Suicide and Life-Threatening Behavior最新文献

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.

Introduction: Suicide is the second leading cause of death in adolescents in the United States. There is an urgent need to advance understanding of risk mechanisms in adolescents to guide early interventions. While prior research has implicated cognition, neural connectivity, and psychopathology in relation to adolescent suicidal ideation (SI) and nonsuicidal self-injury (NSSI), there is a relative lack of clarity regarding the causal structure of these factors, particularly in early adolescence.

Methods: Causal discovery analysis was applied to neuroimaging, neurocognition, and clinical assessment data from the baseline visit of the Adolescent Brain Cognitive Development Study when the participants were 9-10 years old (N = 8937; 49.6% female) to produce models of causal relationships.

Results: In the discovered model, causal pathways from resting state functional connectivity to externalizing and internalizing psychopathology were observed. Greater externalizing psychopathology increased SI and NSSI. Cognitive performance indirectly increased SI and NSSI via its negative relationship with externalizing psychopathology. Finally, more SI increased NSSI.

Conclusions: In this developmental window prior to when the risk of suicide accelerates, it is critical to begin to advance our understanding of the processes that may undergird suicide risk (neural, cognitive performance), features of psychopathology and the potential progression of SI and NSSI (both risk factors for suicide). Future research should incorporate other factors related to SI and NSSI to produce a more comprehensive understanding of the mechanisms of risk. This line of research has the potential for a more comprehensive understanding of risk and provides avenues for prevention.

Introduction: Active suicidal ideation and passive suicidal ideation are distinct but related constructs, each carrying significant clinical implications. However, their real-time predictors remain underexplored in intensive longitudinal studies. This ecological momentary assessment (EMA) study investigated the associations of thwarted belongingness (TB), perceived burdensomeness (PB), and hopelessness with changes in both types of ideation at 2-4 h intervals, and whether a history of suicide attempts moderates these relationships.

Methods: Thirty-one college students (23 females; mean age = 19.83 ± 1.86 years) with current suicidal ideation participated, 17 of whom (54.84%) had a history of suicide attempts. Participants completed EMA assessments five times daily for one week. Data were analyzed using mixed linear models.

Results: TB (β = 0.05, p = 0.007) and hopelessness (β = 0.09, p = 0.006) predicted next-moment active ideation, but these associations became insignificant after all covariates were considered. PB was a robust predictor (β = 0.04, p = 0.032) of subsequent passive ideation, even after accounting for TB, hopelessness, and prior ideation. Notably, hopelessness predicted subsequent active ideation (β = 0.12, p = 0.034) only in participants with a history of suicide attempts.

Conclusion: These findings underscore the distinct predictive roles of PB, TB, and hopelessness, highlighting the importance of considering suicide attempt history in risk assessment for suicidal ideation.

Introduction: The fearlessness about suicide scale (FSS) was developed in response to evidence suggesting fearlessness about suicide is more relevant to the capability for suicide than fearlessness about death. To extend its psychometric validation, this study provides a cross-sectional comparison of the FSS and the acquired capability for suicide-fearlessness about death (FAD) scale.

Methods: Pearson correlations and regression analyses examined associations between both scales with suicidal ideation (SI), pain tolerance, non-suicidal self-injury (NSSI), and eating disorder symptoms in 1233 undergraduates.

Results: In the full sample, the FSS was positively associated with SI, general pain tolerance, NSSI, restriction, purging, and muscle building, but negatively with NSSI pain tolerance. The FAD was positively associated with SI, general pain tolerance, anti-suicide and sensation-seeking NSSI functions, and muscle building, but negatively with NSSI, binge eating, and eating disorder cognitive symptoms. Differential patterns of associations emerged across individuals with and without recent SI.

Conclusions: The FSS appears more strongly associated with painful and frightening experiences hypothesized to contribute to the capability for suicide, whereas the FAD is associated with traits and behaviors associated with unintentional bodily harm. Longitudinal research is needed to examine the FSS's predictive ability for future self-injurious thoughts and behaviors.

Objective: Suicidal ideation and attempts as well as eating disorders (EDs) are common among Iranian individuals. Additionally, ED symptoms are associated with suicidality. According to the interpersonal-psychological theory of suicide (IPTS), factors such as thwarted belongingness, perceived burdensomeness, and capability for suicide must combine for suicidality to occur. The tenets of IPTS have been supported among individuals with ED symptoms from Western countries. However, no study has yet explored how ED symptoms might co-occur with IPTS factors and potentially relate to suicidal ideation and attempts using latent profile analysis (LPA).

