas the association between insight and lifetime suicide attempts was no longer significant. As predicted, the regression analyses revealed that those with greater suicide risk had significantly higher levels of depressive symptoms and hopelessness and more lifetime suicide attempts. Moreover, greater insight into illness appeared to have a close, independent connection to suicidal behavior. Our findings suggest that depression, hopelessness, and greater insight into illness are major risk factors for suicide in patients with schizophrenia. It is plausible that depression mediates the relationship between greater insight into illness and suicidal behavior. Aggressive improvement of insight without the risk of deteriorating depressive symptoms may be warranted to reduce the risk of suicide.
Sareen, Jitender; Isaak, Corinne; Katz, Laurence Y; Bolton, James; Enns, Murray W; Stein, Murray B
Suicide is an important public health problem. Although there have been advances in our knowledge of suicide, gaps remain in knowledge about suicide risk factors and prevention. Here, we discuss research pathways that have the potential to rapidly advance knowledge in suicide risk assessment and reduction of suicide deaths over the next decade. We provide a concise overview of the methodologic approaches that have the capacity to rapidly increase knowledge and change practice, which have been successful in past work in psychiatry and other areas of medicine. We suggest three specific pathways to advance knowledge of suicide risk factors and prevention. First, analysis of large-scale epidemiologic surveys and administrative data sets can advance the understanding of suicide. Second, given the low base rate of suicide, there is a need for networks/consortia of investigators in the field of suicide prevention. Such consortia have the capacity to analyze existing epidemiologic data sets, create multi-site cohort studies of high-risk groups to increase knowledge of biological and other risk factors, and create a platform for multi-site clinical trials. Third, partnerships with policymakers and researchers would facilitate careful scientific evaluation of policies and programs aimed at reducing suicide. Suicide intervention policies are often multifaceted, expensive, and rarely evaluated. Using quasi-experimental methods or sophisticated analytic strategies such as propensity score-matching techniques, the impact of large-scale interventions on suicide can be evaluated. Furthermore, such partnerships between policymakers and researchers can lead to the design and support of prospective RCTs (e.g., cluster randomized trials, stepped wedge designs, waiting list designs) in high-risk groups (e.g., people with a history of suicide attempts, multi-axial comorbidity, and offspring of people who have died by suicide). These research pathways could lead to rapid knowledge uptake
Lee, Seulki; Shin, Aesun
Atopic dermatitis (AD) is a chronic skin disease which has been known to negatively influence the mental health of patients. However, only a few studies have explored the prevalence of psychiatric problems among AD patients, particularly among adolescents. In this study, we aimed to assess the association of AD with depressive symptoms and suicidal behaviors among adolescents by analyzing data from the 2013 Korean Youth Risk Behavior Survey, a nationwide web-based survey. Data from 72,435 adolescent middle and high school students in Korea were analyzed. Students self-reported AD diagnosed by a doctor and yes-or-no answers to questions about depressive symptoms and suicide ideation, suicide planning, and suicide attempts were analyzed. Relationships between AD and depressive symptoms or suicidal behaviors were tested by logistic regression models after controlling for potential confounding factors. The proportion of adolescents who had AD was 6.8%. The proportion of adolescents reporting depressive feelings was 31.0%, suicide ideation was 16.3%, suicide planning was 5.8%, and suicide attempts was 4.2%. Compared to adolescents without AD, adolescents with AD were significantly more likely to experience depressive feelings (odds ratio [OR]: 1.27, 95% confidence interval [Cl]: 1.19-1.36), suicide ideation (OR: 1.34, 95% Cl: 1.24-1.45), suicide planning (OR: 1.46, 95% Cl: 1.32-1.65), and suicide attempts (OR: 1.51, 95% Cl: 1.33-1.72). In the multivariate model, the relationships between AD and suicide ideation (OR: 1.26, 95% Cl:1.16-1.36), suicide planning (OR: 1.28, 95% Cl:1.14-1.44), and suicide attempt (OR: 1.29, 95% Cl:1.13-1.49) were statistically significant. Adolescents who have AD are associated with a higher prevalence of depression symptoms and suicidal behaviors. Adolescent AD patients may need interventions from clinicians and caregivers that use a holistic approach to prevent psychological comorbidities, although further research is needed to clarify this
Schneider, Stephen G.; And Others
Explored relationship of homosexuality to suicidal behavior by questionnaire responses from 52 men in gay and lesbian college organizations and 56 men in homosexual rap groups. Family background of alcoholism and physical abuse, social supports perceived as rejecting homosexuality, and no religious affiliation were associated with history of…
Amiri, Leena; Voracek, Martin; Yousef, Said; Galadari, Alaa; Yammahi, Salem; Sadeghi, Mohammad-Reza; Eskin, Mehmet; Dervic, Kanita
Few studies have investigated suicidal behavior and attitudes of medical students. We are not aware of any previous reports emerging from the Arab world. To investigate suicidal behavior and attitudes among medical students in the United Arab Emirates (UAE). The prevalence of suicidal ideation and attempts as well as attitudes toward suicide and reactions to a hypothetical suicidal friend were assessed using a self-report survey. Furthermore, the survey included the self-assessment of the current mood and religiosity, and socio-demographic information. A group of 115 medical students (mean age 20.7 years, 59.1% female) participated in the survey. The prevalence of lifetime suicidal ideation was 17.5% and of suicide attempts 1.8%. In general, students showed very low acceptability of suicide, strong beliefs in the punishment after death, and highly endorsed communicating problems with parents. Moreover, high acceptance of and support for a suicidal friend were found. Sadness was associated with higher acceptability of suicide and fewer beliefs in punishment after death. Religiosity was associated with less acceptability of suicide, seeing suicide in context of mental illness, communicating problems with parents, and greater support for a suicidal friend. The prevalence of suicidal ideation and attempts among medical students in the UAE was in the lower range in international comparison. Negative attitudes toward suicide were accompanied by a strong support for a suicidal friend, and both were related to religiosity.
Daniel T. L. Shek
Full Text Available The present paper examined the prevalence and psychosocial correlates of adolescent deliberate self-harm (DSH and suicidal behavior in a representative sample of 3,328 secondary school students in Hong Kong. With reference to the previous year, 32.7% of the students reported at least one form of DSH, 13.7% of the respondents had suicide thoughts, 4.9% devised specific suicidal plans, and 4.7% had actually attempted suicide. Adolescent girls had significantly higher rates of DSH and suicidal behavior than did adolescent boys. Having remarried parents was related to an increased likelihood of DSH and suicide. While high levels of family functioning, overall positive youth development, and academic and school performance predicted low rates of DSH and suicidal behavior, cognitive and behavioral competencies were unexpectedly found to be positively associated with DSH and suicidal behavior. Theoretical and practical implications of the findings are discussed.
Shek, Daniel T. L.; Yu, Lu
The present paper examined the prevalence and psychosocial correlates of adolescent deliberate self-harm (DSH) and suicidal behavior in a representative sample of 3,328 secondary school students in Hong Kong. With reference to the previous year, 32.7% of the students reported at least one form of DSH, 13.7% of the respondents had suicide thoughts, 4.9% devised specific suicidal plans, and 4.7% had actually attempted suicide. Adolescent girls had significantly higher rates of DSH and suicidal behavior than did adolescent boys. Having remarried parents was related to an increased likelihood of DSH and suicide. While high levels of family functioning, overall positive youth development, and academic and school performance predicted low rates of DSH and suicidal behavior, cognitive and behavioral competencies were unexpectedly found to be positively associated with DSH and suicidal behavior. Theoretical and practical implications of the findings are discussed. PMID:22566783
Shek, Daniel T L; Yu, Lu
The present paper examined the prevalence and psychosocial correlates of adolescent deliberate self-harm (DSH) and suicidal behavior in a representative sample of 3,328 secondary school students in Hong Kong. With reference to the previous year, 32.7% of the students reported at least one form of DSH, 13.7% of the respondents had suicide thoughts, 4.9% devised specific suicidal plans, and 4.7% had actually attempted suicide. Adolescent girls had significantly higher rates of DSH and suicidal behavior than did adolescent boys. Having remarried parents was related to an increased likelihood of DSH and suicide. While high levels of family functioning, overall positive youth development, and academic and school performance predicted low rates of DSH and suicidal behavior, cognitive and behavioral competencies were unexpectedly found to be positively associated with DSH and suicidal behavior. Theoretical and practical implications of the findings are discussed.
Cheng, Qijin; Chen, Feng; Lee, Esther S T; Yip, Paul S F
In view of the surge of student suicides in March 2016, a large-scale media involvement was engaged to minimize copycat effects and to extensively spread more preventive information. Trend differences between student suicides in overall as well as youth suicides between 2003 and 2016 were examined. Impacts of media involvement were examined as to the changes of their intensities in reporting student suicides in different manners. Local polynomial smoothing method was used to estimate the intensities throughout the study period. The intensity of students' suicides has been slowly increasing since 2006, which was in contrast to the decreasing trend of overall suicide intensity. After our engagement with the media, acute descriptive-reporting in student suicide news has sharply dropped and remained low since then, whereas preventive-reporting has increased sharply in March and April 2016, but dropped back to normal afterwards. The higher intensity of preventive-reporting seemed to have a protective effect on student suicide. Data of student suicides in 2016 were substantially extracted from the local news, which may not contain complete information. The analyses suggested, but could not confirm, a causal relationship between the changes of student suicide news-reporting and the incidents of suicides themselves. The recent surge of student suicides in Hong Kong was statistically abnormal. Media engagement has changed local suicide news-reporting to become more preventive, which could have contributed to the drop of student suicides. It is essential to sustain the media's coverage of preventive reporting to maintain its enduring effect. Copyright © 2017 Elsevier B.V. All rights reserved.
Kutcher, Stan; Wei, Yifeng; Behzadi, Pegah
Suicide in young people is a significant health concern, with numerous community- and school-based interventions promising to prevent suicide currently being applied across Canada. Before widespread application of any one of these, it is essential to determine its effectiveness and safety. We systematically reviewed the global literature on one of the most common community suicide prevention interventions in Canada and summarized data on 2 commonly applied school-based suicide prevention programmes. None of these has demonstrated effectiveness in preventing youth suicide or safety in application. Concurrently with their widespread distribution in Canada, the suicide rate in young women has increased-the first time in over 3 decades. Policy and regulatory implications of these findings are discussed.
DeHay, Tamara; Ross, Sarah; McFaul, Mimi
Suicide is a significant issue in the United States and worldwide, and its prevention is a public health imperative. Primary care practices are an important setting for suicide prevention, as primary care providers have more frequent contact with patients at risk for suicide than any other type of health-care provider. The Western Interstate Commission for Higher Education, in partnership with the Suicide Prevention Resource Center, has developed a Suicide Prevention Toolkit and an associated training curriculum. These resources support the education of primary care providers in evidence-based strategies for identifying and treating patients at risk for suicide. The application of this curriculum to post-graduate medical training is presented here. © The Author(s) 2015.
Ross, Victoria; Kõlves, Kairi; De Leo, Diego
Given the important role teachers play as gatekeepers in school suicide prevention, this study explored teachers' perspectives on what should be done to improve current suicide prevention efforts. The study, in Queensland, Australia, was part of a large-scale survey examining teachers' knowledge, attitudes and experience of suicidality. One hundred and fifteen teachers responded to an online survey question regarding their views on the requirements for school suicide prevention. Qualitative analysis identified five themes from teachers' responses: awareness and stigma reduction, support services for students, education and training, bullying and the role of social media. The results of this study provide some profound insights into teachers' perspectives on suicide and highlight the critical need for improved suicide prevention efforts in schools.
Phillips, Katharine A.
Suicidal ideation, suicide attempts, and completed suicide appear common in individuals with body dysmorphic disorder (BDD). Available evidence indicates that approximately 80% of individuals with BDD experience lifetime suicidal ideation and 24% to 28% have attempted suicide. Although data on completed suicide are limited and preliminary, the suicide rate appears markedly high. These findings underscore the importance of recognizing and effectively treating BDD. However, BDD is underrecognized in clinical settings even though it is relatively common and often presents to psychiatrists and other mental health practitioners, dermatologists, surgeons, and other physicians. This article reviews available evidence on suicidality in BDD and discusses how to recognize and diagnose this often secret disorder. Efficacious treatments for BDD, ie, serotonin reuptake inhibitors (SRIs) and cognitive-behavioral therapy, are also discussed. Although data are limited, it appears that SRIs often diminish suicidality in these patients. Additional research is greatly needed on suicidality rates, characteristics, correlates, risk factors, treatment, and prevention of suicidality in BDD. PMID:18449358
Full Text Available Islam prohibits the taking of one's life, because this way you will interfere with the work of G-d (Allah, which is clear from several places in the Quran. Concerning individual suicide or suicide attempts in various Arab countries the literature is sparse and the incidence low. In this paper we present a review of research from Israel showing that suicide epidemiology among the Arab population of children and adolescents display a low incidence, but an increase has been observed over the past decade, but still much lower than the Jewish population. We believe that there is a need for the development of prevention and intervention strategies in order to keep this incidence low.
Czyz, Ewa K; Horwitz, Adam G; King, Cheryl A
This study's purpose was to examine the predictive validity and clinical utility of a brief measure assessing youths' own expectations of their future risk of suicidal behavior, administered in a psychiatric emergency (PE) department; and determine if youths' ratings improve upon a clinician-administered assessment of suicidal ideation severity. The outcome was suicide attempts up to 18 months later. In this medical record review study, 340 consecutively presenting youths (ages 13-24) seeking PE services over a 7-month period were included. Subsequent PE visits and suicide attempts were retrospectively tracked for up to 18 months. The 3-item scale assessing patients' perception of their own suicidal behavior risk and the clinician-administered ideation severity scale were used routinely at the study site. Cox regression results showed that youths' expectations of suicidal behavior were independently associated with increased risk of suicide attempts, even after adjusting for key covariates. Results were not moderated by sex, suicide attempt history, or age. Receiver-operating characteristic (ROC) analyses indicated that self-assessed expectations of risk improved the predictive accuracy of the clinician-administered suicidal ideation measure. Youths' ratings indicative of lower confidence in maintaining safety uniquely predicted follow-up attempts and provided incremental validity over and above the clinician-administered assessment and improved its accuracy, suggesting their potential for augmenting suicide risk formulation. Assessing youths' own perceptions of suicide risk appears to be clinically useful, feasible to implement in PE settings, and, if replicated, promising for improving identification of youth at risk for suicidal behavior. © 2016 Wiley Periodicals, Inc.
