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Xie T, Jiang W, Liu X, Wang J. Network structure of adolescent social, emotional, and behavioral difficulties and their differential relationships with suicidality. Child Adolesc Ment Health 2024; 29:281-291. [PMID: 38515241 DOI: 10.1111/camh.12693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 03/23/2024]
Abstract
BACKGROUND Social, emotional, and behavioral difficulties (SEBDs) tend to develop during adolescence. Their presence and especially co-occurrence induce numerous disrupting consequences, including suicidality. A recently developed network analysis is suitable to investigate the symptom-level structure of comorbid psychopathology. Rather than pairwise comorbidity networks, the current study investigated a comprehensive network of SEBDs at the symptom level and explored the differential relationships between symptoms of SEBDs and suicidality. METHODS Recruited from four public schools in China, a sample of adolescents (N = 6974, mean age = 15.84, 50.1% boys) were assessed with the Strengths and Difficulties Questionnaire (SDQ) and one suicidality-related item. The cross-sectional network structure of the SEBD symptoms was investigated. The differential associations between individual symptoms of SEBDs and suicidality were also explored with a relative importance analysis. RESULTS The results showed that constantly fidgeting, worry a lot, unhappy, down-hearted, tearful, and easily scared emerged as the most central symptoms in the network of SEBDs. Worry a lot, constantly fidgeting, lose my temper, and being bullied served as bridge symptoms, connecting various domains of SEBDs. In addition, the centrality of symptoms was positively associated with the variance shared with suicidality, with worry a lot and unhappy, down-hearted, and tearful explaining a large portion of the variance of suicidality. CONCLUSIONS Taken together, the results were indicative of close connections among emotional, hyperactivity-inattention, peer, and conduct aspects of adolescent mental health difficulties, as well as the central role of emotional difficulties in the SEBDs network.
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Affiliation(s)
- Tong Xie
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Wanyue Jiang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xiaoyan Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jianping Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
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Hu J, Zheng Y, Xu H, Wang Z, Chang R, Xu L, Cai Y. Perceived stress and suicidal ideation among transgender women in Shenyang and Kunming, China: Exploring the mediating roles of thwarted belongingness, perceived burdensomeness and social exclusion. J Affect Disord 2024:S0165-0327(24)01284-9. [PMID: 39147155 DOI: 10.1016/j.jad.2024.08.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/08/2024] [Accepted: 08/12/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Transgender women have a high prevalence of suicidal ideation, with stress and low interpersonal needs as its main risk factors. This study aimed to investigate the mediating role of interpersonal needs on the relationship between perceived stress and suicidal ideation among transgender women in China. METHODS A cross-sectional study was conducted in Shenyang and Kunming from April to September 2018. 247 transgender women were recruited. Sociodemographic statistics, perceived stress, interpersonal needs and suicidal ideation were obtained. Correlation analysis and mediation analysis were performed to test the relationship among perceived stress, suicidal ideation and interpersonal needs. RESULTS 14.6 % of the participants reported suicidal ideation within a year. Perceived stress was positively correlated with suicidal ideation (r = 0.228, p < 0.001), interpersonal needs and its three dimensions (r = 0.300-0.583, ps < 0.001)-thwarted belongingness, perceived burdensomeness and social exclusion. Interpersonal needs and its three dimensions were also positively correlated with suicidal ideation (r = 0.148-0.299, ps < 0.05). Interpersonal needs, perceived burdensomeness and social exclusion partly mediated the relationship between perceived stress and suicidal ideation, while thwarted belongingness didn't play a mediating role. LIMITATIONS Cross-sectional study limited confirmation of causality between variables. The investigation didn't aim at the specific stressors of sexual minorities. And that participants came from only two regions might affect the generalization of the results. CONCLUSIONS We found a partial mediating role of interpersonal needs between stress and suicidal ideation. Stress reduction and increased social inclusion are needed to reduce suicidal ideation in transgender women.
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Affiliation(s)
- Jiani Hu
- Public Health Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 Xianxia Road, 200335 Shanghai, China; Youth Science and Technology Innovation Studio, affiliated with Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, 1111 Xianxia Road, 200335, Shanghai, China
| | - Yawen Zheng
- Public Health Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 Xianxia Road, 200335 Shanghai, China; Youth Science and Technology Innovation Studio, affiliated with Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, 1111 Xianxia Road, 200335, Shanghai, China.
| | - Huifang Xu
- Public Health Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 Xianxia Road, 200335 Shanghai, China; Youth Science and Technology Innovation Studio, affiliated with Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, 1111 Xianxia Road, 200335, Shanghai, China
| | - Zuxin Wang
- Public Health Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 Xianxia Road, 200335 Shanghai, China; Youth Science and Technology Innovation Studio, affiliated with Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, 1111 Xianxia Road, 200335, Shanghai, China
| | - Ruijie Chang
- Public Health Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 Xianxia Road, 200335 Shanghai, China; Youth Science and Technology Innovation Studio, affiliated with Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, 1111 Xianxia Road, 200335, Shanghai, China.
| | - Lulu Xu
- Public Health Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 Xianxia Road, 200335 Shanghai, China; Youth Science and Technology Innovation Studio, affiliated with Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, 1111 Xianxia Road, 200335, Shanghai, China.
| | - Yong Cai
- Public Health Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 Xianxia Road, 200335 Shanghai, China; Youth Science and Technology Innovation Studio, affiliated with Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, 1111 Xianxia Road, 200335, Shanghai, China.
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Liu Y, Lan D, Zhou Y, Tian H, Xiao J, Gan L, Zhang Y. Role of subjective well-being and resilience in the relationship between hopelessness and suicidal ideation among older adults with moderate to severe ADL limitations in Chinese nursing homes. Geriatr Nurs 2024; 59:418-425. [PMID: 39141949 DOI: 10.1016/j.gerinurse.2024.07.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 07/11/2024] [Accepted: 07/30/2024] [Indexed: 08/16/2024]
Abstract
PURPOSE Hopelessness is a risk factor for suicidal ideation, whereas subjective well-being and resilience are protective factors. Nevertheless, the complicated mechanism underlying these factors has not been fully investigated among older people with moderate to severe ADL limitations in nursing homes. This cross-sectional study investigated the potential role of resilience in mediating the relationship between hopelessness and suicidal ideation as well as whether subjective well-being can moderate this mediating effect. METHODS Older individuals (N = 332; aged ≥ 65 years; 158 males, 174 females) with moderate to severe ADL limitations from 10 nursing homes in Chongqing, China, completed this cross-sectional study from July to December 2022. Hopelessness, resilience, subjective well-being and suicidal ideation were measured. The mediating and moderating effects were explored via regression analysis with bootstrap methods. RESULTS A total of 32.8 % (109/332) of the participants reported current suicidal ideation. The relationship between suicidal ideation and hopelessness was partly influenced by resilience (indirect effect = 0.13, 95 % CI = 0.07∼.20). Subjective well-being moderated the impact of resilience on suicidal ideation (moderating effect = 0.01, 95 % CI = 0.00∼.01) and indirectly impacted the effect of hopelessness on suicidal ideation. CONCLUSION These results emphasize the importance of resilience and subjective well-being in mitigating suicidal ideation, which is a prevalent issue among older adults residing in nursing homes with moderate to severe ADL limitations in China.
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Affiliation(s)
- Ying Liu
- Department of Nursing, Faculty of Nursing, Chongqing Medical and Pharmaceutical College, Shapingba District, Chongqing, 401331, China
| | - Ding Lan
- Department of Training center, Chongqing Medical and Pharmaceutical College, Shapingba District, Chongqing, 401331, China
| | - Yujing Zhou
- Department of Nursing, Faculty of Nursing, Chongqing Medical and Pharmaceutical College, Shapingba District, Chongqing, 401331, China
| | - Hongmei Tian
- Department of Nursing, Faculty of Nursing, Chongqing Medical and Pharmaceutical College, Shapingba District, Chongqing, 401331, China
| | - Juan Xiao
- Department of Training center, Chongqing Medical and Pharmaceutical College, Shapingba District, Chongqing, 401331, China
| | - Lu Gan
- Outpatient Department, Rehabilitation Facility for Retired Cadres, Shapingba District, Chongqing, 400038, China
| | - Yi Zhang
- Higher Education Research Institute, Chongqing Medical and Pharmaceutical College, Shapingba District, Chongqing, 401331, China.
