Archives of Suicide Research最新文献

Objective: Males are at increased risk for suicide, yet less likely to seek and maintain professional help. This discrepancy suggests that current healthcare services may not be adequately tailored to males' needs. This study explores the experiences, barriers, and needs of healthcare providers (HCPs) in supporting males with suicidal ideation and behaviors to inform gender-sensitive mental healthcare practices.

Methods: A mixed-method design was used, combining quantitative data from questionnaires, with qualitative data from focus groups, interviews and open-ended questionnaire responses.

Results: A total of 128 HCPs from diverse professions and settings in Flanders (Dutch-speaking part of Belgium) filled in the questionnaires, eight participated in interviews or focus groups. The findings revealed gender differences in various aspects of treatment. HCPs reported more difficulty discussing suicidal ideation (59.4%) and underlying emotions (77.1%) with males. Males were perceived to prefer practical, goal-oriented interventions and to require more motivational interviewing (46.9%) and psychoeducation (46.9%). Qualitative analyses provided further insight into possible mechanisms behind these gender differences, emphasizing the influence of societal stigma and traditional gender norms on males' socialization and emotional expression. HCPs noted that males often sought care only during acute suicidal crises.

Conclusions: This mixed-method study provides valuable insights into the needs and experiences of HCPs in supporting males with suicidal thoughts. The findings underscore the importance of gender-responsive practices in mental healthcare to address systemic barriers faced by males with suicidal ideation. Tailored interventions, destigmatization efforts, and enhanced HCP training are essential to improve engagement and outcomes for this high-risk group.

Objective: This study explored demographic characteristics of people who disclosed self-harm ideation (SHI) or behaviors (SH) and their accessing of mental health services (MHS) during three government-declared waves of the COVID-19 pandemic in Ontario, Canada.

Methods: We analyze the results of a cross-sectional survey of adults in Ontario aged 18 years or older, representative of the provincial population based on age, gender, and location. The survey was conducted using Delvinia's AskingCanadians panel at three timepoints: August 2020 (n = 2500), March 2021 (n = 2500), and March 2022 (n = 5000). Accessing of MHS was identified in a subsample of survey respondents who reported SHI (wave 1, August 2020, N = 421) and SH (wave 2, March 2021, N = 105; wave 3, March 2022, N = 259). Chi-square tests, Fisher's exact test, and binary logistic regression were employed to identify associations between service access and demographics across waves.

Results: The survey in wave 1 identified 421 respondents with SHI (16.8%). Surveys in wave 2 and 3 identified 105 (4.1%) and 259 respondents (5.2%), respectively with SH. The majority of respondents who disclosed SHI (wave 1) and SH in wave 2 did not access MHS [wave 1 (36.3%); wave 2 (46.7%)], whereas more accessed MHS in wave 3 (60.6%). Older adults, men, people living with others, and in rural areas were less likely to access MHS overall.

Conclusions: MHS access is a key component of comprehensive suicide prevention and intervention. Future prevention efforts should aim to increase MHS access, particularly in specific demographic groups, ensuring timely service access.

Background: In a recent Norwegian regional suicide prevention media campaign, we found small and inconclusive results regarding changes in attitudes to suicide and help-seeking. In this exploratory study we add the data from two other Norwegian regional campaigns, aiming to generate clearer results through a larger sample.

Methods: We compared the attitudes to suicide, mental illness and help-seeking before and after a media campaign carried out in the three regions of Mid-, West-, and South-Norway at different time periods in 2022 and 2023. In total, 3234 adults sampled from the general population and stratified according to sex, age, and geographical location participated in two surveys before and after the campaigns.

Results: When analyzing the entire sample, there was no overall change in attitudes to suicide, mental illness and help-seeking from pre to post campaign. In the subgroup of men who had noticed the campaign (n = 644, 10% of the sample), however, there was a significant reduction in two out of ten undesirable attitudes to suicide. No such changes were seen in the female respondents who had noticed the campaign. For all the statistically significant changes, the effect sizes were small.

Conclusion: Although we found no overall change in attitudes after suicide preventive media campaigns, small changes, such as increased suicide preventive and mental health literacy, occurred in the male subgroup of those who have been exposed to the campaigns. Future suicide prevention media campaigns should consider targeting subgroups with elevated risk for suicide instead of the entire population. In addition, there are methodological aspects of the current exploratory study that should be investigated further.

Objective: The aim of this study is to examine the relationships between defeat, entrapment, and suicidal ideation among emerging adults (operationally defined as ages 18-26) within the framework of the Motivational Phase of the Integrated Motivation-Volitional (IMV) Model and to test the moderating roles of self-critical rumination and social ostracism and its forms (ignored and excluded) in these relationships.

Method: The study used a cross-sectional design with self-report data from 503 emerging adults in Türkiye. Mediation and moderating analyses were conducted using IBM SPSS 22 (PROCESS macro).

