Archives of Suicide Research最新文献

Objective: The goal of this study was to evaluate whether concepts from the cultural theory of suicide operate as culturally specific motivational and volitional moderators on the pathways to suicidal ideation and suicide behavior as described by the integrated motivational-volitional theory within a sample of international students.

Methods: International students (n = 444) were recruited through email advertisements to complete an online survey evaluating entrapment (feelings of being trapped and unable to escape; this could be internal or external), cultural stress, cultural support, idioms of distress, cultural sanctions of suicide, and suicidal ideation and attempts.

Results: Two moderated regression models with 5,000 bootstrapped bias-corrected samples were conducted. Cultural stress was a significant moderator of the relationship between entrapment and suicidal ideation, but cultural support did not moderate the same pathway. Contrary to hypotheses, neither idioms of distress nor cultural sanctions significantly moderated the relationship between suicidal ideation and suicide attempts, although both exhibited a direct main effect. Exploratory post hoc analyses among those with suicidal ideation suggest that cultural sanctions may moderate the relationship between suicidal ideation and attempts when ideation is high.

Conclusion: Experiences of cultural stress may exacerbate the risk for suicide among international students, but the role of other cultural factors is unclear. Further research is needed to identify how cultural components and experiences impact suicide risk among international students.

Suicide is a significant public health concern globally, and deficits in problem-solving ability have been identified as an important risk factor for suicide. Through a comprehensive meta-analysis, this study aims to quantitatively synthesize the relationship between self-appraised problem-solving ability as measured by the Problem Solving Inventory (PSI) and suicidal ideation as indicated by measures of hopelessness and suicidal thoughts. The heterogeneity metrics suggested that the PSI and its subscales relate to suicide-related variables, though the strength and direction of these relationships vary across studies and populations. Despite this variability, the total PSI scale demonstrated the strongest combined effect, indicating its potential utility in suicide risk assessment. There were no significant moderating effects of age or gender composition across the studies, indicating that the relationship between perceived problem-solving abilities and suicide-related outcomes is consistent across age and gender groups. The strong association between perceived problem-solving competencies and reduced hopelessness highlights the potential of targeted interventions to enhance these skills. Such interventions could form a vital component of suicide-prevention strategies, aimed at bolstering the ability to cope with stress and adversity.HIGHLIGHTSTotal PSI scale had the largest combined effect on suicide-related variables.Self-appraised problem-solving has a pronounced association with hopelessness.Findings highlight the potential of interventions to enhance problem-solving.

Objective: Emotion-based impulsivity (EBI) and hazardous drinking have consistently been associated with elevated negative thoughts related to suicide ideation (N-SI); however, the interaction between these risk factors has not been tested empirically. Thus, we tested the moderating effect of hazardous drinking on the relation between EBI and N-SI in a high-risk adult sample.

Method: Cross-sectional, self-report data were used from adults (N = 329, M_age = 36.61 years, SD = 11.38) screened for elevated suicide risk and previous alcohol use via Amazon's Mechanical Turk crowdsourcing platform.

Results: Bivariate correlations indicated significant positive associations between EBI, hazardous drinking, and N-SI. Furthermore, hazardous drinking moderated the relation between EBI and N-SI, such that the association between EBI and N-SI was stronger among those with more severe hazardous drinking. This moderation effect was robust to the inclusion of additional covariates.

Conclusion: This study demonstrated that hazardous drinking strengthens the association between EBI and N-SI among adults with elevated suicide risk and previous alcohol use. These findings underscore the need for clinicians to fully evaluate the drinking behaviors of individuals at risk for suicide. Further directions for research are discussed.

Background: Non-suicidal self-injury (NSSI) is a pressing public health concern on college campuses, with increasing evidence highlighting cybervictimization as a critical predictor of NSSI behaviors. However, the underlying mechanisms through which cybervictimization linking to NSSI behaviors remain under elucidation and warrant further investigation.

Objective: This study aimed to investigate the relationship between cybervictimization and NSSI behaviors among college students, with a specific focus on the mediating role of rumination and the moderating role of resilience in this relationship.

Method: An observational cross-sectional study was conducted with a convenience sample of 1,439 college students from public universities in Hunan Province, China. Data were collected via an online questionnaire assessing cybervictimization, NSSI behaviors, rumination, and resilience. Descriptive statistics and Pearson's correlation analysis were first conducted, and structural equation modeling (SEM) and moderated mediation analysis were then applied to test the proposed relationships.

