Pathways to Late-Life Suicidal Behavior: Cluster Analysis and Predictive Validation of Suicidal Behavior in a Sample of Older Adults With Major Depression.

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Szanto, Katalin; Galfalvy, Hanga; Vanyukov, Polina M; Keilp, John G; Dombrovski, Alexandre Y

Clinical heterogeneity is a key challenge to understanding suicidal risk, as different pathways to suicidal behavior are likely to exist. We aimed to identify such pathways by uncovering latent classes of late-life depression cases and relating them to prior and future suicidal behavior. Data were collected from June 2010 to September 2015. In this longitudinal study we examined distinct associations of clinical and cognitive/decision-making factors with suicidal behavior in 194 older (50+ years) nondemented, depressed patients; 57 nonpsychiatric healthy controls provided benchmark data. The DSM-IV was used to establish diagnostic criteria. We identified multivariate patterns of risk factors, defining clusters based on personality traits, perceived social support, cognitive performance, and decision-making in an analysis blinded to participants' history of suicidal behavior. We validated these clusters using past and prospective suicidal ideation and behavior. Of 5 clusters identified, 3 were associated with high risk for suicidal behavior: (1) cognitive deficits, dysfunctional personality, low social support, high willingness to delay future rewards, and overrepresentation of high-lethality attempters; (2) high-personality pathology (ie, low self-esteem), minimal or no cognitive deficits, and overrepresentation of low-lethality attempters and ideators; (3) cognitive deficits, inability to delay future rewards, and similar distribution of high- and low-lethality attempters. There were significant between-cluster differences in number (P suicide attempts and in the likelihood of future suicide attempts (P = .010, 30 attempts by 22 patients, 2 fatal) and emergency psychiatric hospitalizations to prevent suicide (P = .005, 31 participants). Three pathways to suicidal behavior in older patients were found, marked by (1) very high levels of cognitive and dispositional risk factors suggesting a dementia prodrome, (2) dysfunctional personality traits, and (3) impulsive

Suicidal behavior and self-harm in girls with eating disorders

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Koutek J

2016-04-01

Full Text Available Jiri Koutek, Jana Kocourkova, Iva Dudova Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic Abstract: Comorbid psychopathology, including self-harm and suicidal behavior, is often found in patients with eating disorders. To better understand the reasons for high comorbid psychopathology among eating disorders, self-harm, and suicidal behavior, we examined this comorbidity in female patients hospitalized with eating disorders. In a sample of 47 girls admitted for anorexia nervosa, atypical anorexia nervosa, and bulimia nervosa, 72% had depressive symptoms, 11% had obsessive-compulsive symptoms, 9% had anxiety disorder, 23% had substance abuse, and 57% had disharmonious personality development. Suicidal behavior was present in 60% of patients and self-harm in 49%. Association was found between self-harm and suicidality. In all, 68% of girls with eating disorders had a positive score in the Children’s Depression Inventory questionnaire and 62% of them in the Child Adolescent Suicidal Potential Index questionnaire. Clinical examination of girls with eating disorders should focus on identifying the risk of suicidal behavior and self-harm. Keywords: eating disorders, child, adolescent, self-harm, suicidal behavior

Restrictive Emotionality, Depressive Symptoms, and Suicidal Thoughts and Behaviors among High School Students

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Jacobson, Colleen M.; Marrocco, Frank; Kleinman, Marjorie; Gould, Madelyn S.

2011-01-01

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…

SUICIDAL BEHAVIOR IN CHILDREN AND ADOLESCENTS

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Evrim AKTEPE

2005-04-01

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

Suicide to harass others: clues from mythology to understanding suicide bombing attacks.

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Preti, Antonio

2006-01-01

Suicide by revenge, the Samsonic suicide, and the suicide by devotio, all described in classical mythology and also reported in the ethnographic literature, belong to the same class of suicidal behaviors as kamikaze suicide and the suicide bombing attack: suicide to harass and burden others or suicide with a hostile intent. The lack of a social dimension to share in a positive manner may lead an individual to integrate him/herself in another social structure, e.g., a military organization, which allows the individual to express his/her desires and personal identity only by destroying others and themselves. The dynamics of these forms of suicide are also likely to work in other displays of life-threatening behavior, such as family annihilation, mass murder, and spree killing. A more thorough investigation of the dynamics operating in suicide bombing attacks could, therefore, contribute to preventative strategies against violence at large.

Does Religiosity Predict Suicidal Behavior?

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David Lester

2017-10-01

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.

Trait gratitude and suicidal ideation and behavior: an exploratory study.

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Krysinska, Karolina; Lester, David; Lyke, Jennifer; Corveleyn, Jozef

2015-01-01

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.

Posttraumatic Stress Disorder and Suicidal Behavior: Indirect Effects of Impaired Social Functioning.

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Dutton, Courtney E; Rojas, Sasha M; Badour, Christal L; Wanklyn, Sonya G; Feldner, Matthew T

2016-01-01

Social functioning is negatively impacted by the presence of PTSD, while increasing risk of suicidal behavior among individuals with PTSD. However, little research has examined the specific role of social functioning in the association between PTSD and suicidal behavior. Parallel multiple indirect effects analyses were performed to understand the unique indirect effects of four aspects of social functioning. Indirect effects of PTSD on suicidal ideation were significant through three pathways: interpersonal conflict, perceived family support, and interpersonal apprehension. Perceived family support was the only indirect pathway significantly associated with suicide attempt. Findings suggest that social functioning should be assessed and potentially targeted during treatment to help modify the risk for suicidal behavior among individuals with PTSD.

Understanding Suicide among Sexual Minority Youth in America: An Ecological Systems Analysis

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Hong, Jun Sung; Espelage, Dorothy L.; Kral, Michael J.

2011-01-01

This article examines major risk factors for suicide among sexual minority youth using Bronfenbrenner's ecological systems theory. Although suicidal behavior among sexual minority youth is a major public concern in the United States, understanding of this phenomenon has been limited since the majority of empirical research studies have addressed…

Predictive Validity of the Columbia-Suicide Severity Rating Scale for Short-Term Suicidal Behavior

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Conway, Paul Maurice; Erlangsen, Annette; Teasdale, Thomas William

2017-01-01

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 behavior predicted......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 high risk of suicide. The study was conducted in 2014 on a sample of 85...... 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 predicted suicidal behavior...

Characterization of impulsivity in suicide completers: clinical, behavioral and psychosocial dimensions.

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Zouk, Hana; Tousignant, Michel; Seguin, Monique; Lesage, Alain; Turecki, Gustavo

2006-06-01

Impulsivity is a personality trait thought to be linked to suicide. Yet, not all suicides are highly impulsive. We aimed to better understand clinical, behavioral and psychosocial correlates of the association between suicide and impulsive behavior. One hundred sixty four suicide cases with impulsivity scores based on the Barratt Impulsivity Scale (BIS) were investigated. To examine the most extreme phenotypes, one hundred suicide cases, representing subjects with BIS scores above the 70th percentile and below the 30th percentile, were compared on clinical, behavioral and psychosocial suicide risk factors assessed by way of structured psychological autopsy methods with best informants. The impulsive suicide cases were significantly younger, exhibited higher measures of aggressive behavior, and were more likely to have a cluster B diagnosis as well as lifetime and 6-month prevalence of alcohol and drug abuse/dependence. They also differed significantly from their non-impulsive counterparts on all subscales of the TCI except for Harm Avoidance and Reward Dependence. Impulsive suicide completers were more likely to have had a history of childhood abuse and to have experienced a triggering life event up to a week preceding their death. A multivariate analysis indicated that 6-month prevalence of substance abuse/dependence and high aggressive behavior remained significant even after controlling for other significant variables. This study was carried out using proxy-based interviews. Most of the known clinical and behavioral risk factors commonly associated with suicide are particularly valid for impulsive suicide completers. Further, triggering and adverse life events seem to play a role primarily in impulsive suicide.

Social Aspects of Suicidal Behavior and Prevention in Early Life: A Review

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Alan Apter

2012-03-01

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.

Suicidal Behavior in Eating Disorders

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Bedriye Oncu

2013-03-01

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.

Latina Adolescents Health Risk Behaviors and Suicidal Ideation and Suicide Attempts: Results from the National Youth Risk Behavior Survey 2001-2013.

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Price, James H; Khubchandani, Jagdish

2017-06-01

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.

Understanding Suicidal Ideation in Latino/a Adolescents Living in Puerto Rico.

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Duarté-Vélez, Yovanska; Jones, Richard N; Spirito, Anthony

2017-12-05

Puerto Rican adolescents, as well as other Latinos/as, have been identified at higher risk for suicidal ideation and attempts compared to other ethnic groups. However, research designed to better understand suicidality among Puerto Rican adolescents is rare. A socio-cognitive vulnerability model of suicidal ideation was tested in adolescents living in Puerto Rico. Multiple group path analyses were performed to assess the effect of self-reported socio-environmental and vulnerability factors on suicidal ideation, by sex, in 233 students from the metropolitan area of San Juan, Puerto Rico. Overall, the model explained a large amount of the variance in suicidal ideation (r 2  = .59 for females and r2 = .48 for males). Depressive symptoms had the strongest total effect on suicidal ideation for both sexes (r = .69 for females and r = .53 for males) and negative life events were the most salient socio-environmental factor. Hopelessness had a direct effect on suicidal ideation for males only. Externalizing behaviors had a direct effect on suicidal ideation for both males and females, but it was particularly strong for females. Results support the mediating role of vulnerability factors and the differential importance of socio-environmental and vulnerability factors in understanding suicidal ideation among Puerto Rican adolescents. The relevance of exploring different developmental paths to suicidal ideation, separately by sex, is discussed.

Single-Item Measurement of Suicidal Behaviors: Validity and Consequences of Misclassification.

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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.

Suicidal and online: how do online behaviors inform us of this high-risk population?

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Harris, Keith M; McLean, John P; Sheffield, Jeanie

2014-01-01

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.

Factors associated with suicidal behaviors in mainland China: a meta-analysis

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Li Ying

2012-07-01

Full Text Available Abstract Background Suicide is a major public health issue in China. Studies of suicide risk factors have reported both inconsistent and inconclusive results. This review aimed to determine suicide risk factors in China. Methods Medline/PubMed, EMBASE, CNKI (China National Knowledge Infrastructure and VIP (Chinese Journal of Science and Technology of VIP were searched for relevant reports. Two investigators independently assessed the eligibility of identified studies and extracted data. Pooled odds ratios (and 95% confidence intervals were calculated for each factor with Revman 5.0. Results Forty-four studies with 192,362 subjects were included. The pooled results indicated that mood disorders and stressful life events (physical illness, suicide of relatives increased the risk of suicide ideation among the entire population. Socio-family environment (single or remarried parent, study pressure and academic achievement and unhealthy behaviors (smoking, alcohol drinking, and drug use were risk factors for suicide ideation among youth. Unhealthy behaviors (smoking and alcohol drinking, mood disorders, and stressful life events (suicide of relatives were the main risk factors for attempted suicide. Persons living in rural areas, and those with lower education, mood disorders, and/or a history of negative life events had a higher risk of completed suicide. In China, before 2000, females had a significantly higher rate of completed suicide than males, while after 2000, no significant gender difference was found. Conclusions Socio-family environment, lifestyle, life events and psychiatric/psychological factors are associated with suicidal behaviors in China. Further case–control or cohort studies are needed to better understand suicide behaviors in China. Meanwhile, there is an urgent need for comprehensive studies of suicide interventions among high-risk populations.

Depression, delinquency, and suicidal behaviors among college students.

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Bauer, Rebecca L; Chesin, Megan S; Jeglic, Elizabeth L

2014-01-01

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.

Understanding suicide risk within the Research Domain Criteria (RDoC) framework: A meta-analytic review.

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Glenn, Catherine R; Kleiman, Evan M; Cha, Christine B; Deming, Charlene A; Franklin, Joseph C; Nock, Matthew K

2018-01-01

The field is in need of novel and transdiagnostic risk factors for suicide. The National Institute of Mental Health's Research Domain Criteria (RDoC) provides a framework that may help advance research on suicidal behavior. We conducted a meta-analytic review of existing prospective risk and protective factors for suicidal thoughts and behaviors (ideation, attempts, and deaths) that fall within one of the five RDoC domains or relate to a prominent suicide theory. Predictors were selected from a database of 4,082 prospective risk and protective factors for suicide outcomes. A total of 460 predictors met inclusion criteria for this meta-analytic review and most examined risk (vs. protective) factors for suicidal thoughts and behaviors. The overall effect of risk factors was statistically significant, but relatively small, in predicting suicide ideation (weighted mean odds ratio: wOR = 1.72; 95% CI: 1.59-1.87), suicide attempt (wOR = 1.66 [1.57-1.76), and suicide death (wOR = 1.41 [1.24-1.60]). Across all suicide outcomes, most risk factors related to the Negative Valence Systems domain, although effect sizes were of similar magnitude across RDoC domains. This study demonstrated that the RDoC framework provides a novel and promising approach to suicide research; however, relatively few studies of suicidal behavior fit within this framework. Future studies must go beyond the "usual suspects" of suicide risk factors (e.g., mental disorders, sociodemographics) to understand the processes that combine to lead to this deadly outcome. © 2017 Wiley Periodicals, Inc.

Clustering of Adolescent Dating Violence, Peer Violence, and Suicidal Behavior

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Bossarte, Robert M.; Simon, Thomas R.; Swahn, Monica H.

2008-01-01

To understand the co-occurrence of multiple types of violence, the authors developed a behavioral typology based on self-reports of suicidal behaviors, physical violence, and psychological abuse. Using a sample of dating adolescents from a high-risk school district, they identified five clusters of behaviors among the 1,653 students who reported…

Suicidal behavior in the older patient with schizophrenia

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Kasckow, John; Montross, Lori; Prunty, Laurie; Fox, Lauren; Zisook, Sidney

2011-01-01

Little is known about treating elderly suicidal patients with schizophrenia. The purpose of this article is to review the literature dealing with this population and to discuss what is required to advance this field. Most available studies from middle-aged and older individuals suggest that risk factors include hopelessness, lower quality of life, past traumatic events, depressive symptoms, lifetime suicidal ideation and past attempts; it is not clear whether these findings are generalizable to geriatric populations. Although little treatment research has been performed in older suicidal patients with schizophrenia, an integrated psychosocial and pharmacologic approach is recommended. In addition, one recent study augmented antipsychotic treatment with an SSRI (i.e., citalopram) in a sample of middle-aged and older individuals with schizophrenia with subsyndromal depression; in that study, serotonin selective reuptake inhibitor augmentation reduced depressive symptoms and suicidal ideation. More research is required to better understand suicidal behavior in older patients with schizophrenia. PMID:22028735

Predictive Validity of the Columbia-Suicide Severity Rating Scale for Short-Term Suicidal Behavior: A Danish Study of Adolescents at a High Risk of Suicide.

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Conway, Paul Maurice; Erlangsen, Annette; Teasdale, Thomas William; Jakobsen, Ida Skytte; Larsen, Kim Juul

2017-07-03

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 high risk of suicide. The study was conducted in 2014 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 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 predicted suicidal behavior at follow-up over and above suicidal behavior at baseline. Actual suicide attempts at baseline strongly predicted suicide attempts at follow-up. Baseline suicidal ideation severity and intensity did not significantly predict future actual attempts over and above baseline attempts. The suicidal ideation intensity items deterrents and duration were significant predictors of subsequent actual attempts after adjustment for baseline suicide attempts and suicidal behavior of any type, respectively. Suicidal ideation severity and intensity, and the intensity items frequency, duration and deterrents, all significantly predicted any type of suicidal behavior at follow-up, also after adjusting for baseline suicidal behavior. The present study points to an incremental predictive validity of the C-SSRS suicidal ideation scales for short-term suicidal behavior of any type among high-risk adolescents.

Nursing students attitudes across the suicidal behavior

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Nadja Cristiane Lappann Bott

2015-08-01

Full Text Available Objective. Examine the attitudes of nursing students with the suicidal behavior before and after a training course on the subject. Methodology. Performed quantitative, cross-sectional study, with 58 nursing students from a public university in Minas Gerais (Brazil who participated in training on the theme. For data collection were used the Questionnaire of Attitudes Before Suicidal Behavior. The questionnaire was applied just before the start and the end of the training measuring attitudes toward suicidal behavior. Results. Were found statistically significant differences in negative feelings factors on the patient and perception of professional competence (p <0.05. The right factor to suicide was not significantly different among nursing students. Conclusion. The academic training may have influenced positively the desired changes regarding the attitudes of nursing students across the suicidal behavior.

Pathways to Suicidal Behaviors in Childhood

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Greening, Leilani; Stoppelbein, Laura; Fite, Paula; Dhossche, Dirk; Erath, Stephen; Brown, Jacqueline; Cramer, Robert; Young, Laura

2008-01-01

Path analyses were applied to test a model that includes internalizing and externalizing behavior problems as predictors of suicidal behaviors in children. Parents of an inpatient sample of boys (N = 87; M age = 9.81 years) rated the frequency of suicidal ideation and completed standardized measures of behavior problems. Blind raters rated the…

Allergies and suicidal behaviors: a systematic literature review.

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Kõlves, Kairi; Barker, Emma; De Leo, Diego

2015-01-01

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.

Suicide behavior in persons with intellectual disability.

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Merrick, Joav; Merrick, Efrat; Lunsky, Yona; Kandel, Isack

2005-09-08

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.

Suicide Behavior in Persons with Intellectual Disability

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Joav Merrick

2005-01-01

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.

Fractured Identity: A Framework for Understanding Young Asian American Women's Self-harm and Suicidal Behaviors.

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Hahm, Hyeouk Chris; Gonyea, Judith G; Chiao, Christine; Koritsanszky, Luca Anna

2014-01-01

Despite the high suicide rate among young Asian American women, the reasons for this phenomenon remain unclear. This qualitative study explored the family experiences of 16 young Asian American women who are children of immigrants and report a history of self-harm and/or suicidal behaviors. Our findings suggest that the participants experienced multiple types of "disempowering parenting styles" that are characterized as: abusive, burdening, culturally disjointed, disengaged, and gender-prescriptive parenting. Tied to these family dynamics is the double bind that participants suffer. Exposed to multiple types of negative parenting, the women felt paralyzed by opposing forces, caught between a deep desire to satisfy their parents' expectations as well as societal expectations and to simultaneously rebel against the image of "the perfect Asian woman." Torn by the double bind, these women developed a "fractured identity," which led to the use of "unsafe coping" strategies. Trapped in a "web of pain," the young women suffered alone and engaged in self-harm and suicidal behaviors.

The role of mobile phone technology in understanding and preventing suicidal behavior.

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Beurs, D. de; Kirtley, O.; Kerkhof, A.; Portzky, G.; O'Connor, R.C.

2015-01-01

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

Prevention Starts With Awareness: Adoptive Adolescents at High Risk for Suicidal Behavior.

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Morgan, Leslie

2017-09-01

Adolescents are at higher risk for suicide attempts than other age groups. Suicide is now the second leading cause of death in the United States for ages 12 to 18; moreover, the risk of suicide is significantly higher for adoptive teens. In fact, adoptive teenagers have a four times higher rate of suicide attempts than biological children, perhaps due to the underlying nature of adoption, which can involve a pervasive sense of grief and loss for the adoptee. Unresolved anger and sadness from feelings of abandonment-especially when transitioning to adolescence-can cause a seemingly functional child to dissociate through self-harm and eventually demonstrate suicidal behavior. Little evidence-based research exists on the risk factors for adoptive teens who resort to suicidal behavior. Thus, it is vitally important for school nurses to understand the emotional stressors that adolescent adoptees face throughout life to help identify teens at risk for suicide. School districts and registered nurses are well positioned to address this critical health issue through education, assessment, and intervention.

Risk factors that influence suicidal behavior in affective disorders

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Stanojević Albina

2016-01-01

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.

The addictive model of self-harming (non-suicidal and suicidal behavior

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Hilario eBlasco-Fontecilla

2016-02-01

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.

The Addictive Model of Self-Harming (Non-suicidal and Suicidal) Behavior.

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Blasco-Fontecilla, Hilario; Fernández-Fernández, Roberto; Colino, Laura; Fajardo, Lourdes; Perteguer-Barrio, Rosa; de Leon, Jose

2016-01-01

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.

Bullying and suicidal behavior in jails.

NARCIS (Netherlands)

Blaauw, E.; Winkel, F.W.; Kerkhof, A.J.F.M.

2001-01-01

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

Religious commitment, attitudes toward suicide, and suicidal behaviors among college students of different ethnic and religious groups in Malaysia.

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Foo, Xiang Yi; Alwi, Muhd Najib Mohd; Ismail, Siti Irma Fadhillah; Ibrahim, Normala; Osman, Zubaidah Jamil

2014-06-01

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.

Spirituality Moderates Hopelessness, Depression, and Suicidal Behavior among Malaysian Adolescents.

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Talib, Mansor Abu; Abdollahi, Abbas

2017-06-01

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.

Using the Theory of Planned Behavior to Predict College Students' Intention to Intervene With a Suicidal Individual.

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Aldrich, Rosalie S

2015-01-01

Suicide among college students is an issue of serious concern. College peers may effectively intervene with at-risk persons due to their regular contact and close personal relationships with others in this population of significantly enhanced risk. The current study was designed to investigate whether the theory of planned behavior constructs predicted intention to intervene when a college peer is suicidal. Undergraduate students (n = 367) completed an on-line questionnaire; they answered questions about their attitudes, subjective norms, perceived behavioral control regarding suicide and suicide intervention, as well as their intention to intervene when someone is suicidal. The data were analyzed using multiple regression. The statistical significance of this cross-sectional study indicates that the theory of planned behavior constructs predicts self-reported intention to intervene with a suicidal individual. Theory of planned behavior is an effective framework for understanding peers' intention to intervene with a suicidal individual.

[Suicidal behavior: a psychiatric emergency situation, suicide prevention: a psychiatric obligation].

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Wolfersdorf, M; Schneider, B; Schmidtke, A

2015-09-01

In German psychiatry suicidal behavior is seen as sign of a psychiatric crisis in a person in the context of psychopathology, psychodynamics and psychosocial situation. Psychiatric disorders are found in up to 90% of people who commit suicide and the time span following the decision to commit suicide is often very short, within 24 h. Suicide prevention is a central duty and obligation in psychiatry and psychotherapy. This article gives an overview on the current state of knowledge on suicide from a clinical point of view.

Parent-reported suicidal behavior and correlates among adolescents in China.

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Liu, Xianchen; Sun, Zhenxiao; Yang, Yanyun

2008-01-01

Suicidal risk begins to increase during adolescence and is associated with multiple biological, psychological, social, and cultural factors. This study examined the prevalence and psychosocial factors of parent-reported suicidal behavior in Chinese adolescents. A community sample of 1920 adolescents in China participated in an epidemiological study. Parents completed a structured questionnaire including child suicidal behavior, illness history, mental health problems, family history, parenting, and family environment. Multiple logistic regression was used for data analysis. Overall, 2.4% of the sample talked about suicide in the previous 6 months, 3.2% had deliberately hurt themselves or attempted suicide, and 5.1% had either suicidal talk or self-harm. The rate of suicidal behavior increased as adolescents aged. Multivariate logistic regression indicated that the following factors were significantly associated with elevated risk for suicidal behavior: depressive/anxious symptoms, poor maternal health, family conflict, and physical punishment of parental discipline style. Suicidal behavior was reported by parents. No causal relationships could be made based on cross-sectional data. The prevalence rate of parent-reported suicidal behavior is markedly lower than self-reported rate in previous research. Depressive/anxious symptoms and multiple family environmental factors are associated with suicidal behavior in Chinese adolescents.

Correlates of Suicidal Behavior in a Juvenile Detention Population.

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Rohde, Paul; Seeley, John R.; Mace, David E.

1997-01-01

Identifies the correlates of current suicidal ideation and past suicide attempts among 555 adolescents. Results indicate that suicidal behavior in delinquent boys was associated with depression and decreased social connection, whereas suicidal behavior in delinquent girls was associated with impulsivity and instability. Current ideation was…

Forgiveness and Suicidal Behavior: Cynicism and Psychache as Serial Mediators.

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Dangel, Trever J; Webb, Jon R; Hirsch, Jameson K

2018-02-17

Research is burgeoning regarding the beneficial association of forgiveness with numerous health-related outcomes; however, its particular relationship to suicidal behavior has received relatively little attention. Both cynicism and psychache, or agonizing psychological pain, have displayed deleterious associations with suicidal behavior, but have rarely been incorporated into more comprehensive models of suicidal behavior. Consistent with the recent development of a theoretical model regarding the forgiveness-suicidal behavior association, the present study utilized an undergraduate sample of college students (N = 312) to test a mediation-based model of the cross-sectional association of forgiveness with suicidal behavior, as serially mediated by cynicism and psychache. Dispositional forgiveness of self and forgiveness of uncontrollable situations were each indirectly associated with less suicidal behavior via less psychache. Also, dispositional forgiveness of others was indirectly associated with less suicidal behavior via less cynicism and less psychache, in a serial fashion. The present results are consistent with the extent literature on the forgiveness-suicidal behavior association, cynicism, and psychache, and pending future studies, may be utilized to inform further treatment efforts for individuals at a high risk of attempting suicide.

Risk of suicide ideation associated with problem-solving ability and attitudes toward suicidal behavior in university students.

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McAuliffe, Carmel; Corcoran, Paul; Keeley, Helen S; Perry, Ivan J

2003-01-01

The present paper investigates the risk of lifetime suicide ideation associated with problem-solving ability and attitudes toward suicidal behavior in a sample of 328 university students (41% male, 59% female). The response rate was 77% based on the total number of students registered for the relevant courses. A series of questions assessed lifetime suicide ideation, while problem solving and attitudes toward suicide were measured using the Self-Rating Problem Solving scale and four subscales of the Suicide Opinion Questionnaire, respectively (McLeavey, 1986; Domino et al., 1989). Almost one-third of the students surveyed had lifetime suicide ideation. Both genders were similar in terms of their suicide ideation history, problem solving, and attitudes toward suicidal behavior with the exception that male students were more in agreement with the attitude that suicidal behavior lacks real intent. Compared with 2% of nonideators and ideators, one in four planners reported that they would more than likely attempt suicide at some point in their life. Greater agreement with the attitude that suicidal behavior is normal was associated with significantly increased risk of being an ideator, as was poor problem solving and less agreement with the attitude that suicidal behavior is associated with mental illness.

Bullying and Suicidal Ideation and Behaviors: A Meta-Analysis

Science.gov (United States)

Holt, Melissa K.; Vivolo-Kantor, Alana M.; Polanin, Joshua R.; Holland, Kristin M.; DeGue, Sarah; Matjasko, Jennifer L.; Wolfe, Misty; Reid, Gerald

2015-01-01

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

A Prospective Study of Adolescent Suicidal Behavior Following Hospitalization.

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King, Cheryl A.; And Others

1995-01-01

Identifies specific predictors of suicidal behavior in 100 adolescents during a 6-month follow-up period after psychiatric hospitalization. Eighteen percent reported suicidal behavior during the follow-up period, and this behavior was associated with suicidal thoughts, family dysfunction, and dysthymia. It was not associated with initial…

Association between migraine and suicidal behavior among Ethiopian adults.

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Berhane, Hanna Y; Jamerson-Dowlen, Bethannie; Friedman, Lauren E; Berhane, Yemane; Williams, Michelle A; Gelaye, Bizu

2018-02-12

Despite the significant impact of migraine on patients and societies, few studies in low- and middle-income countries (LMICs) have investigated the association between migraine and suicidal behavior. The objective of our study is to examine the extent to which migraines are associated with suicidal behavior (including suicidal ideation, plans, and attempts) in a well-characterized study of urban dwelling Ethiopian adults. We enrolled 1060 outpatient adults attending St. Paul hospital in Addis Ababa, Ethiopia. Standardized questionnaires were used to collect data on socio-demographics, and lifestyle characteristics. Migraine classification was based on the International Classification of Headache Disorders-2 diagnostic criteria. The Composite International Diagnostic Interview (CIDI) was used to assess depression and suicidal behaviors (i.e. ideation, plans and attempts). Multivariable logistic regression models were used to estimate adjusted odds ratio (AOR) and 95% confidence intervals (95% CIs). The prevalence of suicidal behavior was 15.1%, with a higher suicidal behavior among those who had migraines (61.9%). After adjusting for confounders including substance use and socio-demographic factors, migraine was associated with a 2.7-fold increased odds of suicidal behavior (AOR = 2.7; 95% CI 1.88-3.89). When stratified by their history of depression in the past year, migraine without depression was significantly associated with suicidal behavior (AOR: 2.27, 95% Cl: 1.49-3.46). The odds of suicidal behavior did not reach statistical significance in migraineurs with depression (AOR: 1.64, 95% CI: 0.40-6.69). Our study indicates that migraine is associated with increased odds of suicidal behavior in this population. Given the serious public health implications this has, attention should be given to the treatment and management of migraine at a community level.

Suicide Prevention in Schools as Viewed through the Interpersonal-Psychological Theory of Suicidal Behavior

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Joiner, Thomas E., Jr.

2009-01-01

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…

Firearms and suicide in the United States: is risk independent of underlying suicidal behavior?

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Miller, Matthew; Barber, Catherine; White, Richard A; Azrael, Deborah

2013-09-15

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.

Are Suicidal Behaviors Contagious in Adolescence?: Using Longitudinal Data to Examine Suicide Suggestion.

Science.gov (United States)

Abrutyn, Seth; Mueller, Anna S

2014-04-01

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.

Assessment of Suicidal Behavior in a Psychiatric Emergency Room in Lisbon.

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Marques, João Gama; Guerreiro, Diogo Frasquilho; Sampaio, Daniel

2015-01-01

Some studies alerted for the burden of suicidal attempters at emergency rooms. In this study we characterized the suicidal patients admitted to a Portuguese emergency room. For three years, all patients assessed by the first author after suicidal behaviour were included. Suicidal intentionality was evaluated with the Pierce Suicide Intent Scale. Clinical records were searched for follow-up status and satisfaction level was assessed through telephone call. From 120 included patients 70.8% were female, with mean age of 42.35 years. Pierce Suicide Intent Scale suicidal intentionality was low in 30.1%, medium in 59.3%, and high in 10.6% of the sample. The most important predictors of Pierce Suicide Intent Scale intentionality were male gender (p suicide (p Suicide Intent Scale is useful on suicidal behavior assessment at emergency rooms. Highly intentional suicidal behaviour is related to male sex, social problems and personal and familial psychiatric history. The quality of administrative records on this psychiatric emergency room setting are still unacceptable. The most important variables correlated with higher suicidal intentionality are the same described in other countries. Of the reachable patients, one fifth was satisfied with provided follow-up. We still need studies for better understanding of suicidal behaviour observed on this Portuguese emergency room.

Domains of Chronic Stress and Suicidal Behaviors among Inpatient Adolescents

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Pettit, Jeremy W.; Green, Kelly L.; Grover, Kelly E.; Schatte, Dawnelle J.; Morgan, Sharon T.

2011-01-01

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…

[Stigma - risk factor and consequence of suicidal behavior : Implications for suicide prevention].

Science.gov (United States)

Oexle, N; Rüsch, N

2017-11-16

Mental illness, previous suicidal behavior and loss of a relative by suicide are strong risk factors for suicidality. Both mental illness and suicide are stigmatized, which is a burden for those affected and potentially contributes to suicidality among stigmatized individuals. Many consequences of stigma, e. g. social isolation, low self-esteem and hopelessness, are well-known predictors of suicidality. Interventions to reduce stigmatization might therefore be an important component of successful suicide prevention. This paper discusses the currently available knowledge regarding this hypothesis. Many studies confirmed the association between the stigmatization of mental illness and suicidality and there is initial evidence for the influence of suicide stigma and suicidality. Nevertheless, the effectiveness of anti-stigma interventions to reduce suicidality and prevent suicide has not yet been tested. Reducing stigma among members of the general population and mental health care professionals as well as programs to support individuals in coping with stigmatization could be important components of successful suicide prevention.

