Patricia I Jewett, Lindsay A Taliaferro, Iris W Borowsky, Michelle A Mathiason, Eunice M Areba
Introduction: High rates of suicidal ideation (SI), suicide attempts (SA), and repetitive nonsuicidal self-injury (NSSI) among some ethnoracially minoritized United States youth populations may be related to adverse childhood experiences (ACEs) with structural roots.
Methods: Using the 2013-2019 Minnesota Student Surveys, we assessed associations of student-reported structural ACEs (parental incarceration, housing instability, food insecurity, and foster care involvement) with SI, SA, and repetitive NSSI within the past 12 months using multilevel logistic regression stratified by ethnoracial group (American Indian/Alaskan Native [AIAN], Hmong, other Asian, Black Latino, other Latino, Somali, other Black/African American [AA], Native Hawaiian/Pacific Islander [NHPI], and multiracial), and adjusted for sex, grade, ACEs experienced within one's household, mental health treatment, and perceived safety.
Results: Structural ACEs were strongly associated with increasing SI, SA, and NSSI. At ≥2 structural ACEs, repetitive NSSI rates ranged from 7% to 29% (female), 8% to 20% (male); SA rates ranged from 13% to 35% (female), 10% to 22% (male); and SI rates ranged from 31% to 50% (female), 20% to 32% (male). Black Latino, NHPI, AIAN, and Black/AA students most often reported structural ACE exposures.
Conclusion: Reducing structural ACEs may reduce SI, SA, and repetitive NSSI among ethnoracially minoritized youth populations. Disaggregating diverse youth groups revealed variations in these outcomes that remain hidden when subpopulations are aggregated.
{"title":"Structural adverse childhood experiences associated with suicidal ideation, suicide attempts, and repetitive nonsuicidal self-injury among racially and ethnically minoritized youth.","authors":"Patricia I Jewett, Lindsay A Taliaferro, Iris W Borowsky, Michelle A Mathiason, Eunice M Areba","doi":"10.1111/sltb.13084","DOIUrl":"https://doi.org/10.1111/sltb.13084","url":null,"abstract":"<p><strong>Introduction: </strong>High rates of suicidal ideation (SI), suicide attempts (SA), and repetitive nonsuicidal self-injury (NSSI) among some ethnoracially minoritized United States youth populations may be related to adverse childhood experiences (ACEs) with structural roots.</p><p><strong>Methods: </strong>Using the 2013-2019 Minnesota Student Surveys, we assessed associations of student-reported structural ACEs (parental incarceration, housing instability, food insecurity, and foster care involvement) with SI, SA, and repetitive NSSI within the past 12 months using multilevel logistic regression stratified by ethnoracial group (American Indian/Alaskan Native [AIAN], Hmong, other Asian, Black Latino, other Latino, Somali, other Black/African American [AA], Native Hawaiian/Pacific Islander [NHPI], and multiracial), and adjusted for sex, grade, ACEs experienced within one's household, mental health treatment, and perceived safety.</p><p><strong>Results: </strong>Structural ACEs were strongly associated with increasing SI, SA, and NSSI. At ≥2 structural ACEs, repetitive NSSI rates ranged from 7% to 29% (female), 8% to 20% (male); SA rates ranged from 13% to 35% (female), 10% to 22% (male); and SI rates ranged from 31% to 50% (female), 20% to 32% (male). Black Latino, NHPI, AIAN, and Black/AA students most often reported structural ACE exposures.</p><p><strong>Conclusion: </strong>Reducing structural ACEs may reduce SI, SA, and repetitive NSSI among ethnoracially minoritized youth populations. Disaggregating diverse youth groups revealed variations in these outcomes that remain hidden when subpopulations are aggregated.</p>","PeriodicalId":39684,"journal":{"name":"Suicide and Life-Threatening Behavior","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-01-27DOI: 10.1111/sltb.13044
Carola Hajek Gross, Sofia-Marie Oehlke, Karin Prillinger, Andreas Goreis, Paul L Plener, Oswald D Kothgassner
Introduction: Mentalization-based therapy (MBT) and its adapted version for adolescents (MBT-A) are repeatedly highlighted as promising treatments for reducing self-harm, particularly in borderline personality disorder (BPD). Despite the availability of publications providing evidence of their efficacy in reducing self-harm, recent meta-analyses have yielded mixed results. To inform best-practice clinical decision-making, we conducted a systematic review and meta-analysis. We aimed to disentangle findings for both adolescents and adults on the efficacy of MBT(-A) in reducing self-harm (primary outcome) and symptoms of BPD and depression (secondary outcomes).
