Suicide and Life-Threatening Behavior最新文献

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.

Background: Suicide rates among Black and Hispanic youth have been increasing over the past decade in the United States. The objective of this study was to identify risk factors for suicide ideation and attempt among Black and Hispanic youth in the United States using intersectionality theory and minority stress theory as a framework.

Methods: Data from the CDC Youth Risk Behavior Surveillance System (YRBSS; 2015-2019) were analyzed and delimited to include only Black and Hispanic youth.

Results: About 37% of the subsample identified as Black and 63% of the subsample identified as Hispanic; mean age was 16 years (SE = 0.02). Weighted multivariate logistic regressions were used to explore associations between suicide ideation and attempt, depressive symptoms, bullying, dating violence, and being threatened with a weapon. Black and Hispanic youth who had depressive symptoms, experienced bullying, dating violence, or threatened with a weapon all had increased odds of having suicide ideation and suicide attempt. Hispanic youth had the higher odds of suicide ideation and attempt than Black youth. Girls in the study also had elevated odds of suicide ideation.

Conclusion: This study adds to the literature on risk factors of suicide in Black and Hispanic youth and bringing to awareness the gender disparities in suicide ideation and attempt among youth.

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.

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.

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.

Introduction: Sexual and gender minority (SGM) people are at increased risk for suicidal thoughts and behaviors relative to their cisgender heterosexual peers. However, most research in this area has focused on youth, limiting our understanding of suicide risk among SGM adults.

Methods: To address this gap in the literature, the present study examined suicidal thoughts and behaviors among SGM adults across different age groups using a sample of 10,620 US adults.

Results: Consistent with the literature on youth, SGM adults showed higher rates of suicidal thoughts and behaviors than cisgender heterosexual adults. When examining prevalence rates across various age groups, young adults (18-25) showed greater suicidal thoughts and behaviors relative to adults ages 45+. However, adults ages 25-44 actually showed the highest rate of past month suicidal thoughts compared to adults ages 18-25.

Conclusion: These findings suggest that suicide risk for SGM extends beyond youth and highlights the need for more research on middle-age SGM adults. Additional resources for SGM adults that are not only tailored toward youth and young adults are warranted.

Background: Public safety personnel (PSP) experience occupational stressors and potentially psychologically traumatic events, which increase the odds of screening positive for mental health disorders, and the risk of suicide. This study estimates suicidal ideation, planning, and attempts among Canadian PSP, and assesses associations with Emotional Resilience Skills Training (ERST).

Method: The current study uses a longitudinal prospective sequential experimental cohort design that engages participants for approximately 16 months. Participants (n = 186, 60.5% men) were administered the structured Mini-International Neuropsychiatric Interview at three time points relative to the ERST: pre-training, post-training, and 1-year follow-up.

Results: At pre-training, PSP reported past-month suicidal ideation (n = 24; 12.9%), planning (n = 7; 3.8%), and no attempts. At post-training, PSP reported past-month suicidal ideation (n = 12; 10.1%), suicidal planning (n < 5), and no attempts (n = 0). At the 1-year follow-up, PSP reported past-month suicidal ideation (n = 7; 12.5%), and no planning (n = 0) or attempts (n = 0).

Conclusions: The results indicate suicide-related challenges for PSP, particularly PSP who self-identify as women and females. The results suggest sector-specific differences in suicide attempts, indicating unique sector-specific challenges among PSP. The results evidenced reductions in suicidal ideation and planning directly after ERST; however, attrition impacted analyses at 1-year follow-up. Additional sector-specific mixed-methods research would help inform suicide mitigation strategies.

Trial registration: ClinicalTrials.gov, NCT05530642. Hypotheses Registration: aspredicted.org, #90136. Registered 7 March 2022-Prospectively registered.