Archives of Suicide Research最新文献

Objective: Worldwide helplines are considered an important part of suicide prevention strategies. Nevertheless, evidence regarding the impact of suicide prevention helplines on the suicidality of its users remains limited and is frequently confronted with methodological issues. This study aimed to assess the impact of crisis calls on callers' levels of crisis and suicidality both immediately after the call and at follow-up compared to before the call. After the call, the satisfaction of the callers with the intervention was also assessed.

Methods: A pre-post study, generated automatically by a telephone system, was conducted in order to compare the level of crisis and suicidality (operationalized by five indicators: hopelessness, entrapment, controllability, suicidal intent, and social support) experienced by callers before and immediately after the call and at follow-up (one to two weeks after the call).

Results: Callers (n = 487) showed significant improvement in their level of crisis (p < .001, d = -0.31), hopelessness (p < .001, d = -0.22), entrapment (p < .001, d = -0.25), suicide intent (p < .001, d = -0.37), and social support (p < .001, d = 0.33) after the call compared to before the call. Improvements were also found at follow-up compared to pretest. The satisfaction of callers with the helpline was high.

Conclusions: This study adds to the growing evidence on suicide prevention helplines and addresses some important methodological issues in helpline research. Furthermore, it shows promising results regarding the potential supportive impact of helplines on callers who feel suicidal.

Objective: Poor sleep quality exacerbates suicidal ideation. Depression, anxiety, and stress may play important roles in this relationship. However, the underlying mechanisms remain unknown.

Method: A total of 2,598 young men were recruited for a cross-sectional study focusing on a range of sociodemographic factors, emotions, sleep quality, and suicidal ideation. Parallel, serial, and moderated mediation models were used to determine whether depression, anxiety, and stress mediated the relationship between poor sleep quality and suicidal ideation.

Results: Direct and indirect effects of poor sleep quality on suicidal ideation were observed. Depression, anxiety, and stress mediated the relationship between poor sleep quality and suicidal ideation (β_Depression = 0.166, 95% confidence interval [CI]: 0.144, 0191; β_Anxiety = 0.153, 95% CI: 0.130, 0.177; β_Stress = 0.176, 95% CI: 0.154, 0.200). The serial mediation model indicated that depressive and stress symptoms co-play a serial mediating role in the relationship between poor sleep quality and suicidal ideation (β_a = 0.049, 95% CI: 0.036, 0.062; β_b = 0.099, 95% CI: 0.080, 0.120). The moderated mediation model revealed that the mediating role of stress on the relationship between poor sleep quality and suicidal ideation was moderated by depression (β = 0.173, 95% CI: 0.150, 0.197). Self-reported measures and the study's cross-sectional design preclude the causal inferences reported.

Conclusions: The findings of this study prompt clinical and scientific researchers to consider the interplay among affective disorders when investigating etiological and psychological factors that may contribute to suicidal ideation.

Objective: Contemporary approaches to suicide assessment and treatment incorporate reasons for living (RFL) and reasons for dying (RFD). This study qualitatively explored individuals' self-described RFL and RFD in the context of suicidal thinking and behaviors.

Method: Within a community United Kingdom (UK) sample, adults (N = 331, aged 16+) responded to eight open-ended questions probing their experiences of suicide, defeat, and entrapment. Utilizing these data, which were collected from a larger online survey examining risk and protective factors for suicidal behaviors, this study explored RFL and RFD within these narratives. After the research team established an initial code book, RFL and RFD codes were subsequently analyzed through inductive and deductive thematic analyses.

Results: The present study identified five complimentary RFD-RFL themes: (1) Hopelessness-Hopefulness, (2) Stress of Responsibilities-Duty to Responsibilities, (3) Social Disconnection-Social Connection, (4) Death as Sin-Desire for an Afterlife, and (5) Temporary Escapes as Coping-Entrapment (i.e., a lack of escape). Three subthemes within the RFD theme Entrapment were General/Unspecified, By Feelings, and Within Self.

Conclusions: Identified themes reflect the existing quantitative RFL and RFD literature. The identified RFL and RFD themes are discussed with reference to their clinical applications in advancing suicide-specific assessments and interventions. We propose a dimensional framework for RFD and RFL which informs future suicidal behaviors research and practice.

