Archives of Suicide Research最新文献

Introduction: Police records are an important resource in absence of a national suicide database in the context of Pakistan. We studied suicides reported across three districts of Gilgit-Baltistan (GB); causes, patterns of suicidal behaviors, and classification processes.

Methods: A retrospective survey of police records from GB between 2012 and March 2022 was completed using a structured questionnaire that included demographic characteristics, possible causes, and forensic details. Descriptive statistics and a chi-square test of association were applied. This study was approved by the Institutional Review Board of Shifa International Hospital, Islamabad (IRB 0210-22).

Results: In total, 340 cases of suicides were registered. Among them, 53% (n = 179) were females, 59% (n = 202) unmarried and 40% (n = 136) below 20 years of age. Stress and mental illnesses were reported in 73% (n = 247) cases. Common methods of suicide were hanging (41%; n = 141) and firearms (25%; n = 85). More men compared to women attempted suicide by firearms while more women died by drowning or poisoning. Greater proportion of individuals who were unmarried and had formal education died by suicide compared to their demographic counterparts. Number of individuals having a "mental illness" was higher in men while significantly more women were affected by "domestic stressors." Seven (2.9%) cases reported between 2021 and 2022 were reclassified as homicides.

Conclusion: Suicide is more common among females compared to males, unmarried compared to married, and younger population compared to older population. Cases reclassified as homicide highlight the need for rigorous forensic inquiry of each suicide. Development of effective suicide prevention strategies is urgently required.

Objective: Guided by Minority Stress and Interpersonal and Ideation-to-Action Theories of Suicide, we sought to identify latent classes of painful and provocative events (PPEs), determine associations with class membership, and assess class-specific suicide attempt prevalence among cisgender sexually minoritized men (SMM) with suicidal ideation in the United States.

Method: Using data collected from October 2020 to January 2021 from 1617 SMM reporting past-year suicidal ideation, we performed latent class analysis on 22 PPE items spanning sexual behavior stigma, substance use, high-risk sex, and food and housing insecurity. We used multinomial logistic regression to assess associations with class membership and the Bolck-Croon-Hagenaars method to estimate class-specific past-year suicide attempt prevalence.

Results: Participant mean age was 29 years, 63% (n = 1010) were non-Hispanic white, and 14% (n = 221) reported a past-year suicide attempt. Five classes emerged: Extreme (7%, n = 113), featuring pervasive stigma, polysubstance use, high-risk sex, and food and housing insecurity; Severe/marijuana (15%, n = 236), featuring pervasive stigma, alcohol use, marijuana use, high-risk sex, and food insecurity; Severe (18%, n = 296), featuring the same PPEs minus marijuana use; Moderate (17%, n = 267), featuring family stigma, verbal harassment, some polysubstance use, and high-risk sex; and Mild (44%, n = 705), featuring family and friends stigma, verbal harassment, and alcohol use. Significantly higher suicide attempt prevalence emerged in the Extreme/Severe classes (12-16%) relative to the Mild/Moderate classes (2%).

Conclusions: Stigma and substance use were common across classes, implicating both as key factors shaping suicide risk among SMM. Holistic, multipronged, tailored interventions targeting stigma, substance use, and other PPEs are needed.

This study utilized latent class analysis to identify latent groups of individuals, reflecting the expanded dimensions of suicidality, which encompass not only one's own suicidality but also that of significant others. Drawing on data from Wave 3 and Wave 5 of the National Longitudinal Study of Adolescent to Adult Health, the analysis included 3215 individuals. The LCA revealed three distinct latent classes: the Exposed, the Suicidal, and the Non-Suicidal and Unexposed. Subsequent analysis using the Kruskal-Wallis test found significant longitudinal differences in mental health outcomes, including depression and suicidality, among these three latent classes over a 15-year period. Specifically, the Suicidal Class scored significantly higher than the Exposed Class and the Non-Suicidal and Unexposed Class for both depression and suicidality. Additionally, the Exposed Class scored significantly higher than the Non-Suicidal and Unexposed Class. These findings have implications for mental health researchers and practitioners, including the implementation of preventive and postventive interventions in the early stages, as well as the engagement of individual, family, and community partnerships in these interventions.

Objective: We use 2021 data to compare the demographic patterns of adult White and Black gun ownership with their respective race-specific rates of firearm, non-firearm and total suicide, and the percentage of suicides using firearms.