Methods: Participants (N = 773) were Iranian community members who completed a battery of scales assessing ED symptoms, suicide-related risk factors, as well as suicidal ideation and suicide attempts.

Results: The LPA revealed that a six-class solution best fit the data. The classes with the highest levels of IPTS and binge/purge related symptoms also had the highest odds of suicide attempts.

Conclusions: Our findings suggest that the measurement of thwarted belongingness, perceived burdensomeness, and capability for suicide is particularly important for individuals with binge/purge type eating disorder symptoms. Overall, IPTS factors should be incorporated into assessments of clients presenting with ED symptoms and suicidality.

Introduction: Gendered racism, which emasculates and denigrates the masculinity self-concept and the desirability of Asian American men, has been associated with greater endorsement of suicide ideation. However, no research has examined culturally informed gendered racial factors that could moderate the risk of suicide ideation associated with gendered racism. Based on the potential of affirming gendered racial experiences that can validate and empower Asian American men to resist internalizing the harms of gendered racism, we examined whether affirmative body positive and positive intimacy experiences could moderate the link between gendered racism and suicide ideation.

Methods: We conducted latent moderated structural equation modeling to analyze online convenience data from 876 Asian American men (M_age = 30.78; SD = 9.43).

Results: Gendered racism was significantly associated with suicide ideation. Affirmative body positive experience was a buffer at low to mean levels of gendered racism but was an exacerbator at mean to high levels of gendered racism. Affirmative positive intimacy experiences were a buffer at low and mean levels of gendered racism but not at high levels of gendered racism.

Conclusion: Implications include translating these findings into a more nuanced affirmative support system and gendered racial socialization strategies to help Asian American men engage in healthier and flourishing outcomes.

Background: The Brief Suicide Cognitions Scale (B-SCS) is a self-report measure of suicidogenic cognitions. This study evaluated measurement invariance of the B-SCS among different subgroups. Secondarily, this study sought to evaluate the replicability of the psychometric validity, reliability, and factor structure of the B-SCS.

Methods: Participants included undergraduate students (N = 2000) recruited between 2022 and 2023. Multigroup Confirmatory Factor Analyses (CFA) were conducted comparing participants by race, ethnicity, gender, and sexuality.

Results: Results support the existence of a unidimensional factor structure of the B-SCS. Multigroup CFA analyses yielded all levels of measurement invariance across White and Black, Hispanic and Non-Hispanic, cisgender men and women, and heterosexual and sexual minority individuals. Additionally, the B-SCS was found to have strong internal consistency and good concurrent validity. Finally, the B-SCS was able to discriminate between participants who had a history of suicide attempts and those who did not.

Conclusion: These results indicate that the B-SCS is a valid and reliable tool to be used in assessing suicidogenic cognitions. Moreover, results from measurement invariance analyses indicate that this tool may be viable to use within specific sub-populations examined within this study.

Introduction: US Veterans are at higher risk for suicide compared to the general population. Access to evidence-based practices for suicide prevention (EBP-SPs) is limited; however, emerging research supports the delivery of EBP-SPs through telehealth. The Veterans Health Administration's (VHA) Suicide Prevention (SP) 2.0 Clinical Telehealth Program aims to increase nationwide access to EBP-SPs for Veterans with recent suicidal self-directed violence (SSDV). This paper describes initial outcomes of SP 2.0's Cognitive Behavioral Therapy for SP (CBT-SP).

Methods: From April 2021 to September 2023, SP 2.0 provided EBP-SPs to Veterans via telehealth. Veterans were eligible if they were enrolled in VHA care and engaged in SSDV (suicide attempts and/or preparatory behavior) in the past 12 months. CBT-SP was provided via VHA's telehealth platform, accessible to all 139 VA Health Care Systems in the US. Outcomes were captured via electronic health records and analyzed using logistic regression and generalized linear models. Significance was set at p < 0.003.

Results: Veterans (N = 2712) received an average of 8.54 CBT-SP sessions. Models demonstrated improvements in suicide-related coping, depression, suicidal thought intensity, hopelessness, urge and intent to kill self, and self-efficacy.

Conclusion: Providing CBT-SP via telehealth is feasible and Veterans demonstrated several improvements. Implications and future research directions are discussed.