Methods: Web of Science, Scopus, Embase, PubMed/Medline, and Cochrane Review Database were searched for eligible studies published until September 2022. In total, 14 studies were identified, comprising 612 participants from nine MBT studies (six pre-post, three RCTs) and five MBT-A studies (two pre-post, three RCTs). Aggregated effect sizes were estimated using random-effects models. Meta-regressions were conducted to assess the effect of moderator variables (treatment duration, drop-out rates, and age) on effect sizes.
Results: Overall, both MBT and MBT-A demonstrated promising effects in reducing self-harm (g = -0.82, 95% CI -1.15 to -0.50), borderline personality disorder (g = -1.08, 95% CI -1.38 to -0.77), and depression (g = -1.1, 95% CI -1.52 to -0.68) symptoms. However, when compared to control interventions (TAU, SCM), MBT(-A) did not prove to be more efficacious, with the exception of MBT showing superior effects on BPD symptoms in adults (g = -0.56, 95% CI -0.88 to -0.24).
Conclusion: Although the pre-post evaluations seem promising, this analysis, including RCTs, showed no superiority of MBT(-A) to control conditions, so that prioritizing the application of MBT (-A) for the treatment of self-harm is not supported. Possible explanations and further implications are discussed.
导言:心理治疗(MBT)及其针对青少年的改良版(MBT-A)被反复强调为减少自残(尤其是边缘型人格障碍(BPD))的有效治疗方法。尽管有出版物提供了这些疗法在减少自残方面的疗效证据,但最近的荟萃分析却得出了好坏参半的结果。为了给最佳临床决策提供参考,我们进行了一项系统性回顾和荟萃分析。我们的目的是将青少年和成年人的研究结果区分开来,以了解 MBT(-A)在减少自残(主要结果)以及 BPD 和抑郁症状(次要结果)方面的疗效:方法:在 Web of Science、Scopus、Embase、PubMed/Medline 和 Cochrane Review Database 中检索了 2022 年 9 月之前发表的符合条件的研究。总共确定了 14 项研究,包括来自 9 项 MBT 研究(6 项事后研究,3 项研究性临床试验)和 5 项 MBT-A 研究(2 项事后研究,3 项研究性临床试验)的 612 名参与者。使用随机效应模型估算了综合效应大小。进行了元回归以评估调节变量(治疗持续时间、辍学率和年龄)对效应大小的影响:总体而言,MBT 和 MBT-A 在减少自残(g = -0.82,95% CI -1.15 至 -0.50)、边缘型人格障碍(g =-1.08,95% CI -1.38 至 -0.77)和抑郁症(g =-1.1,95% CI -1.52 至 -0.68)症状方面均表现出良好的效果。然而,与对照干预(TAU、SCM)相比,MBT(-A)并未被证明更有效,但MBT对成人BPD症状(g = -0.56,95% CI -0.88至-0.24)的效果更佳:结论:尽管前后评价似乎很有希望,但包括研究性试验在内的这项分析表明,MBT(-A)并不优于对照条件,因此不支持优先应用MBT(-A)治疗自残。本文讨论了可能的解释和进一步的影响。
{"title":"Efficacy of mentalization-based therapy in treating self-harm: A systematic review and meta-analysis.","authors":"Carola Hajek Gross, Sofia-Marie Oehlke, Karin Prillinger, Andreas Goreis, Paul L Plener, Oswald D Kothgassner","doi":"10.1111/sltb.13044","DOIUrl":"10.1111/sltb.13044","url":null,"abstract":"<p><strong>Introduction: </strong>Mentalization-based therapy (MBT) and its adapted version for adolescents (MBT-A) are repeatedly highlighted as promising treatments for reducing self-harm, particularly in borderline personality disorder (BPD). Despite the availability of publications providing evidence of their efficacy in reducing self-harm, recent meta-analyses have yielded mixed results. To inform best-practice clinical decision-making, we conducted a systematic review and meta-analysis. We aimed to disentangle findings for both adolescents and adults on the efficacy of MBT(-A) in reducing self-harm (primary outcome) and symptoms of BPD and depression (secondary outcomes).</p><p><strong>Methods: </strong>Web of Science, Scopus, Embase, PubMed/Medline, and Cochrane Review Database were searched for eligible studies published until September 2022. In total, 14 studies were identified, comprising 612 participants from nine MBT studies (six pre-post, three RCTs) and five MBT-A studies (two pre-post, three RCTs). Aggregated effect sizes were estimated using random-effects models. Meta-regressions were conducted to assess the effect of moderator variables (treatment duration, drop-out rates, and age) on effect sizes.</p><p><strong>Results: </strong>Overall, both MBT and MBT-A demonstrated promising effects in reducing self-harm (g = -0.82, 95% CI -1.15 to -0.50), borderline personality disorder (g = -1.08, 95% CI -1.38 to -0.77), and depression (g = -1.1, 95% CI -1.52 to -0.68) symptoms. However, when compared to control interventions (TAU, SCM), MBT(-A) did not prove to be more efficacious, with the exception of MBT showing superior effects on BPD symptoms in adults (g = -0.56, 95% CI -0.88 to -0.24).</p><p><strong>Conclusion: </strong>Although the pre-post evaluations seem promising, this analysis, including RCTs, showed no superiority of MBT(-A) to control conditions, so that prioritizing the application of MBT (-A) for the treatment of self-harm is not supported. Possible explanations and further implications are discussed.</p>","PeriodicalId":39684,"journal":{"name":"Suicide and Life-Threatening Behavior","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139567461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-01-12DOI: 10.1111/sltb.13041
Brandon A Knettel, Armstrong Obale, Hamza Iqbal, Mela C Fotabong, Ngaha N Philippe, Margaret Graton, Leila Ledbetter
Objective: One-third of all global suicide deaths occur among adolescents and young adults, making suicide the second leading cause of death among young people. Nearly 80% of suicide deaths occur in low- and middle-income countries, and many African nations have higher rates of suicide than global averages. However, interventions are scarce. We conducted a scoping review of counseling interventions for suicide prevention among youth in Africa.