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Ernst M, Gemke TJ, Olivi LJ, O'Connor RC. Ambulatory assessment of suicidal ambivalence: The temporal variability of the wish to live and the wish to die and their relevance in the concurrent and prospective prediction of suicidal desire. Suicide Life Threat Behav 2024. [PMID: 39096098 DOI: 10.1111/sltb.13120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 07/20/2024] [Accepted: 07/25/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION Suicidal ambivalence is increasingly understood as the result of the interplay of two conflicting motivational orientations, the wish to die (WTD) and wish to live (WTL). However, research is scarce regarding the nature of their relationship, their temporal structure, and their relevance in predicting suicidal desire. METHODS Fifty psychosomatic/psychiatric inpatients (17 reporting suicide attempts) took part in an intensive longitudinal design with 10 signal-contingent prompts per day over 10 days; assessing WTD, WTL, and suicidal desire. We calculated mean values and variability of WTD, WTL, suicidal ambivalence, and suicidal desire and tested mixed-effects models of suicidal desire. RESULTS The mean number of answered prompts was 40.98 (SD = 21.68). Repeated-measures correlation of WTD and WTL was r = -0.60. Patients with a history of suicide attempts reported higher WTD, lower WTL, more suicidal ambivalence, stronger suicidal desire, and showed higher variability in all constructs. At the same assessment, WTD was the strongest statistical predictor of suicidal desire. Only WTL and the interaction of WTD and WTL predicted suicidal desire prospectively. CONCLUSION Wish to die and WTL are likely two distinct (although correlated) constructs that should not be reduced to a single ambivalence score. A stronger focus on WTL holds potential for suicide research and practice.
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Affiliation(s)
- Mareike Ernst
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
- Suicidal Behaviour Research Lab, Mental Health and Wellbeing, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Theresa J Gemke
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - L Julian Olivi
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Rory C O'Connor
- Suicidal Behaviour Research Lab, Mental Health and Wellbeing, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Yavuz BE, Turan S, Mutlu C, Çamlı ŞE. A comparison of the social cognition and neurocognitive characteristics of adolescents with suicide behavior, adolescent with depression and healthy controls. Suicide Life Threat Behav 2024; 54:785-797. [PMID: 38738815 DOI: 10.1111/sltb.13090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/31/2024] [Accepted: 04/18/2024] [Indexed: 05/14/2024]
Abstract
INTRODUCTION Deficits in neurocognition and social-cognition have been suggested to be an endophenotype for suicidal behavior. We aimed to compare the social-cognition and neurocognitive characteristics of adolescents diagnosed with depression with and without suicidal behavior and to investigate whether these functions predict suicide. METHOD Adolescents diagnosed with Major Depressive Disorder (MDD) with suicidal behavior (n = 42); MDD without suicidal behavior (n = 44) and age- and sex-matched controls (n = 43) were included. The University of Pennsylvania Computerized Neurobehavioral Test Battery and Autism Spectrum Screening Questionnaire (ASSQ) were used to evaluate social-cognition and neurocognitive characteristics. RESULTS Several neurocognitive domain values of MDD groups, were significantly different from the control group. Neutral emotion recognition task (p = 0.025) and ASSQ scores were found to be significantly impaired in the patient groups (p < 0.001). Logistic regression analysis showed that, only the increase in the Suicide Probability Scale score was found to be significant as a risk factor predicting suicide (p = 0.007, OR: 1.246). CONCLUSION While the neurocognitive and social-cognitive performances of adolescents with MDD were significantly lower than the control group, these performances in the two depression groups were similar. When the predictors of suicidal behavior were examined, it was found that only the increase in suicidal ideation scores predicted suicide.
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Affiliation(s)
- B Ece Yavuz
- Department of Child and Adolescent Psychiatry, TC Sağlık Bakanlığı Cizre Dr. Selahattin Cizrelioğlu Devlet Hastanesi, Şırnak, Turkey
| | - Serkan Turan
- Department ofChild and Adolescent Psychiatry, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Caner Mutlu
- Department ofChild and Adolescent Psychiatry, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Şafak Eray Çamlı
- Department ofChild and Adolescent Psychiatry, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
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Chang YT, Chang SS, Chan LF, Chen YY, Cheng Q, Shimizu Y, Nishina Y, Zhou L, Yip PSF. Addressing the rising rates of youth suicide: understanding causes and formulating prevention strategies using the iceberg model. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 49:101151. [PMID: 39149140 PMCID: PMC11325789 DOI: 10.1016/j.lanwpc.2024.101151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/08/2024] [Accepted: 07/08/2024] [Indexed: 08/17/2024]
Affiliation(s)
- Yi-Tzu Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
- Population Health Research Center, National Taiwan University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Lai Fong Chan
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Ying-Yeh Chen
- Taipei City Psychiatric Centre, Taipei City Hospital, Taipei, Taiwan
- Institute of Public Health and Department of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Qijin Cheng
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Yuka Nishina
- Japan Suicide Countermeasures Promotion Center, Tokyo, Japan
| | - Liang Zhou
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, Faculty of Social Science, The University of Hong Kong, Hong Kong SAR, China
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China
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Schwinn T, Hirschmiller J, Brähler E, Merzenich H, Faber J, Wild PS, Beutel ME, Ernst M. A powerful safety net: Social support moderates the association of quality of life deficits with suicidal ideation in long-term childhood cancer survivors. J Psychosoc Oncol 2024:1-18. [PMID: 39083714 DOI: 10.1080/07347332.2024.2379827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
OBJECTIVES Cancer survivors are at risk for suicidality. We aimed to expand the knowledge about protective factors and their interplay with risk factors by testing social support as a modifier of the association of Quality of Life (QoL) deficits with suicidal ideation. RESEARCH APPROACH We surveyed N = 633 childhood cancer survivors (CCS) using validated questionnaires (EORTC Core Quality of Life questionnaire QLQ-C30, Patient Health Questionnaire PHQ-9). The interaction of QoL and social support was investigated using multiple linear regression analysis. FINDINGS CCS reporting suicide attempts and current suicidal ideation (SI) had lower QoL. CCS with SI reported less social support. QoL and social support were independently associated with SI and interacted: among CCS with less social support, low QoL was more strongly associated with SI. CONCLUSION The results highlight the need for interdisciplinary survivorship care, and to focus on risk and protective factors to strengthen suicide prevention.
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Affiliation(s)
- Tamara Schwinn
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Judith Hirschmiller
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Integrated Research and Treatment Center Adiposity Diseases, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Hiltrud Merzenich
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörg Faber
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine - Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
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Kim S, Park J, Lee H, Lee H, Woo S, Kwon R, Kim S, Koyanagi A, Smith L, Rahmati M, Fond G, Boyer L, Kang J, Lee JH, Oh J, Yon DK. Global public concern of childhood and adolescence suicide: a new perspective and new strategies for suicide prevention in the post-pandemic era. World J Pediatr 2024:10.1007/s12519-024-00828-9. [PMID: 39008157 DOI: 10.1007/s12519-024-00828-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/20/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Suicide is the second leading cause of death in young people worldwide and is responsible for about 52,000 deaths annually in children and adolescents aged 5-19 years. Familial, social, psychological, and behavioral factors play important roles in suicide risk. As traumatic events such as the COVID-19 pandemic may contribute to suicidal behaviors in young people, there is a need to understand the current status of suicide in adolescents, including its epidemiology, associated factors, the influence of the pandemic, and management initiatives. DATA SOURCES We investigated global and regional suicide mortality rates among children and adolescents aged 5-19 years using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. The suicide mortality rates from 1990 to 2019 were examined in 204 countries and territories across six World Health Organization (WHO) regions. Additionally, we utilized electronic databases, including PubMed/MEDLINE and Scopus, and employed various combinations of terms such as "suicide", "adolescents", "youth", "children", "risk factors", "COVID-19 pandemic", "prevention", and "intervention" to provide a narrative review on suicide within the pediatric population in the post-pandemic era. RESULTS Despite the decreasing trend in the global suicide mortality rate from 1990 to 2019, it remains high. The mortality rates from suicide by firearms or any other specified means were both greater in males. Additionally, Southeast Asia had the highest suicide rate among the six WHO regions. The COVID-19 pandemic seems to contribute to suicide risk in young people; thus, there is still a strong need to revisit appropriate management for suicidal children and adolescents during the pandemic. CONCLUSIONS The current narrative review integrates up-to-date knowledge on suicide epidemiology and the effects of the COVID-19 pandemic, risk factors, and intervention strategies. Although numerous studies have characterized trends in suicide among young people during the pre-pandemic era, further studies are required to investigate suicide during the pandemic and new strategies for suicide prevention in the post-pandemic era. It is necessary to identify effective prevention strategies targeting young people, particularly those at high risk, and successful treatment for individuals already manifesting suicidal behaviors. Care for suicidal children and adolescents should be improved with parental, school, community, and clinical involvement.