Adolescent substance use behavior and suicidal behavior for boys and girls: a cross-sectional study by latent analysis approach.

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Wang, Peng-Wei; Yen, Cheng-Fang

2017-12-08

Adolescent suicidal behavior may consist of different symptoms, including suicidal ideation, suicidal planning and suicidal attempts. Adolescent substance use behavior may contribute to adolescent suicidal behavior. However, research on the relationships between specific substance use and individual suicidal behavior is insufficient, as adolescents may not use only one substance or develop only one facet of suicidal behavior. Latent variables permit us to describe the relationships between clusters of related behaviors more accurately than studying the relationships between specific behaviors. Thus, the aim of this study was to explore how adolescent substance use behavior contributes to suicidal behavior using latent variables representing adolescent suicidal and substance use behaviors. A total of 13,985 adolescents were recruited using a stratified random sampling strategy. The participants indicated whether they had experienced suicidal ideation, planning and attempts and reported their cigarette, alcohol, ketamine and MDMA use during the past year. Latent analysis was used to examine the relationship between substance use and suicidal behavior. Adolescents who used any one of the above substances exhibited more suicidal behavior. The results of latent variables analysis revealed that adolescent substance use contributed to suicidal behavior and that boys exhibited more severe substance use behavior than girls. However, there was no gender difference in the association between substance use and suicidal behavior. Substance use behavior in adolescents is related to more suicidal behavior. In addition, the contribution of substance use to suicidal behavior does not differ between genders.

The Role of Cytokines in the Pathophysiology of Suicidal Behavior

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Ganança, Licínia; Oquendo, Maria A.; Tyrka, Audrey R.; Cisneros-Trujillo, Sebastian; Mann, J. John; Sublette, M. Elizabeth

2016-01-01

Objective Immune dysregulation has been implicated in depression and other psychiatric disorders. What is less clear is how immune dysregulation can affect risk of suicidal behavior. We reviewed the scientific literature concerning cytokines related to suicidal ideation, suicidal behavior and suicide, and surveyed clinical and neurobiological factors associated with cytokine levels that may modulate effects of inflammation on suicide risk. Methods We searched PubMed, Embase, Scopus and PsycINFO for relevant studies published from 1980 through February, 2015. Papers were included if they were written in English and focused on cytokine measurements in patients with suicidal behaviors. Results The literature search yielded 22 studies concerning cytokines and suicidal ideation, suicide attempts or suicide completion. The most consistent finding was elevated interleukin (IL)-6, found in 8 out of 14 studies, in CSF, blood, and postmortem brain. In one study, IL-6 in CSF was also found to be higher in violent than nonviolent attempters and to correlate with future suicide completion. Low plasma IL-2 was observed in 2 studies of suicide attempters, while divergent results were seen for tumor necrosis factor (TNF)-α, interferon (IFN)-γ, transforming growth factor (TGF)-β, IL-4, and soluble Il-2 receptors. Conclusions Given the complexity suggested by the heterogenous cytokine findings, putative mediators and moderators of inflammation on suicidal behavior merit further study. Elevated IL-6 was the most robust cytokine finding, associated with suicidal ideation and both nonfatal suicide attempts and suicides. Future studies should evaluate the predictive value of high IL-6, consider how this may alter brain function to impact suicidal behavior, and explore the potential beneficial effects of reducing IL-6 on suicide risk. PMID:26546783

Subtyping borderline personality disorder by suicidal behavior.

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Soloff, Paul H; Chiappetta, Laurel

2012-06-01

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.

Perceived social support buffers the impact of PTSD symptoms on suicidal behavior: implications into suicide resilience research.

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Panagioti, M; Gooding, P A; Taylor, P J; Tarrier, N

2014-01-01

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.

Suicidal ideation and suicidal behavior according to the C-SSRS in a European cohort of Huntington's disease gene expansion carriers.

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van Duijn, Erik; Vrijmoeth, Eslie M; Giltay, Erik J; Bernhard Landwehrmeyer, G

2018-03-01

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.

Fractured Identity: A Framework for Understanding Young Asian American Women’s Self-harm and Suicidal Behaviors

OpenAIRE

Hahm, Hyeouk Chris; Gonyea, Judith G.; Chiao, Christine; Koritsanszky, Luca Anna

2014-01-01

Despite the high suicide rate among young Asian American women, the reasons for this phenomenon remain unclear. This qualitative study explored the family experiences of 16 young Asian American women who are children of immigrants and report a history of self-harm and/or suicidal behaviors. Our findings suggest that the participants experienced multiple types of “disempowering parenting styles” that are characterized as: abusive, burdening, culturally disjointed, disengaged, and gender-prescr...

Are Suicidal Behaviors Contagious in Adolescence?: Using Longitudinal Data to Examine Suicide Suggestion*

Science.gov (United States)

Abrutyn, Seth; Mueller, Anna S.

2015-01-01

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

Association Between Religion and Suicidal Behaviors in Cancer Patients.

Science.gov (United States)

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.

Mental health and suicidal behavior among graduate students.

Science.gov (United States)

Garcia-Williams, Amanda G; Moffitt, Lauren; Kaslow, Nadine J

2014-10-01

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

Sociodemographic Antecedent Validators of Suicidal Behavior: A Review of Recent Literature.

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Conejero, Ismael; Lopez-Castroman, Jorge; Giner, Lucas; Baca-Garcia, Enrique

2016-10-01

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.

Psychotic Depression and Suicidal Behavior.

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Fredriksen, Kristin J; Schoeyen, Helle K; Johannessen, Jan O; Walby, Fredrik A; Davidson, Larry; Schaufel, Margrethe A

2017-01-01

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.

Youth Suicidal Behavior: An Introduction and Overview

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Miller, David N.; Eckert, Tanya L.

2009-01-01

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…

Adolescent substance use behavior and suicidal behavior for boys and girls: a cross-sectional study by latent analysis approach

OpenAIRE

Wang, Peng-Wei; Yen, Cheng-Fang

2017-01-01

Background Adolescent suicidal behavior may consist of different symptoms, including suicidal ideation, suicidal planning and suicidal attempts. Adolescent substance use behavior may contribute to adolescent suicidal behavior. However, research on the relationships between specific substance use and individual suicidal behavior is insufficient, as adolescents may not use only one substance or develop only one facet of suicidal behavior. Latent variables permit us to describe the relationships...

Suicide and suicidal behavior

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... than prescribed medicines) can reduce the risk of suicide. In homes with children or teenagers: Keep all prescription medicines high up ... or attempted suicide. Alternative Names Depression - suicide; Bipolar - suicide ... in children Depression among the elderly References American Psychiatric Association. ...

Technologies for Assessing Behavioral and Cognitive Markers of Suicide Risk

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2017-10-01

assessing behavioral and cognitive markers of risk for suicide among U.S. Army National Guard personnel. Journal of Environmental Research and Public Policy...effective ways to prevent injury and death from suicide • No reliable method for predicting suicide risk in military personnel • Behavioral (e.g...AWARD NUMBER: W81XWH-15-1-0632 TITLE: Technologies for Assessing Behavioral and Cognitive Markers of Suicide Risk PRINCIPAL INVESTIGATOR: Brian

Childhood experiences and repeated suicidal behavior

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Krarup, Gertrud; Nielsen, Bent; Rask, P

1991-01-01

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...... 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....... 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...

The Role of Affect in Suicidal Thoughts and Behaviors

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Yamokoski, Cynthia A.; Scheel, Karen R.; Rogers, James R.

2011-01-01

Risk factors, theoretical explanations, and treatment suggestions for suicidal behaviors have historically focused largely on cognitions, but a more comprehensive picture may be provided by examining the role of affect in suicidal thoughts and behaviors. In the current study the link between affect and suicide within the theoretical framework of…

[Non-Suicidal Self-Injury (NSSI) and Suicidal Behavior Disorder in the DSM-5].

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Plener, Paul L; Kapusta, Nestor D; Brunner, Romuald; Kaess, Michael

2014-11-01

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.

Effect of Exposure to Suicidal Behavior on Suicide Attempt in a High-Risk Sample of Offspring of Depressed Parents

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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.

2010-01-01

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…

Life adversities and suicidal behavior in young individuals: a systematic review.

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Serafini, Gianluca; Muzio, Caterina; Piccinini, Giulia; Flouri, Eirini; Ferrigno, Gabriella; Pompili, Maurizio; Girardi, Paolo; Amore, Mario

2015-12-01

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.

How do clinicians and suicide attempters understand suicide attempt impulsivity? A qualitative study.

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Rimkeviciene, Jurgita; O'Gorman, John; De Leo, Diego

2016-01-01

Inconsistencies in the definition of impulsive suicide attempts hamper research integration. To expand the currently limited data on how this construct is used in clinical practice, researchers interviewed eight suicide attempters to create timelines of their suicide process, then had seven experienced clinicians review these timelines. Thematic analysis of the patient and clinician data revealed three themes: "thinking out," build-up, and unclear intentionality. The results imply that assessing build-up of agitation and exhaustion symptoms can contribute to understanding acuteness of suicide risk. In addition, uncertainty about one's intentions during the attempt should not be equated to low intent to die.

The Suicidal Narrative and Its Relationship to the Suicide Crisis Syndrome and Recent Suicidal Behavior.

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Cohen, Lisa Janet; Gorman, Bernard; Briggs, Jessica; Jeon, Min Eun; Ginsburg, Tal; Galynker, Igor

2018-02-04

In this study, we introduce the construct of the suicidal narrative, a hypothetical personal narrative linked to imminent suicide, and explore its relationship to near-term suicidal risk and the suicide crisis syndrome (SCS). Psychiatric outpatients (N = 289) were administered the Columbia Suicide-Severity Rating Scale (C-SSRS), Suicide Crisis Inventory (SCI), and Suicide Narrative Inventory (SNI), a novel instrument combining the documented risk factors of Thwarted Belongingness, Perceived Burdensomeness, Humiliation, Social Defeat, Goal Disengagement, and Goal Reengagement. Dimensional measures of past month, lifetime, and past suicidal phenomena, incorporating ideation and behavior, were calculated from the C-SSRS. Structural equation modeling was used to explore the interaction among variables. Factor analysis of the SNI yielded two orthogonal factors, termed Interpersonal and Goal Orientation. The former factor was comprised of Perceived Burdensomeness, Social Defeat, Humiliation, and Thwarted Belongingness, the latter of Goal Disengagement and Goal Reengagement. The Interpersonal factor correlated with both SCS severity and suicidal phenomena in each time frame and the Goal Orientation factor with no other variable. As hypothesized, the proposed model was significant for the past month only. Our findings support the construct of the suicidal narrative and its function as a near-term suicidal risk factor. © 2018 The American Association of Suicidology.

A genome-wide copy number variant study of suicidal behavior.

Directory of Open Access Journals (Sweden)

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.

Self-Compassion and Suicidal Behavior in College Students: Serial Indirect Effects via Depression and Wellness Behaviors

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Kelliher Rabon, Jessica; Sirois, Fuschia M.; Hirsch, Jameson K.

2018-01-01

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…

Suicide-related behaviors and anxiety in children and adolescents: a review.

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Hill, Ryan M; Castellanos, Daniel; Pettit, Jeremy W

2011-11-01

This paper reviews empirical evidence of the association between suicide-related behaviors and anxiety among children and adolescents. It begins with a review of suicide-related behaviors and anxiety, discusses methodological issues related to measurement, and reviews empirical findings published since the last review of this topic in 1988. Evidence is summarized on four criteria necessary to establish anxiety as a causal risk factor for suicide-related behaviors among children and adolescents. There is consistent evidence for a significant association between anxiety and suicide-related behaviors (Criterion 1). Evidence that the influence of anxiety on suicide-related behaviors is not due to a third variable (Criterion 2) is mixed and hindered by methodological limitations. The literature is also unclear as to whether anxiety temporally precedes suicide-related behaviors (Criterion 3). Finally, this review found no evidence to support or refute anxiety's stability independent of and across instances of suicide-related behaviors (Criterion 4). Theoretical and clinical implications of these findings and directions for future research are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

Theories of suicidal behavior applied to Sylvia Plath.

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Lester, D

1998-01-01

The suicide of Sylvia Plath is examined from the perspective of 15 theories of suicidal behavior and is found to fit best with psychoanalytic and cognitive theories of suicide, in particular those of Aaron Beck, Henry Murray, and Edwin Shneidman.

Internet use and suicidal behaviors: internet as a threat or opportunity?

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Robert, Anna; Suelves, Josep Maria; Armayones, Manuel; Ashley, Sivakamy

2015-04-01

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.

[Association of loneliness, impulsivity and alcohol use with suicidal behavior in adolescents].

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Salvo G, Lilian; Castro S, Andrea

2013-04-01

Suicide and suicide attempts are public health problems. Their prevention requives the detection of predictor factors. To determine the predictive valué of loneliness, impulsivity and alcohol use on suicidal behavior in adolescents. Suicidal behavior, Loneliness (UCLA), Impulsivity (Barratt) scales and the Alcohol Use Disorders Identification Test (AUDIT), were applied to 763 high school students aged 14 to 19 years (49% males), living in Chillan, Chile. Nineteen percent of participants had attempted suicide and 34.3% had suicidal ideation. Loneliness, impulsivity and alcohol use were directly related to suicidal behavior. These predictors explained 31 % of the suicidal behavior. The most important risk factor was loneliness, followed by femóle gender, impulsivity and alcohol use. Loneliness, impulsivity and alcohol use are risk factors for suicide among adolescents. Women are at higher risk than men.

Suicidal Desire and the Capability for Suicide: Tests of the Interpersonal-Psychological Theory of Suicidal Behavior among Adults

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Van Orden, Kimberly A.; Witte, Tracy K.; Gordon, Kathryn H.; Bender, Theodore W.; Joiner, Thomas E., Jr.

2008-01-01

The interpersonal-psychological theory of suicidal behavior (T. E. Joiner, 2005) proposes that an individual will not die by suicide unless he or she has both the desire to die by suicide and the ability to do so. Three studies test the theory's hypotheses. In Study 1, the interaction of thwarted belongingness and perceived burdensomeness…

Adolescent suicide and health risk behaviors: Rhode Island's 2007 Youth Risk Behavior Survey.

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Jiang, Yongwen; Perry, Donald K; Hesser, Jana E

2010-05-01

Suicide is the third-leading cause of death among high school students in the U.S. This study examined the relationships among indicators of depressed mood, suicidal thoughts, suicide attempts, and demographics and risk behaviors in Rhode Island high school students. Data from Rhode Island's 2007 Youth Risk Behavior Survey were utilized for this study. The statewide sample contained 2210 randomly selected public high school students. Data were analyzed in 2008 to model for each of five depressed mood/suicide indicators using multivariable logistic regression. By examining depressed mood and suicide indicators through a multivariable approach, the strongest predictors were identified, for multiple as well as specific suicide indicators. These predictors included being female, having low grades, speaking a language other than English at home, being lesbian/gay/bisexual/unsure of sexual orientation, not going to school as a result of feeling unsafe, having been a victim of forced sexual intercourse, being a current cigarette smoker, and having a self-perception of being overweight. The strength of associations between three factors (immigrant status, feeling unsafe, and having forced sex) and suicide indicators adds new information about potential predictors of suicidal behavior in adolescents. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Sadness, suicide, and sexual behavior in Arkansas: results from the youth risk behavior survey 2011.

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Kindrick, Clint; Gathright, Molly; Cisler, Josh M; Messias, Erick

2013-12-01

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.

Nonsuicidal Self-Injury and Suicidal Behavior: A Latent Class Analysis among Young Adults

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Hamza, Chloe A.; Willoughby, Teena

2013-01-01

Although there is a general consensus among researchers that engagement in nonsuicidal self-injury (NSSI) is associated with increased risk for suicidal behavior, little attention has been given to whether suicidal risk varies among individuals engaging in NSSI. To identify individuals with a history of NSSI who are most at risk for suicidal behavior, we examined individual variability in both NSSI and suicidal behavior among a sample of young adults with a history of NSSI (N = 439, Mage = 19.1). Participants completed self-report measures assessing NSSI, suicidal behavior, and psychosocial adjustment (e.g., depressive symptoms, daily hassles). We conducted a latent class analysis using several characteristics of NSSI and suicidal behaviors as class indicators. Three subgroups of individuals were identified: 1) an infrequent NSSI/not high risk for suicidal behavior group, 2) a frequent NSSI/not high risk for suicidal behavior group, and 3) a frequent NSSI/high risk for suicidal behavior group. Follow-up analyses indicated that individuals in the ‘frequent NSSI/high risk for suicidal behavior’ group met the clinical-cut off score for high suicidal risk and reported significantly greater levels of suicidal ideation, attempts, and risk for future suicidal behavior as compared to the other two classes. Thus, this study is the first to identity variability in suicidal risk among individuals engaging in frequent and multiple methods of NSSI. Class 3 was also differentiated by higher levels of psychosocial impairment relative to the other two classes, as well as a comparison group of non-injuring young adults. Results underscore the importance of assessing individual differences in NSSI characteristics, as well as psychosocial impairment, when assessing risk for suicidal behavior. PMID:23544113

Constructing the Suicide Risk Index (SRI): does it work in predicting suicidal behavior in young adults mediated by proximal factors?

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O'Connor, Maebh; Dooley, Barbara; Fitzgerald, Amanda

2015-01-01

Suicide is a key concern among young adults. The aim of the study was to (1) construct a suicide risk index (SRI) based on demographic, situational, and behavioral factors known to be linked to suicidal behavior and (2) investigate whether the association between the SRI and suicidal behavior was mediated by proximal processes (personal factors, coping strategies, and emotional states). Participants consisted of 7,558 individuals aged 17-25 years (M = 20.35, SD = 1.91). Nearly 22% (n = 1,542) reported self-harm and 7% (n = 499) had attempted suicide. Mediation analysis revealed both a direct effect (ß = .299, 95% CI = [.281, .317], p suicidal behavior. The strongest mediators were levels of self-esteem, depression, and avoidant coping. Interventions to increase self-esteem, reduce depression, and encourage adaptive coping strategies may prevent suicidal behavior in young people.

A systematic review of social factors and suicidal behavior in older adulthood

DEFF Research Database (Denmark)

Fässberg, Madeleine Mellqvist; van Orden, Kimberly A; Duberstein, Paul

2012-01-01

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......Suicide in later life is a global public health problem. The aim of this review was to conduct a systematic analysis of studies with comparison groups that examined the associations between social factors and suicidal behavior (including ideation, non-fatal suicidal behavior, or deaths) among...... suicide risk, especially among men....

Available Supports and Coping Behaviors of Mental Health Social Workers Following Fatal and Nonfatal Client Suicidal Behavior

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Ting, Laura; Jacobson, Jodi M.; Sanders, Sara

2008-01-01

Research indicates that mental health social workers risk being confronted with fatal and nonfatal client suicidal behaviors during professional practice. Although reactions to client suicidal behavior have been documented, there is little empirical evidence about coping behaviors and available supports following client suicidal behavior. This…

Wolfram syndrome and suicide: Evidence for a role of WFS1 in suicidal and impulsive behavior.

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Sequeira, Adolfo; Kim, Caroline; Seguin, Monique; Lesage, Alain; Chawky, Nadia; Desautels, Alex; Tousignant, Michel; Vanier, Claude; Lipp, Olivier; Benkelfat, Chawki; Rouleau, Guy; Turecki, Gustavo

2003-05-15

There is evidence suggesting that subjects affected with the Wolfram syndrome (WFS) and normal carriers present an increased risk of psychiatric disorders, particularly depression and suicidal behavior. We investigated a possible role of the gene involved in WFS (WFS1) in the neurobiology of suicide and the potential modulatory effect on traits associated to suicidal behavior. Genetic variation at WFS1 (H611R, R456H, and I333V) was investigated in 111 suicide victims and 129 normal controls. Possible effects on psychopathology and behavioral traits were investigated in a subsample of suicide cases (N = 31) for whom phenotyping was carried out by means of structured psychiatric interviews and questionnaires adapted for psychological autopsies. We found a significantly higher frequency of the 611R/611R genotype in suicide completers as compared to controls (chi(2) = 19.21, df=2, P = 0.001). Suicide completers with this genotype had higher scores on measures of impulsivity (t = -3.15, df = 15.3, P = 0.006); novelty seeking (NS) (t = -3.35, df = 13.8, P = 0.005); and conversely, lower scores of persistence (t = 2.4, df = 16.6, P = 0.028). Scores of impulsivity and NS remained higher in subjects with the associated genotype after adjusting for age, gender, and psychopathology. These results suggest a role for WFS1 in the pathophysiology of impulsive suicide, and are consistent with previous clinical reports suggesting an increased risk of suicidal behavior in WFS homozygotes and heterozygotes. However, these findings are preliminary and should be confirmed in independent samples. Copyright 2003 Wiley-Liss, Inc.

Identifying Adolescents at Highly Elevated Risk for Suicidal Behavior in the Emergency Department

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Berona, Johnny; Czyz, Ewa; Horwitz, Adam G.; Gipson, Polly Y.

2015-01-01

Abstract Objective: The feasibility and concurrent validity of adolescent suicide risk screening in medical emergency departments (EDs) has been documented. The objectives of this short-term prospective study of adolescents who screened positive for suicide risk in the ED were: 1) to examine adolescents' rate of suicidal behavior during the 2 months following their ED visits and compare it with reported rates for psychiatric samples; and 2) to identify possible predictors of acute risk for suicidal behavior in this at-risk sample. Method: Participants were 81 adolescents, ages 14–19 years, seeking services for psychiatric and nonpsychiatric chief complaints, who screened positive for suicide risk because of recent suicidal ideation, a suicide attempt, and/or depression plus alcohol or substance misuse. A comprehensive assessment of suicidal behavior, using the Columbia-Suicide Severity Rating Scale, was conducted at baseline and 2 month follow-up. Results: Six adolescents (7.4%) reported a suicide attempt and 15 (18.5%) engaged in some type of suicidal behavior (actual, aborted, or interrupted suicide attempt; preparatory behavior) during the 2 months following their ED visit. These rates suggest that this screen identified a high-risk sample. Furthermore, adolescents who screened positive for suicidal ideation and/or attempt plus depression and alcohol/substance misuse were most likely to engage in future suicidal behavior (38.9%). Conclusions: In this study, use of a higher screen threshold (multiple suicide risk factors) showed promise for identifying highly elevated acute risk for suicidal behavior. PMID:25746114

The Association Between Suicidal Behavior, Attentional Control, and Frontal Asymmetry

Directory of Open Access Journals (Sweden)

Catherine Thompson

2018-03-01

Full Text Available It can be difficult to identify those at risk of suicide because suicidal thoughts are often internalized and not shared with others. Yet to prevent suicide attempts it is crucial to identify suicidal thoughts and actions at an early stage. Past studies have suggested that deficits in attentional control are associated with suicide, with the argument that individuals are unable to inhibit negative thoughts and direct resources away from negative information. The current study aimed to investigate the association of suicidal behavior with neurological and behavioral markers, measuring attentional bias and inhibition in two Stroop tasks. Fifty-four participants responded to the color of color words in a standard Stroop task and the color of positive, negative, and neutral words in an emotional Stroop task. Electroencephalographic (EEG activity was recorded from frontal areas during each task and at resting. Participants were separated into a low-risk and high-risk group according to their self-reported suicidal behavior. Participants in the high-risk group showed slower response times in the color Stroop and reduced accuracy to incongruent trials, but faster response times in the emotional Stroop task. Response times to the word “suicide” were significantly slower for the high-risk group. This indicates an attentional bias toward specific negative stimuli and difficulties inhibiting information for those with high levels of suicidal behavior. In the emotional Stroop task the high-risk group showed reduced activity in leftward frontal areas, suggesting limitations in the ability to regulate emotional processing via the left frontal regions. The findings support the argument that deficits in attentional control are related to suicidal behavior. The research also suggests that under certain conditions frontal asymmetry may be associated with suicidal behavior.

The Association Between Suicidal Behavior, Attentional Control, and Frontal Asymmetry

Science.gov (United States)

Thompson, Catherine; Ong, Elsie Li Chen

2018-01-01

It can be difficult to identify those at risk of suicide because suicidal thoughts are often internalized and not shared with others. Yet to prevent suicide attempts it is crucial to identify suicidal thoughts and actions at an early stage. Past studies have suggested that deficits in attentional control are associated with suicide, with the argument that individuals are unable to inhibit negative thoughts and direct resources away from negative information. The current study aimed to investigate the association of suicidal behavior with neurological and behavioral markers, measuring attentional bias and inhibition in two Stroop tasks. Fifty-four participants responded to the color of color words in a standard Stroop task and the color of positive, negative, and neutral words in an emotional Stroop task. Electroencephalographic (EEG) activity was recorded from frontal areas during each task and at resting. Participants were separated into a low-risk and high-risk group according to their self-reported suicidal behavior. Participants in the high-risk group showed slower response times in the color Stroop and reduced accuracy to incongruent trials, but faster response times in the emotional Stroop task. Response times to the word “suicide” were significantly slower for the high-risk group. This indicates an attentional bias toward specific negative stimuli and difficulties inhibiting information for those with high levels of suicidal behavior. In the emotional Stroop task the high-risk group showed reduced activity in leftward frontal areas, suggesting limitations in the ability to regulate emotional processing via the left frontal regions. The findings support the argument that deficits in attentional control are related to suicidal behavior. The research also suggests that under certain conditions frontal asymmetry may be associated with suicidal behavior. PMID:29593586

Trait liabilities and specific promotive processes in psychopathology: The example of suicidal behavior.

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Buchman-Schmitt, Jennifer M; Brislin, Sarah J; Venables, Noah C; Joiner, Thomas E; Patrick, Christopher J

2017-07-01

The RDoC matrix framework calls for investigation of mental health problems through analysis of core biobehavioral processes quantified and studied across multiple domains of measurement. Critics have raised concerns about RDoC, including overemphasis on biological concepts/measures and disregard for the principle of multifinality, which holds that identical biological predispositions can give rise to differing behavioral outcomes. The current work illustrates an ontogenetic process approach to addressing these concerns, focusing on biobehavioral traits corresponding to RDoC constructs as predictors, and suicidal behavior as the outcome variable. Data were collected from a young adult sample (N=105), preselected to enhance rates of suicidality. Participants completed self-report measures of traits (threat sensitivity, response inhibition) and suicide-specific processes. We show that previously reported associations for traits of threat sensitivity and weak inhibitory control with suicidal behavior are mediated by more specific suicide-promoting processes-namely, thwarted belongingness, perceived burdensomeness, and capability for suicide. The sample was relatively small and the data were cross-sectional, limiting conclusions that can be drawn from the mediation analyses. Given prior research documenting neurophysiological as well as psychological bases to these trait dispositions, the current work sets the stage for an intensive RDoC-oriented investigation of suicidal tendencies in which both traits and suicide-promoting processes are quantified using indicators from different domains of measurement. More broadly, this work illustrates how an RDoC research approach can contribute to a nuanced understanding of specific clinical problems, through consideration of how general biobehavioral liabilities interface with distinct problem-promoting processes. Copyright © 2016 Elsevier B.V. All rights reserved.

Suicidal behavior among delinquent former child welfare clients.

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Björkenstam, C; Björkenstam, E; Ljung, R; Vinnerljung, B; Tuvblad, C

2013-06-01

Child welfare clients represent a high-risk group for delinquency and adult criminality, but also for future suicidal behavior. We examine associations between delinquency and suicidal behavior in a national child welfare population. This register-based cohort study is based on data for all Swedish former child welfare clients born between 1972 and 1981 that experienced interventions before their adolescent years. We followed 27,228 individuals from age 20 years until 31 December 2006. Juvenile delinquency was defined as being convicted of at least one crime between age 15 and 19. The risk of suicidal behavior was calculated as incidence rate ratios (IRRs). Fifteen percent of the women and 40% of the men had at least one conviction between the age 15 and 19. The adjusted risk of suicidal behavior among women with five or more convictions was 3.5 (95% CI 2.0-6.2); corresponding IRR for men was 3.9 (95% CI 3.1-4.9). Child welfare experience-specifically of out-of-home care-in combination with delinquency is a potent risk factor for suicidal behavior among young adults. However, we cannot exclude that some of this association is an epiphenomenon of uncontrolled confounders, such as impulsivity or severity of psychiatric disease. Despite this caveat, results should be disseminated to practitioners in the health and correction services.

Suicidal behavior in the Ukraine, 1988-1998.

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Kryzhanovskaya, L; Pilyagina, G

1999-01-01

This report studies the available data concerning suicide rates in the Ukraine and points to the importance of appropriate monitoring of suicides and attempted suicides. It illustrates the necessity of collecting this information and of developing "The Ukrainian National Program on Suicide Prevention." Unfortunately, suicide research and publications about suicide rates were prohibited in the former Soviet Union, so some of the data about suicidal behavior in the Ukraine is incomplete. We used the official suicide death statistics of the Ukraine from the Center of Statistics (Ukrainian Ministry of Health) for the period 1988-1998. The overall rate of suicide in the Ukraine is relatively high. Official statistics in the Ukraine show that there were 29.6 suicides per 100,000 population in 1998. The frequency of completed suicide differs in the various regions of the country, suicides being more frequent in the industrially developed regions and in the rural areas of the country than in the cities. In the western part of the Ukraine the frequency of suicide is relatively low (11.1 per 100,000). Between 1988 and 1997 the suicide rate increased by 57%. In 1998 the suicide rate for women was approximately five times lower than that for men.

A model of suicidal behavior in war veterans with posttraumatic mood disorder.

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Sher, Leo

2009-08-01

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.

A case report of suicidal behavior related to subclinical hyperthyroidism

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Joo SH

2014-04-01

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

Suicidal behavior-related hospitalizations among pregnant women in the USA, 2006-2012.

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Zhong, Qiu-Yue; Gelaye, Bizu; Miller, Matthew; Fricchione, Gregory L; Cai, Tianxi; Johnson, Paula A; Henderson, David C; Williams, Michelle A

2016-06-01

Suicide is one of the leading causes of maternal mortality in many countries, but little is known about the epidemiology of suicide and suicidal behavior among pregnant women in the USA. We sought to examine trends and provide nationally representative estimates for suicidal behavior (including suicidal ideation and suicide and self-inflicted injury) among pregnant women from 2006 to 2012 in the USA. Pregnant women aged 12-55 years were identified through pregnancy- and delivery-related hospitalization records from the National (Nationwide) Inpatient Sample. Suicidal behavior was identified by the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Annual, nationwide estimates and trends were determined using discharge and hospital weights. The prevalence of suicidal ideation more than doubled from 2006 to 2012 (47.5 to 115.0 per 100,000 pregnancy- and delivery-related hospitalizations), whereas the prevalence of suicide and self-inflicted injury remained stable. Nearly 10 % of suicidal behavior occurred in the 12-18-year group, showing the highest prevalence per 100,000 pregnancy- and delivery-related hospitalizations (158.8 in 2006 and 308.7 in 2012) over the study period. For suicidal ideation, blacks had higher prevalence than whites; women in the lowest income quartile had the highest prevalence. Although the prevalence of suicidal behavior was higher among hospitalizations with depression diagnoses, more than 30 % of hospitalizations were for suicidal behavior without depression diagnoses. Our findings highlight the increasing burden and racial differences in suicidal ideation among US pregnant women. Targeted suicide prevention efforts are needed for high-risk pregnant women including teens, blacks, and low-income women.

