Suicide and Life-Threatening Behavior最新文献

Introduction: Bisexual individuals face elevated suicide risk, yet relatively little is known about short-term fluctuations in suicidal ideation (SI) and related constructs within this population. This study compared the frequency and variability of SI facets among bisexual and heterosexual college students.

Method: Sixty-two students (38 heterosexual; 24 bisexual) completed ambulatory assessments five times daily for 10 days, rating suicidal desire, wish to live (WTL), and wish to die (WTD). Analyses included generalized linear models and descriptive and variability statistics.

Results: Bisexual participants reported lower WTL and higher suicide desire and WTD than heterosexual peers, with the most robust effects observed for WTD. Bisexual participants were also more likely to endorse non-zero suicidal desire and WTD and experienced more frequent large moment-to-moment changes in these constructs. Models revealed similar variability in suicidal desire and WTD across groups, whereas bisexual individuals exhibited modestly higher variability in WTL.

Conclusion: Findings suggested that bisexual individuals not only reported higher levels of suicidal desire and WTD but also experienced these states more frequently, with more frequent acute shifts over time. These results highlighted the importance of monitoring short-term fluctuations in suicidal thoughts and behaviors when assessing suicide risk in bisexual populations.

Background: Suicide is a leading cause of death among young males in Australia. Tomorrow Man's "Breaking the Man Code" workshops aim to challenge potentially harmful masculine norms and promote positive attitudes towards help-seeking among adolescent boys in schools.

Methods: Our stratified cluster randomized trial was undertaken with 1225 boys (mean (SD) age = 15.04 (0.74) years) across 24 Australian secondary schools: 13 randomized to intervention, 11 to waitlist control. Primary outcome was mean change in intentions to seek help for personal or emotional problems 4 to 8 weeks from baseline. Secondary outcomes included conformity to masculine norms, depression risk, perceived social support, and quality of life. Purpose-designed closed-ended questions captured other behavioral and attitudinal changes. The trial was prospectively registered with ANZCTR.

Results: Estimated mean change in scores from baseline between the two groups on the primary outcome was -0.07 (95% confidence interval: -1.75, 1.62; p = 0.937). Purpose-designed questions revealed increased help-offering, connection with friends, and some potential barriers to change.

Conclusions: Further research is needed to understand the impacts of school-based interventions for boys.

Trial registration: Prospectively registered with ANZCTR: ACTRN12620001134910.

Objectives: This study aims to examine the five-year evolution of NSSI and identify the predictive factors associated with its persistence.

Method: Adolescents aged 12-18 years who attended a CAP outpatient clinic between 2014 and 2016 were retrospectively reviewed. Those with a history of NSSI formed the study group, while those without NSSI comprised the control group. Of 126 adolescents with NSSI, 51 were successfully re-evaluated five years later.

Results: The participants' mean age at T1 was M = 15.5 years, and at T2 it was M = 22.0 years. Adolescents who continued to engage in NSSI showed significantly greater difficulties in impulse control, body effectiveness, and identity diffusion compared to those who discontinued the behavior. In logistic regression analysis, identity diffusion and body effectiveness were significant predictors of persistence. Higher identity diffusion had nearly 18 times higher odds of maintaining NSSI (OR 17.99 95% CI [2.195, 147.418]), and those with higher body effectiveness had 1.4 times higher odds of persistence (OR 1.40 95% CI [1.115, 1.774]).

Conclusion: Identity diffusion showed the strongest association with persistent NSSI, whereas higher body effectiveness was modestly related to its continuation. These findings point to potential links between identity- and body-related processes and the long-term continuation of NSSI.

Objective: The aim of this study is to conduct a longitudinal evaluation of the effectiveness of Dialectical Behavior Therapy (DBT) based on the "Internet Plus" model on adolescents with Non-Suicidal Self-Injury (NSSI).