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Affiliation(s)
- Soeun Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jaeyu Park
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Hyeri Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Hayeon Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Selin Woo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Rosie Kwon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Sunyoung Kim
- Department of Family Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-e-Asr University of Rafsanjan, Rafsanjan, Iran
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique-Hôpitaux de Marseille, Aix Marseille University, Marseille, France
| | - Guillaume Fond
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique-Hôpitaux de Marseille, Aix Marseille University, Marseille, France
| | - Laurent Boyer
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique-Hôpitaux de Marseille, Aix Marseille University, Marseille, France
| | - Jiseung Kang
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Jun Hyuk Lee
- Health and Human Science, University of Southern California, Los Angeles, CA, USA
| | - Jiyeon Oh
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
- Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea.
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Naifeh JA, Ursano RJ, Stein MB, Mash HBH, Aliaga PA, Fullerton CS, Shor R, Kao TC, Sampson NA, Kessler RC. Optimism, Sociability, and the Risk of Future Suicide Attempt among U.S. Army Soldiers. Mil Med 2024; 189:e1642-e1652. [PMID: 38015994 PMCID: PMC11221425 DOI: 10.1093/milmed/usad457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/02/2023] [Accepted: 11/15/2023] [Indexed: 11/30/2023] Open
Abstract
INTRODUCTION Most research on suicide attempts among U.S. service members has been focused on risk factors that occur during service. There is an important gap in our understanding of premilitary factors, such as personality characteristics, that may be associated with future suicide attempt risk during service. Of particular importance is identifying risk factors for the 1/3 of suicide attempters who never receive a mental health diagnosis (MH-Dx)-and therefore are not identified as having a mental health problem in the military healthcare system-prior to their suicide attempt. MATERIALS AND METHODS Using two components of the Army Study to Assess Risk and Resilience in Servicemembers, we examined the association of personality facets from the Tailored Adaptive Personality Assessment System, a computerized instrument administered prior to entering service, with medically documented suicide attempts during service. A 2010-2016 sample of historical administrative records from U.S. Regular Army enlisted soldiers with complete data on 11 commonly administered Tailored Adaptive Personality Assessment System facets was examined using a series of logistic regression analyses to identify the facets associated with future suicide attempt. Significant facets were then applied to data from a longitudinal cohort study of 11,288 soldiers surveyed upon entering basic combat training and followed via administrative records for their first 48 months of service. This research was approved by the Institutional Review Boards at the collaborating institutions. RESULTS Analysis of the historical administrative data (87.0% male, 61.6% White non-Hispanic), found that low Optimism (odds ratio (OR) = 1.2 [95% CI = 1.0-1.4]) and high/low (vs. moderate) Sociability (OR = 1.3 [95%CI = 1.1-1.6]) were associated with suicide attempt after adjusting for other univariable-significant facets and socio-demographic and service-related variables. When examined in the longitudinal survey cohort, low Optimism (OR = 1.7 [95% CI = 1.1-2.4]) and high/low (vs. moderate) Sociability (OR = 1.7 [95% CI = 1.1-2.5]) were still associated with increased odds of documented suicide attempt during service, even after adjusting for each other, socio-demographic and service-related variables, and medically documented MH-Dx. Mental health diagnosis had a significant two-way interaction with Optimism (F = 5.27, p = 0.0236) but not Sociability. Stratified analyses indicated that low Optimism was associated with suicide attempt among soldiers without, but not among those with, a MH-Dx. Interactions of Optimism and Sociability with gender were nonsignificant. In the full model, population attributable risk proportions for Optimism and Sociability were 15.0% and 18.9%, respectively. Optimism and Sociability were differentially associated with suicide attempt risk across time in service. CONCLUSIONS Optimism and Sociability, assessed prior to entering U.S. Army service, are consistently associated with future suicide attempt during service, even after adjusting for other important risk factors. While Sociability is equally associated with suicide attempt among those with and without a MH-Dx, Optimism is specifically associated with suicide attempt among soldiers not identified in the mental healthcare system. Risk differences across time in service suggest that Optimism and Sociability interact with stressors and contextual factors in particular developmental and Army career phases.
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Affiliation(s)
- James A Naifeh
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Robert J Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Murray B Stein
- Department of Psychiatry and School of Public Health, University of California San Diego, La Jolla, CA 92093-0855, USA
- VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Holly B Herberman Mash
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Pablo A Aliaga
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Carol S Fullerton
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Rachel Shor
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Tzu-Cheg Kao
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
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Sanz-Gómez S, Vera-Varela C, Alacreu-Crespo A, Perea-González MI, Guija JA, Giner L. Impulsivity in fatal suicide behaviour: A systematic review and meta-analysis of psychological autopsy studies. Psychiatry Res 2024; 337:115952. [PMID: 38723408 DOI: 10.1016/j.psychres.2024.115952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/03/2024] [Accepted: 05/04/2024] [Indexed: 06/18/2024]
Abstract
Our aim is to review and perform a meta-analysis on the role of impulsivity in fatal suicide behaviour. We included papers who used psychological autopsy methodology, assessed adult death by suicide, and included assessment of impulsivity. We excluded papers about assisted suicide, terrorist suicide, or other cause of death other than suicide or postmortem diagnosis made only from medical records or database. 97 articles were identified. 33 were included in the systematic review and nine in the meta-analysis. We found that people who die by suicide with high impulsivity are associated with younger age, substance abuse, and low intention to die, whereas those with low impulsivity were associated with older age, depression, schizophrenia, high intention to die and low social support. In the meta-analysis, suicide cases had higher impulsivity scores than living controls (Hedges' g = 0.59, 95 % CI [0.28, 0.89], p=.002). However, studies showed heterogeneity (Q = 90.86, p<.001, I2=89.0 %). Impulsivity-aggressiveness interaction was assessed through meta-regression (β=0.447, p=.045). Individuals with high impulsivity would be exposed to a higher risk of fatal suicide behaviour, aggressiveness would play a mediating role. People who die by suicide with high and low impulsivity display distinct characteristics, which may reflect different endophenotypes leading to suicide by different pathways.
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Affiliation(s)
| | | | | | | | - Julio Antonio Guija
- Servicio de Psiquiatría Forense, Instituto de Medicina Legal y Ciencias Forenses de Sevilla, Seville, Spain
| | - Lucas Giner
- Department of Psychiaty, Universidad de Sevilla, Seville, Spain
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11
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Falcó R, Santana-Monagas E, Moreno-Amador B, Piqueras JA, Marzo JC. Suicidal Risk During Adolescence: Could Covitality Be Part of the Solution? Arch Suicide Res 2024; 28:948-963. [PMID: 37847011 DOI: 10.1080/13811118.2023.2262553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
OBJECTIVE The covitality model suggests that the co-disposition and synergy of core psychosocial assets (i.e., covitality) buffer the negative impact of stressful events and prevent the emergence of mental health problems during adolescence. At this stage of development, suicide already constitutes the leading cause of unnatural death in Europe. The present study aimed to examine how covitality relates to bidimensional mental health status (i.e., psychopathology and subjective well-being) and suicidal risk. METHOD Participants were 5,296 Spanish students ages 12 to 18 years (Mage ± SD = 14.19 ± 1.53), 50.2% male. RESULTS In a structural equation mediational model, covitality acted as a powerful shield of psychosocial strengths against suicidality, via an indirect effect entirely mediated by its impact on bidimensional mental health. The total variance in suicidal risk explained by the set of independent variables was 61.8%, while the total variance of psychopathology and subjective well-being explained by covitality was 54.1% and 75.6%, respectively. CONCLUSIONS These preliminary findings highlight the need for further study of covitality as a defense strategy against adolescent suicide. HIGHLIGHTSCovitality promote subjective well-being and prevent psychopathological symptoms.These self-perceived psychosocial strengths do not have direct effect on suicidality.Covitality is related to lower suicidal risk through indirect mechanisms: via bidimensional approach to mental health status (BMH).
