Moral objections to suicide and suicidal ideation among mood disordered Whites, Blacks, and Hispanics

Roles of Loneliness, Stress, and Religiosity in Suicide Ideation Among Nigerian Older Adults

Suicidal behavior in older adults is a fundamental public health problem globally and the highest suicide rates occur in low- and middle-income countries (LMICs). However, there is limited research on suicidality among older adults, especially in sub-Saharan Africa. We sought to find out whether loneliness, stress and religiosity would be associated with suicide ideation in a sample of sub-Saharan African older adults (N = 500; aged 51-70 years, Mage = 58.97, SD = 6.16; 45.6% women). They completed the Beck Suicidal Ideation Scale, the UCLA Loneliness Scale-version 3, Perceived Stress Scale, and Religiosity Scale. Regression results showed that whereas suicidal ideation could be increased by loneliness and stress, religious older adults were less likely to report suicidal ideation. Interventions aimed at managing and protecting the mental health of older adults during their transition to late adulthood should guard them against loneliness and buffer their resilience and coping strategies with the connectedness that religiosity offers.

Differences in Beliefs About Suicide by Occupation in a Representative Sample of Adults in the United States, General Social Survey 2002-2021

OBJECTIVE

Beliefs about suicide are important aspects of suicide prevention gatekeeper trainings. This study sought to determine if workers in finance- and legal/judicial-related industries have significantly different levels of suicide acceptability compared to the general US population.

METHOD

Cross-sectional data are from the 2002 to 2021 General Social Survey (GSS). Suicide acceptability was measured with four dichotomous items to which respondents indicated yes/no if they thought someone has the right to end their life in four negative life scenarios. Occupational categories were coded based on U.S. Census Bureau occupation and industry codes. Covariates for multiple logistic regression analyses included age, educational attainment, sex, race, ethnicity, survey year, and religiosity.

RESULTS

Among the 15,166 respondents, 651 people worked in finance-related occupations and 319 people worked in legal/judicial-related occupations. In adjusted models, people in finance-related occupations had greater odds of endorsing suicide as acceptable if one has an incurable disease (aOR = 1.25, 95%CI = 1.03-1.52) and marginally greater odds of endorsing suicide as acceptable if one dishonors their family (aOR = 1.31, 95%CI = 0.99-1.74) than the general adult population. People in legal/judicial-related occupations were more likely to endorse 3 of the 4 suicide acceptability items compared to the general adult population, however these differences were not statistically significant after accounting for demographic factors.

CONCLUSION

Workers in non-clinical industries that frequently see clients during negative life events are prime audiences for gatekeeper trainings but may have entrenched beliefs about suicide acceptability. Research is needed to determine how these beliefs may impact gatekeeper training.

Hopelessness, Interpersonal, and Emotion Dysregulation Perspectives on Suicidal Ideation: Tests in a Clinical Sample

OBJECTIVE

The present study directly compared three perspectives of suicidality: Interpersonal Theory of Suicide (IPTS), Hopelessness Theory, and a perspective emphasizing emotion dysregulation.

METHOD

219 adults seeking outpatient psychological services completed questionnaires during intake between November 2015 and February 2019. Patients were included if they completed surveys related to thwarted belongingness (TB), perceived burdensomeness (PB), hopelessness, depressive symptoms, negative affect, and Borderline Personality Disorder (BPD) symptoms. Analyses tested the ability of TB, PB, depressive symptoms, hopelessness, and emotion dysregulation to relate to total scores on Beck Scale for Suicide Ideation. We employed Pearson's correlations and linear regressions to investigate these relations.

RESULTS

Constructs related to emotion dysregulation-negative affect (r = 0.161, p < .05) and Borderline Personality Disorder symptoms (r = 0.284, p < .01)-were significantly correlated with suicidal ideation, as were those relevant to Hopelessness Theory-depressive symptoms (r = 0.46, p < .01) and hopelessness (r = 0.45, p < .01)- and IPTS-TB (r = 0.36, p < .01) and PB (r = 0.43, p < .01). Notably the combinations of constructs as proposed by theories were significantly associated with suicidal ideation, but did not improve upon single constructs. This indicated that theoretically relevant constructs alone were strongly associated with suicidal ideation, but were not bested by interactions.