Life Cycle and Suicidal Behavior among Women

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Pablo Mendez-Bustos

2013-01-01

Full Text Available It is nowadays accepted that, independently of methodological issues, women commit fewer suicides than men but make more frequent attempts. Yet, female suicidal risk varies greatly along the lifetime and is linked to the most significant moments in it. A wide analysis of the existing literature was performed to provide a narrative description on the evolution of female suicidal rates from childhood to old age, considering the milestones in their life history. A detailed analysis of gender differences in suicidal behavior is key to establish preventive measures and priorities. More specific studies are needed to adapt future interventions on female suicide.

Suicidal behavior among Turkish patients with Parkinson’s disease

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Ozdilek B

2014-03-01

Full Text Available Betul Ozdilek,1 Bulent Kadri Gultekin21Department of Neurology, 2Department of Psychiatry, Erenkoy Mental Health and Neurology Training and Research Hospital, Istanbul, TurkeyObjective: To investigate the predictors of suicidal ideation and attempts among Turkish Parkinson’s disease (PD patients.Materials and methods: The study comprised 120 patients with PD. Clinical findings were obtained by using the Unified Parkinson’s Disease Rating Scale. Disease severity was measured by the Hoehn and Yahr staging scale, and the Schwab and England Activities of Daily Living scale was used for patient disability. Psychiatric evaluation was performed by the same psychiatrist using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV Axis I Disorders. Severity of depression was measured with the Hamilton Depression Rating Scale. Suicidal ideation and attempts were considered positive if experienced during the patient’s lifetime. The Suicide Probability Scale was used to assess the risk of suicide. Data were analyzed by logistic regression models to identify variables associated with suicidal ideation and attempts.Results: Based on logistic regression analysis, education level, age of disease onset, disease duration, depression, and history of impulse-control disorder (ICD behaviors were significant predictors of suicidal ideation. The risk rate in the presence of depression and history of ICD behaviors was increased by 5.92 and 4.97, respectively. Additionally, lifetime prevalence of suicidal ideation was found in 11.6% (14 of 120 of PD patients, although no patient had ever attempted suicide.Conclusion: Turkish patients with PD who exhibit a high risk for suicidal ideation also experience disease starting at an earlier age, longer disease duration, presence of depression, and ICD behaviors, and should be monitored carefully.Keywords: Parkinson’s disease, suicidal behavior, risk factors

Media Influences on Suicidal Thoughts and Behaviors

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Pirkis, Jane E; Mok, Katherine; Robinson, Jo

2016-01-01

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...

Factors relating to adolescent suicidal behavior: a cross-sectional Malaysian school survey.

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Chen, Paul C Y; Lee, Lai Kah; Wong, Kam Cheong; Kaur, Jagmohni

2005-10-01

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.

Exposure to suicidal behaviors: A common suicide risk factor or a personal negative life event?

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Harris, Keith M; Bettiol, Silvana

2017-02-01

Numerous suicide risk factors have been proposed but not adequately validated for epidemiology, treatment and prevention efforts. Exposures to suicidal behaviors (ESB), from family and friend suicide attempts and completions, were tested for validity as a suicidal risk factor and also for measurement and construct adequacy. An anonymous online survey yielded 713 participants (aged 18-71), who reported ESB, completed the Suicidal Affect-Behavior-Cognition Scale (SABCS), and comprised a broad spectrum on those variables. Tests of dimensionality and internal consistency showed the four ESB variables (attempts/completions through family/friends) were independent and did not form a common factor or an identifiable ESB latent trait. ESB variables were, however, associated with demographic and psychiatric histories. A battery of tests revealed no meaningful associations between ESB and total suicidality or suicide risk factors (social support, depression, anxiety, stress, satisfaction with life and emotional stability). In addition, in contrast to previous reports, young adults ( n = 200; aged 18-20) showed no increased suicidality due to ESB. Results showed no validity for ESB as a common risk factor for suicidality or other psychopathology, or as a latent trait. ESB showed evidence as a personal negative life event with individual effects and interpretations.

Emergency Nursing Experiences in Assisting People With Suicidal Behavior: A Grounded Theory Study.

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Vedana, Kelly Graziani Giacchero; Magrini, Daniel Fernando; Miasso, Adriana Inocenti; Zanetti, Ana Carolina Guidorizzi; de Souza, Jacqueline; Borges, Tatiana Longo

2017-08-01

To understand emergency nursing experiences in assisting people with suicidal behavior. Grounded theory study with symbolic interactionism conducted in 2015 to 2016 in Brazil with 19 nurses. Assistance for people with suicidal behavior is critical, challenging, evokes different feelings and requires knowledge, skills and emotional control. Nurses did not feel prepared or supported, and identified recurrent gaps and problems. Nurses occupied a limited role, restricted to attending to physical needs. They predominantly manifested opposition, judgments and incomprehension about patients. This study presents key elements to be addressed in interventions and investigations regarding nursing support, training and supervision. Copyright © 2017 Elsevier Inc. All rights reserved.

Suicidal behavior, negative affect, gender, and self-reported delinquency in college students.

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Langhinrichsen-Rohling, Jennifer; Arata, Catalina; Bowers, David; O'Brien, Natalie; Morgan, Allen

2004-01-01

The associations among suicidal behavior, negative affect, and delinquency were assessed via an anonymous self-report survey administered to male and female college students ( N = 383). Contrary to our hypothesized results, there were no gender differences in rates of suicidal ideation and attempts. Confirming our hypotheses about gender differences, college men did report significantly more delinquent behavior than college women. College men also scored higher on the suicide-proneness scale, which contained a mixture of death-related, risk-related, and negative self- and health-related items. Furthermore, as predicted, college students with a history of depression, suicide ideation, and/or suicide attempts all reported significantly more delinquent behavior. Self-reported delinquency and current levels of depressive symptomology emerged as significant predictors of suicide-prone behavior for both college men and women, explaining 34% of the variance for women and 17% for men. Levels of engagement in suicide-prone behavior and feelings of depression were elevated in college students with any type of juvenile arrest history. Students with an arrest history were also more likely to have had a diagnosis of depression and to have engaged in suicide ideation in their past. These findings suggest there are complex links between depression, delinquency, and suicidal behavior in college men and women.

[Suicidal behavior prevention for children under age 13: A systematic review].

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Baux-Cazal, L; Gokalsing, E; Amadeo, S; Messiah, A

2017-05-01

Our objective was to review international literature on suicidal behavior prevention for children under age 13. We gathered all relevant articles on suicide prevention for children under 13. We researched all publications in the French and English languages in PubMed (MEDLINE), PsychINFO and SUDOC databases published until February 2014, with the keywords "child", "child preschool", "prevention and control", "suicide", and "suicide attempted". Publications were included if they described suicidal behavior prevention programs (suicide prevention programs, attempted-suicide prevention programs, suicidal ideation screening programs), and if the studies concerned children under age 13. We also included references cited in the articles if they were not already present in our searches but met inclusion criteria. Studies were excluded if they analyzed populations of children and adolescents without sub-analysis for children under age 13. A total of 350 potentially relevant articles were identified, 33 of which met the inclusion criteria, including 4 retrieved from articles' bibliography. Preventive measures against suicidal behavior for children under 13 exist and include: social programs, maltreatment prevention, curriculum-based suicide prevention programs, suicide screening in schools, gatekeepers, reduction of access of lethal means of suicide, suicide screening by primary care, and post-suicide intervention programs. Overall, the evidence was limited by methodological concerns, particularly a lack of RCTs. However, positive effects were found: school-based suicide prevention programs and gatekeepers increased knowledge about suicide and how to seek help, post-suicide programs helped to reduce psychological distress in the short term. One study showed a decreased risk of attempted-suicide after entry into the child welfare system. There are promising interventions but there is not enough scientific evidence to support any efficient preventive measure against

Gender differences in nonfatal suicidal behavior in Pakistan: significance of sociocultural factors.

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Khan, M M; Reza, H

1998-01-01

Suicidal behavior is an understudied subject in Pakistan. A variety of social, legal, and religious factors make reporting and data collection on suicide and nonfatal suicidal behavior difficult. To study the problem, a retrospective case-note analysis was carried out in which the sociodemographic and clinical characteristics of 262 female and 185 male suicidal individuals admitted to a university hospital in Karachi, Pakistan, are compared. Three quarters of the suicidal persons were under the age of 30 years. Compared to men, women were younger and more often married. Both women and men tended to use self-poisoning with benzodiazepines, but more women used organophosphate insecticides. In Pakistani society, legal, social, and economic discrimination predisposes women to psychological distress and subsequent suicidal behavior. The study highlights the need for culture-specific research on suicidal behavior in Pakistan.

Psychological models of suicide.

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Barzilay, Shira; Apter, Alan

2014-01-01

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.

Self-Harm and Suicidal Behaviors in Hong Kong Adolescents: Prevalence and Psychosocial Correlates

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Daniel T. L. Shek

2012-01-01

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.

Psychological distress and risk for suicidal behavior among university students in contemporary China.

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Tang, Fang; Byrne, Majella; Qin, Ping

2018-03-01

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.

Subjective quality of life and suicidal behavior among Taiwanese schizophrenia patients.

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Kao, Yu-Chen; Liu, Yia-Ping; Cheng, Tsung-Hsing; Chou, Ming-Kuen

2012-04-01

Research of suicidal behavior in individuals with schizophrenia has often suggested that clinical characteristics and symptoms likely influence a patient's suicidal risk. However, there is a lack of research describing the link between patients' subjective quality of life (SQOL) and suicidal behavior in non-Western countries. Therefore, the current study attempts to explore how schizophrenia patients' SQOL and their suicidal behavior are related in a Taiwanese sample. In this study, 102 schizophrenia outpatients were investigated using the Taiwanese World Health Organization Quality of Life Schedule-Brief Version (WHO-QOL-BREF-TW), several Beck-Related symptom rating scales, and the Positive and Negative Syndrome Scale (PANSS) for psychopathology. These patients were also evaluated for suicidal risk using the critical items of the Scale for Suicide Ideation (SSI) and lifetime suicide attempts. Statistical analyses, including independent sample t tests, analysis of covariance (ANCOVA) and logistic stepwise regression models were completed. Compared with the non-suicidal group, suicidal patients had significantly lower scores in SQOL domains. The differences in social domain remained significant after adjusting for depressive symptoms. In multiple logistic regression analyses, level of depressive and psychotic symptoms increased and poor social and psychological SQOL were significant contributors to suicidal behavior. Having removed depressive symptoms from the model, only dissatisfaction with social SQOL was associated with heightened suicidal risk. Schizophrenia is associated with a high suicidal risk, of which depressive and psychotic symptoms are the major correlates. Again, the present study confirms and extends previous research showing that dissatisfied SQOL, particularly dissatisfaction with social relationships, should be considered in the assessment of suicidal risk in outpatients with schizophrenia, even when accounting other possible confounding factor

Suicidal Behavior Among Inpatients with Schizophrenia and Mood Disorders in Chengdu, China

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Ran, Mao-Sheng; Wu, Qiu-Hua; Conwell, Yeates; Chen, Eric Yu-Hai; Chan, Cecilia Lai-Wan

2004-01-01

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…

Suicide and Suicide Risk in Lesbian, Gay, Bisexual, and Transgender Populations: Review and Recommendations

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Haas, Ann P.; Eliason, Mickey; Mays, Vickie M.; Mathy, Robin M.; Cochran, Susan D.; D'Augelli, Anthony R.; Silverman, Morton M.; Fisher, Prudence W.; Hughes, Tonda; Rosario, Margaret; Russell, Stephen T.; Malley, Effie; Reed, Jerry; Litts, David A.; Haller, Ellen; Sell, Randall L.; Remafedi, Gary; Bradford, Judith; Beautrais, Annette L.; Brown, Gregory K.; Diamond, Gary M.; Friedman, Mark S.; Garofalo, Robert; Turner, Mason S.; Hollibaugh, Amber; Clayton, Paula J.

2011-01-01

Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these populations. This article is a culmination of a three-year effort by an expert panel to address the need for better understanding of suicidal behavior and suicide risk in sexual minority populations, and stimulate the development of needed prevention strategies, interventions and policy changes. This article summarizes existing research findings, and makes recommendations for addressing knowledge gaps and applying current knowledge to relevant areas of suicide prevention practice. PMID:21213174

Impulsive aggression, delay discounting, and adolescent suicide attempts: effects of current psychotropic medication use and family history of suicidal behavior.

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Bridge, Jeffrey A; Reynolds, Brady; McBee-Strayer, Sandra M; Sheftall, Arielle H; Ackerman, John; Stevens, Jack; Mendoza, Kristen; Campo, John V; Brent, David A

2015-03-01

Impulsive-aggressive behaviors have been consistently implicated in the phenomenology, neurobiology, and familial aggregation of suicidal behavior. The purpose of this study was to extend previous work by examining laboratory behavioral measures of delayed reward impulsivity and impulsive aggression in adolescent suicide attempters and never-suicidal comparison subjects. Using the Point Subtraction Aggression Paradigm (PSAP) and the Delay Discounting Task (DDQ), the authors examined delay discounting and impulsive aggression in 40 adolescent suicide attempters, ages 13-18, and 40 never-suicidal, demographically matched psychiatric comparison subjects. Overall, suicide attempters and comparison subjects performed similarly on the PSAP and DDQ. There was a significant group by current psychotropic medication use interaction (p=0.013) for mean aggressive responses on the PSAP. Group comparisons revealed that attempters emitted more aggressive responses per provocation than comparison subjects, only in those not on psychotropic medication (p=0.049), whereas for those currently treated with psychotropic medication, there were no group differences (p>0.05). This interaction effect was specific to current antidepressant use. Among all subjects, family history of suicidal behavior (suicide or suicide attempt) in first degree relatives was significantly correlated with both delay discounting (r=-0.22, p=0.049), and aggressive responding (r=0.27, p=0.015). Family history of suicidal behavior was associated with delay discounting, but not with aggressive responding on the PSAP, after controlling for relevant covariates. In this study, impulsive-aggressive responding was associated with suicide attempt only in those not being treated with antidepressants. Future work to replicate and extend these findings could have important therapeutic implications for the treatment of depressed suicide attempters, many of whom are affected by impulsive aggression.

Structuring Roles and Gender Identities Within Families Explaining Suicidal Behavior in South India.

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Lasrado, Reena A; Chantler, Khatidja; Jasani, Rubina; Young, Alys

2016-05-01

This paper examines the social structures, culture, gendered roles, and their implications for suicidal behavior in South India. Exploring the cultural process within the structures of family and society to understand suicide and attempted suicide from the perspectives of survivors, mental health professionals, and traditional healers has not been achieved in the existing suicide-related research studies conducted in India to date. This study aimed to explore the cultural implications of attempted suicide by examining the survivors' life stories, their perceptions, and service providers' interpretations of problem situation. A qualitative design was used drawing on constant comparison method and thematic analysis. The analysis was underpinned by the theoretical concepts of Bourdieu's work. In-depth interviews were conducted with 15 survivors of attempted suicide, eight mental health professionals, and eight traditional healers from Southern India. The study found interactions among visible and invisible fields such as faith, power, control, culture, family, religion, and social systems to have strengthened the disparities in gender and role structures within families and societies and to have impacted survivors' dispositions to situations. The role of culture in causing suicide and attempted suicide is explained by unraveling the negative impact of interacting cultural and structural mechanisms.

Community Structural Instability, Anomie, Imitation and Adolescent Suicidal Behavior

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Thorlindsson, Thorolfur; Bernburg, Jon Gunnar

2009-01-01

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…

[Validation of a path model on adolescents' suicidal ideation and violent behavior].

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Park, Hyun Sook

2007-10-01

This study examined the fitness of a path model on the relationship among stress, self-esteem, aggression, depression, suicidal ideation, and violent behavior for adolescents. The subjects consisted of 1,177 adolescents. Data was collected through self-report questionnaires. The data was analyzed by the SPSS and AMOS programs. Stress, self-esteem, aggression, and depression showed a direct effect on suicidal ideation for adolescents, while stress, self-esteem, and aggression showed an indirect effect on suicidal ideation for adolescents. Stress, self-esteem, aggression, and suicidal ideation showed a direct effect on violent behavior for adolescents, while stress, self-esteem, aggression, and depression showed an indirect effect on violent behavior for adolescents. The modified path model of adolescent's suicidal ideation and violent behavior was proven correct. These results suggest that adolescent's suicidal ideation and violent behavior can be decreased by reducing stress, aggression, and depression and increasing self-esteem. Based on the outcomes of this study, it is necessary to design an intervention program that emphasizes reducing stress, aggression, and depression and increasing self-esteem in order to decrease adolescents' suicide ideation and violence.

Behavioral and psychosocial factors associated with suicidal ideation among adolescents.

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Lee, GyuYoung; Ham, Ok Kyung

2018-04-10

Suicidal ideation poses a serious threat to the well-being of adolescents and is the strongest risk factor for suicide. Indeed, Korea ranks first among Organisation for Economic Cooperation and Development countries regarding the age-standardized suicide rates. In the present study, we examined multiple levels of factors associated with the suicidal ideation of adolescents in Korea by applying the Ecological Models of Health Behavior. A cross-sectional study was conducted with a convenience sample of 860 adolescents. The instruments included the Beck Depression Inventory and the Adolescent Mental Health and Problem Behavior Questionnaire. The data were analyzed using hierarchical multiple regression. Sixteen percent of participants reported suicidal ideation. Intrapersonal (sleep disturbance, Internet game addiction, destructive behavior, and depressive symptoms) and interpersonal factors (family conflicts and peer victimization) were associated with suicidal ideation. Because multiple factors were associated with suicidal ideation among adolescents, both intrapersonal (sleep disturbance, Internet game addiction, and depression) and interpersonal factors (family conflicts and peer problems) should be considered in the development of suicide-prevention programs. These programs could include campaigns changing the norms (permissive attitudes toward school violence) and the development of strict and rigorous school non-violence policies. © 2018 John Wiley & Sons Australia, Ltd.

Tolerance for psychological pain and capability for suicide: Contributions to suicidal ideation and behavior.

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Meerwijk, Esther L; Weiss, Sandra J

2018-04-01

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.

Suicidal Behavior and Help Seeking among Diverse College Students

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Brownson, Chris; Becker, Martin Swanbrow; Shadick, Richard; Jaggars, Shanna S.; Nitkin-Kaner, Yael

2014-01-01

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…

Suicidality, psychopathology, and the internet: Online time vs. online behaviors.

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Harris, Keith M; Starcevic, Vladan; Ma, Jing; Zhang, Wei; Aboujaoude, Elias

2017-09-01

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.

Correlates of Alaska Native Fatal and Nonfatal Suicidal Behaviors 1990-2001

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Wexler, Lisa; Hill, Ryan; Bertone-Johnson, Elizabeth; Fenaughty, Andrea

2008-01-01

Factors correlated with suicidal behavior in a predominately Alaska Native region of Alaska are described, and the correlates relating to fatal and nonfatal suicide behaviors in this indigenous population are distinguished. Suicide data from the region (1990-2001) were aggregated and compared to 2000 U.S. Census Data using chi-squared tests.…

Sexual and Gender Minority Youth Suicide: Understanding Subgroup Differences to Inform Interventions.

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O'Brien, Kimberly H McManama; Putney, Jennifer M; Hebert, Nicholas W; Falk, Amy M; Aguinaldo, Laika D

2016-08-01

Sexual and gender minority (SGM) youth are disproportionately affected by suicide-related thoughts and behaviors relative to their heterosexual and/or non-transgender peers. Theory and empirical evidence suggest that there are unique factors that contribute to this elevated risk, with distinguishable differences among SGM subgroups. Although SGM youth suicide prevention research is in its nascence, initial findings indicate that interventions which focus on family support and acceptance may be beneficial. It is critical that we develop and test tailored interventions for SGM youth at risk for suicide, with specific attention to subgroup differences and reductions in suicide-related thoughts and behaviors as outcomes.

Laboratory Measured Behavioral Impulsivity Relates to Suicide Attempt History

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Dougherty, Donald M.; Mathias, Charles W.; Marsh, Dawn M.; Papageorgiou, T. Dorina; Swann, Alan C.; Moeller, F. Gerard

2004-01-01

The purpose of this study was to examine the relationship between laboratory behavioral measured impulsivity (using the Immediate and Delayed Memory Tasks) and suicidal attempt histories. Three groups of adults were recruited, those with either: no previous suicide attempts (Control, n = 20), only a single suicide attempt (Single, n = 20), or…

SUICIDAL THOUGHTS AND BEHAVIORS IN CHILDREN AND ADOLESCENTS WITH CHRONIC TIC DISORDERS.

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Storch, Eric A; Hanks, Camille E; Mink, Jonathan W; McGuire, Joseph F; Adams, Heather R; Augustine, Erika F; Vierhile, Amy; Thatcher, Alyssa; Bitsko, Rebecca; Lewin, Adam B; Murphy, Tanya K

2015-10-01

Despite evidence of elevated risk factors for suicidal thoughts and behavior in youth with Tourette syndrome and chronic tic disorders (CTD), few studies have actually examined that relationship. This study documented the frequency and clinical correlates of suicidal thoughts and behaviors in a sample of children and adolescents with CTD (N = 196, range 6-18 years old). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control. Youth and parents completed a battery of measures that assessed co-occurring psychiatric diagnoses, child emotional and behavioral symptoms, and impairment due to tics or co-occurring conditions. A structured diagnostic interview identified that 19 youths with CTD (9.7%) experienced suicidal thoughts and/or behaviors, which was elevated compared to 3 youths (3%) who experienced these thoughts in a community control sample (N = 100, range 6-18 years old, P = .03). For youth with CTD, suicidal thoughts and behaviors were frequently endorsed in the context of anger and frustration. The Child Behavior Checklist (CBCL) anxious/depressed, withdrawn, social problems, thought problems, and aggressive behavior subscales, as well as the total internalizing problems scale, were associated with the presence of suicidal thoughts and/or behaviors. Suicidal thoughts and/or behaviors were significantly associated with tic symptom severity; tic-related impairment; and obsessive-compulsive, depressive, anxiety, and attention-deficit/hyperactivity disorders' symptom severity. CBCL anxiety/depression scores mediated the relationship between tic severity and suicidal thoughts and behaviors. Findings suggest that about 1 in 10 youth with CTD experience suicidal thoughts and/or behaviors, which are associated with a more complex clinical presentation and often occur in the presence of anger and frustration. © 2015 Wiley Periodicals, Inc.

Revisiting the Association of Aggression and Suicidal Behavior in Schizophrenic Inpatients

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Neuner, Tanja; Hubner-Liebermann, Bettina; Hausner, Helmut; Hajak, Goran; Wolfersdorf, Manfred; Spiessl, Hermann

2011-01-01

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 =…

Psychological and sociological aspects of parenting and their relation to suicidal behavior.

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Flouri, Eirini

2005-01-01

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.

Decision-Making in Suicidal Behavior: The Protective Role of Loss Aversion.

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Hadlaczky, Gergö; Hökby, Sebastian; Mkrtchian, Anahit; Wasserman, Danuta; Balazs, Judit; Machín, Núria; Sarchiapone, Marco; Sisask, Merike; Carli, Vladimir

2018-01-01

Loss aversion is a central and well operationalized trait behavior that describes the tendency for humans to strongly prefer avoiding losses to making equivalent gains. Human decision-making is thus biased toward safer choices. The aim of this study was to explore the relationship between loss aversion and suicidal behavior in a large cohort of adolescents recruited in 30 schools of seven European countries for a longitudinal study (Current Controlled Trials ISRCTN65120704). We hypothesized that individuals with higher loss aversion would be less likely to attempt suicide. A mixed monetary gamble task was used to generate loss aversion scores for each participant. Logistic regression was used to estimate the cross-sectional association between loss aversion and life-time suicide attempts in the baseline sample ( N  = 2,158; 156 attempters), and incident attempts were predicted in a 4-month prospective model ( N  = 1,763; 75 attempters). Multiple regression was used to estimate the association between loss aversion and suicidal ideation. Loss aversion was a significant predictor of attempted suicide in both the cross-sectional (OR = 0.79; P  = 0.005) and prospective analysis (OR = 0.81; P  = 0.040), adjusting for depression, anxiety, stress, and sex. The correlation between pre and post measures of loss aversion was r  = 0.52 ( P  loss aversion was not (cross-sectional model: P  = 0.092; Prospective model: P  = 0.390). This suggests that the concept of loss aversion may be useful in understanding the transition from suicidal thoughts to attempts. This and previous studies suggest that altered decision-making is involved in suicide attempts. In our study, we show the involvement of loss aversion in particular, and propose that individuals high in loss aversion are discouraged from carrying out the suicide attempt because of a greater focus on the negative consequences of the decision.

Examining Adolescent Suicidal Behaviors in Relation to Gun Carrying and Bullying

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Romero, Andrea; Bauman, Sheri; Ritter, Marissa; Anand, Payal

2017-01-01

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…

Autobiographical memory and suicidal behavior in bipolar disorder

OpenAIRE

Sanden, Eva

2008-01-01

The “cry of pain” model for suicidal behavior has received empirical support in studies of several mental disorders. As the first of its kind this study aims at investigating the association between overgeneral autobiographical memory, a vital aspect in the “cry of pain” model, and suicidal behavior in Bipolar Disorder. Further, this study seeks to explore the association between overgeneral autobiographical memory and hopelessness and exposure to trauma. Individuals with previous sui...

An Ecological Understanding of Youth Suicide in South Korea

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Lee, Seung-yeon; Hong, Jun Sung; Espelage, Dorothy L.

2010-01-01

This article reviews risk factors for youth suicide in South Korea (hereafter referred to as Korea), based on the ecological systems theory. Although youth suicide is a major concern for Korean society, understanding of this phenomenon has been limited since most of the empirical studies address personal characteristics without much consideration…

Restricting youth suicide: behavioral health patients in an urban pediatric emergency department.

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Rogers, Steven C; DiVietro, Susan; Borrup, Kevin; Brinkley, Ashika; Kaminer, Yifrah; Lapidus, Garry

2014-09-01

Suicide is the third leading cause of death among individuals age 10 years to 19 years in the United States. Adolescents with suicidal behaviors are often cared for in emergency departments (EDs)/trauma centers and are at an increased risk for subsequent suicide. Many institutions do not have standard procedures to prevent future self-harm. Lethal means restriction (LMR) counseling is an evidence-based suicide prevention strategy that informs families to restrict access to potentially fatal items and has demonstrated efficacy in preventing suicide. The objectives of this study were to examine suicidal behavior among behavioral health patients in a pediatric ED and to assess the use of LMR by hospital staff. A sample of 298 pediatric patients was randomly selected from the population of behavioral health patients treated at the ED from January 1 through December 31, 2012 (n = 2,294). Descriptive data include demographics (age, sex, race/ethnicity, etc,), chief complaint, current and past psychiatric history, primary diagnosis, disposition, alcohol/drug abuse, and documentation of any LMR counseling provided in the ED. Of the 298 patients, 52% were female, 47% were white, and 76% were in the custody of their parents. Behavior/out of control was the most common chief complaint (43%). The most common diagnoses were mood disorder (25%) and depression (20%). Thirty-four percent of the patients had suicidal ideation, 22% had a suicide plan, 32% had documented suicidal behavior, and 25% of the patients reported having access to lethal means. However, only 4% of the total patient population received any LMR counseling, and only 15% of those with access to lethal means had received LMR counseling. Providing a safe environment for adolescents at risk for suicidal behaviors should be a priority for all families/caretakers and should be encouraged by health care providers. The ED is a key point of entry into services for suicidal youth and presents an opportunity to implement

Suicidality in the veterinary profession: interview study of veterinarians with a history of suicidal ideation or behavior.

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Platt, Belinda; Hawton, Keith; Simkin, Sue; Dean, Rachel; Mellanby, Richard J

2012-01-01

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.

Suicidal Behavior and Associations with Quality of Life among HIV-Infected Patients in Ibadan, Nigeria.

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Oladeji, Bibilola Damilola; Taiwo, Babafemi; Mosuro, Olushola; Fayemiwo, Samuel A; Abiona, Taiwo; Fought, Angela J; Robertson, Kevin; Ogunniyi, Adesola; Adewole, Isaac F

Suicidality has rarely been studied in HIV-infected patients in sub-Saharan Africa. This study explored suicidal behavior in a clinic sample of people living with HIV, in Nigeria. Consecutive patients were interviewed using the Composite International Diagnostic Interview (CIDI-10.0) and the World Health Organization Quality of Life (WHO-QOL-HIV-BREF). Associations of suicidal behavior were explored using logistic regression models. In this sample of 828 patients (71% female, mean age 41.3 ± 10 years), prevalence of suicidal behaviors were 15.1%, 5.8%, and 3.9% for suicidal ideation, plans, and attempts, respectively. Women were more likely than men to report suicidal ideation (odds ratio 1.7; 95% confidence interval 1.05-2.64). Depression and/or anxiety disorder was associated with increased odds of all suicidal behaviors. Suicidal behavior was associated with significantly lower overall and domain scores on the WHO-QOL. Suicidal behaviors were common and significantly associated with the presence of mental disorders and lower quality of life.

Behavioral Risk Assessment of the Guarded Suicidal Patient

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Simon, Robert I.

2008-01-01

Psychiatrists and other mental health professionals are trained to assess patients by direct observation and examination. Short inpatient length of stay, brief outpatient visits, emergency room evaluations, and other time-limited clinical settings require rapid assessment of suicide risk. Recognition of behavioral suicide risk factors can assist…

Diagnostics of suicidal behavior risks of children and adolescents in educational institutions

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Pavlova T.S.

2014-12-01

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

Attitudes and Perceptions of Suicide and Suicide Prevention Messages for Asian Americans

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Priyata Thapa

2015-12-01

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.

The influence of media reporting of a celebrity suicide on suicidal behavior in patients with a history of depressive disorder.

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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

2007-11-01

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.

Intention to Enact and Enactment of Gatekeeper Behaviors for Suicide Prevention: an Application of the Theory of Planned Behavior.

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Kuhlman, Shane T W; Walch, Susan E; Bauer, Kristina N; Glenn, April D

2017-08-01

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.

Child/Adolescent Abuse and Suicidal Behavior: Are They Sex Related?

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Gal, Gilad; Levav, Itzhak; Gross, Raz

2012-01-01

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…

High Risk Suicidal Behavior in Veterans - Assessment of Predictors and Efficacy of Dialectical Behavioral Therapy

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2015-12-01

gender sub-analyses. 15. SUBJECT TERMS Borderline Personality Disorder , SUICIDE 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER...this will be to identify symptoms associated with suicidal behavior that may advise future treatment. We will assess symptom domains including mood ...extend beyond personality disorder diagnosis. Thirty suicide attempters with BPD (SABPD+) will be compared with 30 suicide attempters without BPD

On "intention" in the definition of suicide.

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Andriessen, Karl

2006-10-01

The need for a comprehensive nomenclature in suicidology is now well recognized. In this paper the focus is on the issue of intention, which is identified as an essential aspect of any definition of suicide and suicidal behavior primarily because of its distinction from accidental behavior. The distinction between the retrospective perspective of motives versus the prospective perspective of intentions is highlighted, and I argue that the latter is more closely related to suicidal behavior. Finally, while motives and intentions tend to be used together in research, there is a need for sound research to clarify the roles of intentions in order to better understand suicide and attempted suicide.

Epidemiological Evidence on the Link Between Drug Use and Suicidal Behaviors Among Adolescents

OpenAIRE

Wilcox, Holly C.

2004-01-01

Depression, substance abuse, and aggressive behavior disorders have shown to be among the most influential risk factors for suicide in community and clinical studies of adolescents and adults. Increasing evidence suggests that adolescents who use and abuse alcohol and drugs are at increased risk for suicidal ideation, attempted suicide, and completed suicide, although conclusive evidence has not yet been presented suggesting that drug use causes suicidal thoughts and behaviors. This paper rev...