Method: We performed structured searches of the Medline, Embase, PyscINFO, African Index Medicus, Global Heath Database, and Proquest Dissertations and Theses Global databases. Studies were eligible for inclusion if they described a counseling intervention conducted in Africa, focused on participants under age 22, and included a suicide-related outcome.
Results: After removal of duplicates, 1808 titles and abstracts were screened and 10 studies were identified for full-text review. Of these, six included adult participants and did not disaggregate results for youth, two did not describe an intervention, and two did not include a relevant outcome. Thus, no studies were eligible for inclusion.
Conclusions: This empty review highlights the striking absence of published research on a life-threatening public health challenge, representing a distinct call to action for improved efforts in adolescent suicide prevention in Africa.
目的:全球三分之一的自杀死亡病例发生在青少年和年轻人身上,自杀已成为年轻人的第二大死因。近 80% 的自杀死亡发生在中低收入国家,许多非洲国家的自杀率高于全球平均水平。然而,干预措施却很少。我们对预防非洲青少年自杀的咨询干预措施进行了范围界定:我们对 Medline、Embase、PyscINFO、African Index Medicus、Global Heath Database 和 Proquest Dissertations and Theses Global 数据库进行了结构化检索。只要研究描述了在非洲进行的咨询干预,以 22 岁以下的参与者为研究对象,并包含与自杀相关的结果,就符合纳入条件:去除重复内容后,共筛选出 1808 篇标题和摘要,并确定了 10 篇研究进行全文审阅。其中,6 项研究包括成年参与者,但未对青少年的结果进行分类,2 项研究未对干预措施进行描述,2 项研究未包含相关结果。因此,没有研究符合纳入条件:这篇空洞的综述突出表明,对于这一威胁生命的公共卫生挑战,公开发表的研究成果明显不足,这也是对改进非洲青少年自杀预防工作的明确要求。
{"title":"A profound absence of counseling interventions for suicide prevention among youth in Africa: A call to action based on an empty scoping review.","authors":"Brandon A Knettel, Armstrong Obale, Hamza Iqbal, Mela C Fotabong, Ngaha N Philippe, Margaret Graton, Leila Ledbetter","doi":"10.1111/sltb.13041","DOIUrl":"10.1111/sltb.13041","url":null,"abstract":"<p><strong>Objective: </strong>One-third of all global suicide deaths occur among adolescents and young adults, making suicide the second leading cause of death among young people. Nearly 80% of suicide deaths occur in low- and middle-income countries, and many African nations have higher rates of suicide than global averages. However, interventions are scarce. We conducted a scoping review of counseling interventions for suicide prevention among youth in Africa.</p><p><strong>Method: </strong>We performed structured searches of the Medline, Embase, PyscINFO, African Index Medicus, Global Heath Database, and Proquest Dissertations and Theses Global databases. Studies were eligible for inclusion if they described a counseling intervention conducted in Africa, focused on participants under age 22, and included a suicide-related outcome.</p><p><strong>Results: </strong>After removal of duplicates, 1808 titles and abstracts were screened and 10 studies were identified for full-text review. Of these, six included adult participants and did not disaggregate results for youth, two did not describe an intervention, and two did not include a relevant outcome. Thus, no studies were eligible for inclusion.</p><p><strong>Conclusions: </strong>This empty review highlights the striking absence of published research on a life-threatening public health challenge, representing a distinct call to action for improved efforts in adolescent suicide prevention in Africa.</p>","PeriodicalId":39684,"journal":{"name":"Suicide and Life-Threatening Behavior","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11021152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-01-05DOI: 10.1111/sltb.13036
Roberto López, Christianne Esposito-Smythers, Annamarie B Defayette, Katherine M Harris, Lauren Seibel, Emma D Whitmyre
Introduction: While negative affect and problem-solving deficits have been consistently linked to suicidal thoughts and behaviors, the latter are often conceptualized and studied as time- and/or context-invariant. Though requiring additional empirical support, theory suggests that discrimination may strengthen the relation between rejection sensitivity and increases in negative affect as well as declines in problem-solving abilities following rejection. The aim of the current study was to test this claim using a social rejection paradigm (i.e., Cyberball) with young adults experiencing past-month suicidal ideation.