Result: The study sample comprised 1439 college students with a mean age of 18.44 ± 0.84 years. Pearson's correlation analysis revealed significant positive associations between NSSI behaviors and both cybervictimization (r = 0.29, p < 0.01) and rumination (r = 0.17, p < 0.01), and a negative association with resilience (r = -0.25, p < 0.01). Moderated mediation analysis indicated that rumination mediated while resilience moderated the positive correlation between cybervictimization and NSSI behaviors (all p < 0.05).

Conclusion: The study highlights the critical role of rumination as a mediator and resilience as a moderator in the relationship between cybervictimization and NSSI behaviors. These findings provide crucial insights for developing and implementing interventions to prevent and reduce NSSI behaviors among college students, underscoring the importance of addressing both cognitive processes and personal resources to effectively mitigate and eliminate NSSI risks among college students with cybervictimization experiences.

Objective: Nearly 50,000 Americans die each year from suicide, despite suicide death being a rare event in the context of health risk assessment and modeling. Prior research has underscored the need for contextualizing suicide risk models in terms of their potential uses and generalizability. This sensitivity analysis makes use of the Maryland Suicide Data Warehouse (MSDW) and illustrates how results inform clinical decision support.

Method: A cohort of 1 million living control patients were extracted from the MSDW in addition to 1,667 patients who had died by suicide between the years 2016 and 2019 according to the Maryland Office of the Medical Examiner (OCME). Data were extracted and aggregated as part of a 4-year retrospective design. Binary logistic and two penalized regression models were deployed in a repeated fivefold cross-validation. Model performances were evaluated using sensitivity, positive predictive value (PPV), and F1, and model coefficients were ranked according to coefficient size.

Results: Several features were significantly associated with patients having died by suicide, including male sex, depressive and anxiety disorder diagnoses, social needs, and prior suicidal ideation and suicide attempt. Cross-validated binary logistic regression outperformed either ridge or LASSO (least absolute shrinkage and selection operator) models but generally achieved low-to-moderate PPV and sensitivity across most thresholds and a peak F1 of 0.323.

Conclusions: Suicide death prediction is constrained by the context of use, which determines the best balance of precision and recall. Predictive models must be evaluated close to the level of intervention. They may not hold up to different needs at different levels of care.

Mental health problems and suicide risk among veterinarians and veterinary nurses are well documented in the literature. Data on veterinary assistants have been overlooked, however. In addition, information on Portuguese veterinary professionals is lacking. An online sample of 833 Portuguese veterinary professionals (443 veterinarians, 287 nurses, and 103 assistants) completed self-report questionnaires about suicide risk and mental health between December 2022 and March 2023. Descriptive analysis revealed that 3.5% of respondents attempted suicide during their lifetime; 17.2% experienced extremely severe depression and suicidal ideation; 17.8% and 27.0% experienced extremely severe stress and anxiety, respectively; and 27.4% and 27.7% reported burnout and compassion fatigue, respectively. Multiple linear regression analysis revealed that professionals with a history of mental illness history; with current clinical symptoms of depression, anxiety, and stress; and working more than 40 hours per week experienced greater levels of burnout, compassion fatigue, and suicide ideation. Other variables such as being a woman, being a veterinary assistant, and disagreeing with motives for euthanasia also predicted some mental health problems. Mental health problems in the Portuguese veterinary professionals are a major health concern. These professionals are at higher risk for suicide, and clinical implications and guidelines are discussed.

Objective: The safety planning intervention is an evidence-based practice shown to reduce suicide risk, but implementation of high-quality safety planning has proven challenging. We aimed to understand clinician perspectives on the safety planning intervention to inform future implementation efforts.

Method: This cross-sectional survey of clinicians who care for patients at risk of suicide in an academic medical center asked about comfort levels and fidelity to components of the safety planning intervention and assessed implementation barriers and facilitators. We used exploratory data analysis and regression analysis to explore clinician perspectives and assess the relationship between formal training and implementation.

Results: Ninety-two clinicians responded to the survey. Two-thirds of participants (64.9%) endorsed using all six core elements of the safety planning intervention. Participants who reported receiving formal training in safety planning were significantly more likely to report being comfortable completing a safety plan (p < .001); those with higher levels of comfort were significantly more likely to endorse using all of the core elements of the safety planning intervention (p < .001).