Suicidal communication signifies suicidal intent in Chinese completed suicides.

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Zhou, Xue Mei; Jia, Shu Hua

2012-11-01

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.

Dying online: live broadcasts of Chinese emerging adult suicides and crisis response behaviors.

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Ma, Jing; Zhang, Wei; Harris, Keith; Chen, Qiang; Xu, Xiaolin

2016-08-11

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.

Dying online: live broadcasts of Chinese emerging adult suicides and crisis response behaviors

Directory of Open Access Journals (Sweden)

Jing Ma

2016-08-01

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

Low validity of Google Trends for behavioral forecasting of national suicide rates.

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Tran, Ulrich S; Andel, Rita; Niederkrotenthaler, Thomas; Till, Benedikt; Ajdacic-Gross, Vladeta; Voracek, Martin

2017-01-01

Recent research suggests that search volumes of the most popular search engine worldwide, Google, provided via Google Trends, could be associated with national suicide rates in the USA, UK, and some Asian countries. However, search volumes have mostly been studied in an ad hoc fashion, without controls for spurious associations. This study evaluated the validity and utility of Google Trends search volumes for behavioral forecasting of suicide rates in the USA, Germany, Austria, and Switzerland. Suicide-related search terms were systematically collected and respective Google Trends search volumes evaluated for availability. Time spans covered 2004 to 2010 (USA, Switzerland) and 2004 to 2012 (Germany, Austria). Temporal associations of search volumes and suicide rates were investigated with time-series analyses that rigorously controlled for spurious associations. The number and reliability of analyzable search volume data increased with country size. Search volumes showed various temporal associations with suicide rates. However, associations differed both across and within countries and mostly followed no discernable patterns. The total number of significant associations roughly matched the number of expected Type I errors. These results suggest that the validity of Google Trends search volumes for behavioral forecasting of national suicide rates is low. The utility and validity of search volumes for the forecasting of suicide rates depend on two key assumptions ("the population that conducts searches consists mostly of individuals with suicidal ideation", "suicide-related search behavior is strongly linked with suicidal behavior"). We discuss strands of evidence that these two assumptions are likely not met. Implications for future research with Google Trends in the context of suicide research are also discussed.

Suicidal behavior among homeless people in Japan.

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Okamura, Tsuyoshi; Ito, Kae; Morikawa, Suimei; Awata, Shuichi

2014-04-01

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.

Emotional Intelligence Is a Protective Factor for Suicidal Behavior

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Cha, Christine B.; Nock, Matthew K.

2009-01-01

Emotional intelligence is found to be a protective factor for suicidal behavior after examining the relations between childhood sexual abuse and suicidal ideation and attempts to emotional intelligence. Childhood sexual abuse is found to be a strong predictive of the results.

Attempted suicide in Ghana: motivation, stigma, and coping.

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Osafo, Joseph; Akotia, Charity Sylvia; Andoh-Arthur, Johnny; Quarshie, Emmanuel Nii-Boye

2015-01-01

To understand the experiences of suicidal persons in Ghana, 10 persons were interviewed after they attempted suicide. Thematic analysis of data showed that motivation for suicidal behavior included social taunting, hopelessness, and partner's infidelity. Suicidal persons reported stigma expressed through physical molestation and social ostracism, which left them traumatized. However, they coped through social support from relations, religious faith, and use of avoidance. Community-wide sensitive education should target reducing stigma and also increase mental health education on suicidal behavior in Ghanaian communities.

Associations between suicidal behavior and childhood abuse and neglect: A meta-analysis.

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Liu, Jianbo; Fang, Yumin; Gong, Jingbo; Cui, Xilong; Meng, Tiantian; Xiao, Bo; He, Yuqiong; Shen, Yanmei; Luo, Xuerong

2017-10-01

Relationships of some types of childhood maltreatment and suicidal behavior remain controversial and inconclusive. Medline, Embase, PsycINFO and Cochrane library were searched for eligible studies, and the results were synthesized in meta-analyses. childhood maltreatment was associated positively with suicidal behavior in the total population and maltreatment subgroups. Emotional abuse had the strongest effect (OR =2.33, SMD =0.660, Psuicidal behavior in men and women (women: OR =4.84, Psuicidal behavior in the general population (OR =3.78, Psuicide attempt (OR =1.11, SMD =0.48, Psuicidal ideation. Some subgroup samples were not sufficiently large. Childhood maltreatment increases the risk of suicidal behavior. Emotional abuse had the strongest effect among the five types of maltreatment. The risk of suicidal behavior is higher in the general population, women, and individuals with chronic schizophrenia who have histories of childhood maltreatment. Copyright © 2017. Published by Elsevier B.V.

Effects of Cognitive Behavioral Therapy for Insomnia on Suicidal Ideation in Veterans

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Trockel, Mickey; Karlin, Bradley E.; Taylor, C. Barr; Brown, Gregory K.; Manber, Rachel

2015-01-01

Objective: To examine the effects of cognitive behavioral therapy for insomnia (CBT-I) on suicidal ideation among Veterans with insomnia. Design: Longitudinal data collected in the course of an uncontrolled evaluation of a large-scale CBT-I training program. Setting: Outpatient and residential treatment facilities. Participants: Four hundred five Veterans presenting for treatment of insomnia. Interventions: Cognitive behavioral therapy for insomnia. Measurement and Results: At baseline, 32% of patients, compared with 21% at final assessment, endorsed some level of suicidal ideation [χ2(df = 1) = 125; P suicidal ideation. The effect of change in insomnia severity on change in depression severity was also significant. After controlling for change in depression severity and other variables in the model, the effect of change in insomnia severity on change in suicidal ideation remained significant. Conclusion: This evaluation of the largest dissemination of cognitive behavioral therapy for insomnia (CBT-I) in the United States found a clinically meaningful reduction in suicidal ideation among Veterans receiving CBT-I. The mechanisms by which effective treatment of insomnia with CBT-I reduces suicide risk are unknown and warrant investigation. The current results may have significant public health implications for preventing suicide among Veterans. Citation: Trockel M, Karlin BE, Taylor CB, Brown GK, Manber R. Effects of cognitive behavioral therapy for insomnia on suicidal ideation in veterans. SLEEP 2015;38(2):259–265. PMID:25515115

[CHALLENGES IN THE INTERVENTION OF PUERTO RICAN ADOLESCENTS THAT SHOW SUICIDAL BEHAVIOR].

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Vélez, Yovanska Duarté; Dávila, Paloma Torres; Hernández, Samariz Laboy

2015-01-01

This article is a case study of a Puerto Rican adolescent with suicidal behavior. The adolescent began a Socio-Cognitive Behavioral Therapy for Suicidal Behavior (SCBT), an ambulatory treatment, after being hospitalized for a suicide attempt. The SCBT incorporates an ecological and developmental perspective to CBT. She initially presented low self-esteem, and significant depressive and anxiety symptoms. At the end of treatment, the adolescent revealed a significant change in symptoms, and a better use of her coping skills. No suicidal ideation was presented during previous months, neither during follow up. Case analysis allowed treatment protocol modifications, particularly family sessions and communication skills, thus contributing to its further feasibility.

Anxiety and its disorders as risk factors for suicidal thoughts and behaviors: A meta-analytic review

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Bentley, Kate H.; Franklin, Joseph C.; Ribeiro, Jessica D.; Kleiman, Evan M.; Fox, Kathryn R.; Nock, Matthew K.

2016-01-01

Suicidal thoughts and behaviors are highly prevalent public health problems with devastating consequences. There is an urgent need to improve our understanding of risk factors for suicide to identify effective intervention targets. The aim of this meta-analysis was to examine the magnitude and clinical utility of anxiety and its disorders as risk factors for suicide ideation, attempts, and deaths. We conducted a literature search through December 2014; of the 65 articles meeting our inclusion criteria, we extracted 180 cases in which an anxiety-specific variable was used to longitudinally predict a suicide-related outcome. Results indicated that anxiety is a statistically significant, yet weak, predictor of suicide ideation (OR=1.49, 95% CI: 1.18, 1.88) and attempts (OR=1.64, 95% CI: 1.47, 1.83), but not deaths (OR=1.01, 95% CI: 0.87, 1.18). The strongest associations were observed for PTSD. Estimates were reduced after accounting for publication bias, and diagnostic accuracy analyses indicated acceptable specificity but poor sensitivity. Overall, the extant literature suggests that anxiety and its disorders, at least when these constructs are measured in isolation and as trait-like constructs, are relatively weak predictors of suicidal thoughts and behaviors over long follow-up periods. Implications for future research priorities are discussed. PMID:26688478

Internet Addiction among Adolescents May Predict Self-Harm/Suicidal Behavior: A Prospective Study.

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Pan, Pei-Yin; Yeh, Chin-Bin

2018-06-01

To explore the role of Internet addiction in the development of self-harm/suicidal behavior among adolescents after 1-year of follow-up. We conducted this 1-year, prospective cohort study of 1861 adolescents (mean age 15.93 years) attending a senior high school in Taiwan; 1735 respondents (93.2%) were classified as having no history of self-harm/suicidal attempts in the initial assessment and were referred to as the "noncase" cohort. The Chen Internet Addiction Scale was used to identify individuals with Internet addiction. The participants were evaluated for self-harm/suicidal behavior again 1 year later and the "noncase" cohort was selected for statistical analysis. To examine the relationship between Internet addiction and self-harm/suicidal behavior, multivariate logistic regression analysis was performed using Internet addiction at baseline as the predictor for newly developed self-harm/suicidal behavior in the next year, after adjustment for potential confounding variables. The prevalence rate of Internet addiction at baseline was 23.0%. There were 59 students (3.9%) who were identified as having developed new self-harm/suicidal behaviors on follow-up assessments. After controlling for the effects of potential confounders, the relative risk of newly emerging self-harm/suicidal behavior for participants who were classified as Internet addicted was 2.41 (95% CI 1.16-4.99, P = .018) when compared with those without Internet addiction. Our findings indicate that Internet addiction is prospectively associated with the incidence of self-harm/suicidal behavior in adolescents. Copyright © 2018 Elsevier Inc. All rights reserved.

Comparison of Baseline Characteristics between Community-based and Hospital-based Suicidal Ideators and Its Implications for Tailoring Strategies for Suicide Prevention: Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior.

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Park, C Hyung Keun; Lee, Jae Won; Lee, Sang Yeol; Moon, Jungjoon; Shim, Se Hoon; Paik, Jong Woo; Kim, Shin Gyeom; Cho, Seong Jin; Kim, Min Hyuk; Kim, Seokho; Park, Jae Hyun; You, Sungeun; Jeon, Hong Jin; Ahn, Yong Min

2017-09-01

In this cross-sectional study, we aimed to identify distinguishing factors between populations with suicidal ideation recruited from hospitals and communities to make an efficient allocation of limited anti-suicidal resources according to group differences. We analyzed the baseline data from 120 individuals in a community-based cohort (CC) and 137 individuals in a hospital-based cohort (HC) with suicidal ideation obtained from the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) study. First, their sociodemographic factors, histories of medical and psychiatric illnesses, and suicidal behaviors were compared. Second, diagnosis by the Korean version of the Mini International Neuropsychiatric Interview, scores of psychometric scales were used to assess differences in clinical severity between the groups. The results revealed that the HC had more severe clinical features: more psychiatric diagnosis including current and recurrent major depressive episodes (odds ratio [OR], 4.054; P suicide risk (OR, 4.817; P suicidality. © 2017 The Korean Academy of Medical Sciences.

Personality and Suicidal Behavior in Old Age: A Systematic Literature Review

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Anna Szücs

2018-05-01

Full Text Available BackgroundSuicide rates generally peak in the second half of life and are particularly high in older men; however, little is known about the contribution of dispositional factors to late-life suicide. Maladaptive personality traits have been strongly implicated in suicide among younger adults, but the extent to which they continue to play a role in late-life suicidal behavior is unclear. We also do not know whether specific personality profiles interact with the stressors of aging to cause suicidal behavior.MethodsWe sought to synthesize the data on personality pathology in late-life suicidal ideation and behavior via a systematic review using the PubMed, Google Scholar, PsycInfo, Scopus, Ovid, Web of Science, Embase, and Cochrane search engines. The included key words related to three descriptors: “personality,” “suicide,” and “elderly.” Included articles evaluated personality based on the Five-Factor Model (FFM or ICD/DSM diagnostic criteria in older samples with minimum age cutoffs of 50 years or older. Our original search identified 1,183 articles, of which 31 were retained.ResultsIncluded studies were heterogeneous in their design and personality measurements. Studies of categorical personality disorders were particularly scarce and suggested a stronger association with late-life suicidal ideation than with death by suicide. Only obsessive–compulsive and avoidant personality traits were associated with death by suicide in old age, but only in studies that did not control for depression. All personality constructs were positively linked to suicidal ideation, except for histrionic personality, which emerged as a negative predictor. Studies employing the FFM also indicated that older adults who died by suicide were less likely to display a maladaptive personality profile than elderly suicide attempters and younger suicide victims, having both lower levels of neuroticism and higher levels of conscientiousness than these

Aggression, impulsivity, and suicide behavior: a review of the literature.

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Gvion, Yari; Apter, Alan

2011-01-01

This article reviews the literature on the association between impulsivity aggression and suicide. The key words impulsivity, aggression, and suicide were entered into the pubmed, psychlit, and proqest databases. Significant articles were scrutinized for relevant information. Impulsivity and aggression are highly correlated with suicidal behavior across psychiatric samples, nosological borders, and non-psychiatric populations. Impulsivity and aggression are related but the nature of this relationship remains unclear. The literature is confusing and contradictory. This is probably due to the difficulty in defining and separating out these concepts and the fact that there is much overlap between them. Future research should aim at clarifying and refining these concepts as well as their link to all the different forms of suicidal behavior.

Adverse obstetric outcomes during delivery hospitalizations complicated by suicidal behavior among US pregnant women.

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Zhong, Qiu-Yue; Gelaye, Bizu; Smoller, Jordan W; Avillach, Paul; Cai, Tianxi; Williams, Michelle A

2018-01-01

The effects of suicidal behavior on obstetric outcomes remain dangerously unquantified. We sought to report on the risk of adverse obstetric outcomes for US women with suicidal behavior at the time of delivery. We performed a cross-sectional analysis of delivery hospitalizations from 2007-2012 National (Nationwide) Inpatient Sample. From the same hospitalization record, International Classification of Diseases codes were used to identify suicidal behavior and adverse obstetric outcomes. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were obtained using logistic regression. Of the 23,507,597 delivery hospitalizations, 2,180 were complicated by suicidal behavior. Women with suicidal behavior were at a heightened risk for outcomes including antepartum hemorrhage (aOR = 2.34; 95% CI: 1.47-3.74), placental abruption (aOR = 2.07; 95% CI: 1.17-3.66), postpartum hemorrhage (aOR = 2.33; 95% CI: 1.61-3.37), premature delivery (aOR = 3.08; 95% CI: 2.43-3.90), stillbirth (aOR = 10.73; 95% CI: 7.41-15.56), poor fetal growth (aOR = 1.70; 95% CI: 1.10-2.62), and fetal anomalies (aOR = 3.72; 95% CI: 2.57-5.40). No significant association was observed for maternal suicidal behavior with cesarean delivery, induction of labor, premature rupture of membranes, excessive fetal growth, and fetal distress. The mean length of stay was longer for women with suicidal behavior. During delivery hospitalization, women with suicidal behavior are at increased risk for many adverse obstetric outcomes, highlighting the importance of screening for and providing appropriate clinical care for women with suicidal behavior during pregnancy.

Cognitive, Emotional, Temperament, and Personality Trait Correlates of Suicidal Behavior.

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Giner, Lucas; Blasco-Fontecilla, Hilario; De La Vega, Diego; Courtet, Philippe

2016-11-01

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.

The Associations Between Children's and Adolescents' Suicidal and Self-Harming Behaviors, and Related Behaviors Within Their Social Networks: A Systematic Review.

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Quigley, Jody; Rasmussen, Susan; McAlaney, John

2017-01-01

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.

Hopelessness, defeat, and entrapment in posttraumatic stress disorder: their association with suicidal behavior and severity of depression.

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Panagioti, Maria; Gooding, Patricia A; Tarrier, Nicholas

2012-08-01

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.

Adaptive Characteristics and Suicidal Behavior: A Gender Comparison of Young Adults

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Ellis, Jon B.; Lamis, Dorian A.

2007-01-01

Differences in suicidal behavior and adaptive characteristics were examined in college students with a particular emphasis on gender differences. Participants consisted of 344 undergraduate students who were administered a revised version of the Suicide Behaviors Questionnaire (SBQ), the Expanded Reasons for Living Inventory (RFL), and a…

The mediating role of non-suicidal self-injury in the relationship between impulsivity and suicidal behavior among inpatients receiving treatment for substance use disorders.

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Anestis, Michael D; Tull, Matthew T; Lavender, Jason M; Gratz, Kim L

2014-08-15

Several theories posit a direct role of impulsivity in suicidal behavior. The interpersonal-psychological theory of suicidal behavior (IPTS) argues that the relationship between impulsivity and suicidal behavior is explained by the painful and/or provocative experiences (PPEs) often encountered by impulsive individuals. It thus seems plausible that nonsuicidal self-injury (NSSI), itself associated with impulsivity, might account for the relationship between impulsivity and suicidal behavior. We examined data from 93 adult inpatients (54.8% male) seeking treatment for substance use disorders. Patients completed a structured interview assessing prior suicidal behavior and a series of self-report questionnaires examining impulsivity, NSSI, and psychopathology. Four impulsivity dimensions (negative urgency, positive urgency, lack of premeditation, lack of perseverance) were associated with lifetime number of suicide attempts and/or suicide potential. Furthermore, results supported our hypotheses, as all but one relation was better accounted for by NSSI and, in the one exception, the direct effect was non-significant. Findings are consistent with the IPTS and suggest that suicidal behavior may not be a direct manifestation of impulsivity, but facilitated through exposure to PPEs capable of altering an individual׳s relationship to pain and fear of death. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Specific features of suicidal behavior in patients with narcissistic personality disorder.

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Blasco-Fontecilla, Hilario; Baca-Garcia, Enrique; Dervic, Kanita; Perez-Rodriguez, M Mercedes; Lopez-Castroman, Jorge; Saiz-Ruiz, Jeronimo; Oquendo, Maria A

2009-11-01

Suicidal behavior is a clinically significant but underestimated cause of mortality in narcissistic personality disorder. Currently, there are no reliable estimates of suicidal behavior for this population. The main objective of this study was to test whether or not suicide attempters diagnosed with narcissistic personality disorder are different in terms of impulsivity and expected lethality from suicide attempters with other cluster B personality disorders. In a sample of 446 suicide attempters, patients with cluster B personality disorder diagnoses (n = 254) as assessed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), version of the International Personality Disorder Examination-Screening Questionnaire (IPDE-SQ) were compared in terms of expected lethality and impulsivity (measured by the Beck Suicidal Intent Scale and the Barratt Impulsiveness Scale, respectively). The subjects were admitted to the emergency departments of the Ramón y Cajal Hospital and the Fundación Jiménez Diaz University Hospital in Madrid, Spain, between January 1999 and January 2003. Suicide attempts of subjects diagnosed with narcissistic personality disorder had higher expected lethality than those of subjects without narcissistic personality disorder (t = -4.24, df = 439, P personality disorder (t = 0.28, df = 439, P = .795), antisocial personality disorder (t = 0.66, df = 439, P = .504), and borderline personality disorder (t = 1.13, df = 439, P = .256), respectively. Suicide attempters diagnosed with narcissistic personality disorder did not significantly differ from suicide attempters without narcissistic personality disorder in terms of impulsivity measures (t = -0.33, df = 442, P = .738), while suicide attempters diagnosed with antisocial personality disorder, histrionic personality disorder, and borderline personality disorder were significantly more impulsive than suicide attempters without these diagnoses (t = -3.96, df = 442, P

Child and Adolescent Suicide Attempts, Suicidal Behavior, and Adverse Childhood Experiences in South Africa: A Prospective Study.

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Cluver, Lucie; Orkin, Mark; Boyes, Mark E; Sherr, Lorraine

2015-07-01

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.

Dialectical behavior therapy for suicidal adolescents with borderline personality disorder.

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Klein, Dena A; Miller, Alec L

2011-04-01

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.

Academic Deans and Suicidal Individuals: Comparison and Contrast of Selected Behavioral Outcomes.

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DiNapoli, Joan B.

The research question for this dissertation study was: Do behavioral outcomes identified in people who commit suicide exist in people who publicly exhibit productive behavioral outcomes and have not attempted suicide? More specifically, do selective affective and physiological behavioral outcomes identified in people who kill themselves exist is…

Cognitive-Behavioral Therapy for Suicide Prevention (CBT-SP): Treatment Model, Feasibility, and Acceptability

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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

2009-01-01

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…

Chol understandings of suicide and human agency.

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Imberton, Gracia

2012-06-01

According to ethnographic material collected since 2003, the Chol Mayan indigenous people in southern Mexico have different causal explanations for suicide. It can be attributed to witchcraft that forces victims to take their lives against their own will, to excessive drinking, or to fate determined by God. However, it can also be conceived of as a conscious decision made by a person overwhelmed by daily problems. Drawing from the theoretical framework developed by Laura M. Ahearn, inspired by practice theory, the paper contends that these different explanations operate within two different logics or understandings of human agency. The first logic attributes responsibility to supernatural causes such as witchcraft or divine destiny, and reflects Chol notions of personhood. The second logic accepts personal responsibility for suicide, and is related to processes of social change such as the introduction of wage labor, education and a market economy. The contemporary Chol resort to both logics to make sense of the human drama of suicide.

Cross-national analysis of the associations among mental disorders and suicidal behavior: findings from the WHO World Mental Health Surveys.

Directory of Open Access Journals (Sweden)

Matthew K Nock

2009-08-01

age-of-onset of mental disorders and suicidal behaviors, as well as the narrow focus on mental disorders as predictors of nonfatal suicidal behaviors, each of which must be addressed in future studies.This study found that a wide range of mental disorders increased the odds of experiencing suicide ideation. However, after controlling for psychiatric comorbidity, only disorders characterized by anxiety and poor impulse-control predict which people with suicide ideation act on such thoughts. These findings provide a more fine-grained understanding of the associations between mental disorders and subsequent suicidal behavior than previously available and indicate that mental disorders predict suicidal behaviors similarly in both developed and developing countries. Future research is needed to delineate the mechanisms through which people come to think about suicide and subsequently progress from ideation to attempts.

77 FR 48989 - Draft Guidance for Industry on Suicidal Ideation and Behavior: Prospective Assessment of...

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2012-08-15

...] Draft Guidance for Industry on Suicidal Ideation and Behavior: Prospective Assessment of Occurrence in... ``Suicidal Ideation and Behavior: Prospective Assessment of Occurrence in Clinical Trials.'' The purpose of... suicidal ideation and behavior in clinical trials of drug and biological products, including drugs for...

The moderating effects of parenting styles on African-American and Caucasian children's suicidal behaviors.

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Greening, Leilani; Stoppelbein, Laura; Luebbe, Aaron

2010-04-01

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.

Associations between Delinquency and Suicidal Behaviors in a Nationally Representative Sample of Adolescents

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Thompson, Martie P.; Kingree, J. B.; Ho, Ching-hua

2006-01-01

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…

Assessing for suicidal behavior in youth using the Achenbach System of Empirically Based Assessment.

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Van Meter, Anna R; Algorta, Guillermo Perez; Youngstrom, Eric A; Lechtman, Yana; Youngstrom, Jen K; Feeny, Norah C; Findling, Robert L

2018-02-01

This study investigated the clinical utility of the Achenbach System of Empirically Based Assessment (ASEBA) for identifying youth at risk for suicide. Specifically, we investigated how well the Total Problems scores and the sum of two suicide-related items (#18 "Deliberately harms self or attempts suicide" and #91 "Talks about killing self") were able to distinguish youth with a history of suicidal behavior. Youth (N = 1117) aged 5-18 were recruited for two studies of mental illness. History of suicidal behavior was assessed by semi-structured interviews (K-SADS) with youth and caregivers. Youth, caregivers, and a primary teacher each completed the appropriate form (YSR, CBCL, and TRF, respectively) of the ASEBA. Areas under the curve (AUCs) from ROC analyses and diagnostic likelihood ratios (DLRs) were used to measure the ability of both Total Problems T scores, as well as the summed score of two suicide-related items, to identify youth with a history of suicidal behavior. The Suicide Items from the CBCL and YSR performed well (AUCs = 0.85 and 0.70, respectively). The TRF Suicide Items did not perform better than chance, AUC = 0.45. The AUCs for the Total Problems scores were poor-to-fair (0.33-0.65). The CBCL Suicide Items outperformed all other scores (ps = 0.04 to youth's risk for suicidal behavior. The low burden of this approach could facilitate wide-spread screening for suicide in an increasingly at-risk population.

The Associations Between Children's and Adolescents’ Suicidal and Self-Harming Behaviors, and Related Behaviors Within Their Social Networks: A Systematic Review

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Quigley, J.; Rasmussen, S.; McAlaney, John

2017-01-01

© 2017, Copyright © International Academy for Suicide Research.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, wit...

A pilot integrative genomics study of GABA and glutamate neurotransmitter systems in suicide, suicidal behavior, and major depressive disorder.

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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

2016-04-01

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.

Cognition As a Therapeutic Target in the Suicidal Patient Approach

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da Silva, Antônio Geraldo; Malloy-Diniz, Leandro Fernandes; Garcia, Marina Saraiva; Figueiredo, Carlos Guilherme Silva; Figueiredo, Renata Nayara; Diaz, Alexandre Paim; Palha, António Pacheco

2018-01-01

The current considerations about completed suicides and suicide attempts in different cultures call the attention of professionals to this serious public health problem. Integrative approaches have shown that the confluence of multiple biological and social factors modulate various psychopathologies and dysfunctional behaviors, such as suicidal behavior. Considering the level of intermediate analysis, personality traits and cognitive functioning are also of great importance for understanding the suicide phenomenon. About cognitive factors, we can group them into cognitive schemas of reality interpretation and underlying cognitive processes. On the other hand, different types of primary cognitive alterations are related to suicidal behavior, especially those resulting from changes in frontostriatal circuits. Among such cognitive mechanisms can be highlighted the attentional bias for environmental cues related to suicide, impulsive behavior, verbal fluency deficits, non-adaptive decision-making, and reduced planning skills. Attentional bias consists in the effect of thoughts and emotions, frequently not conscious, about the perception of environmental stimuli. Suicidal ideation and hopelessness can make the patient unable to find alternative solutions to their problems other than suicide, biasing their attention to environmental cues related to such behavior. Recent research efforts are directed to assess the possible use of attention bias as a therapeutic target in patients presenting suicide behavior. The relationship between impulsivity and suicide has been largely investigated over the last decades, and there is still controversy about the theme. Although there is strong evidence linking impulsivity to suicide attempts. Effective interventions address to reduce impulsivity in clinical populations at higher risk for suicide could help in the prevention. Deficits in problem-solving ability also seem to be distorted in patients who attempt suicide. Understanding

Cognition As a Therapeutic Target in the Suicidal Patient Approach

Directory of Open Access Journals (Sweden)

Antônio Geraldo da Silva

2018-02-01

Full Text Available The current considerations about completed suicides and suicide attempts in different cultures call the attention of professionals to this serious public health problem. Integrative approaches have shown that the confluence of multiple biological and social factors modulate various psychopathologies and dysfunctional behaviors, such as suicidal behavior. Considering the level of intermediate analysis, personality traits and cognitive functioning are also of great importance for understanding the suicide phenomenon. About cognitive factors, we can group them into cognitive schemas of reality interpretation and underlying cognitive processes. On the other hand, different types of primary cognitive alterations are related to suicidal behavior, especially those resulting from changes in frontostriatal circuits. Among such cognitive mechanisms can be highlighted the attentional bias for environmental cues related to suicide, impulsive behavior, verbal fluency deficits, non-adaptive decision-making, and reduced planning skills. Attentional bias consists in the effect of thoughts and emotions, frequently not conscious, about the perception of environmental stimuli. Suicidal ideation and hopelessness can make the patient unable to find alternative solutions to their problems other than suicide, biasing their attention to environmental cues related to such behavior. Recent research efforts are directed to assess the possible use of attention bias as a therapeutic target in patients presenting suicide behavior. The relationship between impulsivity and suicide has been largely investigated over the last decades, and there is still controversy about the theme. Although there is strong evidence linking impulsivity to suicide attempts. Effective interventions address to reduce impulsivity in clinical populations at higher risk for suicide could help in the prevention. Deficits in problem-solving ability also seem to be distorted in patients who attempt

Parenting behavior and the Interpersonal-Psychological Theory of Suicide: a mediated moderation analysis with adolescents.

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Cero, Ian; Sifers, Sarah K

2013-09-25

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, p<.05, κ(2)=.07). Conversely, the effect of parental boundaries on suicide attempts was significant for boys, but not for girls, and was mediated by exposure to violence (b=.029, SE(boot)=.021, p<.05, κ(2)=.07). This study involved retrospective report with proxy-measures of IPTS constructs. Future research should consider multiple informants and additional measures. Findings highlight potential mechanisms by which parenting 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.

Associations of childhood bullying victimization with lifetime suicidal behaviors among new U.S. Army soldiers.

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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

2017-08-01

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.

The Economic Cost of Suicide and Non-Fatal Suicide Behavior in the Australian Workforce and the Potential Impact of a Workplace Suicide Prevention Strategy.

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Kinchin, Irina; Doran, Christopher M

2017-03-27

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.

The Economic Cost of Suicide and Non-Fatal Suicide Behavior in the Australian Workforce and the Potential Impact of a Workplace Suicide Prevention Strategy

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Irina Kinchin

2017-03-01

Full Text Available 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.

Heavy alcohol use and suicidal behavior among people who use illicit drugs: A cohort study.

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Kennedy, Mary Clare; Marshall, Brandon D L; Hayashi, Kanna; Nguyen, Paul; Wood, Evan; Kerr, Thomas

2015-06-01

People who use illicit drugs (PWUD) are known to experience high rates of suicidal behavior. While heavy alcohol use has been associated with suicide risk, its impact on the suicidal behavior of PWUD has not been well characterized. Therefore, we examined the relationship between heavy alcohol use and suicidal behavior among PWUD in Vancouver, Canada. Data are derived from two prospective cohort studies of PWUD in Vancouver, Canada, from 2005 to 2013. Participants completed questionnaires that elicited information regarding sociodemographics, drug use patterns, and mental health problems, including suicidal behavior. We used recurrent event survival analyses to estimate the independent association between at-risk/heavy drinking (based on National Institute of Alcohol Abuse and Alcoholism [NIAAA] criteria) and risk of incident, self-reported suicide attempts. Of 1757 participants, 162 participants (9.2%) reported 227 suicide attempts over the 8-year study period, resulting in an incidence rate of 2.5 cases per 100 person-years. After adjusting for potential confounders, including intensive illicit drug use patterns, heavy alcohol use (adjusted hazard ratio [AHR] = 1.97; 95% confidence interval [CI] = 1.39, 2.78) was positively associated with an increased risk of suicidal behavior. We observed a high burden of suicidal behavior among a community-recruited sample of PWUD. Heavy alcohol use predicted a higher risk of suicide attempt, independent of other drug use patterns. These findings demonstrate the need for evidence-based interventions to address suicide risk among PWUD, particularly those who are heavy consumers of alcohol. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The continuity and duration of depression and its relationship to non-suicidal self-harm and suicidal ideation and behavior in adolescents 12-17.