Methods: The sample consisted of 50 participants. Lifetime discrimination and rejection sensitivity were assessed prior to Cyberball. Negative affect and problem-solving abilities were assessed pre- and post-Cyberball. SPSS and the PROCESS macro were used to test relations among variables of interest.
Results: Rejection sensitivity predicted greater problem-solving decrements, but not negative affect, following rejection among individuals who had experienced higher (vs. lower) levels of lifetime discrimination.
Conclusion: Addressing rejection sensitivity and sources of discrimination within the context of treatment may reduce the impact of social rejection on problem-solving abilities among young adults at risk for suicide.
导言虽然消极情绪和解决问题能力的缺失一直与自杀想法和行为有关,但后者通常被概念化并被研究为与时间和/或环境无关。尽管还需要更多的实证支持,但理论表明,歧视可能会加强拒绝敏感性与消极情绪增加以及拒绝后问题解决能力下降之间的关系。本研究的目的是使用社交拒绝范式(即网络球),对过去一个月有自杀倾向的年轻人进行测试:方法:样本由 50 名参与者组成。方法:样本由 50 名参与者组成,在玩网络球之前对他们的终生辨别力和拒绝敏感度进行了评估。消极情绪和解决问题的能力则在玩网络球前后进行评估。使用 SPSS 和 PROCESS 宏检验相关变量之间的关系:结果:在一生中遭受过较高(与较低)程度歧视的人中,拒绝敏感性预示着被拒绝后解决问题的能力会下降,而消极情绪则不会:结论:在治疗过程中解决拒绝敏感性和歧视来源问题,可以减少社会拒绝对有自杀风险的年轻人解决问题能力的影响。
{"title":"Relations between discrimination, rejection sensitivity, negative affect, and decrements in problem-solving ability following social rejection: An experimental investigation.","authors":"Roberto López, Christianne Esposito-Smythers, Annamarie B Defayette, Katherine M Harris, Lauren Seibel, Emma D Whitmyre","doi":"10.1111/sltb.13036","DOIUrl":"10.1111/sltb.13036","url":null,"abstract":"<p><strong>Introduction: </strong>While negative affect and problem-solving deficits have been consistently linked to suicidal thoughts and behaviors, the latter are often conceptualized and studied as time- and/or context-invariant. Though requiring additional empirical support, theory suggests that discrimination may strengthen the relation between rejection sensitivity and increases in negative affect as well as declines in problem-solving abilities following rejection. The aim of the current study was to test this claim using a social rejection paradigm (i.e., Cyberball) with young adults experiencing past-month suicidal ideation.</p><p><strong>Methods: </strong>The sample consisted of 50 participants. Lifetime discrimination and rejection sensitivity were assessed prior to Cyberball. Negative affect and problem-solving abilities were assessed pre- and post-Cyberball. SPSS and the PROCESS macro were used to test relations among variables of interest.</p><p><strong>Results: </strong>Rejection sensitivity predicted greater problem-solving decrements, but not negative affect, following rejection among individuals who had experienced higher (vs. lower) levels of lifetime discrimination.</p><p><strong>Conclusion: </strong>Addressing rejection sensitivity and sources of discrimination within the context of treatment may reduce the impact of social rejection on problem-solving abilities among young adults at risk for suicide.</p>","PeriodicalId":39684,"journal":{"name":"Suicide and Life-Threatening Behavior","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139098906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2023-12-21DOI: 10.1111/sltb.13035
Meagan Docherty, Joanna Kubik, Grant Drawve
Introduction: Suicide remains a leading cause of death in the U.S., and firearms are one of the most lethal methods of suicide. This study examines personal and contextual factors that predict suicide with a firearm compared to other methods across stages of adulthood.
Methods: Data on adult suicide decedents from 2009 to 2019 were obtained from Colorado's National Violent Death Reporting System (NVDRS) data (N = 11,512). The dataset includes incident and person characteristics collected by law enforcement and coroners. Zip code level data were integrated from the American Community Survey.
Results: Age, sex, race, marital status, military service, substance use, suicide attempt history, mental health, and location characteristics (population density, as well as age, education, veteran status, and household status of population) predicted suicide by firearm. Risk was particularly high for males in older adulthood. We further explored age-specific models (young, middle-aged, and older adults) to determine salient risk factors for each group.
