Archives of Suicide Research最新文献

Individuals who have experienced suicidal thoughts or behaviors report experiencing stigma from social contacts and treatment providers. Although research has measured experiences of stigma related to suicide, tools measuring destigmatizing or adaptive cognitions related to suicide are limited. This study adapted a resource from NowMattersNow.org listing 10 things people with lived experience of suicide said they wished they knew when they were suicidal. These 10 things were modified into pilot items for the development of a measure of adaptive cognitions about suicide. Participants (N = 1,258) completed the pilot items, demographic items, and convergent/divergent measures. The sample was randomly split 25% (n = 314)/75% (n = 944) for exploratory and confirmatory analyses. Exploratory factor analysis, confirmatory factor analysis, internal consistency estimates, measurement invariance testing, and correlations with other measures were performed. A two-factor model was identified, with one factor related to coping beliefs and one factor related to destigmatizing beliefs. Four items that did not clearly load into the two identified factors were dropped, leaving six items in the final scale (three for each factor). This obtained a good fit in a CFA framework. Scores on the two factors correlated in the expected directions with measures related to stigma, mental health, and experiences with suicide. The measure was invariant across gender. However, lower-than-desirable internal consistency estimates were obtained. The resultant measure, the Adaptive Suicide Cognitions Scale, assesses two constructs that may be useful to examine further, with the goal of reducing the severity and impacts of suicide-related stigma.

Objective: Suicide is widely acknowledged as a pervasive global public health issue. Support for those bereaved by suicide (postvention) is a neglected area of research. Suicide loss survivors struggle with guilt, stigma, and a drive to comprehend. This study aimed to assess the ramifications of bereavement by suicide within a cohort of peer-support group members.

Method: Data were collected using in-depth face-to-face and online semi-structured interviews. Audio-recordings of the interviews were transcribed and analyzed via Interpretative Phenomenological Analysis. Eight people, recruited from a UK Peer Support Group, participated.

Findings: Five Group Experiential Themes emerged: (1) "Never going to live a normal life"; (2) "You just wear a mask"; (3) "I'm conflicted"; (4) "I just want change"; (5) "Everyone in the room understood." Findings provide insights into the mindset of a cross-section of those bereaved by suicide and the all-encompassing, pervasive, life-shattering consequences of becoming a suicide loss survivor. These include the duality of their inner torment and public persona, perpetual possession of conflicting thoughts and perspectives, and alienation.

Conclusions: A unique level of comprehension as to the power of peer-support groups is also outlined. Implications for practice include the signposting of postvention services requiring enhancement and the vital role played by peer-support groups in assisting those impacted.

Objective: Text-based crisis services often gather information on users' suicide risk prior to intervention. Suicide.ca's crisis chat service uses a triage questionnaire combining a screening question on suicidal intent with the Suicidal Ideation Attributes Scale (SIDAS) to help identify users at highest risk. This study aimed to: (1) evaluate the SIDAS's psychometric properties in a real-world setting; and (2) assess its predictive validity in identifying users likely to be classified as high risk by counselors; and (3) examine whether combining the SIDAS with the suicidal intent question improves detection of high-risk users.

Method: At triage, users completed the French version of the SIDAS along with questions on age, gender, and suicidal intent. Data from 1,480 users who subsequently received crisis intervention were analyzed. Predictive validity was evaluated using counselors' suicide risk assessments.

Results: Confirmatory factor analysis replicated the unifactorial structure of the SIDAS. All items showed satisfactory factor loadings except item 2. Internal consistency was good (ω = .80). ROC analysis showed low sensitivity and specificity in differentiating high- vs low-risk users. Adding the SIDAS (cutoff ≥ 32) to the suicidal intent item in a hierarchical regression yielded a statistically significant but modest increase in explained variance.

Conclusions: The SIDAS showed similar psychometric performance in a real-world context. While a revised cutoff improved prediction slightly, its added value in identifying users deemed high risk by counselors appears limited. The clinical utility of the SIDAS and implications of using a revised cutoff for triage in text-based intervention services will be discussed.

Objective: Understanding patterns of suicide risk over the course of development can aid our ability to prevent suicide. Our community-based study examined changes in suicide risk status and predictors of changes in risk status in a sample of 521 adolescents over six assessments between the start of middle school and young adulthood (ages 12-22).

Methods: Suicidal thoughts and behaviors (STB) were measured with the Diagnostic Interview Schedule for Children and the Moods and Feelings Questionnaire. Latent transition analysis (LTA) was utilized to evaluate transitions in suicide risk status over the course of development. Nine risk factors' initial values and change over time were modeled as predictors in the LTA.

Results: Latent class analysis identified a four-class model of developmental suicide risk patterns: Class 1: Infrequent STB (73-87% of participants), Class 2: Diminishing STB (1-17% of participants), Class 3: Escalating STB (6-16% of participants), and Class 4: Consistently High STB (1-5% of participants). LTA demonstrated that infrequent STB members and escalating STB members were likely to maintain their risk class across time points.

Conclusions: Classification of STB trajectories demonstrated self-worth and family involvement were salient variables affecting transitions in risk over time and suggest prevention targets early in adolescence that could have impact on suicide risk in adulthood.

Objective: Disclosure of self-injurious thoughts and behaviors (SITBs) can serve as a catalyst to receiving mental health and lifesaving care; yet, many young people do not disclose these experiences to their therapists. In this study we aimed to identify barriers to adolescents disclosing their SITBs to their therapists and to compare these barriers across non-disclosure of suicidal ideation, suicidal behavior, and non-suicidal self-injury.

Method: Participants (n = 292) all had lived experience of at least one SITB and were an average age of 15.55 years, with the majority identifying as cisgender girls (68.15%). Using inductive content analysis of open-ended responses, six main categories of disclosure barriers were identified.

Results: These overarching barriers were: Agency Theft, Irrelevance, Therapeutic (Mis)Alliance, Internalized Stigma, Anticipated Stigma, and Lacking Disclosure Self-Efficacy. The majority (85.29%) of subordinate barriers were common across the three SITBs.

Conclusions: Adolescents may hesitate to disclose their SITBs to their therapists for many reasons; prioritizing the therapeutic relationship and working collaboratively with adolescents could be instrumental in not only fostering disclosure but also an overall more positive therapeutic experience.

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.