Archives of Suicide Research最新文献

Introduction: The prodromal phase preceding the onset of First Episode Psychosis (FEP) is associated with an increased risk of Suicidal Behaviors (SBs). The aim of this study was to identify specific structural brain abnormalities linked to SBs that occur prior to the onset of FEP.

Methods: Voxel-based morphometry analyses were used to investigate differences in brain Grey Matter (GM) volume using the CAT12 toolbox within SPM12. Covariates, including gender, age, handedness, intracranial volume, depression severity, and global cognitive functioning, were controlled for as confounding factors.

Results: Significant reductions in GM were observed in the left superior temporal gyrus, dorsal posterior cingulate cortex, precuneus, cuneus, anterior cerebellum (p-FWE corrected < 0.05, k > 50) as well as in the right amygdala (0.96 ± 0.06 vs. 1.01 ± 0.05; F = 4.78; p < 0.05) and left amygdala (0.97 ± 0.06 vs. 1.02 ± 0.05; F = 8.97; p = 0.01).

Conclusions: History of SB prior to the onset of the psychotic disorder was related to wider and more widespread brain GM alterations. The regions identified are involved in cognitive and emotional processes such as emotional regulation, social cognition, perseverative thinking, and pain tolerance. These findings suggest that structural brain abnormalities related to SB occurring before FEP onset may serve as early biomarkers for identifying individuals at increased risk of suicide.

Objective: Evidence for Gatekeeper Training (GKT) has shown that training outcomes are generally maintained at follow-up. Research on how improvements in GKT outcomes translate to intervention behavior is inconclusive, and some studies show that despite significant positive effects on GKT outcomes, there is no effect on GK behaviors.

Method: A non-experimental pre-post and follow-up survey design was used with a sample of 60 participants who voluntarily completed one of 12 half-day (4-hour) GKT sessions. Path Analysis was applied to pre- and post-intervention training outcomes, and a third model assessed the behavioral effect of the change in participant scores from pre- to post.

Results: Suicide prevention knowledge retained by participants at 6-months after GKT was predictive of increased GK behavior in the 6-months following GKT. Knowledge at follow-up was the only significant predictor of behavior (p < .05), no other regression pathways were significant.

Conclusions: Gatekeeper preparedness, efficacy, and reluctance outcomes were not predictive of GK behavior. The findings of this study represent a lack of understanding regarding how the specific aims of GKT are translated into intervention behavior to identify, intervene, support, and refer potentially at-risk individuals.

Objective: Suicide prevention professionals and programs have focused on reaching not only individuals with suicide ideation, but also family, friends, and other acquaintances, referred to as suicide gatekeepers. Social media provide platforms that allow health communicators to reach a large population. This research focuses on examining and testing the most effective message framing (how the message provides a reward or consequence for the receiver) and message construct (precise focus and wording of a message) for social media posts intended to positively influence suicide gatekeeper intervention behavior on behalf of a friend or peer.

Method: An experiment tested the influence of message construct (between subjects) and message frame (within subjects). The experiment randomized the 1285 participants between the ages of 18 and 34 into the three message construct conditions (significance, preventability, and beneficence).

Results: The results suggest gain-framed messages have a more positive influence than loss-framed messages on all social media message outcome variables (likelihood of social media message engagement, perceived message effectiveness, self-efficacy, response efficacy, empathy, and behavioral expectation), and state empathy mediates the relationship between message frame and these variables. Message construct condition and other mediation results were less substantial, although some evidence suggests that the significance message construct may increase social media message sharing and perceived message effectiveness.

Conclusion: Results show strong evidence of the effectiveness of using gain frames in social media messages aimed at suicide gatekeepers. Other considerations include highlighting the significance of suicide and utilizing empathy appeals to strengthen social media message engagement and behavioral intention.

Objective: Research indicates that non-heterosexual students face a higher risk of suicidal thoughts and attempts compared to heterosexual peers. However, differences in suicidal behavior between sexual orientation groups among students in Lithuania remain underexplored.

Method: Data were collected via an online survey of students from 17 higher education institutions in Lithuania. Participants answered sociodemographic questions, reported suicidal thoughts and attempts at various time periods, and completed the PHQ-4. Prevalence was calculated for the full sample and sexual orientation groups. Logistic regression examined associations between suicidal behavior and sexual orientation, controlling for confounding variables.

