Suicide and Life-Threatening Behavior最新文献

Introduction: Risk factors for suicide after parental suicide may include points in the lifecourse when reminders of the deceased trigger grief resurgence. We hypothesized that risk of suicide attempt and suicide is elevated among suicide-bereaved offspring on reaching the age at which a parent died by suicide.

Methods: We conducted a self-controlled case series (SCCS) study using national register data on all individuals bereaved by parental suicide living in Denmark from 1980 to 2016. We compared relative incidence of our combined outcome (any secondary-care episode of self-harm or suicide) during the exposure period (2 years centred on the birthday representing age correspondence) and the 15-year unexposed periods either side. We repeated these models for offspring bereaved by parental non-suicide death as an indirect comparison.

Results: Risk of self-harm or suicide was elevated on reaching the age at parental suicide (n = 188; IRR_adj: 2.02, 95% CI: 1.21-3.38) relative to flanking periods, but not at parental non-suicide death (n = 734; IRR_adj: 0.76; 95% CI: 0.39-1.50).

Conclusions: Reaching the age at which a parent died by suicide appears to represent a vulnerable period for suicidality, countering public perceptions that time heals linearly. This indicates a need for support in the lead up to age correspondence.

Introduction: Suicidal ideation has high rates among individuals at Clinical High Risk for Psychosis (CHR-P). CHR-P mental states are currently defined as attenuated psychotic symptoms, brief intermittent psychotic symptoms, or genetic risk and functioning deterioration syndrome. However, the relationship between psychotic experiences and suicidality in CHR-P subjects is still not fully understood. Research emphasizes the need to address suicidality in CHR-P individuals due to its incidence and severe socio-economic impact. This study aimed to assess the baseline prevalence and 2-year incidence rates of suicidal thinking and behaviors in an Italian CHR-P sample, investigate the stability of suicidal ideation over 2 years, and examine its associations with treatment outcomes, sociodemographic characteristics, and clinical factors.

Methods: CHR-P participants were treated in an "Early Intervention in Psychosis" program and completed the PANSS and the GAF scale at baseline and every 12 months.

Results: 180 CHR-P individuals were enrolled (92 with suicidal ideation [SI+]). SI+ subjects had a higher baseline prevalence of past suicide attempts. Over 2 years, a decrease in suicidal ideation severity was observed in the total group. Longitudinal improvement in disorganized symptoms was a key predictor of the decrease in suicidal ideation. Participants with a history of suicide attempts were more likely to attempt again.

Conclusion: Addressing disorganization is crucial for suicide prevention in the CHR-P population. Continuous risk monitoring and preventive actions are needed for those with past suicide attempts.

Introduction: Self-reliance, emotional control, and honor ideology may prevent help-seeking when suicidal ideation emerges. Furthermore, these factors are associated with an increased likelihood of firearm ownership and unsecure storage, which could facilitate suicide attempts. The rurality of residence may impact these associations, as rural regions report increased independence, honor culture, and firearm prevalence. Therefore, this study examined how emotional control, self-reliance, and honor ideology relate to firearm storage and help-seeking for suicidal ideation, with rurality moderating these associations.

Methods: Participants were 733 adults (63.6% female, 33.5% male, and 2.9% transgender/other) who reported past-month suicidal ideation. Analyses tested associations between emotional control, self-reliance, and honor ideology with help-seeking for suicidal ideation and firearm storage, with rurality moderating these associations.

Results: The association of self-reliance and decreased help-seeking willingness for suicidal ideation was significant for those in non-urban areas. The association of emotional control and decreased help-seeking willingness for suicidal ideation was significant for those in urban areas. No variables predicted firearm storage.

Conclusions: Self-reliance and emotional control could be barriers for help-seeking regardless of gender identity that depend on rurality. Clinicians may target emotional control/self-reliance via strengths-based approaches with an emphasis on when these constructs could be maladaptive, as this could promote help-seeking.

Background: Youth who hold multiply marginalized identities often experience barriers in accessing care following psychiatric hospitalization METHODOLOGY: The following commentary piece shares a case amalgamation from a multidisciplinary gender clinic in a tertiary care children's hospital which illustrates the myriad of ways that our current mental healthcare systems fail to connect youth efficiently and effectively to the evidence-based, culturally relevant, and affirming care that they require, particularly youth experiencing overlapping systems of discrimination and disadvantage.

Conclusions: This piece highlights the inaccessibility of dialectical behavior therapy for multiply marginalized youth, and outlines suggestions for improving access to high-quality care for minoritized youth engaging in suicidal behavior.

Introduction: Firearms account for more than half of suicide deaths in the United States (US) and both ownership and access are associated with increased risk of intentional and unintentional injury. Despite evidence linking ownership and access to suicide risk, individuals may be reticent to answer questionnaire items assessing ownership. The current study examined characteristics of individuals who do not provide a response (nonresponders) to a firearm ownership item in a community sample.

Methods: Data were collected from a cross-sectional online survey of 10,625 US adults. Univariate and multivariate analyses were conducted to examine demographic, emotional distress, and suicide risk differences across three groups (firearm owners, nonowners, and nonresponders).

Results: Nonresponders were significantly younger, more likely to be female and non-White than firearm owners and nonowners. Nonresponders were less likely to endorse recent suicidal ideation and probable PTSD than firearm owners, but more likely to endorse probable PTSD than nonowners. Firearm owners were significantly more likely to report several correlates of suicide risk than nonowners.

Conclusions: Nonresponders may be a unique subgroup with distinct demographic, emotional distress, and suicide risk profiles compared to both firearm owners and nonowners. Implications of these findings for future directions are discussed.

