Suicide and Life-Threatening Behavior最新文献

Background: Empirically supported suicide risk assessment and conceptualization is a central aim of the Zero Suicide model. The Suicide Status Form (SSF) is the essential document and scaffolding of the Collaborative Assessment and Management of Suicidality-Brief Intervention (CAMS-BI) and is hypothesized as an example of a psychological assessment as therapeutic intervention (PATI). However, this hypothesis has never been directly tested.

Methods: N = 57 patients deemed at risk for outpatient suicidal behavior and treated as part of an inpatient psychiatric consultation and liaison service were recruited to participate in CAMS-BI at a Level 1 trauma center in the southeastern United States. During the CAMS-BI process, patients were asked to rate their subjective units of distress (SUDS) at five time points throughout the intervention (k = 285).

Results: The omnibus random intercept multilevel model revealed a significant difference in pre- to post-session ratings of SUDS across patients. Post hoc pairwise comparisons revealed no significant differences between SSF sections (e.g., Section A, Section B, and Section C) and relative reductions in SUDS; however, there was an observable trend toward a favorable effect of Section A of the SSF.

Conclusions: The SSF may represent an example of PATI pending replication and extension of the current results.

Introduction: Suicide is the third leading cause of death among US young adults, with significant racial/ethnic disparities related to the risk for suicide among Latine young adults. Despite the elevated risk for suicide, culturally relevant risk factors are not well-known. Intergenerational acculturative conflict (IAC) among Latine youth is a sociocultural factor associated with suicide ideation.

Method: Although widely cited, the interpersonal theory of suicide (IPTS) lacks consistent support among Latine groups. The following cross-sectional study examined relationships between IAC categories (cultural preference, autonomy, and dating/staying out late), IPTS risk factors (i.e., thwarted belongingness and perceived burdensomeness), and suicide ideation frequency among 376 Mexican descent college students sampled using participant pools and snowball sampling (73.7% female: M_age = 19.88).

Results: Mediation analyses supported the hypotheses that IPTS risk factors partially explained the links between IAC categories and suicide ideation frequency.

Conclusions: These findings advance our understanding of how sociocultural constructs, such as IAC, influence the IPTS and future advancements in culturally responsive treatments for suicide.

Introduction: Suicide prevention training that teaches skills to support a person experiencing thoughts of suicide and create community support networks, often termed, "gatekeeper" training (GKT), has been a longstanding pillar of international, national, and local suicide prevention efforts. GKT aims to improve knowledge, attitudes, and self-efficacy in identifying individuals at risk for suicide, hopefully enhancing one's willingness and ability to intervene with a person experiencing a crisis. However, little is known about GKT's effectiveness in creating the essential behavior change (e.g., increase in intervening behaviors) it sets out to accomplish.

Methods: This paper explores the history and theoretical background of GKT, reviews the current state of research on GKT, and provides framing and recommendations for next steps to advance research and practice around GKT.

Results & conclusion: Through positioning GKT appropriately within the field of suicide prevention, we argue that the field of suicide prevention needs more rigorous research around GKT that includes long-term follow-up data on usage of skills learned during training, data on outcomes of those who have received an intervention from a trained gatekeeper, and the integration of implementation science to further our understanding of which trainings are appropriate for which helpers.

Background: Healthcare, research, policy, and legislative stakeholders need timely, accurate, and detailed information on the effectiveness and potential harms of suicide prevention approaches. We created the Suicide Prevention Trials Database (SPTD) to provide a centralized, publicly accessible, detailed database of harmonized study-level suicide prevention clinical trial data.

Methods: We searched for randomized controlled trials (RCTs) of suicide prevention published from 1980 to 2023. Over 300 data variables were extracted from each RCT.

Results: We identified a total of 140 unique RCTs in 180 articles. Most of the included RCTs compared two treatment arms (92%), and the remainder compared three arms (88%). Nearly half of the RCTs reported on Behavioral Interventions (49%), followed by Care Management, Follow-up, or Monitoring (16%). Typically, the comparator condition was Treatment as Usual (53%). Interventions were most often delivered in person (61%) in an individual format (79%).

Conclusions: The SPTD provides efficient, accurate, up-to-date access to a comprehensive suicide prevention trials database, which can be utilized by a range of stakeholders. It can reduce the time required for high-quality systematic reviews and provides researchers, administrators, and funders with current data on the state of the literature.

Introduction: Over 90% of all adolescent suicides occur in low- and middle-income countries (LMIC), yet the majority of suicide research has focused on primarily high-income countries (HIC).

Method: Using nationally representative data on 82,494 adolescents from thirty-four LMIC, this research employed machine learning to compare the predictive effects of multiple determinants of suicidal behaviors previously identified in the literature.