Objective: Suicidality is a critical public health concern, especially among emerging adults who have experienced trauma. However, limitations remain in understanding the associations of suicidal risk and stress-responding. The current study experimentally evaluated the extent to which suicidal thoughts and behaviors (lifetime ideation/attempts, past-year suicidal ideation, threat of suicide attempt, likelihood of suicide in the future) were associated with self-reported psychological and physiological reactivity to a trauma-relevant stress induction task via breathing tasks.

Method: The sample comprised 94 trauma-exposed undergraduate students (M_age = 20.30; 61.7% women) who completed a laboratory-based, within-subjects study. Participants completed both a voluntary hyperventilation challenge and a normal breathing control task and reported psychological and physiological reactivity before and after each trauma-relevant stress induction task.

Results: An overall path model indicated past-year suicidal ideation was significantly positively associated with psychological reactivity (β = .51); no other associations were significant.

Conclusions: Identifying patterns between stress-responding and suicidal thoughts and behaviors may allow researchers and clinicians to develop programs to reduce the risk of suicide in young adults in the future, especially among those who are trauma-exposed.

Background: The objectives of this study were to investigate the relationship between perinatal risk factors and suicidal ideation and attempts in young adults in Pelotas, Brazil.

Methods: The data were collected from the 1993 Pelotas Birth Cohort study. Every pregnant woman who gave birth in one of the hospitals in Pelotas Brazil in 1993 was invited to participate in the study. The current study uses perinatal data collected in 1993, and follow-ups at ages 18 and 22. The primary outcome was lifetime suicide attempts with past month suicide ideation a secondary outcome. The association between perinatal predictors and suicidal ideation or lifetime suicide attempts was investigated using hierarchical logistic regression.

Findings: There was an analytic sample size of 3493. The perinatal factors association with lifetime suicide attempts were sex (OR = 2.25 CI: 1.76-2.89), paternal education at birth (OR = 0.60, 95%CI: 0.36-0.99), maternal education (9-11 years OR = 2.81, 95%CI: 1.41-5.59, & 0-8 years OR = 2.21, 95%CI: 1.07-4.58), support from friends or neighbors at birth (OR = 0.36 95%CI: 0.17-0.77), and maternal smoking during pregnancy (OR = 1.41, 95%CI: 1.10-1.79). Patterns of associations were broadly similar with suicidal ideation. Interactions between sex and the perinatal factors paternal education, maternal education, smoking and support from friends were assessed and found to be not significant.

Conclusion: Several factors during the perinatal period are associated with risk of lifetime suicide attempts and ideation in young adults in Brazil. Early-life factors associated with suicide-related concerns in early adulthood were similar to those observed in studies from high-income settings.

The weeks following an inpatient psychiatric hospitalization are known to be the highest-risk time for suicide. Interventions are needed that are well-matched to the dynamic nature of suicidal thoughts and easily implementable during this high-risk time. We sought to determine the feasibility and acceptability of a novel registered clinical trial that combined three brief in-person sessions to teach core cognitive-behavioral therapy (CBT) skills during hospitalization followed by smartphone-based ecological momentary intervention (EMI) to facilitate real-time practice of the emotion management skills during the 28 days after hospital discharge. Results from this pilot study (N = 26) supported some aspects of feasibility and acceptability. Regarding feasibility, 14.7% of all screened inpatients met study eligibility criteria. Half (50.3%) of those who were ineligible were ineligible because they were not part of the population for whom this treatment was designed (e.g., symptoms such as psychosis rendered them ineligible for the current study). Those who were otherwise eligible based on symptoms were primarily ineligible due to inpatient stays that were too short. Nearly half (48%) of study participants did not receive all three in-person sessions during their hospitalization. Among enrolled participants, rates of engagement with the smartphone-based assessment and EMI prompts were 51.47%. Regarding acceptability, quantitative and qualitative data supported the perceived acceptability of the intervention, and provided recommendations for future iterations. Well-powered effectiveness (and effectiveness-implementation) studies are needed to determine the effects of this promising and highly scalable intervention approach.