Introduction: Guided by Opara et al.'s (2022), Integrated Model of the Interpersonal Psychological Theory of Suicide and Intersectionality Theory, the current study examined contextual stressors experienced disparately by Black youth (racial discrimination, poverty, and community violence) as moderators of the association between individual motivating factors for suicidal thoughts and behaviors (perceived burdensomeness, thwarted belongingness, and hopelessness) and active suicidal ideation.

Method: Participants were 457 Black adolescent boys (mean age = 15.31, SD = 1.26) who completed self-report surveys.

Results: As predicted, the association between perceived burdensomeness and active suicidal ideation was significantly moderated by economic stress. In addition, the association between peer belongingness and suicidal ideation was significantly moderated by racial discrimination, but there were no moderating effects for school belongingness. Finally, the association between hopelessness and suicidal ideation was significantly moderated by both racial discrimination and witnessing community violence.

Conclusion: These findings highlight the need for research, interventions, and policy work devoted to using integrated approaches of individual and socioeconomically relevant patterns of suicidal thoughts and behaviors to support Black youth exposed to various forms of structural oppression.

Introduction: Identifying variables linked to distinct suicide outcomes has long been among suicidology's research priorities. Cognitive theories of suicide identify attentional processes that may vary for individuals at a greater suicide risk. However, an overreliance on self-report and objective measures that are poor estimates of attention has led to mixed findings.

Method: The current study utilizes eye tracking with a novel passive viewing task to explore differences in viewing patterns for suicide- and neutral-image pairings, as a function of suicide outcomes. Young adults (N = 124, 83.9% women) were oversampled for recent suicidal thoughts and behaviors, and completed a series of self-report questionnaires specific to suicide history, as well as relevant covariates prior to completing the eye-tracking task.

Results: Multilevel modeling revealed that individuals with low-to-moderate ratings of past-year ideation displayed a significant decline in the amount of time spent viewing suicide images as compared to neutral images over the course of the task (oculomotor avoidance). However, the same pattern was not seen among individuals with high suicide ideation, specifically those with resolved plans and preparation. Furthermore, no differences were found between people with and without a suicide attempt history.

Conclusion: These results suggest a suicide-specific disengagement bias among individuals high in suicide ideation and more specifically, resolved plans and preparation.

Introduction: Suicide rates in the military are a significant public health concern. The suicide prevention safety planning intervention is a brief and effective intervention in which a provider and patient work collaboratively to recognize warning signs of a suicidal crisis and create a defined list of coping strategies and supports for use during future crises (Stanley & Brown, 2012). Implementation of safety planning has been supported by the Department of Defense (DoD), yet readily available training and continuing education for healthcare providers in this intervention is limited and passive in nature. Existing safety planning training experiences and needs of DoD behavioral health providers are unknown. The present study is an exploratory qualitative assessment of current safety planning in DoD to inform the design and development of an interactive virtual standardized training patient.

Method: Ten military behavioral health providers completed semi-structured interviews.

Results: Thematic content analysis was conducted, and three themes are described in this paper: variety of training received, barriers to receiving suicide safety planning training, and desires for future training. Lack of protected time for training and a lack of access to training resources were identified as key barriers.

Conclusions: Rich data obtained can help inform the key design features and relevance of new safety planning intervention training approaches.

Introduction: High rates of suicidal ideation (SI), suicide attempts (SA), and repetitive nonsuicidal self-injury (NSSI) among some ethnoracially minoritized United States youth populations may be related to adverse childhood experiences (ACEs) with structural roots.

Methods: Using the 2013-2019 Minnesota Student Surveys, we assessed associations of student-reported structural ACEs (parental incarceration, housing instability, food insecurity, and foster care involvement) with SI, SA, and repetitive NSSI within the past 12 months using multilevel logistic regression stratified by ethnoracial group (American Indian/Alaskan Native [AIAN], Hmong, other Asian, Black Latino, other Latino, Somali, other Black/African American [AA], Native Hawaiian/Pacific Islander [NHPI], and multiracial), and adjusted for sex, grade, ACEs experienced within one's household, mental health treatment, and perceived safety.

Results: Structural ACEs were strongly associated with increasing SI, SA, and NSSI. At ≥2 structural ACEs, repetitive NSSI rates ranged from 7% to 29% (female), 8% to 20% (male); SA rates ranged from 13% to 35% (female), 10% to 22% (male); and SI rates ranged from 31% to 50% (female), 20% to 32% (male). Black Latino, NHPI, AIAN, and Black/AA students most often reported structural ACE exposures.

Conclusion: Reducing structural ACEs may reduce SI, SA, and repetitive NSSI among ethnoracially minoritized youth populations. Disaggregating diverse youth groups revealed variations in these outcomes that remain hidden when subpopulations are aggregated.

Objective: To examine whether the Social Life Impact for Mother (SLIM) scale in the first trimester predicts postpartum suicide risk.

Methods: We used part of the hospital-based prospective study conducted in obstetric clinics and hospitals in four populous prefectures in Japan (N = 7,462). Participants completed the SLIM scale, including nine risk factors in the first trimester, and postpartum suicide risk was assessed as item-10 in the Edinburgh Postnatal Depression Scale, self-harm ideation, at one month after delivery (N = 5,697).

Results: The weighted total score of the SLIM scale which was calculated using the results of odds ratio predicted postpartum suicide risk with moderate accuracy. Pregnant women with 6+ scores of the new SLIM score were 4.26 (95%CI = 3.12-5.01) times more likely to have postpartum suicide risk. The original SLIM score also predicted postpartum suicide risk. The new SLIM score showed higher accuracy than the original score.

Conclusion: The SLIM scale at the first trimester of prenatal checkups may be useful for obstetricians to predict postpartum suicide risk and start to provide support for the expecting mothers. Both weighted total scores could be utilized according to the purpose of implementing the SLIM scale at obstetric institutions.