Conclusion: This study highlights the need for comprehensive suicide prevention approaches that consider both individual and contextual risk factors, as well as unique risks in each stage of adulthood.
{"title":"Examining predictors of suicide by firearm in young, middle, and late adulthood.","authors":"Meagan Docherty, Joanna Kubik, Grant Drawve","doi":"10.1111/sltb.13035","DOIUrl":"10.1111/sltb.13035","url":null,"abstract":"<p><strong>Introduction: </strong>Suicide remains a leading cause of death in the U.S., and firearms are one of the most lethal methods of suicide. This study examines personal and contextual factors that predict suicide with a firearm compared to other methods across stages of adulthood.</p><p><strong>Methods: </strong>Data on adult suicide decedents from 2009 to 2019 were obtained from Colorado's National Violent Death Reporting System (NVDRS) data (N = 11,512). The dataset includes incident and person characteristics collected by law enforcement and coroners. Zip code level data were integrated from the American Community Survey.</p><p><strong>Results: </strong>Age, sex, race, marital status, military service, substance use, suicide attempt history, mental health, and location characteristics (population density, as well as age, education, veteran status, and household status of population) predicted suicide by firearm. Risk was particularly high for males in older adulthood. We further explored age-specific models (young, middle-aged, and older adults) to determine salient risk factors for each group.</p><p><strong>Conclusion: </strong>This study highlights the need for comprehensive suicide prevention approaches that consider both individual and contextual risk factors, as well as unique risks in each stage of adulthood.</p>","PeriodicalId":39684,"journal":{"name":"Suicide and Life-Threatening Behavior","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-01-24DOI: 10.1111/sltb.13045
Jessica V Weatherford, Allison K Ruork, Qingqing Yin, Ana C Lopez, Shireen L Rizvi
Introduction: Borderline personality disorder (BPD) is a disorder of pervasive emotion dysregulation associated with high rates of self-injurious thoughts and behaviors (SITB). Understanding specific emotion states in relation to SITB is important for effective intervention.
Methods: The current study examined whether, and how, the specific emotion of shame contributes to suicide ideation and urges to engage in non-suicidal self-injury (NSSI) both directly, and indirectly via anger, among individuals with BPD. Participants (N = 100) were enrolled in a 6-month comprehensive dialectical behavior therapy (DBT) program and provided daily ratings of shame, anger, suicide ideation, and urges for NSSI.
Results: We found that higher daily ratings of shame and anger were directly associated with higher same-day ratings of both suicidal ideation and urges for NSSI. Furthermore, anger partially mediated the relationships between shame and both suicidal ideation and urges for NSSI.
Conclusion: These findings highlight shame and anger as potential antecedents of SITB among individuals with BPD. Clinical approaches, such as DBT, that include personalized, ongoing, clinical assessment of these specific affective states may be particularly important for treatment of SITB.
{"title":"Shame, suicidal ideation, and urges for non-suicidal self-injury among individuals with borderline personality disorder receiving dialectical behavior therapy: The mediating role of anger.","authors":"Jessica V Weatherford, Allison K Ruork, Qingqing Yin, Ana C Lopez, Shireen L Rizvi","doi":"10.1111/sltb.13045","DOIUrl":"10.1111/sltb.13045","url":null,"abstract":"<p><strong>Introduction: </strong>Borderline personality disorder (BPD) is a disorder of pervasive emotion dysregulation associated with high rates of self-injurious thoughts and behaviors (SITB). Understanding specific emotion states in relation to SITB is important for effective intervention.</p><p><strong>Methods: </strong>The current study examined whether, and how, the specific emotion of shame contributes to suicide ideation and urges to engage in non-suicidal self-injury (NSSI) both directly, and indirectly via anger, among individuals with BPD. Participants (N = 100) were enrolled in a 6-month comprehensive dialectical behavior therapy (DBT) program and provided daily ratings of shame, anger, suicide ideation, and urges for NSSI.</p><p><strong>Results: </strong>We found that higher daily ratings of shame and anger were directly associated with higher same-day ratings of both suicidal ideation and urges for NSSI. Furthermore, anger partially mediated the relationships between shame and both suicidal ideation and urges for NSSI.</p><p><strong>Conclusion: </strong>These findings highlight shame and anger as potential antecedents of SITB among individuals with BPD. Clinical approaches, such as DBT, that include personalized, ongoing, clinical assessment of these specific affective states may be particularly important for treatment of SITB.</p>","PeriodicalId":39684,"journal":{"name":"Suicide and Life-Threatening Behavior","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139543195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2023-12-11DOI: 10.1111/sltb.13031
Kirsten Christensen, Sarah E Victor, Andrew K Littlefield, Sean M Mitchell
Introduction: Non-suicidal self-injury (NSSI) urges and behaviors are associated with lower perceived social support and related constructs (e.g., perceived rejection). However, no studies have examined the concordance of retrospective (baseline) and ecological momentary assessment (EMA) perceived social support assessments. Retrospective and EMA reports are often only weakly to moderately correlated; measurement approaches may, therefore, impact observed associations between variables. We tested whether average EMA-reported perceived emotional social support uniquely predicts EMA-reported NSSI urges and behaviors above baseline-reported retrospective self-report of perceived emotional social support alone.
