Crisis-The Journal of Crisis Intervention and Suicide Prevention最新文献

Background: Disclosure of a stigmatized experience such as suicidal thoughts and behaviors can have both positive and negative consequences. While online social media platforms have become an increasingly prevalent mode of disclosure for suicide attempt survivors, it remains unclear how suicide attempt survivors perceive online disclosures. Aims: We sought to explore the advantages and disadvantages of suicide-related disclosure via social media, from the perspective of suicide attempt survivors. Method: As part of a larger study, we analyzed responses from qualitative interviews with suicide attempt survivors (n = 18) and coded responses around advantages and disadvantages of disclosing via social media. Results: Advantages of social media disclosure discussed by participants were: anonymity, easy connection to support, and opportunity to support others. Disadvantages of disclosure via social media included: potential for triggering others, negative responses (e.g., trolling, cyberbullying), communication barriers, and the perception of attention-seeking. Limitations: The sample was a relatively small convenience sample who were open enough about their experiences with suicide to participate in research interviews. Conclusion: Quantitative methods are warranted to determine the relative salience of advantages and disadvantages. Future investigations might delve into the decision-making process of suicide-related disclosure via social media and develop guidance for making disclosure decisions.

Background/Aims: This study examines how normative beliefs (human rights-based and rationality-based) about suicide aligned with their support for compulsory psychiatric treatment. Method: A national telephone survey of 1,087 Taiwanese participants was conducted to assess opinions on suicide rights, suicide rationality, and psychiatric intervention. Multinominal logistic regression analyzed the relationship between beliefs about suicide and attitudes toward compulsory intervention. Results: Between 68.9% and 83.7% of the sample supported involuntary treatments, with 37.6% acknowledging the right to suicide and 24.7% considering suicide rational. Belief in this right did not correlate with support for compulsory treatment. However, those viewing suicide as rational were less likely to support compulsory psychiatric referral for those with, or without, mental illness (adjusted odds ratio [aOR] = 0.39, 95% confidence interval [CI] 0.27-0.57, p ≤.001; aOR = 0.29, 95% CI 0.16-0.53, p ≤.001) and compulsory psychiatric admission (aOR = 0.36, 95% CI 0.25-0.54, p ≤.001). Limitation: The cross-sectional design limits causal inferences. Relevant factors such as economic status, mental health stigma, and family suicide history were not measured. Conclusion: Compulsory psychiatric treatment was widely supported in Taiwan. Belief in the right to suicide had little impact, but individuals who viewed suicide as rational were more likely to oppose the intervention. This highlights the need to address cultural narratives for mental health policymaking.

Background: Military service is a significant stressor for posttraumatic stress disorder (PTSD) and suicidal ideation (SI). The study aimed to examine direct and indirect associations between unit social support, sense of coherence (SOC), PTSD, and SI. Method: This cross-sectional study included 140 Israeli soldiers (M_age 20.41 [SD = 1.19]). Data were extracted from self-report questionnaires. Mediation analyses were used to evaluate direct and indirect associations between unit social support (DRRI-2), SOC (SOC-13), PTSD (PCL-5), and SIS (Beck Suicide Ideation Scale). Results: Correlational analyses revealed that unit social support and SOC were positively related to each other, while both were negatively associated with PTSD symptoms and SI. A positive relationship existed between PTSD symptoms and SI, confirming their connection. Path analyses revealed two main patterns: first, unit social support was negatively associated with SI, but this relationship worked via two pathways, one through its negative relationship with PTSD symptoms and one through its positive relationship with SOC. Second, SOC was negatively associated with SI, primarily by reducing PTSD symptoms. Limitations: This is a cross-sectional study with no experimental manipulation; causal inferences are limited. Conclusion: SOC is negatively related to PTSD and SI, a finding in-line with longitudinal studies, which reveal SOC's buffering effect on these two outcomes. This highlights the importance of interventions aimed at enhancing soldiers' SOC, which could contribute to mitigating suicidality.

Background: Empathy plays a crucial role in motivating community engagement in suicide prevention. However, its relationship with helping behavior is not linear and can be influenced by moderating variables. Objective: This study examined the moderating role of self-efficacy and suicide-related knowledge (factual and perceived) in the relationship between empathy and the willingness to help. Method: Participants (N = 1,096) were recruited via social media and completed an online survey assessing sociodemographic data, empathy, willingness to help individuals at risk of suicide, intervention self-efficacy, and suicide-related knowledge (factual and perceived). Results: The moderation analyses showed that perceived knowledge is the main moderator of the relationship between empathy and willingness to help people at risk of suicide, with this association strengthening as perceived knowledge increases. Limitations: The cross-sectional design and use of convenience sampling restrict causal inference and reduce the generalizability of the findings. Conclusion: Multiple factors that shape the relationship between empathy and willingness to help in at-risk situations should be considered when developing intervention programs that promote empathy as a suicide prevention strategy.