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Wallace ER, O'Neill S, Lagdon S. Risk and protective factors for suicidality among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people, from countries with a high global acceptance index (GAI), within the context of the socio-ecological model: A scoping review. J Adolesc 2024; 96:897-924. [PMID: 38372179 DOI: 10.1002/jad.12308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people experience higher prevalence rates of suicidality than their heterosexual and/or cisgender peers. However, there is limited research that can inform suicide prevention efforts. Our aim was to synthesize quantitative, qualitative, and mixed methods research on risk and protective factors among LGBTQ+ young people, from countries with a high Global Acceptance Index. METHODS A scoping review guided by Arksey and O'Malley's five-stage framework, using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews protocol. Five databases and grey literature were searched for relevant studies. Identified factors were clustered by thematic type, according to the socio-ecological model to identify empirical trends and knowledge gaps. The mixed methods appraisal tool was used for quality assessment of studies. RESULTS Sixty-six studies met our inclusion criteria. Overall, 59 unique risk factors and 37 unique protective factors were identified. Key risk factors include past suicidality, adverse childhood experiences, internalized queerphobia, minority stress, interpersonal violence, bullying, familial conflict, and anti-LGBTQ+ policies/legislation. Key protective factors include self-affirming strategies, adult/peer support, at-school safety, access to inclusive healthcare, family connectedness, positive coming out experiences, gender-affirming services and LGBTQ+ inclusive policies and legislation. CONCLUSIONS Overall, our findings affirm that multiple risk and protective factors, at all levels of the socio-ecological model, interact in complex, unique and diverse ways upon suicidality among LGBTQ+ young people. Implications for suicide prevention are discussed. Further empirical studies are required, particularly at the communities, policies, and societal levels of the socio-ecological model, and these studies should include a focus on protective factors and significant within-group differences.
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Affiliation(s)
| | - Siobhan O'Neill
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Susan Lagdon
- School of Psychology, Ulster University, Coleraine, Northern Ireland
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Liu L, Wang W, Lian Y, Wu X, Li C, Qiao Z. Longitudinal Impact of Perfectionism on Suicidal Ideation among Chinese College Students with Perceived Academic Failure: The Roles of Rumination and Depression. Arch Suicide Res 2024; 28:830-843. [PMID: 37470419 DOI: 10.1080/13811118.2023.2237088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
OBJECTIVE Suicide has become a nonnegligible cause of death among emerging adults, and academic performance is one of the most significant factors in Chinese college students' suicidal ideation. Based on this, we examined the risk and protective sides of perfectionism on suicidal ideation among college students with perceived academic failure experiences. METHOD In the current study, a total of 674 Chinese college students (63.6% females, Mage = 19.96, SD = 1.31) with perceived academic failure in the past six months participated in a survey and completed self-report measures assessing perfectionism, rumination, depression, and suicidal ideation twice with a six-month interval. RESULTS Negative perfectionism was a risk factor for suicidal ideation, while positive perfectionism had an opposite effect. In addition, intrusive rumination, deliberate rumination, and depression serially mediated the association between positive/negative perfectionism and suicidal ideation. CONCLUSION The results indicated perfectionism has both positive and negative sides to suicidal ideation. Clinicians might be aware of the risk and protective components of perfectionism when intervening with suicidal ideation among college students with perceived academic failure experiences.
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O'Dwyer ST, Sansom A, Mars B, Reakes L, Andrewartha C, Melluish J, Walker A, Biddle L, Slater T, Burrows D, Hastings RP, Moran P, Stallard P, Janssens A. Suicidal Thoughts and Behaviors in Parents Caring for Children with Disabilities and Long-Term Illnesses. Arch Suicide Res 2024:1-18. [PMID: 38949265 DOI: 10.1080/13811118.2024.2363230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
OBJECTIVE There is a growing body of evidence on suicide risk in family carers, but minimal research on parents caring for children with disabilities and long-term illnesses. The aim of this study was to conduct the first dedicated research on suicide risk in parent carers and identify: (1) the number of parent carers experiencing suicidal thoughts and behaviors, and (2) the risk and protective factors for suicidality in this population. METHOD A cross-sectional survey of parent carers in England (n = 750), co-produced with parent carers. Suicidal thoughts and behaviors were measured with questions from the Adult Psychiatric Morbidity Survey. Frequencies summarized the proportion of carers experiencing suicidal thoughts and behaviors. Logistic regressions identified risk and protective factors. RESULTS 42% of parents had experienced suicidal thoughts and behaviors while caring for a disabled or chronically ill child. Only half had sought help for these experiences. Depression, entrapment, dysfunctional coping, and having a mental health diagnosis prior to caring, were significant risk factors. CONCLUSION Parent carers contemplate suicide at levels that exceed those of other family carers and the general public. There is an urgent need, in policy and practice, to recognize parent carers as a priority group for prevention and intervention.
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Tran T, Nguyen H, Shochet I, Nguyen N, La N, Wurfl A, Orr J, Nguyen H, Stocker R, Fisher J. Coping Self-Efficacy and Thoughts of Self-Harm Among Adolescents in Vietnam: A Longitudinal Study. Arch Suicide Res 2024; 28:1022-1034. [PMID: 37837377 DOI: 10.1080/13811118.2023.2265444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
We aimed to determine the effect of coping self-efficacy on thoughts of self-harm among adolescents attending high school in Hanoi, Vietnam. Longitudinal data were collected using the Center for Epidemiologic Studies Depression Scale Revised and the Coping Self-Efficacy Scale among 552 Year 10 students. The prevalence of thoughts of death and/or self-injury on at least 1 day in the past week was 16.9% at baseline and 14.5% at 8-month follow-up. When baseline coping self-efficacy was greater by one standard deviation, the odds of having thoughts of self-harm at follow-up were reduced by 42%. Our findings suggest that school-based programs that aim to strengthen coping strategies may be useful in preventing self-harm among adolescents.
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Choi NG, Marti CN, Choi BY. Mental Health Treatment Use, Perceived Treatment Need, and Reasons for Non-Use Among U.S. Adults with Serious Suicidal Thoughts During the COVID-19 Pandemic. Community Ment Health J 2024; 60:972-984. [PMID: 38372825 DOI: 10.1007/s10597-024-01249-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/11/2024] [Indexed: 02/20/2024]
Abstract
Analyzing the 2021 National Survey on Drug Use and Health data with generalized linear models, we examined: (1) COVID pandemic-related and other correlates of mental health treatment use and unmet perceived treatment need among U.S. adults who experienced serious suicidal thoughts (N = 3,177); and (2) correlates of self-reported reasons for not receiving treatment. We found that 61% used any mental health treatment, and 48% of users and 37% of nonusers reported perceived treatment need. Significant correlates of treatment use were demographic factors, insurance, major depressive disorder, and illicit drug use disorder. Significant correlates of perceived treatment need were age 18-34, some college education, and major depressive episode. Perceived negative effect of the COVID pandemic on mental health was a significant factor for both treatment use and perceived need. The most frequent reasons for not getting treatment were the cost of treatment or lack of insurance and stigma-related concerns.
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Affiliation(s)
- Namkee G Choi
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX, 78712, USA.
| | - C Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX, 78712, USA
| | - Bryan Y Choi
- Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine and BayHealth, Philadelphia, USA
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Zhang B, Wang J, Abdullah AB. The effects of art therapy interventions on anxiety in children and adolescents: A meta-analysis. Clinics (Sao Paulo) 2024; 79:100404. [PMID: 38936289 PMCID: PMC11260852 DOI: 10.1016/j.clinsp.2024.100404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/18/2024] [Indexed: 06/29/2024] Open
Abstract
OBJECTIVE This study aimed to assess the effects of art therapy on anxiety among children and adolescents. METHODS We searched several databases, including PubMed, Web of Science, Embase (via Ovid), PsychINFO (through EBSCO), and The Cochrane Library, comprising the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials. Additionally, Chinese databases such as CNKI (China National Knowledge Infrastructure) and Wan Fang Data were explored from their beginnings until October 22, 2023. Studies that investigated the impact of art therapy on anxiety compared to a control group were included. The methodological quality of these randomized controlled trials was evaluated using the Cochrane Handbook's risk of bias instrument. RESULTS Six studies involving 422 participants were included. The findings indicated a notable decrease in anxiety symptoms due to art therapy, with a Standardized Mean Difference (SMD) of -1.42, 95% Confidence Interval (95%CI -2.33, -0.51), p < 0.002. Notably, there was pronounced heterogeneity, as evidenced by Tau2 = 1.41, Chi2 = 101.19, df = 6, and I² = 94%, with Z = 3.06. CONCLUSION Art therapy significantly improved the anxiety symptoms of children and adolescents, positioning it as an effective means of treating anxiety.
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Affiliation(s)
- Bo Zhang
- Guizhou Equipment Manufacturing Polytechnic, Guizhou, China; Universiti Utara Malaysia, Malaysia.