Methods: Seventy-four NSSI patients were randomly divided into an intervention group (36 cases) and a control group (38 cases). The intervention group underwent a 3-month "Internet Plus" DBT intervention, whereas the control group received standard psychological intervention. The Adolescent Non-suicidal Self-injury Assessment Questionnaire (ANSAQ), the Hamilton Depression Rating Scale (17 items, HAMD-17), and the Simplified Coping Style Questionnaire (SCSQ) were administered to assess NSSI behavior, depressive symptoms, and coping strategies at baseline and at 1, 2, and 3 months post-intervention.

Results: The intervention group demonstrated significant improvements in the frequency of self-injury, depressive symptoms, and coping strategies (p < 0.05), with notable differences compared to the control group.

Conclusion: The "Internet Plus" DBT intervention model has a positive effect on improving the symptoms of adolescents with NSSI.

Introduction: Youth experiencing high levels of functional impairment may be at risk for suicidal ideation, but variables contributing to this risk remain unclear. The present study investigates the role of perceived burdensomeness toward others as an explanatory variable in the association between functional impairment and suicidal ideation in a sample of clinically referred youth, and whether this relationship differs by age.

Methods: N = 383 clinically-referred youth aged 6 to 17 (M_age = 10.17, SD_age = 2.96; 81.8% Hispanic) completed measures of impairment, perceived burdensomeness, suicidal ideation, and depressive symptoms.

Results: Functional impairment was significantly associated with perceived burdensomeness (B = 0.39, p < 0.001), and perceived burdensomeness was significantly associated with suicidal ideation (B = 0.02, p < 0.001). The indirect effect of impairment on suicidal ideation through perceived burdensomeness was statistically significant (B = 0.005, SE = 0.002). The conditional indirect effect was significant and strengthened as a function of age.

Conclusion: These findings provide novel evidence that perceived burdensomeness may explain the link between impairment and suicidal ideation in youth, and that this explanatory link strengthens with increasing age. Clinically, results underscore the need for developmentally tailored interventions that target perceptions of burdensomeness to mitigate suicidal thoughts in at-risk youth.

Background: Nonsuicidal self-injury (NSSI) is recognized as a global public health concern among adolescents. Although some studies have explored the relationship between self-disgust and NSSI, the discussion remains limited, and the underlying mechanisms have yet to be fully elucidated. This study examined the longitudinal effects of self-disgust on NSSI, as well as the potential indirect effects of depression and psychache on this relationship.

Methods: A total of 832 Chinese adolescents participated in a two-wave longitudinal study with a six-month interval. The structural equation model was used to investigate the chain mediating roles of depression and psychache in the relationship between self-disgust and NSSI.

Results: The findings indicated that higher levels of self-disgust were predictive of NSSI 6 months later. The higher levels of depression were predictive of psychache 6 months later. Additionally, depression and psychache played chain mediating roles in the relationship between self-disgust and NSSI.

Conclusions: This longitudinal study provides evidence that self-disgust may contribute to adolescent NSSI by promoting depression and exacerbating psychache. These findings highlight the importance of addressing self-disgust in prevention and intervention strategies aimed at reducing NSSI risk among adolescents.

Background: Little is known about the prevalence of self-injurious thoughts and behaviors, including suicidal ideation (SI), suicide attempts (SA), and non-suicidal self-injury (NSSI) for transgender and gender-diverse (TGD) deaf adults.

Methods: This project used data collected as part of the 2017 TransLifeline Mental Health Survey. Study participants include N = 4245, self-identified TGD adults ages 18-87 that currently live in the United States. Chi-square analyses compared endorsement of lifetime and recent SI, SAs, and NSSI between TGD deaf and TGD hearing adults.

Results: Compared to their TGD hearing peers, TGD deaf participants, regardless of gender identity, were more likely to endorse hospitalization for SI, despite equivalent endorsement of past-year and lifetime SI compared to their TGD hearing peers. Similarly, TGD deaf participants, regardless of gender or racial/ethnic identity, were more likely to endorse a lifetime hospitalization for a SA. Lastly, although TGD deaf participants were equally likely as their TGD hearing peers to endorse lifetime experiences of NSSI, TGD deaf participants were more likely to report hospitalization for NSSI.