Duval, Fabrice; Mokrani, Marie-Claude; Lopera, Felix Gonzalez; Diep, Thanh Son; Rabia, Hassen; Fattah, Saïd
The aim of this study was to investigate the relationship between suicidal behavior and hypothalamic-pituitary thyroid (HPT) axis activity in depressed patients. The serum levels of thyrotropin (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were evaluated before and after 0800 and 2300 h thyrotropin-releasing hormone (TRH) challenges, on the same day, in 95 medication-free DSM-IV euthyroid major depressed inpatients and 44 healthy hospitalized controls. Compared to controls: (1) patients with a positive suicide history (PSH; n=53) showed lower basal FT4 (at 0800 h: p<0.005; at 2300 h: p<0.03), but normal FT3 levels, while patients with a negative suicide history (NSH; n=42) showed normal FT4 and FT3 levels; (2) TSH responses to TRH (DeltaTSH) were blunted in NSHs (at 0800 h: p<0.03; at 2300 h: p<0.00001), but not in PSHs; (3) both NSHs and PSHs showed lower DeltaDeltaTSH values (differences between 2300 h-DeltaTSH and 0800 h-DeltaTSH) (p<0.000001 and p<0.003, respectively). Compared to NSHs, basal FT4 levels were reduced in PSHs (at 0800 h: p<0.002; at 2300h: p<0.006). HPT parameters were not significantly different between recent suicide attempters (n=32) and past suicide attempters (n=21). However, compared to controls, recent suicide attempters showed lower 2300 h-DeltaTSH (p<0.04) and DeltaDeltaTSH (p<0.002) values, and lower basal FT4 values (at 0800 h: p<0.006; at 2300 h: p<0.02). Our results, obtained in a large sample of depressed inpatients, indicate that various degrees of HPT axis dysregulation are associated with the history of suicide. Copyright 2010. Published by Elsevier Ltd.
Stallman, Helen M
Suicide is a leading cause of premature death and, despite significant investment, the prevalence rate has remained relatively stable for more than a decade. Theoretically, the use of 'safety planning' as a response to suicidality likely maintains suicide as a potential solution for vulnerable people. This paper describes a theoretically-supported paradigm shift from safety planning to 'coping planning' to improve patient outcomes and improve the confidence and competence of clinicians working with people with suicidality. Coping planning is a strategy used to support people with acute distress. Its components of 'caring', 'collaborating' and 'connecting' reinforce existing strengths, promote self-efficacy and link people with more intensive supports, as needed. Coping planning overcomes the limitations of existing approaches. It reframes suicide prevention from managing patients disclosing suicidality to ensuring patients have minimally sufficient temporary support to help them cope. This approach has the potential to promote coping self-efficacy and prevent deterioration that leads to suicide.
Romero, Andrea; Bauman, Sheri; Ritter, Marissa; Anand, Payal
Guided by the interpersonal theory of suicide, this study examines the associations between gun carrying, bullying, and suicidal behaviors among high school students. Arizona Youth Risk Behavior Surveys were completed by 2,677 students in 2011; 9.0% reported suicide attempt in the past year, 5.5% carried a gun in the past 30 days, 8.5% were…
Thompson, Martie P.; Kingree, J. B.; Ho, Ching-hua
Suicide was the second leading cause of death for 14-17 years olds in 2002. Prior studies indicate that suicidal behaviors are especially common among juvenile delinquents, yet this association has not been examined in a national sample. The 2003 Youth Risk Behavior Surveillance System was used to examine associations between suicidal behaviors…
Spirito, Anthony; Mehlenbeck, Robyn; Barnett, Nancy; Lewander, William; Voss, Alexis
Substance use is an important risk factor for suicidal behavior in adolescence. In this study, rates of substance use in a sample of adolescents who had attempted suicide were examined as were the relationships of mood state and behavior problems to substance use. Results suggest that alcohol use among suicide attempters is more strongly related…
Bantjes, Jason; Swartz, Leslie; Cembi, Sithembile
Practitioners of traditional African medicine (traditional healers) are an important part of the health care system in South Africa, yet their voices are often absent from discussions about public health. In this context, we set out to investigate how a group of traditional healers in South Africa understand suicide and suicide prevention. In-depth, semistructured interviews were conducted with 6 traditional healers and analysed using thematic content analysis. The traditional healers report they are frequently consulted by suicidal individuals and they are confident about their ability to help people in a suicidal crisis. Findings suggest that traditional healers understand suicidal behaviour as a symptom of social disconnection and cultural discontinuity. Traditional healers report that suicidal individuals can be helped by reestablishing interpersonal connections, reconnecting to family and ancestors, and renewing their cultural identities through rituals. These findings suggest that there is some congruence between the way traditional healers understand suicide and the Western scientific and biomedical literature. Our findings raise important questions about cultural approaches to suicide research which are commonly premised on dualistic thinking that constructs culture as something distinct from Western biomedicine.
among exposed teens . Of the exposed group, 2.5 percent reported having made a (first) suicide attempt during the 18 months of follow-up compared...Gatekeeper Training for Suicide Prevention A Theoretical Model and Review of the Empirical Literature Crystal Burnette, Rajeev Ramchand, Lynsay...REPORT TYPE 3. DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE Gatekeeper Training for Suicide Prevention: A Theoretical Model and
Suicide is the second leading cause of death for college students; annually approximately 1,100 students in institutions of higher education die by suicide. However, most research related to college student suicide was conducted using the sample of 4-year institutions. Community colleges have seldom been included in the sample of suicide research…
Juan Luis Muñoz
Full Text Available According to the WHO (World Health Organization and the European Union, suicide is considered to be a health problem of prime importance and to be one of the principal causes of unnatural death. In Spain, the number of suicides has increased 12% since 2005 . The Research Project “European Regions Enforcing Actions against Suicide (EUREGENAS, funded by the Health Program 2008-2013, has as main objective the description of an integrated model of Mental Health orientated to the prevention of suicide. The differences that allow distinguishing the meaning of prevention in suicide behavior are described and explained through a qualitative methodological strategy and through the creation of discussion groups formed by different groups of health professionals. The results highlight the existing differences between the diverse health professionals who come more in contact with this problem and it shows as well the coincidence of meaning that suicide has to be considered as a priority in the field of health.
Rihmer, Zoltán; Döme, Péter; Gonda, Xénia
In this paper we gather and discuss the results of our workgroup on depression and suicide prevention published between 1985 and 2015. We hope that this summary will focus the interest of the scientific community on suicidology and turn the attention of decision-makers on the fact that despite of its marked decrease in the past three decades, the suicide rate in Hungary is still the second highest in the EU. So, based on expert opinion, joint action is needed in order to achieve a further decrease of suicide rate in Hungary.
Crepeau-Hobson, M Franci; Leech, Nancy L
There is considerable evidence that being exposed to the suicide or suicidal behavior of another can increase the risk for suicide. Significant relationships between media coverage and youth suicide have been documented in the professional literature. Exposure to familial suicidal behavior has also been established as a risk factor for youth suicidal behavior; However, peer suicide exposure is not as clear cut as research results in this area have been mixed. In the current paper the empirical literature focused on the associations between exposure to peer suicides and suicide attempts and youth suicidal behavior is critically reviewed. Effect sizes were computed for each of the 23 studies included in the review to allow for cross-study comparisons. The results demonstrate that having a friend or acquaintance attempt suicide is significantly related to risk for suicidal thoughts and behavior. However, the support for the relationship between the suicide of a peer and youth suicidal behavior was less consistent. Implications for clinical practice and suicide postvention as well as areas of future research are discussed. © 2013 The American Association of Suicidology.
West, Bethany A
Full Text Available Purpose: The current study examines the associations between a range of risk factors and reports of suicide attempts, and attempts requiring medical care in a nationally representative study of high school students. The goal is to examine sex differences in the risk factors that are associated with suicide attempts and attempt-related injuries requiring treatment by a health-care provider. Methods: Data from the 2007 Youth Risk Behavior Survey for students in grades 9-12 were used to assess the prevalence and risk factors for suicidal behavior as well as differences in these for boys and girls. Cross-sectional multivariate logistic regression analyses were computed to determine the most important risk factors for suicide attempts and for suicide attempts requiring medical care for the sample overall and also stratified for boys and for girls. Results: Overall, 6.9% of adolescents attempted suicide (9.3% of girls versus 4.6% of boys. Girls were more likely than boys to report a suicide attempt in the past year (Adj.OR=2.89. Among girls, sadness (Adj.OR=5.74, weapon carrying (Adj.OR=1.48, dating violence (Adj.OR=1.60, forced sex (Adj.OR=1.72, and huffing glue (Adj.OR=2.04 were significantly associated with suicide attempts. Among boys, sadness (Adj.OR=10.96, weapon carrying (Adj.OR=1.66, forced sex (Adj.OR=2.60, huffing glue (OR=1.63, hard drug use (Adj.OR=2.18, and sports involvement (Adj.OR=1.52 were significantly associated with suicide attempts. Conclusions: These findings demonstrate similarities and differences in terms of the modifiable risk factors that increase risk for suicide attempts among boys and girls. In terms of the differences between boys and girls, hard drug use and sports involvement may be important factors for suicide prevention strategies that are directed specifically towards boys, while dating violence victimization may be an important risk factor to address for girls. Overall, these findings can help guide prevention
Yin, Honglei; Pantazatos, Spiro P; Galfalvy, Hanga; Huang, Yung-Yu; Rosoklija, Gorazd B; Dwork, Andrew J; Burke, Ainsley; Arango, Victoria; Oquendo, Maria A; Mann, John J
Gamma-amino butyric acid (GABA) and glutamate are the major inhibitory and excitatory neurotransmitters in the mammalian central nervous system, respectively, and have been associated with suicidal behavior and major depressive disorder (MDD). We examined the relationship between genotype, brain transcriptome, and MDD/suicide for 24 genes involved in GABAergic and glutamatergic signaling. In part 1 of the study, 119 candidate SNPs in 24 genes (4 transporters, 4 enzymes, and 16 receptors) were tested for associations with MDD and suicidal behavior in 276 live participants (86 nonfatal suicide attempters with MDD and 190 non-attempters of whom 70% had MDD) and 209 postmortem cases (121 suicide deaths of whom 62% had MDD and 88 sudden death from other causes of whom 11% had MDD) using logistic regression adjusting for sex and age. In part 2, RNA-seq was used to assay isoform-level expression in dorsolateral prefrontal cortex of 59 postmortem samples (21 with MDD and suicide, 9 MDD without suicide, and 29 sudden death non-suicides and no psychiatric illness) using robust regression adjusting for sex, age, and RIN score. In part 3, SNPs with subthreshold (uncorrected) significance levels below 0.05 for an association with suicidal behavior and/or MDD in part 1 were tested for eQTL effects in prefrontal cortex using the Brain eQTL Almanac (www.braineac.org). No SNPs or transcripts were significant after adjustment for multiple comparisons. However, a protein coding transcript (ENST00000414552) of the GABA A receptor, gamma 2 (GABRG2) had lower brain expression postmortem in suicide (P = 0.01) and evidence for association with suicide death (P = 0.03) in a SNP that may be an eQTL in prefrontal cortex (rs424740, P = 0.02). These preliminary results implicate GABRG2 in suicide and warrant further investigation and replication in larger samples. © 2016 Wiley Periodicals, Inc.
Peltzer, Karl; Yi, Siyan; Pengpid, Supa
A large data gap remains on suicidal behaviors among youth in the Association of Southeast Asian Nations (ASEAN) countries, despite the increasing rates of suicide in Asian cultures that may be related to rapid economic changes and the loss of social stability. This study was therefore conducted to explore the prevalence of and factors associated with suicidal ideation and suicide attempts among university students in six ASEAN member states. Data were collected in a cross-sectional survey of 4675 undergraduate university students, mean age 20.6 years (SD=2.7), range of 18-30 years, from Cambodia, Indonesia, Malaysia, Myanmar, Thailand and Vietnam. The overall prevalence of ever suicidal ideation and ever suicide attempt among students in this study was 11.7% and 2.4%, respectively. Different rates of these suicidal behaviors were observed across the countries. In multivariable logistic regression models, suicidal ideation was significantly associated with psychosocial factors including childhood sexual abuse, depressive symptoms, involvement in physical fights, and poor academic performance as well as socio-environmental factors including living with parents or guardians and low involvement in organized religious activity. Suicide attempt was significantly associated with childhood sexual abuse, depressive symptoms, low involvement in organized religious activity and being underweight or overweight. Our findings suggest that individual-level strategies for suicide prevention should be targeted toward students with poor academic performance, mental health problems and a history of adverse childhood experiences. Particular attention should be paid to the role of families that could be a potential stressor in the lives of university students. Copyright © 2017 Elsevier B.V. All rights reserved.
Staehr, Mia Antoni; Munk-Andersen, Ebbe
Our aim was to examine suicidal behaviours among asylum seekers in Denmark. A retrospective quantitative analysis of data from reports to the Danish Red Cross Asylum Department on suicidal behaviours among persons over 15 years of age in the period 2001-2003 and from 54 medical records of suicidal asylum seekers in Denmark in 2001 was carried out. The number of suicide attempts by asylum seekers in 2001 was 3.4 times higher than by Danish residents. Furthermore, the rate of suicide attempts by asylum seekers grew in the following two years. Suicidal behaviours are most frequent among asylum seekers between 30 and 39 years of age. There are national differences. The preferred method of suicide attempt is intake of medicine. Stress-related diagnoses constitute three fourths of all diagnoses. One analysis suggests that the long waiting time (average 20.8 months) faced by asylum seekers combined with rejection of asylum cases may trigger a rapid suicidal reaction. Other factors may also be active, as 44% of suicide attempts occur within six months after arrival in the country. The results are discussed in relation to other research on the vulnerability of refugees, immigrants and asylum seekers and also in relation to length of waiting time, growing mental morbidity and the increasing number of rejections of asylum applications during recent years, a period characterized by a reduction of staff at the asylum centers. It is recommended that prevention of suicidal behaviour shall be given higher legal and administrative priority.
Depp, Colin A.; Moore, Raeanne C.; Perivoliotis, Dimitri; Holden, Jason L.; Swendsen, Joel; Granholm, Eric L.
Despite the increasing attention to social appraisals in suicide risk, the interpersonal correlates of suicidal thoughts and behavior in schizophrenia are not well understood. Ecological momentary assessment could reveal whether dysfunctional social appraisals and behavior are evident in people with schizophrenia with suicidal ideation. A total of 93 outpatients with diagnoses of schizophrenia with (n = 18, 19%) and without (N = 75; 81%) suicidal ideation participated in one week of intensive...
Mitchell, Sharon L.; Kader, Mahrin; Darrow, Sherri A.; Haggerty, Melinda Z.; Keating, Niki L.
This study assesses short-term and long-term learning outcomes of Question, Persuade, Refer (QPR) suicide prevention training in a college setting. Two hundred seventy-three participants completed pretest, posttest, and follow-up surveys regarding suicide prevention knowledge, attitudes, and skills. Results indicated: (a) increases in suicide…
Miller, David N.; Eckert, Tanya L.; Mazza, James J.
