Suicide and Life-Threatening Behavior最新文献

Background: Improved understanding of how US service members transition from chronic/baseline to acute suicide risk is warranted. One such model, the Integrated Motivational Volitional Model of Suicide, posits entrapment as central to this process. However, entrapment has not been extensively investigated within military populations.

Methods: This study examines the factor structure, reliability, and predictive validity of the Entrapment Scale (E-Scale) within a military population. Exploratory structural equation modeling (SEM) and confirmatory factor analysis compared one- versus two-factor structures of the E-Scale. Autoregressive SEM assessed if E-Scale scores predicted suicidal ideation and suicide attempt likelihood at 6- and 12-month follow-up, and examined whether the impact of entrapment was moderated by social support (i.e., appraisal, tangible, and belonging).

Results: Results favored a two-factor solution (external and internal) of entrapment. The relationship between entrapment and suicide outcomes was moderated by perceived social support but in unexpected directions. Unexpectedly, social support strengthened the relationship between external entrapment and suicide outcomes for most models. Only tangible support moderated the relationship between internal entrapment (IE) and suicide outcomes as predicted.

Conclusions: IE is linked with suicidal ideation in the short-term, whereas external entrapments relationship with suicide outcomes may reflect more persistent social challenges for military members.

Background: Suicidal ideation occurs at relatively high rates among adults identifying as sexual minorities compared to those identifying as heterosexual, and minority stress is one explanation for this disparity. Minority stress is known to associate with increased suicidal ideation, but research on how minority stress associates with suicidal ideation in sexual minority adults across the adult lifespan is lacking.

Methods: Data were collected online from 284 sexual minority adults ranging in age from 18 to 85. Participants were recruited from Prolific and completed self-report measures assessing past-month suicidal ideation and multiple sexual minority stressors.

Results: The minority stressors of acceptance concerns, concealment motivation, and difficulty processing one's identity were positively correlated with likelihood of past-month suicidal deation. Age moderated the relationship between two minority stressors and suicidal ideation: identity uncertainty and internalized homonegativity. These relationships were only significant among older adults, compared to middle-age and younger adults.

Conclusion: Specific internalized minority stressors about one's sexual identity were significantly associated with past-month suicidal ideation for older adults. More research is needed on how minority stress impacts recent suicidal ideation for sexual minority adults across the lifespan.

Objective: Crisis line callers experience reductions in distress and suicidal ideation and utilize more health care following calls. The purpose of this study was to determine whether changes in distress and suicidal ideation during a call are associated with later healthcare contact and utilization.

Method: Veterans Crisis Line calls from 599 veterans were extracted with call dates between 12/1/2018 and 11/30/2019. Calls were coded for changes in distress and suicidal ideation and linked with VA medical records to obtain healthcare data. Generalized Linear Mixed Modeling was used to examine the associations of changes in distress and suicidal ideation with healthcare contact (yes/no) and utilization (days of treatment) in the month (30 days) following the call.

Results: Reductions in distress were associated with behavioral (i.e., mental and substance use) healthcare utilization, F(1, 596) = 4.52, p = 0.03, and reductions in suicidal ideation were associated with any healthcare utilization, F(1, 596) = 6.45, p = 0.01. Changes in distress and suicidal ideation were not associated with healthcare contact.

Conclusion: Responders need to help resolve distress and suicidal ideation and link callers with treatment. Unresolved distress and suicidal thoughts may signify later problems with treatment utilization. Research is needed to determine causality.

Introduction: The suicide crisis syndrome (SCS) has demonstrated efficacy in predicting suicide attempts, showing potential utility in detecting at-risk individuals who may not be willing to disclose suicidal ideation (SI). The present international study examined differences in intentions to utilize mental health and suicide prevention resources among community-based adults with varying suicide risk (i.e., presence/absence of SCS and/or SI).

Methods: A sample of 16,934 community-based adults from 13 countries completed measures about the SCS and SI. Mental health and suicide prevention resources were provided to all participants, who indicated their intentions to use these resources.

Results: Individuals with SCS (55.7%) were just as likely as those with SI alone (54.0%), and more likely than those with no suicide-related symptoms (45.7%), to report willingness to utilize mental health resources. Those with SI (both with and without SCS) were more likely to seek suicide prevention resources (52.6% and 50.5%, respectively) than those without SI (41.7% and 41.8%); however, when examining endorsements for personal use, those with SCS (21.6%) were more likely to use resources than individuals not at risk (15.1%).

Conclusions: These findings provide insight into individuals' willingness to use resources across configurations of explicitly disclosed (SI) and indirect (SCS) suicide risk.

Introduction: The objective of this study was to compare jealousy as a correlate of intimate partner homicide-suicide cases to homicide-only cases using data from the National Violent Death Reporting System (NVDRS), a state-based surveillance system maintained by the Centers for Disease Control and Prevention. Jealousy is categorized as jealous feelings or distress over a current or former intimate partner's relationship or suspected relationship with another person.

Methods: NVDRS data from a 5-year period (2016-2020) was used to estimate frequencies and identify significant differences in jealousy and other sociodemographic, mental health, relationship, and incident-related correlates of intimate partner homicide-suicide compared to homicide-only cases. Cases were included if they involved an intimate partner single homicide or a single homicide followed by suicide.

Results: The study sample included 5335 cases (intimate partner homicide-suicide n = 1402; homicide-only n = 3933). A significantly higher percentage of intimate partner homicide-suicide cases reported jealousy preceding the event (9%) compared to homicide-only cases (6%). Compared with homicide-only cases, homicide-suicide cases had 3.5 greater odds of recording jealousy as a precipitating event.