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Oliva V, Roberto N, Andreo-Jover J, Bobes T, Canal Rivero M, Cebriá A, Crespo-Facorro B, de la Torre-Luque A, Díaz-Marsá M, Elices M, Fernández-Rodrigues V, Gonzalez-Pinto A, Palao Tarrero A, Pérez-Diez I, Rodríguez-Vega B, Ruiz-Veguilla M, Saiz PA, Seijo-Zazo E, Toll-Privat A, McIntyre RS, Vieta E, Grande I, Pérez-Solà V. Anxious and depressive symptoms and health-related quality of life in a cohort of people who recently attempted suicide: A network analysis. J Affect Disord 2024; 355:210-219. [PMID: 38548208 DOI: 10.1016/j.jad.2024.03.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Suicide is an international health concern with immeasurable impact from the perspective of human and social suffering. Prior suicide attempts, anxious and depressive symptoms, and relatively lower health-related quality of life (HRQoL) are among the most replicated risk factors for suicide. Our goal was to visualize the distribution of these features and their interconnections with use of a network analysis approach in individuals who recently attempted suicide. METHODS Individuals with a recent suicide attempt were recruited from nine University Hospitals across Spain as part of the SURVIVE cohort study. Anxious and depressive symptoms, and perceived HRQoL were included in the network analysis. Network structures were estimated with the EBICglasso model. Centrality measures and bridge symptoms connecting communities were explored. Subnetworks comparing younger and older individuals, and women and men were analyzed. RESULTS A total of 1106 individuals with a recent suicide attempt were included. Depressed mood was the symptom with the greatest influence in the overall network, followed by anxiety symptoms such as feeling nervous, worrying, restless, and having difficulties to relax. Perceived general health was associated with increased suicidal ideation in the whole sample. Older people showed a specific connection between perceived general health and depressed mood. LIMITATIONS The cross-sectional design does not allow determination of established causality. CONCLUSIONS Depressed mood was the core network's symptom and, therefore, an important target in the management and prevention of suicide. HRQoL had more influence on the network of older populations, in which it should be a primary focus.
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Affiliation(s)
- Vincenzo Oliva
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Natalia Roberto
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Jorge Andreo-Jover
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 2, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Teresa Bobes
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - Manuel Canal Rivero
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Hospital Virgen del Rocio de Sevilla, Spain; IBIS, Universidad de Sevilla, Spain
| | - Anabel Cebriá
- Mental Health Department, Parc Taulí Hospital Universitari, Neuroscience and Mental Health Research Area, Institut d'Investigació I Innovació ParcTaulí (I3PT), Sabadell, Spain
| | - Benedicto Crespo-Facorro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Hospital Virgen del Rocio de Sevilla, Spain; IBIS, Universidad de Sevilla, Spain
| | - Alejandro de la Torre-Luque
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain
| | - Marina Díaz-Marsá
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain; Hospital Clínico San Carlos, Madrid, Spain
| | - Matilde Elices
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Institut de Neuropsiquiatria i Addicions, Hospital del Mar, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain; Hospital del Mar Medical Research Institute, IMIM, Barcelona, Spain
| | | | - Ana Gonzalez-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Hospital Universitario Araba-Santiago, Instituto de Investigación Sanitaria Bioaraba, Universidad del País Vasco, Spain
| | - Angela Palao Tarrero
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 2, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Iván Pérez-Diez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Beatriz Rodríguez-Vega
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 2, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Miguel Ruiz-Veguilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Hospital Virgen del Rocio de Sevilla, Spain; IBIS, Universidad de Sevilla, Spain
| | - Pilar A Saiz
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - Elisa Seijo-Zazo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - Alba Toll-Privat
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Institut de Neuropsiquiatria i Addicions, Hospital del Mar, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain; Hospital del Mar Medical Research Institute, IMIM, Barcelona, Spain
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5T 2S8, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A8, Canada; Brain and Cognition Discovery Foundation, Toronto, ON M5S 1M2, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Eduard Vieta
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Iria Grande
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Víctor Pérez-Solà
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parc de Salut Mar, Barcelona, Spain
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Calvo S, Carrasco JP, Conde-Pumpido C, Esteve J, Aguilar EJ. Does suicide contagion (Werther effect) take place in response to social media? A systematic review. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024:S2950-2853(24)00032-2. [PMID: 38848950 DOI: 10.1016/j.sjpmh.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/10/2024] [Accepted: 05/27/2024] [Indexed: 06/09/2024]
Abstract
INTRODUCTION The Werther, Copycat or contagion effect of suicidal behaviour is a complex phenomenon that can arise due to exposure to media stories in which identifiable people take their lives. On the contrary, the Papageno effect prevents people from suicide by promoting positives examples of suicidal crisis management. Impact of both effects has been widely studied in different types of situations, but its existence in social media is a source of much debate. METHODS A systematic search following the PRISMA guidelines of PubMed, Scopus, Embase, PsycInfo, Web of Science and the references of prior reviews yielded 25 eligible studies. RESULTS Most of the studies found were observational, with very different methodologies and generally with low risk of bias. In these, the results suggest the existence of the Werther effect in response to social media stories about suicide. This is mediated by multiple factors, including the characteristic of the users, the type of interaction and the content of the publications. At the same time, the Papageno effect is also described. Evidence found by type of social media and future implications are discussed. CONCLUSION Suicidal content on social media can be both contagious and protective. It is confirmed that the Werther and Papageno effects may occur in response to social media, so they could be an interesting target for preventive interventions.
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Affiliation(s)
- Serena Calvo
- Pediatrics Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Juan Pablo Carrasco
- Psychiatry Deparment, Consorcio Hospitalario Provincial de Castellón, Castellón, Spain.
| | - Celia Conde-Pumpido
- Psychiatry Deparment, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Jose Esteve
- Psychiatry Deparment, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Eduardo Jesús Aguilar
- Psychiatry Deparment, Hospital Clínico Universitario de Valencia, Valencia, Spain; INCLIVA Instituto de Investigación Sanitaria, Valencia, Spain; CIBERSAM Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain; University of Valencia, Department of Medicine, Valencia, Spain
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Huo M, Yang Z, Yang L, Chen S. Can sports participation be a protective factor against suicide-related outcomes in adolescents: a systematic review. Front Psychol 2024; 15:1341795. [PMID: 38899127 PMCID: PMC11186485 DOI: 10.3389/fpsyg.2024.1341795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/10/2024] [Indexed: 06/21/2024] Open
Abstract
Background Suicide-related outcomes among adolescents have become a serious public health problem worldwide. Emerging evidence suggests that sports participation may interact with suicide-related outcomes. The objective of this systematic review is to systematically review and summarize the association between sports participation and suicide-related outcomes among adolescents. Design A systematic review according to PRISMA Statement (International Platform of Registered Systematic Review and Meta-Analysis Protocols registration: INPLASY202330072) https://inplasy.com/inplasy-2023-3-0072/. Methods The literature search was conducted in three electronic databases: Web of Science, PubMed, and EBSCOhost. Results A total of 16 studies (12 cross-sectional studies, 4 prospective studies) met the inclusion criteria were evaluated. Strong consistent evidence was found for the negative association between suicidal ideation, suicide attempts, and sports participation among adolescents. There was insufficient evidence to support consistency in the association between sports participation and suicide plans, and no evidence regarding gender differences between sports participation and these suicide-related outcomes. Furthermore, there was heterogeneity in the measures of sports participation and suicide-related outcomes across the included studies. Conclusion Evidence suggests that more sports participations are associated with lower suicidal ideation and suicide attempts in adolescents. However, the directionality of the observed associations should be examined based on more high-quality longitudinal studies in the future.
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Affiliation(s)
- Meilin Huo
- Department of Physical Education, Huaide College of Changzhou University, Changzhou, China
| | - Zhen Yang
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Li Yang
- School of Physical Education, South China University of Technology, Guangzhou, China
| | - Sitong Chen
- Centre for Mental Health, Shenzhen University, Shenzhen, China
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21
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Grimland M, Benatov J, Yeshayahu H, Izmaylov D, Segal A, Gal K, Levi-Belz Y. Predicting suicide risk in real-time crisis hotline chats integrating machine learning with psychological factors: Exploring the black box. Suicide Life Threat Behav 2024; 54:416-424. [PMID: 38345174 DOI: 10.1111/sltb.13056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND This study addresses the suicide risk predicting challenge by exploring the predictive ability of machine learning (ML) models integrated with theory-driven psychological risk factors in real-time crisis hotline chats. More importantly, we aimed to understand the specific theory-driven factors contributing to the ML prediction of suicide risk. METHOD The dataset consisted of 17,654 crisis hotline chat sessions classified dichotomously as suicidal or not. We created a suicide risk factors-based lexicon (SRF), which encompasses language representations of key risk factors derived from the main suicide theories. The ML model (Suicide Risk-Bert; SR-BERT) was trained using natural language processing techniques incorporating the SRF lexicon. RESULTS The results showed that SR-BERT outperformed the other models. Logistic regression analysis identified several theory-driven risk factors significantly associated with suicide risk, the prominent ones were hopelessness, history of suicide, self-harm, and thwarted belongingness. LIMITATIONS The lexicon is limited in its ability to fully encompass all theoretical concepts related to suicide risk, nor to all the language expressions of each concept. The classification of chats was determined by trained but non-professionals in metal health. CONCLUSION This study highlights the potential of how ML models combined with theory-driven knowledge can improve suicide risk prediction. Our study underscores the importance of hopelessness and thwarted belongingness in suicide risk and thus their role in suicide prevention and intervention.
