Archives of Suicide Research最新文献

Background: Although the risks associated with non-suicidal self-harm (NSSH) have been widely described in the literature, evidence remains fragmented regarding how these risks are understood and managed by individuals with lived experience.

Objective: Our systematic review aimed to identify the risks perceived by those who engage in NSSH and the risk management strategies they utilized.

Methods: We searched five databases and performed a quality assessment and meta-synthesis of qualitative findings. We summarized the quantitative findings from one study because a narrative synthesis was not feasible.

Results: We included 37 eligible studies (n = 34 qualitative only; n = 3 mixed methods), with only one presenting quantitative findings. Our meta-synthesis of qualitative findings highlighted three overarching themes: (1) Physical risks: understanding and managing injuries; (2) Interpersonal risks: impacts of and responses to self-harm; (3) Intrapersonal risks: a personal assessment. Individuals who self-harm showed a nuanced understanding of all overarching risks. Management strategies included damage limitation and concealment of scars. The perceived utility of risk management strategies varied from useful to counterproductive. Quantitative findings from one study showed that users of online self-harm communities perceive similar physical and interpersonal risks, including fears of judgment and stigma.

Conclusion: Views on self-harm risk management strategies were mixed. Incorporating lived experience perspectives can promote person-centered care for NSSH, enhancing peer support interventions and collaborative clinician-patient risk management plans.

This prospective longitudinal study examined associations between Dark Triad traits and suicidal ideation through interpersonal pathways among Chinese university students (N = 2,018 across three waves), guided by the Interpersonal Theory of Suicide (ITS). Analyses revealed distinct patterns: Machiavellianism showed positive associations with suicidal ideation through thwarted belongingness, while psychopathy was positively linked to suicidal ideation via both thwarted belongingness and perceived burdensomeness. Narcissism demonstrated negative associations with suicidal ideation through reduced thwarted belongingness. Gender differences emerged prominently, with perceived burdensomeness serving as a more salient pathway between psychopathy and suicidal ideation for women, whereas thwarted belongingness was more strongly associated with Machiavellianism and narcissism for men. These findings, observed in a collectivistic cultural context, extend the ITS by demonstrating how personality traits may differentially relate to suicide risk through gender-specific interpersonal mechanisms. The results suggest the potential value of tailored prevention approaches with particular attention to burden-related concerns for women and belongingness-focused strategies for men-while highlighting the need for further research to examine these associations across diverse populations.

Objective: The Looming Vulnerability Model suggests that rapidly approaching or increasing threats, like visual looming stimuli, can potentially contribute suicidal thoughts and behaviors. This study investigates the neurobiological basis of this theory in suicide attempters, focusing on the EEG power spectrum.

Methods: In a case-control design, participants completed a visual Looming task involving threatening and neutral stimuli during EEG neuroimaging. The final sample included 15 participants with recent suicide attempts and major depressive disorder (SA+MDD), 19 participants with major depressive disorder (MDD), and 18 Healthy Controls (HC). EEG absolute power was calculated and group differences were analyzed using ANOVA with post-hoc tests.

Results: Participants in the SA+MDD group showed significantly greater delta band power in frontopolar regions (AF3, Fp2, Fpz) compared to HC under both task conditions. Theta band power over the right frontal cortex during both conditions differentiated SA+MDD from MDD participants, while increased beta synchronization in the right premotor area distinguished SA+MDD from both MDD and HC, particularly during trials with neutral stimuli. Additionally, gamma band desynchronization to threatening stimuli was observed in SA+MDD compared to MDD.

Conclusions: The findings support a link between electrophysiological responses to looming stimuli and recent suicide attempts. Increased delta and theta power may reflect heightened emotional processing and sensitivity to threat or pain, while elevated beta activity may indicate increased demands on motor inhibition. Gamma desynchronization may reflect a residual vulnerability to suicidal behavior in the aftermath of a recent attempt.

Objective: To Quantify the risk of suicide following self-harm within the various healthcare settings to which patients present to help understand the risk factors involved.

Method: A matched case-control study using electronic records for primary care, secondary care (hospitals) and national mortality registries in England between 2001-2019 (N = 594674). Cases with a death attributed to suicide were compared with a randomly selected control population.