Conclusions: TGD deaf adults are at an increased risk of making a SA in their lifetime and at an increased risk for hospitalization for SI, SAs, and NSSI.

Caring Cards is a novel adaptation of caring contacts, where Veterans with a history of suicidality (card makers) create cards for Veterans with active suicidality (recipients). Aims included (1) establishing Caring Cards' feasibility and acceptability, including an optional meetup group, and (2) evaluating pre-/postchanges in thwarted belongingness, perceived burdensomeness, social connectedness, and suicide ideation. Participants included 30 card makers and 50 recipients receiving care at a Veterans Affairs Center. Groups of 5-10 card makers met weekly for 3-6 months to create cards; recipients received cards monthly for 6 months. Outcomes were collected at baseline and follow-up (one month postparticipation completion). Card makers demonstrated marginal feasibility (69.4% average attendance). Card maker attrition was greater than expected (60%). These rates may have been impacted by COVID-19. Card maker follow-up was feasible (70%). There was 0% attrition for recipients; however, follow-up was marginally feasible (68%). The optional meetup group was not feasible (36.4% attendance). All participants found the intervention acceptable (> 75% average satisfaction). There were no significant pre-/postdifferences across card maker outcomes. Recipients reported significant reductions in thwarted belongingness (d = 0.27) and perceived rejection (d = 0.41). Results highlight the promise of Caring Cards as a low-cost, highly scalable intervention.

Introduction: In the past two decades, suicide attempts and deaths involving prescription opioids have sharply increased. Research is needed to understand how prescription opioid misuse may increase suicide risk. Contemporary suicide theories suggest opioid use may increase suicide capability by increasing pain tolerance, altering fears related to death, or increasing one's understanding of lethal doses and/or access to means. This study examined the role of these dimensions of suicide capability in the association between prescription opioid misuse and self-reported likelihood of future suicidal behaviors.

Methods: Individuals with chronic pain, past year depression, and a current prescription of opioids for pain (N = 166) completed assessments of opioid misuse, suicide capability (i.e., fearlessness about death, pain tolerance, and suicide preparation and rehearsal), and suicidal behaviors.

Results: Analyses demonstrated significant indirect relations of prescription opioid misuse to the perceived future likelihood of suicide planning and attempts (both in general and involving opioids specifically) through suicide capability in the form of suicide preparation and rehearsal, controlling for suicide attempt history.

Conclusion: Findings suggest that prescription opioid misuse may increase suicide risk by increasing familiarity with a potential suicide method, consistent with extant literature highlighting the role of practical suicide capability in suicide risk.

Introduction: Persistent suicidal ideation (PSI) represents a clinically relevant phenomenon that remains insufficiently understood. The aim of this scoping review was to provide an overview of empirical studies investigating PSI, with a focus on definitions, operationalizations, and associations with indicators of mental health, suicidal behaviors, and treatment approaches.

Materials and methods: Following established guidelines for conducting scoping reviews, a systematic search of the literature was conducted, and studies were screened according to predefined inclusion criteria.

Results: N = 44 articles reporting on n = 40 individual studies were included in this review. The results indicate that several empirical studies have addressed PSI, most commonly using longitudinal designs. However, the absence of a consistent conceptualization across studies led to diverse and heterogeneous operationalizations and partly contradictory findings, making synthesis difficult.

Discussion: A major limitation of this review lies in the inconsistent terminology across publications, which may have resulted in missed studies. Furthermore, case studies and theoretical works were excluded, narrowing the scope of the findings.

Conclusion: The clinical relevance of PSI contrasts with the lack of empirical findings addressing its epidemiological and phenomenological characteristics. Future research should establish a common definition and operational criteria for PSI.