CONCLUSIONS

This project compared constructs relevant to three theories of suicidality among a sample of treatment seeking outpatients. Findings indicated that suicidal ideation assessment was similarly informed by Hopelessness Theory and IPTS, and to a lesser degree emotion dysregulation. The cross sectional nature of the data and the reliance upon self-report measures limit the inferences that can be made.

Correlates of suicide risk among Black and White adults with behavioral health disorders in criminal-legal systems

BACKGROUND

Adults with behavioral health disorders in criminal-legal systems are at heightened risk of suicide relative to the general population. Despite documented racial disparities in criminal processing and behavioral health treatment, few studies have examined racial differences in suicide risk in this already high-risk population. This study examined 1) the correlates of suicide risk in this population overall and by race and 2) the moderating role of race in these associations.

METHODS

We investigated correlates of clinician-rated suicide risk at baseline in a statewide sample of 2,827 Black and 14,022 White adults with criminal-legal involvement who engaged in community-based behavioral health treatment. Regression-based approaches were used to model suicide risk and test for evidence of interaction effects.

RESULTS

Findings showed the strongest correlates of suicide risk were greater behavioral health needs, evidence of self-harm, and a primary mental health diagnosis or co-occurring diagnosis. In race-specific analyses, correlates of suicide risk were mostly similar for both Black and White clients, with a couple exceptions. Interaction terms testing between-group effects on correlates of suicide risk were non-significant.

CONCLUSIONS

Adults with behavioral health disorders in criminal-legal systems experience similar risk factors for suicide as the general population. Similar to prior research, we found that Black adults, in particular, are at lower risk for suicide overall. Contrary to expectations, we found similarities in correlates of suicide risk across race in our sample of felony-level adults with behavioral health disorders in the criminal-legal system. Prior research shows that behavioral health professionals should be cognizant of cultural factors when developing a comprehensive approach to suicide care and treatment. Our findings show correlates of suicide risk are largely stable in Black and White adults involved in criminal-legal systems, suggesting culturally responsive treatment for suicide risk should target shared risk factors.

[Psychometric properties of the Russian version of the brief «Reasons for Living Inventory»]

OBJECTIVE

To investigate psychometric properties of the Russian version of the brief Reasons for Living Inventory (bRFL) in patients with non-psychotic mental disorders (NPMD) and to define its association with current suicide ideation.

MATERIAL AND METHODS

Six hundred and 15 consecutive patients with NPMD were included. The median age was 27 (19) years; 403 (65.5%) were female. Cronbach's alpha, Cronbach's alpha coefficient if an item is deleted and corrected item-total correlation were used for the internal consistency evaluation. The internal structure assessment was based on the exploratory and confirmatory factor analysis. To identify an association of bRFL with current suicidal ideation, MANCOVA was used.

RESULTS

An internal consistency of bRFL was good (Cronbach's Alpha-0.856). The exploratory factor analysis revealed a 6-factor model, explaining 80.22% of variance. These factors were: «survival and coping beliefs», «responsibility to family», «child related concerns», «fear of suicide», «fear of social disapproval» and «moral objections». The confirmatory factor analysis indicated a good agreement of the 6-factor model with an empirical data (CMIN/DF - 2.98, CFI - 0.956, SRMR - 0.05, RMSEA - 0.057, PNFI - 0.497). Regardless of gender and age, the total scores of bRFL and its subscales were significantly lower in patients with suicide ideation (p<0.01).

CONCLUSION

The Russian version of bRFL is a reliable and valid tool for the assessment of the adaptive beliefs and expectations that form an anti-suicidal barrier.