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Zubrick, Stephen R; Hafekost, Jennifer; Johnson, Sarah E; Sawyer, Michael G; Patton, George; Lawrence, David

2017-10-01

There is a significant overlap between non-suicidal self-harm and suicidal ideation and behavior in young people with both symptom continuity and symptom duration implicated in this association. A population sample of Australian 12-17 year olds. Interviewers collected measures for DSM disorders, symptom duration and continuity, and background information from their parents, while young people self-reported symptoms of depression, non-suicidal self-harm and suicidal ideation and behaviors. This report focusses on the 265 young people who met the DSM criteria for Major Depressive Disorder based on their own self-reports. Relative to young people who had at least one period 2 months or longer without symptoms since first onset, young people who had the continuous presence of depressive symptoms since their first onset had significantly higher odds for life-time self-harm, 12-month self-harm, multiple self-harm, suicidal ideation and suicide attempt within the past 12 months. The duration of depressive symptoms and the continuity of these symptoms each independently contribute to elevating the risks of non-suicidal self-harming and suicidal ideation and behaviors. Reliance on self-report from the young people and time constraints prohibiting administering diagnostic modules other than the Major Depressive Disorder and estimating self-reported co-morbidity. Among young people with a Major Depressive Disorder, self-reports about duration of depressive symptoms as well as the continuity of symptoms, each independently contributes to elevated risks of non-suicidal self-harming and suicidal ideation and behaviors. As well, un-remitting as opposed to episodic symptoms in this group of young people are common and are a powerful indicator of suffering associated with both self-harm and suicidal behavior. Copyright © 2017 Elsevier B.V. All rights reserved.

A within-person approach to risk for suicidal ideation and suicidal behavior: Examining the roles of depression, stress, and abuse exposure.

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Miller, Adam Bryant; Eisenlohr-Moul, Tory; Giletta, Matteo; Hastings, Paul D; Rudolph, Karen D; Nock, Matthew K; Prinstein, Mitchell J

2017-07-01

This study tests a novel, within-person model that reexamines depression and stress as risk factors for suicidal ideation and behavior among adolescent girls with and without sexual/physical abuse histories. This longitudinal study includes data from 220 adolescent girls between 12 and 16 years of age (M = 14.69 years, SD = 1.37; 61% White). At baseline, adolescents reported the presence or absence of prior abuse as part of a clinical interview. At baseline and every 3 months for 18 months, adolescents completed measures of suicidal ideation and behavior, depressive symptoms, and stress. Multilevel models examined within-person mean, deviations from within-person mean, depression, and stress and their interactions with abuse as predictors of suicidal ideation and behavior. In addition to within-person mean depression, higher-than-usual depression (odds ratio [OR] = 1.99) and higher-than-usual stress (OR = 1.53) predicted greater risk of suicidal ideation at each follow-up assessment. Periods of higher-than-usual stress (1 SD increase) and periods of higher-than-usual depression (1 SD increase) were associated with an 82% and 57% increase in the odds of suicidal behavior, respectively, but only among those with abuse histories. Depression, stress, and abuse are well-known risk factors for suicidal ideation and behavior; however, it has been unclear for whom, and when, these factors have their greatest impact. These results show that depression and stress are potent risk factors among those with a history of abuse and that within-person elevations in these risk factors signal increased short-term risk of suicidal ideation and behavior. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Suicidal behavior and attitudes in Slovak and Turkish high school students: a cross-cultural investigation.

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Eskin, Mehmet; Palova, Eva; Krokavcova, Martina

2014-01-01

Suicidal behavior and its variation across social contexts are of importance for the science of suicidology. Due to its special character controlled experimental studies on suicide are ruled out for ethical reasons. Cross-cultural studies may throw light on the etiology of both suicidal behavior and its cross-cultural variation. The present study compared suicidal behavior and attitudes in 423 Slovak and 541 Turkish high school students by means of a self-report questionnaire. The two groups reported similar percentages (Slovak = 36.4%; Turkish = 33.8%) of lifetime, past 12-months or current suicidal ideation but significantly more Turkish (12.2%) than Slovak (4.8%) students reported lifetime or past 12-months suicide attempts. Slovak adolescents displayed more liberal and permissive attitudes toward suicide, while those of Turkish adolescents were more rejecting. Turkish students rated themselves to be more religious and hence they believed to a greater extent that suicidal persons would be punished in a life after death than their Slovak peers. However, attitudes of Turkish students toward an imagined suicidal close friend were more accepting than the attitudes of Slovak students. Comparison of suicidal and nonsuicidal students revealed that those reporting suicidal ideation or attempts were more accepting of suicide and viewed suicide as a solution to a greater extent than the nonsuicidal ones. The results from this study suggest that cultural factors play a role in suicidal behavior, attitudes and reactions in a predicted direction.

Progression of suicidal ideation to suicidal behavior from a perspective of selected suicidological models.

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Rodziński, Paweł; Rutkowski, Krzysztof; Ostachowska, Anna

2017-06-18

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.

Impact of treatment intensity on suicidal behavior and depression in borderline personality disorder: a critical review.

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Davidson, Kate M; Tran, Cathy F

2014-04-01

The effectiveness of less versus more intensive psychological therapies in reducing suicidal behavior and depression in suicidal patients with borderline personality disorder (BPD) was examined. Electronic databases were searched. Trials were separated into less versus more intensive therapies. Suicidal acts and depression outcome data were assessed. Six trials met search criteria (cognitive-behavioral therapy for personality disorder, mentalization-based therapy, dialectical behavior therapy). Seven measures of suicidal acts and two measures of depression were used in studies. Both less and more intensive therapies report significant decreases in suicidal behaviors. Apart from one small trial, both less and more intensive therapies report decreases in depression with no differences between therapies and control conditions. Two follow-up studies showed that reductions in suicidal behavior and depression are maintained over time. The authors conclude that both less and more intensive therapies are effective in treating depression and suicidal behaviors in patients with BPD. Clinicians should deliver the least intensive interventions that will provide these significant health gains.

Towards understanding and predicting suicidality in women: biomarkers and clinical risk assessment.

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Levey, D F; Niculescu, E M; Le-Niculescu, H; Dainton, H L; Phalen, P L; Ladd, T B; Weber, H; Belanger, E; Graham, D L; Khan, F N; Vanipenta, N P; Stage, E C; Ballew, A; Yard, M; Gelbart, T; Shekhar, A; Schork, N J; Kurian, S M; Sandusky, G E; Salomon, D R; Niculescu, A B

2016-06-01

Women are under-represented in research on suicidality to date. Although women have a lower rate of suicide completion than men, due in part to the less-violent methods used, they have a higher rate of suicide attempts. Our group has previously identified genomic (blood gene expression biomarkers) and clinical information (apps) predictors for suicidality in men. We now describe pilot studies in women. We used a powerful within-participant discovery approach to identify genes that change in expression between no suicidal ideation (no SI) and high suicidal ideation (high SI) states (n=12 participants out of a cohort of 51 women psychiatric participants followed longitudinally, with diagnoses of bipolar disorder, depression, schizoaffective disorder and schizophrenia). We then used a Convergent Functional Genomics (CFG) approach to prioritize the candidate biomarkers identified in the discovery step by using all the prior evidence in the field. Next, we validated for suicidal behavior the top-ranked biomarkers for SI, in a demographically matched cohort of women suicide completers from the coroner's office (n=6), by assessing which markers were stepwise changed from no SI to high SI to suicide completers. We then tested the 50 biomarkers that survived Bonferroni correction in the validation step, as well as top increased and decreased biomarkers from the discovery and prioritization steps, in a completely independent test cohort of women psychiatric disorder participants for prediction of SI (n=33) and in a future follow-up cohort of psychiatric disorder participants for prediction of psychiatric hospitalizations due to suicidality (n=24). Additionally, we examined how two clinical instruments in the form of apps, Convergent Functional Information for Suicidality (CFI-S) and Simplified Affective State Scale (SASS), previously tested in men, perform in women. The top CFI-S item distinguishing high SI from no SI states was the chronic stress of social isolation. We

Pronounced prefronto-temporal cortical thinning in schizophrenia: Neuroanatomical correlate of suicidal behavior?

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Besteher, Bianca; Wagner, Gerd; Koch, Kathrin; Schachtzabel, Claudia; Reichenbach, Jürgen R; Schlösser, Ralf; Sauer, Heinrich; Schultz, C Christoph

2016-10-01

Schizophrenia is characterized by increased mortality for which suicidality is the decisive factor. An analysis of cortical thickness and folding to further elucidate neuroanatomical correlates of suicidality in schizophrenia has not yet been performed. We searched for relevant brain regions with such differences between patients with suicide-attempts, patients without any suicidal thoughts and healthy controls. 37 schizophrenia patients (14 suicide-attempters and 23 non-suicidal) and 50 age- and gender-matched healthy controls were included. Suicidality was documented through clinical interview and chart review. All participants underwent T1-weighted MRI scans. Whole brain node-by-node cortical thickness and folding were estimated (FreeSurfer Software) and compared. Additionally a three group comparison for prefrontal regions-of-interest was performed in SPSS using a multifactorial GLM. Compared with the healthy controls patients showed a typical pattern of cortical thinning in prefronto-temporal regions and altered cortical folding in the right medial temporal cortex. Patients with suicidal behavior compared with non-suicidal patients demonstrated pronounced (psuicidal patients with non-suicidal patients significant (psuicidal behaviour in schizophrenia. We identified cortical thinning in a network strongly involved in regulation of impulsivity, emotions and planning of behaviour in suicide attempters, which might lead to neuronal dysregulation in this network and consequently to a higher risk of suicidal behavior. Copyright © 2016 Elsevier B.V. All rights reserved.

The Moderating Effects of Parenting Styles on African-American and Caucasian Children's Suicidal Behaviors

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Greening, Leilani; Stoppelbein, Laura; Luebbe, Aaron

2010-01-01

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…

Social behavior, interaction appraisals, and suicidal ideation in schizophrenia: The dangers of being alone

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Depp, Colin A.; Moore, Raeanne C.; Perivoliotis, Dimitri; Holden, Jason L.; Swendsen, Joel; Granholm, Eric L.

2016-01-01

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...

Dating violence and suicidal behavior in adolescents.

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Holmes, Kristin; Sher, Leo

2013-01-01

The aim of this paper is to assess the possible consequences of adolescent physical, emotional and sexual dating violence through a review of the literature on the topic. An electronic search of major biomedical bibliographic databases (Pubmed, ISI, PsycINFO) was used to retrieve articles providing information on the prevalence rates, risk factors, associated consequences and possible preventive measures for adolescent dating violence across different populations. Currently, there have been few longitudinal studies conducted to identify potential risk factors for entering a violent dating relationship in adolescence. Risky behaviors such as early sexual intercourse may predispose someone for victimization. Dating violence itself is also a predictor of future dating violence. Adolescent dating violence was associated with an increase in other violence-related behaviors, substance use, depression, poorer educational outcomes, posttraumatic stress, unhealthy weight control and risky sexual behavior. The association between adolescent dating violence and an increase in suicidal behavior is a major public health concern. Future research should focus on longitudinal studies so that a causal relationship between dating violence and suicidality may be better understood.

The Role of Difficulty in Identifying and Describing Feelings in Non-Suicidal Self-Injury Behavior (NSSI): Associations With Perceived Attachment Quality, Stressful Life Events, and Suicidal Ideation.

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Cerutti, Rita; Zuffianò, Antonio; Spensieri, Valentina

2018-01-01

Objective: Core alexithymic features, such as the difficulty in identifying and describing feelings, are associated with poor attachment styles and emotional trauma, which influence the capacity to regulate affect. Additionally, emotional regulation has been found to be the most commonly identified function associated with non-suicidal self-injury behavior (NSSI) in adolescents as they attempt to modulate strong emotions. However, few studies have examined the link between difficulty in identifying and describing feelings (core components of alexithymia), NSSI behaviors, quality of attachment, life stressors and suicidal ideation in healthy early adolescents. Consequently, this study aims to investigate these constructs and the relationship among them in a large non-clinical sample of adolescents. Methods: Seven hundred and nine middle school students (50.4% males), aged 10-15 years ( M = 12.6; SD = 1.06) were involved in this study. In order to investigate the variables considered in the study, the following measures were administered: the Deliberate Self-Harm Inventory exploring non-suicidal self-injurious behaviors; the Alexithymia Questionnaire for Children examining difficulty in identifying and describing feelings; the Inventory of Parent and Peer Attachment assessing the quality of parental and peer attachment; the Life Stressor Checklist-Revised outlining stressful/traumatic events and the Children's Depression Inventory evaluating suicidal ideation. Results: We found significantly positive relationships among difficulty in identifying and describing feelings, NSSI behaviors, stressful events, and suicidal ideation. Data indicated a significant negative association of difficulty in identifying and describing feelings with quality of attachment to parents and peers. Further findings highlighted that difficulty in identifying and describing feelings significantly mediated the effect of quality of attachment (parent and peer) on NSSI and suicidal ideation

Ruminative subtypes and impulsivity in risk for suicidal behavior.

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Valderrama, Jorge; Miranda, Regina; Jeglic, Elizabeth

2016-02-28

Rumination has been previously linked to negative psychological outcomes, including depression and suicidal behavior. However, there has been conflicting research on whether or not two different subtypes of rumination - brooding and reflection - are more or less maladaptive. The present research sought to (1) examine whether individuals high in brooding but lower in reflection would show higher trait and behavioral impulsivity, relative to individuals low in brooding and low in reflection; and (2) examine impulsivity as a mediator of the relation between ruminative subtypes and suicidal ideation. In Study 1, participants (N=78) were recruited based on high, average, and low scores on a measure of brooding and reflective rumination. Individuals who scored high in brooding and average in reflection scored significantly higher in negative urgency, that is, in the tendency to act rashly in an attempt to reduce negative affect, than did those who scored low in brooding and low in reflection. Study 2 (N=1638) examined the relationship between ruminative subtypes, impulsivity, and suicide risk. We found an indirect relationship between brooding and suicide risk through lack of premeditation and lack of perseverance, independently of reflection. These findings are discussed in relation to cognitive risk for suicide. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Gender differences in adolescent coping behaviors and suicidal ideation: findings from a sample of 73,238 adolescents.

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Kim, Sun Mi; Han, Doug Hyun; Trksak, George H; Lee, Young Sik

2014-01-01

Suicide among adolescents is an emerging global public health problem as well as a socioeconomic problem. Stress-coping strategies have been shown to be associated with suicidal ideation. We examined coping behaviors related to suicidal ideation and gender differences in adolescents using the data from the 2010 Korea Youth Risk Behavior Survey (ages 12-19 years; N = 73,238). Logistic regression analysis was used to evaluate associations between suicidal ideation and specific coping behaviors while controlling for potentially confounding variables. In both male and female groups, the coping behavior "drinking alcoholic beverages" and "smoking cigarettes" were positively associated with suicidal ideation. "Watching TV," "playing online/mobile games," and "sleeping" were negatively associated with suicidal ideation in both groups. In males, "engaging in sports" was negatively related to suicidal ideation. In females, "venting by talking to others" and "eating" were negatively related to suicidal ideation. The results indicate that there are gender differences in the effects of coping behaviors on adolescent suicidal ideation, and that developing adaptive coping strategies may function to reduce suicidality. Future studies are needed to examine whether improving coping skills can reduce suicidal ideation in a gender-specific manner.

Familism, parent-adolescent conflict, self-esteem, internalizing behaviors and suicide attempts among adolescent Latinas.

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Kuhlberg, Jill A; Peña, Juan B; Zayas, Luis H

2010-08-01

Adolescent Latinas continue to report higher levels of suicide attempts than their African-American and White peers. The phenomenon is still not understood and is theorized to be the result of the confluence of many cultural, familial, and individual level factors. In Latino cultures, belief in the importance of the family, the value known as familism, appears to protect youth's emotional and behavioral health, but parent-adolescent conflict has been found to be a risk factor for suicide attempts. The role of familism in relation to parent-adolescent conflict, self-esteem, internalizing behaviors, and suicide attempts has not been studied extensively. To address this question, we interviewed 226 adolescent Latinas, 50% of whom had histories of suicide attempts. Using path analysis, familism as a cultural asset was associated with lower levels of parent-adolescent conflict, but higher levels of internalizing behaviors, while self-esteem and internalizing behaviors mediated the relationship between parent-adolescent conflict and suicide attempts. Our findings point to the importance of family involvement in culturally competent suicide prevention and intervention programs. Reducing parent-daughter conflict and fostering closer family ties has the added effect of improving self-esteem and shrinking the likelihood of suicide attempts.

Suicidal ideation in Pakistani college students.

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Khokher, Sehar; Khan, Murad M

2005-01-01

Suicidal behavior includes ideation, attempts and completed suicides. Information on suicidal behavior from Pakistan, a conservative South Asian Islamic country, is lacking. To address the issue, a pilot study was carried out to assess the prevalence of suicidal ideation in Pakistani college students. Suicidal ideation was assessed on the basis of responses to four questions contained in the depression subscale of the General Health Questionnaire-28. Of the total 217 completed questionnaires, the overall rate of suicidal ideation was 31.4%. While there was no significant difference between genders, more females (33%) than males (29.2%) responded positively. Respondents belonging to single parent families and those living at home, compared to those using hostel facilities, reported higher rates. The reported rate in our sample is higher than similar studies conducted elsewhere. There is the need for more information in this important area of suicidal behavior, including studying such feelings in school going children as well as in a larger community sample. The findings of such studies can contribute to our understanding of the suicidal process in the Pakistani population and to address it at various levels.

Traditional and new media's influence on suicidal behavior and contagion.

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Ortiz, Patricia; Khin Khin, Eindra

2018-03-01

The role of nonfictional and fictional media in suicide contagion has been well established, ostensibly beginning with the publication of Goethe's The Sorrows of Young Werther in 1774. In recent decades, the emergence of several new forms of media (e.g. websites, social media, blogs, smartphone applications) has revolutionized the communication and social interaction paradigms. This article reviews "the Werther effect" (or suicide contagion related to media), special populations who are more influential or susceptible, current media reporting guidelines and their effectiveness, and the latest research on new media and its effect on suicide and suicide contagion. The aim is to update recommendations on how to mitigate the potential negative effects of both traditional and new media on suicidal behavior and suicide contagion. Copyright © 2018 John Wiley & Sons, Ltd.

The 5-HTTLPR polymorphism, impulsivity and suicide behavior in euthymic bipolar patients.

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Malloy-Diniz, Leandro Fernandes; Neves, Fernando Silva; de Moraes, Paulo Henrique Paiva; De Marco, Luiz Armando; Romano-Silva, Marco Aurélio; Krebs, Marie-Odile; Corrêa, Humberto

2011-09-01

Suicide behavior is very frequent in Bipolar Disorder (BD) and they are both closely associated with impulsivity. Furthermore they are, impulsivity, BD and suicide behavior, associated with serotonergic function, at least partially, under genetic determinism and somewhat associated with the serotonin transporter gene polymorphism, the 5-HTTLPR. We aimed to assess different impulsivity components in BD sub-grouped by suicidal attempt and healthy controls. We hypothesized that the non-planning/cognitive impulsivity, could be more closely associated with suicidal behavior. We further associated 5-HTTLPR genotypes with neuropsychological results to test the hypothesis that this polymorphism is associated with cognitive impulsivity. We assessed 95 euthymic bipolar patients sub-grouped by suicidal attempt history in comparison with 94 healthy controls. All subjects underwent a laboratory assessment of impulsivity (Continuous Performance Test and Iowa Gambling Test). Furthermore the genotyping of 5-HTTLPR was performed in all subjects. We found that bipolar patients are more impulsive than healthy controls in all impulsivity dimensions we studied. Furthermore bipolar patients with a suicide attempt history have a greater cognitive impulsivity when compared to both bipolar patients without such a history as well when compared to healthy controls. No association was found between 5-HTTLPR genotypes and neuropsychological measures of impulsive behavior. The sample studied can be considered small and a potentially confounding variable - medication status - was not controlled. A lifetime suicide attempt seems associated with cognitive impulsivity independently of the socio-demographic and clinical variables studied as well with 5-HTTLPR genotype. Further studies in larger samples are necessary. Copyright © 2011 Elsevier B.V. All rights reserved.

Functional disability and suicidal behavior in middle-aged and older adults: A systematic critical review.

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Lutz, Julie; Fiske, Amy

2018-02-01

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.

Multimarker analysis suggests the involvement of BDNF signaling and microRNA biosynthesis in suicidal behavior.

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Pulay, Attila J; Réthelyi, János M

2016-09-01

Despite moderate heritability estimates the genetics of suicidal behavior remains unclear, genome-wide association and candidate gene studies focusing on single nucleotide associations reported inconsistent findings. Our study explored biologically informed, multimarker candidate gene associations with suicidal behavior in mood disorders. We analyzed the GAIN Whole Genome Association Study of Bipolar Disorder version 3 (n = 999, suicidal n = 358) and the GAIN Major Depression: Stage 1 Genomewide Association in Population-Based Samples (n = 1,753, suicidal n = 245) datasets. Suicidal behavior was defined as severe suicidal ideation or attempt. Candidate genes were selected based on literature search (Geneset1, n = 35), gene expression data of microRNA genes, (Geneset2, n = 68) and their target genes (Geneset3, n = 11,259). Quality control, dosage analyses were carried out with PLINK. Gene-based associations of Geneset1 were analyzed with KGG. Polygenic profile scores of suicidal behavior were computed in the major depression dataset both with PRSice and LDpred and validated in the bipolar disorder data. Several nominally significant gene-based associations were detected, but only DICER1 associated with suicidal behavior in both samples, while only the associations of NTRK2 in the depression sample reached family wise and experiment wise significance. Polygenic profile scores negatively predicted suicidal behavior in the bipolar sample for only Geneset2, with the strongest prediction by PRSice at Pt  suicide and the cross-disorder association of DICER1. Polygenic risk prediction of the selected miRNA genes indicates that the miRNA system may play a mediating role, but with considerable pleiotropy. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Suicidal and self-injurious behavior among patients with alcohol and drug abuse

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Al-Sharqi AM

2012-07-01

Full Text Available Abdullah Mohammed Al-Sharqi,1 Khaled Saad Sherra,2 Abdulhameed Abdullah Al-Habeeb,3 Naseem Akhtar Qureshi3,41Private Clinic, Riyadh, Saudi Arabia; 2Psychiatric Department, Faculty of Medicine, Mansoura University, Egypt; 3General Administration for Mental Health and Social Services, 4General Directorate of Research and Studies, Ministry of Health, Riyadh, Saudi ArabiaBackground: Self-injurious behavior, a major public health problem globally, is linked with alcohol and drug abuse. This cross-sectional study aimed to identify the prevalence and correlates of self-harming behavior in patients with alcohol or drug abuse problems.Methods: This was a one-year study that recruited a convenience sample of 736 outpatients and inpatients identified with alcohol or drug abuse, and was conducted at Al-Amal mental health hospitals in three major cities. All consecutively selected patients were interviewed on five working days for data collection on a semistructured sociodemographic form using the Columbia Suicide Severity Rating Scale Risk Assessment version.Results: In addition to the socioclinical profile revealed, 50.7% of respondents reported any suicidal ideation, while 6.9% reported self-injurious behavior without intent to die. Any suicidal and self-injurious behavior was reported by 13.1% of participants. A total of 71.3% of respondents reported any recent negative activating events. In addition to any treatment history, observed correlates were hopelessness (60.7%, perceived burden on family (29.5%, refusing a safety plan (26.1%, and sexual abuse (11%. Conversely, reasons for living (64.9%, fear of death or dying due to pain and suffering (64.3%, and spirituality (92% were largely endorsed as protective factors. There were multiple significant odds ratios (P ≤ 0.01 revealed when independent socioclinical variables were compared with dependent variables in terms of suspected risk and protective factors. In an adjusted logistic regression model

Dissociable Patterns of Neural Activity during Response Inhibition in Depressed Adolescents with and without Suicidal Behavior

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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.

2011-01-01

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…

Seasonality of Suicidal Behavior

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Woo, Jong-Min; Okusaga, Olaoluwa; Postolache, Teodor T.

2012-01-01

A seasonal suicide peak in spring is highly replicated, but its specific cause is unknown. We reviewed the literature on suicide risk factors which can be associated with seasonal variation of suicide rates, assessing published articles from 1979 to 2011. Such risk factors include environmental determinants, including physical, chemical, and biological factors. We also summarized the influence of potential demographic and clinical characteristics such as age, gender, month of birth, socioeconomic status, methods of prior suicide attempt, and comorbid psychiatric and medical diseases. Comprehensive evaluation of risk factors which could be linked to the seasonal variation in suicide is important, not only to identify the major driving force for the seasonality of suicide, but also could lead to better suicide prevention in general. PMID:22470308

Ecstasy Use and Suicidal Behavior among Adolescents: Findings from a National Survey

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Kim, Jueun; Fan, Bin; Liu, Xinhua; Kerner, Nancy; Wu, Ping

2011-01-01

The relationship between ecstasy use and suicidal behavior among adolescents in the United States was examined. Data from the adolescent subsample (ages 12-17, N = 19,301) of the 2000 National Household Survey on Drug Abuse were used in the analyses. Information on adolescent substance use, suicidal behaviors, and related sociodemographic, family,…

Testing the warning signs of suicidal behavior among suicide ideators using the 2009 National survey on drug abuse and health.

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Gunn, John F; Lester, David; McSwain, Stephanie

2011-01-01

In order to help crisis counselors assess clients for their suicidal risk, in 2003 the American Association of Suicidology proposed ten warning signs, memorized through the acronym IS PATH WARM However, little research has been done investigating their effectiveness for predicting suicidal behavior The present study compared (1) suicide ideators with non-suicide ideator controls and (2) suicide ideators with suicide attempters on six of the IS PATH WARM warning signs, along with depression in the past year, marital status, and gender With regards to the comparison between suicide ideators and non-ideators, all variables but gender; abuse of alcohol in the past year, and anxiety in the past year were predictive of suicide ideation. However, when comparing suicide ideators who had not made a suicide attempt with those who had, only anger/aggression, depression in the past year, and marital status were predictive of a suicide attempt.

Depressed parents' attachment: effects on offspring suicidal behavior in a longitudinal, family study

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MacGregor, Erica K.; Grunebaum, Michael F.; Galfalvy, Hanga C.; Melhem, Nadine; Burke, Ainsley K.; Brent, David A.; Oquendo, Maria A.; Mann, J. John

2015-01-01

Objective To investigate relationships of depressed parents' attachment style to offspring suicidal behavior. Method 244 parents diagnosed with a DSM-IV depressive episode completed the Adult Attachment Questionnaire at study entry. Baseline and yearly follow-up interviews of their 488 offspring tracked suicidal behavior and psychopathology. Survival analysis and marginal regression models with correlated errors for siblings investigated the relationship between parent insecure attachment traits and offspring characteristics. Data analyzed were collected 1992–2008 during a longitudinal family study completed January 31, 2014. Results Parent avoidant attachment predicted offspring suicide attempts at a trend level (p=0.083). Parent anxious attachment did not predict offspring attempts (p=0.961). In secondary analyses, anxious attachment in parents was associated with offspring impulsivity (p=0.034), and in offspring suicide attempters, was associated with greater intent (p=0.045) and lethality of attempts (p=0.003). Avoidant attachment in parents was associated with offspring impulsivity (p=0.025) and major depressive disorder (p=0.012). Parent avoidant attachment predicted a greater number of suicide attempts (p=0.048) and greater intent in offspring attempters (p=0.003). Results were comparable after adjusting for parent diagnosis of borderline personality disorder. Conclusion Insecure avoidant, but not anxious, attachment in depressed parents may predict offspring suicide attempt. Insecure parent attachment traits were associated with impulsivity and major depressive disorder in all offspring, and with more severe suicidal behavior in offspring attempters. Insecure parental attachment merits further study as a potential target to reduce risk of offspring psychopathology and more severe suicidal behavior. PMID:25098943

Depressed parents' attachment: effects on offspring suicidal behavior in a longitudinal family study.

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MacGregor, Erica K; Grunebaum, Michael F; Galfalvy, Hanga C; Melhem, Nadine; Burke, Ainsley K; Brent, David A; Oquendo, Maria A; Mann, J John

2014-08-01

To investigate relationships of depressed parents' attachment style to offspring suicidal behavior. 244 parents diagnosed with a DSM-IV depressive episode completed the Adult Attachment Questionnaire at study entry. Baseline and yearly follow-up interviews of their 488 offspring tracked suicidal behavior and psychopathology. Survival analysis and marginal regression models with correlated errors for siblings investigated the relationship between parent insecure attachment traits and offspring characteristics. Data analyzed were collected 1992-2008 during a longitudinal family study completed January 31, 2014. Parental avoidant attachment predicted offspring suicide attempts at a trend level (P = .083). Parental anxious attachment did not predict offspring attempts (P = .961). In secondary analyses, anxious attachment in parents was associated with offspring impulsivity (P = .034) and, in offspring suicide attempters, was associated with greater intent (P = .045) and lethality of attempts (P = .003). Avoidant attachment in parents was associated with offspring impulsivity (P = .025) and major depressive disorder (P = .012). Parental avoidant attachment predicted a greater number of suicide attempts (P = .048) and greater intent in offspring attempters (P = .003). Results were comparable after adjusting for parent diagnosis of borderline personality disorder. Insecure avoidant, but not anxious, attachment in depressed parents may predict offspring suicide attempt. Insecure parental attachment traits were associated with impulsivity and major depressive disorder in all offspring and with more severe suicidal behavior in offspring attempters. Insecure parental attachment merits further study as a potential target to reduce risk of offspring psychopathology and more severe suicidal behavior. © Copyright 2014 Physicians Postgraduate Press, Inc.

Modern theories of suicidal behavior in adolescents and young people

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T.S. Pavlova; G.S. Bannikov

2014-01-01

We propose three current models, formulated over the last decade and not yet published in Russian, focused on teenage suicide: the development model of suicidal behavior in adolescents (J.A. Bridge, T.R. Goldstein, D.A. Brent); interpersonal model of (T.E. Joiner); some recent developments in the cognitive theory (A. Spirito, J.D. Matthews, A. Wenzel, A.T. Beck). Four groups of psychological aid targets for adolescents with suicidal tendencies are revealed: 1) targets of the current emotional...

Effects of contingent self-esteem on depressive symptoms and suicidal behavior.

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Lakey, Chad E; Hirsch, Jameson K; Nelson, Lyndsay A; Nsamenang, Sheri A

2014-01-01

Contingent self-esteem, or self-worth hinged upon successfully meeting standards or attaining goals, requires continual maintenance and validation. Despite the inherent instability that accompanies contingent self-esteem, relatively little is known about how it relates to markers of mental health. A sample of 371 college students completed measures of self-esteem, contingent self-esteem, suicidal behaviors, and depression. Individuals with fragile low self-esteem, described as highly contingent, reported greater depressive symptoms and suicidal behavior. Among those with secure high self-esteem, or high yet noncontingent, depression and suicide risk were markedly lower. Therapeutically promoting positive but noncontingent self-worth may reduce poor mental health outcomes.

The Mediating Roles of Anxiety Depression, and Hopelessness on Adolescent Suicidal Behaviors

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Thompson, Elaine Adams; Mazza, James J.; Herting, Jerald R.; Randell, Brooke P.; Eggert, Leona L.

2005-01-01

The purpose of this study was to explore the roles of anxiety, depression, and hopelessness as mediators between known risk factors and suicidal behaviors among 1,287 potential high school dropouts. As a step toward theory development, a model was tested that posited the relationships among these variables and their effects on suicidal behaviors.…

Prevalence and correlates of suicidal thought and self-destructive behavior among an elderly hospital population in Iran.

