Archives of Suicide Research最新文献

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.

Objective: Universal screening improves suicide risk detection in individuals presenting to the emergency department (ED) who are not presenting with a psychiatric chief complaint, what we refer to as incidental risk. We sought to better understand characteristics of individuals who present with incidental risk and to evaluate their suicide-related outcomes after the ED visit.

Methods: Two samples (cross-sectional, longitudinal) from the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) study were used. Combined, the samples allowed for comparison of baseline characteristics and suicide-related outcomes for participants with incidental risk compared to those with negligible risk (any kind of chief complaint and negative suicide risk) and clinically congruent risk (psychiatric chief complaint and positive suicide risk). Univariable and multivariable logistic regression analyses were completed.

Results: Universal screening differentially improved the identification of suicide risk among non-white individuals, potentially reducing racial disparities in risk detection. Participants presenting with incidental risk were generally more similar to those with congruent risk than they were to those with negligible risk across demographics and clinical characteristics. Those with incidental suicide risk exhibited similar post-visit suicide-related outcomes compared to those with congruent risk, yet they were far less likely to receive clinical assessments and interventions during the ED visit.

Conclusions: The results of this study highlight an opportunity to broaden evidence-based suicide prevention practices in the ED where logistically possible. EDs may need to consider redesigning their clinical approach to address suicide risk among those who present with medical complaints but screen positive for suicide risk.

Objective: Suicide on railways cause immense emotional distress for families, bystanders, and railway staff and carries substantial economic costs. Although behaviors suggesting ambivalence have been identified in individuals dying by suicide at railway stations, relatively little is known about this phenomenon. We conducted a scoping review to examine the prevalence and characteristics of ambivalence among individuals who died by suicide at railway stations and, secondly, to identify factors, which may influence ambivalence in the suicidal process.

Method: Following a 6-stage model, evidence identified in PubMed and Google Scholar was reviewed and discussed with experts. Findings were grouped into central themes.

Results: Only 16 relevant publications were identified, implying that ambivalence has been addressed relatively infrequently in studies of individuals who have died by suicide at railway stations. Nevertheless, signs of ambivalence have been observed in a substantial proportion of such individuals. Behaviors indicative of ambivalence include hesitation, letting trains pass, and climbing back up on the platform after having jumped. At-risk individuals may express suicidal intentions either directly or indirectly, possibly in the hope of intervention. Based on recordings from surveillance cameras and interviews with survivors, some behaviors of at-risk individuals at railway stations may be interpreted as signs of an internal conflict.

Conclusions: Some at-risk individuals at railway stations exhibit signs of ambivalence. This may increase the probability of detection of and intervention. Further, those designing interventions at railway stations, such as encouragement of help-seeking, trained gatekeepers, and means restriction, might consider addressing ambivalence of at-risk individuals.

Background: Deaths by suicide have significant impacts on those bereaved. This study examined the utilization of supports by adults bereaved by suicide and associations with personal growth.

Methods: Data on adults bereaved in a personal capacity were obtained from the Irish Suicide Bereavement Survey. Regression analyses identified factors relating to the utilization of both informal and formal supports and the relationship between utilization of supports and personal growth.

Results: Of the 2,059 participants, three-quarters of participants (74%) were female, and the mean age was 41 years. Most participants were family members of the deceased (73%), while one-quarter were friends or acquaintances (27%). Informal supports were received by most participants (85%), while two-thirds (67%) accessed formal support. Greater perceived social support was positively associated with utilization of both formal and informal supports. Men, those from ethnic minorities, and non-family members were less likely to access formal supports. Having received informal support emerged as the strongest predictor of formal support utilization. Utilization of informal supports was associated with positive personal growth among men.

Conclusions: Having access to multiple forms of support is a critical feature of postvention. Future research should consider the development of proactive outreach and signposting for hard-to-reach groups.

Objective: Family conflict is associated with adolescent depression and suicidality. Whether the conflict level differs among adolescents based on presenting concern is unknown. This study compared family conflict between adolescents with self-injurious thoughts and behavior (SITB), those with depression, and healthy controls with neither condition.

Method: Data were collected from 495 adolescents with SITB (n = 151), depression (n = 256), and healthy controls (n = 88). Adolescents were between 12 and 17 years old (M = 15.07, SD = 1.60; 65.3% female, 24.3% male, 10.4% nonbinary; 61.4% White). Family conflict was assessed by adolescent and parent report on the Conflict Behavior Questionnaire and compared by informant across diagnostic groups, controlling for demographic variables and depression status.

Results: Adolescents with SITB experienced greater conflict with their mothers than adolescents with depression (p = .033), and greater conflict with their mothers (p < .001) and fathers (p = .029) compared with controls. Adolescents with depression reported more conflict with mothers (p = .015), and not fathers (p = .232), compared with controls. Parents of adolescents with SITB (p = .002) or depression (p < .001) both reported greater family conflict than parents of controls. Parent report of family conflict did not differ between the two clinical groups (p = .814).

Conclusion: Adolescent and parent perceptions of family conflict differ across diagnostic groups, with adolescents experiencing SITB reporting the highest family conflict. The link between family conflict and mental health problems may be a function of presenting clinical concern, informant, and parent role.

