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

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.

Background: Given the known bidirectional relationship between trauma and suicide, there is a critical need for suicide prevention efforts to be grounded in a trauma-informed approach. Aims: The purpose of this scoping review is to identify and map the current literature base for trauma-informed approaches to suicide prevention across all levels of prevention, settings, and population groups. Methods: A systematic search was conducted in seven academic databases, with results screened in duplicate. Results: 27 papers (n = 1 systematic review, n = 2 mixed methods, n = 8 qualitative, n = 5 quantitative, n = 11 discussion papers) were eligible for inclusion, primarily published in the past five years, mostly from the United States. The majority focus on children/young people, at the selective or indicated level. Lived experience leadership is lacking, and most do not explore suicide-specific outcomes. Limitations: The results may not represent global trauma-informed suicide prevention strategies, and the paper does not evaluate the effectiveness of these approaches. Conclusion: The explicit application of trauma-informed care to suicide prevention strategies has been a much-needed addition to the recent academic literature. More work is needed to ensure this approach is embedded across all levels of suicide prevention, with lived experience involvement, to better support individuals, communities, and the workforce.

Background: A majority of research concerning media impacts on suicide has focused on the harmful impacts. In contrast, the present study focuses on positive media impacts, the Papageno effect. The central hypothesis is that the higher the exposure of the public to films portraying a story of a suicidal person who ultimately recovers, the lower the suicide rate. Methodology: Data on suicides per 100,000 were from the US Public Health Service. Seven online film bibliographies were searched to include American films that (1) contained a person initially attempting suicide and then conquering their problems and (2) were in the top 50 at the box office. The number of such portrayals per year comprised the chief independent variable, while adjustments were made for three core theoretical constructs. Results: Sixty-one narratives met the inclusion criteria. An AR-1 Cochrane-Orcutt multivariate analysis showed that controlling for the other predictors, each additional exposure to a Papageno story significantly decreased the suicide rate (b = -.059, SE = .023, t = -2.51, p = .015). The full model explained 89% of the variance. Limitations: Only half a century was assessed. Conclusion: This is the first analysis linking the yearly frequency of Papageno narratives to a lower national suicide rate.

Background: Suicidal ideation changes over time. Few studies have examined socioeconomic inequalities in suicide ideation regarding interrelated indicators of incidence, persistence, and remission. Aim: We aimed to investigate how socioeconomic characteristics are related to the incidence, persistence, and remission of suicidal ideation in South Korea. Methods: We assessed the incidence of suicidal ideation at the 1-year follow-up among individuals without prior suicidal ideation and its persistence and remission at the 2-year follow-up. We conducted a multinomial logistic regression analysis to examine the association between SES and three indicators of the course of suicidal ideation. Results: Among 8,334 respondents, the 12-month incidence of suicidal ideation was 2.1%. Among these cases, 18.5% persisted, while 81.5% remitted. Low SES, particularly income, was strongly associated with the incidence, persistence, and remission of suicidal ideation. The socioeconomic association was strongest for persistent suicidal ideation (adjusted odds ratio [aOR]: 3.66; 95% confidence interval [CI]: 1.47-9.10), followed by incidence (aOR: 1.59; 95% CI: 1.10-2.29) and remission (aOR: 1.32; 95% CI: 0.88-1.97) of suicidal ideation. Limitations: We could not examine changes in these risk factors during the follow-up period. Conclusion: Adverse socioeconomic circumstances may precipitate the worsening in the course of suicidal ideation. Addressing the socioeconomic determinants of suicidal ideation should be prioritized.

Background: Sexual fluidity (SF) is common among adolescence and has been previously linked to experiences of psychological distress and suicidal thoughts (ST). Aims: To explore the relationship SF and ST in adolescence while accounting for the impact of school belonging, social connectedness, and parental relationships. Methods: Using W1 and W2 of the ADD Health, participants were categorized into four groups: (1) consistently heterosexual, (2) SF sexual minority (SM) to heterosexual, (3) SF heterosexual to SM, and (4) SM at both waves. Results: Hierarchical logistic regression revealed that sexual fluidity between Waves 1 and 2 was associated with ST with those in the SM-SM group and Het-SM group. However, after accounting for social connectedness, school belonging, and parental relationship, the risk among the sexually fluid group (Het-SM) was no longer significant. Additionally, mediation analysis found that there were no significant indirect effects of sexual fluidity on suicidal thoughts. Limitations: ADD Health W1 and W2 are from the mid-1990s, SM questions are limited in responses, and there are no direct questions relevant to sexual fluidity. Conclusion: Findings suggest that sexual fluidity is related to suicidal thoughts only through its shared relationship with belongingness and connectedness variables. Greater reporting of belonging and connectedness was associated with reductions in reporting of suicidal thoughts.

Background: The relative risk of subsequent suicidal behaviors (and suicide mortality) is high following an episode of hospital-treatment for suicidal behavior. This study evaluated the effectiveness of telehealth aftercare interventions in reducing suicidal behaviors. Methods: A systematic review was conducted using 13 online databases (from inception until July 2024). Analyses included narrative synthesis and random effects meta-analyses based on study design. Risk of bias was assessed by Cochrane tools. Results: We identified n = 14 studies involving n = 14,420 participants. Pooled effect estimates compared to usual treatment showed nonsignificantly reduced suicidal behavior in nonrandomized controlled trials (RR, 0.676 [CI 95% 0.453-1.008]), (7 studies), but no difference in randomized controlled trials (RR, 0.929 [CI 95% 0.734-1.175]) (6 studies, one study precluded analysis). The overall risk of bias was high across studies. Limitations: Many studies were underpowered, telehealth was often delivered in combination with other interventions, and the mode of telehealth was limited to telephone. Conclusions: Telehealth does not appear to confer benefit above usual treatment for suicidal behavior during follow-up, although the small number of studies and high risk of bias limits confidence in the precision of estimates of effect size. Further research might use well-designed studies to examine different clinical end points for suicidal behavior (number of or time to events) or other outcomes (retention in aftercare or other healthcare treatment).

Aims: The study aim was to determine whether brief online suicide awareness training could increase rail workers': (1) knowledge about how to intervene safely with someone at risk on the rail; (2) belief that the rail industry could help to reduce suicides on the rail; (3) confidence to intervene with someone at risk on the rail; and (4) likelihood that they would intervene with someone at risk on the rail. Method: 1,050 rail workers completed the training and pre-/postsurveys designed to assess the impact of the training. We calculated the proportional mean change between the pre- and postintervention periods for each outcome. Results: Significant increases were observed across all outcomes. For rail workers' knowledge of how to intervene safely the proportional mean difference was 1.15 (95% CI: 1.14 to 1.16), for belief that rail workers can help to reduce rail suicides it was 1.14 (95% CI: 1.13 to 1.16), for confidence to intervene with someone at risk on the rail it was 1.24 (95% CI: 1.22 to 1.27), and for likelihood of intervention with someone at risk on the rail it was 1.03 (95% CI: 1.02 to 1.05). Limitations: This study relied on a pre-/postdesign without a control group, limiting causal inferences. Conclusion: Brief online suicide prevention awareness training appears to be effective in improving outcomes.