Results: In the association between defeat and suicidal ideation, entrapment functioned as a partial mediator. In the association between defeat and entrapment, self-critical rumination functioned as a buffering moderator. In the association between entrapment and suicidal ideation, being ignored functioned as a reinforcing moderator, whereas excluded and social ostracism did not moderate this association.

Conclusions: The motivational stage of the IMV Model is empirically validated in the emerging adult sample in Türkiye and provides a functional framework for explaining the process leading to suicidal ideation. The study adds an additional cognitive layer to the model through self-critical rumination, revealing the dynamics of the defeat-entrapment relationship in a more nuanced way. Furthermore, by examining social ostracism and its forms (ignored and excluded), it makes an important contribution to how social threats and relational vulnerabilities intersect with the motivational processes conceptualized in the model.

Objective: Bisexual + people experience higher rates of suicidality and self-harm compared to heterosexual and lesbian/gay people. We examined the association between sexual violence (SV) and suicidality, current urges to self-harm, and current suicidal intent among bisexual + college students. We tested whether posttraumatic stress disorder (PTSD) symptoms would explain these links and whether discrimination due to sexual minority identity (i.e., heterosexism) would exacerbate the association between SV severity and PTSD symptoms.

Method: Students were recruited from two large, public minority-serving universities. A subsample of 454 bisexual + students (ages 18-25; 73.6% cisgender women, 15.4% gender minority, 10.8% cisgender men; 50.2% White, 22.2% Black, 15.9% Asian; 21.8% Hispanic/Latino/a/x) were selected for the current study. Two indirect effects models were tested examining: (1) suicidality in the full sample, and (2) current urges to self-harm and suicidal intent in a subsample of 244 bisexual + students who screened positive for suicide risk.

Results: There was no interaction between SV severity and heterosexism. Both SV severity and heterosexism had direct associations with greater PTSD symptoms. In turn, greater PTSD symptoms explained the associations of SV severity and heterosexism with greater suicidality and likelihood to report current urges to self-harm and current suicidal intent.

Conclusions: SV severity and heterosexism appear to be important risk factors for suicidality and self-harm via PTSD symptoms among bisexual + young adults. Results suggest the need for prevention and public health intervention efforts to reduce risk for SV and discrimination due to sexual identity in addition to individual-level interventions to reduce PTSD symptoms.

Background: Post-discharge phone interventions have shown efficacy in reducing suicide attempts during the high-risk period following psychiatric hospitalization. However, few studies have examined the feasibility and cost-effectiveness of such interventions in transitional age youth (TAY; ages 18-25), a group at elevated risk for suicidal behavior post-discharge.

Methods: TAY hospitalized psychiatrically for suicidal ideation or suicide attempt (n = 389) received a brief post-discharge telephone intervention consisting of three phone contacts within two weeks. Calls assessed suicidality and reinforced safety planning. Feasibility and costs were examined, along with predictors of outcomes (rehospitalization and suicide attempts within three months). Exploratory analyses compared the intervention cohort with a non-concurrent control group (n = 479) to tentatively examine outcome differences.

Results: Among TAY for whom an intervention attempt was made, 60.5% had at least one contact with intervention staff, with low intervention costs (<$60/person). Confidence in the safety plan on the day after discharge predicted suicidal behavior at 90 days. Exploratory analyses indicated similar rates of suicide attempts but higher rehospitalization rates in the intervention cohort versus control cohort.

Discussion: Brief, phone-based suicide prevention interventions are feasible and low-cost in real-world settings for TAY. They may help identify high-risk individuals (e.g., those with low confidence in the safety plans) to tailor additional supports. Exploratory results suggest potential benefits and feasibility, warranting further study through randomized controlled trials.

Objective: There is a need to better understand, among people experiencing suicidal ideation (SI), who is at greatest risk of transitioning to suicide attempts. The present study assessed the moderating role of emotion dysregulation in the association of SI intensity and suicide attempts among participants experiencing distress.

Method: Linear, logistic, and hurdle negative binomial models tested associations in a high-risk sample of crisis hotline callers cross-sectionally and longitudinally over a two-week follow-up. Both the likelihood of attempting suicide and the number of suicide attempts were examined.

Results: Emotion dysregulation did not moderate the association of SI intensity with the likelihood of ever attempting suicide. However, higher SI intensity was cross-sectionally associated with more suicide attempts at lower levels of emotion dysregulation. Higher SI intensity prospectively predicted higher odds of a suicide attempt at the two-week follow-up.

Conclusions: Individuals with more intense SI are more likely to attempt suicide. However, among those with intense SI and a history of attempting, better emotion regulation was unexpectedly associated with more attempts. Further research is needed to disentangle the complex interrelations between SI intensity, suicide attempts, and emotion dysregulation.