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Affiliation(s)
- Meytal Grimland
- Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
- Shalvata Mental Health Center, Hod Hasharon, Israel
| | - Joy Benatov
- Department of Special Education, University of Haifa, Haifa, Israel
| | - Hadas Yeshayahu
- Department of Special Education, University of Haifa, Haifa, Israel
| | - Daniel Izmaylov
- Department of Software and Information Systems Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Avi Segal
- Department of Software and Information Systems Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Kobi Gal
- Department of Software and Information Systems Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- School of Informatics, University of Edinburgh, Edinburgh, UK
| | - Yossi Levi-Belz
- Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
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22
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Ge Y, Zhang M. Interpersonal relationships and suicidal ideation among Chinese youths: A network analysis. J Affect Disord 2024; 354:267-274. [PMID: 38494135 DOI: 10.1016/j.jad.2024.03.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 02/27/2024] [Accepted: 03/09/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Suicidal ideation is a noteworthy health problem that requires further study in the field of interpersonal relationships. The main scope of relationships include family, teachers, peers, and the Internet. However, few studies have considered the effects of interpersonal interactions. Based on the Interpersonal Theory of Suicide, this study explores the relation between different interpersonal relationships and suicidal ideation. METHODS A network analysis approach was used to test the relationships. Cross-sectional data (N = 1694; 52.1 % boys; Mage = 11.86 years, SD = 1.59) were collected from primary and secondary students in October-November 2022. Participants completed a survey including demographic part and questionnaires: Positive and Negative Suicide Ideation Inventory (PANSI), Interpersonal Needs Questionnaire (INQ), Family Adaptability and Cohesion Evaluation Scale (FACES II), Inventory of Parent and Peer Attachment (IPPA), Student-Teacher Relationship Scale (STRS) and Facebook Intensity Scale (FIS). RESULTS All variables showed a significant correlation in this inferred network. Family, teacher-student, and peer relationships are protective against suicidal ideation. The closeness of the teacher-student relationship showed the highest strength centrality. However, online interpersonal relationship is a risk factor for suicide. Thwarted belongingness and perceived burdensomeness are proximal factors of suicidal ideation that influenced all interpersonal relationships. LIMITATIONS The network analysis as a data-driven and exploratory method may be limited to provide exact cause and effect relationship. CONCLUSIONS This study shows that teacher-student connections may be more important than other relationships of young people. Improper peer and online interpersonal relationship could be risky for suicide. Further studies are needed to examine the role of these relationships elaborately.
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Affiliation(s)
- Yuanjie Ge
- College of Education, Huaibei Normal University, Huaibei, China
| | - Min Zhang
- College of Education, Huaibei Normal University, Huaibei, China.
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Chen Y, Han X, Jiang Y, Jiang Y, Huang X, Wang W, Guo L, Xia R, Liao Y, Zhang H, Teopiz KM, McIntyre RS, Fan B, Lu C. Longitudinal Association between Stressful Life Events and Suicidal Ideation in Adults with Major Depression Disorder: The Mediating Effects of Insomnia Symptoms. Behav Sci (Basel) 2024; 14:467. [PMID: 38920799 PMCID: PMC11200868 DOI: 10.3390/bs14060467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/27/2024] Open
Abstract
Stressful life events (SLEs) and suicidal ideation (SI) are prevalent in persons with major depression disorder (MDD). Less is known about the underlying role of insomnia symptoms in the association between SLEs and SI. This three-wave prospective cohort study sought to investigate the longitudinal association among SLEs, insomnia symptoms, and SI in persons with MDD. The study population included 511 persons with MDD (mean [SD] age, 28.7 [6.7] years; 67.1% were females). Generalized estimated equations (GEEs) were utilized to explore prospective association among exposure of SLEs, insomnia symptoms, and SI. Additionally, a structural equation model (SEM) was employed to estimate the longitudinal mediating effect of insomnia symptoms in the relationship between SLEs and SI. Our study demonstrated that cumulative SLEs were determined to be longitudinally associated with SI in persons with MDD. We further observed that the association between SLEs and SI was significantly mediated by insomnia symptoms. Clinicians assessing persons with MDD, especially those with the history of SLE, could carefully evaluate and promptly treat insomnia symptoms as part of personalized assessment of their depressive illness, thereby achieving early prevention and intervention for suicidal behaviors in persons with MDD.
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Affiliation(s)
- Ya Chen
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (Y.C.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Xue Han
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China; (X.H.)
| | - Yingchen Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (Y.C.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Yunbin Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (Y.C.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Xinyu Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (Y.C.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (Y.C.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (Y.C.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Ruirui Xia
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China; (X.H.)
| | - Yuhua Liao
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China; (X.H.)
| | - Huimin Zhang
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China; (X.H.)
| | - Kayla M. Teopiz
- Brain and Cognition Discovery Foundation, Toronto, ON M2J 4A6, Canada
| | - Roger S. McIntyre
- Brain and Cognition Discovery Foundation, Toronto, ON M2J 4A6, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON M2J 4A6, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M2J 4A6, Canada
| | - Beifang Fan
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China; (X.H.)
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (Y.C.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
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Huen JMY, Osman A, Lew B, Yip PSF. Utility of Single Items within the Suicidal Behaviors Questionnaire-Revised (SBQ-R): A Bayesian Network Approach and Relative Importance Analysis. Behav Sci (Basel) 2024; 14:410. [PMID: 38785901 PMCID: PMC11117767 DOI: 10.3390/bs14050410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
The Suicidal Behaviors Questionnaire-Revised (SBQ-R) comprises four content-specific items widely used to assess the history of suicide-related thoughts, plans or attempts, frequency of suicidal ideation, communication of intent to die by suicide and self-reported likelihood of a suicide attempt. Each item focuses on a specific parameter of the suicide-related thoughts and behaviors construct. Past research has primarily focused on the total score. This study used Bayesian network modeling and relative importance analyses on SBQ-R data from 1160 U.S. and 1141 Chinese undergraduate students. The Bayesian network analysis results showed that Item 1 is suitable for identifying other parameters of the suicide-related thoughts and behaviors construct. The results of the relative importance analysis further highlighted the relevancy of each SBQ-R item score when examining evidence for suicide-related thoughts and behaviors. These findings provided empirical support for using the SBQ-R item scores to understand the performances of different suicide-related behavior parameters. Further, they demonstrated the potential value of examining individual item-level responses to offer clinically meaningful insights. To conclude, the SBQ-R allows for the evaluation of each critical suicide-related thought and behavior parameter and the overall suicide risk.
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Affiliation(s)
- Jenny Mei Yiu Huen
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China; (J.M.Y.H.)
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
| | - Augustine Osman
- Department of Psychology, The University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - Bob Lew
- School of Applied Psychology, Griffith University, Mount Gravatt, QLD 4122, Australia
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China; (J.M.Y.H.)
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
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25
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O'Donnell S, Egan T, Clarke N, Richardson N. Prevalence and associated risk factors for suicidal ideation, non-suicidal self-injury and suicide attempt among male construction workers in Ireland. BMC Public Health 2024; 24:1263. [PMID: 38720265 PMCID: PMC11077913 DOI: 10.1186/s12889-024-18483-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/28/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Suicide among male construction workers are reported to be disproportionally high compared to the working age population. However, there is minimal understanding of the prevalence and associated factors for suicidal ideation, non-suicidal self-injury, and suicide attempt among this occupational group globally. METHODS A cross-sectional study was conducted on a large sample of male construction workers in Ireland (n = 1,585). We investigated the prevalence of suicidal ideation, non-suicidal self-injury and suicide attempts and sociodemographic, occupational, and mental health factors associated with these three outcomes. Multivariable Poisson regression was performed to estimate the prevalence rate ratio of suicidal ideation (model 1 primary outcome), while multivariable logistic regression was used to estimate the odds ratio of non-suicidal self-injury (model 2 primary outcome), and suicide attempt (model 3 primary outcome). RESULTS The lifetime prevalence rate for suicidal ideation was 22%, 6% for non-suicidal self-injury, and 6% for suicide attempt. In univariate modelling, socio-demographic and occupation-specific factors associated with the three outcomes included younger age (suicidal ideation and non-suicidal self-injury), not being in a relationship (suicide attempt) and working 35-44 h per week (suicidal ideation and suicide attempt). The mental health factors generalized anxiety disorder, depression, and suicide bereavement were significantly associated with increased risk of the three outcomes. In fully adjusted multivariable models, increasing severity of generalized anxiety disorder and depression were associated with an increased prevalence rate ratio of suicidal ideation, and a higher odds ratio of non-suicidal self-injury and suicide attempt. CONCLUSION Suicidal ideation, non-suicidal self-injury and suicide attempt are significant issues for male construction workers that require specific attention. Findings highlight a need to support younger male construction workers and those bereaved by suicide. They also highlight the need for the early detection and treatment of generalized anxiety disorder and depression in order to intervene in, and potentially prevent, suicidality among male construction workers.
