Suicide and Life-Threatening Behavior最新文献

Introduction: When experiencing suicidal thoughts, many individuals do not tell others, making it difficult to ensure suicide prevention resources reach those who need it.

Methods: The current study utilizes a large sample of US adults who have experienced suicidal ideation in their lifetime (n = 1074) to examine predictors of disclosures. We also explore who participants disclose to and how helpful these disclosures are rated.

Results: A majority (n = 812, 75.6%) reported disclosing. Black and Hispanic participants were less likely to disclose than White participants. Those who were never married were more likely to disclose, as were those who have attempted suicide. Mental healthcare utilization and favorable attitudes toward mental healthcare were also positive predictors of disclosure. More participants reported disclosing to a personal connection (n = 532, 65.5%) than a mental health professional (n = 282, 34.8%). On average, most sources were rated as neither helpful nor harmful.

Conclusion: The study highlights those who may be at a higher risk of experiencing suicidal thoughts but going unidentified. To increase helpfulness of disclosures, suicide prevention programming should emphasize training for laypersons and professionals on how to effectively respond when someone reveals that they are thinking of suicide.

Introduction: One's relationship with, attitudes toward, and subjective experiences of the body have been theorized to contribute to self-preservation and self-destruction. These components of body regard have demonstrated associations with suicidal thoughts and behaviors but remain understudied. This study examined whether body regard acts as a moderator of the relationship between suicide ideation and attempts as well as its effect on the relationships of other established suicide risk factors.

Methods: A random sample survey of 2021 young adults was conducted assessing body regard, fearlessness about death, depression, anxiety, stress, lifetime NSSI, and past year suicide ideation and attempts.

Results: A logistic regression analyses revealed that body regard was a significant predictor of past year suicide attempt, alongside NSSI, and suicide ideation. Follow-up moderation analyses found that body regard significantly moderated the effect of suicide ideation such that ideation was only significantly associated with suicide attempts when body regard was low. High body regard also weakened the effect of ideation on attempts across levels of NSSI.

Conclusions: Body regard may operate as a volitional factor for suicide attempts while also buffering the moderating relationships of other risk factors. Etiological models, assessment, and treatments aimed at addressing suicide risk should include attention to one's body regard.

Introduction: To expand access to suicide prevention and support services, the Veteran Crisis Line (VCL) added text capabilities in 2011. It is unknown whether the likelihood of a contact being terminated by the user varies by contact type. We aimed to assess whether contact resolution varies by contact type after accounting for Veterans' sociodemographic and clinical characteristics, contact risk, and reasons for contact.

Method: A retrospective cohort study of VCL phone and text contacts regarding identified VHA enrollees between 2016 and 2021 was performed. To examine differences in contact resolution between contact types, inverse probability of treatment weights were used to balance characteristics of text and phone contacts.

Results: Relative to phone contacts, text contacts were associated with 3.39 percentage point (PP) (95% CI, 3.27-3.50; p < 0.001) lower likelihood of receiving an emergency dispatch/welfare check, 2.65 PP (95% CI, 2.55-2.76; p < 0.001) lower likelihood of requiring arrangement for same-day care, and 9.47 (95% CI, 9.34-9.59; p < 0.001) PP higher likelihood of being terminated by the user.

Conclusions: VCL text contact was associated with an increased likelihood of being terminated by the user. Further investigation is needed to understand the reasons for terminating contact for those who texted VCL.

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.

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: 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.