Results: The one-year suicide risk, adjusted for age and sex, was higher after recorded self-harm in primary care (odds ratio OR: 83, 95% confidence intervals CI: 76-91) and secondary care data (OR 124; 95% CI: 111-138) compared to those with no self-harm records. Suicide risk was highest in the first month after self-harm in primary care (OR 310; 95% CI: 244-393) and secondary care data (OR 458; 95% CI: 331-633). Suicide risk increased with the number of self-harm admissions in the final year (OR for patients with ≥3 self-harm attempts 505; 95% CI: 227-1123: p < 0.0001 for trend). While suicide risk following self-harm was increased across all age-groups and sexes, it was higher in females and older individuals compared to their counterparts with no self-harm records (p < 0.05).

Conclusion: In both the primary care and secondary care datasets, the one-year relative suicide risk following self-harm was high, which is consistent with previous studies. The increased risk of suicide mortality following self-harm in older individuals and females may inform risk-stratification after a self-harm event.

Objective: Men are more likely than women to die by suicide, while women are more likely to report suicidal ideation and make suicide attempts. To understand this, it is necessary to consider the ways in which men and women are exposed to divergent pressures in gendered social roles. We reviewed the literature to identify a set of seven pathways by which masculinity may impact upon suicidality (moderation of the relationship between masculinity and suicidality by adverse life events, mediation of the relationship between masculinity and suicidality by help-seeking, social support, maladaptive coping, impulsivity, and mental health, and a protective function of positive masculine psychological characteristics on suicidality), and tested these in two samples.

Method: In Study 1 we tested pathways in a sample of 195 participants in an online survey. In Study 2 we tested pathways in a sample of 48 participants admitted to hospital for a suicide attempt. In both studies we included both men and women, and tested moderation of relationships by sex.

Results: Both studies demonstrated a protective role of "positive" masculine psychological characteristics in the development of suicidality. There was also support from both for an indirect effect of "negative" masculine psychological characteristics on suicidal ideation through impulsivity (those high in negative masculinity had higher suicidal ideation due to increased levels of impulsivity). In Study 1 only, the relationship between negative masculine psychological characteristics and suicidal ideation was mediated by help seeking and by maladaptive coping (amongst men only). In all other cases, results were consistent across men and women.

Conclusions: Our results suggest both protective and risk functions of masculinity in the development of suicidality, and provide evidence for pathways from negative masculinity to suicidality through impulsivity and help-seeking, as well as protective functions of positive masculine psychological characteristics, providing potential targets for clinical intervention.

Objective: Insomnia and nightmares have been identified as significant predictors of suicidal ideation (SI), but the specific psychological processes underlying this relationship remain unclear. The current study aimed to examine the insomnia/nightmares-SI relationship, concerning the mediating role of defeat and entrapment according to the integrated motivational-volitional (IMV) model in the Iranian population.

Methods: Participants (N = 459) completed a self-report survey assessing insomnia/nightmare symptoms, feelings of entrapment and defeat, and SI. Path analysis was conducted to evaluate the mediating effect of defeat and entrapment on the association between insomnia/nightmares and SI.

Results: Findings indicated that insomnia/nightmare symptoms were correlated with SI. Moreover, findings demonstrated that entrapment mediated the relationship between insomnia $(\beta \text{\hspace{0.17em}=\hspace{0.17em}0.03,}p\text{\hspace{0.17em}=\hspace{0.17em}0.001})$/nightmares $(\beta \text{\hspace{0.17em}=\hspace{0.17em}0.24,}p<\text{0.072})$ and SI. Additionally, insomnia $(\beta \text{=} \text{0.07,}p\text{\hspace{0.17em}=\hspace{0.17em}0.001})$ and nightmares $(\beta \text{\hspace{0.17em}=\hspace{0.17em}0.04,}p\text{\hspace{0.17em}=\hspace{0.17em}0.022})$ had indirect effect on SI through defeat.

Conclusion: The findings offer new insights into the psychological mechanisms linking insomnia/nightmare symptoms and SI by highlighting the role of defeat and entrapment. However, the complicated relationship between sleep disturbances and SI warrants further examination through longitudinal studies. Such studies are crucial for developing targeted interventions to prevent the emergence of SI in individuals who suffer from sleep disturbances.

Objective: Suicide is the leading cause of death on the railway networks, yet little is known about the geography and socio-environmental determinants of such deaths in England.

Method: We analyzed official records of all suspected suicides recorded on England's mainline railway from April 2019 to March 2021 (N = 436), alongside area-level data (e.g., deprivation and urbanicity) and railway characteristics (e.g., station size). We used SaTScan's Poisson discrete scan statistic to detect spatial-temporal clusters and compared suicides at station and non-station locations, including stations with no recorded suicides over the study period.

