Suicide and Life-Threatening Behavior最新文献

Introduction: Fatality review is a public health approach designed to inform efforts to prevent fatalities of a certain kind (e.g., suicide, homicide) or in a specific setting or population (e.g., hospitals, youth). Despite extensive literature on fatality review generally, the literature on suicide review teams specifically is scant. The aim of this paper is to: describe the implementation of a local adult suicide review commission, detail examples of initial outcomes and recommendations developed by the commission, and provide recommendations and/or best practices for how to develop and implement an adult suicide review team.

Methods: We utilize framing questions from the American Association of Suicidology's psychological autopsy framework. By using these guiding questions in the discussion, members are invited to explore not only the stressors that may have more immediately preceded the suicide event itself, but to situate those stressors in the context of the individual's life course.

Results: Several recommendations proposed by our commission have resulted in tangible outcomes and are detailed using Haddon's Matrix as a guiding prevention planning tool.

Implications: We have highlighted the need to move beyond looking at individual-level help-seeking to focus on structural/systemic issues that result in stress or create unsafe environments for at-risk individuals.

Introduction: Deficits in neurocognition and social-cognition have been suggested to be an endophenotype for suicidal behavior. We aimed to compare the social-cognition and neurocognitive characteristics of adolescents diagnosed with depression with and without suicidal behavior and to investigate whether these functions predict suicide.

Method: Adolescents diagnosed with Major Depressive Disorder (MDD) with suicidal behavior (n = 42); MDD without suicidal behavior (n = 44) and age- and sex-matched controls (n = 43) were included. The University of Pennsylvania Computerized Neurobehavioral Test Battery and Autism Spectrum Screening Questionnaire (ASSQ) were used to evaluate social-cognition and neurocognitive characteristics.

Results: Several neurocognitive domain values of MDD groups, were significantly different from the control group. Neutral emotion recognition task (p = 0.025) and ASSQ scores were found to be significantly impaired in the patient groups (p < 0.001). Logistic regression analysis showed that, only the increase in the Suicide Probability Scale score was found to be significant as a risk factor predicting suicide (p = 0.007, OR: 1.246).

Conclusion: While the neurocognitive and social-cognitive performances of adolescents with MDD were significantly lower than the control group, these performances in the two depression groups were similar. When the predictors of suicidal behavior were examined, it was found that only the increase in suicidal ideation scores predicted suicide.

Objectives: Non-suicidal self-injury (NSSI) is theorized to be reinforced by its emotional consequences. Mental images of NSSI are commonly reported as occurring prior to NSSI. Based on the known functional properties of anticipatory mental imagery as an emotional and motivational amplifier, this study investigated whether NSSI mental imagery constitutes a proximal and dynamic mechanism underpinning NSSI risk.

Method: An intensive ecological momentary assessment (EMA) study was conducted to track the occurrence and characteristics of NSSI mental imagery alongside NSSI urge and behavior in naturalistic settings. A sample of N = 43 individuals aged 17 to 24 with a history of repetitive NSSI completed EMA surveys seven times a day for 14 days.

Results: Mental preoccupation in the form of NSSI mental imagery-based flash-forwards to the actions, bodily sensations, and emotional benefits of NSSI was found to occur when NSSI urge was high but not when urge was low. Critically, objective cross-panel analyses showed that higher frequencies of NSSI imagery occurrence predicted greater future NSSI urge and increased likelihood of acting on urge, over and above current urge.

Conclusions: Mental imagery of NSSI is not simply an epiphenomenal by-product of NSSI urge and may constitute a dynamic and proximal novel intervention target.

Introduction: Little research has been done on how people mentally simulate future suicidal thoughts and urges, a process we term suicidal prospection.

Methods: Participants were 94 adults with recent suicidal thoughts. Participants completed a 42-day real-time monitoring study and then a follow-up survey 28 days later. Each night, participants provided predictions for the severity of their suicidal thoughts the next day and ratings of the severity of suicidal thoughts over the past day. We measured three aspects of suicidal prospection: predicted levels of desire to kill self, urge to kill self, and intent to kill self. We generated prediction errors by subtracting participants' predictions of the severity of their suicidal thoughts from their experienced severity.

Results: Participants tended to overestimate (although the average magnitude was small and the modal error was zero) the severity of their future suicidal thoughts. The best fitting models suggested that participants used both their current suicidal thinking and previous predictions of their suicidal thinking to generate predictions of their future suicidal thinking. Finally, the average severity of predicted future suicidal thoughts predicted the number of days participants thought about suicide during the follow-up period.

Conclusions: This study highlights prospection as a psychological process to better understand suicidal thoughts and behaviors.

Background: Emotion Regulation (ER) and Suicide Crisis Syndrome (SCS) are psychological processes involved in suicide. Within ER, both the use of rumination and dysfunctional emotion beliefs are associated with suicide. SCS, a pre-suicidal mental state involving cognitive and affective dysregulation, is related to short-term suicide risk.

Aims: Here, we first examined associations between ER (beliefs about the uncontrollability of emotions and rumination), SCS and suicide behavior, and second, we test a multistep model in which ER factors are linked to suicide behavior through SCS.