Results: The full sample included 2,012 participants (ages 18-29, M = 21.62, SD = 2.35), of whom 13.5% identified as bisexual and 4.4% as lesbian/gay. Suicidal thoughts were reported by 40.7%-63.6% of heterosexual, 53.4%-76.1% of lesbian/gay students, and 66.5%-89.7% of bisexual students. Suicide attempts were reported by 1.0%-15.0% of heterosexual, 2.3%-20.5% of lesbian/gay, and 4.1%-25.8% of bisexual students. Lesbian/gay students had higher odds of suicidal behavior compared to heterosexual students (AOR = 1.710, 95% CI [1.017, 2.875]), while bisexuals exhibited even higher odds (AOR 1.710-4.197, 95% CI [1.242, 6.047]). Bisexuals also showed higher odds compared to lesbian/gay students (AOR 2.529-2.626, 95% CI [1.307, 4.895]).

Conclusions: A higher proportion of non-heterosexual students in Lithuania report suicidal thoughts and attempts compared to heterosexual counterparts. The findings further underscore a relationship between sexual orientation and suicidal behavior, with bisexual students exhibiting the highest vulnerability.

Given the well-documented association between emotion regulation (ER) deficits and suicidal thoughts and behaviors (STBs), and the limited understanding of their neural mechanisms, we reviewed studies across five databases that included validated ER tasks and neuroimaging techniques such as functional magnetic resonance imaging and electroencephalography. This systematic review synthesizes evidence from 11 neuroimaging studies to explore the neural correlates of ER deficits in individuals with STBs. Findings revealed that individuals with STBs exhibit heightened activation in the dorsolateral and ventrolateral prefrontal cortex during ER tasks, alongside increased amygdala reactivity to negative stimuli (e.g., sad facial expressions), in implicit ER paradigms. Heterogeneity in prefrontal cortex activation suggests that task- and population-specific neural signatures may influence these patterns. Our review also identifies methodological limitations in the current literature, including a reliance on cross-sectional designs and small sample sizes, which limit generalizability. These limitations highlight the need for longitudinal and multi-modal studies to better understand the dynamic neural patterns associated with ER and STBs. By elucidating the neural underpinnings of ER deficits in STBs, these findings may enable earlier identification of at-risk individuals and the development of personalized, targeted interventions (e.g., transcranial magnetic stimulation).

Autobiographical memory, a critical cognitive process for recalling personal events, is closely linked to mental health. Depressive disorders are characterized by overgeneralized and negative memory patterns, which impair future-oriented thinking and exacerbate hopelessness. Current evaluations of autobiographical memory are subjective and limited by human bias. In this study, we applied Natural Language Processing using Large Language Models (LLMs) to analyze autobiographical memory narratives, uncovering that their valence can predict depression, suicidal ideation, and prior suicide attempts. Furthermore, valence correlated with core components of the Three-Step Theory of suicide, such as hopelessness and lack of connectedness. By integrating advanced computational techniques, our approach demonstrated high predictive accuracy and offers a scalable, objective method for assessing suicide risk. These findings highlight the potential of LLM-based analysis in enhancing psychological assessment and informing interventions, paving the way for innovative clinical applications in mental health care.

Objective: Families are amongst those most impacted by a suicide attempt. Young people exposed to the suicide attempt of a family member experience high levels of distress and are at risk of suicide themselves. Yet, there is a lack of knowledge about their lived experience and needs. Thus, this study aimed to explore the lived experience of young people with a family member who has attempted suicide.

Method: In this phenomenological qualitative study, nine semi-structured interviews were conducted via video software. Participants were aged between 17 to 30 years (mean: 23, SD: 5.05). Family members had a range of relationships to the young person; four were brothers, two were mothers, two were fathers, and one was a cousin. An Interpretative Phenomenological Analysis was conducted on transcribed interviews.

Results: Four themes were generated from the analysis: 1. Fundamentally rocked; 2. I'm responsible, it's up to me; 3. Moving both toward and away from help (for me); and 4. Families coming together.

Conclusion: Young people experience significant immediate and ongoing burden and distress, including feelings of guilt and hypervigilance, after the suicide attempt of a family member. They wanted to discuss and connect with their family about the traumatic event, however most parents were unwilling or unable to do so, even though these discussions can be transformational. Targeted support and co-designed interventions, including resources, peer support and family-focused clinical support, are needed.