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Ekramzadeh, Sahra; Javadpour, Ali; Draper, Brian; Mani, Arash; Withall, Adrienne; Sahraian, Ali

2012-09-01

Few studies have examined suicidal ideation and behavior in hospitalized physically ill elderly patients, a group potentially at high risk. Our aim was to investigate the prevalence and risk factors for suicide ideation, and direct and indirect self-destructive behaviors among a sample of elderly inpatients. A cross-sectional study was conducted in 2009; 650 inpatients aged 60 years and over were screened from various medical services in teaching hospitals affiliated to Shiraz University of Medical Sciences in Iran. Suicidal ideation and behavior were measured with the Beck Scale for Suicidal Ideation (BSSI) and the Harmful Behavior Scale (HBS). Depression was measured with the Geriatric Depression Scale (GDS), medical burden with the geriatric version of the Cumulative Illness Rating Scale (CIRS-G), life events with the Paykel Life Event Scale, and social support with the Perceived Social Support Scale. Of the 650 patients screened with a mean age of 70.5 years (SD ± 7.5), 570 met inclusion criteria and of these 123 (21.6%) reported suicidal ideation on the BSSI and 80 (14.4%) had at least one self-destructive behavior included in the HBS. There was a significant correlation between suicide ideation and harmful behaviors (r = 0.503, p = 0.001). In a regression analysis, depressive symptoms, increased burden of medical conditions, marital status, history of substance use, history of traumatic life events, lack of perceived social support, and poor education were associated with both suicide ideation and harmful behavior. From demographic variables, living without a spouse and unemployment were predictors of suicidal ideation and behavior. Hospitalized, physically ill elderly patients have high rates of suicidal ideation and self-destructive behavior and these vary according to psychosocial and clinical factors. The general hospital is therefore a potential site for the recognition of suicidal individuals and implementation of proximal suicide prevention strategies.

Psychosocial correlates of suicidal ideation in rural South African adolescents.

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Shilubane, Hilda N; Ruiter, Robert A C; Bos, Arjan E R; van den Borne, Bart; James, Shamagonam; Reddy, Priscilla S

2014-01-01

Suicide is a prevalent problem among young people in Southern Africa, but prevention programs are largely absent. This survey aimed to identify the behavioral and psychosocial correlates of suicidal ideation among adolescents in Limpopo. A two-stage cluster sample design was used to establish a representative sample of 591 adolescents. Bivariate correlations and multiple linear regression analyses were conducted. Findings show that suicidal ideation is prevalent among adolescents. The psychosocial factors perceived social support and negative feelings about the family and the behavioral factors forced sexual intercourse and physical violence by the partner were found to increase the risk of suicidal ideation. Depression mediated the relationship between these psychosocial and behavioral risk factors and suicidal ideation. This study increased our understanding of the psychosocial and behavioral predictors of adolescent suicidal ideation. The findings provide target points for future intervention programs and call for supportive structures to assist adolescents with suicidal ideation.

Association of atopic dermatitis with depressive symptoms and suicidal behaviors among adolescents in Korea: the 2013 Korean Youth Risk Behavior Survey.

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Lee, Seulki; Shin, Aesun

2017-01-03

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

School connectedness and suicidal thoughts and behaviors: A systematic meta-analysis

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Marraccini, Marisa E.; Brier, Zoe M.F.

2017-01-01

Among the protective factors associated with reduced risk for suicide, scientific inquiries into school connectedness are especially important considering that schools are ideally situated to provide interventions reaching the vast majority of youth. Although there is a wealth of research that supports the association between school connectedness and reduced self-report of adolescents having a suicidal thought or making a suicide attempt, inconsistencies in the way studies have measured and operationalized school connectedness limit synthesis across findings. This meta-analytic study investigates the literature exploring associations between school connectedness and suicidal thoughts and behaviors across general and sub-populations (high risk and sexual minority youth) using a random effects model. Eligible studies examined a measure of school connectedness explicitly referred to as “school connectedness” or “connections at school” in relation to suicidal ideation or suicide attempts among youth enrolled in school (grades 6–12). Multiple meta-regression analyses were conducted to explore the influence of school connectedness measurement variation, as well as participant characteristics. Results, including 16 samples, support that higher school connectedness is associated with reduced reports of suicidal thoughts and behaviors across general (OR = 0.536), high-risk (OR = 0.603), and sexual minority (OR = 0.608) adolescents. Findings are consistent when analyzed separately for suicidal ideation (OR = 0.529) and suicide attempts (OR = 0.589) and remain stable when accounting for measurement variability. Although limited by its cross-sectional nature, findings support recent calls to increase school connectedness and proffer important implications for screening and intervention efforts conducted in schools. PMID:28080099

Suicidal Disclosures among Friends: Using Social Network Data to Understand Suicide Contagion*

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Mueller, Anna S.; Abrutyn, Seth

2015-01-01

A robust literature suggests that suicide is socially contagious; however, we know little about how and why suicide spreads. Using network data from the National Longitudinal Study of Adolescent to Adult Health, we examine the effects of alter’s (1) disclosed and (2) undisclosed suicide attempts, (3) suicide ideation and (4) emotional distress on ego’s mental health one year later to gain insights into the emotional and cultural mechanisms that underlie suicide contagion. We find that when egos know about alter’s suicide attempt, they report significantly higher levels of emotional distress and are more likely to report suicidality, net of extensive controls; however, alter’s undisclosed suicide attempts and ideation have no significant effect on ego’s mental health. Finally, we find evidence that emotional distress is contagious in adolescence, though it does not seem to promote suicidality. We discuss the implications of our findings for suicide contagion specifically and sociology more generally. PMID:25722129

Suicide-Related Knowledge and Confidence Among Behavioral Health Care Staff in Seven States.

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Silva, Caroline; Smith, April R; Dodd, Dorian R; Covington, David W; Joiner, Thomas E

2016-11-01

Death by suicide is a serious and growing public health concern in the United States. This noncontrolled, naturalistic study examined professionals' knowledge about suicide and confidence in working with suicidal individuals, comparing those who had received either of two gatekeeper trainings-Question, Persuade, and Refer (QPR) or Applied Suicide Intervention Skills Training (ASIST)-or other suicide-relevant training or no training. Participants (N=16,693) were individuals in various professional roles in the field of behavioral health care in Indiana, Kentucky, New York, Pennsylvania, Tennessee, Texas, and Utah. Participants completed a survey assessing suicide knowledge and skills confidence. Most participants (52.9%) reported no previous suicide prevention or assessment training. Individuals with suicide-relevant training demonstrated greater suicide knowledge and confidence than those with no such training. Among those who had received any training, no differences were found in suicide knowledge; however, individuals who had received ASIST reported greater confidence in working with suicidal individuals, compared with those who had received other training. Professional role and prior experience with a client who had died by suicide had significant positive relationships with suicide knowledge and confidence. Regional differences emerged between states and are examined within the context of statewide suicide prevention initiatives. Increasing access to and incentives for participating in suicide-relevant training among behavioral health care staff may foster a more knowledgeable and confident group of gatekeepers. Future research should examine whether increases in knowledge and confidence among staff translate into actual changes in practice that help protect and serve at-risk individuals.

Intrapersonal positive future thinking predicts repeat suicide attempts in hospital-treated suicide attempters.

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O'Connor, Rory C; Smyth, Roger; Williams, J Mark G

2015-02-01

Although there is clear evidence that low levels of positive future thinking (anticipation of positive experiences in the future) and hopelessness are associated with suicide risk, the relationship between the content of positive future thinking and suicidal behavior has yet to be investigated. This is the first study to determine whether the positive future thinking-suicide attempt relationship varies as a function of the content of the thoughts and whether positive future thinking predicts suicide attempts over time. A total of 388 patients hospitalized following a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, suicidal intent and positive future thinking). Fifteen months later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. During follow-up, 25.6% of linked participants were readmitted to hospital following a suicide attempt. In univariate logistic regression analyses, previous suicide attempts, suicidal ideation, hopelessness, and depression-as well as low levels of achievement, low levels of financial positive future thoughts, and high levels of intrapersonal (thoughts about the individual and no one else) positive future thoughts predicted repeat suicide attempts. However, only previous suicide attempts, suicidal ideation, and high levels of intrapersonal positive future thinking were significant predictors in multivariate analyses. Positive future thinking has predictive utility over time; however, the content of the thinking affects the direction and strength of the positive future thinking-suicidal behavior relationship. Future research is required to understand the mechanisms that link high levels of intrapersonal positive future thinking to suicide risk and how intrapersonal thinking should be targeted in treatment interventions. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Exposure to suicide is associated with increased risk for suicidal thoughts and behaviors among National Guard military personnel.

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Bryan, Craig J; Cerel, Julie; Bryan, AnnaBelle O

2017-08-01

Research suggests that individuals who know someone who died by suicide are at increased risk for posttraumatic stress disorder (PTSD), depression, and recent suicidal thoughts. Studies have not yet investigated the association of suicide exposure with suicide attempts, however, especially among high-risk subgroups of military personnel such as the National Guard. An anonymous online survey was completed by 971 military personnel assigned to the National Guard in Utah and Idaho. Weighted analyses were conducted to ensure demographic matching to the full population. Univariate and multivariate logistic regression was used to test the association of suicide exposure with psychiatric condition, suicide ideation, and suicide attempts. 65.4% of National Guard personnel reported knowing someone who had died by suicide. On average, participants knew 3.0 (SD=2.0) suicide decedents. Total number of known suicide decedents was associated with significantly increased risk for PTSD (OR=1.18, p=.008), depression (OR=1.19, p=.003), and suicide ideation (OR=2.48, p<.001), but not suicide attempt (OR=1.34, p=.472). Perceived closeness to the suicide decedent was associated with significantly increased risk for PTSD (OR=1.54, p<.001), depression (OR=1.36, p=.031), suicide ideation (OR=1.24, p=.039), and suicide attempt (OR=1.69, p=.026). The majority of participants who experienced suicidal thoughts and attempts after the suicide exposure had a previous history of suicide ideation. Suicide exposure is common among National Guard personnel, and is associated with increased risk for PTSD, depression, and suicidal thoughts and behaviors. Risk is highest for those personnel who know multiple suicide decedents and were closer to the suicide decedent. Copyright © 2017 Elsevier Inc. All rights reserved.

Symptoms of attention-deficit/hyperactivity disorder (ADHD) moderate suicidal behaviors in college students with depressed mood.

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Patros, Connor H G; Hudec, Kristen L; Alderson, R Matt; Kasper, Lisa J; Davidson, Collin; Wingate, LaRicka R

2013-09-01

College students with attention-deficit/hyperactivity disorder-related hyperactive/impulsive (HI) and/or inattentive (IA) symptoms may be at greater risk for suicidal behavior due to core and secondary symptoms that increase their potential to engage in behaviors that put them at risk for suicidal behavior. Consequently, the current study examined the moderating effect of combined HI/IA symptoms, in addition to independent HI and IA symptoms on the relationship between depressed mood and suicidal thoughts and behavior. A sample of 1,056 undergraduate students (61.5% female, 96.4% aged 18-24 years) provided self-report ratings of mood, suicidal behavior (thoughts, self-harm, attempts, and need for medical attention), and current HI/IA symptoms. Significant moderation effects were detected, such that greater HI/IA symptoms were associated with a stronger relationship between depressed mood and suicidal ideation and attempts, but not self-harm. Current HI and IA symptoms significantly moderated the relationship between depressed mood and suicidal thoughts and suicide attempts, but did not moderate the relationship between depressed mood and self-harm and need for medical attention. The current findings suggest that the presence of combined HI/IA symptoms conveys increased suicide risk for depressed college students. Additionally, results suggest a complex relationship between independent HI and IA symptoms and severe suicidal outcomes. © 2013 Wiley Periodicals, Inc.

Suicide-related behaviors in older patients with new anti-epileptic drug use: data from the VA hospital system

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Dersh Jeffrey J

2010-01-01

Full Text Available Abstract Background The U.S. Food and Drug Administration (FDA recently linked antiepileptic drug (AED exposure to suicide-related behaviors based on meta-analysis of randomized clinical trials. We examined the relationship between suicide-related behaviors and different AEDs in older veterans receiving new AED monotherapy from the Veterans Health Administration (VA, controlling for potential confounders. Methods VA and Medicare databases were used to identify veterans 66 years and older, who received a care from the VA between 1999 and 2004, and b an incident AED (monotherapy prescription. Previously validated ICD-9-CM codes were used to identify suicidal ideation or behavior (suicide-related behaviors cases, epilepsy, and other conditions previously associated with suicide-related behaviors. Each case was matched to controls based on prior history of suicide-related behaviors, year of AED prescription, and epilepsy status. Results The strongest predictor of suicide-related behaviors (N = 64; Controls N = 768 based on conditional logistic regression analysis was affective disorder (depression, anxiety, or post-traumatic stress disorder (PTSD; Odds Ratio 4.42, 95% CI 2.30 to 8.49 diagnosed before AED treatment. Increased suicide-related behaviors were not associated with individual AEDs, including the most commonly prescribed AED in the US - phenytoin. Conclusion Our extensive diagnostic and treatment data demonstrated that the strongest predictor of suicide-related behaviors for older patients newly treated with AED monotherapy was a previous diagnosis of affective disorder. Additional, research using a larger sample is needed to clearly determine the risk of suicide-related behaviors among less commonly used AEDs.

Preliminary effectiveness of surviving the teens(®) suicide prevention and depression awareness program on adolescents' suicidality and self-efficacy in performing help-seeking behaviors.

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King, Keith A; Strunk, Catherine M; Sorter, Michael T

2011-09-01

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.

Risk and Protective Factors for Suicide in Patients with Alcoholism

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Leo Sher

2006-01-01

Full Text Available Alcoholism is associated with a high risk for suicidal behavior. Up to 40% of persons with alcoholism attempt suicide at some time and 7% end their lives by committing suicide. Risk factors include being male, older than 50 years of age, living alone, being unemployed, poor social support, interpersonal losses, continued drinking, consumption of a greater amount of alcohol when drinking, a recent alcohol binge, previous alcohol treatment, a family history of alcoholism, a history of comorbid substance abuse (especially cocaine, a major depressive episode, serious medical illness, suicidal communication, and prior suicidal behavior. Suicidal behavior is especially frequent in patients with comorbid alcoholism and major depression. However, all patients with alcoholism should be evaluated for suicide risk. Understanding of risk and vulnerability to suicidal behavior in alcoholism still outweighs our knowledge of protective factors and resilience. Knowledge of protective factors for suicide may help to prevent and/or predict suicidal behavior. Protective factors for suicide in alcoholism are quite varied and include an individual's biological and behavioral characteristics, as well as attributes of the environment and culture. Protective factors include effective clinical care for psychiatric (including alcoholism and drug abuse and physical disorders, easy access to a variety of clinical interventions and support for seeking help, restricted access to highly lethal means of suicide, strong connections to family and community support, skills in problem solving and conflict resolution, cultural and religious beliefs that discourage suicide and support self-preservation. Future studies are necessary to determine which interventions may reduce suicidal behavior in alcoholism.

Suicidal Behavior among Latina College Students

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Chesin, Megan S.; Jeglic, Elizabeth L.

2012-01-01

Latina college students are one of the fastest-growing segments of the college student population. Although there is evidence suggesting Latina high school students are at increased risk of engaging in suicidal behavior, it is unclear Bwhether this risk continues in college. Over the course of 3 years, 554 Latina college students, the majority of…

Suicidal behaviors among adolescents in juvenile detention: role of adverse life experiences.

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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.

Poor response to antidepressants predicts new suicidal ideas and behavior in depressed outpatients.

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Courtet, Philippe; Jaussent, Isabelle; Lopez-Castroman, Jorge; Gorwood, Philip

2014-10-01

Only a few studies have investigated the factors associated with suicidal behavior after antidepressant treatment onset in adults. We examined the specific predictors of de novo suicidal ideas or attempts among depressed patients in the community, including subjects potentially at risk of suicidal behaviors, who initiated a new antidepressant treatment. A large set of GPs and psychiatrists throughout France followed-up, for 6 weeks, 4357 outpatients for whom an antidepressant drug was prescribed. Dimensions related with antidepressant-induced suicidal events, such as depression, anxiety or hopelessness, were assessed longitudinally using univariate and multivariate approaches among subjects with treatment-emergent suicide ideation or attempts. New suicidal ideas were observed in 9% of patients with no suicidal ideation at baseline (n=81), while suicidal attempts were reported for 1.7% of the sample during the 6-week observation period (n=75). The onset of suicidal ideas and attempts was associated with the initial features of the patients (baseline level of anxiety, past history of suicide attempts and alcohol misuse) and the non-improvement of depression. Worsening of depressive symptoms during the follow-up increased the onset of new suicidal ideas (OR=5.67, pideas or attempts, the link between antidepressants and suicide risk might be more adequately explained by a poor response to antidepressant treatment rather than by a direct trigger-effect. This naturalistic study is limited by the use of non-structured diagnoses and self-report outcomes. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

Gender-specific effects of depression and suicidal ideation in prosocial behaviors.

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Ricardo Cáceda

Full Text Available Prosocial behaviors are essential to the ability to relate to others. Women typically display greater prosocial behavior than men. The impact of depression on prosocial behaviors and how gender interacts with those effects are not fully understood. We explored the role of gender in the potential effects of depression on prosocial behavior.We examined prosocial behaviors using a modified version of the Trust Game in a clinical population and community controls. Study participants were characterized on the severity of depression and anxiety, presence of suicidal ideation, history of childhood trauma, recent stressful life events, and impulsivity. We correlated behavioral outcomes with gender and clinical variables using analysis of variance and multiple regression analysis.The 89 participants comprised four study groups: depressed women, depressed men, healthy women and healthy men (n = 16-36. Depressed men exhibited reciprocity more frequently than healthy men. Depression induced an inversion of the gender-specific pattern of self-centered behavior. Suicidal ideation was associated with increased reciprocity behavior in both genders, and enhancement of the effect of depression on gender-specific self-centered behavior.Depression, particularly suicidal ideation, is associated with reversal of gender-specific patterns of prosocial behavior, suggesting abnormalities in sexual hormones regulation. This explanation is supported by known abnormalities in the hypothalamus-pituitary-adrenal and hypothalamus-pituitary-gonadal axes found in depression.

[Suicidal Behavior and Attention Decifit Hyperactivity Disorder in Adolescents of Medellin (Colombia), 2011-2012].

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Restrepo-Bernal, Diana; Bonfante-Olivares, Laura; Torres de Galvis, Yolanda; Berbesi-Fernández, Dedsy; Sierra-Hincapié, Gloria

2014-01-01

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.

Relations Among Behavioral and Questionnaire Measures of Impulsivity in a Sample of Suicide Attempters

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Bagge, Courtney L.; Littlefield, Andrew K.; Rosellini, Anthony J.; Coffey, Scott F.

2013-01-01

Despite the focus on impulsivity within suicide research, it remains unclear the extent to which impulsivity assessments, that purportedly tap similar constructs, show significant overlap in samples of individuals with suicidal behaviors. In a sample of 69 suicide attempters, we took a multitrait, multimethod approach to examine the relation among various questionnaire and behavioral assessments of impulsivity facets. With the exception of urgency and go-stop performance there was little evid...

Association between parental psychopathology and suicidal behavior among adult offspring: results from the cross-sectional South African Stress and Health survey

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2014-01-01

Background Prior studies have demonstrated a link between parental psychopathology and offspring suicidal behavior. However, it remains unclear what aspects of suicidal behavior among adult offspring are predicted by specific parental mental disorders, especially in Africa. This study set out to investigate the association between parental psychopathology and suicidal behavior among their adult offspring in a South African general population sample. Method Parental psychopathology and suicidal behavior in offspring were assessed using structured interviews among 4,315 respondents from across South Africa. The WHO CIDI was used to collect data on suicidal behavior, while the Family History Research Diagnostic Criteria Interview was used to assess prior parental psychopathology. Bivariate and multivariate survival models tested the associations between the type and number parental mental disorders (including suicide) and lifetime suicidal behavior in the offspring. Associations between a range of parental disorders and the onset of subsequent suicidal behavior (suicidal ideation, plans, and attempts) among adult offspring were tested. Results The presence of parental psychopathology significantly increased the odds of suicidal behavior among their adult offspring. More specifically, parental panic disorder was associated with offspring suicidal ideation, while parental panic disorder, generalized anxiety disorder and suicide were significantly associated with offspring suicide attempts. Among those with suicidal ideation, none of the tested forms of parental psychopathology was associated with having suicide plans or attempts. There was a dose–response relationship between the number of parental disorders and odds of suicidal ideation. Conclusions Parental psychopathology increases the odds of suicidal behavior among their adult offspring in the South African context, replicating results found in other regions. Specific parental disorders predicted the onset and

Impulsivity, aggression and suicidal behavior in unipolar and bipolar disorders.

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Perroud, Nader; Baud, Patrick; Mouthon, Dominique; Courtet, Philippe; Malafosse, Alain

2011-11-01

Predictors of suicidal behaviors (SB) in bipolar (BD) and major depressive disorder (MDD) patients are poorly understood. It has been recognized that behavioral dysregulation characterizes SB with traits of impulsivity and aggression being particularly salient. However, little is known about how these traits are segregated among mood disorder patients with and without a history of suicide attempt (SA). This article aims to compare impulsivity and aggression between 143 controls, 138 BD and 186 MDD subjects with or without a history of SA. BD and MDD patients showed higher impulsivity scores (BIS-10 = 57.9 vs. 44.7, p impulsivity helped to distinguish MDD subjects without a history of SA from those with such a history, this was not the case in BD subjects where no difference in impulsive traits was observed between BD without and with history of SA (57.2 vs. 63.2 for BIS-10; p = 0.259). Impulsive and aggressive traits were strongly correlated in suicide attempters (independently of the diagnosis) but not in non-suicide attempters. Dimensional traits were not characterized at different stages of illness. Impulsivity, as a single trait, may be a reliable suicide risk marker in MDD but not in BD patients, and its strong correlation with aggressive traits seems specifically related to SB. Our study therefore suggests that the specific dimension of impulsive aggression should be systematically assessed in mood disorder patients to address properly their suicidal risk. Copyright © 2011 Elsevier B.V. All rights reserved.

Emphasis on Autonomy and Propensity for Suicidal Behavior in Younger and Older Adults

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O'Riley, Alisa A.; Fiske, Amy

2012-01-01

A cognitive style marked by emphasis on autonomy has been linked to negative outcomes throughout the life span. Two preliminary studies are presented that examined factors on a measure of autonomy (Personal Style Inventory-Revised) in relation to propensity for suicidal behavior (Suicidal Behaviors Questionnaire-14; SBQ-14). Perfectionism, B =…

Micro- and Macrosystem Predictors of High School Male Suicidal Behaviors

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Beck-Cross, Cathy; Cooper, Robyn

2015-01-01

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…

ADHD and Aggression as Correlates of Suicidal Behavior in Assaultive Prepubertal Psychiatric Inpatients

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Goodman, Geoff; Gerstadt, Cherie; Pfeffer, Cynthia R.; Stroh, Martha; Valdez, Adina

2008-01-01

Forty-three psychiatrically hospitalized prepubertal children were assessed regarding their assaultive and suicidal behaviors. These children were subsequently classified into two groups, assaultive/suicidal (AS) and assaultive-only (AO). AS children had higher aggression and suicidal-scale scores, but not higher depression scores, and were more…

Conflict-related anterior cingulate functional connectivity is associated with past suicidal ideation and behavior in recent-onset schizophrenia.

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Minzenberg, Michael J; Lesh, Tyler; Niendam, Tara; Yoon, Jong H; Cheng, Yaoan; Rhoades, Remy; Carter, Cameron S

2015-06-01

Suicide is highly prevalent in schizophrenia (SZ), yet it remains unclear how suicide risk factors such as past suicidal ideation or behavior relate to brain function. Circuits modulated by the prefrontal cortex (PFC) are altered in SZ, including in dorsal anterior cingulate cortex (dACC) during conflict-monitoring (an important component of cognitive control), and dACC changes are observed in post-mortem studies of heterogeneous suicide victims. We tested whether conflict-related dACC functional connectivity is associated with past suicidal ideation and behavior in SZ. 32 patients with recent-onset of DSM-IV-TR-defined SZ were evaluated with the Columbia Suicide Severity Rating Scale and functional MRI during cognitive control (AX-CPT) task performance. Group-level regression models relating past history of suicidal ideation or behavior to dACC-seeded functional connectivity during conflict-monitoring controlled for severity of depression, psychosis and impulsivity. Past suicidal ideation was associated with relatively higher functional connectivity of the dACC with the precuneus during conflict-monitoring. Intensity of worst-point past suicidal ideation was associated with relatively higher dACC functional connectivity in medial parietal lobe and striato-thalamic nuclei. In contrast, among those with past suicidal ideation (n = 17), past suicidal behavior was associated with lower conflict-related dACC connectivity with multiple lateral and medial PFC regions, parietal and temporal cortical regions. This study provides unique evidence that recent-onset schizophrenia patients with past suicidal ideation or behavior show altered dACC-based circuit function during conflict-monitoring. Suicidal ideation and suicidal behavior have divergent patterns of associated dACC functional connectivity, suggesting a differing pattern of conflict-related brain dysfunction with these two distinct features of suicide phenomenology. Published by Elsevier Ltd.

The Influence of Parental Psychopathology on Offspring Suicidal Behavior across the Lifespan.

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Geilson Lima Santana

Full Text Available Suicide tends to occur in families, and parental psychopathology has been linked to offspring suicidal behaviors. This study explores the influence of parental mental disorders across the lifespan. Data are from the Sao Paulo Megacity Mental Health Survey, a cross-sectional household study with a representative sample of the adult population living in the Sao Paulo Metropolitan Area, Brazil (N=2,942. Survival models examined bivariate and multivariate associations between a range of parental disorders and offspring suicidality. After controlling for comorbidity, number of mental disorders and offspring psychopathology, we found that parental psychopathology influences suicidal behaviors throughout most part of the life cycle, from childhood until young adult years. Generalized anxiety disorder (GAD and antisocial personality were associated with offspring suicidal ideation (OR 1.8 and 1.9, respectively, panic and GAD predicted suicidal attempts (OR 2.3 and 2.7, respectively, and panic was related to the transition from ideation to attempts (OR 2.7. Although noticed in many different stages of the lifespan, this influence is most evident during adolescence. In this period, depression and antisocial personality increased the odds of suicidal ideation (OR 5.1 and 3.2, respectively, and depression, panic disorder, GAD and substance abuse predicted suicidal attempts (OR varying from 1.7 to 3.8. In short, parental disorders characterized by impulsive-aggression and anxiety-agitation were the main predictors of offspring suicidality across the lifespan. This clinically relevant intergenerational transmission of suicide risk was independent of offspring mental disorders, and this underscores the need for a family approach to psychopathology.

Exposure to Prescription Drugs Labeled for Risk of Adverse Effects of Suicidal Behavior or Ideation among 100 Air Force Personnel Who Died by Suicide, 2006-2009

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Lavigne, Jill E.; McCarthy, Michael; Chapman, Richard; Petrilla, Allison; Knox, Kerry L.

2012-01-01

Prescription drugs for many indications are labeled with warnings for potential risk of suicidal ideation or behavior. Exposures to prescription drugs labeled for adverse effects of suicidal behavior or ideation among 100 Air Force personnel who died by suicide between 2006 and 2009 are described. Air Force registry data were linked to…

Behavioral and emotional responses to interpersonal stress: A comparison of adolescents engaged in non-suicidal self-injury to adolescent suicide attempters.

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Kim, Kerri L; Cushman, Grace K; Weissman, Alexandra B; Puzia, Megan E; Wegbreit, Ezra; Tone, Erin B; Spirito, Anthony; Dickstein, Daniel P

2015-08-30

Prominent theoretical models and existing data implicate interpersonal factors in the development and maintenance of suicidal behavior and non-suicidal self-injury (NSSI). However, no known study has yet used computerized behavioral tasks to objectively assess responses to interpersonal conflict/collaboration among teens engaged in NSSI or having made a suicide attempt. The current study, therefore, compared interpersonal functioning indexed by the Prisoner's Dilemma (PD) task among three mutually exclusive groups, adolescents (ages 13-17): engaged in NSSI only without history of a suicide attempt (n=26); who made a suicide attempt without history of NSSI (n=26); and typically developing controls (n=26). Participants also completed the Interpersonal Sensitivity Measure to assess their general sensitivity to/awareness of others' behaviors and feelings. No significant between-group differences were found in PD task performance; however, compared to typically developing control participants and those who had made a suicide attempt, the NSSI group reported significantly more stress during the task. Additionally, NSSI participants rated themselves as more interpersonally sensitive compared to both attempters and typically developing controls. Given the lack of knowledge about whether these groups either differentially activate the same circuitry during stressful interpersonal interactions or instead rely on alternative, compensatory circuits, future work using event-related functional magnetic resonance imaging is warranted. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Modern theories of suicidal behavior in adolescents and young people

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T.S. Pavlova

2014-08-01

Full Text Available We propose three current models, formulated over the last decade and not yet published in Russian, focused on teenage suicide: the development model of suicidal behavior in adolescents (J.A. Bridge, T.R. Goldstein, D.A. Brent; interpersonal model of (T.E. Joiner; some recent developments in the cognitive theory (A. Spirito, J.D. Matthews, A. Wenzel, A.T. Beck. Four groups of psychological aid targets for adolescents with suicidal tendencies are revealed: 1 targets of the current emotional state of a teenager (feelings of abandonment, self-perception as a burden to the loved ones, anxiety, hopelessness, heartache; 2 targets affecting personal predispositions (primitive defense mechanisms, impulsivity, aggression; 3 targets associated with cognitive functioning (cognitive rigidity, black-and-white thinking, thinking errors; and 4 targets reflecting a need to work with behavioral manifestations (narrow range of coping strategies used.

Risk factors for suicidal behaviors among Filipino Americans: a data mining approach.

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Kuroki, Yusuke

2015-01-01

Filipino Americans have lower suicide rates than other Asian ethnic groups. The present study examined risk factors for suicide ideation and attempt among Filipino Americans with random forest. The data were from the Filipino American Community Epidemiological Study (Takeuchi, 2011). The results showed that the important predictors for suicide ideation were depressive disorder, substance use disorder, and years in the United States. The important predictors for suicide attempt were the number of family relatives and family conflict. Clinicians are advised to investigate familial and cultural factors among Filipino Americans. How family and cultural factors may affect suicidal behaviors were further discussed.

The Association between Non-Medical Prescription Drug Use and Suicidal Behavior among United States Adolescents

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Amanda L. Divin

2014-11-01

Full Text Available Adolescence represents a vulnerable time for the development of both drug use/abuse and mental illness. Although previous research has substantiated a relationship between drug use and suicidal behavior, little research has examined this relationship with non-medical prescription drug use. Given the growing prevalence of non-medical prescription drug use (NMPDU among adolescents, this study explored the association between NMPDU and suicidal behavior. Nationally representative data were derived from 16, 410 adolescents who completed the 2009 National Youth Risk Behavior Survey. Approximately 19.8% of participants reported lifetime NMPDU. NMPDU was associated with significantly increased odds of suicidal behavior (P < 0.01, with seriously considering attempting suicide and making a plan about attempting suicide representing the strongest correlates for males and females. Results suggest the importance of 1 continued reinforcement of drug education programs in high school begun at earlier ages and 2 mental health care and screenings among adolescents.

Self-harm and suicidal behavior in borderline personality disorder with and without bulimia nervosa.