Covariate Health Determinants of Suicidal Ideation, Suicide Plans, and Suicide Attempts Among African American Males With and Without Major Depressive Episode

This study aimed to examine risk of suicidal ideation, suicide plans, and suicide attempts among African American males with and without major depressive episodes while adjusting for covariates of age, education, and income. Data from the 2018 National Survey on Drug Use and Health were extracted and analyzed. We found data for 2,301 adult African American men with and without major depressive episodes, representing a population size of 13,210,069.53 in the United States. African American men with major depressive episodes were at higher risk for suicidal ideation and suicide planning than their counterparts without a major depressive episode. However, the two groups with and without major depressive episodes had equal risk chances for suicide attempts. A closer examination of suicide covariate variables among African American men with and without a major depressive episode furnishes critical distinctions between the two populations. This subtle distinction can facilitate more responsive, tailored suicide-prevention strategies for the male African American population, especially among the at-risk male adults in this group with major depressive episodes.HighlightsMajor depressive episodes significantly predicted suicidal ideation and suicide plans among African American males.After adjustment for covariates, African American males with major depressive episodes had a higher risk of suicidal ideation and suicide plans than their counterparts without a major depressive episode.After adjustment for covariates, the risk of suicide attempts remained equal among African American males.

Evaluating Suicide Risk Using the Reasons for Dying-Reasons for Living (RFD-RFL) Index in a Military Psychiatric Inpatient Setting

The present study aimed to explore reasons for dying (RFD) and reasons for living (RFL) among suicidal inpatients, conceptualize the RFD-RFL index, and examine whether suicide risk indicators were associated with the RFD-RFL index scores. Participants were military personnel (N = 167) psychiatrically hospitalized following a suicide-related crisis who provided baseline data as part of a randomized controlled trial. Family was the most commonly reported RFL (39.7%) and was the top ranked RFL for 65.9% of participants. The most frequently endorsed RFD categories included general descriptors of self (26.9%), general statements about escape (19.7%), and others/relationships (19.1%). Greater RFD-RFL index scores were associated with a greater wish to die relative to wish to live, greater hopelessness, and with a history of lifetime multiple suicide attempts. Endorsing more RFD relative to RFL may indicate heightened suicide risk. Results of this study identify the characteristics of RFD and RFL among a high-risk, military sample, and provide preliminary support for the clinical utility of evaluating the quantities of RFD and RFL. Clinicians are encouraged to explore RFD and RFL when working with suicidal patients. Future research may explore military-specific RFD and evaluate the validity of the proposed RFD-RFL index.

Religious Coping, Hopelessness, and Suicide Ideation in Subjects with First-Episode Major Depression: An Exploratory Study in the Real World Clinical Practice

BACKGROUND

This study aimed to evaluate the potential relationships between religious coping, hopelessness, and suicide ideation in adult outpatients with the first episode of major depressive disorder (MDD).

METHODS

Ninety-four adult outpatients with MDD were assessed through the Hamilton Depression Rating Scale (HAM-D), the Beck Hopelessness Scale (BHS), and the Scale of Suicide Ideation (SSI). Religious coping was assessed with the Italian version of the Brief RCOPE scale, consisting of seven positive coping items (PosCop) and seven negative coping items (NegCop).

RESULTS

The results showed that the Brief RCOPE PosCop scale exhibited a strong inverse correlation with HAM-D, BHS, and SSI, whereas HAM-D and BHS were positively correlated with SSI. Brief RCOPE NegCop scores were positively correlated only with SSI. Regression analysis with SSI as the dependent variable showed that higher Brief RCOPE PosCop scores were associated with lower suicide ideation, whereas higher HAM-D and BHS scores were associated with higher suicide ideation.

CONCLUSION

Positive religious coping may be a protective factor against the development of suicide ideation, perhaps counteracting the severity of depressive symptoms and hopelessness. The evaluation of religious coping should be performed in all subjects with MDD in everyday clinical practice. However, this study was preliminary, and limitations must be considered.

Sex and ethnic differences among South Tirolean suicides: A psychological autopsy study

Objective

The aim of the research is to study whether any differences exist in the rates and characteristics of suicide by ethnicity and sex in South Tirol, Italy.

Methods

Psychological autopsy interviews were conducted for suicides who died between March 1997 and July 2006.