Background: Signage designed to encourage help-seeking is a suicide prevention intervention used at public sites where suicides occur. Aims: We aimed to investigate the perspectives of people with lived experience of suicide on signs that are designed to encourage help-seeking. Method: We conducted a qualitative study using semistructured interviews undertaken in Melbourne, Australia, during April 2021. We showed participants photos of existing Lifeline (Australia's largest national crisis support line) signage used at public sites that are known for suicide and asked for their feedback. We used a deductive coding approach, guided by the interview topics and study aims. Results: We interviewed 12 participants, and most had previously seen such signs and could recollect elements of these. Participants considered that empathetic and uncomplicated messaging was important and viewed Lifeline branding favorably. Signs that participants perceived as unhelpful were those that contain multiple or unclear messaging, or messaging considered patronizing. The use of the word crisis was also viewed unfavorably by some. Limitations: Study limitations include our small sample size and our broad definition of lived experience. Conclusion: Our results may be of use to organizations looking to create or update signs. Future signs should be codesigned with people with lived experience of suicide.

Background: Suicide is a growing public health concern in India, with Kerala being one of the states with the highest suicide rates. Responsible media reporting is a crucial population-level suicide prevention strategy. However, the quality of suicide reporting in newspapers remains a concern. Aim: To assess the quality of newspaper reports of suicide in Kerala, India, against the World Health Organization (WHO) media guidelines for reporting suicide. Method: Content analysis of suicide reports published by the 11 most widely circulated Malayalam daily newspapers in Kerala, between June and November 2023. Results: A total of 1,068 suicide news reports were analyzed. Harmful reporting practices, such as reporting the method used (90.9%), mentioning negative life events (36.8%), stating the method in headlines (46.7%), and using photographs of the deceased (69.9%), were common, while helpful practices, such as providing contact details of helplines (0.7%), were rare. Limitations: The study is limited to print newspaper reports and does not examine suicide reporting in other media formats. Additionally, it focuses only on Malayalam newspapers in Kerala. Conclusion: The study highlights a low level of adherence to WHO guidelines indicating the need for effective dissemination of the guidelines and training of media professionals.

Background: Although emotion dysregulation and adverse childhood experiences (ACEs) are key psychosocial risk factors for suicidal ideation and suicide attempts, it remains unclear which specific dimensions of these factors can distinguish the transition from ideation to attempts. Aims: To determine whether specific dimensions of emotion dysregulation and adverse childhood experiences differentiate young adults with histories of suicidal ideation from those with histories of suicide attempts. Method: A sample of 418 young adults (63% non-Latinx White; 71% female; M = 23.56, SD = 2.85) completed measures of ACEs, emotion dysregulation, and suicidal ideation and attempts. Multinomial logistic regression assessed how specific dimensions of emotion dysregulation and ACEs predicted membership in three groups: no history of ideation or attempts, ideation only, and attempt history, controlling for depressive symptoms, age, and gender. Results: The suicidal ideation group reported greater cumulative ACEs and depressive symptoms than those without ideation/attempt history. The suicide attempts group reported greater ACEs and difficulties with goal-directed behavior than the other two groups. Difficulties engaging in goal-directed behavior and emotional awareness were more predictive of membership in the suicide attempts than the suicidal ideation group. Limitations: The cross-sectional, retrospective design, and predominantly White female sample limit causal inferences and generalizability. Conclusion: Focusing on specific emotion regulation strategies may improve outcomes for young adults at risk for suicidal ideation and attempts and with a history of ACEs. Goal-directed behavior and emotional awareness offer promising targets for intervention to reduce suicide risk in this population.

Background: Taiwan is among the few jurisdictions adopting a legislative approach to suicide prevention; a Suicide Prevention Act was implemented in June 2019. Aim: This study evaluates overall, age-, sex-, and method-specific suicide rates before and after the implementation of the Act. Methods: Monthly suicide mortality data from 2015 to 2023 were analyzed using interrupted time-series analysis using segmented regression with a quasi-Poisson distribution. Incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were reported. Results: An immediate 10.1% reduction in overall suicide rates was observed after the enactment of the Suicide Prevention Act (IRR = 0.899, 95% CI = 0.837-0.966), although long-term trends remained unchanged. Hanging suicides declined steadily (IRR = 0.996, 95% CI = 0.993-0.999), while jumping suicides rose. Youth suicides (15-24 years) stabilized postintervention, and the 45-64-year age group experienced a significant decline (IRR = 0.849, 95% CI = 0.764, 0.942). In contrast, suicide rates among older adults (≥65 years) increased. Limitations: Unmeasured factors may have affected the results. Some components of the plan began before the Act, limiting attribution of effects solely to the law. Conclusion: Taiwan's legislative approach may have helped stabilize suicide rates, especially among youth and middle-aged adults. Ongoing efforts should focus on older adults and shifts in suicide methods.

Background: Meta-analytic evidence indicates that there tends to be an increase in suicides in the period after news reporting on celebrity suicides. Importantly, this evidence relies on original research, including present-day celebrities who died by suicide. Aim: The present paper supplements this perspective by providing historical evidence, testing whether celebrity suicide news was related to increases in suicides in fin-de-siècle Vienna (1890-1913). Method: Significant figures (N = 58) were identified using the Austrian Biographical Dictionary. Civil death registers for the city of Vienna were used to identify suicides occurring in periods immediately after a given celebrity's death (and in the control periods). A content analysis assessed media attention. Results: Media attention was positively related to increases in suicides, a finding consistent with the Werther effect hypothesis. However, the analysis indicated that only one suicide with massive media attention drove this association - Colonel Redl's suicide in 1913. Limitations: Causal interpretations are limited. Conclusion: Colonel Redl's suicide seems to hold a special historical position. This historical evidence supplements the available meta-analytic evidence on celebrity suicide news effects occurring today.