Conclusions: Training in the evidence-based safety planning intervention is associated with clinician comfort and awareness of the core elements of the intervention. Our results suggest that there are gaps in clinician training and that formal safety planning intervention training could have a positive effect on clinician comfort and treatment fidelity.

Objectives: Adolescent suicidal behavior is highly prevalent in pediatric psychiatric emergency departments, and there is a growing occurrence of such behavior among preadolescent children. This study aims to examine the psychosocial factors associated with nonfatal suicidal behaviors in children (<12 years old) and adolescents (aged 12-18), to gain insight into unique and shared characteristics of suicidal behavior across these two age groups.

Method: This study investigates the psychosocial characteristics associated with suicidal ideation and behaviors in an emergency department sample of 183 children and adolescents aged 7-18 years in Israel. Participants completed a diagnostic interview, and self-report and parent-report questionnaires of psychosocial measures. Cross-sectional correlational and regression analyses were used to determine significant correlates of suicidal outcomes within the two age groups.

Results: Among adolescents, females exhibited a higher prevalence of suicidal thoughts and behaviors, while in children, both boys and girls showed similar rates. Depression correlated with suicidal ideation for both adolescents and children. In children, anxiety and conduct symptoms were associated with suicidal behavior, whereas in adolescents, suicidal behavior was associated with depression and anxiety.

Conclusions: The present findings contribute to the growing understanding of factors associated with suicidal thoughts and behaviors among children in comparison to adolescents. These findings underscore the importance of targeting specific risk factors when developing assessment and intervention strategies tailored to the two age groups.

Objectives: Suicide prevention gatekeeper training (GKT) is considered an important component of an overall suicide-prevention strategy. The primary aim of this study was to conduct the first robust review of systematic reviews of GKT to examine the overall effectiveness of GKT on knowledge, self-efficacy, attitudes, behavioral intentions, and behavioral change. The study also examined the extent to which outcomes were retained long term, the frequency of refresher sessions, and the effectiveness of GKT with Indigenous populations and e-learning delivery.

Methods: For this review of reviews, MEDLINE, PsycINFO, Embase; and the Cochrane Database of Systematic Reviews were searched. ROBIS was applied to assess risk of bias and findings were synthesized using narrative synthesis.

Results: Six systematic reviews were included comprising 61 studies, of which only 10 were randomized controlled trials (RCTs). Immediate positive effects of GKT on knowledge, skills, and self-efficacy were confirmed, including for interventions tailored for Indigenous communities. Evidence was mixed for change in attitude; few studies measured e-learning GKT, retention of outcomes, booster sessions, behavioral intentions, and behavioral change, with some positive results.

Conclusions: Evidence supports the immediate effects of GKT but highlights a need for more high-quality RCTs, particularly for Indigenous and e-learning GKT. This review identified a concerning lack of long-term follow-up assessments at multiple time points, which could capture behavioral change and a significant gap in studies focused on post-training interventions that maintain GKT effects over time.

Suicide is one of the leading causes of death worldwide, and in the perinatal period, the trend is increasing, even up to 100 times in the US. No studies have been carried out with validated instruments despite abundant recommendations to do so. This study aims to determine the prevalence of perinatal suicide risk in Spanish women, as well as the factors associated with it. A cross-sectional study was carried out with 908 women in the perinatal stage. Sociodemographic and obstetric variables, anxiety level (GAD-7), social support (DUKE-UNC), risk of intimate violence (WAST), and suicidal ideation (Paykel) were collected. Crude (OR) and adjusted odds ratios (aOR) were calculated using logistic regression for the main risk factors for suicidal ideation. The prevalence of suicidal ideation was 19.3% (175), and suicide attempt 2.4% (22). In the perinatal stage, the risk factors were anxiety [aOR of 1.08 (95% CI: 1.04-1.31)], experiencing a possible situation of intimate partner violence [aOR of 1.59 (95% CI: 1.04-2.43)], and a risk of PPD [aOR of 3.00 (95% CI: 1.86-4.81)]. Perceived social support appears as a protective factor [aOR of 0.97 (95% CI: 0.95-0.99)], along with skin-to-skin contact with the baby during childbirth [aOR 0.50 (95% CI: 0.28-0.88)]. Conclusions: Presenting anxiety or depression, little social support, and living in a possible situation of intimate partner violence are associated with a greater risk of suicidal ideation during the perinatal stage.