Objective: Although emotion dysregulation is a transdiagnostic risk factor for psychopathology, research typically focuses on dysregulation of negative emotions only. We investigated the contributions of dimensions of emotional experience, emotion beliefs, and non-suicidal self-injury (NSSI) to both negative and positive emotion dysregulation.

Method: 441 participants (M age = 23.65, 73.5% female, 39.0% with lifetime NSSI) reported their negative and positive emotion reactivity, intensity, perseveration, and dysregulation, as well as their NSSI history and beliefs about the controllability and usefulness of emotions.

Results: Emotion intensity, perseveration, uncontrollability beliefs, and NSSI were uniquely associated with emotion dysregulation. Counter to predictions, emotion reactivity was associated with less dysregulation. Greater perseveration was associated with greater dysregulation of both negative and positive emotions, but only for participants who believed emotions were uncontrollable. NSSI also moderated the associations between emotion experiences and dysregulation. Among individuals who self-injure, increased emotional intensity was associated with greater dysregulation of positive emotions. Among individuals who self-injure and believed emotions were more useful, increased reactivity was linked to less dysregulation of positive emotions. Conversely, for those without a NSSI history who believed emotions were less useful, increased reactivity was associated with less dysregulation of positive emotion.

Conclusion: Emotion beliefs are an important mechanism associated with dysregulation of both negative and positive emotion. Positive emotions play a complex role in dysregulation, influenced by cognitive (controllability and usefulness beliefs) and behavioral factors (NSSI), underscoring the need for future research to explore dysregulation of both negative and positive emotions to improve emotional well-being.HighlightsEmotion experiences, beliefs, and NSSI are linked toand positive and negative emotion dysregulation.Extended emotions responses are linked to dysregulation only in the context of believing emotions areuncontrollable.Similar emotion beliefs relate differently to experiences and dysregulation depending on NSSI status.

Background: Suicide is a leading cause of death among adolescents in the United States. Timely suicide-related disclosure may be a gateway to life-saving interventions and support, yet little is known about how adolescents interpret the specific responses they receive after disclosing suicide ideation (SI) or suicide attempts (SAs). Existing research has relied heavily on self-report surveys and has not captured the concrete verbal, emotional, and behavioral reactions adolescents perceive as supportive or unsupportive. This study addresses this gap by qualitatively exploring adolescents' recalled experiences of disclosure responses from both informal and formal supports.

Methods: Semi-structured interviews were conducted with 82 adolescents (ages 12-19 years) who presented for clinical care related to SI or SA within the prior two weeks. Interviews drew from the Adolescent Suicide Ideation Interview and probed disclosure decisions and perceived reactions. Data were analyzed using thematic analysis to identify patterns in supportive and unsupportive responses.

Results: Analysis revealed a range of supportive (i.e., Providing Guidance and Supportive Action, Shared Emotional Experiences, Encouragement and Affirmation, Engagement and Communication, and Physical Presence and Comfort) and unsupportive (i.e., Forcible or Coercive Action, Minimizing or Dismissing Concerns, Blame and Guilt-Inducing Responses, and Anger and Hostile Reactions) disclosure responses.

Conclusions: Supportive responses fostered safety and willingness to seek help, while unsupportive responses contributed to emotional distress and the desire to conceal in the future. Findings highlight the importance of caregiver and peer responses following suicide-related disclosure and suggest opportunities for interventions in crisis settings to enhance the disclosure experience.

Background: Stressful Life Events (SLEs) during adolescence are linked to a higher risk of suicidal behavior and nonsuicidal self-injury (NSSI). However, the specific impact of each type of SLE has been under-researched. Socio-emotional strengths, including belief in self, belief in others, Emotional Competence, and Engaged Living, are key promotive factors for mental health and may mitigate the impact of SLEs on suicidal behavior and NSSI. This study aims to systematically explore the potential indirect effects of socio-emotional strengths in the relationship between SLEs over the past year, grouped by functional areas, and indicators of suicidal behavior and NSSI.

Method: 2,283 adolescents aged 10 to 19 years (M = 13.99; SD = 1.40) participated in the study, completing scales on SLEs, socio-emotional strengths, and suicidal behavior and NSSI reported over the past year.

Results: From the sample, 13.4% of participants reported suicidal desire, 10.5% suicidal ideation, 6.6% NSSI, 5.5% suicide planning, and 2.2% suicide attempts. In the main analyses, Suicidal Behavior (Death Wishes, Ideation, Plans, Attempts) and NSSI were modeled separately. Belief-in-Self and Engaged Living were negatively associated with both outcomes, while Emotional Competence showed a small positive link with suicidal behavior. Peer and Health-Related SLEs had direct effects on both suicidal behavior and NSSI. Indirect effects emerged through Belief-in-Self and Engaged Living.

Conclusions: Socio-emotional strengths may play a protective and mediating role in the association between SLEs and Suicidal Behaviors and NSSI in adolescents. Findings highlight the relevance of targeting these strengths in school-based prevention efforts.