Conclusion: Findings suggest that intimate partner homicide-suicide cases are distinct from homicide-only cases both in terms of individual- and incident-level and situational factors, including the presence of jealousy.

Objective: Inpatient suicide remains difficult to predict. This study aimed to identify individual patient predictors to help identify those at greater risk.

Methods: This case-control study was undertaken in an independent mental health service in Ireland. Cases were drawn from all admissions to the service between March 2004 and February 2019. Controls were matched for date of admission. Univariate and multivariate analyses were conducted.

Results: Thirty-three cases of inpatient suicide were compared to 132 controls. The inpatient suicide rate was 76.2 per 100,000 admissions. The rate of inpatient suicide fell in line with national rates despite less restrictive practices being implemented in the service. Males accounted for 66% of cases. Hanging was the most common method of suicide overall and among male patients, and drowning was the most common among females. Male gender, tertiary referral, an adverse psychosocial event during admission, a period of absence without leave and expressing hopelessness were identified as independent risk factors for inpatient suicide. Substance use, involuntary detention, family history of suicide, and number of previous admissions were not significant.

Conclusions: While not highly sensitive, a period of absence without leave, tertiary referral and hopelessness are important predictors of inpatient suicide risk that treating teams should consider in care planning.

Introduction: Adolescent suicidal ideation (SI) and non-suicidal self-injury (NSSI) are crucial public health issues, yet their co-developmental trajectories during early adolescence and their associations with predictors and outcomes are unclear. This study aimed to (a) identify heterogeneous co-developmental trajectories of SI and NSSI, (b) explore associations between transdiagnostic predictors and trajectories, and (c) assess suicide attempt risk across trajectories.

Methods: Four hundred fifty-three adolescents (M_age = 12.35 years, 48.3% boys) completed surveys at 6-month intervals across 2 years. At Time 1 (Nov 2020), participants completed surveys encompassing SI, and NSSI, along with family, peer, and individual predictors. Subsequent surveys (Times 2-4) measured SI and NSSI, with suicide attempts queried at Time 4.

Results: Parallel process latent class growth models revealed three co-developmental groups (i.e., Stable low NSSI and SI; Moderate-NSSI and high-SI, parallel decreasing; High-NSSI and moderate-SI, parallel increasing). Multivariate logistic regression indicated that group membership was predicted by parental rejection, parental warmth, bullying victimization, depressive and anxiety symptoms, thwarted belongingness, and perceived burdensomeness. Adolescents in the "High-NSSI and moderate-SI, parallel increasing" group reported the highest suicide attempt frequency.

Conclusion: These findings underscore subgroup distinctions and transdiagnostic predictors in comprehending SI and NSSI progression, emphasizing the necessity of dynamic monitoring and tailored interventions for distinct subgroup characteristics.

Introduction: Resting heart rate has been distinctly related to both internalizing (high pulse) and externalizing (low pulse) disorders. We aimed to explore the associations between resting heart rate and suicidal behavior (nonfatal suicide attempt [SA] and suicide death [SD]) and evaluate if such associations exist beyond the effects of internalizing/externalizing symptomatology.

Method: We used Cox proportional hazards models to evaluate the associations between resting heart rate (age 19) and later SA/SD in 357,290 Swedish men. Models were controlled for internalizing disorders, externalizing disorders, and resilience (the ability to deal with adversity). Co-relative analysis (comparing pairs of different genetic relatedness) was used to control for unmeasured family confounders and improve causal inference.

Results: In baseline models, low resting heart rate was associated with SA (HR = 0.96; 95% CI: 0.95,0.98) and high resting heart rate with SD (HR = 1.04; 95% CI: 1.002,1.07). The association with SA remained after adjustment for all confounders (HR = 0.98). However, the association with SD did not persist after controlling for covariates. Co-relative analysis did not support causal associations.

Conclusions: Our findings raise interesting etiological questions for the understanding of suicidal behaviors but do not support the usefulness of resting heart rate in suicide prediction.

Introduction: While suicides in the United States decreased during the COVID-19 pandemic, statistically significant decreases have been limited to White people throughout a large portion of 2020.

Methods: This paper outlines possible explanations for racial/ethnic differences in suicidality in the early pandemic phases.

Results: We propose both distal (i.e., tele-mental health usage, internet and technology access, employment protections, and economic security) and proximal (cultural beliefs, coping strategies, clustering, pulling together, and embracing life) factors that may have helped build and foster community and mental wellness. However, this paper argues these factors did not extend, or did not extend as much, to many communities of color.

Conclusions: We argue that these disparities are due to the myriad effects of discrimination and systemic racism, encapsulated broadly by the minority stress theory, and provide suggestions for relief and research.

Introduction: Prior research has established individuals living in cultures of honor to be at higher risk for suicide. However, research has yet to examine how emotion regulation may play a role in explaining this link. The current research intended to address if those who endorse honor norms, who are keen to protect their reputation, might engage in emotional suppression as a way to avoid being seen as weak, thus heightening their risk for suicide.

Method: Data were collected using a survey design across three studies (total N = 988). Studies 1 and 2 were cross-sectional designs with MTurk and undergraduate samples. Study 3 was conducted longitudinally using CloudResearch.

Results: Results demonstrated those higher in honor endorsement engage in emotional suppression to avoid being seen as weak (Study 1), that emotional suppression and subsequent depression indirectly explain the relationship between honor endorsement and suicide attempts (Study 2), and that relationships between honor endorsement and changes in suicidal ideation are explained by emotional suppression and depressive symptomology (Study 3).

Conclusion: Findings provide needed insight into the daily emotional experiences of honor endorsers and how it may influence suicidality, providing a point of entry for clinicians to construct meaningful honor-oriented intervention programs.