Suicide and Life-Threatening Behavior最新文献

Objective: Sharing one's suicidal thoughts and behaviors, or suicide-related disclosure, allows adolescents to recruit help from others. Despite elevated risk among culturally minoritized youth, their suicide-related disclosure remains understudied.

Methods: 191 adolescents (M = 15.98, SD = 1.04, range = 13-17), including minoritized youth (38% racially, 19% ethnically, 40% gender, and 77% sexually), were recruited via social media ads and completed an anonymous online survey on suicide-related disclosure to informal support sources (e.g., family, friends). Disclosure rates, targets, and reasons for disclosure and nondisclosure were compared based on race, ethnicity, gender identity, and sexual orientation.

Results: Racially minoritized adolescents less often disclosed suicidal ideation and more strongly endorsed fear of negative reactions and resistance to intervention as reasons for nondisclosure, and reciprocity as reasons for disclosure, than White adolescents. Cisgender adolescents less often disclosed suicidal ideation and more strongly endorsed dismissal of suicide risk as reasons for nondisclosure than gender minoritized adolescents. Non-Hispanic adolescents more strongly endorsed help-seeking as reasons for disclosure than Hispanic adolescents. While adolescents overall disclosed most often to friends, heterosexual adolescents disclosed more to family than sexually minoritized adolescents.

Conclusion: Racial and gender disparities in suicide-related disclosure may occur for distinct reasons among adolescents. Uncovering patterns of disclosure may facilitate detection of suicide risk among minoritized youth.

Introduction: People who identify as sexual minorities (SM) report higher rates of nonsuicidal self-injury (NSSI) than heterosexual individuals. One explanatory factor that may be important in this relation is self-defective beliefs. The present study examined the role of self-defective beliefs in the link between sexual orientation and NSSI.

Method: Participants were college-aged women (n = 145) with (n = 84) and without (n = 61) recent, recurrent NSSI, completed measures of NSSI and self-defective beliefs. Participants were recruited from a large college and surrounding area in the northeastern U.S.

Results: suggest that SM participants were more likely to report a history of NSSI, frequent and versatile NSSI, and greater self-defective beliefs compared to heterosexual participants, but not more likely to report medically severe NSSI. Results from cross-sectional mediation analyses revealed that self-defective beliefs mediated the relation between SM identity and lifetime NSSI history and partially mediated the relations for NSSI medical severity and versatility, but not NSSI frequency.

Conclusions: Taken together, our findings suggest that self-defective beliefs are a salient cognitive concern associated with indicators of NSSI severity in college-aged SM women. Additional research is needed to determine whether these findings replicate in SM men, transgender, and gender diverse populations.

Introduction: Rising rates of suicidal thoughts and behaviors (STBs) among U.S. Latina adolescents urgently need attention. Life is Precious (LIP) is a culturally responsive, community-based, afterschool-model program offering wellness-support services to supplement outpatient mental health treatment for Latina adolescents experiencing STB's. This 12-month quasi-experimental pilot study explored LIP's impact on clinical outcomes.

Methods: Latina adolescents newly enrolled in LIP and receiving outpatient treatment (n = 31) and those newly starting outpatient treatment only (n = 12; Usual Care) were assessed for Suicidal Ideation (Suicidal Ideation Questionnaire; SIQ) and depressive symptoms (Patient Health Questionnaire-9). We estimated differences in mean scores using longitudinal linear mixed models and adjusted risk ratios (ARRs) of SIQ-25%, SIQ-50%, and PHQ-9-5-point improvements using exact logistic models.

Results: The direction of the estimated impact of LIP was positive [differences (95% CIs): -15.5 (-34.16, 3.15) for SIQ; -1.16 (-4.39, 2.07) for PHQ-9], with small-to-moderate nonsignificant effect sizes (0.19-0.34). LIP participants saw two to three times higher prevalence than controls of SIQ-25%, SIQ-50%, and PHQ-9-5-point improvements; ARRs (95% CIs) were 1.91 (0.61, 3.45), 3.04 (0.43, 11.33), and 1.97 (0.44, 5.07), respectively. Suicidal behaviors also decreased in LIP.

Conclusion: The effects of LIP were in positive directions across clinical outcomes, warranting further research on its effectiveness in decreasing STBs.

Introduction: The development of evidence-based treatments relies on accurate theoretical frameworks sensitive to the lived realities of the populations from which they are derived. Yet, the perspectives of Black youth are vastly underrepresented in extant theories of suicidal behavior. Cultural Consensus Modeling provides an evidence-based approach for developing a culturally informed understanding of suicide risk among Black youth.

Method: Participants were 50 Black adolescents (M_age = 16.20 years; 76.0% male) who completed Phase 1 of a Cultural Consensus Modeling study. Participants freely listed reasons for suicide and reasons for living among similar peer Black youth. Responses were synthesized and coded for major themes.

Results: The most common reasons for suicide were racism (40%), depression (32%), poverty (26%), and bullying (22%). The most common reasons for living were family (58%), having a purpose or goals (36%), friends (30%), and hope for a better future (26%).