Objective: Healthcare services are potential interventions points before suicide. The aim of the current study was to explore whether mental health (MH) multimorbidity is associated with contact with healthcare services before suicide.

Methods: A retrospective study was conducted using data from the Irish Probable Suicide Deaths Study (IPSDS), over the period 2015-2020. MH conditions were recorded on the basis of collateral information, including medical diagnosis or/and undiagnosed. The IPSDS cohort (n = 3625), comprising deaths given a coronial verdict of suicide and deaths on the balance of probabilities, was allocated to three mutually exclusive health groups: (a) no MH conditions, (b) one MH condition only, (c) two or more MH conditions ("MH multimorbidity"). Descriptive statistics (p ≤ 0.05) and binary logistic regression analyses with odds ratios (OR) and 95% CIs (p ≤ 0.01) are presented.

Results: One fifth (20%) of the IPSDS cohort had MH multimorbidity, which was more prevalent among those aged 35-44 years. The unadjusted logistic regression analysis indicated that those with multimorbidity were significantly more likely to have contacted health services before suicide, compared to those with no MH conditions. This finding was substantially unchanged following adjustment for sex, age, and labor market position (OR = 12.170, 95% CI 9.595-15.437, p < .001) and in a sensitivity analysis restricted to a subset of deaths given a coronial verdict of suicide (OR = 12.728, 95% CI 9.635-16.814).

Conclusions: Our findings suggest that those who experience MH multimorbidity and are in contact with health services should be targeted with tailor-made suicide prevention interventions.

Objective: Suicide is a significant global public health issue, with occupations like farming-marked by financial instability and isolation-facing elevated risks. Despite international evidence, suicidality among Austrian farmers remains unstudied. This study compared suicidal ideation between Austrian farmers (n = 2,006) and the general population (n = 2,007), while identifying sociodemographic, occupational, and behavioral risk factors of suicidality in farmers.

Method: Data were collected via online surveys (October 2024-February 2025), utilizing the PHQ-9 for suicidal ideation and the Suicide Behaviors Questionnaire-Revised (SBQ-R) for suicidality and analyzed with Chi-square tests and logistic regression models adjusted for age and gender disparities.

Results: Farmers reported significantly higher suicidal ideation (19.7%) than the general population (14.3%; χ² = 20.62, p < .001), with 1.4 times greater age- and gender- adjusted odds (95% CI:1.17-1.64). Key risk factors for suicidality in farmers included financial distress (very poor vs. very good: aOR = 2.64, p = .008), high agricultural workload (aOR = 1.01/hour, p = .03), and residing in Eastern Austria vs. Western Austria (aOR = 1.76, p = .003). Protective factors included physical activity outside work (aOR = 0.65, p = .005) and living in a relationship (aOR = 0.61, p = .024).

Conclusions: This study highlights increased suicidal ideation among farmers compared to the general population. Financial instability, high workload, regional differences, physical activity, as well relationships seem influential. Community-based interventions promoting social support and physical activity may mitigate risks, highlighting the interplay of economic and psychosocial factors in farmer suicidality.

Objective: Suicide is the second leading cause of death for adolescents globally. Offset (both early and late) pubertal timing exposes adolescents to additional biological and psychosocial challenges, rendering them at heightened risk for psychopathology. Few studies have examined the relations between pubertal timing and suicidal ideation and attempts, as well as associated underlying mechanisms.

Method: Participants were 29,099 Chinese adolescents (M_age = 12.8, 47.9% female) in a large-scale epidemiology survey. Multi-group structural equation modeling was conducted to examine the associations between pubertal timing and suicidal ideation and attempts, the indirect effects through bullying and victimization and internalizing problems, and sex differences in these links.

Results: Early-maturing adolescents were at elevated risk for experiencing suicidal ideation and attempts. These effects were partly mediated through bullying and victimization experiences and internalizing symptoms. Early-maturing male adolescents were more likely to engage in bullying and experience victimization, whereas female adolescents were particularly vulnerable to internalizing problems and suicidal ideation and attempts following victimization experiences. Late-maturing conferred risk for suicidal attempts among female adolescents.

Conclusions: The findings highlight the potent role of offset pubertal timing in adolescent suicidal ideation and attempts, as well as sex differences in associated risk processes. The results also emphasize the importance of focusing on both mental health and social contextual changes elicited by offset pubertal timing among adolescents as intervention targets.