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Reas, Deborah L; Pedersen, Geir; Karterud, Sigmund; Rø, Øyvind

2015-06-01

Few studies have investigated whether a diagnosis of Bulimia nervosa (BN) confers additional risk of life-threatening behaviors such as self-harm and suicidal behavior in borderline personality disorder (BPD). Participants were 483 treatment-seeking women diagnosed with BPD according to the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II; First, Gibbon, Spitzer, Williams, & Benjamin, 1997; Diagnostic and Statistical Manual of Mental Disorders, 4th ed.; APA, 1994) and admitted to the Norwegian Network of Psychotherapeutic Day Hospitals between 1996 and 2009. Of these, 57 (11.8%) women met DSM-IV diagnostic criteria for BN according to the Mini-International Neuropsychiatric Interview (M.I.N.I.; Sheehan et al., 1998) and they were compared with women with BPD and other Axis I disorders. We found that comorbid BN is uniquely and significantly associated with increased risk of suicidal behavior among women being treated for BPD. Findings underscore the importance of routinely screening for BN among women seeking treatment for BPD, as co-occurring bulimia appears to be a significant marker for immediate life-threatening behaviors in this already high-risk population, which is a significant public health issue. A significantly greater proportion of women with BPD-BN reported suicidal ideation at intake (past 7 days), engaged in self-harm behavior during treatment, and attempted suicide during treatment. All bivariate associations remained significant in the logistic regression models after controlling for mood, anxiety, and substance-related disorders. The presence of a concurrent diagnosis of BN among women with BPD is significantly and uniquely associated with recent suicidal ideation, and self-harm behavior and suicide attempts during treatment after controlling for major classes of mental disorders. Co-occurring BN appears to represent a significant marker for immediate life-threatening behaviors in women seeking treatment for BPD

Increased severity of suicidal behavior in impulsive aggressive patients exposed to familial adversities.

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Lopez-Castroman, J; Jaussent, I; Beziat, S; Guillaume, S; Baca-Garcia, E; Genty, C; Olié, E; Courtet, P

2014-10-01

The mechanisms by which childhood abuse and family history of suicidal behavior (FHS) lead to an increased risk of suicidal behavior are still unknown. Impulsive aggression may play an intermediate role. We investigated whether greater scores for aggression and impulsivity might be associated with the effects of FHS and/or childhood abuse on the severity of suicidal behavior. We examined the scores of three scales measuring impulsive aggression in a sample of 696 suicide attempters. We compared the highest and lowest scores with regard to reports of childhood abuse and FHS using adjusted multinomial regression models. Genetic polymorphisms of the serotonergic system known to be associated with impulsive aggression were also analyzed. Patients with high impulsive aggressive scores showed significant differences in sociodemographic, clinical and suicidal features compared with patients with low impulsive aggressive scores. Adjusted results showed that combinations of some types of childhood abuse and FHS, particularly emotional abuse and emotional neglect, are associated with high impulsivity and hostility scores. The SS genotype of the serotonin transporter gene (5-HTTLPR) was associated with high levels of impulsivity when the subjects reported emotional abuse [odds ratio (OR) 5.55, 95% confidence interval (CI) 1.75-17.5] or physical abuse (OR 5.03, 95% CI 1.50-16.9) in their childhood. Our results support the role of impulsive aggression as one of the links that may connect childhood abuse and FHS with severity of suicidal behavior.

Cognitive-Behavioral Family Treatment for Suicide Attempt Prevention: A Randomized Controlled Trial.

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Asarnow, Joan Rosenbaum; Hughes, Jennifer L; Babeva, Kalina N; Sugar, Catherine A

2017-06-01

Suicide is a leading cause of death. New data indicate alarming increases in suicide death rates, yet no treatments with replicated efficacy or effectiveness exist for youths with self-harm presentations, a high-risk group for both fatal and nonfatal suicide attempts. We addressed this gap by evaluating Safe Alternatives for Teens and Youths (SAFETY), a cognitive-behavioral, dialectical behavior therapy-informed family treatment designed to promote safety. Randomized controlled trial for adolescents (12-18 years of age) with recent (past 3 months) suicide attempts or other self-harm. Youth were randomized either to SAFETY or to treatment as usual enhanced by parent education and support accessing community treatment (E-TAU). Outcomes were evaluated at baseline, 3 months, or end of treatment period, and were followed up through 6 to 12 months. The primary outcome was youth-reported incident suicide attempts through the 3-month follow-up. Survival analyses indicated a significantly higher probability of survival without a suicide attempt by the 3-month follow-up point among SAFETY youths (cumulative estimated probability of survival without suicide attempt = 1.00, standard error = 0), compared to E-TAU youths (cumulative estimated probability of survival without suicide attempt = 0.67, standard error = 0.14; z = 2.45, p = .02, number needed to treat = 3) and for the overall survival curves (Wilcoxon χ 2 1  = 5.81, p = .02). Sensitivity analyses using parent report when youth report was unavailable and conservative assumptions regarding missing data yielded similar results for 3-month outcomes. Results support the efficacy of SAFETY for preventing suicide attempts in adolescents presenting with recent self-harm. This is the second randomized trial to demonstrate that treatment including cognitive-behavioral and family components can provide some protection from suicide attempt risk in these high-risk youths. Clinical trial registration information

The Relationship between Body Dysmorphic Disorder Behaviors and the Acquired Capability for Suicide

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Witte, Tracy K.; Didie, Elizabeth R.; Menard, William; Phillips, Katharine A.

2012-01-01

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…

Relations between Nonsuicidal Self-Injury and Suicidal Behavior in Adolescence: A Systematic Review.

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Salome Grandclerc

Full Text Available Nonsuicidal self-injury (NSSI and suicidal behaviors, both important issues in adolescent health care, are frequently associated and possibly clinically related. Our objective was to explore the views of relations between nonsuicidal self-injury and suicidal behaviors during adolescence and young adulthood (11-25 years expressed in the scientific (medical and psychological literature. We adopted a textual approach to the process of synthesis to tell the story of the findings from the included studies. Our narrative systematic review of 64 articles found that they share the same risk factors. Integrated models envision nonsuicidal self-injury as a gateway enabling teens to acquire the capability for suicide. Because suicidal behavior short-circuits thought, it is difficult to conceive an intention to die during adolescents' acts of self-injury. Intention is constructed by the narrative of the act, influenced by numerous elements from the psychopathologic, cultural, religious, and philosophic context. Techniques of mentalizing-based treatments and work on the meaning that adolescents attribute to their behaviors might improve care.

Rising youth suicide and the changing cultural context in South Korea.

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Park, B C Ben; Soo Im, Jeong; Strother Ratcliff, Kathryn

2014-01-01

South Korean society faces a serious challenge in the increasing rates of youth suicidal behavior. There is a need both to gain a better understanding of the causes of this behavior and to develop strategies for responding to this critical public health issue. This article analyzes how psychological, sociopsychological, and subcultural factors influence suicidal proneness among Korean youth as well as makes suggestions for developing social policies that could reduce Korean youth suicidal behaviors. Correlation and multivariate regression analyses on suicide proneness and depression were employed using a sample of 172 South Korean youths (aged 18-24) selected from the 2009 General Social Survey collected through face-to-face interviews. Young people's suicidal proneness is associated with depression, a tolerant attitude toward suicide, strained family relations, living in rural areas, being female, and being closely related to survivors of suicide or potential suicides. The findings from this study reveal the significance of social and cultural factors as influences on recent youth suicidal behavior in Korea. The analysis suggests that the underlying risk factors of suicidal behavior are embedded in the changing social and cultural context of Korean society. Thus, suicide prevention efforts should involve more than merely treating any underlying psychiatric disorders.

Influential Factors for and Outcomes of Hospitalized Patients with Suicide-Related Behaviors: A National Record Study in Taiwan from 1997-2010.

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Yu-Wen Lin

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

Narcissistic Personality Disorder and suicidal behavior in mood disorders.

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Coleman, Daniel; Lawrence, Ryan; Parekh, Amrita; Galfalvy, Hanga; Blasco-Fontecilla, Hilario; Brent, David A; Mann, J John; Baca-Garcia, Enrique; Oquendo, Maria A

2017-02-01

The relationship of Narcissistic Personality Disorder (NPD) to suicidal behavior is understudied. The modest body of existing research suggests that NPD is protective against low-lethality suicide attempts, but is associated with high lethality attempts. Mood-disordered patients (N = 657) received structured interviews including Axis I and II diagnosis and standardized clinical measures. Following chi-square and t-tests, a logistical regression model was constructed to identify predictors of suicide attempt. While there was no bivariate relationship of NPD on suicide attempt, in the logistic regression patients with NPD were 2.4 times less likely to make a suicide attempt (OR = 0.41; 95% CI = 0.19 - 0.88; p disorder, and to have high aggression and hostility scores. Limitations include that the sample consists of only mood-disordered patients, a modest sample size of NPD, and the data are cross-sectional. The multivariate protective effect of NPD on suicide attempt is consistent with most previous research. The lower impulsivity of NPD patients and less severe personality pathology relative to other personality disorders may contribute to this effect. No relationship of NPD to attempt lethality was found, contradicting other research, but perhaps reflecting differences between study samples. Future studies should oversample NPD patients and include suicide death as an outcome. Clinical implications include discussion of individualized suicide risk assessment with NPD patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder.

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Linehan, Marsha M; Comtois, Katherine Anne; Murray, Angela M; Brown, Milton Z; Gallop, Robert J; Heard, Heidi L; Korslund, Kathryn E; Tutek, Darren A; Reynolds, Sarah K; Lindenboim, Noam

2006-07-01

Dialectical behavior therapy (DBT) is a treatment for suicidal behavior and borderline personality disorder with well-documented efficacy. To evaluate the hypothesis that unique aspects of DBT are more efficacious compared with treatment offered by non-behavioral psychotherapy experts. One-year randomized controlled trial, plus 1 year of posttreatment follow-up. University outpatient clinic and community practice. One hundred one clinically referred women with recent suicidal and self-injurious behaviors meeting DSM-IV criteria, matched to condition on age, suicide attempt history, negative prognostic indication, and number of lifetime intentional self-injuries and psychiatric hospitalizations. One year of DBT or 1 year of community treatment by experts (developed to maximize internal validity by controlling for therapist sex, availability, expertise, allegiance, training and experience, consultation availability, and institutional prestige). Trimester assessments of suicidal behaviors, emergency services use, and general psychological functioning. Measures were selected based on previous outcome studies of DBT. Outcome variables were evaluated by blinded assessors. Dialectical behavior therapy was associated with better outcomes in the intent-to-treat analysis than community treatment by experts in most target areas during the 2-year treatment and follow-up period. Subjects receiving DBT were half as likely to make a suicide attempt (hazard ratio, 2.66; P = .005), required less hospitalization for suicide ideation (F(1,92) = 7.3; P = .004), and had lower medical risk (F(1,50) = 3.2; P = .04) across all suicide attempts and self-injurious acts combined. Subjects receiving DBT were less likely to drop out of treatment (hazard ratio, 3.2; P Dialectical behavior therapy appears to be uniquely effective in reducing suicide attempts.

ADad 9: Suicidal behavior in Anxiety Disorders among adolescents in a rural community population in India.

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Russell, Paul Swamidhas Sudhakar; Nair, M K C; Chandra, Abhiram; Subramaniam, Vinod Shanmukham; Bincymol, K; George, Babu; Samuel, Beulah

2013-11-01

The risk of suicidal behavior associated with Anxiety Disorders (AD) among adolescents is known. However, concurrent mood disorders complicate these findings, and no data is available from India as well as from the community. This study aimed to address the suicidal risk associated with AD from different perspectives. The authors prospectively collected data for 500 adolescents in a community with independent, trained raters. Risk for suicidal behavior was measured with SADPERSONS scale, socio-economic status with Modified Kuppuswamy Scale, depression and anxiety disorders with Beck Depression Inventory and Screen for Child Anxiety Related Emotional Disorders respectively. The relationship between predictors and need for preventive action was analyzed with univariate and multivariate regression analyses and a predictive model was built. Suicidal behavior was increased by the presence of AD (adjusted OR = 6.28), the number of co-morbid AD (adjusted OR = 2.04), severity of the AD (adjusted OR = 4.98). Being a boy increased the risk of suicidal behavior associated with AD (adjusted OR = 9.37), Generalized Anxiety Disorder (adjusted OR = 5.65), Separation Anxiety Disorder (unadjusted OR = 3.28), Social Anxiety Disorder (unadjusted OR = 5.91) while controlling for the confounding effect of Depressive Disorder. Gender did not have an influence on Panic Disorder. Presence of AD and co-morbid Depressive Disorder significantly contributed to a risk model for suicidal behavior. Anxiety Disorder is associated with the risk for potential suicidal behavior. Adolescent boys with AD and Depressive Disorder need to be identified as the high risk group for suicide prevention in the community.

Prevalence of suicidal behaviors in patients with major depressive disorder in China: A comprehensive meta-analysis.

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Dong, Min; Wang, Shi-Bin; Li, Yan; Xu, Dan-Dan; Ungvari, Gabor S; Ng, Chee H; Chow, Ines H I; Xiang, Yu-Tao

2018-01-01

Suicidal behaviors are common in major depressive disorder (MDD) and contribute significantly to premature death. The objective of this meta-analysis is to estimate the pooled prevalence of suicidal behaviors in patients with MDD in China. The relevant databases in English (PubMed, Embase, PsycINFO and Cochrane Library) and Chinese (Chinese National Knowledge Infrastructure, Wanfang and Chinese Biological Medical Literature) were systematically and independently searched from their inceptions until January 23, 2017. Original studies that reported the prevalence of suicidal behaviors including suicidal ideation (SI), suicide plan (SP), suicide attempt (SA) and completed suicide (CS) were included. Thirty three articles that met the inclusion criteria were analyzed. The pooled lifetime prevalence of SI, SP and SA were 53.1% (95% CI: 42.4-63.4%), 17.5% (95% CI: 5.8-42.3%) and 23.7% (95% CI: 19.9-28.0%), respectively. One-month prevalence of SI and SA were 27.7% (95% CI: 15.4-44.5%) and 20.3% (95% CI: 12.1-32.2%), respectively. The pooled prevalence of SA during hospitalization and after onset of MDD were 17.3% (95% CI: 12.4-23.7%) and 42.1% (95% CI: 26.1-60.0%), respectively. Subgroup analyses revealed significant differences in both lifetime prevalence of SI and SA between genders, and between outpatients and inpatients with MDD. Suicidal behaviors are common in MDD patients in China. Regular screening and effective intervention for suicidal behavior in MDD patients are warranted. Copyright © 2017 Elsevier B.V. All rights reserved.

Does Availability of Mental Health Resources Prevent Recurrent Suicidal Behavior? An Ecological Analysis

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Cooper, Sara L.; Lezotte, Dennis; Jacobellis, Jillian; DiGuiseppi, Carolyn

2006-01-01

This study examines whether availability of mental health resources in the county of residence is associated with subsequent suicidal behavior after a previous suicide attempt. Among 10,922 individuals who attempted suicide in Colorado between 1998 and 2002, residence in a county that offered a minimum safety-net of mental health services…

Youth Suicidal Behavior

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... self-injury x Exposure to friends’/family members’ suicide xii Low self-esteem xiii Protective Factors Family and school connectedness iii ... Reduced access to firearms vii Academic achievement ix Self-esteem xi Talking to teens about suicide does not make them want to kill themselves. ...

Specific Coping Behaviors in Relation to Adolescent Depression and Suicidal Ideation

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Horwitz, Adam G.; Hill, Ryan M.; King, Cheryl A.

2011-01-01

The coping strategies used by adolescents to deal with stress may have implications for the development of depression and suicidal ideation. This study examined coping categories and specific coping behaviors used by adolescents to assess the relation of coping to depression and suicidal ideation. In hierarchical regression models, the specific…

Inflammation and lithium: clues to mechanisms contributing to suicide-linked traits.

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Beurel, E; Jope, R S

2014-12-16

Suicide is one of the leading causes of death in the United States, yet it remains difficult to understand the mechanistic provocations and to intervene therapeutically. Stress is recognized as a frequent precursor to suicide. Psychological stress is well established to cause activation of the inflammatory response, including causing neuroinflammation, an increase of inflammatory molecules in the central nervous system (CNS). Neuroinflammation is increasingly recognized as affecting many aspects of CNS functions and behaviors. In particular, much evidence demonstrates that inflammatory markers are elevated in traits that have been linked to suicidal behavior, including aggression, impulsivity and depression. Lithium is recognized as significantly reducing suicidal behavior, is anti-inflammatory and diminishes aggression, impulsivity and depression traits, each of which is associated with elevated inflammation. The anti-inflammatory effects of lithium result from its inhibition of glycogen synthase kinase-3 (GSK3). GSK3 has been demonstrated to strongly promote inflammation, aggressive behavior in rodents and depression-like behaviors in rodents, whereas regulation of impulsivity by GSK3 has not yet been investigated. Altogether, evidence is building supporting the hypothesis that stress activates GSK3, which in turn promotes inflammation, and that inflammation is linked to behaviors associated with suicide, including particularly aggression, impulsivity and depression. Further investigation of these links may provide a clearer understanding of the causes of suicidal behavior and provide leads for the development of effective preventative interventions, which may include inhibitors of GSK3.

Suicide and general elections in Austria: do preceding regional suicide rate differentials foreshadow subsequent voting behavior swings?

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Voracek, Martin; Formann, Anton K; Fülöp, Gerhard; Sonneck, Gernot

2003-05-01

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.

Applying computer adaptive testing to optimize online assessment of suicidal behavior: a simulation study.

NARCIS (Netherlands)

de Beurs, D.P.; de Vries, A.L.M.; de Groot, M.H.; de Keijser, J.; Kerkhof, A.J.F.M.

2014-01-01

Background: The Internet is used increasingly for both suicide research and prevention. To optimize online assessment of suicidal patients, there is a need for short, good-quality tools to assess elevated risk of future suicidal behavior. Computer adaptive testing (CAT) can be used to reduce

Mass media in system of predictors for suicidal behavior in adolescents

Directory of Open Access Journals (Sweden)

O. V. Vihristyuk

2013-04-01

Full Text Available The article provides an overview of international sources that attempt to identify the effect of mass media information messages concerning suicide on the public. We concern the possibility of imitative suicides after media coverage of suicide incidents (“Werter syndrome”, providing data on suicides increase following media reports on this topic. We discuss the data obtained by surveys conducted among Internet users of pro-suicidal web sites. On the example of recent international research, we note that despite the contradicting research results, the mass media impact on suicidal adolescents and young adults is possible, especially among young people most affected by external influences. The analysis of causes, motives and methods of suicide among adolescents and young people, as described by media, showed that among the causes dominate family and peers conflicts, among the motives – “protest"”, “revenge” (48% and “call” (16.6%. Pre-suicidal period in 75% of patients was characterized as affective and stressful. The article emphasizes that simplification of media reports and their focusing on one of the suicide risk factors (family, school, or Internet cannot see the whole picture of suicidal behavior as a set of internal and external factors and their interaction.

Are autistic traits associated with suicidality? A test of the interpersonal‐psychological theory of suicide in a non‐clinical young adult sample

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Pelton, M. K.

2017-01-01

Autism spectrum conditions (ASC) has recently been associated with increased risk of suicidality. However, no studies have explored how autistic traits may interact with current models of suicidal behavior in a non‐clinical population. The current study therefore explored how self‐reported autistic traits interact with perceived burdensomeness and thwarted belongingness in predicting suicidal behavior, in the context of the Interpersonal‐Psychological Theory of Suicide (IPTS). 163 young adults (aged 18–30 years) completed an online survey including measures of thwarted belonging and perceived burdensomeness (Interpersonal Needs Questionnaire), self‐reported autistic traits (Autism Spectrum Quotient), current depression (Centre for Epidemiological Studies Depression Scale), and lifetime suicidality (Suicide Behavior Questionnaire‐Revised). Results showed that burdensomeness and thwarted belonging significantly mediated the relationship between autistic traits and suicidal behavior. Both depression and autistic traits significantly predicted thwarted belonging and perceived burdensomeness. Autistic traits did not significantly moderate the relationship between suicidal behavior and thwarted belonging or perceived burdensomeness. Results suggest that the IPTS provides a useful framework for understanding the influence of autistic traits on suicidal behavior. However, the psychometric properties of these measures need be explored in those with clinically confirmed diagnosis of ASC. Autism Res 2017, 10: 1891–1904. © 2017 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. Lay Summary Recent research has shown that people with high autistic traits are more likely to attempt suicide. However, no studies have explored why. We found that people with high autistic traits were more likely to experience feelings that they do not belong in the world, are a burden on others, and depression, which may

Peer Victimization and Suicidal Behaviors among High School Youth

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Crepeau-Hobson, Franci; Leech, Nancy L.

2016-01-01

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…

Can brief behavioral health interventions reduce suicidal and self-harm ideation in primary care patients?

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Dueweke, Aubrey R; Rojas, Sasha M; Anastasia, Elizabeth A; Bridges, Ana J

2017-09-01

We examined whether brief behavioral health visits reduced suicidal and self-harm ideation among primary care patients and compared the effectiveness of interventions that targeted ideation directly (i.e., safety planning) with those that targeted ideation indirectly through management of underlying mental illness (e.g., behavioral activation). We examined first- and last-visit data from 31 primary care patients with suicidal or self-harm ideation seen by behavioral health consultants. Patients reported significantly lower frequencies of suicidal and self-harm ideation at their final visit than at their initial visit. Patients whose ideation was targeted directly showed greater improvements than patients whose ideation was targeted indirectly. Although preliminary, results suggest mild to moderate suicidal ideation could be addressed in primary care through integration of behavioral health consultants into the medical team. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Relations among behavioral and questionnaire measures of impulsivity in a sample of suicide attempters.

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Bagge, Courtney L; Littlefield, Andrew K; Rosellini, Anthony J; Coffey, Scott F

2013-08-01

Despite the focus on impulsivity within suicide research, it remains unclear the extent to which impulsivity assessments, that purportedly tap similar constructs, show significant overlap in samples of individuals with suicidal behaviors. In a sample of 69 suicide attempters, we took a multitrait, multimethod approach to examine the relation among various questionnaire and behavioral assessments of impulsivity facets. With the exception of urgency and go-stop performance, there was little evidence of concordance between questionnaire and behavioral measures. These findings suggest researchers cannot presume that measures of "impulsivity" assess similar psychological processes and that more nuanced terminology is needed. © 2013 The American Association of Suicidology.

Understanding the Links Between Self-Report Emotional Intelligence and Suicide Risk: Does Psychological Distress Mediate This Relationship Across Time and Samples?

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Sergio Mérida-López

2018-05-01

Full Text Available Objective: In the last decades, increasing attention has been paid to examining psychological resources that might contribute to our understanding of suicide risk. Although Emotional Intelligence (EI is one dimension that has been linked with decreased suicidal ideation and behaviors, we detected several gaps in the literature in this area regarding the research designs and samples involved. In this research, we aimed to test a mediator model considering self-report EI, psychological distress and suicide risk across samples adopting both cross-sectional and prospective designs in two independent studies.Method: In Study 1, our purpose was to examine the potential role of psychological distress as a mediator in the relationship between self-report EI and suicide risk in a community sample comprised of 438 adults (270 women; mean age: 33.21 years. In Study 2, we sought to examine the proposed mediator model considering a 2-month prospective design in a sample of college students (n = 330 in T1; n = 311 in T2; 264 women; mean age: 22.22 years.Results: In Study 1, we found that psychological distress partially mediated the effect of self-report EI on suicide risk. More interestingly, findings from Study 2 showed that psychological distress fully mediated the relationship between self-report EI and suicide risk at Time 2.Conclusion: These results point out the role of psychological distress as a mediator in the association between self-report EI and suicide risk. These findings suggest an underlying process by which self-report EI may act as a protective factor against suicidal ideation and behaviors. In line with the limitations of our work, plausible avenues for future research and interventions are discussed.

Suicidal ideation among Malaysian adolescents.

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Ahmad, NoorAni; Cheong, Siew Man; Ibrahim, Nurashikin; Rosman, Azriman

2014-09-01

Adolescence is the time of greatest risk for the first onset of suicidal behaviors. This study aimed to identify the risk and protective factors associated with suicidal ideation among Malaysian adolescents. Data from the 2012 Malaysia Global School-based Student Health Survey, a nationwide study using a 2-stage cluster sampling design, were analyzed. The survey used a self-administered validated bilingual questionnaire and the Depression Anxiety and Stress Scale. The prevalence of suicidal ideation was 7.9%. Analysis revealed that suicidal ideation was positively associated with depression, anxiety, stress, substance use, being bullied, and being abused at home, either physically or verbally. In addition, suicidal ideation was significantly higher among females and among the Indians and Chinese. Having close friends and married parents were strongly protective against suicidal ideation. Understanding the risk and protective factors is important in providing comprehensive management for suicidal ideation. © 2014 APJPH.

Demographics as predictors of suicidal thoughts and behaviors: A meta-analysis.

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Xieyining Huang

Full Text Available Certain demographic factors have long been cited to confer risk or protection for suicidal thoughts and behaviors. However, many studies have found weak or non-significant effects. Determining the effect strength and clinical utility of demographics as predictors is crucial for suicide risk assessment and theory development. As such, we conducted a meta-analysis to determine the effect strength and clinical utility of demographics as predictors.We searched PsycInfo, PubMed, and GoogleScholar for studies published before January 1st, 2015. Inclusion criteria required that studies use at least one demographic factor to longitudinally predict suicide ideation, attempt, or death. The initial search yielded 2,541 studies, 159 of which were eligible. A total of 752 unique statistical tests were included in analysis.Suicide death was the most commonly studied outcome, followed by attempt and ideation. The average follow-up length was 9.4 years. The overall effects of demographic factors studied in the field as risk factors were significant but weak, and that of demographic factors studied as protective factors were non-significant. Adjusting for publication bias further reduced effect estimates. No specific demographic factors appeared to be strong predictors. The effects were consistent across multiple moderators.At least within the narrow methodological constraints of the existing literature, demographic factors were statistically significant risk factors, but not protective factors. Even as risk factors, demographics offer very little improvement in predictive accuracy. Future studies that go beyond the limitations of the existing literature are needed to further understand the effects of demographics.

[A pilot study of differences in behavioral and linguistic characteristics between Sina suicide microblog users and Sina microblog users without suicide idea].

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Guan, Li; Hao, Bibo; Liu, Tianli; Cheng, Qijin; Yip, Paul Siu Fai; Zhu, Tingshao

2015-05-01

To investigate how suicide microblog users in China "act" and "speak" differently from other microblog users without suicide idea. The suicide group consisted of 31 Chinese microblog users identified as suicide via online information provided by a Sina microblog user, and the control group consisted of 30 active microblog users without suicide idea screened by using suicide-related psychological scales. The differences in 10 microblog use behavioral characteristics and 88 linguistic characteristics between the suicide group and the control group were compared with normality test and rank sum test respectively. In the behavioral characteristics, the suicide group used hyperlinks and "@" less frequently than the control group [0.04 (0.04) vs. 0.06 (0.04), P=0.029; 0.60 (0.27) vs. 0.69 (0.18), P=0.028], and was more self-focused [0.47 (0.25) vs. 0.30 (0.10), P=0.010]. In the linguistic characteristics, the suicide group showed less frequency in using measure word, work related word and apostrophe than the control group (P<0.05), and showed more frequency in using pronoun, personal pronoun, third person singular, non-specific pronoun, word expressing social experience, word expressing anxiety, word expressing exclusion, sexual word, religious word, second person singular, human being related word, negative emotion related word, anger related word, sadness or death related word (P<0.05). Suicides seemed to interact less with others, showed more self-concern and more negative expressions, use more cognitively exclusive, death-related, religion-related words, and use less work-related words. The results of this study might be helpful for the research on suicide among netizen.

Suicide behavior and associated psychosocial factors among adolescents in Campeche, Mexico.

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González-Forteza, Catalina; Juárez-López, Carlos E; Jiménez, Alberto; Montejo-León, Liliana; Rodríguez-Santisbón, Ulises R; Wagner, Fernando A

2017-12-01

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.

Examining the interplay among family, culture, and latina teen suicidal behavior.

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Gulbas, Lauren E; Zayas, Luis H

2015-05-01

In this article, we explore the relationships among culture, family, and attempted suicide by U.S. Latinas. We analyzed qualitative interviews conducted with Latina teen suicide attempters (n = 10) and their parents. We also incorporated data collected from adolescents with no reported history of self-harm (n = 10) and their parents to examine why some individuals turned to suicide under similar experiences of cultural conflict. Our results reveal that Latina teens who attempted suicide lacked the resources to forge meaningful social ties. Without the tools to bridge experiences of cultural contradiction, the girls in our study described feeling isolated and alone. Under such conditions, adolescents turned to behaviors aimed at self-destruction. Unlike their peers who attempted suicide, adolescent Latinas with no lifetime history of attempted suicide were able to mobilize resources in ways that balanced experiences of acculturative tension by creating supportive relationships with other individuals. © The Author(s) 2014.

Family history of suicide and exposure to interpersonal violence in childhood predict suicide in male suicide attempters.

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Rajalin, Mia; Hirvikoski, Tatja; Jokinen, Jussi

2013-05-15

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.

[Relationship between cyberbullying and the suicide related psychological behavior among middle and high school students in Anhui Province].

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Wang, Gengfu; Fang, Yu; Jiang, Liu; Zhou, Guiyang; Yuan, Shanshan; Wang, Xiuxiu; Su, Puyu

2015-11-01

To examine the prevalence rate of cyberbullying in middle and high school students in Anhui Province and explore the relationship between cyberbullying and suicide related psychological behavior. A total of 5726 middle and high school students from the 7th to the 12th grades in three regular middle schools and three regular high schools recruited from three cities in the Anhui Province (Tongling, Chuzhou, and Fuyang). Tongling, Chuzhou, and Fuyang are in the south, middle and north of Anhui, respectively. Each city was selected one regular middle school and one regular high school, and 8 classes were selected form each grade from each school. A stratified cluster random sampling method was used to randomly select 5726 participants among the six schools. Self-reports on cyberbullying and suicide related psychological behavior were collected. Among these 5726 adolescents, 46.8% of them involved in cyberbullying. Among them, 3.2% were bullies, 23.8% were victims, and 19.8% were both. Prevalence rates of suicide idea, suicide plan, suicide preparation, suicide implementation were 19.3%, 6.9%, 4.7% and 1.8%, respectively. Cyberbullying involvement, as victims, bullies or bully-victims, increased the risk of four kinds of suicide related psychological behavior (suicide idea, suicide plan, suicide preparation, suicide implementation) (P Cyberbullying has become a common occurrence in middle and high school students. Additionally, cyberbullying is closely related to suicide related psychological behavior among middle and high school students.

The Role of Optimism in the Interpersonal-Psychological Theory of Suicidal Behavior

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Rasmussen, Kathy A.; Wingate, LaRicka R.

2011-01-01

A possible relationship between Joiner's (2005) interpersonal-psychological theory of suicidal behavior and optimism was investigated by examining the ability of optimism to act as a moderator of perceived burdensomeness, thwarted belongingness, and acquired capability to engage in self-injury in the prediction of suicidal ideation. Results…

Non-Fatal Suicidal Behaviors in Adolescents

OpenAIRE

Jena, S.; Sidhartha, T.

2004-01-01

In the USA, suicide ranked as the third leading cause of death for adolescents in 1999. Non-fatal suicidal behaviours are suicidal thought, specific suicidal plan and suicide attempt. Prospective studies have emphasized the high subsequent suicide rates in clinically presenting suicide attempters. This study was planned to critically review the existing international literature on this area, and compare, if possible, with the Indian data. Both electronic and manual search for published and un...

Characteristics of Youth With Combined Histories of Violent Behavior, Suicidal Ideation or Behavior, and Gun-Carrying.

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Logan, Joseph E; Vagi, Kevin J; Gorman-Smith, Deborah

2016-11-01

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.

Predictors of Suicidal Behavior in a Sample of Turkish Suicide Attempters

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Sayar, Kemal; Kose, Samet; Acar, Burcin; Ak, Ismail; Reeves, Robert A.

