Suicide and Life-Threatening Behavior最新文献

Introduction: Conformity to the masculine norms of self-reliance and emotional control is linked to suicidal ideation. Risk factors for suicidal ideation, such as perceived burdensomeness and thwarted belongingness, may explain the relationship between conformity to the masculine norms of self-reliance/emotional control and suicidal ideation. The current study expanded on past cross-sectional research by testing if perceived burdensomeness and/or thwarted belongingness mediated longitudinal relationships between conformity to self-reliance/emotional control and suicidal ideation.

Methods: Two hundred and sixty-nine US men completed self-report measures at three timepoints spaced 1 month apart. An adapted version of a longitudinal autoregressive three-wave mediation model was used to test study hypotheses.

Results: Conformity to self-reliance longitudinally predicted perceived burdensomeness, which in turn longitudinally predicted suicidal ideation. Thwarted belongingness had nonsignificant longitudinal relationships with conformity to masculine norms or suicidal ideation.

Conclusion: Results suggest that perceived burdensomeness links relationships between self-reliance and suicidal ideation. Clinicians working with male-identified clients may consider assessing and targeting extreme self-reliance or perceived burdensomeness by helping clients to flexibly negotiate certain standards of masculinity.

Introduction: Suicide among Black youth has become a public health concern. To better understand the rapid increase in Black youth suicide, we aimed to determine whether there had been changes in the risk correlates and their impacts on suicidality among Black youth over the past three decades.

Methods: We analyzed four suicide-related outcomes-ideation, planning, attempts, and attempt-related injuries-using Black youth's responses from the 1991-2021 Youth Risk Behavior Survey (survey-adjusted n = 31667.12). Potential correlates considered were demographics, sexuality, injury, violence, bullying, diet, physical activity, mental health, substance use, school connectedness, and exposure to community violence. Correlate-by-year interactions were included to allow for time-varying effects of factors. Missing data were imputed five times, and logistic LASSO regressions were used to select important factors.

Results: Rates of suicidal ideation decreased from 22% (1991) to 12% (2005), then increased to 22% (2021). Suicide planning and attempts had similar trends, whereas rates of injuries remained stable (ranging from 2% to 4%). Correlates identified for all four outcomes were similar and consistent over time, including violent behaviors, substance use, body image concerns, and sex. All correlates' effects remained unchanged over time.

Conclusion: Although trends of suicidality in Black youth changed over time, correlates associated with them remained stable.

Background: Crisis Stabilization Centers (CSCs) are a critical component of the crisis response system and the 988 Lifeline expansion that may promote ED diversion. To maximize CSC care quality and effectiveness, brief psychotherapy interventions that focus on recovery, match CSC workflows, and have the potency to reduce suicide attempts and deaths are needed but do not exist. The purpose of this study was to establish the feasibility, acceptability, appropriateness, and social validity of a novel, ultra-brief, 60-min psychotherapy intervention-Toward Hope, Recovery, Interpersonal Connection, Values, and Engagement for Crisis (THRIVE-C).

Methods: We recruited CSC stakeholders (n = 15) and CSC study therapists (n = 5) to complete surveys, followed by a pilot study of THRIVE-C with CSC guests (n = 54).

Results: CSC stakeholders, study therapists, and guests found THRIVE feasible, acceptable, appropriate, and socially valid. CSC guests experienced THRIVE-C as satisfactory, established a positive therapeutic alliance (bond), and 91% of guests endorsed behavioral intentions to attend outpatient psychotherapy appointments after discharge. Further, 94% of guests completed all phases of THRIVE, demonstrating clinical readiness to work on suicide recovery beyond physical safety or stabilization from suicide alone.

Conclusion: Preliminary findings suggest that further development and testing of THRIVE are needed.

Trial registration: This study was registered with ClinicalTrials.gov (Identifier NCT05558891).

Objective: Suicide is a leading cause of mortality among perinatal populations. Despite increasing rates, research on this topic remains limited. This paper examined (1) change in self-injurious thoughts and behaviors (SITBs) from pregnancy to postpartum, (2) associations between risk factors and SITBs, and (3) whether risk factors moderated change in SITBs.

Methods: Participants (N = 223) reported on SITBs, emotion dysregulation, and partner stress at the third trimester and 7 months postpartum, and childhood trauma at the third trimester. We tested study aims with generalized linear models.

Result: While self-injurious thoughts did not change from pregnancy to postpartum, the odds of self-injurious behaviors were 3.56 times higher postpartum (OR = 3.56, p = 0.011), even while accounting for risk factors. Higher concurrent emotion dysregulation was associated with self-injurious thoughts during pregnancy and postpartum (OR = 1.04, p < 0.001; OR = 1.05, p < 0.001) and with behaviors postpartum (OR = 1.05, p = 0.002). Childhood trauma was associated with self-injurious thoughts during pregnancy (OR = 2.54, p = 0.004) and postpartum (OR = 2.05, p = 0.028) and with behaviors postpartum (OR = 3.25, p = 0.009). Partner relationship conflict was not associated with self-injurious thoughts or behaviors at either time point. Higher rates of prenatal risk factors increased the odds of SITBs in the postpartum period.

Conclusion: Findings support interventions addressing childhood trauma and emotion dysregulation for prevention of SITBs before postpartum, when risk is higher.

Objective: The Family Check-Up (FCU) is a family-focused prevention program originally developed to reduce externalizing behaviors, which has demonstrated improvements in internalizing behaviors and suicide. The present study attempted a conceptual replication of previous results from a separate trial of the FCU, initiated in early childhood, that found that the FCU predicts reductions in suicide risk via improvements in youth self-regulation.

