Archives of Suicide Research最新文献

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.

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).