Results: Most railway suicides-particularly those occurring at stations-took place in urban areas, typically at locations with a very low incidence of previous suicides. A large majority (84.5%) lived within 2 miles of a station and died close to home (median 2.1 miles) or their last known location (1.5 miles). Suicides occurred most often at stations (43.3%), followed by trackside locations (37.6%), foot/level crossing (15.1%) or other rail areas (3.9%). These were often not the nearest station to the deceased (59.6%), but were generally smaller and more likely to be served by fast/non-stopping trains. Across the network, stations without suicides were far less likely to be served by such trains (66% vs. 94.3%; OR = 6.62, 95% CI 3.33-13.18).

Conclusions: Urbanicity and the availability of non-stopping train services are key predictors of railway suicide. Restricting access to high-speed trains-especially at smaller urban stations and at non-station locations-could be an effective element of broader strategies and local partnership approaches to prevent suicide.

Employment pressure has emerged as a significant stressor among Chinese university students, yet the psychological mechanisms linking this pressure to suicidal ideation remain underexplored. This study investigated how expressive suppression and depressive symptoms mediate the relationship between employment pressure and suicidal ideation. Data were collected between March and June 2024. A sample of 10,839 Chinese university students completed standardized measures of employment pressure, expressive suppression, depressive symptoms, and suicidal ideation through an online survey. Path analysis revealed that employment pressure positively predicted suicidal ideation both directly and indirectly. Expressive suppression significantly mediated the relationship between employment pressure and suicidal ideation. Furthermore, expressive suppression and depressive symptoms serially mediated the association between employment pressure and suicidal ideation. These findings suggest that employment pressure maybe associated with increased suicidal ideation through pathways involving expressive suppression, which in turn may exacerbate depressive symptoms. Interventions targeting emotion regulation strategies and depressive symptoms may help mitigate the negative psychological impact of employment pressure among Chinese university students facing competitive job markets.

Background: Perseverative coping refers to the persistent use of ineffective coping strategies, including the repetition of previously abandoned approaches. No empirical studies explored the mechanisms of stress and perseverative coping influences on suicide. Drawing on the stress and coping model of suicide risk and the diathesis-stress model of suicide, this study assessed the hypothesis that perceived stress moderates the relationship between perseverative coping and suicidal thoughts/suicide attempts.

Method: Participants comprised 912 college students (women = 485, men = 427) who completed self-report measures assessing perceived stress and perseverative coping. Six months later, they completed an additional questionnaire assessing suicidal thoughts/suicide attempts.

Results: Higher levels of perseverative coping and perceived stress were associated with higher levels of suicidal thoughts/suicide attempts. Moderating analysis revealed a significant interaction between perceived stress and perseverative coping, including that perceived stress moderated the relationship between perseverative coping and suicidal thoughts/suicide attempts.

Conclusions: This result indicated that when perceived stress was high, elevated levels of perseverative coping were associated with an increase in suicidal thoughts/suicide attempts. These findings implied that the transactional model of stress may contribute to the development of suicide research and that perseverative coping may prevent stress-induced suicidal thoughts/suicide attempts.

Objective: Sexual minority young adults (SM-YAs) experience high rates of interpersonal discrimination, which increases their risk of suicidal ideation. However, little is known about the mechanisms that underly this association. According to the Anxiety Buffer Disruption Theory (ABDT) exposure to interpersonal discrimination can influence the development of a negative social worldview (i.e., antagonistic perceptions of others and the future of society) leading to the onset and maintenance of suicidal ideation. We aimed to test the utility of ABDT in articulating the association between exposure to interpersonal discrimination and suicidal ideation by examining the mediating role of negative social worldview.

Method: Hypotheses were tested using structural equation modeling with 3 waves of data from a national sample of 670 SM-YAs aged 18 to 26 at baseline.

Results: Analyses largely supported the proposed model. T1 interpersonal discrimination was directly associated with increases in both T2 negative social worldviews and T3 suicidal ideation. T2 negative social worldviews was also directly associated with increased T3 suicidal ideation. T1 exposure to interpersonal discrimination was indirectly associated with increased T3 suicidal ideation via increases in T2 negative social worldviews.

Conclusions: Study results suggest that clinical and preventive interventions for suicidal ideation should target the influence of discriminatory experiences and the negative social worldviews they induce.