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Affiliation(s)
- Shane O'Donnell
- National Centre for Men's Health, South East Technological University (Carlow Campus), Kilkenny Road, Carlow, Ireland.
| | - Tom Egan
- School of Business, South East Technological University (Waterford Campus), Cork Road, Waterford, Ireland
| | - Nicholas Clarke
- RCSI University of Medicine and Health Sciences, 123 St Stephen's Green, Dublin, Ireland
| | - Noel Richardson
- National Centre for Men's Health, South East Technological University (Carlow Campus), Kilkenny Road, Carlow, Ireland
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26
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Isaeva ER, Ryzhova DM, Stepanova AV, Mitrev IN. Assessment of Suicide Risk in Patients with Depressive Episodes Due to Affective Disorders and Borderline Personality Disorder: A Pilot Comparative Study. Brain Sci 2024; 14:463. [PMID: 38790442 PMCID: PMC11119353 DOI: 10.3390/brainsci14050463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 03/26/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024] Open
Abstract
This study assessed suicidal risk in patients suffering from non-psychotic depressive disorders within various clinical and nosological forms (F31-F34 mood disorders and F60.31-emotionally unstable personality disorder). Clinical and psychological features were presented, as well as predictors of suicidal risk in patients of these groups. We performed a comparative analysis of the anxiety and depression level, the level of mental pain, fear of death and the severity of anti-suicidal motives in patients with affective disorders and borderline personality disorder (BPD). Based on the results, 100% of patients in these clinical nosological groups were found to have a high level of suicidal risk. Patients with affective disorders have weak anti-suicidal motives and are not fully aware of the consequences of their own death. Patients with BPD have a higher suicidal risk than patients with affective disorders; they are characterized by less pronounced social orientation, demonstrativeness, self-centeredness, less pronounced levels of anxiety and fear of death.
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Affiliation(s)
- Elena Rudolfovna Isaeva
- Department of General and Clinical Psychology, Academician I.P. Pavlov First St. Petersburg State Medical University, 197022 Saint Petersburg, Russia;
| | - Daria Maksimovna Ryzhova
- Department of General and Clinical Psychology, Academician I.P. Pavlov First St. Petersburg State Medical University, 197022 Saint Petersburg, Russia;
| | - Anna Vladimirovna Stepanova
- 10th Department—Center for Treatment of Depression and Anxiety, V. M. Bekhterev Psychiatry and Neurology National Medical Research Center, 192019 Saint Petersburg, Russia;
| | - Ivo Nestorov Mitrev
- Department of Psychiatry and Medical Psychology, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria;
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27
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Yang C, Huebner ES, Tian L. Prediction of suicidal ideation among preadolescent children with machine learning models: A longitudinal study. J Affect Disord 2024; 352:403-409. [PMID: 38387673 DOI: 10.1016/j.jad.2024.02.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Machine learning (ML) has been widely used to predict suicidal ideation (SI) in adolescents and adults. Nevertheless, studies of accurate and efficient models of SI prediction with preadolescent children are still needed because SI is surprisingly prevalent during the transition into adolescence. This study aimed to explore the potential of ML models to predict SI among preadolescent children. METHODS A total of 4691 Chinese children (54.89 % boys, Mage = 10.92 at baseline) and their parents completed relevant measures at baseline and the children provided 6-month follow-up data for SI. The current study compared four ML models: Random Forest (RF), Decision Tree (DT), Support Vector Machine (SVM), and Multilayer Perceptron (MLP), to predict SI and to identify variables with predictive value based on the best-performing model among Chinese preadolescent children. RESULTS The RF model achieved the highest discriminant performance with an AUC of 0.92, accuracy of 0.93 (balanced accuracy = 0.88). The factors of internalizing problems, externalizing problems, neuroticism, childhood maltreatment, and subjective well-being in school demonstrated the highest values in predicting SI. CONCLUSION The findings of this study suggested that ML models based on the observation and assessment of children's general characteristics and experiences in everyday life can serve as convenient screening and evaluation tools for suicide risk assessment among Chinese preadolescent children. The findings also provide insights for early intervention.
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Affiliation(s)
- Chi Yang
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, South China Normal University, Ministry of Education, Guangzhou 510631, People's Republic of China; School of Psychology, South China Normal University, Guangzhou 510631, People's Republic of China
| | - E Scott Huebner
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| | - Lili Tian
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, South China Normal University, Ministry of Education, Guangzhou 510631, People's Republic of China.
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Altwaijri Y, Benjet C, Al-Habeeb A, Al-Subaie A, Akkad M, Alammar S, Bilal L, Naseem T. Suicidal thoughts and behaviors in the Kingdom of Saudi Arabia. J Affect Disord 2024; 352:429-436. [PMID: 38382818 DOI: 10.1016/j.jad.2024.02.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 02/06/2024] [Accepted: 02/16/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE Suicidal thoughts and behaviors (STB) constitute an escalating public health concern globally. Despite the growing burden of suicidal ideation, plan, and attempts, national information on the trends of STB is lacking in the Kingdom of Saudi Arabia (KSA). Therefore, we aim to report on the prevalence, correlates, and treatment-seeking behaviors associated with STB in the country using nationally representative information from The Saudi National Mental Health Survey (SNMHS). METHODS The SNMHS is a national household survey of Saudi citizens aged 15-65 (n = 4004). The adapted Composite International Diagnostic Interview (CIDI) 3.0 was administered to produce lifetime and 12-month prevalence and treatment estimates of STB in the KSA. Associated correlates were calculated using cross tabulations and logistic regressions. RESULTS Suicidal ideation, plan, and attempt had respective lifetime prevalence rates of 4.90 %, 1.78 %, and 1.46 %; 12-month prevalence rates of 1.82 %, 0.89 %, and 0.63 %. Significant correlates of STB include younger age, female gender, low education, urban rearing, and singe marital status. STB were also significantly associated with the presence of prior mental disorders, childhood adversities, and low treatment-seeking. CONCLUSIONS High unmet need and significant sociocultural and psychological risk factors have been identified in association with STB in the KSA. Given the community-based nature of the SNMHS and the limited national data on STB in the Middle East and North Africa region, our findings can extend to inform the necessary healthcare policies, treatment plans, and prevention strategies needed to alleviate the burdens of STB in the region.
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Affiliation(s)
- Yasmin Altwaijri
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia; SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Corina Benjet
- Center for Global Mental Health, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Abdulhameed Al-Habeeb
- National Center for Mental Health Promotion, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah Al-Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Psychiatry, Edrak Medical Center, Riyadh, Saudi Arabia
| | - Marya Akkad
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia; SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Sarah Alammar
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Lisa Bilal
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia; SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Talal Naseem
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Research Department, King Salman Center for Disability Research, Riyadh, Saudi Arabia; SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Vimalanathane M, Abhilasha P, Prasad A, Ramachandran AS, Subramanian K. Suicidal Behavior and Its Association With Psychological Distress, Coping Mechanisms, and Resilience: A Cross-Sectional Study. Cureus 2024; 16:e60322. [PMID: 38883099 PMCID: PMC11177240 DOI: 10.7759/cureus.60322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction Recent literature reveals that psychological factors such as resilience and coping mechanisms can act as buffers against suicide risk. Indian literature on the interplay between psychological risk and protective factors of suicidal behavior is scarce. Methods A cross-sectional descriptive study was done among suicide attempters in a tertiary care hospital in Southern India. A semi-structured proforma was used to obtain sociodemographic data and suicide attempt characteristics. Suicide intent, lethality, stressful life events, perceived stress, subjective distress, coping strategies, and resilience were recorded using standard rating scales. Inferential analyses were carried out with p≤ 0.05 set as statistical significance. Results Pesticide poisoning (46.7%) was the most common mode of suicide attempt. Significant gender differences emerged in the mode of suicide attempt, coping strategies, and resilience. Depression (48.7%) was the most common psychiatric comorbidity. Increased perceived stress was associated with the presence of psychiatric comorbidity, past history of suicide attempts, and high-intent suicide attempts. Maladaptive coping strategies were associated with substance abuse and a history of past suicide attempts. Low resilience levels were associated with hanging attempts, psychiatric or substance use disorder comorbidity, past history of suicide attempts, high-intent suicide attempts, and less lethal suicide attempts. Conclusion Perceived stress levels, coping strategies, and resilience have significant relationships with suicidal behavior and act as avenues for suicide prevention efforts.