Methods: Data on gun ownership came from a nationally representative sample of over 19,000 respondents to the 2021 National Firearms Survey. Both race-specific gun ownership and suicide rates were stratified by respondent demographics-sex (male, female), census region (Northeast, South, Midwest, West), urbanicity (metropolitan or non-metropolitan), and age (18-29, 30-44, 45-59, 60+).

Results: White adults reported higher rates of gun ownership than did Black adults (33% vs 24%) but a firearm was used in a similar percentage of suicides (56% vs 58%). The demographic patterns of gun ownership of White and Black adults were similar-those least likely to report owning firearms were females, those living in the Northeast, residents of metropolitan areas, and younger adults. But the suicide patterns were somewhat different-whereas suicide rates among White adults were highest among older Whites and among Whites in non-metropolitan areas, suicide rates among Black adults were highest among younger Blacks and similar in metropolitan and non-metropolitan areas.

Conclusions: The self-reported levels and patterns of Black gun ownership cannot explain why such a high percentage of Black suicides are firearm suicides or why firearm and total suicide rates of Black adults fall so dramatically with age.

Objective: The Suicide Crisis Syndrome (SCS) has accumulated support as an indicator of suicide risk in patient settings; however, it has not been evaluated in military/veteran populations. The present study tested the factorial structure, measurement invariance, latent mean differences, and incremental validity of a SCS proxy variable developed from the Military Suicide Research Consortium's (MSRC) Common Data Elements (CDE).

Method: A secondary data analysis of 6,556 adults (40.5% current service members, 27.0% veterans, 26.6% civilians) who participated in MSRC-funded studies was conducted. CDE items were selected to form a SCS proxy, which was tested in subsequent analyses.

Results: A bifactor model exhibited superior model fit to alternative configurations. This model was partially invariant across those with differing histories of suicide and military service. Individuals with a history of suicidal ideation or attempts had more severe SCS symptoms than those without such history, and the SCS factor was incrementally related to lifetime suicide attempts and their characteristics above other relevant factors.

Conclusions: These findings provide evidence for the generalizability of the SCS to military service member and veteran populations, as well as the potential utility of proxy measures as an assessment tool in settings in which lengthy measures may be prohibitive.

Objectives: This study aimed to identify specific affective antecedents of non-suicidal self-injury (NSSI) and alcohol use, and to examine affective trajectories before and after these behaviors.

Method: Fifty-six undergraduates (71% female, 25% non-White, 20.2 ± 1.3 years old) meeting criteria for probable alcohol or substance use disorder participated in 28-days of ecological momentary assessment, completing four daily surveys assessing affect, self-punishment cognitions, and engagement in NSSI and alcohol use. Contemporaneous and time-lagged graphical vector autoregressive (GVAR) models were used to examine affect dynamics surrounding NSSI and alcohol use. Zero-inflated Bayesian binomial regression was used to investigate the relationship between momentary affect and likelihood of engaging in either NSSI or alcohol at the next prompt. Multilevel modeling was used to examine trajectories of affective states pre- and post-engagement in NSSI and alcohol use.

Results: GVAR models revealed significant relationships between jitteriness and being afraid with next timepoint NSSI, and excitement with next timepoint alcohol use. Bayesian regression with horseshoe priors identified self-punishment and loneliness as predictors of NSSI. Moreover, Bayesian regression revealed that excitement predicted alcohol use among those without alcohol use disorder (AUD), while belongingness predicted alcohol use among those with AUD. Multilevel models revealed self-punishment and loneliness followed a negative quadratic trajectory around NSSI events. Excitement and belongingness did not relate to slopes of time.

Conclusions: The findings suggest NSSI is used to reduce negative emotional states, whereas alcohol consumption initially enhances positive emotional states in individuals without an AUD and may be used to increase belongingness in those with an AUD.

Background: Suicide is a significant but understudied public health concern in developing nations like Pakistan, where risks factors have not been investigated by mixed methods studies. Hence, we aimed to explore the risk factors for suicide based on a mixed methodology.

Methods: This study followed a mixed methods convergent component design. A retrospective case-control psychological autopsy with a semistructured interview protocol was performed. Additionally, health professionals' opinions on the psychiatric risk factors for suicide were assessed through qualitative interviews. Data were collected between 2021 and 2022 and analyzed by SPSS (V-25) and thematic analysis (NVIVO-12 Plus).