Firearm availability is correlated with increased risk of suicide but its link with suicidal ideation remains unclear. Previous studies are limited by retrospective reports and prospective designs with lengthy gaps between assessments that are ill-suited for measuring fluctuations in suicidal ideation. This study used ecological momentary assessment (EMA) to repeatedly assess suicidal ideation in a sample of 138 U.S. adults (81 handgun owners, 57 non-owners). Participants received six EMA prompts per day for 28 consecutive days. Results revealed no group differences in the frequency, maximum amplitude, or variability of suicidal ideation across male and female handgun owners and non-owners. Stability of suicidal ideation significantly differed across groups, however (F(1,132) = 4.5, p = 0.036); male handgun owners had the strongest stability and male non-owners had the weakest stability. Stability of suicidal ideation was significantly lower when participants reported a firearm was nearby as compared to when no firearm was nearby (F(4,17732) = 5.6, p < 0.001). Results suggest firearm availability increases reactivity to the environment, slows recovery from acutely elevated risk states, and may increase vulnerability to sudden shifts to higher risk states characterized by increased probability of suicidal behavior. Although these effects were observed in both handgun owners and non-owners, they disproportionately impact handgun owners because they report being near firearms more often.

Objective: Psychiatric multimorbidity is a well-documented risk factor for suicide. However, diagnostic heterogeneity and patterns of comorbidity likely exists within the population of those who attempt suicide. Person-centered statistical approaches, such as latent class analysis (LCA), extract distinguishable groups differentiated by prevalence and comorbidity of psychiatric disorders.

Method: The present study used LCA to identify typologies of psychiatric heterogeneity in a sample of 213 inpatients (M age = 33.04 [SD = 12.67]; 57.3% female; 62.4% White; 23.9% Hispanic/Latino) with a history of suicide attempt who were recruited for a suicide prevention clinical trial. Class differences in suicide history characteristics; demographic characteristics; and cognitive-affective and behavioral risk factors, obtained from an initial evaluation involving the administration of a semi-structured diagnostic interview, suicide risk assessment, and battery of self-report measures, were explored.

Results: LCA identified three classes in the best-fitting solution: Depressive-High Comorbidity (n = 68), Depressive-Low Comorbidity (n = 86), and Bipolar (n = 59). The Depressive-Low Comorbidity class reported less severe suicidal ideation (p < .001), anxiety (p < .001), stress (p < .001), unlovability beliefs (p = .006), and impulsivity (p < .001). The Depressive-Low Comorbidity class also reported fewer actual attempts than the Bipolar class (p = .001) and fewer interrupted attempts than the Depressive-High Comorbidity class (p = .004).

Conclusions: The Depressive-High Comorbidity and Bipolar classes consistently endorsed higher levels of suicide risk factors. These findings may help to illuminate typologies of suicide attempters with unique clinical needs, which is an essential step toward personalized medicine.

Objective: Bullying has consistently been highlighted as a risk factor for youth self-harm. Less is known about associations by bullying sub-type (i.e., physical, verbal, relational, cyberbullying), among boys and girls in diverse urban populations. This study aimed to explore: (1) prevalence of bullying and lifetime self-harm; (2) cross-sectional associations between bullying and self-harm. Both aims investigated bullying sub-types and the role of sex.

Method: Baseline data on bullying victimization and lifetime self-harm were drawn from REACH (Resilience, Ethnicity and AdolesCent Mental Health), an accelerated cohort study of adolescent mental health in London, United Kingdom. Data on baseline self-harm and sex were available for 3,060 adolescents aged 11-14 years (M_age=12.4, 50.6% girls, >80% ethnic minority groups) from 10 schools.

Results: Prevalence of bullying in the past six months was 22.3% and lifetime self-harm was 16.9%. Both were more common in girls than boys (adjusted risk ratios: bullying, 1.13 [1.02,1.25]; self-harm, 1.45 [1.03,1.86]). By bullying sub-type, prevalence estimates ranged from 4.1% (cyberbullying) to 16.6% (physical bullying). Bullying was associated with self-harm (aRR 3.35 [2.89,3.82]) for both girls (aRR 3.61 [3.07,4.14]) and boys (aRR 2.96 [2.27,3.65]), independent of sex, age, free school meals and ethnic group. All sub-types were associated with self-harm (aRRs 3.16-4.34), for girls and boys.

Conclusions: These baseline findings underline the importance of exploring nuances between bullying sub-types and self-harm, by sex or gender.