The purpose of this article is to provide a comprehensive review of school-based suicide prevention programs from a public health perspective. A literature review of empirical studies examining school-based suicide prevention programs was conducted. Studies were required to contain information pertaining to the implementation and outcomes of a…
Wachter Morris, Carrie A.; Taub, Deborah J.; Servaty-Seib, Heather L.; Lee, Ji-Yeon; Miles, Nathan; Werden, Donald; Prieto-Welch, Susan L.
Suicide is the second leading cause of death among college students. One effective strategy for suicide prevention is gatekeeper training. Gatekeeper training has been described as a prevention strategy that improves detection and referral of at-risk individuals. Purdue recognized that only some of the resident assistants (RAs) were receiving this…
White, Jennifer; Morris, Jonathan; Hinbest, Jerry
The development and implementation of a new school-based suicide prevention education programme in one secondary school in Vancouver, British Columbia, recently provided us with an opportunity to conduct an in-depth, qualitative case study. The purpose of our study was to deepen our understanding of how school-based suicide prevention education…
Ghoncheh, R.; Kerkhof, A.; Koot, H.M.
Background: E-learning modules can be a useful method for educating gatekeepers in suicide prevention and awareness. Aims: To review and provide an overview of e-learning modules on suicide prevention designed for gatekeepers and assess their effectiveness. Method: Two strategies were used. First,
risk factors across individual, family, workplace , and community were significantly related to men’s perpetration of physical abuse against their...Family Maltreatment, Substance Problems, and Suicidality: Prevention Surveillance and Ecological Risk/ Protective Factors Models PRINCIPAL...CONTRACT NUMBER Family Maltreatment, Substance Problems, and Suicidality: Prevention Surveillance and Ecological Risk/ Protective Factors Models 5b
Japan's national suicide prevention efforts following the 1998 surge in the number of suicide deaths can be divided into three stages: the first stage administrated mainly by the health ministry (1998-2005), the second and transitional stage when it was upgraded to a full governmental issue (2005-2006), and the third and present stage following the promulgation of the Basic Act for Suicide Prevention in 2006. In June 2007, the General Principles for Suicide Prevention Policy (GPSP), a guideline on how the national government should act to promote suicide prevention, was announced, urging local governments to tackle the problem of suicide. The GPSP was set to be revised after around five years from its publication, and, thus, a revised GPSP was published in August of 2012. Based on the five years of challenges, the revised GPSP states that suicide prevention strategies should move on to more practical and community-oriented ones. The National Center of Neurology and Psychiatry (NCNP), through its Center for Suicide Prevention, played a coordinating role in putting forward a proposal for the revision, working with 29 academic societies including the Japanese Society of Psychiatry and Neurology (JSPN). In February 2013, by further developing the relationships with academic societies, etc., which were forged in the above-mentioned process, NCNP set up the Preparatory Committee for the Evidence-based Suicide Prevention Consortium in order to contribute to suicide prevention strategies from an academic perspective. Meanwhile, in the World Health Organization's 66th World Health Assembly held in May 2013, the Comprehensive Mental Health Action Plan 2013-2020 was approved. Its core principle is "no health without mental health", and it has the following four objectives: (1) to strengthen effective leadership and governance for mental health; (2) to provide comprehensive, integrated, and responsive mental health and social care services in community-based settings; (3) to
Rajalin, Mia; Hirvikoski, Tatja; Jokinen, Jussi
Family studies, including twin and adoption designs, have shown familial transmission of suicidal behaviors. Early environmental risk factors have an important role in the etiology of suicidal behavior. The aim of the present study was to assess the impact of family history of suicide and childhood trauma on suicide risk and on severity of suicide attempt in suicide attempters. A total of 181 suicide attempters were included. Family history of suicide was assessed with the Karolinska Suicide History Interview or through patient records. Childhood trauma was assessed with the Karolinska Interpersonal Violence Scale (KIVS) measuring exposure to violence and expressed violent behavior in childhood (between 6 and 14 years of age) and during adult life (15 years or older). Suicide intent was measured with the Freeman scale. Male suicide attempters with a positive family history of suicide made more serious and well planned suicide attempts and had a significantly higher suicide risk. In logistic regression, family history of suicide and exposure to interpersonal violence as a child were independent predictors of suicide in male suicide attempters. The information about family history of suicide and exposure to interpersonal violence as a child derives from the patients only. In the first part of the inclusion period the information was collected from patient records. The results of this study imply that suicides among those at biological risk might be prevented with the early recognition of environmental risks. Copyright © 2012 Elsevier B.V. All rights reserved.
Robert J. Cramer
Full Text Available The juxtaposition of increasing suicide rates with continued calls for suicide prevention efforts begs for new approaches. Grounded in the Centers for Disease Control and Prevention (CDC framework for tackling health issues, this personal views work integrates relevant suicide risk/protective factor, assessment, and intervention/prevention literatures. Based on these components of suicide risk, we articulate a Social-Ecological Suicide Prevention Model (SESPM which provides an integration of general and population-specific risk and protective factors. We also use this multi-level perspective to provide a structured approach to understanding current theories and intervention/prevention efforts concerning suicide. Following similar multi-level prevention efforts in interpersonal violence and Human Immunodeficiency Virus (HIV domains, we offer recommendations for social-ecologically informed suicide prevention theory, training, research, assessment, and intervention programming. Although the SESPM calls for further empirical testing, it provides a suitable backdrop for tailoring of current prevention and intervention programs to population-specific needs. Moreover, the multi-level model shows promise to move suicide risk assessment forward (e.g., development of multi-level suicide risk algorithms or structured professional judgments instruments to overcome current limitations in the field. Finally, we articulate a set of characteristics of social-ecologically based suicide prevention programs. These include the need to address risk and protective factors with the strongest degree of empirical support at each multi-level layer, incorporate a comprehensive program evaluation strategy, and use a variety of prevention techniques across levels of prevention.
Lee, Jeane B.; Bartlett, Mary L.
Despite its entrenchment as a standard of practice, no-suicide contracts fail to achieve their purpose as an effective part of treatment or as an effective method of inoculating counselors against potential lawsuits should a client commit suicide. Critical elements for managing suicidal clients and counselor liability without reliance on the…
Milner, Allison; Page, Kathryn; Spencer-Thomas, Sally; Lamotagne, Anthony D
There are a number of published studies on workplace suicide prevention activities, and an even larger number of activities that are not reported on in academic literature. The aim of this review was to provide a systematic assessment of workplace suicide prevention activities, including short-term training activities, as well as suicide prevention strategies designed for occupational groups at risk of suicide. The search was based on Meta-analysis of Observational Studies in Epidemiology (MOOSE) Guidelines. The databases used for the searches were the Cochrane Trials Library and PubMed. A range of suicide prevention websites were also searched to ascertain the information on unpublished workplace suicide prevention activities. Key characteristics of retrieved studies were extracted and explained, including whether activities were short-term training programmes or developed specifically for occupations at risk of suicide. There were 13 interventions relevant for the review after exclusions. There were a few examples of prevention activities developed for at-risk occupations (e.g. police, army, air force and the construction industry) as well as a number of general awareness programmes that could be applied across different settings. Very few workplace suicide prevention initiatives had been evaluated. Results from those that had been evaluated suggest that prevention initiatives had beneficial effects. Suicide prevention has the potential to be integrated into existing workplace mental health activities. There is a need for further studies to develop, implement and evaluate workplace suicide prevention programmes. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Sinyor, Mark; Pirkis, Jane; Picard, André; McKeown, David; Vincent, Margaret; Cheung, Christian; Schaffer, Ayal; Fordham, Jan; Mishaiel, Rosie; Heisel, Marnin
Media reporting on suicide may have harmful and/or protective effects on deaths by suicide, depending on the nature of the coverage. Canada's first forum on this important issue was held in Toronto on November 6, 2015. Participating in the forum were public health policy-makers, mental health and suicide prevention experts and senior media representatives. This commentary summarizes the content of the forum and highlights the need for ongoing collaboration between suicide prevention experts and media professionals aimed at safe and respectful reporting that maintains the public's need to be informed.
De Luca, Susan M; Franklin, Cynthia; Yueqi, Yan; Johnson, Shannon; Brownson, Chris
The impact of suicidal ideation on college students' academic performance has yet to be examined, yet mental health is often linked with academic performance. Underclassmen and upperclassmen were compared on behavioral health outcomes related to academic success (N = 26,457). Ideation (b = -0.05, p extracurricular activities during the past year. Ideation, beyond mental health, is an important when assessing academic performance. Increasing students' connections benefits students experiencing behavioral concerns but also aids in suicide prevention initiatives and improves academic outcomes. Creating integrated health care systems on campus where physical, mental health and academic support services is crucial to offer solutions for students with severe or co-morbid mental health histories.
Gassman-Pines, Anna; Ananat, Elizabeth Oltmans; Gibson-Davis, Christina M
We investigated the impact of statewide job loss on adolescent suicide-related behaviors. We used 1997 to 2009 data from the Youth Risk Behavior Survey and the Bureau of Labor Statistics to estimate the effects of statewide job loss on adolescents' suicidal ideation, suicide attempts, and suicide plans. Probit regression models controlled for demographic characteristics, state of residence, and year; samples were divided according to gender and race/ethnicity. Statewide job losses during the year preceding the survey increased girls' probability of suicidal ideation and suicide plans and non-Hispanic Black adolescents' probability of suicidal ideation, suicide plans, and suicide attempts. Job losses among 1% of a state's working-age population increased the probability of girls and Blacks reporting suicide-related behaviors by 2 to 3 percentage points. Job losses did not affect the suicide-related behaviors of boys, non-Hispanic Whites, or Hispanics. The results were robust to the inclusion of other state economic characteristics. As are adults, adolescents are affected by economic downturns. Our findings show that statewide job loss increases adolescent girls' and non-Hispanic Blacks' suicide-related behaviors.
Liu, Wan-ting; Kuang, Li; Ai, Ming; Li, Xue-mei; Chen, Jian-mei; Lou, Dan-dan; Niu, Ya-juan; Phillips, Michael R
To investigate the prevalence of self-reported suicidal behavior in university students and to compare the related risk factors between two selected groups. A questionnaire survey on situation of suicidal behavior and risk factors was conducted among 9808 university students. The overall rate of suicide attempts among university students was 1.7%. Factors as suicidal attitude, having associates who had suicidal experience and negative life events, were significantly different between groups with or without suicide attempts. Risk factors on suicidal behavior were as follows: high frequency of feeling hopeless in the last year (OR = 4.23, 95%CI: 3.05 - 5.85), first degree relatives with suicide behavior (OR = 2.85, 95%CI: 1.72 - 4.73), having associates with suicide behavior (OR = 2.82, 95%CI: 2.05 - 3.88), having had sexual experience (OR = 2.73, 95%CI: 1.88 - 3.96), daily live being influenced by the existing psychological problems in the last month (OR = 2.53, 95%CI: 1.80 - 3.56), being female (OR = 2.47, 95%CI: 1.77 - 3.45) and having other relatives with suicide behaviors (OR = 2.36, 95%CI:1.63 - 3.41). Psychological, biological and social factors had influenced on suicidal behaviors among university students which all called for effective intervention to be implemented.
Berrouiguet, Sofian; Alavi, Zarrin; Vaiva, Guillaume; Courtet, Philippe; Baca-García, Enrique; Vidailhet, Pierre; Gravey, Michel; Guillodo, Elise; Brandt, Sara; Walter, Michel
Suicidal behaviour and deliberate self-harm are common among adults. Research indicates that maintaining contact either via letter or postcard with at-risk adults following discharge from care services can reduce reattempt risk. Feasibility trials demonstrated that intervention through text message was also effective in preventing suicide repetition amongst suicide attempters. The aim of the current study is to investigate the effect of text message intervention versus traditional treatment on reducing the risk of suicide attempt repetition among adults after self-harm. The study will be a 2-year multicentric randomized controlled trial conducted by the Brest University Hospital, France. Participants will be adults discharged after self-harm, from emergency services or after a short hospitalization. Participants will be recruited over a 12-month period. The intervention is comprised of an SMS that will be sent at h48, D7, D15 and monthly. The text message enquires about the patients' well-being and includes information regarding individual sources of help and evidence-based self help strategies. Participants will be assessed at the baseline, month 6 and 13. As primary endpoint, we will assess the number of patients who reattempt suicide in each group at 6 months. As secondary endpoints, we will assess the number of patients who reattempt suicide at 13 month, the number of suicide attempts in the intervention and control groups at 6 and 13 month, the number of death by suicide in the intervention and control groups at month 6 and 13. In both groups, suicidal ideations, will be assessed at the baseline, month 6 and 13. Medical costs and satisfaction will be assessed at month 13. This paper describes the design and deployment of a trial SIAM; an easily reproducible intervention that aims to reduce suicide risk in adults after self-harm. It utilizes several characteristics of interventions that have shown a significant reduction in the number of suicide reattempts. We
Sheehan, Johann; Griffiths, Kathleen; Rickwood, Debra; Carron-Arthur, Bradley
Over the past two decades, governments have invested significantly in policies and strategies to prevent the tragic loss of life to suicide. However, there has been little focus on evaluating the implementation of such policies. This paper reports on the evaluation of the implementation of "Managing the Risk of Suicide: A Suicide Prevention Strategy for the ACT 2009-2014," the Australian Capital Territory's (ACT) suicide prevention strategy. We sought to answer two questions: (1) Could agencies provide data reporting on their progress in implementing the activities for which they were responsible?; and (2) Could a judgment about implementation progress be made and, if so, to what extent was the activity implemented? Individually tailored electronic surveys were sent to 18 ACT agencies annually over 4 years to measure their progress in implementing activities for which they had responsibility. By year four, full data were provided for 64% of activities, maximal partial data for 9%, and minimal partial data for 27%. Forty-two per cent of activities were fully implemented, 20% were partially implemented, and 38% were not implemented or could not be measured. It is possible to measure implementation of suicide prevention strategies, but appropriate processes and dedicated resources must be in place at the outset.
Cheng, Qijin; Fu, King-wa; Caine, Eric; Yip, Paul S F
The Hong Kong news media report suicide-related events more frequently and sensationally than Western countries. Little is known about Hong Kong media professionals' experiences and thoughts about such reporting. To understand Hong Kong media professionals' experiences and perceptions of suicide reporting and whether the news media can be better engaged into suicide prevention. We conducted three focus groups of journalists from both the Cantonese and English language news media. Data were analyzed using grounded theory methods. We discerned three rationales from participants regarding their intense coverage of suicide-related events: (1) satisfying commercial competitiveness, (2) addressing social problems, and (3) responding to readers' interests. The first rationale was a dominant and vigorous motivating factor, and often influenced suicide reporting among local Cantonese media. Media professionals recommended engagement strategies targeted at frontline journalists, media managers, and general media consumers. We see potential to involve news media professionals in Hong Kong as working partners in suicide prevention. To succeed, this effort requires engagement in a proactive, consistent, and sustained fashion.