Methods: The current study examined whether the FCU would predict reductions in youth suicidality via improvements in self-regulatory ability, in an independent trial of the FCU, initiated in early adolescence. The sample included 782 families, youth were 50.7% female, and 11 years old at baseline.

Results: Findings from previous trials were partially replicated, suggesting that improvements in self-regulatory skills in early adolescence support long-term reductions in suicide risk into early adulthood. However, the indirect effect of the FCU on suicide-related outcomes was only observed at the level of statistical trend in the current trial. Findings are discussed in the context of broader suicide treatments for youth involving family members and targeting important mechanisms of risk.

Trial registration: NCT01490307.

Introduction: Service members with mental health difficulties and access to a firearm are at an increased risk for suicide. Mental healthcare providers are well-positioned to discuss firearms and create safety plans; however, many service members do not seek treatment. This study aims to identify potential sociodemographic predictors of recent mental healthcare utilization among firearm-owning service members who report past month distress.

Methods: The sample included 268 US military service members. Participants reported whether they attended at least one behavioral health visit in the 3 months prior to participation.

Results: Females, individuals of a racial background other than Black or White, older individuals, and those who have never been active-duty were more likely to have attended a session. Additionally, the likelihood of utilization was higher among those who reported past week wish to die and suicidal behaviors in the past year.

Conclusion: While certain service members are less likely to have utilized mental healthcare, findings suggest that those with suicidal ideation and access to a firearm are likely to engage in at least one appointment. As such, providing mental healthcare providers with training and resources for promoting secure firearm storage is an important avenue for suicide prevention.

Purpose: To assess temporal patterns of Veteran suicide deaths from 2001 to 2021.

Methods: Data from Veterans Affairs (VA) and Department of Defense (DoD) administrative sources and the VA/DoD Mortality Data Repository identified 133,867 Veteran suicides from 2001 to 2021. Incidence Rate Ratios (IRRs) and Joinpoint regression assessed patterns of Veteran suicide across seasons, days of the week, and 14 holidays; overall and by sex and age.

Results: Incidence of Veteran suicide was highest in summers and on Mondays. Veteran suicide incidence was lower on six holidays: Martin Luther King Jr. Day (IRR = 0.82, 95% CI = 0.73-0.93), Presidents' Day (IRR = 0.88, 0.78, 0.99), Memorial Day (IRR = 0.89, CI = 0.79-0.99), Labor Day (IRR = 0.88, CI = 0.78-0.98), Thanksgiving (IRR = 0.81, CI = 0.71-0.92), and Christmas (IRR = 0.78, CI = 0.68-0.89). Suicide incidence was elevated on New Year's Day (IRR = 1.17, CI = 1.05-1.31), particularly among Veterans 25-34 years old (IRR = 1.64, CI = 1.19-2.26). An increasing trend in daily average suicides was indicated from December 30th to January 1st (β = 1.79, p < 0.05). Both seasonal and day of the week effects were present in most subpopulations. Holiday effects were most prevalent among men and varied by age.

Conclusions: Veteran suicide incidence was elevated in summer months, on Mondays, and on New Year's Day. Temporal patterns differed by sex and age. Findings can inform ongoing Veteran suicide prevention efforts.

Objective: This study investigates the social norms of suicide acceptability among sexual and gender minority (GM) individuals, aiming to replicate and extend previous findings.

Method: Participants (n = 1962) aged 18-35 were recruited through social media and university email lists. Participants were randomly assigned to one of five vignettes depicting a non-lethal suicide attempt following either general (e.g., failed relationship) or LGBTQ+ specific stressors (e.g., same-sex encounter). Measures assessed perceptions of suicidal behavior, acceptability of suicide, empathy with the decision to attempt suicide, perceived emotional adjustment, suicide intent, and character of the suicidal person. Data were analyzed using a 4 (identity type) × 5 (scenario) between-subject ANCOVAs.

Results: Significant differences were found across minority types. Sexual and gender minority participants viewed suicidal behavior more positively and as more acceptable compared to cisgender heterosexual participants. Gender minority participants perceived higher levels of emotional adjustment and lower suicidal intent than all other groups. No significant group differences were found in empathy toward the decision to attempt suicide.

Conclusion: The findings suggest that suicide is viewed as permissible and perhaps normalized within LGBTQ+ communities, potentially increasing risk. Interventions targeting permissive suicide scripts may be crucial for suicide prevention among LGBTQ+ populations.

Background: This study investigated the trajectories of interpersonal stress and psychological pain and their effects on self-harm behaviors in adolescents and explored the reciprocal associations between interpersonal stress and NSSI/SA.

Methods: The participants included 1149 adolescents (50.3% women; M_age = 12.86, SD = 0.69) who participated in three waves of data collection. Latent class growth models and cross-lagged panel models were used to identify subgroups of individuals and interactions between interpersonal stress and NSSI/SA.

Results: Controlling for sex and age, compared to the low interpersonal stress class, the moderate to high and increasing classes have higher risks of NSSI and SA. Compared to adolescents in the low increasing feelings with high increasing avoidance class, those in the low increasing feelings with low decreasing avoidance class reported lower probabilities of NSSI and SA. Pain avoidance and painful feelings mediated the pathway from interpersonal stress to NSSI/SA, whereas pain arousal mediated the pathway from NSSI/SA to interpersonal stress.

Conclusions: Shared impact of interpersonal stress and distinct effects of psychological pain over time on maintaining and distinguishing self-harm behaviors were found. Adolescent crisis interventions should simultaneously focus on building social networks within the school context and regulating maladaptive minds.