Results: Based on the mixed methods meta-inferences, suicidal ideation; depression; hopelessness; social isolation; previous history of self-harm and traumatic experiences; lack of motivation; purposelessness; feeling like a burden; substance abuse; impulsivity; anger; anxiety; psychiatric disorders such as personality disorders, bipolar disorder, schizophrenia, gaming addiction, and eating disorders; and family history of psychiatric illness were identified as risk factors for suicide.

Conclusion: More must be learned about the mental health components contributing to suicide and the culturally appropriate prevention methods used in Pakistan. This study reveals novel targets for suicide prevention and may aid policymaking by providing a better understanding of predictors and specific psychiatric characteristics of suicide in Pakistan.

Background: Alcohol abuse and suicide are significant public health problems. Specifically, more than three million people die each year from alcohol abuse and 700,000 from suicide. Research indicates that alcohol abuse is associated with suicidality, and that there are significant gender differences in both. By means of a large representative population sample, this study quantifies the associations between suicidal ideation and alcohol misuse in the German population.

Methods: Based on a survey of 2,513 individuals from 2015, prevalence estimates and logistic regression models were used to estimate the association between suicidal ideation (i.e., past-year suicidal ideation according to the Suicidal Behavior Questionnaire Revised [SBQ-R] and alcohol consumption (i.e., past year high-risk drinking according to the Alcohol Use Disorders Identification Test [AUDIT-C]).

Results: High-risk drinking (24.78%) and suicidal ideation (5.09%) were highly prevalent in this representative German population sample. These estimates differed significantly between men and women: Men were more likely to report high-risk drinking (30.14%) compared to women (20.56%), while a greater proportion of women (5.95%) reported suicidal ideation when compared to men (4.00%). Moreover, the association of suicidal ideation and high-risk drinking was weaker in women (OR = 1.64 CI 95% [1.03-2.62]) than in men (OR = 5.62 CI 95% [2.72-11.60]).

Conclusion: The high prevalence of suicidal ideation and high-risk drinking in women and underscores the necessity for low-level interventions and public health initiatives aimed at prevention and intervention against the escalation of high-risk drinking and suicidal behavior. Prevention efforts should consider gender-specific patterns of risk.

Objective: The Interpersonal-Psychological Theory of Suicide (IPTS) is a well-established framework to assess suicide risk, yet few studies have applied the framework to examine relevance and applicability to suicide phenomenology in Black American men. We address this gap by qualitatively exploring the suitability of the IPTS framework using a psychiatric sample of Black men.

Method: We conducted semi-structured interviews with 15 Black adult men (Mean age = 32.1, min:18, max: 79) with a history of suicidal thoughts and behaviors (STBs). We conducted thematic analysis using an inductive and deductive coding approach using Dedoose v. 8.

Results: Overall, IPTS constructs were represented in participant narratives. Thwarted belongingness emerged as the most prominent construct of the theory, followed by hopelessness, and suicide capability. Participants noted the role of racism in their STB from multiple levels, including internalized, interpersonal, and structural racism.

Conclusions: Black men reported aspects of the Interpersonal Psychological Theory of Suicide (IPTS), notably experiences of social isolation, which were often attributed to racism. Our findings highlight the relative importance of certain IPTS constructs among Black men, namely the significance of thwarted belongingness and its relationship with social marginalization. Our findings identify future areas of expansion for the IPTS framework to capture broader sociocultural dynamics in racialized populations.

Objective: The present study seeks to explore the relationship between sexual fluidity and suicidal thoughts (STs) and behaviors (STBs) among adults in early and middle adulthood.

Methods: This study utilized data from Waves IV and V of the National Longitudinal Study of Adolescent to Adult Health (ADD Health). Participants were categorized into four groups: (1) heterosexual at both waves, (2) sexual minority (SM) at Wave IV but heterosexual at Wave V, (3) heterosexual at Wave IV and SM at Wave V, and (4) SM at Wave IV and Wave V.

Results: Hierarchical logistic regression revealed that sexual fluidity between Waves IV and V was associated with STs. Those who were heterosexual-identifying at Wave IV but identified as an SM at Wave V were close to four times as likely to report STs at Wave V than were those who identified as heterosexual at both waves. Those who were an SM at Waves IV and V were almost twice as likely to report STs compared to those who were heterosexual at both waves. Additionally, χ² results showed that suicide attempts (SAs) and sexual fluidity were associated. Similarly, SA prevalence was highest during periods in which participants identified as SMs.

Conclusions: Transitioning into a sexually minoritized status is associated with increased risk of STBs, whereas transitioning into a nonminoritized status was not.