Full Text Available We analyze various preventive and proactive suicide programs, which operate in a number of Western countries. We consider various measures implemented under the auspices of the WHO, as well as in the framework of the European Alliance Against Depression. Following J. Henden, wediscuss three types of suicide prevention: primary, secondary and tertiary. Primary prevention covers the population as a whole – suicide prevention is to promote the value of health and life. This type of prevention is addressed to a wide audience, including teenagers and young adults groups. Secondary prevention is aimed at those who have attempted to commit suicide, because the presence of attempts is a significant feature that allows to predict next attempts. Tertiary prevention is addressed to suicider’s close circle, it aims at help the suicider’s relatives to survive this event, use the appropriate ways of coping with the tragic situation.
Voracek, Martin; Formann, Anton K; Fülöp, Gerhard; Sonneck, Gernot
Suicide-epidemiological research on short-term effects of elections on national/regional suicide and parasuicide incidence has yielded contradictory evidence. Reversing the cause-effect relationship of this line of research we investigated whether preceding regional suicide rates are related to subsequent election results. For Austria's 121 districts, we regressed averaged standardized suicide rates for the preceding period (1988-1994) on political parties' subsequent electoral gains/losses (1999-to-1995) while controlling for a set of 12 domain-relevant psychosocial/economic indices. Stepwise weighted multiple regression led to a significant model. The 1999-to-1995 electoral gains/losses of two opposition parties, together with the population variation caused by migration balance and by births/deaths balance, accounted for a substantial part (30%) of the variability in preceding district-level suicide rates. Various other social indices failed to contribute further substantial increments to this model. This finding suggests that variations in preceding regional suicide incidence might be mirrored in subsequent changes in voting behavior. A speculative post hoc explanation for the finding is offered: on a community level, suicide's aftermath might produce socially and politically alienated survivors of suicide who co-shape swings towards opposition parties in subsequent general elections. The finding calls for more research on suicide's long-term aftermath. Within-country replicability and cross-national generalizability await further investigation. At present, the factor/mechanism accounting for this finding is neither well-established nor has been directly tested.
Nakanishi, Miharu; Endo, Kaori; Ando, Shuntaro
A suicide prevention strategy was launched in Japan in 2006 to address the high suicide rate, which had increased considerably since 1998. The national strategy from 2007 involved the enhancement of psychiatric treatment services at emergency medical facilities and supportive observation by individuals close to patients. The national suicide rate has decreased gradually since 2008; however, national information regarding the number of patients who had engaged in deliberate self-harm was absent. Therefore, the present study examined the longitudinal trend in hospital admissions due to deliberate self-harm in Japan. Data from the National Patient Survey between 1996 and 2014-a nationally representative cross-sectional survey of inpatient care every 3 years-were used. Data for 13,014 patients were included in the estimation of the number of hospital admissions due to deliberate self-harm. The results show that the estimated number of admissions due to deliberate self-harm increased from 2078 in September 1996 to 3189 in September 2008, when the national number of suicide cases peaked, and decreased to 1783 in 2014. Approximately half of the patients were admitted to hospital because of self-harm via means other than drug poisoning, which had a high mortality rate (5.6%). The proportion of patients receiving public assistance was higher in those who had engaged in deliberate self-harm (8.5%) relative to that observed in the general population. Overall, the trend in deliberate self-harm was synchronous with the number of suicide cases over time. As economic poverty has been associated with suicidal ideation and behavior and some recipients of public assistance tend to abuse psychotropic medication, the public assistance program should provide mental health support for recipients of social benefit schemes.
Jacobson, Colleen M.; Marrocco, Frank; Kleinman, Marjorie; Gould, Madelyn S.
Depression and suicidal thoughts and behaviors are prevalent among youth today. The current study sought to further our understanding of the correlates of depression and suicidality by assessing the relationship between restrictive emotionality (difficulty understanding and expressing emotions) and depressive symptoms and suicidal ideation and…
Witte, Tracy K.; Didie, Elizabeth R.; Menard, William; Phillips, Katharine A.
In a sample of 200 individuals diagnosed with body dysmorphic disorder (BDD), we utilized the interpersonal-psychological theory for suicide as a framework to examine BDD behaviors that might be associated with suicide risk, insofar as they might increase the acquired capability for suicide. We predicted that physically painful BDD behaviors…
... with an unsupportive family or in a hostile environment Attempted suicide before Children and teenagers Suicide in children and teenagers often ... 10, 2015. Kennebeck S, et al. Suicidal behavior in children and ... murder-suicide. American Journal of Men's Health. In press. Accessed April 10, ...
Krysinska, Karolina; Martin, Graham
Population attributable risk (PAR) estimates have been used in suicide research to evaluate the impact of psychosocial and socioeconomic risk factors, including affective disorders, traumatic life events, and unemployment. A parallel concept of preventive fraction (PF), allowing for estimation of the impact of protective factors and effectiveness…
Anderson, Mary Jane
The problem of adolescent suicide worldwide is discussed. Teen suicide is the second leading cause of death among 15-19 year olds in the United States, and has become an increasing concern for counselors employed in schools. Contributing factors to suicide, such as cultural and socio-demographic factors, dysfunctional family patterns, cognitive…
Maris, Ronald W.
Explores some of the possible distinctive traits of midlife suicides, which include: loss of spouse, years of heavy drinking, reaching the age of high depression risk, and occupational problems. Midlife suicides tend to be highest among white males, although female suicide rates peak in midlife. The paper concludes with a review of assessment and…
K. Nahit Ozmenler
Full Text Available Many factors may play role in the emergence of suicidal behavior. Familial tendency including some features of personality structure, hopelessness, affective disorder, and suicide behavior have attracted close attention recently. Personality disorders seem to be prevalent in individuals who attempt suicide. Beside it has been reported that personality disorders and other psychiatric disorder comorbidity increase the risk of suicide. To present the relationship between suicide and personality is quite important for developing strategies in order to prevent suicide attempt. In this field, the data show variability based on scales used for the evaluation of personality, its definition and classification in the research. For example, while some authors used DSM criteria or ICD criteria, others preferred to focus on the temperament and character dimensions of personality. In studies based on diagnostic criteria; B group personality disorders, such as antisocial and borderline personality disorders were found to be most common comorbid personality disorder diagnosis. In studies aiming to investigate the relationship among suicide attempt, temperament and character features, the suicide attempters were found to have lower levels of self directedness, cooperativeness, and higher scores for self transcendence. Suicidal patients were inclined to have higher scores in several temperament groups like harm avoidance, novelty seeking, and reward dependence. Tendency to impulsive behavior is reported as a common denominator for suicidal patients. Individuals, who have familial or acquired tendency of impulsivity, could react more dramatically and present with depressive and pessimistic mood when they have difficulties and encounter stress factors in their daily routine and could easily develop depressive disorders. These factors as a whole could lead to self destructive actions like suicide. Individual or familial history of suicide attempts or completed
van Duijn, Erik; Vrijmoeth, Eslie M; Giltay, Erik J; Bernhard Landwehrmeyer, G
Huntington's disease (HD) gene expansion carriers are at an increased risk of suicide, but so far, no studies have investigated the full spectrum of suicidality, including suicidal ideation, suicidal behavior and self-injurious behavior. We included 1451 HD gene expansion carriers (age 48.4 years (SD 14.0), 54.8% female) of the REGISTRY study of the European Huntington's Disease Network. Lifetime suicidal ideation and suicidal behavior were assessed with the Columbia-Suicidal Severity Rating Scale. Motor symptoms and disease stage were assessed using subscales of the Unified Huntington's Disease Rating Scale, and depressed mood and irritability were assessed by the Problem Behaviors Assessment. Lifetime passive suicidal ideation was reported by 21.2%. Participants in stage II showed the highest prevalence rate of suicidal ideation, while participants in stage IV/V showed the highest prevalence of suicidal behavior. A lifetime suicide attempt was reported by 6.5% of the HD gene expansion carriers. In multivariate regression analyses, both suicidal ideation and suicidal behavior were associated with a depressed mood, and to a lesser extend to irritability. Results may have been affected by denial or recall bias and no conclusions can be made about the temporal and causal relationships with depressed mood and irritability because of the cross-sectional analyses. Given the high prevalence of suicidal ideation and suicidal behavior in all stages of HD, it is important to screen HD gene expansion carriers for suicidal ideation and suicidal behavior on a regular basis in clinical practice. Copyright © 2017 Elsevier B.V. All rights reserved.
Vasiliadis, Helen-Maria; Lesage, Alain; Latimer, Eric; Seguin, Monique
Little is known about the costs and effects of suicide prevention programs at the population level. We aimed to determine (i) the costs associated with a suicide death and using prospective values (ii) the costs and effects of transferring, into a Canadian context, the results of the European Nuremberg Alliance against Depression (NAD) trial with the addition of 4 community-based suicide prevention strategies. These included the training of family physicians in the detection and treatment of depression, population campaigns aimed at increasing awareness about depression, the training of community leaders among first responders and follow-up of individuals who attempted suicide. This study includes a prospective value implementation study design. Using published data and information from interviews with Canadian decision makers, we assessed the costs of a suicide death in the province of Quebec and the costs of potentially implementing the NAD multi-modal suicide prevention programs, and the incremental cost-effectiveness ratio (ICER), from a health care system and societal perspective, associated with the NAD program while considering the friction cost method (FCM) and human capital approach (HCA) (discounted at 3%.) The costs considered included those incurred for the suicide prevention program and direct medical and non-medical costs as well as those related to a police investigation and funeral costs. Indirect costs associated with loss of productivity and short term disability were also considered. Sensitivity analyses were also carried out. Costs presented were in 2010 dollars. The annual total cost of implementing the suicide prevention programs in Quebec reached CAD23,982,293. The most expensive components of the program included the follow-up of individuals who had attempted suicide and psychotherapy for bereaved individuals. These accounted for 39% and 34% of total costs. The ICER associated with the implementation of the programs reached on average CAD3
Panagioti, Maria; Gooding, Patricia A; Tarrier, Nicholas
Research has shown an increased frequency of suicidal behaviors in those with PTSD, but few studies have investigated the factors that underlie the emergence of suicidal behavior in PTSD. Two theories of suicide, the Cry of Pain and the Schematic Appraisal Model of Suicide, propose that feelings of hopelessness, defeat, and entrapment are core components of suicidality. This study aimed to examine the association between suicidal behavior and hopelessness, defeat, and entrapment in trauma victims with and without a PTSD diagnosis. The results demonstrated that hopelessness, defeat, and entrapment were significantly positively associated with suicidal behavior in those with PTSD. Hopelessness and defeat were also significantly positively associated with suicidal behavior in trauma victims without PTSD. In those with PTSD, the relationship between suicidal behavior and hopelessness and entrapment remained significant after controlling for comorbid depression. The findings provide support for the contemporary theories of suicidality and have important clinical implications.
Full Text Available The article describes the main techniques used in empirical studies abroad for diagnostics of risks of suicidal behavior in children and adolescents in population sampling: Beck Self-Rating Depression Inventory, The Hopelessness Scale for Children, Inventory of Suicide Orientation, Self-Destructive Thought Assessment Scale, The Life-Attitudes Schedule, A measure of adolescent potential for suicide (MAPS, Multi-Attitude Suicide Tendency Scale in adolescent samples, PATHOS, The Reasons for Living Inventory, Suicide Probability Scale (SPS, Validity of the Self-Harm Behavior Questionnaire
Chan, Lai Fong; Maniam, T; Saini, Suriati Mohamed; Shah, Shamsul Azhar; Loh, Sit Fong; Sinniah, Aishvarya; Idris, Zawaha Haji; Che Rus, Sulaiman; Hassan Nudin, Siti Sa'adiah; Tan, Susan Mooi Koon
The aim of this study was to determine the association between sexual abuse, substance abuse and socio-demographic factors with suicidal ideation (SI), plans (SP) and deliberate self-harm (DSH) and propose steps to prevent youth suicidal behavior. This was a cross-sectional study of 6786 adolescents aged 17-18 years, selected randomly from all Malaysian adolescents to undergo compulsory youth camps located in Selangor, Malaysia (2008-2009). Participants were assessed using self-administered questionnaires developed to reflect the local cultural setting. However, only 4581 subjects were analyzed after excluding incomplete data. The rates of SI, SP and DSH were 7.6%, 3.2% and 6.3%, respectively. The multivariable-adjusted odds ratio showed that sexual abuse was associated with SI 1.99 (95% CI: 1.56-2.55), SP 1.57 (95% CI: 1.09-2.27) and DSH 2.26 (95% CI: 1.75-2.94); illicit drug use was associated with SI 4.05 (95% CI: 2.14-7.67), SP 2.62 (95% CI: 1.05-6.53) and DSH 2.06, (95% CI: 1.05-4.04); for alcohol use DSH was 1.34 (95% CI: 1.00-1.79). Being female was associated with all suicidal behaviors: SI 2.51 (95% CI: 1.91-3.30), SP 2.07 (95% CI: 1.39-3.08) and DSH 1.59 (95% CI: 1.19-2.11). Given the well-founded concern of increasing risk of suicidal behavior among youth, preventive efforts should adopt a more comprehensive approach in dealing with sexual abuse and substance abuse, and their sequelae, especially in girls. Copyright © 2013 Wiley Publishing Asia Pty Ltd.