Methods: 93 young adults (ages 18-34) with past-month NSSI urges or behaviors and lifetime NSSI behaviors completed a semi-structured interview, self-report surveys, and a 2-week EMA protocol.
Results: Baseline- and EMA-reported perceived emotional social support were positively correlated (Kendall's tau-b = 0.51). Average EMA-reported social support was uniquely associated with EMA-reported NSSI urges but not NSSI behaviors.
Conclusions: EMA-reported perceived emotional social support captured information not represented by baseline reports alone, but improvement in model fit was modest. EMA-reported social support may further improve the estimation of EMA-reported NSSI urges if modeled as a proximal predictor of NSSI. Further work is needed to clarify temporal directions between social support and NSSI urges. Limitations are discussed.
简介非自杀性自伤(NSSI)冲动和行为与较低的感知社会支持和相关结构(如感知排斥)有关。然而,目前还没有研究对回顾性(基线)和生态瞬间评估(EMA)感知社会支持评估的一致性进行研究。回顾性报告和 EMA 报告通常只有弱到中等程度的相关性;因此,测量方法可能会影响观察到的变量之间的关联。我们测试了EMA报告的平均感知情感社会支持是否能独特地预测EMA报告的NSSI冲动和行为,而不是仅仅预测基线报告的感知情感社会支持的回顾性自我报告。方法:93名有上月NSSI冲动或行为和终生NSSI行为的年轻成年人(18-34岁)完成了半结构化访谈、自我报告调查和为期2周的EMA方案:基线和 EMA 报告的感知情感社会支持呈正相关(Kendall's tau-b = 0.51)。平均 EMA 报告的社会支持与 EMA 报告的 NSSI 冲动独特相关,但与 NSSI 行为无关:结论:EMA 报告的感知情感社会支持捕捉到了基线报告所不能代表的信息,但对模型拟合度的改善不大。如果将 EMA 报告的社会支持作为 NSSI 的近端预测因子,可能会进一步改善对 EMA 报告的 NSSI 冲动的估计。还需要进一步的工作来明确社会支持和 NSSI 冲动之间的时间方向。本文还讨论了研究的局限性。
{"title":"A comparison of retrospectively reported and ecological momentary assessment-reported perceived social support in predicting ecological momentary assessment-reported non-suicidal self-injury.","authors":"Kirsten Christensen, Sarah E Victor, Andrew K Littlefield, Sean M Mitchell","doi":"10.1111/sltb.13031","DOIUrl":"10.1111/sltb.13031","url":null,"abstract":"<p><strong>Introduction: </strong>Non-suicidal self-injury (NSSI) urges and behaviors are associated with lower perceived social support and related constructs (e.g., perceived rejection). However, no studies have examined the concordance of retrospective (baseline) and ecological momentary assessment (EMA) perceived social support assessments. Retrospective and EMA reports are often only weakly to moderately correlated; measurement approaches may, therefore, impact observed associations between variables. We tested whether average EMA-reported perceived emotional social support uniquely predicts EMA-reported NSSI urges and behaviors above baseline-reported retrospective self-report of perceived emotional social support alone.</p><p><strong>Methods: </strong>93 young adults (ages 18-34) with past-month NSSI urges or behaviors and lifetime NSSI behaviors completed a semi-structured interview, self-report surveys, and a 2-week EMA protocol.</p><p><strong>Results: </strong>Baseline- and EMA-reported perceived emotional social support were positively correlated (Kendall's tau-b = 0.51). Average EMA-reported social support was uniquely associated with EMA-reported NSSI urges but not NSSI behaviors.</p><p><strong>Conclusions: </strong>EMA-reported perceived emotional social support captured information not represented by baseline reports alone, but improvement in model fit was modest. EMA-reported social support may further improve the estimation of EMA-reported NSSI urges if modeled as a proximal predictor of NSSI. Further work is needed to clarify temporal directions between social support and NSSI urges. Limitations are discussed.</p>","PeriodicalId":39684,"journal":{"name":"Suicide and Life-Threatening Behavior","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11021162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138807974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-02-29DOI: 10.1111/sltb.13038
Tyler C Hein, Karen Austin, Peter P Grau, Jessica A Keith, Nathan J Claes, Nicholas W Bowersox
Objective: Military sexual trauma (MST) has been identified as a risk factor for suicidal behavior. To inform suicide prevention efforts within the Veterans Health Administration (VHA), this study evaluates predictors of non-fatal suicide attempts (NFSAs) among VHA patients who experienced MST.
