Archives of Suicide Research最新文献

Objective: Emotion-based impulsivity (EBI) and hazardous drinking have consistently been associated with elevated negative thoughts related to suicide ideation (N-SI); however, the interaction between these risk factors has not been tested empirically. Thus, we tested the moderating effect of hazardous drinking on the relation between EBI and N-SI in a high-risk adult sample.

Method: Cross-sectional, self-report data were used from adults (N = 329, M_age = 36.61 years, SD = 11.38) screened for elevated suicide risk and previous alcohol use via Amazon's Mechanical Turk crowdsourcing platform.

Results: Bivariate correlations indicated significant positive associations between EBI, hazardous drinking, and N-SI. Furthermore, hazardous drinking moderated the relation between EBI and N-SI, such that the association between EBI and N-SI was stronger among those with more severe hazardous drinking. This moderation effect was robust to the inclusion of additional covariates.

Conclusion: This study demonstrated that hazardous drinking strengthens the association between EBI and N-SI among adults with elevated suicide risk and previous alcohol use. These findings underscore the need for clinicians to fully evaluate the drinking behaviors of individuals at risk for suicide. Further directions for research are discussed.

Objective: Suicidal communications (SCs)-also known as suicide threats or "gestures," whereby an individual verbally or behaviorally signals suicidal intent-present a serious challenge to clinicians and loved ones, who may struggle to determine the appropriate level of response. Yet, few studies have examined clinical correlates of SCs, partly due to inconsistent operationalization. It is critical to identify mechanisms that maintain SCs and clarify associated suicide risk, especially among individuals with borderline personality disorder (BPD), among whom SCs are relatively common.

Method: Adults (N = 108) with BPD receiving a 6-month course of dialectical behavior therapy (DBT) reported on SCs and other suicidal thoughts and behaviors (STBs) at intake, mid-treatment, and end-of-treatment. Participants also completed measures assessing BPD severity, emotion dysregulation, and DBT skills uptake.

Results: Participants who endorsed lifetime SCs (53%) reported higher BPD severity and worse emotion dysregulation at baseline. However, dosage of DBT-conceptualized as both skills uptake and length of time in treatment-reduced the incidence of SCs. There were no significant associations between lifetime SCs and engagement in other STBs, both at baseline and during treatment.

Conclusion: Current findings support a conceptualization of SCs as an expression of severe emotion dysregulation, which may be alleviated by DBT. Specifically, DBT may protect against SCs by teaching alternative, more adaptive coping strategies, even in the presence of heightened emotion dysregulation. Finally, though results indicate a lack of association between SCs and other STBs, further researcher is needed before clinical recommendations can be made.

Background: Non-suicidal self-injury (NSSI) is a pressing public health concern on college campuses, with increasing evidence highlighting cybervictimization as a critical predictor of NSSI behaviors. However, the underlying mechanisms through which cybervictimization linking to NSSI behaviors remain under elucidation and warrant further investigation.

Objective: This study aimed to investigate the relationship between cybervictimization and NSSI behaviors among college students, with a specific focus on the mediating role of rumination and the moderating role of resilience in this relationship.

Method: An observational cross-sectional study was conducted with a convenience sample of 1,439 college students from public universities in Hunan Province, China. Data were collected via an online questionnaire assessing cybervictimization, NSSI behaviors, rumination, and resilience. Descriptive statistics and Pearson's correlation analysis were first conducted, and structural equation modeling (SEM) and moderated mediation analysis were then applied to test the proposed relationships.

Result: The study sample comprised 1439 college students with a mean age of 18.44 ± 0.84 years. Pearson's correlation analysis revealed significant positive associations between NSSI behaviors and both cybervictimization (r = 0.29, p < 0.01) and rumination (r = 0.17, p < 0.01), and a negative association with resilience (r = -0.25, p < 0.01). Moderated mediation analysis indicated that rumination mediated while resilience moderated the positive correlation between cybervictimization and NSSI behaviors (all p < 0.05).

Conclusion: The study highlights the critical role of rumination as a mediator and resilience as a moderator in the relationship between cybervictimization and NSSI behaviors. These findings provide crucial insights for developing and implementing interventions to prevent and reduce NSSI behaviors among college students, underscoring the importance of addressing both cognitive processes and personal resources to effectively mitigate and eliminate NSSI risks among college students with cybervictimization experiences.

Objective: Suicide rates continue to rise, particularly among young adults, with college student-athletes representing a specific subgroup of concern. The aim of this systematic review was to clarify the individual and environmental risk factors for suicide specific to U.S. college student-athletes.