Lung, F-W; Liao, S-C; Wu, C-Y; Lee, M-B
The effectiveness of suicide prevention programmes is an important issue worldwide today. The impact of urbanization and gender is controversial in suicide rates. Hence, this study adjusted on potential risk factors and secular changes for suicide rates in gender and rural/urban areas. Observational study. A Suicide Prevention Center was established by the Executive Yuan in Taiwan in 2005 and tried to carry out suicidal intervention in the community in every city and town. There were two phases, including the first phase of the programme from 2005 to 2008, and the second phase of the programme from 2009 to 2013. The crude suicide rates data from the period of 1991-2013, which recruited nine urban and 14 rural areas in Taiwan, were extracted from the Taiwanese national mortality data file. The suicide rates in two areas of Taiwan (Taipei city and Yilan County) were further used to compare the differences between urban and rural areas. The results show that unemployment increased the suicide rate in men aged 45-64 years and in women older than 65 years of age in Taiwan. High divorce and unemployment rates resulted in increased suicide rates in men in the city, whereas emotional distress was the main cause of suicides in men in rural areas. The main method of suicide was jumping from a high building for both sexes in the city, whereas drowning was the most common method of suicide for men in rural areas. Following the intervention programme, suicide behaviour began to decrease in all urban and rural areas of Taiwan. This study showed the cumulative effect of the intervention programme in decreasing the suicide rate in Taiwan. Moreover, the gender-specific suicidal rate and disparity in suicidal methods in urban and rural areas should be considered in further preventive strategies in Taiwan. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Cero, Ian; Sifers, Sarah K
Multiple features of parenting have been associated with development of suicide-related behaviors in adolescents. However, findings are inconsistent on which aspects of parenting are protective or harmful and why. This investigation sought to reconcile these discrepancies through the Interpersonal-Psychological Theory of Suicide (IPTS), which argues that suicide ideation and the capability to attempt suicide are etiologically distinct. Responses of 200 Midwestern public school students to the Profiles of Student Life: Attitudes and Behavior survey were analyzed using mediated moderation analysis. Participant sex significantly moderated the relationships between parenting variables and suicide attempts and these relationships were accounted for by IPTS variables. Specifically, the effect of parental support on suicide attempts was twice as strong for girls. Self-esteem mediated this interaction (b=-.011, SE(boot)=.008, pparental boundaries on suicide attempts was significant for boys, but not for girls, and was mediated by exposure to violence (b=.029, SE(boot)=.021, pparenting behaviors could influence sex differences in adolescent suicide-relate behaviors, and that some parenting behavior is associated with reduced adolescent suicide attempts. Findings also suggest the IPTS is able to account for previously identified inconsistencies in the effects of parenting behaviors on adolescent suicide-related behaviors. Implications for theory and intervention are discussed. © 2013 Elsevier B.V. All rights reserved.
Cho, Yoshinori; Inagaki, Masatoshi
In view of the fact that the suicide rate in Japan has remained high since 1998, the Basic Act on Suicide Prevention was implemented in 2006 with the objective of comprehensively promoting suicide prevention measures on a national scale. Based on this Basic Act, in 2007, the Japanese government formulated the General Principles of Suicide Prevention Policy as a guideline for recommended suicide prevention measures. These General Principles were revised in 2012 in accordance with the initial plan of holding a review after five years. The Basic Act places an emphasis on the various social factors that underlie suicides and takes the perspective that suicide prevention measures are also social measures. The slogan of the revised General Principles is "Toward Realization of a Society in which Nobody is Driven to Commit Suicide". The General Principles list various measures that are able to be used universally. These contents would be sufficient if the objective of the General Principles were "realization of a society that is easy to live in"; however, the absence of information on the effectiveness and order of priority for each measure may limit the specific effectiveness of the measures in relation to the actual prevention of suicide. In addition, considering that nearly 90% of suicide victims are in a state at the time of committing suicide in which a psychiatric disorder would be diagnosed, it would appear from a psychiatric standpoint that measures related to mental health, including expansion of psychiatric services, should be the top priority in suicide prevention measures. However, this is not the case in the General Principles, in either its original or revised form. Revisions to the General Principles related to clinical psychiatry provide more detailed descriptions of measures for individuals who unsuccessfully attempt suicide and identify newly targeted mental disorders other than depression; however, the overall proportion of contents relating to
Erlangsen, Annette; Nordentoft, Merete; Conwell, Yeates
The number of older adults is growing rapidly. This fact, combined with the high rates of suicide in later life, indicates that many more older adults will die by their own hands before rigorous trials can be conducted to fully understand the best approaches to prevent late life suicide....
Moilanen, Donna L.; Bradbury, Susan
Examined a collaboration between health education and psychological services in generating a high school depression and suicide prevention program. The five-component program raised awareness of teen depression and suicide, increased communication about these issues within the school and community, and provided information about available…
Kapur, Navneet; Turnbull, Pauline; Hawton, Keith; Simkin, Sue; Mackway-Jones, Kevin; Gunnell, David
Suicide by self-poisoning is a prevalent cause of death worldwide. A substantial proportion of individuals who poison themselves come into contact with medical services before they die. Our focus in the current study was the medical management of drug self-poisoning in industrialized countries and its possible contribution to suicide prevention.…
In this book, David Capuzzi, a renowned expert on suicide, encourages suicide prevention in schools through the use of a clear and effective crisis management plan designed to identify and serve at-risk youth. His concise, step-by-step framework provides essential information for school counselors, administrators, and faculty on suicide…
Limiting access to some methods of suicide, a strategy known as means restriction, is gaining support among mental-health researchers. Some suicides can be prevented, the logic goes, if it is more challenging for an impulsive individual to harm himself. But on most campuses, that strategy has not taken hold. Instead, counseling and education tend…
Cimini, M. Dolores; Rivero, Estela M.
This chapter explores the critical role of crisis intervention and other support after a suicide has occurred as part of a comprehensive suicide prevention response within college and university campuses. The important components of postsuicide intervention campus crisis response and protocols and the identification of key stakeholders to…
Taub, Deborah J.; Servaty-Seib, Heather L.; Miles, Nathan; Lee, Ji-Yeon; Wachter Morris, Carrie A.; Prieto-Welch, Susan L.; Werden, Donald
Resident assistants (RAs) can serve as important suicide prevention gatekeepers. The purpose of the study was to determine if training improved RAs' crisis communications skills and suicide-related knowledge and to determine if the knowledge elements predicted crisis communications skills. New RAs showed significant improvement in all areas from…
Newcomer, Alison R; Roth, Kimberly B; Kellam, Sheppard G; Wang, Wei; Ialongo, Nicholas S; Hart, Shelley R; Wagner, Barry M; Wilcox, Holly C
The Good Behavior Game (GBG) is a universal classroom-based preventive intervention directed at reducing early aggressive, disruptive behavior and improving children's social adaptation into the classroom. The GBG is one of the few universal preventive interventions delivered in early elementary school that has been shown to reduce the risk for future suicide attempts. This paper addresses one potential mechanism by which the GBG lowers the risk of later suicide attempt. In this study, we tested whether the GBG, by facilitating social adaptation into the classroom early on, including the level of social preference by classmates, thereby lowers future risk of suicide attempts. The measure of social adaptation is based on first and second grade peer reports of social preference ("which children do you like best?"; "which children don't you like?"). As part of the hypothesized meditational model, we examined the longitudinal association between childhood peer social preference and the risk of future suicide attempt, which has not previously been examined. Data were from an epidemiologically based randomized prevention trial, which tested the GBG among two consecutive cohorts of first grade children in 19 public schools and 41 classrooms. Results indicated that peer social preference partially mediated the relationship between the GBG and the associated reduction of risk for later suicide attempts by adulthood, specifically among children characterized by their first grade teacher as highly aggressive, disruptive. These results suggest that positive childhood peer relations may partially explain the GBG-associated reduction of risk for suicide attempts and may be an important and malleable protective factor for future suicide attempt.
Stokes, Marquita L; McCoy, Kathleen P; Abram, Karen M; Byck, Gayle R; Teplin, Linda A
Suicide is prevalent among youth, especially those involved in the juvenile justice system. Although many studies have examined suicidal ideation and behavior in delinquent youth, prevalence rates vary widely. This article reviews studies of suicidal ideation and behavior in youth in the juvenile justice system, focusing on the point of contact: incarceration status and stage of judicial processing. Suicidal ideation and behavior are prevalent and increase with greater involvement in the juvenile justice system. Depression, sexual abuse, and trauma were the most commonly identified predictors of suicidal ideation and behavior. Prevalence rates of suicidal ideation and behavior vary by gender and race/ethnicity, indicating the need for gender-specific and culturally relevant interventions. © The Author(s) 2015.
Tompkins, Tanya L.; Witt, Jody; Abraibesh, Nadia
The current study sought to evaluate the suicide prevention gatekeeper training program QPR (Question, Persuade, and Refer) among school personnel using a non-equivalent control group design. Substantial gains were demonstrated from pre- to post-test for attitudes, knowledge, and beliefs regarding suicide and suicide prevention. Exploratory…
Kleespies, Phillip M; Van Orden, Kimberly A; Bongar, Bruce; Bridgeman, Diane; Bufka, Lynn F; Galper, Daniel I; Hillbrand, Marc; Yufit, Robert I
Psychologist practitioners are not immune to some mental health problems, including suicidality, for which they provide services. In the aftermath of two recent psychologist suicides, the American Psychological Association's Advisory Committee on Colleague Assistance (ACCA) initiated the formation of a conjoint ad hoc committee consisting of members from ACCA, the American Psychological Association (APA) Practice Directorate, and the Section on Clinical Emergencies and Crises (Section VII of APA's Division 12) to investigate the incidence of psychologist suicide and its impact on colleagues, students or interns, patients or clients, and the profession. The committee reviewed the extant empirical literature on suicide rates for psychologists, evaluated unpublished data on psychologist suicide provided by the National Institute of Occupational Safety and Health (NIOSH), interviewed colleague survivors, reviewed published case reports of the impact of therapist suicides, and linked their findings to the literature on professional distress, impairment, and self-care. The committee concluded that there is evidence suggestive of an elevated risk of suicide for psychologists in past decades. It further concluded that there is a need for further research to confirm if there is a heightened risk of suicide for psychologists in the present day, and to determine factors that might contribute to such risk. Accounts from colleague-survivors suggest that the impact of a psychologist's suicide can affect many people including family, colleagues, students, and patients or clients. This article offers suggestions for possible preventive approaches, for intervention with potentially at-risk colleagues, and for postvention efforts in the wake of a colleague suicide.
Serafini, Gianluca; Muzio, Caterina; Piccinini, Giulia; Flouri, Eirini; Ferrigno, Gabriella; Pompili, Maurizio; Girardi, Paolo; Amore, Mario
Suicidal behavior in young people is a significant public health problem. However, it is not yet clear whether adversities (adverse life events) may be related to suicidality in adolescence and early adulthood. This paper aimed to investigate systematically the association between the type/number of adverse life events and experiences and suicidal behavior in young people. We developed a detailed strategy to search relevant articles in Pubmed, Scopus, PsycInfo, and Science Direct (January 1980-January 2015) about adverse life events and suicidal behavior. Adverse life events and experiences included maltreatment and violence, loss events, intra-familial problems, school and interpersonal problems. Studies were restricted to suicidal behavior in young people aged 10-25 years. The search yielded 245 articles, of which 28 met our inclusion criteria. Most studies reported a strong association between adversities and suicidality (both suicidal ideation and attempts). Based on the main results, the number of adversities or negative life events experienced seemed to have a positive dose-response relationship with youth suicidal behavior. However, the type of event experienced also appeared to matter: one of the most consistent findings was the association between suicidal behavior and experience of sexual abuse. More prospective studies are needed to elucidate the relative importance of risk accumulation and risk specificity for youth suicide.
Kuramoto-Crawford, S Janet; Smith, Kelley E; McKeon, Richard
This study characterized mental health facilities that offer suicide prevention services or outcome follow-up after discharge. The study analyzed data from 8,459 U.S. mental health facilities that participated in the 2010 National Mental Health Services Survey. Logistic regression analyses were used to compare facilities that offered neither of the prevention services with those that offered both or either service. About one-fifth of mental health facilities reported offering neither suicide prevention services nor outcome follow-up. Approximately one-third offered both, 25% offered suicide prevention services only, and 21% offered only outcome follow-up after discharge. Facilities that offered neither service were less likely than facilities that offered either to offer comprehensive support services or special programs for veterans; to offer substance abuse services; and to be accredited, licensed, or certified. Further examination of facilitators and barriers in implementing suicide prevention services in mental health facilities is warranted.
Suicide is the tenth most common cause of death in the United States. People may consider suicide when they are hopeless and can't see ... event. People who have the highest risk of suicide are white men. But women and teens report ...
Full Text Available Maria Zschoche, Angelika Anita Schlarb Faculty of Psychology and Sports Science, University of Bielefeld, Bielefeld, Germany Purpose: Sleep disturbances are a common problem during adolescence. Often there is a relationship with the mental health of the affected person. The existing literature concerning the link between sleep disturbances and aggressive behavior and sleep disturbances and suicidality during adolescence shows no clear results. The present study tested a mediation model to prove the relation between sleep problems, aggressive behavior, and suicidality during adolescence. To take the link between suicidality and depression into account, the amount of depressive symptoms was included into the mediation model. Methods: A sample of 93 adolescents aged 14–18 years (30% male was studied. A survey was conducted to interview the adolescents about their mental health, sleep-related behaviors, aggressive behavior, and suicidality. Results: Sleep problems and suicidality measures were significantly related to each other. Furthermore, aggressive behavior and suicidality showed a significant relationship. The expected link between sleep problems and aggressive behavior was not significant. For the mediation model, no significant influence of aggressive behavior on the relationship between the amount of sleep problems and suicidality was found. However, the impact of depressive symptoms on the relationship between sleep problems and suicidality was significant. Conclusion: Sleep problems and overall suicidality in adolescents are significantly connected, even after adjusting for several possible influencing factors. Aggressive behavior could not be confirmed as a mediator for the association between sleep problems and suicidality in adolescents. Further studies to examine the link between insomnia symptoms, aggressive behavior, and suicidality in adolescents are necessary. Keywords: adolescents, aggressive behavior, sleep problems
Gibbs, Jeremy J; Goldbach, Jeremy
This is the first known study to explore how religious identity conflict impacts suicidal behaviors among lesbian, gay, bisexual, and transgender (LGBT) young adults and to test internalized homophobia as a mediator. A secondary analysis of 2,949 youth was conducted using a national dataset collected by OutProud in 2000. Three indicators of identity conflict and an internalized-homophobia scale (mediator), were included in logistic regressions with three different suicide variable outcomes. Internalized homophobia fully mediates one conflict indicator and partially mediates the other two indicators' relationship with suicidal thoughts. Internalized homophobia also fully mediates the relationship between one conflict indicator and chronic suicidal thoughts. Two indicators were associated with twice the odds of a suicide attempt. LGBT young adults who mature in religious contexts have higher odds of suicidal thoughts, and more specifically chronic suicidal thoughts, as well as suicide attempt compared to other LGBT young adults. Internalized homophobia only accounts for portions of this conflict.
of young persons who had severe suicidal thoughts or who had attempted suicide showed that risk of repetition was reduced in the intervention group, and that the intervention group obtained a significantly greater improvement in Beck's Depression Inventory, Hopelessness Scale, Rosenberg Self-Esteem Scale...