Methods: For VHA patients in fiscal year (FY) 2019 who previously screened positive for a history of MST, documented NFSAs were assessed. Using multivariable logistic regression, demographic, clinical, and VHA care utilization predictors of NFSAs were assessed.
Results: Of the 212,215 VHA patients who screened positive for MST prior to FY 2019 and for whom complete race, service connection, and rurality information was available, 1742 (0.8%) had a documented NFSA in FY 2019. In multivariable logistic regression analyses, total physical and mental health morbidities were not associated with NFSA risk. Predictors of a documented NFSA included specific mental health diagnoses [adjusted odds ratio (aOR) range: 1.28-1.94], receipt of psychotropic medication prescriptions (aOR range: 1.23-2.69) and having a prior year emergency department visit (aOR = 1.32) or inpatient psychiatric admission (aOR = 2.15).
Conclusions: Among VHA patients who experienced MST, specific mental health conditions may increase risk of NFSAs, even after adjustment for overall mental health morbidity. Additionally, indicators of severity of mental health difficulties such as receipt of psychotropic medication prescriptions and inpatient psychiatric admissions are also associated with increased risk above and beyond risk associated with diagnoses. Findings highlight targets for suicide prevention initiatives among this vulnerable group within VHA and may help identify patients who would benefit from additional support.
{"title":"Predictors of non-fatal suicide attempts among Veterans Health Administration (VHA) patients who experienced military sexual trauma.","authors":"Tyler C Hein, Karen Austin, Peter P Grau, Jessica A Keith, Nathan J Claes, Nicholas W Bowersox","doi":"10.1111/sltb.13038","DOIUrl":"10.1111/sltb.13038","url":null,"abstract":"<p><strong>Objective: </strong>Military sexual trauma (MST) has been identified as a risk factor for suicidal behavior. To inform suicide prevention efforts within the Veterans Health Administration (VHA), this study evaluates predictors of non-fatal suicide attempts (NFSAs) among VHA patients who experienced MST.</p><p><strong>Methods: </strong>For VHA patients in fiscal year (FY) 2019 who previously screened positive for a history of MST, documented NFSAs were assessed. Using multivariable logistic regression, demographic, clinical, and VHA care utilization predictors of NFSAs were assessed.</p><p><strong>Results: </strong>Of the 212,215 VHA patients who screened positive for MST prior to FY 2019 and for whom complete race, service connection, and rurality information was available, 1742 (0.8%) had a documented NFSA in FY 2019. In multivariable logistic regression analyses, total physical and mental health morbidities were not associated with NFSA risk. Predictors of a documented NFSA included specific mental health diagnoses [adjusted odds ratio (aOR) range: 1.28-1.94], receipt of psychotropic medication prescriptions (aOR range: 1.23-2.69) and having a prior year emergency department visit (aOR = 1.32) or inpatient psychiatric admission (aOR = 2.15).</p><p><strong>Conclusions: </strong>Among VHA patients who experienced MST, specific mental health conditions may increase risk of NFSAs, even after adjustment for overall mental health morbidity. Additionally, indicators of severity of mental health difficulties such as receipt of psychotropic medication prescriptions and inpatient psychiatric admissions are also associated with increased risk above and beyond risk associated with diagnoses. Findings highlight targets for suicide prevention initiatives among this vulnerable group within VHA and may help identify patients who would benefit from additional support.</p>","PeriodicalId":39684,"journal":{"name":"Suicide and Life-Threatening Behavior","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-01-15DOI: 10.1111/sltb.13042
Erik J Reinbergs, Megan L Rogers, Jacqueline R Anderson, Sarah M Pryor
Introduction: Firearms are the most frequent means of youth suicide for the 14-18-year-old age group, and adolescent firearm access confers substantial increases in the risk of suicidal behaviors. There have been significant increases in firearm purchases and firearm violence in the United States since the onset of the COVID-19 pandemic.
Methods: This study uses four time points of nationally representative data from the Youth Risk Behavior Survey (YRBS) from 2015 to 2021 to examine the differential associations of reporting having carried a firearm and suicide-related outcomes, after controlling for relevant demographic factors. As a sensitivity analysis, we examined whether a similar risk pattern was seen for the probability of reporting depressed mood.
Results: Results reveal significant increases in suicide-related outcomes among students who reported carrying a firearm and no significant increases among those who did not. Unlike the suicide-related outcomes, increases in depressed mood overtime were not limited to students who carried firearms, suggesting that the risk associated with firearms may be specific to suicide-related outcomes.