Results

332 individuals belonging to the three major South Tirolean ethnic groups (Germans, Italians, Ladins [Ladin is a Rhaeto-Romance language related to the Venetian and Swiss Romansh languages]) died by suicide. Around 23% of the victims had experienced suicidal behaviour among family members, and more than 31% of them had experienced trauma during their childhood. Germans were 1.37 times more at risk to commit suicide than Italians (95% CI: 1.04/1.80; z = 2.26, p < .05). 69% of the suicides had attended school for less than 8 years: Germans (OR = 4.62; 95% CI: 2.52/8.47; p < .001) and Ladins (OR = 11.24; 95% CI: 2.99/42.30; p < .001) were more likely to have lower education than Italians. There were several differences by ethnicity and sex but no sex-by-ethnicity interactions.

Conclusions

The study indicated that suicide, an alarming health and social problem in South Tirol, may require different preventive interventions for men and women and for those of different ethnicities.

Reasons for Living and Coping with Suicidal Ideation among Adolescents in Malaysia

Introduction

The rate of suicide ideation everywhere continues to increase, and adolescents are therefore at risk of displaying suicidal behaviour. This study examined the protective role of the reasons for living and coping strategies in reducing suicidal ideation among young adolescents in Malaysia.

Methods

A cross-sectional survey was conducted among 176 adolescents aged between 13 and 19 years of age with the majority being Malay and Muslim. The Brief Reasons for Living for Adolescents (BRFL-A), Jalowiec Coping Scale and Suicide Ideation Scale were employed.

Results

The results showed that the reasons for living and palliative coping strategy correlated negatively with suicide ideation; although, further analysis using multiple regression revealed that family alliance and optimistic and palliative coping strategies were found to be significant reasons for living that protect adolescents from suicidal thoughts. Also, those adolescents who used emotive and evasive coping strategies had higher suicidal ideation.

Conclusion

Cultural and social values continue to play an important role in protecting adolescents in Malaysia from suicidal behaviour.

Moral Objections and Fear of Hell: An Important Barrier to Suicidality

This review explores the literature to test the hypothesis that 'moral objections to suicide (MOS), especially the conviction of going to hell after committing suicide, exert a restraining effect on suicide and suicidality.' Medline and PsycInfo were searched using all relevant search terms; all relevant articles were selected, rated and reviewed. Fifteen cross-sectional studies were available on this topic, and raise sufficient evidence to confirm a restraining effect of MOS, and sparse data on fear of hell. MOS seem to counteract especially the development of suicidal intent and attempts, and possibly the lethality of suicidal attempts. A differential pattern of influence of MOS on the suicidal continuum is suggested.

Comparing characteristics of suicide attempters with suicidal ideation and those without suicidal ideation treated in the emergency departments of general hospitals in China

Suicide attempts are more frequent than suicides, and suicidal ideation has been identified as an important precursor of both attempted and completed suicide. In this study, we compare the characteristics of suicide attempters with suicidal ideation and suicide attempters without suicidal ideation who were treated in the emergency departments of general hospitals in China. We identified 166 people as having suicidal ideation and 73 people who did not have suicidal ideation. The suicide attempters with suicidal ideation were more likely to be more depressed, older, have a lower score on life quality, female, divorced and unemployed, report having religious beliefs, have a suicide attempt history and a psychiatric diagnosis, and intend to reduce pain as motives. However, the suicide attempters without suicidal ideation were more likely to have a more self-rescue ideation and were more impulsive, and to threaten or intend revenge on others as motives. Multivariate logistic regression analysis identified the following independent predictors of suicidal ideation in the suicide attempters: a higher score on Hamilton Depression Rating Scale, religious beliefs, non-impulsive suicide attempts, and a psychiatric diagnosis. The results indicate the importance of developing different interventions for the two groups to prevent future suicide in China.