Method: Databases searched included the State University of New York (SUNY) libraries, Google Scholar, Web of Science, PsychINFO, Semantic Scholar, and PubMed. No date restrictions were applied, resulting in 112 articles and reports included in this review. Studies examining U.S. student-athletes participating in intercollegiate athletics within the context of suicide, including ideation, actions, or attempts, met the inclusion criteria for this thematic review. The PRISMA framework guided the literature selection and content review.

Results: Risk factors included the convergence of academic and athletic pressure, toxic team culture, barriers to accessing services, complexities of the athlete identity, and experiences of injury.

Conclusion: Given these unique risk factors, approaches to suicide prevention, intervention, and postvention for U.S. college student-athletes should include mandated suicide training for college athletic department personnel, routine mental health screening for athletes, improved access to mental health services, and the implementation of collaborative multidisciplinary care.

Objective: Maternal suicide is a leading cause of death during pregnancy and after birth (perinatal period). Perinatal suicidality is associated with significant adverse consequences for mother and baby. It is vital that women experiencing suicidality are identified early and given access to appropriate care. Screening measures are one way to identify women requiring additional support. No self-report screening measures have been specifically designed to identify suicidality in perinatal women. This study sought to determine the content validity, acceptability, and potential clinical utility of 22 suicide-related items that have been adapted and/or developed for use with perinatal women.

Method: Two-round Delphi study. Thirty panelists with expertise and/or experience in perinatal mental health, suicidality and/or the development of measurement instruments took part. Items were rated against five dimensions, "relevance," "clarity," "acceptability," "effectiveness," and "feasibility." Consensus was determined as ≥70% panelists endorsing "quite" or "highly" for all dimensions. Response options were also rated on three dimensions, and qualitative feedback was explored.

Results: Ten items reached consensus ≥70% for all five dimensions in round-one and a further four reached consensus in round-two, totaling 14 items. Twenty-one response scales/items reached consensus ≥70% in both rounds. The top-ranking item for identifying suicidal ideation was "Have you had thoughts about ending your own life?" Qualitative findings highlighted key areas to be addressed. These included the implications of item content, the importance of asking perinatal women about suicidality, and the need for all pregnant and postnatal women to receive appropriate information about perinatal mental health and suicidality.

Conclusions: Specifically developed screening measures to identify perinatal suicidality are warranted. Findings from this study will help to inform the continuing development of suicidality items for measures to be used with pregnant and postnatal women in clinical and research settings.

Objective: The suicide crisis syndrome (SCS) is a suicide-specific acute cognitive-affective state that seeks to identify individuals at increased near-term risk of suicide. However, little is known about its correlates in psychiatric populations. We aimed to assess symptom severity and sociodemographic correlates of SCS in patients with major depressive disorder (MDD), compared to healthy controls.

Methods: Between November 2021 and August 2022, we cross-sectionally administered the revised Suicide Crisis Inventory (SCI-2) to patients with MDD and matched healthy controls across 24 centers in India. We compared SCS total and domain scores between groups using independent samples t-tests. Linear regressions were used to determine the sociodemographic characteristics uniquely associated with SCS, over and above clinical diagnosis.

Results: We obtained responses from 1196 patients with MDD (Mean age = 38.1 ± 12.2 years, 54.8% female) and 1067 controls (Mean age = 36.7 ± 11.4 years, 50.5% female). The MDD group had significantly greater severity of total SCS symptoms (t[2063]= -58.57, p < 0.001, Cohen's d = 2.42) and each of its five domains. In multivariate analyses, age (B= -.37, SE=.11, p < 0.001), female sex (B = 3.61, SE = 1.62, p = 0.026), and living in a nuclear family (B= -3.97, SE = 1.73, p = 0.022) were significantly associated with SCS symptoms. The relationship between age and SCS symptoms was significantly stronger among MDD patients (B= -0.48, SE = 0.14, p < 0.001).

Conclusion: Our findings are consistent with prior cross-national investigations of SCS correlates in community samples and overlap with correlates of suicidal behavior. These results point to the potential utility of the SCS construct in early identification of at-risk individuals and prevention of subsequent suicidal behavior.

Objective: Crisis lines face challenges in identifying individuals at high suicide risk. We aimed to compare two routine methods for predicting suicide acts at different time points.

Methods: In this prospective cohort study, we recruited and monitored 8859 callers from the Beijing Psychological Support Hotline. We evaluated their suicide risk through two strategies during their index calls: (a) one screening about suicidal ideation, plan, or behavior in the last two weeks and (b) the Comprehensive Suicidal Risk Assessment Scale, which included more risk factors, such as depression, hopelessness, and psychological distress. We monitored their suicidal behaviors for one year through telephone interviews.