Conclusions: Carrying a firearm is associated with significant increases in the risk of suicidal ideation and behaviors among youth and this risk has increased between 2015 and 2021. Implications for youth suicide prevention and directions for future research are discussed.
{"title":"Firearm carrying and adolescent suicide risk outcomes between 2015 and 2021 across nationally representative samples.","authors":"Erik J Reinbergs, Megan L Rogers, Jacqueline R Anderson, Sarah M Pryor","doi":"10.1111/sltb.13042","DOIUrl":"10.1111/sltb.13042","url":null,"abstract":"<p><strong>Introduction: </strong>Firearms are the most frequent means of youth suicide for the 14-18-year-old age group, and adolescent firearm access confers substantial increases in the risk of suicidal behaviors. There have been significant increases in firearm purchases and firearm violence in the United States since the onset of the COVID-19 pandemic.</p><p><strong>Methods: </strong>This study uses four time points of nationally representative data from the Youth Risk Behavior Survey (YRBS) from 2015 to 2021 to examine the differential associations of reporting having carried a firearm and suicide-related outcomes, after controlling for relevant demographic factors. As a sensitivity analysis, we examined whether a similar risk pattern was seen for the probability of reporting depressed mood.</p><p><strong>Results: </strong>Results reveal significant increases in suicide-related outcomes among students who reported carrying a firearm and no significant increases among those who did not. Unlike the suicide-related outcomes, increases in depressed mood overtime were not limited to students who carried firearms, suggesting that the risk associated with firearms may be specific to suicide-related outcomes.</p><p><strong>Conclusions: </strong>Carrying a firearm is associated with significant increases in the risk of suicidal ideation and behaviors among youth and this risk has increased between 2015 and 2021. Implications for youth suicide prevention and directions for future research are discussed.</p>","PeriodicalId":39684,"journal":{"name":"Suicide and Life-Threatening Behavior","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139467056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-01-22DOI: 10.1111/sltb.13043
Harun Khan, Catherine Barber, Deborah Azrael
Objectives: Suicide by sodium nitrite may be an emerging trend in the United States. Our mixed-methods study aims to: (1) describe the rates of suicides secondary to sodium nitrite self-poisoning in the United States between 2018 and 2020 and (2) characterize the use of sodium nitrite as a suicide method.
Methods: Using NVDRS data, descriptive statistics, population-based incident rates/year and incidence estimates across 50 states were calculated. An inductive thematic analysis characterized the use of sodium nitrite as a suicide method on review of medical examiner and law enforcement reports.
Results: 260 incidents were identified as suicides secondary to self-poisoning with sodium nitrite/nitrate across 37 states and 1 territory-69% of which occurred in 2020. The typical victim was a white male student with a known depressive disorder and a history of suicidal thoughts (n = 120). The annual suicide rate using sodium nitrite increased from 0.01-0.09/100,000 person-years over the three-year period. Online forums were used to share knowledge on the procurement and preparation of sodium nitrite poisoning.
Conclusions: Sodium nitrite self-poisoning is an increasingly used planned suicide method among young people. Further studies are required to identify the impact of means safety interventions on the incidence of sodium nitrite self-poisoning incidents.
{"title":"Suicide by sodium nitrite poisoning: Findings from the National Violent Death Reporting System, 2018-2020.","authors":"Harun Khan, Catherine Barber, Deborah Azrael","doi":"10.1111/sltb.13043","DOIUrl":"10.1111/sltb.13043","url":null,"abstract":"<p><strong>Objectives: </strong>Suicide by sodium nitrite may be an emerging trend in the United States. Our mixed-methods study aims to: (1) describe the rates of suicides secondary to sodium nitrite self-poisoning in the United States between 2018 and 2020 and (2) characterize the use of sodium nitrite as a suicide method.</p><p><strong>Methods: </strong>Using NVDRS data, descriptive statistics, population-based incident rates/year and incidence estimates across 50 states were calculated. An inductive thematic analysis characterized the use of sodium nitrite as a suicide method on review of medical examiner and law enforcement reports.</p><p><strong>Results: </strong>260 incidents were identified as suicides secondary to self-poisoning with sodium nitrite/nitrate across 37 states and 1 territory-69% of which occurred in 2020. The typical victim was a white male student with a known depressive disorder and a history of suicidal thoughts (n = 120). The annual suicide rate using sodium nitrite increased from 0.01-0.09/100,000 person-years over the three-year period. Online forums were used to share knowledge on the procurement and preparation of sodium nitrite poisoning.</p><p><strong>Conclusions: </strong>Sodium nitrite self-poisoning is an increasingly used planned suicide method among young people. Further studies are required to identify the impact of means safety interventions on the incidence of sodium nitrite self-poisoning incidents.</p>","PeriodicalId":39684,"journal":{"name":"Suicide and Life-Threatening Behavior","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139513794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}