Suicide Acceptability and Sexual Orientation: Results from the General Social Survey 2008-2014

Lesbian, gay, and bisexual (LGB) individuals have higher prevalence of lifetime suicide ideation and attempt than their heterosexual peers, but less is known about differences in suicide acceptability (i.e., believing suicide is a viable answer to a problem). The purpose of this study was to examine if LGB adults had greater suicide acceptability than heterosexual adults. A total of 4 items in the General Social Surveys from 2008 to 2014 assessed whether a nationally representative sample of U.S. adult respondents (n = 5,037) thought it acceptable for individuals to kill themselves if one: goes bankrupt, dishonors their family, is tired of living, or has an incurable disease. Multiple logistic regression analyses were used to assess the association of sexual orientation with suicide acceptability items after adjusting for confounding factors. Compared with heterosexuals, lesbians/gays had higher odds of reporting suicide acceptability if one goes bankrupt (OR = 1.92; 95% CI: 1.06, 3.46), dishonors family (OR = 1.83; 95% CI: 1.01, 3.28), or is tired of living (OR = 2.25; 95% CI: 1.30, 3.90). Bisexual and heterosexual groups were largely similar across the 4 suicide acceptability items. No sexual orientation differences were observed for reporting acceptability of suicide in the instance of an incurable disease. Post hoc analyses revealed significant interactions between sex and sexual orientation, such that differences in suicide acceptability seemed to be driven by sexual minority women rather than by sexual minority men. Suicide acceptability differs by sexual orientation, and community-level interventions around changing norms about suicide may be a prevention strategy for sexual minority individuals.

Permissive beliefs and attitudes about older adult suicide: a suicide enabling script?

OBJECTIVES

In the United States, suicide rates are highest among European American older adults. This phenomenon calls attention to cultural factors, specifically, the suicide beliefs and attitudes of European Americans. Beliefs and attitudes matter in the vulnerability to suicide. As predicted by cultural scripts of suicide theory, suicide is most likely among individuals and in communities where it is expected and is most acceptable. This study examined beliefs about the precipitants of, and protectors against older adult suicide, as well as suicide attitudes, in a predominantly European American community.

DESIGN AND METHODS

Two hundred and fifty-five older adults (86% European American) and 281 younger adults (81% European American) indicated what they thought were the most likely older adult suicide precipitants and protectors, and their opinion about older adult suicide, depending on precipitant.

RESULTS

Health problems were the most endorsed older adult suicide precipitants. Suicide precipitated by health problems was also rated most positively (e.g., rational, courageous). Older adults, persons with more education, and persons who did not identify with a religion expressed the most favorable attitudes about older adult suicide, across suicide precipitants. Men viewed older adult suicide as more admissible, and women, with more sympathy. Perceived suicide protectors included religiosity among older adults, and supportive relationships among younger adults.

CONCLUSIONS

The belief, in this study's predominantly European American community, that older adult suicide is triggered by health problems, together with favorable attitudes about older adult suicide, suggest an enabling older adult suicide script, with implications for suicide risk and prevention.

Suicidality in High-Risk Psychiatric Patients: The Contribution of Protective Factors

OBJECTIVE

This study's objective was determine the incremental association of reasons for living to the lifetime number of suicide attempts in relation to other known risk and protective factors in a sample of psychiatric patients with extensive psychopathology in residential treatment.

METHODS

Participants (n = 131) completed a demographic questionnaire that also asked for information about lifetime suicide history, psychiatric history, trauma, and abuse history. Additional measures of resilience, reasons for living (RFL), and impulsiveness were completed.

RESULTS

A history of sexual abuse was associated with an increasing lifetime number of suicide attempts, while a history of physical abuse and trait impulsiveness were not associated with the lifetime number of suicide attempts. Survival and coping beliefs, a subscale of the Reasons for Living Inventory (RFLI), was found to add incremental predictive validity to the number of lifetime suicide attempts. A composite fear variable, combining fear of suicide and fear of social consequences of suicide, was negatively correlated with lifetime number of attempts but did not add incremental validity to the prediction of lifetime number of suicide attempts.

CONCLUSION

In a sample of participants with significant psychiatric impairment, the protective factor of survival and coping beliefs may be an important barrier to repeated suicide attempts and may be considered a suicide-specific resilience measure. Understanding the psychological processes contributing to the development of such protective factors as resilience, meaning in life, and coping resources is an important area of study and a potential avenue for targeted therapeutic intervention in high-risk populations.