2004-01-01

In a Turkish sample, 100 suicide attempters, were compared with 60 healthy controls on measures of hopelessness, depression, and suicidal ideation. Suicide attempters were more depressive, more hopeless, and displayed greater suicidal ideation than healthy controls. Depression severity rather than hopelessness correlated with suicidal intent.…

Associations between the timing of childhood adversity and adulthood suicidal behavior: A nationally-representative cohort.

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Chang, Hyoung Yoon; Chung, Yeonseung; Keyes, Katherine M; Jung, Sun Jae; Kim, Seung-Sup

2015-11-01

Although childhood adversities (CAs) are known to be associated with later suicidal behavior, it is uncertain whether the timing of specific CAs may influence this association. We analyzed nationally representative data for 9205 participants from the Korean Welfare Panel Study. Four different CAs (parental death, parental divorce, suspension of school education and being raised in a relative's house due to financial strain) were assessed and were categorized as early childhood and adolescent onset. Lifetime experiences of suicidal behaviors along with the age of the first time experience were recorded. Cox regression was used. After adjusting for age, sex, and childhood socioeconomic status, parental death before the age of 12 was associated with adulthood suicidal behavior (ideation HR 1.35, 95% CI 1.13, 1.61; attempt HR 1.60, 95% CI 1.02, 2.52), while suspension of school due to financial strain was associated with suicidal behavior when it occurred at adolescence (ideation HR 1.48, 95% CI 1.22, 1.79; plan HR 1.69, 95% CI 1.16, 2.48). When we also adjusted for adulthood SES, which is a potential mediator, there was no significant change except that the association between early parental death and suicidal attempt became non-significant (HR: 1.43, 95% CI: 0.92, 2.26). Experience of CA was assessed retrospectively, and the assessment of suicidal attempt was not specifically defined. There could be selection bias due to loss to the follow-up. There may be a critical period for the effect of CA on later suicidal behavior depending on the characteristics of CA. Copyright © 2015 Elsevier B.V. All rights reserved.

TPH2 -703G/T SNP may have important effect on susceptibility to suicidal behavior in major depression.

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Yoon, Ho-Kyoung; Kim, Yong-Ku

2009-04-30

Serotonergic system-related genes can be good candidate genes for both major depressive disorder (MDD) and suicidal behavior. In this study, we aimed to investigate the association of serotonin 2A receptor gene -1438A/G SNP (HTR2A -1438A/G), tryptophan hydroxylase 2 gene -703G/T SNP (TPH2 -703G/T) and serotonin 1A receptor C-1019G (HTR1A C-1019G) with suicidal behavior. One hundred and eighty one suicidal depressed patients and 143 non-suicidal depressed patients who met DSM-IV criteria for major depressive disorder were recruited from patients who were admitted to Korea University Ansan Hospital. One hundred seventy six normal controls were healthy volunteers who were recruited by local advertisement. Patients and normal controls were genotyped for HTR2A -1438A/G, TPH2 -703G/T and 5-HT1A C-1019G. The suicidal depressed patients were evaluated by the lethality of individual suicide attempts using Weisman and Worden's risk-rescue rating (RRR) and the Lethality Suicide Attempt Rating Scale-updated (LSARS-II). In order to assess the severity of depressive symptoms of patients, Hamilton's Depression Rating Scale (HDRS) was administered. Genotype and allele frequencies were compared between groups by chi(2) statistics. Association of genotype of the candidate genes with the lethality of suicidal behavior was examined with ANOVA by comparing the mean scores of LSARS and RRR according to the genotype. There were statistically significant differences in the genotype distributions and allele frequencies of TPH2 -703G/T between the suicidal depressive group and the normal control group. The homozygous allele G (G/G genotype) frequency was significantly higher in suicidal depressed patients than in controls. However, no differences in either genotype distribution or in allele frequencies of HTR2A -1438A/G and HTR1A C-1019G were observed between the suicidal depressed patients, the non-suicidal depressed patients, and the normal controls. There were no differences in the

The Association between Inappropriate Weight Control Behaviors and Suicide Ideation and Attempt among Korean Adolescents.

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Lee, Sang Ah; Jang, Suk Yong; Shin, Jaeyong; Ju, Yeong Jun; Nam, Jin Young; Park, Eun Cheol

2016-10-01

Suicide is a leading cause of death among adolescents globally, and body weight is also a recognized reason for adolescent suicide. Therefore, we investigated the association between weight control behaviors (WCB) and suicide ideation and attempt, focusing on inappropriate weight control measures. We used data from the 2014 Korea Youth Risk Behavior Web-based Survey, representing a total of 35,224 boys and 34,361 girls aged 12 to 18 years. Adolescents were classified into groups based on WCB: appropriate WCB, inappropriate WCB, and no WCB. We performed logistic regression models to examine associations between WCB and suicide ideation and attempt, controlling for covariates. Both boys and girls with inappropriate WCB were more likely to report suicide ideation and attempt. Underweight and normal weight boys with inappropriate WCB were more likely to think or attempt suicide, and underweight girls with inappropriate WCB were also more likely to attempt suicide. Among five common WCB combinations, the combination of "regular exercise, fasting, eating less" was highly associated with suicide ideation and attempt. We confirmed that inappropriate WCB is associated with suicide ideation and attempt among Korean adolescents. Given the high incidence rate of suicide among adolescents and the adverse effect of inappropriate WCB, encouraging adolescents to control their weight in healthy ways is imperative.

The Effectiveness of Family-Based Cognitive-Behavior Grief Therapy to Prevent Complicated Grief in Relatives of Suicide Victims: The Mediating Role of Suicide Ideation

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de Groot, Marieke; Neeleman, Jan; van der Meer, Klaas; Burger, Huibert

2010-01-01

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 therapy, the effect of suicide ideation on the…

Building Models for the Relationship between Attitudes toward Suicide and Suicidal Behavior: Based on Data from General Population Surveys in Sweden, Norway, and Russia

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Renberg, Ellinor Salander; Hjelmeland, Heidi; Koposov, Roman

2008-01-01

Our aim was to build a model delineating the relationship between attitudes toward suicide and suicidal behavior and to assess equivalence by applying the model on data from different countries. Representative samples from the general population were approached in Sweden, Norway, and Russia with the Attitudes Toward Suicide (ATTS) questionnaire.…

Adverse Childhood Experiences and Suicide Attempts: The Mediating Influence of Personality Development and Problem Behaviors.

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Perez, Nicholas M; Jennings, Wesley G; Piquero, Alex R; Baglivio, Michael T

2016-08-01

Adverse childhood experiences, comprised of forms of maltreatment and certain dysfunctional household environments, can affect the development of a child in a variety of different ways. This multitude of developmental changes may subsequently produce compounding harmful effects on the child's life and increase acutely maladaptive outcomes, including adolescent suicidal behavior. This study uses data collected from 2007 to 2012 for 64,329 Florida Department of Juvenile Justice youth (21.67 % female, 42.88 % African American, and 15.37 % Hispanic) to examine the direct and indirect effects of adverse childhood experiences on suicide attempts. Using a generalized structural equation model, the effects of adverse childhood experience scores are estimated on suicidal behavior through pathways of certain aspects of a child's personality development (aggression and impulsivity), as well as adolescent problem behaviors (school difficulties and substance abuse). The results show that a large proportion of the relationship between childhood adversity and suicide is mediated by the aforementioned individual characteristics, specifically through the youth's maladaptive personality development. These results suggest that, if identified early enough, the developmental issues for these youth could potentially be addressed in order to thwart potential suicidal behavior.

Can sports events affect suicidal behavior? A review of the literature and implications for prevention.

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Andriessen, Karl; Krysinska, Karolina

2009-01-01

Engagement in sports and physical activity, either actively as an athlete or in a passive way as a spectator, impacts interpersonal behavior and physical and mental health. The study reviews literature on the relationship between sports spectatorship and suicidal behavior to ascertain whether sports spectatorship has an impact on suicidal behavior, either increasing the risk or being a protective factor. The literature was searched via PubMed/MEDLINE and PsycINFO. Nine studies published between 1986 and 2006 were identified. The reviewed studies focused on the impact of sports events on the societal level, and analyzed data regarding national or local suicide rates. Their results indicate that sports events can have an impact on suicide mortality and morbidity, but this relationship seems to be mediated by age, gender, marital status, and alcohol consumption, as well as the process and outcome of the game (e.g., victory vs. defeat of the favored team). There is some evidence that sports events can reduce the rates of suicide on the societal level; however, there is a lack of studies exploring how sports spectatorship might influence levels of suicide risk in individuals and how mediating variables might operate on the individual level.

Karolinska Interpersonal Violence Scale predicts suicide in suicide attempters.

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Jokinen, Jussi; Forslund, Kaj; Ahnemark, Ewa; Gustavsson, J Petter; Nordström, Peter; Asberg, Marie

2010-08-01

Both childhood trauma and violent behavior are important risk factors for suicidal behavior. The aim of the present study was to construct and validate a clinical rating scale that could measure both the exposure to and the expression of violence in childhood and during adult life and to study the ability of the Karolinska Interpersonal Violence Scale (KIVS) to predict ultimate suicide in suicide attempters. A total of 161 suicide attempters and 95 healthy volunteers were assessed with the KIVS measuring exposure to violence and expressed violent behavior in childhood (between 6-14 years of age) and during adult life (15 years or older). The Buss-Durkee Hostility Inventory (BDHI), "Urge to act out hostility" subscale from the Hostility and Direction of Hostility Questionnaire (HDHQ), and the Early Experience Questionnaire (EEQ) were used for validation. All patients were followed up for cause of death and a minimum of 4 years from entering in the study. Five patients who committed suicide within 4 years had significantly higher scores in exposure to violence as a child, in expressed violent behavior as an adult, and in KIVS total score compared to survivors. Suicide attempters scored significantly higher compared to healthy volunteers in 3 of the 4 KIVS subscales. There were significant correlations between the subscales measuring exposure to and expression of violent behavior during the life cycle. BDHI, Urge to act out hostility, and EEQ validated the KIVS. Exposure to violence in childhood and violent behavior in adulthood are risk factors for completed suicide in suicide attempters. Behavioral dysregulation of aggression is important to assess in clinical work. The KIVS is a valuable new tool for case detection and long-term clinical suicide prevention. Copyright 2010 Physicians Postgraduate Press, Inc.

Risk factors for suicide completion in major depression: a case-control study of impulsive and aggressive behaviors in men.

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Dumais, A; Lesage, A D; Alda, M; Rouleau, G; Dumont, M; Chawky, N; Roy, M; Mann, J J; Benkelfat, C; Turecki, Gustavo

2005-11-01

Major depression is a major risk factor for suicide. However, not all individuals with major depression commit suicide. Impulsive and aggressive behaviors have been proposed as risk factors for suicide, but it remains unclear whether their effect on the risk of suicide is at least partly explained by axis I disorders commonly associated with suicide, such as major depression. With a case-control design, a comparison of the level of impulsive and aggressive behaviors and the prevalence of associated psychopathology was carried out with control for the presence of primary psychopathology. One hundred and four male suicide completers who died during an episode of major depression and 74 living depressed male comparison subjects were investigated with proxy-based interviews by using structured diagnostic instruments and personality trait assessments. The authors found that current (6-month prevalence) alcohol abuse/dependence, current drug abuse/dependence, and cluster B personality disorders increased the risk of suicide in individuals with major depression. Also, higher levels of impulsivity and aggression were associated with suicide. An analysis by age showed that these risk factors were more specific to younger suicide victims (ages 18-40). A multivariate analysis indicated that current alcohol abuse/dependence and cluster B personality disorder were two independent predictors of suicide. Impulsive-aggressive personality disorders and alcohol abuse/dependence were two independent predictors of suicide in major depression, and impulsive and aggressive behaviors seem to underlie these risk factors. A developmental hypothesis of suicidal behavior, with impulsive and aggressive behaviors as the starting point, is discussed.

A theory-based approach to understanding suicide risk in shelter-seeking women.

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Wolford-Clevenger, Caitlin; Smith, Phillip N

2015-04-01

Women seeking shelter from intimate partner violence are at an increased risk for suicide ideation and attempts compared to women in the general population. Control-based violence, which is common among shelter-seeking women, may play a pivotal role in the development of suicide ideation and attempts. Current risk assessment and management practices for shelter-seeking women are limited by the lack of an empirically grounded understanding of increased risk in this population. We argue that in order to more effectively promote risk assessment and management, an empirically supported theory that is sensitive to the experiences of shelter-seeking women is needed. Such a theory-driven approach has the benefits of identifying and prioritizing targetable areas for intervention. Here, we review the evidence for the link between coercive control and suicide ideation and attempts from the perspective of Baumeister's escape theory of suicide. This theory has the potential to explain the role of coercive control in the development of suicide ideation and eventual attempts in shelter-seeking women. Implications for suicide risk assessment and prevention in domestic violence shelters are discussed. © The Author(s) 2014.

Suicidal Behavior Among People Living with HIV (PLHIV) in Medical Care in Estonia and Factors Associated with Receiving Psychological Treatment.

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Lemsalu, Liis; Rüütel, Kristi; Laisaar, Kaja-Triin; Lõhmus, Liilia; Raidvee, Aire; Uusküla, Anneli

2017-06-01

People living with HIV (PLHIV) have higher rates of suicidal behavior than the general population. This study assessed suicidal behavior (ideation and/or attempts, ever and in the past 12 months) among PLHIV receiving outpatient HIV medical care in Estonia and associations between suicidal behavior and psychological treatment. The cross-sectional study collected data from January to November 2013 using a self-report questionnaire. Eight hundred PLHIV participated, 39 % (n = 306) of whom had been suicidal. Lifetime prevalence was 36 % for suicidal ideation and 20 % for attempts. Younger age, incarceration, having ever abused alcohol and also injected drugs, having lived with HIV for more than 10 years, and being depressed were associated with lifetime suicidal behavior. Suicidal behavior within the past 12 months was reported by 20 % (n = 156) of respondents. Of these, 27 % received psychological treatment (counseling and/or psychotherapy), 20 % had taken antidepressants, and 49 % sedatives. Individuals perceiving a need for treatment were significantly more likely to receive psychological treatment when experiencing suicidal behavior (OR 25.65, 95 % CI 2.92-225.47). In conclusion, suicidal behavior is frequent among PLHIV but psychological treatment is not often received. One of the barriers to treatment is patients' lack of perceived need for help.

Structural Alterations in the Corpus Callosum Are Associated with Suicidal Behavior in Women with Borderline Personality Disorder

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Alexander Lischke

2017-04-01

Full Text Available Structural alterations in the corpus callosum (CC, the major white matter tract connecting functionally related brain regions in the two hemispheres, have been shown to be associated with emotional instability, impulsivity and suicidality in various mental disorders. To explore whether structural alterations of the CC would be similarly associated with emotional instability, impulsivity and suicidality in borderline personality disorder (BPD, we used diffusion tensor imaging (DTI to assess the structural integrity of the CC in 21 BPD and 20 healthy control (HC participants. Our hypothesis-driven analyses revealed a positive correlation between BPD participants’ suicidal behavior and fractional anisotropy (FA in the splenium and genu of the CC and a negative correlation between BPD participants’ suicidal behavior and mean diffusivity (MD in the splenium of CC. Our exploratory analyses suggested that suicidal BPD participants showed less FA and more MD in these regions than HC participants but that non-suicidal BPD participants showed similar FA and MD in these regions as HC participants. Taken together, our findings suggest an association between BPD participants’ suicidal behavior and structural alterations in regions of the CC that are connected with brain regions implicated in emotion regulation and impulse control. Structural alterations of the CC may, thus, account for deficits in emotion regulation and impulse control that lead to suicidal behavior in BPD. However, these findings should be considered as preliminary until replicated and extended in future studies that comprise larger samples of suicidal and non-suicidal BPD participants.

A longitudinal population-based study exploring treatment utilization and suicidal ideation and behavior in major depressive disorder.

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Chartrand, Hayley; Robinson, Jennifer; Bolton, James M

2012-12-10

This study aimed to longitudinally examine the relationship between treatment utilization and suicidal behavior among people with major depressive disorder in a nationally representative sample. Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (Wave 1: N=43,093; Wave 2: N=34,653). Suicidal and non-suicidal individuals at Wave 1 were compared based on subsequent treatment utilization. Suicidal behavior at Wave 2 was compared between people with major depressive disorder who had sought treatment at Wave 1 versus those that had not. Individuals with past year major depressive disorder at Wave 1 who attempted suicide were more likely to be hospitalized at follow up compared to non-suicidal people with major depressive disorder [adjusted odds ratio (AOR)=4.46; 95% confidence interval [95% CI]: 2.54-7.85]; however, they were not more likely to seek other forms of treatment. Among those with past year major depressive disorder who sought treatment at baseline, visiting an emergency room (AOR=3.08; 95% CI: 1.61-5.89) and being hospitalized (AOR=2.41; 95% CI: 1.13-5.14), was associated with an increased likelihood of attempting suicide within 3 years even after adjusting for mental disorder comorbidity, depression severity, and previous suicidal behavior. Unable to draw conclusions about completed suicide or adequacy of treatment. Suicidal behavior does not lead individuals with major depressive disorder to seek treatment with professionals or use antidepressant medications; instead, they are more likely to use emergency services. These findings suggest that treatment efforts for people with major depressive disorder who are suicidal need improvement. Copyright © 2012 Elsevier B.V. All rights reserved.

[The association of bullying with suicide ideation, plan, and attempt among adolescents with GLB or unsure sexual identity, heterosexual identity with same-sex attraction or behavior, or heterosexual identity without same-sex attraction or behavior].

Science.gov (United States)

Montoro, Richard; Thombs, Brett; Igartua, Karine J

Context Bullying is a known risk factor for suicidality, and suicide is the second leading cause of death for adolescents. Both are increased in sexual minority youth (SMY). As SMY are comprised of youth who self-identify as gay, lesbian, bisexual (GLB) or who have same-sex attractions or behaviors, our previous finding that different subgroups have different risks for suicidality is understandable. Given that the difference was along sexual identity lines (GLB vs heterosexual SMY), the analysis of bullying data in the same subgroups was felt to be important.Objective To compare the association of bullying and suicide among heterosexual students without same-sex attractions or behaviors, heterosexual students with same-sex attractions and behaviors, and students with gay, lesbian or bisexual (GLB) or unsure sexual identities.Design The 2004 Quebec Youth Risk Behavior Survey (QYRBS) questionnaire was based on the 2001 Center for Disease Control Youth Risk Behavior Survey, and included items assessing the three dimensions of sexual orientation (identity, attraction and behavior), health risk behaviors, experiences of harassment, and suicidal ideation, plans and attempts.Methods A total of 1852 students 14-18 years of age from 14 public and private high schools in Montréal Québec were surveyed anonymously during the 2004-2005 academic year.Main outcome measure Self reports of suicidal ideation, suicidal plan and suicide attempts in the last 12 months.Results In all, 117 students (6.3%) had a non-heterosexual identity (GLB or unsure) and 115 students (6.3%) had a heterosexual identity with same-sex attraction or behavior. Bullying occurred in 24% of heterosexual students without same-sex attraction or behavior, 32% of heterosexual students with same-sex attraction or behavior, and 48% of non-heterosexually identified students. In multivariable analysis, the common risk factors of age, gender, depressed mood, drug use, fighting, physical and sexual abuse, and

Epidemiological investigation of a youth suicide cluster: Delaware 2012.

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Fowler, Katherine A; Crosby, Alexander E; Parks, Sharyn E; Ivey, Asha Z; Silverman, Paul R

2013-01-01

In the first quarter of 2012, eight youth (aged 13-21 years) were known to have died by suicide in Kent and Sussex counties, Delaware, twice the typical median yearly number. State and local officials invited the Centers for Disease Control and Prevention to assist with an epidemiological investigation of fatal and nonfatal youth suicidal behaviors in the first quarter of 2012, to examine risk factors, and to recommend prevention strategies. Data were obtained from the Delaware Office of the Medical Examiner, law enforcement, emergency departments, and inpatient records. Key informants from youth-serving organizations in the community were interviewed to better understand local context and perceptions of youth suicide. Eleven fatal and 116 nonfatal suicide attempts were identified for the first quarter of 2012 in Kent and Sussex counties. The median age was higher for the fatalities (18 years) than the nonfatal attempts (16 years). More males died by suicide, and more females nonfatally attempted suicide. Fatal methods were either hanging or firearm, while nonfatal methods were diverse, led by overdose/poisoning and cutting. All decedents had two or more precipitating circumstances. Seventeen of 116 nonfatal cases reported that a peer/friend recently died by or attempted suicide. Local barriers to youth services and suicide prevention were identified. Several features were similar to previous clusters: Occurrence among vulnerable youth, rural or suburban setting, and precipitating negative life events. Distribution by sex and method were consistent with national trends for both fatalities and nonfatalities. References to the decedents in the context of nonfatal attempts support the concept of 'point clusters' (social contiguity to other suicidal youth as a risk factor for vulnerable youth) as a framework for understanding clustering of youth suicidal behavior. Recommended prevention strategies included: Training to identify at-risk youth and guide them to services

The Interpersonal Psychological Theory of Suicide: Suicidal Ideation and Behaviors of Lesbian, Gay, and Bisexual College Students and Their Heterosexual Peers

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Ploskonka, Rachel Ann

2017-01-01

Lesbian, gay, and bisexual (LGB) college students are among the most vulnerable to suicidal ideation and behaviors when compared to both heterosexual college students and other, generally older, members of the LGB community (Oswalt & Wyatt, 2011). Joiner's (2005) interpersonal psychological theory of suicide seems to be a possible framework…

Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior: a randomized trial.

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Mehlum, Lars; Tørmoen, Anita J; Ramberg, Maria; Haga, Egil; Diep, Lien M; Laberg, Stine; Larsson, Bo S; Stanley, Barbara H; Miller, Alec L; Sund, Anne M; Grøholt, Berit

2014-10-01

We examined whether a shortened form of dialectical behavior therapy, dialectical behavior therapy for adolescents (DBT-A) is more effective than enhanced usual care (EUC) to reduce self-harm in adolescents. This was a randomized study of 77 adolescents with recent and repetitive self-harm treated at community child and adolescent psychiatric outpatient clinics who were randomly allocated to either DBT-A or EUC. Assessments of self-harm, suicidal ideation, depression, hopelessness, and symptoms of borderline personality disorder were made at baseline and after 9, 15, and 19 weeks (end of trial period), and frequency of hospitalizations and emergency department visits over the trial period were recorded. Treatment retention was generally good in both treatment conditions, and the use of emergency services was low. DBT-A was superior to EUC in reducing self-harm, suicidal ideation, and depressive symptoms. Effect sizes were large for treatment outcomes in patients who received DBT-A, whereas effect sizes were small for outcomes in patients receiving EUC. Total number of treatment contacts was found to be a partial mediator of the association between treatment and changes in the severity of suicidal ideation, whereas no mediation effects were found on the other outcomes or for total treatment time. DBT-A may be an effective intervention to reduce self-harm, suicidal ideation, and depression in adolescents with repetitive self-harming behavior. Clinical trial registration information-Treatment for Adolescents With Deliberate Self Harm; http://ClinicalTrials.gov/; NCT00675129. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Is Young Adulthood a Critical Period for Suicidal Behavior among Sexual Minorities? Results from a US National Sample.

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Fish, Jessica N; Rice, Cara E; Lanza, Stephanie T; Russell, Stephen T

2018-03-29

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).

Preliminary Effectiveness of Surviving the Teens[R] Suicide Prevention and Depression Awareness Program on Adolescents' Suicidality and Self-Efficacy in Performing Help-Seeking Behaviors

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King, Keith A.; Strunk, Catherine M.; Sorter, Michael T.

2011-01-01

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]…

Are autistic traits associated with suicidality? A test of the interpersonal-psychological theory of suicide in a non-clinical young adult sample.

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Pelton, M K; Cassidy, S A

2017-11-01

Autism spectrum conditions (ASC) has recently been associated with increased risk of suicidality. However, no studies have explored how autistic traits may interact with current models of suicidal behavior in a non-clinical population. The current study therefore explored how self-reported autistic traits interact with perceived burdensomeness and thwarted belongingness in predicting suicidal behavior, in the context of the Interpersonal-Psychological Theory of Suicide (IPTS). 163 young adults (aged 18-30 years) completed an online survey including measures of thwarted belonging and perceived burdensomeness (Interpersonal Needs Questionnaire), self-reported autistic traits (Autism Spectrum Quotient), current depression (Centre for Epidemiological Studies Depression Scale), and lifetime suicidality (Suicide Behavior Questionnaire-Revised). Results showed that burdensomeness and thwarted belonging significantly mediated the relationship between autistic traits and suicidal behavior. Both depression and autistic traits significantly predicted thwarted belonging and perceived burdensomeness. Autistic traits did not significantly moderate the relationship between suicidal behavior and thwarted belonging or perceived burdensomeness. Results suggest that the IPTS provides a useful framework for understanding the influence of autistic traits on suicidal behavior. However, the psychometric properties of these measures need be explored in those with clinically confirmed diagnosis of ASC. Autism Res 2017, 10: 1891-1904. © 2017 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. Recent research has shown that people with high autistic traits are more likely to attempt suicide. However, no studies have explored why. We found that people with high autistic traits were more likely to experience feelings that they do not belong in the world, are a burden on others, and depression, which may increase their likelihood of

Validity of Suicidality Items from the Youth Risk Behavior Survey in a High School Sample

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May, Alexis; Klonsky, E. David

2011-01-01

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…

Prevention of suicide

Directory of Open Access Journals (Sweden)

Rajiv Gupta

2017-01-01

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.

Association between interpersonal trust, reciprocity, and suicidal behaviors: A longitudinal cohort study in South Korea.

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Kim, Ja Young; Yoon, Jaehong; Kim, Myoung-Hee; Kim, Seung-Sup

2017-06-01

While a growing body of evidence suggest that social capital including interpersonal trust and reciprocity might be associated with mental health outcomes, few studies have explored the relationship with suicidal behaviors. This research examined the prospective association between interpersonal trust and reciprocity and suicidal behaviors using the Korea Welfare Panel Study, a nationally representative longitudinal cohort dataset in South Korea. Interpersonal trust and reciprocity were assessed at the 7th wave of the survey (2012), and each measure was classified into two categories (low vs. high). Experience of suicidal ideation, planning, and attempt was assessed between the 8th (2013) and 10th wave (2015) of the surveys. After adjusting for confounders including lifetime experience of suicidal behaviors at the 7th wave of the survey (2012) as well as socio-demographic information, the low interpersonal trust group was more likely to experience suicidal ideation (OR: 1.30, 95% CI: 1.11-1.53) compared to the high interpersonal trust group whereas no statistically significant association was observed in the reciprocity analysis. Copyright © 2017 Elsevier Inc. All rights reserved.

Sexual behavior, depressive feelings, and suicidality among Estonian school children aged 13 to 15 years.

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Heidmets, L; Samm, A; Sisask, M; Kõlves, K; Aasvee, K; Värnik, A

2010-01-01

The present paper is based on a WHO Collaborative Cross-National Study "Health Behavior in School-Aged Children (HBSC)." It aimed at describing and analyzing how the sexual behaviors of 13- to 15-year-old Estonian school children were associated with self-reported depressive feelings and suicidality. Distinctive behavioral traits in relation to age of first sexual intercourse were also investigated. Self-reported questionnaires from school children (n = 3,055) were analyzed. In total, 15.2% of school children reported being nonvirgin. Among 13-year-olds, 2.9% of girls and 6.8% of boys were nonvirgins. Approximately 25% of the 15-year-old girls and boys were nonvirgins. The likelihood of depressive feelings and suicidal ideation increased significantly in both genders with loss of virginity. Boys who had lost their virginity at 13 years or younger were 4.2 times more likely to have suicidal thoughts; comparable girls were 7.8 times more likely to have suicidal thoughts. Compared to virgins, youths who had lost their virginity reported poor self-assessed health and more risk behaviors in themselves and their peers. Experiences of sexual intercourse increased the odds ratios for depressive feelings and suicidality. The earlier sexual intercourse was initiated, the greater were the odds of lower mental well-being. Risk behaviors emerged as a complex phenomenon requiring complex prevention.

I felt so hurt and lonely: Suicidal behavior in South Asian-Surinamese, Turkish, and Moroccan women in the Netherlands

NARCIS (Netherlands)

van Bergen, D.; van Balkom, A.J.L.M.; Smit, J.H.; Saharso, Sawitri

2012-01-01

Young immigrant women in the Netherlands demonstrate disproportionate rates of suicidal behavior. This study investigated the origins of suicidal behavior in South Asian-Surinamese, Turkish, and Moroccan immigrant young women in order to identify ethnic- and gender-specific patterns of suicidal

"I felt so hurt and lonely": Suicidal behavior in South Asian-Surinamese, Turkish, and Moroccan women in the Netherlands

NARCIS (Netherlands)

van Bergen, D.D.; van Balkom, A.J.L.M.; Smit, J.H.; Saharso, S.

2012-01-01

Young immigrant women in the Netherlands demonstrate disproportionate rates of suicidal behavior. This study investigated the origins of suicidal behavior in South Asian-Surinamese, Turkish, and Moroccan immigrant young women in order to identify ethnic- and gender-specific patterns of suicidal

Chronotype differences in suicidal behavior and impulsivity among suicide attempters.

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Selvi, Yavuz; Aydin, Adem; Atli, Abdullah; Boysan, Murat; Selvi, Fatih; Besiroglu, Lutfullah

2011-03-01

Morning- and evening-type individuals differ on a number of psychological and biological variables. There has been increasing interest in the relationship between chronotype and personality traits. The aim of this study was to investigate the relationship between impulsivity and chronotype in suicide attempters. Eighty-nine suicide attempters were included in the study, and systematic information on suicide attempts was recorded. The Morningness-Eveningness Questionnaire was applied to determine chronotype, and attempter impulsivity was measured by the total score of the Barratt Impulsiveness Scale. Significant differences between chronotype and impulsivity scores were found. Evening-type subjects reported significantly higher impulsivity scores than both neither- and morning-types. A significant association between chronotype and type of suicide attempt was detected. The largest proportion of violent suicide attempters were evening-type subjects. Violent suicide attempters also reported significantly higher impulsivity scores than nonviolent attempters. Previous studies have pointed out possible relations between eveningness and impulsivity. Current findings suggest that eveningness may be a risk factor for violent suicide attempts by increasing impulsivity.

[The sociology of gender: an original perspective for a better understanding of suicide in men].

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Roy, Philippe

2012-01-01

There is a general consensus that suicide is a social problem. But what exactly is the contribution of sociology to research on suicide? This paper proposes a brief overview of the historical bases of the sociology of suicide and its evolution through the study of deviance and exclusion. On the level of application, the sociology of gender contributed to better understand how some aspects of male socialisation, such as the rigid relations with norms of the male role, may act as suicide risk factors or as a path to recovery.

Attempted suicide and completed suicide among young people

DEFF Research Database (Denmark)

Christoffersen, Mogens

The study explore risk factors associated with the onset of suicidal behavior in young people aged 15 to 24. The study survey possible risk factors and protective factors in order to evaluate if altering the conditions of children’s upbringing, structural factors, geographical segregation......, or individual resource deficits could reduce their suicidal behavior (first time suicide attempts and completed suicides). These issues are being examined using data gathered during a 10-year longitudinal study of two births cohorts of more than 145,000 young people born in 1966 or 1980. In the Nordic welfare...... model it is an ambition to level-out inequalities and give children the same opportunities despite parental income or educational resources. The paper focuses on suicidal behavior as an extreme indicator of individual disadvantage and social disintegration in order to disentangle groups of risk factors...

Gender differences in suicide and suicide attempts among US Army soldiers.