Materials & methods: We conducted two cross-sectional studies to address this issue by self-reports. Study 1 used a community sample (N = 421). Study 2 used a clinical sample (N = 70).

Results: Results from both studies showed that beliefs about the uncontrollability of emotions and rumination were associated with higher levels of SCS symptoms and suicide behavior, and that SCS was associated with suicide behavior. In addition, path analyses showed that uncontrollability beliefs were linked to rumination, which in turn was associated with SCS, and this variable mediated the association between ER factors and suicide ideation (in both community and clinical samples) and suicide attempts (in the community sample).

Discussion: As we expected, in both samples, uncontrollability of emotions and rumination were positively related with SCS and suicide behavior.

Conclusion: We emphasize the importance of addressing uncontrollability beliefs and rumination in suicide prevention.

Introduction: Suicide is a leading cause of death, making suicide prevention a major public health priority. Increasing understanding of factors influencing suicidal behavior is paramount. Previous research has implicated psychological closeness, characterized by perceptions of how close/distant or attached/detached one feels to a particular object, as a cognitive factor that influences suicidal behavior. However, a better understanding of how psychological closeness to suicide methods is conceptualized by relevant populations is needed to improve its assessment and understand how it may confer risk for suicide.

Methods: The goal was to refine the conceptualization of psychological closeness to suicide methods by incorporating feedback from relevant populations. We conducted 30 interviews with those primarily identifying as having lived experience of suicide (n = 10), clinicians who work with suicidal patients (n = 11), and suicide researchers (n = 9). A rigorous thematic approach using NVivo software was used to uncover common themes.

Results: Primary themes included familiarity, comfort, and attachment, with one emerging theme of symbolism. We define these themes, provide context to their meaning, and share exemplary quotes across diverse participants.

Conclusion: We consider clinical, research, and policy implications from an interdisciplinary lens and discuss the strengths and limitations of this study.

Background: Rewards can both validate and promote the stature of a researcher in their field. Research has been mixed on the role of gender as a predictor of receiving scholarly awards, but much of it lacks control for research excellence, and awards in interdisciplinary associations have been neglected. This study fills these gaps for suicidology.

Methods: Bibliometric data from the Web of Science was utilized for this study. To control for research excellence the analysis is restricted to the 116 most highly prolific researchers, each with 70 or more works published on suicide, from the Web of Science. The research awards in suicidology, given by three different interdisciplinary associations, include the Louis I. Dublin Award, the Morselli Medal, and the Stengel Research Award. The link between gender and receipt of a major award is adjusted for possible mediators including long-term research productivity (h-index), years of experience, and organizational prestige.

Results: While the percentage of women winning awards is less than that of men, we find that there is no significant difference between the genders. The quality of research and years of experience predict the receipt of each award.

Conclusion: Based on a bibliometric analysis, women are not at a disadvantage in receiving research awards in suicidology. These results are consistent with recent research on gender and awards in economics, mathematics, and psychology.

Objective: The aim of the study was to explore the psychological characteristics of the individuals with various suicide risks using computerized text analysis, in the hopes of a better understanding of suicide trajectories.

Methods: 627 first-time callers' records were randomly selected from Taiwan An-Shin Hotline database between 2013 and 2018. The voice records were evaluated by two psychologists to determine the levels of suicide risk (156 with uncertainty of risk, 177 with low suicidal ideation, 157 with high suicidal ideation, and 137 with suicide preparation/attempt) and transcribed into text. The Linguistic Inquiry and Word Count 2015 (LIWC2015) program combined with Chinese dictionary were then used to calculate the frequency of word categories.

Results: Exploratory factor analysis identified four mindsets of language characteristics, named "opposition and questioning", "active engagement", "negative rumination", and "focus on death". Psychological descriptions of the mindsets were also obtained through correlation analysis with the LIWC2015 categories and indicators. The four mindsets effectively distinguished the callers with different levels of suicide risk.

Conclusion: The psychological characteristics of people with various suicide risks can be described and differentiated via the closed-word categories and composite indicators. These results provide useful information for practitioners and researchers.

Introduction: Men have an increased risk to die by suicide compared to women but are underrepresented in suicide research. To improve individual risk prediction for suicide-related thoughts and behaviors (STBs), risk factors are increasingly being studied at an individual level. The possible affect-regulatory function of suicidal ideation has hardly been investigated ideographically and has not yet been tested in a male sample.

Methods: We investigated the bidirectional associations between suicidal ideation and negative and positive affect in a sample of n = 21 male inpatients with unipolar depression and a history of suicidal ideation both at the group level and at the individual level. Participants underwent an intensive ecological momentary assessment for 6 days with 10 data points per day.

Results: We found no evidence for an affect-regulatory function of suicidal ideation at the group level, neither for effects of affect on subsequent suicidal ideation (antecedent affect-regulatory hypothesis) nor for effects of suicidal ideation on subsequent affect (consequence affect-regulatory hypothesis). Person-specific analyses revealed substantial variability in strength and direction of the considered associations, especially for the associations representing the antecedent hypothesis.

Conclusion: The demonstrated between-person heterogeneity points to the necessity to individualize the investigation of risk factors to enhance prediction and prevention of STBs.