Do reasons for living protect against suicidal thoughts and behaviors? A systematic review of the literature

BACKGROUND

Few studies have investigated protective factors against suicide.

OBJECTIVES

To identify whether reasons for living (RFL), measured with the Reasons for Living Inventory (RFLI), protect against suicidal ideation (SI), attempts (SA) and suicide death.

METHOD

This systematic review followed the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) statement guidelines. PubMed database was searched for studies published until October 2015. Studies were eligible if they used RFLI or one of its versions. All eligible studies were included, regardless of study design, quality indicators, and target populations. No publication year limit was imposed. We included 39 studies.

RESULTS

RFL may protect against SI and SA and yield a predictive value. The role of two specific reasons for living (Moral Objections to Suicide and Survival and Coping Beliefs) was particularly emphasized. No study investigating suicide death was found.

CONCLUSION

RFL may moderate suicide risk factors and correlate with resilience factors. Moreover, RFL may depend on and interact with numerous factors such as DSM-IV Axis I disorders, personality disorders and features, coping abilities and social support. Clinicians could develop therapeutic strategies aimed at enhancing RFL, like Dialectical Behavior Therapy and Cognitive Behavioral Therapies, to prevent suicidal thoughts and behaviors and improve the care management of suicidal patients.

Perceived racism and suicide ideation: mediating role of depression but moderating role of religiosity among African American adults

Suicide is a public health problem for African Americans who are young and of working age. The purpose of this study was to examine mediated and moderated effects of perceived racism on suicide ideation in a community sample of 236 African American men and women. Measures of suicide ideation, depression symptoms, intrinsic/extrinsic religiosity, and perceived racism were administered. Perceived racial discrimination was directly and indirectly associated with suicide ideation. For participants who reported low levels of extrinsic religiosity, the mediated effect of perceived racism (via depression symptoms) was significant. These findings provide some insight into suicide vulnerability for specific subgroups of African Americans.

Associations between reasons for living and diminished suicide intent among African-American female suicide attempters

African-American women are at high risk for suicide ideation and suicide attempts and use emergency psychiatric services at disproportionately high rates relative to men and other ethnic groups. However, suicide death rates are low for this population. Cultural variables in the African-American community may promote resilience and prevent fatal suicidal behavior among African-American women. The present study evaluated self-reported reasons for living as a protective factor against suicidal intent and suicide attempt lethality in a sample of African-American female suicide attempters (n = 150). Regression analyses revealed that reasons for living were negatively associated with suicidal intent, even after controlling for spiritual well-being and symptoms of depression. These results indicate that the ability to generate and contemplate reasons for valuing life may serve as a protective characteristic against life-threatening suicidal behavior among African-American women. Implications for research and clinical practice are further discussed.

Validation of reasons for living and their relationship with suicidal ideation in Korean college students

This study aimed to examine the validity of reasons for living (RFL) and the protective role they may play against suicidal ideation in college students in South Korea. A total of 277 undergraduate students participated by completing the College Student Reasons for Living Inventory (CS-RFL), along with measures of suicide risk including depression, hopelessness, and suicidal ideation. The five CS-RFL subscales displayed strong negative correlations with the three indicators of suicide risk. Hierarchical regression analysis results revealed significant main effects of Survival and Coping Beliefs and Moral Objections to Suicide on suicidal ideation after controlling for depression and hopelessness. Moreover, a general tendency toward lower levels of RFL, especially Moral Objections and Responsibility to Family and Friends, was observed compared to those reported in Asian American and European American students. Qualitative studies are needed to increase the validity of RFL inventories and verify whether the observed cultural differences, such as lower Moral Objections, are due to actual variance in underlying belief systems or mere systematic effects of the study variables or measurement bias. Overall, the strong relationship between RFL and suicidal ideation suggest that RFL may be an important factor in assessing suicide risk and devising preventive measures for Korean college students.