Results: The number of callers who attempted suicide or died by suicide within 24 hours (1.2%), 30 days (3.8%), 180 days (6.9%), or 365 days (9.1%) was: 102, 341, 615, and 802, respectively. The sensitivities, specificities, and positive predictive values for screening for recent suicidal history were higher than those of the comprehensive scale for predicting suicidal acts within each time point. However, with the increasing duration of the follow-up, the screening had a poorer predictive ability than the comprehensive scale (predicting suicide acts within 270 days: Youden's index, 34.5% vs. 36.2%.; the Area under the Receiver Operator Characteristic Curve, 67.2% vs. 68.1%), especially among those without a history of suicide attempts.

Conclusions: Screening for recent suicidal history is valid for predicting suicidal acts within six months; however, screening is insufficient for predicting long-term suicidal acts compared to assessing more suicide risk factors.

Objective: Suicide is among the leading causes of death among adolescents. Many risk factors for suicide are well known, and self-harm ideation and behavior are among the strongest. Still, there is limited research on factors that distinguish those with self-harm ideation and those who self-harm. Our aim is to investigate nonpsychiatric risk factors that distinguish between adolescents with self-harm ideation, those who self-harm, and those who engage in repeated self-harm.

Method: This survey analysis was based on findings from a cross-sectional study (N = 7,943 adolescents). Multinomial logistic regression was employed to compare the effects of various exposures (including social relations, happiness, vulnerability, being bullied, self-worth, physical and sexual abuse) on self-harm ideation, self-harm, and repeated self-harm, using a reference group of adolescents without self-harming behavior.

Results: Adolescents exhibiting self-harming behavior showed significantly higher levels of exposure, with the highest exposure observed in the repeated self-harm group. Vulnerability and lack of self-worth emerged as the most significant risk factors. Additionally, we found a clear dose-response effect across all groups.

Conclusions: This study highlights the significant increase in the risk of self-harm with the accumulation of risk factors in adolescents' lives, emphasizing the importance of providing support and assistance to those exposed to multiple risk factors. Addressing these factors may help reduce the risk of suicidal behavior, as self-harm remains one of the strongest risk factors for suicide attempt and suicide. Furthermore, the findings point out the critical role of single risk factors, particularly vulnerability and lack of self-worth.

Objective: Self-harm among children and adolescents is a global public health issue, with concerning trends of increased rates of hospital presenting self-harm in younger age groups (5-12 years). Few studies have investigated risk factors of emerging self-harm in preadolescent populations (<12 years). This study aimed to identify key factors associated with recent (past 12-months) self-harm in preadolescents (5-12 years) compared to adolescents (13-18 years).

Method: This cross-sectional case-control study recruited 305 parents/guardians who had a child (aged 5-18 years) that had (i) recently engaged in self-harm (case group) or (ii) never engaged in self-harm (control group). Participants completed an online parent-report questionnaire that assessed demographic characteristics and self-harm, childhood adversity, child-parent relationships, peer relationships, and problematic digital media use. Data were analyzed using univariate and multivariate logistic regression analyses.

Results: Poorer emotion regulation (OR = 1/0.76 = 1.32), lower parental age (OR = 1/0.83 = 1.20), lower household income (OR = 4.38), problematic peer relationships (OR = 1.38), and lifetime suicidal ideation (OR = 20.34) were associated with increased odds of self-harm among all youth ages. Higher parent education was associated with greater odds of self-harm among preadolescents (OR = 0.02). Lifetime mental health diagnosis (OR = 7.84) and lower levels of childhood adversity (OR = 0.60) were associated with greater odds of recent self-harm among adolescents.

Conclusions: Coordinated multi-agency efforts are essential for holistically addressing common, modifiable individual, social, and socioeconomic risk factors of youth self-harm that may help to prevent onset in young people.

With its susceptibility in victimized populations and the potential for suicidality, non-suicidal self-injury (NSSI) is among the most severe health concerns in college students, indicating an urgency to explore its antecedents and interventions. The present study aims to examine the relationship between bullying victimization and NSSI and the mediating roles of internal shame, external shame, depressive symptoms, and PTSD symptoms based on the general strain theory, the vulnerability-stress theory, and the transactional stress theory. By adopting a three-time-point design with 6-month intervals, hypotheses were tested using data from 634 Chinese college students (374 female; Mage = 18.97). Through a structural equation modeling approach, the study found that bullying victimization was positively correlated with NSSI via internal shame and depressive symptoms. However, this study found no evidence for the mediating association of either external shame or PTSD symptoms in the examined relationship. Through a lens of emotion-driven mechanism, this study contributes to understanding the roles of internal shame and depressive symptoms in NSSI intervention strategies among victims of bullying. The results also illuminate the differentiation of the mechanisms of internal and external shame and the discrepancy between depressive symptoms and PTSD symptoms as two types of post-traumatic symptomatology.