Conclusion: Responses highlighted issues of racism and social justice, depression, and poverty, as well as the protective role of relationships, living for the future, and contributing to Black empowerment. Future research should utilize Cultural Consensus Modeling to elevate the voices of Black youth, improving extant theories of suicide, and identifying unique mechanisms or opportunities for prevention.

Introduction: Sexual and gender minority (SGM) individuals report a higher prevalence rate of nonsuicidal self-injury (NSSI) compared to their cisgender heterosexual peers. Minority stress theory posits that the unique stressors experienced by those with a minoritized sexual orientation and/or gender identity increase the risk of negative health outcomes. As such, SGM stress may be a significant risk factor for NSSI and may help explain the disparate prevalence rates in the community.

Method: Thus, a meta-analysis was conducted to assess the relationship between SGM stress and NSSI (k = 42; N = 253,686).

Results: Broadly, SGM stress was significantly positively related to NSSI engagement (r = 0.15). While this effect size is small in absolute size, it is comparable to other evidence-based risk factors for NSSI, such as impulsivity. Contrary to our hypothesis, the number of items used to assess NSSI engagement did not significantly moderate the relationship (b = -0.001). Exploratory analyses found no significant difference between proximal and distal SGM stressors (b = 0.07), sexual minority stress and gender minority stress (b = 0.03), nor assessment of lifetime compared to past year NSSI engagement (b = 0.08).

Conclusion: Overall, the results of this meta-analysis support that SGM stress is a significant risk factor for NSSI and should be integrated into interventions for NSSI.

Background: Literature on how to translate information extracted from clinical progress notes into numeric scores for 3-step theory of suicide (3ST) factors is nonexistent. We determined which scoring option would best discriminate between patients who will attempt or die by suicide and patients with neither suicidal ideation nor attempts, and we tested hypotheses related to the 3ST.

Methods: We used terminology-driven natural language processing (NLP) to extract information from Veterans Health Administration (VHA) clinical progress notes. Counts of those extractions served as input to evaluate candidate scoring options for each 3ST factor (psychological pain, hopelessness, connectedness, capability for suicide). Logistic regression models adjusted for common demographic characteristics were used to test the 3ST hypotheses.

Results: Optimal contrasts between groups were obtained with P - A for psychological pain, hopelessness, and capability for suicide, and $A/\left(P+1\right)$ for connectedness, where P and A, respectively, indicate the patient-level number of extractions indicating presence and absence of the factor.

Limitations: Additional research is necessary to verify whether our conclusions hold in a cohort that is more reflective of the general VHA population.

Conclusion: Terminology-driven 3ST factor scores discriminate patients who attempt or die by suicide from patients without suicidal ideation or attempts. Our results corroborate the validity of the 3ST for VHA patients.

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: Data from the general population of youth show increases in suicide ideation and attempt in recent years, with rates of increase differing across sex and racial/ethnic groups. This study assessed trends in suicide ideation and attempt from 2016 to 2021 in youth in juvenile detention, across sex, age, and racial/ethnic groups.

Methods: We leveraged state-wide suicide screening data of all detained youth (n = 53,769) from 2016 to 2021. We analyzed data for periods defined by statistically significant changes in trends of lifetime suicide attempt, past 6-month suicide attempt, and current suicide ideation.

Results: The prevalence of lifetime, but not past six-month, attempts increased, whereas the prevalence of current suicide ideation decreased annually from 2016 to 2021. Overall trends were qualified by distinct patterns among subgroups: rates of lifetime attempt increased among male, adolescent, and Black youth, while rates of current ideation decreased among male, adolescent, and White and Hispanic youth.

Conclusion: These data document increasing rates of lifetime suicide attempts in detained youth from 2016 to 2021, especially among male and Black adolescents, concomitant with decreasing rates of current suicide ideation. Suicide prevention approaches for detained youth may need to prioritize variables besides or in addition to suicide ideation.

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: Today, dying by suicide is one of the most important mental health challenges in the world, and proper planning and using various preventive methods play an important role in this field. The present research aimed to study comparatively the effectiveness of text-based intervention in reducing emotional distress of people involved in psychosocial crises, comparing it with phone-based intervention.

Methods: In this study, the Distress Thermometer, assessing emotional distress, was used at the start and end of both text and phone-based interventions to explore their effectiveness in crisis de-escalation and management. This study comprises two samples within an overarching study, with 700 clients receiving text-based intervention and 737 clients receiving phone-based intervention.

Results: The research findings indicate the effectiveness of both methods in reducing emotional distress among individuals in crisis. The mean emotional distress significantly differed between pre-and post-tests. Importantly, prior to controlling for baseline distress levels, text-based intervention demonstrated particularly strong efficacy in reducing emotional distress, showing a statistically significant difference.

Conclusion: Recognizing the effectiveness of both intervention methods and particularly the favorable response of young people with immediate suicide risk to text-based intervention, prioritizing the implementation of text-based systems is recommended in the national suicide prevention programs of developing countries.