Objective: Harsh parenting is a family risk factor that can lead to non-suicidal self-injury (NSSI) in adolescents. Based on the developmental psychopathology model and the identity disruption model, this study aimed to investigate the mechanism underlying the relationship between harsh parenting and NSSI using a one-year longitudinal design. Specifically, the study focused on the mediating role of identity confusion and the moderating role of intentional self-regulation in this association.

Methods: Three waves of data (T1, T2, and T3) were collected at 6-month intervals between May 2023 and May 2024. A total of 564 Chinese adolescents from four schools in Central China (54.3% boys; M_age at T1 = 14.48 years) completed questionnaires regarding harsh parenting (T1), identity confusion (T2), intentional self-regulation (T2), and NSSI (T1 and T3). All measures used in this study have demonstrated good reliability and validity in prior research.

Results: The results of the structural equation modeling indicated a mediation process in which T1 harsh parenting positively predicted T2 identity confusion, which subsequently predicted higher T3 NSSI. Furthermore, the latent moderated structural equations analysis revealed that T2 intentional self-regulation buffered the effect of T2 identity confusion on T3 NSSI, thereby mitigating the mediation process.

Conclusions: The results of this study illustrate how harsh parenting, identity confusion, and intentional self-regulation contribute to NSSI and offer recommendations for preventing and addressing NSSI among adolescents.

Objective: Assessing psychological pain is crucial for evaluating suicide risk. This study examined differences in psychological pain between patients with suicide attempts, those with suicidal ideation, clinical, and non-clinical controls using a newly translated German version of the Mee-Bunney Psychological Pain Assessment Scale (MBPPAS).

Method: A cross-sectional study was conducted with two independent samples collected a different sites (sample 1: n = 409; sample 2: n = 171), resulting in a total sample of N = 580 (59% female; age: M = 34.6, SD = 13.2). All analyses were conducted on the combined full sample. Participants were divided into four groups: patients with a suicide attempt (SUAT), patients with suicidal ideation but no lifetime suicide attempt (SUID), clinical control patients without suicidal ideation or attempts (CLIN), and non-clinical control participants (HLTH). MBPPAS scores were compared across groups.

Results: SUAT reported significantly higher psychological pain than SUID (p < .001, d = 0.42), CLIN (p < .001, d = 1.46), and HLTH (p < .001, d = 1.04). SUID had significantly higher MBPPAS scores than both CLIN (p < .001, d = 3.01) and HLTH (p < .001, d = 2.57). Internal consistency of the German MBPPAS was excellent (α = .93, ω = .93), and the scale showed good psychometric properties regarding convergent, incremental, and criterion validity.

Conclusions: The findings highlight significant differences in psychological pain across clinical and control groups, supporting the utility of the German MBPPAS in identifying psychological pain in patients at varying levels of suicide risk.

Objective: Negative affective states are known risk factors for suicidal ideation (SI). However, most research to date has used cross-sectional or longitudinal designs with long follow-up periods to understand these relationships. Thus, the current study aimed to understand how specific negative affective states may act as acute risk factors for same day SI and predict next day SI.

Methods: Daily diary cards from 83 adults (4,648 observations; M_age = 29.5; 67% female; 61% White) seeking treatment at an 8-week dialectical behavioral therapy (DBT) intensive outpatient program were analyzed. Sadness, anger, anxiety, guilt, and shame were independently evaluated to understand their association with same day SI intensity and examine how they predicted next day SI intensity.

Results: Multilevel regression revealed at the within person level that increases in all five affective states was associated with same day SI. However, only increased sadness and guilt, and decreased anxiety, predicted next day SI, covarying for same day SI.

Conclusion: Sadness and guilt may be salient acute risk factors for next day SI. Clinicians who implement treatments that use daily diary cards, such as DBT, may want to attend to these specific affective states when monitoring client diary cards and during suicide risk assessment.

Objective: According to the Cognitive Emotional Model of Non-Suicidal Self-Injury (NSSI), this behavior is governed by a complex interplay of NSSI-related cognitions (i.e., a person's expected outcomes of self-injury and self-efficacy to resist NSSI) and emotion-regulatory strategies (i.e., cognitive reappraisal and expressive suppression). To empirically test this proposition, the current study examined the moderating roles of self-efficacy to resist NSSI, cognitive reappraisal, and expressive suppression in the relationships between outcome expectancies and NSSI frequency among university students.

Method: 559 university students (M = 20.7 years, 74.2% female, 40.3% with a NSSI history) completed an online self-report questionnaire.

Results: Self-efficacy to resist NSSI was a strong protective factor by diminishing the strength of the associations between expectations of affect regulation, communication, and negative self-beliefs and NSSI frequency. The relationships between outcome expectancies and self-efficacy to resist NSSI in predicting self-injury were further contingent on a person's use of expressive suppression. Specifically, a tendency to use expressive suppression strengthened the risk associated with the relationship between affect-regulatory expectancies and self-efficacy to resist NSSI, b = 1.05 [.64, 1.46], t = 5.04, p < .001, and attenuated the protection conferred by the relationship between negative self-beliefs expectancies and self-efficacy, b = -.17 [-.34, -.00], t = -2.02, p = .04.

Conclusions: In collectively examining the cognitive-emotional correlates of NSSI, the current findings empirically support the Cognitive-Emotional Model of NSSI and highlight the potential utility of targeting outcome expectancies and self-efficacy to resist NSSI in prevention and intervention initiatives.