Jovanović, Nikolina; Podlesek, Anja; Medved, Vesna; Grubišin, Jasmina; Mihaljevic-Peleš, Alma; Goran, Tošić; Lovretić, Vanja
Suicide in schizophrenia is a serious problem--ideation rates go up to 40%, and approximately one half of patients attempt suicide at least once. The distinction between attempters and ideators is vital in everyday clinical practice. To explore the association between psychopathology and suicidal behavior in a comparative study of three groups of patients with schizophrenia: suicide ideators, suicide attempters, and subjects without suicide ideation and behavior. The study included 509 patients: suicide attempters (n = 159), ideators (n = 180), and a comparative group (n = 170). The clinical assessment consisted of a structured psychiatric interview and an evaluation of sociodemographics, suicidality (SIBQ), psychopathology (PANSS), and depression (CDSS). Suicide attempters were more depressed than ideators, and both groups had higher CDSS scores than the comparative group. The overall contribution of positive, negative, and general PANSS symptoms was not statistically significant enough to differentiate ideators from attempters. A principal component analysis of the PANSS items revealed five components: disinhibition, withdrawal, anxiety and guilt, reality distortion, and disorganization. Two logistic regression analyses showed that suicide ideation or attempt was significantly related to depression, anxiety, guilt, gender, age, and number of previous hospitalizations. Compared to suicide ideators, attempters were more depressed, had a higher number of previous hospitalizations, and lower education. The results indicate that clinicians should look for depression, anxiety, and guilt feelings, while positive and negative symptoms seem to be less relevant for suicide assessment in schizophrenia.
Tang, Fang; Xue, Fuzhong; Qin, Ping
Stressful life events are common among youth students and may induce psychological problems and even suicidal behaviors in those with poor coping skills. This study aims to assess the influence of stressful life events and coping skills on risk for suicidal behavior and to elucidate the underlying mechanism using a large sample of university students in China. 5972 students, randomly selected from 6 universities, completed the questionnaire survey. Logistic regression analysis was performed to estimate the effect of stressful life events and coping skills on risk for suicidal behavior. Bayesian network was further adopted to probe their probabilistic relationships. Of the 5972 students, 7.64% reported the presence of suicidal behavior (attempt or ideation) within the past one year period. Stressful life events such as strong conflicts with classmates and a failure in study exam constituted strong risk factors for suicidal behavior. The influence of coping skills varied according to the strategies adapted toward problems with a high score of approach coping skills significantly associated with a reduced risk of suicidal behavior. The Bayesian network indicated that the probability of suicidal behavior associated with specific life events was to a large extent conditional on coping skills. For instance, a stressful experience of having strong conflicts with classmates could result in a probability of suicidal behavior of 21.25% and 15.36% respectively, for female and male students with the score of approach coping skills under the average. Stressful life events and deficient coping skills are strong risk factors for suicidal behavior among youth students. The results underscore the importance of prevention efforts to improve coping skills towards stressful life events.
Pullen, Julie M; Gilje, Fredricka; Tesar, Emily
Internationally, little is known regarding the amount of educational content on suicide in undergraduate nursing curriculum. The literature conducted found few published research studies on implementation of suicide prevention instruction in baccalaureate nursing curriculum, even though various international healthcare and nursing initiatives address suicide prevention. The aim was to describe senior baccalaureate students' responses to an evidence-based suicide prevention gatekeeper training program entitled Question-Persuade-Refer implemented in a required course. This is a multi-method descriptive study. Data were collected utilizing a pre-post-survey questionnaire administered to 150 students in four classes of a psychiatric nursing course over a two-year period. The quantitative data were statistically significant (p suicide'. Students responded very positively to the evidence based suicide prevention gatekeeper training program. The instruction addresses various national initiatives and strategies filling a void in nursing curriculum, as well as empowering students to engage in suicide prevention interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.
Notredame, Charles-Édouard; Pauwels, Nathalie; Walter, Michel; Danel, Thierry; Vaiva, Guillaume
Media coverage of suicide can result in increased morbi-mortality suicidal rates, due to an imitation process in those who are particularly vulnerable. This phenomenon is known as "Werther effect". Werther effect's magnitude depends on several qualitative and quantitative characteristics of the media coverage, in a dose-effect relationship. An extensive (in terms of audience and history repetition) and salient coverage (glorification of suicide, description of the suicidal method, etc.) increases the risk of contagion. Celebrities' suicide is particularly at risk of Werther effect. Media may also have a preventive role with respect to suicide. Indeed, according to "Papageno effect", journalists could, under certain conditions, help preventing suicide when reporting suicide stories. Two main theories in the field of social psychology have been proposed to account for Werther and Papageno effects: social learning theory and differential identification. Identification of Werther and Papageno effects uncovers new responsibilities and potentialities for the journalists in terms of public health. Their description provides a basis for promising targeted prevention actions. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Straub, Joana; Keller, Ferdinand; Sproeber, Nina; Koelch, Michael G; Plener, Paul L
Research in adults has identified an association between bipolar disorder and suicidal behavior. This relationship, however, has been insufficiently investigated in adolescents to date. 1,117 adolescents from 13 German schools (mean age = 14.83, SD = .63; 52.7% females) completed an extended German version of the Center for Epidemiological Studies Depression Scale (CES-D), which assesses depressive and manic symptoms during the last week, as well as the Self-Harm Behavior Questionnaire (SHBQ) for the assessment of lifetime suicidal behavior. In the present sample 39.4% of the girls and 23.1% of the boys reported lifetime suicidal thoughts and 7.1% of the girls as well as 3.9% of the boys a lifetime history of suicide attempts. 18.7% of the adolescent sample revealed elevated symptoms of depression and 9% elevated levels of mania symptoms. Elevated sum scores of depression and mania were associated with a higher number of suicidal ideations and suicide attempts. A block-wise regression analysis revealed that sum scores of depression and mania predicted suicidal ideations best. Concerning suicide attempts, the best predictors were age as well as depression and mania sum scores. Suicidal behavior was reported more often when adolescents demonstrate symptoms of mania as well as symptoms of depression than when they demonstrate only depressive symptoms. The presence of bipolar symptoms in adolescents should alert clinicians to the heightened possibility of suicidal behavior.
Deslauriers, Jessica; Belleville, Karine; Beaudet, Nicolas; Sarret, Philippe; Grignon, Sylvain
Schizophrenia patients show a high rate of premature mortality due to suicide. The pathophysiological mechanisms of these suicidal behaviors in schizophrenia do not appear to involve serotonergic neurotransmission as found in the general population. Our aim was to develop an in vivo model of schizophrenia presenting suicide-trait-related behaviors such as aggressiveness, impulsivity, anxiety and helplessness. We opted for a two-hit model: C57BL/6 dams were injected with polyI:C on gestational day 12. The pups were submitted to social isolation for 4weeks after weaning. During the last week of social isolation and 30min before behavioral testing, the mice received vehicle, lithium chloride or clozapine. Lithium chloride is well known for its suicide preventive effects in the non-schizophrenic population, while clozapine is the antipsychotic with the best-established suicide preventive effect. The two-hit model induced several schizophrenia-related and suicide-trait-related behaviors in male, but not female, mice. Additionally, lithium chloride improved prepulse inhibition, aggressiveness, impulsivity and anxiety-like behavior in socially isolated mice only, whereas clozapine prevented behavioral abnormalities mainly in mice prenatally exposed to polyI:C and submitted to isolated rearing. The distinct effects of lithium chloride and clozapine suggested that mice prenatally exposed to polyI:C and submitted to social isolation presented a distinct phenotype from that of mice submitted to social isolation only. Because diagnosing suicidal risk in patients is a challenge for psychiatrists given the lack of specific clinical predictors, our in vivo model could help in gaining a better understanding of the mechanisms underlying suicidal behavior in the context of schizophrenia. Copyright © 2016 Elsevier Inc. All rights reserved.
Barzilay, Shira; Apter, Alan
Suicidal behavior is highly complex and multifaceted. Consequent to the pioneering work of Durkheim and Freud, theoreticians have attempted to explain the biological, social, and psychological nature of suicide. The present work presents an overview and critical discussion of the most influential theoretical models of the psychological mechanisms underlying the development of suicidal behavior. All have been tested to varying degrees and have important implications for the development of therapeutic and preventive interventions. Broader and more in-depth approaches are still needed to further our understanding of suicidal phenomena.
O'Donnell, I; Farmer, R; Catalan, J
Detailed case reports of incidents of suicide and attempted suicide on the London Underground railway system between 1985 and 1989 were examined for the presence of suicide notes. The incidence of note-leaving was 15%. Notes provided little insight into the causes of suicide as subjectively perceived, or strategies for suicide prevention.
Ward, Janice E.; Odegard, Melissa A.
A considerable amount of literature points to the criticality of implementing prevention and intervention strategies to address suicide in the context of schools. The authors address these elements along with a case study to increase student safety in schools.
Full Text Available Objectives: The factors associated with repetition of attempted suicide are poorly categorized in the Iranian population. In this study, the prevalence of different psychiatric disorders among women who attempted suicide and the risk of repetition were assessed. Methods: Participants were women admitted to the Poisoning Emergency Hospital, Kermanshah University of Medical Sciences following failed suicide attempts. Psychiatric disorders were diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV symptom checklist. Risk of repetition was evaluated using the Suicide Behaviors Questionnaire-Revised (SBQ-R. Results: About 72% of individuals had a SBQ-R score >8 and were considered to be at high risk for repeated attempted suicide. Adjustment disorders were the most common psychiatric disorders (40.8%. However, the type of psychiatric disorder was not associated with the risk of repetition (p=0.320. Marital status, educational level, employment, substance use, history of suicide among family members, and motivation were not determinant factors for repetition of suicide attempt (p=0.220, 0.880, 0.220, 0.290, 0.350 and 0.270, respectively. Younger women were associated with violent methods of attempted suicide, such as self-cutting, whereas older individuals preferred consumption of poison (p<0.001. Drug overdose was more common among single and married women whereas widows or divorcees preferred self-burning (p=0.004. Conclusion: About 72% of patients with failed suicide attempts were at high risk for repeated attempts. Age, marital status, and type of psychiatric disorder were the only determinants of suicide method. Adjustment disorders were the most common psychiatric disorders among Iranian women. However, this did not predict the risk of further attempts.
Zimri S Yaseen
Full Text Available BACKGROUND: Suicide has been linked to intense negative affect. However, little is known about the range of affects experienced by suicidal persons, or the separate effects of affect valence and intensity. We examine a novel self-report scale, the 17-item Affective Intensity Rating Scale (AIRS, and its relation to suicidality in a high-risk sample. METHODOLOGY/PRINCIPAL FINDINGS: Patients presenting with suicidality were recruited from the Emergency Department in a large urban hospital, and completed a battery of assessments there. Structure of the AIRS was assessed using Maximum Likelihood Factor Analysis with Oblimin rotation. Convergent and divergent validity were assessed by regressing AIRS subscales against Brief Symptom Inventory subscales. Relation to suicidality was assessed by regression of suicide attempt status against scale and subscale scores, and individual items and two-way item interactions, along with significant clinical and demographic factors. 176 subjects were included in analyses. Three reliable subscales were identified within the AIRS measure: positive feelings towards self, negative feelings towards self, and negative feelings towards other. Only individual AIRS items associated significantly with suicide attempt status; strong 'feelings of love' associated positively with actual suicide attempt, while 'feelings of calm' and 'positive feelings towards self' associated negatively. Interaction analyses suggest 'calm' moderates the association of 'love' with suicide attempt. CONCLUSIONS/SIGNIFICANCE: Factor analysis of the AIRS is consistent with a circumplex model of affect. Affective dimensions did not predict suicidal behavior, but intense feelings of love, particularly in the absence of protective feelings of calm or positive self-view associated with current attempt.
Hammerton, Gemma; Zammit, Stanley; Mahedy, Liam; Pearson, Rebecca M; Sellers, Ruth; Thapar, Anita; Collishaw, Stephan
Offspring of mothers with depression are a high-risk group for the development of suicide-related behavior. These offspring are therefore a priority for preventive interventions; however, pathways contributing to risk, including specific aspects of offspring psychopathology, remain unclear. The aim of this study was to examine whether offspring symptoms of major depressive disorder (MDD), generalized anxiety disorder (GAD), disruptive behavior disorder (DBD), attention-deficit/hyperactivity disorder (ADHD), and alcohol abuse independently mediate the association between maternal depression and offspring suicide-related behavior. Data were used from a population-based birth cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC). Three distinct classes of depression symptoms across the mothers' first 11 years of their child's life were identified (minimal, moderate, chronic-severe). Offspring psychopathology was assessed at age 15 years and suicide-related behavior at age 16 years. Data were analyzed using structural equation modeling. There was evidence for increased risk of suicidal ideation in offspring of mothers with chronic-severe depression symptoms in comparison to offspring of mothers with minimal symptoms (odds ratio = 3.04, 95% CI = 2.19, 4.21). This association was independently mediated by offspring MDD, GAD, and DBD symptoms. The same mechanisms were found for offspring of mothers with moderate depression symptoms over time. Results were similar for offspring suicide attempt except for additional evidence of an indirect effect through offspring ADHD symptoms. Findings highlight that suicide prevention efforts in offspring of mothers with depression should not only be targeted at offspring with MDD; it is also important to consider offspring with other forms of psychopathology. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Hammerton, Gemma; Zammit, Stanley; Mahedy, Liam; Pearson, Rebecca M.; Sellers, Ruth; Thapar, Anita; Collishaw, Stephan
Objective Offspring of mothers with depression are a high-risk group for the development of suicide-related behavior. These offspring are therefore a priority for preventive interventions; however, pathways contributing to risk, including specific aspects of offspring psychopathology, remain unclear. The aim of this study was to examine whether offspring symptoms of major depressive disorder (MDD), generalized anxiety disorder (GAD), disruptive behavior disorder (DBD), attention-deficit/hyperactivity disorder (ADHD), and alcohol abuse independently mediate the association between maternal depression and offspring suicide-related behavior. Method Data were used from a population-based birth cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC). Three distinct classes of depression symptoms across the mothers’ first 11 years of their child’s life were identified (minimal, moderate, chronic-severe). Offspring psychopathology was assessed at age 15 years and suicide-related behavior at age 16 years. Data were analyzed using structural equation modeling. Results There was evidence for increased risk of suicidal ideation in offspring of mothers with chronic-severe depression symptoms in comparison to offspring of mothers with minimal symptoms (odds ratio = 3.04, 95% CI = 2.19, 4.21). This association was independently mediated by offspring MDD, GAD, and DBD symptoms. The same mechanisms were found for offspring of mothers with moderate depression symptoms over time. Results were similar for offspring suicide attempt except for additional evidence of an indirect effect through offspring ADHD symptoms. Conclusion Findings highlight that suicide prevention efforts in offspring of mothers with depression should not only be targeted at offspring with MDD; it is also important to consider offspring with other forms of psychopathology. PMID:25901775
Kwok, Sylvia Y.C.L.; Shek, Daniel T. L.
Utilizing Daniel Goleman's theory of emotional competence, Beck's cognitive theory, and Rudd's cognitive-behavioral theory of suicidality, the relationships between hopelessness (cognitive component), social problem solving (cognitive-behavioral component), emotional competence (emotive component), and adolescent suicidal ideation were examined. Based on the responses of 5,557 Secondary 1 to Secondary 4 students from 42 secondary schools in Hong Kong, results showed that suicidal ideation was...