Survey of Minnesota parent attitudes regarding school-based depression and suicide screening and education

School-based depression screening and education programs are recommended for addressing the high rates of children's mental illness. The objectives of this study were to (1) identify Minnesota parent attitudes regarding the provision of school-based depression and suicide screening and education and (2) identify predictors of parent support for these school-based programs. A random sample of 1,300 Minnesota households with children ages 5-18 years was surveyed by mail. Chi-square tests and regression analyses were used to detect differences in parent support for depression and suicide screening and education across demographic categories, and parent beliefs and knowledge about depression and suicide. The response rate of eligible households was 43 % (N = 511). Overall, 84-89 % of parents supported school-based depression and suicide screening and education. After adjusting for all variables, parent support for depression screening was associated with greater knowledge [OR 8.48, CI(1.30-55.21)] and fewer stigmatizing beliefs [OR 0.03, CI(0.01-0.12)]. Support for suicide screening was associated with fewer stigmatizing beliefs [OR 0.03, CI(0.01-0.10)]. Support for depression education was associated with fewer stigmatizing beliefs [OR 0.32, CI(0.10-1.00)] and lower educational attainment [OR 0.59, CI(0.40-0.89)]. Support for suicide education was associated with greater knowledge [OR 7.99, CI(1.02-62.68)], fewer stigmatizing beliefs [OR 0.26, CI(0.07-0.92)], and lower educational attainment [OR 0.60, CI(0.38-0.94)]. Parent support for school-based depression and suicide screening and education was high. Parent education to decrease stigmatizing beliefs and increase knowledge about depression and suicide may increase support among the minority of parents who do not endorse such programs.

Protective factors and suicidality in members of Arab kindred

BACKGROUND

Relatively little is known about the role of protective factors in an Arab population in the presence of suicidal risk factors.

AIMS

To examine the role of protective factors in a subsample of in large Arab Kindred participants in the presence of suicidal risk factors.

METHODS

We assessed protective and risk factors in a sample of 64 participants (16 suicidal and 48 nonsuicidal) between 15 and 55 years of age, using a comprehensive structured psychiatric interview, the Composite International Diagnostic Interview (CIDI), self-reported depression, anxiety, hopelessness, impulsivity, hostility, and suicidal behavior in first-degree and second-relatives. We also used the Religiosity Questionnaire and suicide attitude (SUIATT) and multidimensional perceived support scale.

RESULTS

Suicidal as opposed to nonsuicidal participants were more likely to have a lifetime history of major depressive disorder (MDD) (68.8% vs. 22.9% χ2=11.17, p=.001), an anxiety disorder (87.5% vs. 22.9, χ2=21.02, p<.001), or posttraumatic stress disorder (PTSD) (25% vs. 0.0%, Fisher's, p=.003). Individuals who are otherwise at high risk for suicidality have a much lower risk when they experience higher perceived social support (3.31±1.36 vs. 4.96±1.40, t=4.10, df=62, p<.001), and they have the view that suicide is somehow unacceptable (1.83±.10 vs. 1.89±.07, t=2.76, df=60, p=.008).

CONCLUSIONS

Taken together with other studies, these data suggest that the augmentation of protective factors could play a very important role in the prevention of incidental and recurrent suicidal behavior in Arab populations, where suicidal behavior in increasing rapidly.

The Spanish Reasons for Living Inventory (SRFL-I): factor structure and association with suicide risk among Spanish speaking Hispanics

The present study examined the factor structure of a Spanish-translated version of the Reasons for Living Inventory (SRFL-I; Oquendo, Baca-Garcia, Graver et al., 2000). Participants (N = 168) were from a combined sample of bilingual undergraduate students and monolingual Spanish speaking outpatients at a community health center. Factor analytic results yielded a seven factor structure: Survival Beliefs, Suicide Appraisal, Problem Solving Beliefs, Family Related Concerns, Suicide Self-Efficacy, Moral Objections, and Fear of Suicide. The SRFL-I subscales displayed high internal consistencies, as well as appropriate convergent and divergent associations with depression and suicide indicators. As expected, subscales (Problem Solving Beliefs, Moral Objections, Survival Beliefs, and Suicide Self-Efficacy) from the SRFL-I displayed direct and moderating effects on suicide risk indicators. Results are discussed with respect to how culturally specific beliefs among Hispanics are reflected using the SRFL-I.