Results: Results indicate that distinct predictors are present for suicidal ideation, suicidal planning, and suicide attempts in youth living in LMIC as well as shared predictors common to all three behaviors.

Conclusion: These findings provide insights into the unique needs in global mental health policy and efforts within and across adolescents in LMIC.

Objective: Suicide risk for youth in resource- limited settings has been largely underrepresented in the literature and requires targeted examination of practical ways to address this growing public health concern. The present study focuses on the clinical utility of depression risk assessment tools addressing how and for whom suicide prevention intervention is most beneficial within a low-middle-income-country, high suicide risk youth sample.

Methods: Youth who reported a previous suicide attempt versus those who did not were criterion to test the validity of depression and hopelessness symptom assessment tools. We used item analyses to identify depressive symptom endorsements that most informed youth suicide risk, which will better equip rural practitioners for targeted intervention and monitoring of youth with an already high risk for suicide.

Results: Findings demonstrated that practitioners may target symptoms of social anhedonia, depressed mood, concentration disturbance, feelings of worthlessness, sleep disturbance, and fatigue for suicide prevention-intervention efforts among high-risk youth.

Conclusions: Study implications are for clinicians' use of the BDI-II and CES-D for depression symptom identification and suicide risk monitoring in settings with limited mental health infrastructure.

Background: One mainstay of psychiatric treatment for suicidal crises is inpatient psychiatric hospitalization. Despite the need to secure immediate safety and stabilization, inpatient treatment for acutely suicidal patients remains diagnosis-specific, which may fail to directly target and adequately manage suicidal behavior as a symptom and reason for admission or treatment. The post-discharge period is a high-risk period for repeat suicide attempts or death by suicide, but overburdened workforce and high patient turnover make it difficult to provide suicide-specific treatment.

Methods: In response to this need, we developed the Suicide Prevention Inpatient Group Treatment (SPIGT), a four-module, group-based intervention, which provides evidence-supported concrete tools and psychoeducation to directly address suicidality. To assess feasibility and acceptability of implementation, the SPIGT was piloted on an inpatient psychiatric unit starting in 2016. Group participants were given optional, anonymous surveys after each module. Unit clinicians also completed optional, anonymous surveys to assess their attitudes towards the intervention.

Results: Results indicate that participants responded very favorably to each module, and that unit clinicians felt that the implementation of this intervention was feasible and acceptable.

Conclusion: The SPIGT shows promise as a scalable suicide-specific, brief intervention, which addresses an unmet and critical need in suicide prevention.

Background: The interpersonal-psychological theory of suicidal behavior (IPTSB) is widely applied to explain non-fatal suicide behaviors, but yet to be tested empirically with a Ghanaian sample.

Aims: Using a total of 800 junior high school students (JHS) in the Greater Accra Region of Ghana, this study tests the utility of the IPTSB with the aim of having a better understanding of how suicide behavior is occurring among this young generation of Ghanaians.

Materials and methods: The study used the WHO-CIDI's self-reported measures on suicide behavior and the Interpersonal needs questionnaire, which measures the elements of the IPTSB. Structural equation modeling was performed using Mplus to test the overall fit of the model as well as associations among the predictor variables and outcome variables.

Results: The study found the IPTSB was significant for explaining 12-month and lifetime suicide behaviors in the sample. Also, 12-month suicide attempt was significantly associated with increased 12-month suicide ideation, increased acquired capability and increased perceived burdensomeness. In addition, 12-month suicide ideation was significantly associated with increased thwarted belongingness and increased perceived burdensomeness.

Discussion and conclusion: This study provides new information for clinicians and policy makers working to reduce suicide behavior among Ghanaian adolescents.

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.

Introduction: Nonsuicidal self-injury (NSSI) and suicidal ideation (SI) are widespread mental health concerns among adolescents. As fear of negative evaluation (FNE) and self-disgust are also common psychological phenomena among adolescents, existing research suggests that there may be reciprocal predictive relationships between FNE and NSSI/SI with self-disgust playing a mediating role. This study aimed to investigate the reciprocal relationships between FNE and NSSI, as well as FNE and SI, and the mediating role of self-disgust.

Method: Random intercept cross-lagged panel models (RI-CLPMs) were employed. A total of 515 Chinese secondary school students (50.7% boys; baseline M_age = 12.31 years, SD = 0.81) completed self-report questionnaires regarding FNE, self-disgust, NSSI, and SI. The assessment was conducted in four waves, 6 months apart.

Results: The results were as follows: (1) There were bidirectional relations between FNE and NSSI through self-disgust. (2) There was a unidirectional association from FNE to SI via self-disgust.

Conclusion: These findings have expanded the theoretical understanding of adolescent NSSI and SI, and highlighted the importance of offering personalized psychological counseling and therapy services at the intrapersonal level for adolescents.