Shek, Daniel T. L.; Yu, Lu
The present paper examined the prevalence and psychosocial correlates of adolescent deliberate self-harm (DSH) and suicidal behavior in a representative sample of 3,328 secondary school students in Hong Kong. With reference to the previous year, 32.7% of the students reported at least one form of DSH, 13.7% of the respondents had suicide thoughts, 4.9% devised specific suicidal plans, and 4.7% had actually attempted suicide. Adolescent girls had significantly higher rates of DSH and suicidal ...
Breslau, Joshua; Su, Maxwell; Miller, Matthew; Medina-Mora, Maria Elena; Aguilar-Gaxiola, Sergio
Objectives. We examined migration to the United States as a risk factor for suicidal behavior among people of Mexican origin. Methods. We pooled data from 2 nationally representative surveys in the United States (2001–2003; n = 1284) and Mexico (2001–2002; n = 5782). We used discrete time survival models to account for time-varying and time-invariant characteristics, including psychiatric disorders. Results. Risk for suicidal ideation was higher among Mexicans with a family member in the United States (odds ratio [OR] = 1.50; 95% confidence interval [CI] = 1.06, 2.11), Mexican-born immigrants who arrived in the United States at 12 years or younger (OR = 1.84; 95% CI = 1.09, 3.09), and US-born Mexican Americans (OR = 1.56; 95% CI = 1.03, 2.38) than among Mexicans with neither a history of migration to the United States nor a family member currently living there. Risk for suicide attempts was also higher among Mexicans with a family member in the United States (OR = 1.68; 95% CI = 1.13, 2.52) and US-born Mexican Americans (OR = 1.97; 95% CI = 1.06, 3.65). Selection bias caused by differential migration or differential return migration of persons at higher risk of suicidal ideation or attempt did not account for these findings. Conclusions. Public health efforts should focus on the impact of Mexico–US migration on family members of migrants and on US-born Mexican Americans. PMID:19150909
A study illustrates how legal sanction promotes a culture that transforms suicide into assisted suicide and encourages choosing death when faced with serious illness. The question of extending legal euthanasia to those not physically ill complicates the issue. Also, doctors may feel they can end a terminally-ill patient's life without consent.…
Sakamoto, Shinji; Tanaka, Eriko; Kameyama, Akiko; Takizawa, Tohru; Takizawa, Shiho; Fujishima, Satoko; Nara, Mieko; Sakashita, Tomoe; Oyama, Hirofumi; Ono, Yutaka
As the suicide rate in Japan has remained high since 1998, various suicide prevention measures have been implemented in Japanese local communities. To report our findings on the effect of a psychoeducational video as a suicide prevention measure in a Japanese rural town. Questionnaires were randomly mailed to 2,000 residents aged between 30 and 79 years. Within 4 weeks, volunteers in the town visited the residents individually and collected the questionnaires. The variables reported in this study are demographics, awareness of suicide prevention measures available in the town, whether the residents watched the video, help-seeking from advisers regarding suicidal ideation and financial problems and attitudes towards suicide. We analysed data collected from 1,118 people who reported their demographics (i.e. sex, age, and job) and whether they had watched the video. By conducting a series of logistic regression and multiple regression analyses and controlling for demographic variables, we found that watching the video had substantial psychoeducational effects. Despite conducting a cross-sectional study, our new suicide prevention measures were considered effective for psychoeducation. However, further studies using a longitudinal design are needed. © The Author(s) 2014.
Campbell-Sills, Laura; Kessler, Ronald C; Ursano, Robert J; Rosellini, Anthony J; Afifi, Tracie O; Colpe, Lisa J; Heeringa, Steven G; Nock, Matthew K; Sampson, Nancy A; Sareen, Jitender; Schoenbaum, Michael; Sun, Xiaoying; Jain, Sonia; Stein, Murray B
Prior studies have documented associations of childhood bullying victimization with suicidal behaviors. However, many failed to adjust for concomitant risk factors and none investigated this relationship in military personnel. This study aimed to estimate independent associations of childhood bullying victimization with suicidal behaviors among U.S. Army soldiers. Soldiers reporting for basic training completed a cross-sectional survey assessing mental disorders, suicidal behaviors, and childhood adversities including two types of bullying victimization: (1) Physical Assault/Theft and (2) Bullying Comments/Behaviors. Associations of childhood bullying experiences with suicidal behaviors were estimated using discrete-time survival analysis of person-year data from 30,436 soldiers. Models adjusted for sociodemographic factors, childhood maltreatment by adults, and mental disorders. After comprehensive adjustment for other risk factors, more frequent Physical Assault/Theft by peers during childhood was associated with increased odds of lifetime suicidal ideation (adjusted odds ratio [AOR] = 1.18, 95% CI: 1.11-1.26, P Bullying Comments/Behaviors were associated with increased risk of ideation (AOR = 1.30, 95% CI: 1.26-1.35, P bullying victimization, exposure to the most persistent bullying was associated with two- to fourfold increase in risk for suicidal behaviors. Childhood bullying victimization is associated with lifetime suicidal behaviors among new soldiers. Exposure to Bullying Comments/Behaviors during childhood is associated with progression from suicidal ideation to plan. Improved recognition of these relationships may inform risk mitigation interventions for soldiers. © 2017 Wiley Periodicals, Inc.
Dueweke, Aubrey R; Schwartz-Mette, Rebecca A
Joiner's interpersonal-psychological theory of suicide (IPTS) is predated by literature examining maladaptive interpersonal behaviors associated with depression; however, research has not examined the potential relevance of such behaviors for the IPTS. The current study aimed to expand understanding of suicide risk by examining two maladaptive interpersonal behaviors in the context of Joiner's IPTS model. Structural equation modeling examined associations between depressive symptoms, social-cognitive predictors of suicide, maladaptive interpersonal behaviors, and suicide risk in 228 college students (53.9% female; M = 19.5 years, SD = 1.8). Social-cognitive IPTS variables mediated the relation between depressive symptoms and maladaptive interpersonal behavior. Both social-cognition and maladaptive interpersonal behavior mediated the effect of depressive symptoms on suicide risk. Findings have the potential to add to our understanding of the interplay of social-cognitive factors and interpersonal behaviors associated with suicide risk. Directions for future research are discussed.
Jeffrey A Gross
Full Text Available Suicide and suicide attempts are complex behaviors that result from the interaction of different factors, including genetic variants that increase the predisposition to suicidal behaviors. Copy number variations (CNVs are deletions or duplications of a segment of DNA usually larger than one kilobase. These structural genetic changes, although quite rare, have been associated with genetic liability to mental disorders, such as autism, schizophrenia, and bipolar disorder. No genome-wide level studies have been published investigating the potential role of CNVs in suicidal behaviors. Based on single-nucleotide polymorphism array data, we followed the Penn-CNV standards to detect CNVs in 1,608 subjects, comprising 475 suicide and suicide attempt cases and 1,133 controls. Although the initial algorithms determined the presence of CNVs on chromosomes 6 and 12 in seven and eight cases, respectively, compared with none of the controls, visual inspection of the raw data did not support this finding. Furthermore we were unable to validate these findings by CNV-specific real-time polymerase chain reaction. Additionally, rare CNV burden analysis did not find an association between the frequency or length of rare CNVs and suicidal behavior in our sample population. Although our findings suggest CNVs do not play an important role in the etiology of suicidal behaviors, they are not inconsistent with the strong evidence from the literature suggesting that other genetic variants account for a portion of the total phenotypic variability in suicidal behavior.
de Groot, M H; de Winter, R F P; van der Plas, W; Kerkhof, A J F M
Multidisciplinary evaluation of suicide cases effectively decreases the suicide rate in mental health care. A new suicide prevention tool (KEHR) can be used in this connection. KEHR has been developed on the basis of the Dutch multidisciplinary practice guideline on the assessment and treatment of suicidal behaviour. The guideline can serve as a frame of reference for the multidisciplinary evaluation of suicide cases. KEHR aims to provide professionals with a better method for preventing suicide. To describe and evaluate the recently developed KEHR strategy for reducing the number of suicide cases in mental health care. Naturalistic and observational study. In the course of a year 22 out of 23 suicide cases that had occurred in the pilot institution were evaluated with the help of the KEHR system. Outcomes were discussed with members of multidisciplinary teams. Quantitative and qualitative methods were used in the evaluation process. Professionals from the main disciplines involved were very willing to use the new tool and were prepared to reflect on their views on the outcomes. The professionals were ready to learn from the suicide cases. Data collected with the tool provided information that can be used to improve guideline adherence. However, the use of KEHR did not lead automatically to the formulation of adjustments and improvements relating to suicidal patients. A specific procedure for improving individual and team performance needs to be developed and tested thoroughly. KEHR is a promising strategy for improving and enhancing the guideline on the diagnosis and treatment of suicidal behaviour of patients in mental health care. Special procedures need to be developed and studied in order to implement the improvements deemed necessary as a result of the pilot study. The KEHR tool (in the Dutch language) is accessible to mental health care workers after online registration (www.mijnkehr.nl).
Mann, J John; Michel, Christina A
About 21,000 suicides in the United States in 2014 involved a firearm. The authors reviewed evidence from around the world regarding the relationship between firearm ownership rates and firearm suicide rates and the potential effectiveness of policy-based strategies for preventing firearm suicides in the United States. Relevant publications were identified by searches of PubMed, PsycINFO, MEDLINE, and Google Scholar from 1980 to September 2015, using the search terms suicide AND firearms OR guns. Excluding duplicates, 1,687 results were found, 60 of which were selected for inclusion; these sources yielded an additional 10 studies, for a total of 70 studies. Case-control and ecological studies investigating geographic and temporal variations in firearm ownership and firearm suicide rates indicate that greater firearm availability is associated with higher firearm suicide rates. Time-series analyses, mostly from other countries, show that legislation reducing firearm ownership lowers firearm suicide rates. Because the Second Amendment curtails legislation broadly restricting firearm access in the United States, the emphasis is shifted to restricting access for those at risk of harming themselves or others. Most suicides involve guns purchased years earlier. Targeted initiatives like gun violence restraining orders, smart gun technology, and gun safety education campaigns potentially reduce access to already purchased firearms by suicidal individuals. Such measures are too new to have evidence of effectiveness. Broadly reducing availability and access to firearms has lowered firearm suicide rates in other countries but does not appear feasible in the United States. Approaches restricting access of at-risk individuals to already purchased firearms by engaging the public and major stakeholders require urgent implementation and outcome evaluation for firearm suicide prevention.
Ichikawa, Masao; Inada, Haruhiko; Kumeji, Minae
A recent preliminary communication suggested that the calming effect of blue lights installed at the ends of railway platforms in Japan reduced suicides by 84%. This estimate is potentially misleading from an epidemiological point of view and is reconsidered in the present study. Governmental data listing all railway suicide attempts in Japan from April 2002 to March 2012 were used to investigate the proportion of suicide attempts within station premises, where blue lights are potentially installed, and at night, when they would be lit. For those suicide attempts within station premises, we also estimated the proportion that occurred at the ends of the platforms at night. Of 5841 total reported suicide attempts, 43% occurred within the station premises, 43% occurred at night (from 18:00 to 05:59), and 14% occurred both within the station premises and at night. Of the 2535 attempts within station premises, 32% occurred at night and 28% at most were at the end of a platform at night. The exact proportion of nighttime suicide attempts at the ends of railway platforms was not calculable. Nonetheless, the proportion of suicide attempts that is potentially preventable by blue lights should be less than our conservative estimate. The installation of blue lights on platforms, even were they to have some effect in preventing railway suicides at night, would have a much smaller impact than previously estimated. © 2013 Published by Elsevier B.V.
Harlow, Alyssa F; Bohanna, India; Clough, Alan
Indigenous young people have significantly higher suicide rates than their non-indigenous counterparts. There is a need for culturally appropriate and effective suicide prevention programs for this demographic. This review assesses suicide prevention programs that have been evaluated for indigenous youth in Australia, Canada, New Zealand, and the United States. The databases MEDLINE and PsycINFO were searched for publications on suicide prevention programs targeting indigenous youth that include reports on evaluations and outcomes. Program content, indigenous involvement, evaluation design, program implementation, and outcomes were assessed for each article. The search yielded 229 articles; 90 abstracts were assessed, and 11 articles describing nine programs were reviewed. Two Australian programs and seven American programs were included. Programs were culturally tailored, flexible, and incorporated multiple-levels of prevention. No randomized controlled trials were found, and many programs employed ad hoc evaluations, poor program description, and no process evaluation. Despite culturally appropriate content, the results of the review indicate that more controlled study designs using planned evaluations and valid outcome measures are needed in research on indigenous youth suicide prevention. Such changes may positively influence the future of research on indigenous youth suicide prevention as the outcomes and efficacy will be more reliable.
Havârneanu, Grigore M; Burkhardt, Jean-Marie; Paran, Françoise
This review covers a central aspect in railway safety which is the prevention of suicides and trespassing accidents. The paper attempts to answer the following research question: 'What measures are available to reduce railway suicide and trespass, and what is the evidence for their effectiveness?' The review is based on 139 relevant publications, ranging from 1978 to 2014. The analysis aimed to identify the past and current trend in the prevention practice by looking both quantitatively and qualitatively at the recommended measures. According to the results, there has been a constant focus on suicide prevention, and only relatively recent interest in trespass countermeasures. The content analysis revealed 19 main preventative categories which include more than 100 specific measures. We identified 16 common categories against railway suicide and trespass, and 3 categories of specific measures to prevent suicide. There are only 22 studies which provide empirical support for the effectiveness of measures. Actual combinations of measures are barely evaluated, but several challenges emerge from the literature. The discussion focuses on the need for a unified approach to suicide and trespass prevention, and on the importance to consider the effect mechanism of the measures in order to design better interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.
Generally the child and adolescent group is the second most at-risk age group for non-fatal suicides after ... The influence of the mass media and information technology on vulnerable people can precipitate suicidal ... depression and altered social contact as children.13 In South. Africa, HIV-AIDS sufferers have been shown ...
Full Text Available Alberto Verrotti1, Alessandra Cicconetti2, Barbara Scorrano2, Domenico De Berardis2,3, Carla Cotellessa2, Francesco Chiarelli1, Filippo Maria Ferro21Department of Pediatrics; 2Department of Oncology and Neuroscience, Institute of Psychiatry, University “G. d’Annunzio” of Chieti, Italy; 3Department of Mental Health, Teramo, ItalyAbstract: Depression and suicide tendencies are common in chronic diseases, especially in epilepsy and diabetes. Suicide is one of the most important causes of death, and is usually underestimated. We have analyzed several studies that compare mortality as a result of suicide in epileptic patients and in the general population. All the studies show that epileptic patients have a stronger tendency toward suicide than healthy controls. Moreover it seems that some kinds of epilepsy have a higher risk for suicide (temporal-lobe epilepsy. Among the risk factors are surgery therapy (suicide tendency five times higher than patients in pharmacological therapy, absence of seizures for a long time, especially after being very frequent, and psychiatric comorbidity (major depression, anxiety-depression disorders, personality disorders, substance abuse, psychoses. The aim of the review was to analyze the relationship between suicide and epilepsy, to identify the major risk factors, and to analyze effective treatment options.Keywords: epilepsy, suicide, depression
male suicide rates over females has been relatively constant,. i.e. an approximate ratio = 3.6:1. An exception .... suicidal behaviour involve children and adolescents. Generally the child and adolescent group is the .... depression and altered social contact as children.13 In South. Africa, HIV-AIDS sufferers have been shown ...
The risk factors of suicide which occur in people of all genders, ages and ethnicities, although complex to fully understand, share certain characteristics that include depression (other mental disorders, psychosis or substance abuse disorder), a prior suicide attempt, family history of a mental disorder or substance abuse, ...
Gallo, Laura L.
Suicide is the second leading cause of death for adolescents and has become a public health concern in the United States. In addition, certain groups of students are more at risk for suicide than others. School counselors have an ethical obligation to protect their students and are in an ideal position to educate students and staff about the risks…
posttraumatic stress disorder (PTS) symptoms are also good predictors of suicidal ..... psychological responses of the organism itself to such forces52. Stress in the military context refers to events or forces in the environment, outside the person, .... Biopsychosocial risk factors include family history of suicide, mental disorders ...
Blasco, Maria Jesús; Castellví, Pere; Almenara, José; Lagares, Carolina; Roca, Miquel; Sesé, Albert; Piqueras, José Antonio; Soto-Sanz, Victoria; Rodríguez-Marín, Jesús; Echeburúa, Enrique; Gabilondo, Andrea; Cebrià, Ana Isabel; Miranda-Mendizábal, Andrea; Vilagut, Gemma; Bruffaerts, Ronny; Auerbach, Randy P; Kessler, Ronald C; Alonso, Jordi
Suicide is a leading cause of death among young people. While suicide prevention is considered a research and intervention priority, longitudinal data is needed to identify risk and protective factors associate with suicidal thoughts and behaviors. Here we describe the UNIVERSAL (University and Mental Health) project which aims are to: (1) test prevalence and 36-month incidence of suicidal thoughts and behaviors; and (2) identify relevant risk and protective factors associated with the incidence of suicidal thoughts and behaviors among university students in Spain. An ongoing multicenter, observational, prospective cohort study of first year university students in 5 Spanish universities. Students will be assessed annually during a 36 month follow-up. The surveys will be administered through an online, secure web-based platform. A clinical reappraisal will be completed among a subsample of respondents. Suicidal thoughts and behaviors will be assess with the Self-Injurious Thoughts and Behaviors Interview (SITBI) and the Columbia-Suicide Severity Rating Scale (C-SSRS). Risk and protective factors will include: mental disorders, measured with the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and Screening Scales (CIDI-SC), and the Epi-Q Screening Survey (EPI-Q-SS), socio-demographic variables, self-perceived health status, health behaviors, well-being, substance use disorders, service use and treatment. The UNIVERSAL project is part of the International College Surveys initiative, which is a core project within the World Mental Health consortium. Lifetime and the 12-month prevalence will be calculated for suicide ideation, plans and attempts. Cumulative incidence of suicidal thoughts and behaviors, and mental disorders will be measured using the actuarial method. Risk and protective factors of suicidal thoughts and behaviors will be analyzed by Cox proportional hazard models. The study will provide valid, innovative and useful data for developing
Pratt, D.; Tarrier, N.; Dunn, G.; Awenat, Y.; Shaw, J.; Ulph, F.; Gooding, P.
Background Prisoners have an exceptional risk of suicide. Cognitive behavioural therapy for suicidal behaviour has been shown to offer considerable potential, but has yet to be formally evaluated within prisons. This study investigated the feasibility of delivering and evaluating a novel, manualised cognitive behavioural suicide prevention (CBSP) therapy for suicidal male prisoners. Methods A pilot randomised controlled trial of CBSP in addition to treatment as usual (CBSP; n=31) compared to treatment as usual alone (TAU; n=31), was conducted in a male prison in England. The primary outcome was self-injurious behaviour occurring within the past six months. Secondary outcomes were dimensions of suicidal ideation, psychiatric symptomatology, personality dysfunction and psychological determinants of suicide, including depression and hopelessness. The trial was prospectively registered (number ISRCTN59909209). Results Relative to TAU, participants receiving CBSP therapy achieved a significantly greater reduction in suicidal behaviours with a moderate treatment effect (Cohen’s d=−0.72, 95%CI: −1.71 to 0.09; baseline mean [SD], TAU: 1.39[3.28] vs CBSP: 1.06[2.10], 6 months mean [SD], TAU: 1.48[3.23] vs CBSP: 0.58[1.52]). Significant improvements were achieved on measures of psychiatric symptomatology and personality dysfunction. Improvements on psychological determinants of suicide were non-significant. More than half of participants in the CBSP group achieved a clinically significant recovery by the end of therapy, compared to a quarter of the TAU group. Conclusions The delivery and evaluation of cognitive behavioural suicide prevention therapy within a prison is feasible. CBSP therapy offers significant promise in the prevention of prison suicide and an adequately powered randomised controlled trial is warranted. PMID:26165919
Pigeon, Wilfred R; Pinquart, Martin; Conner, Kenneth
The potential association of various sleep disturbances to suicidal thoughts and behaviors is the subject of several reviews. The current meta-analysis was conducted to estimate the size of the association generally as well as between more specific relationships. Electronic databases for years 1966-2011 were searched to identify candidate studies using PubMed search terms suicide and sleep or sleep initiation/maintenance disorders or dreams or nightmares or sleep disorders/psychology or sleep disorders/epidemiology as well as Ovid search terms suicide and sleep or insomnia or nightmares. The search was supplemented by cross-referencing from identified articles and reviews. Original studies reporting both sleep disturbance and suicide outcomes were identified with 39 of 98 studies (40%) comprising 147,753 subjects selected for inclusion. Data were extracted by multiple independent observers and verified by a study author. The meta-analysis was performed using random-effects models. The size of associations was calculated for all types of sleep disturbances and suicide outcomes combined and for more specific categories including nightmares, insomnia, and insomnia subtypes and suicidal ideation, suicide attempts, and suicide. Moderator effects were evaluated. Overall, sleep disturbance was significantly associated with an increased relative risk for suicidal ideation, suicide attempt, and suicide ranging from 1.95 (95% CI, 1.41-2.69) to a relative risk of 2.95 (95% CI, 2.48-3.50) in unadjusted studies. Associations were smaller, but remained highly significant among adjusted studies. Depression did not moderate the association between sleep and suicide variables. This meta-analysis supports an association between sleep disturbance and suicidal thoughts and behaviors. Sleep disturbances in general, as well as insomnia and nightmares individually, appear to represent a risk factor for suicidal thoughts and behavior. This proposition is further bolstered by the result
May, Alexis; Klonsky, E. David
The Youth Risk Behavior Survey (YRBS) is used by the United States Centers for Disease Control to estimate rates of suicidal thoughts and behaviors in adolescents. This study investigated the validity of the YRBS suicidality items by examining their relationship to criterion variables including loneliness, anxiety, depression, substance use, and…
Storch, Eric A.; Sulkowski, Michael L.; Nadeau, Josh; Lewin, Adam B.; Arnold, Elysse B.; Mutch, P. Jane; Jones, Anna M.; Murphy, Tanya K.
This study investigated the phenomenology and clinical correlates of suicidal thoughts and behaviors in youth with ASD (N = 102; range 7-16 years). The presence of suicidal thoughts and behavior was assessed through the Anxiety Disorders Interview Schedule-Child and Parent Versions. Children and parents completed measures of anxiety severity,…
Linehan, Marsha M.; Laffaw, Julie A.
Compared suicidal behaviors among two populations in the same geographical area: clients at a psychology clinic versus individuals from the general population. In both samples, 10 percent of the individuals reported prior parasuicidal behavior; the two populations were also quite similar on reports of prior suicidal ideation. (JAC)
Wong, Susan P. Y.; Phillips, Michael R.
Three hundred fifty-three women (median age = 32 years) admitted to the emergency rooms of nine general hospitals serving rural areas in China were interviewed for nonfatal suicidal behavior. Spousal conflict was the most commonly reported cause for their suicidal behavior and one third of respondents reported being victims of physical abuse by…
Harkavy-Friedman, Jill M.; Nelson, Elizabeth A.; Venarde, David F.; Mann, J. John
Understanding the relationship between depression and suicidal behavior among individuals with schizophrenia and schizoaffective disorder can aid assessment and treatment. In this study, 86 individuals with schizophrenia and schizoaffective disorder were assessed for past and current suicidal behavior, depression, hopelessness, and reasons for…
Gal, Gilad; Levav, Itzhak; Gross, Raz
The association between childhood and adolescent abuse and suicidal behavior, and the possible contribution of abuse to sex differences in non lethal suicidal behavior, was investigated. Data were extracted from the Israel-based component of the WHO World Mental Health Survey (Kessler & Utsun, 2008a). Increased risk for ideation, plan, and…
Not Dead Yet is a national disability rights organization formed in 1996 to articulate and organize the disability rights opposition to legalization of assisted suicide. In the first half of 2009, Not Dead Yet and four other national disability organizations joined in an amicus brief filed in Baxter v. State of Montana, an assisted suicide case on appeal to the state Supreme Court. Autonomy, Inc., another disability organization, filed an amicus brief in favor of a constitutional right to assisted suicide. The author reviews the lower court opinion and the key arguments in these amicus briefs from the perspective of Not Dead Yet. The Montana District Court concluded that the privacy and dignity provisions of the Montana Constitution establish a constitutional right to physician assisted suicide for terminally ill people, and that potential abuses of that right could be regulated by state statute. The author addresses the question, "What does disability have to do with it?" The author uses a combination of clinical research, legal analysis and the Oregon Reports on assisted suicide to examine the claim that abuses can be prevented by restricting assisted suicide to competent people who are terminally ill and choose it voluntarily. Autonomy, Inc.'s arguments explicitly depend on the medical profession's ability to reliably predict terminal status, and the capacity of society and the law to implement a double standard of suicide prevention and suicide assistance based on terminal status. Not Dead Yet's central argument is that such a double standard based on health status constitutes unlawful discrimination under the Americans With Disabilities Act. The author highlights data from the Oregon Reports demonstrating that lethal prescriptions were issued to people who were not terminally ill under the law's definition, and examines various problems of implementation and enforcement under the Oregon and Washington assisted suicide statutes. Particular attention is given to
Lohner, Johannes; Konrad, Norbert
Self-injurious behavior involving deliberate self-harm and suicide attempts by inmates while under custodial authority is a major problem for prisons and jails (prevalence, legal obligation for suicide prevention, and stress for officers). The differentiation of "serious" vs. "non-serious" and often manipulative suicide attempts as distinct phenomena, each with its own clinical features, is controversially discussed in current literature and a challenge for every diagnostician. If distinct clinical presentations and histories can be observed, an estimation of the seriousness of each act of self-injurious behavior can be simplified, whereby appropriate treatment of the individual case becomes possible. The aim of the study was to find differences between self-injurious behavior of "low seriousness" (i.e. low lethality and low suicidal intent) and of "high seriousness". Therefore, inmates showing self-injurious behavior were divided into subgroups of deliberate self-harm and suicide attempters on the basis of the act's intent and lethality. This was followed by a comparison of the clinical presentations of the individual inmates constituting the subgroups. Hence, 49 inmates showing self-injurious behavior were interviewed and tested with a variety of instruments (SCID-I and II, PCL-R, BDI-II, BHS, BSS, SIS, etc.), and their prison and health files were examined. The results indicate significant correlations between seriousness and some demographic, prison-related variables as well as different measures of depression. Negative, but nonsignificant correlations could be observed with regard to cluster B personality disorders. The PCL-R total score as well as PCL-R factor 1 showed a statistical trend for negative correlations with measures of seriousness. Inmates showing deliberate self-harm and suicide attempters seem to differ in a number of ways. Implications on how the individual prisoner should be treated are discussed.
Feinstein, Anthony; Pavisian, Bennis
Mortality rates are elevated in people with multiple sclerosis (MS) relative to the general population. There is, however, some uncertainty whether suicide contributes to this. Epidemiological data suggest that the standardized mortality ratio (SMR) for suicide in MS is approximately twice that of the general population with younger males in the first few years following diagnosis most at risk. Rates of suicidal intent, a potential harbinger of more self-destructive behavior, are also elevated, but the frequency with which intent is followed by suicide is not known. Depression, severity of depression, social isolation, and alcohol abuse are associated with thoughts of suicide. The variables linked with suicide and suicidal intent are therefore well defined and should be readily available from routine clinical inquiry. While vigilance on the part of clinicians is required, particularly in the context of high-risk patients, it is also recognized that prevention is dependent on full disclosure of intent.
Naud, Hélène; Daigle, Marc S
To measure the predictive power of the Suicide Probability Scale (SPS) in a male inmate population (federal penitentiary) with the added contribution of actuarial data. SPS scores and data from the files of 518 inmates were analyzed in relation to their suicidal behaviors over the following 10 years. During this period, 12 inmates committed suicide (2.32%), 43 engaged in non-lethal self-harm (8.3%) and 15 expressed serious suicidal intention (2.9%), for a total of 70 (13.51%) who manifested at least one form of suicidal behavior. The records of the 518 inmates allowed identifying seven actuarial variables (out of 24 documented) that distinguished the group that acted out. These variables were tested in combination with the SPS score to determine the best predictive models of suicidal behavior. Depending on type of suicidal behavior and on observation period, the following seven variables could prove useful in improving the predictive capacity of the SPS: age, prior suicidal behavior, borderline personality disorder, length of sentence, number of sentences, prior incarceration in a provincial prison, and juvenile priors. However, analyses did not allow developing a better predictive model for the specific subgroup of suicide completers. SPS is improved when adding actuarial data. Copyright © 2013 Elsevier Ltd. All rights reserved.
Brown, Gregory K; Ten Have, Thomas; Henriques, Gregg R; Xie, Sharon X; Hollander, Judd E; Beck, Aaron T
Suicide attempts constitute a major risk factor for completed suicide, yet few interventions specifically designed to prevent suicide attempts have been evaluated. To determine the effectiveness of a 10-session cognitive therapy intervention designed to prevent repeat suicide attempts in adults who recently attempted suicide. Randomized controlled trial of adults (N = 120) who attempted suicide and were evaluated at a hospital emergency department within 48 hours of the attempt. Potential participants (N = 350) were consecutively recruited from October 1999 to September 2002; 66 refused to participate and 164 were ineligible. Participants were followed up for 18 m