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Affiliation(s)
- Mayura Vimalanathane
- Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed-to-be University), Puducherry, IND
| | | | - Amritha Prasad
- Department of Psychiatry, Sree Gokulam Medical College Hospital and Research Foundation, Trivandrum, IND
| | - Arul Saravanan Ramachandran
- Department of Psychiatry, SRM (Sri Ramaswamy Memorial) Medical College Hospital & Research Institute, SRM (Sri Ramaswamy Memorial) Institute of Science and Technology, Chennai, IND
| | - Karthick Subramanian
- Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed-to-be University), Puducherry, IND
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30
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Adshead C, Runacres J. Sharing is Caring: A Realist Evaluation of a Social Support Group for Individuals Who Have Been Bereaved by Suicide. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:172-190. [PMID: 35098795 DOI: 10.1177/00302228211070152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM To understand the experiences and perceived impact on the wellbeing of individuals attending a suicide bereavement social support group. DESIGN A qualitative study guided by a realist evaluation framework. METHODS Data were collected from May-July 2020 using online semistructured individual interviews with participants (N = 6), from the North West of England recruited from a suicide bereavement support group's social media. Data were analysed using thematic analysis informed by the realist framework. RESULTS Effective social support includes the prioritisation of building meaningful connections with like-minded individuals, providing a safe space for authentic self-expression aiding personal relationship maintenance. Contextual factors included: Societal and cultural stigma of suicide, self-stigma and gender norms. Mechanisms influencing support seeking include: Not wanting to burden loved ones due to judgement, and a lack of understanding. IMPACT Policymakers can reduce demand on healthcare systems by developing tailored support groups to suit individual needs.
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Dempsey RC, Dodd AL, Gooding PA, Jones SH. The Types of Psychosocial Factors Associated with Suicidality Outcomes for People Living with Bipolar Disorder: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:525. [PMID: 38791740 PMCID: PMC11120682 DOI: 10.3390/ijerph21050525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 05/26/2024]
Abstract
Bipolar Disorder is associated with high rates of suicidal thoughts, behaviors, and outcomes, yet the lived experience of suicidality and Bipolar Disorder is not particularly well understood. Understanding the role of psychosocial aetiologies in suicidality outcomes for those living with Bipolar Disorder is key for developing appropriately targeted interventions focusing on factors that are amenable to change. In line with PRISMA guidance, we conducted a scoping review to identify the types of psychosocial factors studied in relation to the experience of suicidality for people living with Bipolar Disorder diagnoses. Systematic literature searches identified a sample of 166 articles from which key study data were extracted and charted. A narrative synthesis of the reviewed literature is presented ordered by the factors investigated across studies, a frequency count of the types of psychological/social aetiologies studied, and a brief overview of the key findings for each aetiology. Most of the identified literature took the form of quantitative cross-sectional studies, with only one qualitative study and 18 quantitative prospective studies. The most studied aetiologies were trauma (specifically early adverse experiences and childhood traumas) and stressful life events, impulsivity (primarily subjective self-reported trait impulsivity), social support and functioning, and personality/temperament factors. Only six studies in the final sample reported basing their research questions and/or hypotheses on an explicit theoretical model of suicide. The literature was primarily focused on using self-report measurements of key aetiologies and on factors which lead to worsened suicidality rather than focusing on potentially protective or buffering factors. Future research needs to better justify the aetiologies investigated in relation to suicidality outcomes for people living with Bipolar Disorder, including a firmer basis in theory and hypothesis testing, more prospective designs, and the use of alternative assessments of psychosocial aetiologies in addition to self-report questionnaires.
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Affiliation(s)
- Robert C. Dempsey
- Department of Psychology, Faculty of Health and Education, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Alyson L. Dodd
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Patricia A. Gooding
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Steven H. Jones
- Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK
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Souza K, Sosu EM, Thomson S, Rasmussen S. A systematic review of the studies testing the integrated motivational-volitional model of suicidal behaviour. Health Psychol Rev 2024:1-25. [PMID: 38626312 DOI: 10.1080/17437199.2024.2336013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 03/22/2024] [Indexed: 04/18/2024]
Abstract
Despite the influence of the integrated motivational-volitional (IMV)1 model on research and practice, the supporting literature has not been systematically synthesised. This systematic review aims to synthesise the literature testing the IMV model of suicidal behaviour. Using citation and database searching, PsycINFO, EMBASE, PubMed, Web of Science, and Google Scholar were searched for studies referencing the IMV model (last searched on 28th March 2023). Included studies empirically tested the hypotheses of the model. Quality assessment was conducted using the National Institute of Health tool. Findings from 98 records (100 studies, 138,365 participants) were narratively synthesised. Results from studies directly testing the hypothesised pathways of the model supported the defeat-entrapment-suicidal ideation pathway of the IMV model. Case-control studies comparing differences between control, ideation, and enactment groups were consistent with hypotheses in univariate and cross-sectional analyses. However, support for the model was mixed for case-control multivariate and prospective studies. Due to low overlap in variables studied, the role of specific pre-motivational phase variables and stage-specific moderators was inconclusive. The studies received overall good quality ratings. The IMV model presents a promising framework for understanding and preventing suicide. Defeat, entrapment, and key variables may be useful in informing suicide prevention measures.
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Affiliation(s)
- Kenvil Souza
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Edward M Sosu
- Strathclyde Institute of Education, University of Strathclyde, Glasgow, UK
| | - Scott Thomson
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Susan Rasmussen
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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Baryshnikov I, Rosenström T, Isometsä E. Predicting a short-term change of suicidal ideation in inpatients with depression: An ecological momentary assessment. J Affect Disord 2024; 350:1-6. [PMID: 38232774 DOI: 10.1016/j.jad.2023.12.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/30/2023] [Accepted: 12/31/2023] [Indexed: 01/19/2024]
Abstract
INTRODUCTION Patients with depression often require inpatient treatment due to their high suicide risk. Ecological momentary assessment (EMA) studies have shown that suicidal ideation (SI) fluctuates over time. As affective instability and psychological pain (PP) are common experiences in borderline personality disorder (BPD), often comorbid with depression, we examined factors predicting short-term changes of SI in depressive inpatients with or without BPD. METHODS Psychiatric inpatients with depression with (N = 30) or without (N = 37) comorbid BPD assessed their anxiety, PP, severity of depression, SI, and hopelessness three times daily using visual analogue scales. Multilevel regression models were estimated. RESULTS Altogether 4320 EMA observations, spanning on average 3.4 successive days, were collected. Only severity of depression (β = 0.19; [95 % CI = 0.06, 0.32]) and previous SI (β = 0.32; [95 % CI = 0.23, 0.41]) predicted near-future SI within several hours. PP predicted near-future SI in inpatients with depression and BPD (β = 0.28; [95 % CI = 0.11, 0.46]), but not in patients without BPD. LIMITATIONS The follow-up data represents only the first days of hospitalization. The context of the EMA is the acute psychiatric ward, affecting generalizability to outpatients. CONCLUSIONS Short-terms changes in SI are predicted by changes in severity of depression and previous SI in depressed inpatients without BPD, and also by changes in PP in depressed inpatients with BPD. As SI and its risk factors may oscillate within a time scale of hours, frequent monitoring of momentary severity of depression, PP, and SI may be warranted in inpatient settings.
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Affiliation(s)
- Ilya Baryshnikov
- Department of Psychiatry, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
| | - Tom Rosenström
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
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Ünsal E, Şengün İnan F. 'I live it all together…sadness, desperation': A qualitative exploration of psychosocial challenges and needs of young people after suicide attempt. Arch Psychiatr Nurs 2024; 49:1-9. [PMID: 38734443 DOI: 10.1016/j.apnu.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/07/2023] [Accepted: 01/13/2024] [Indexed: 05/13/2024]
Abstract
This study aimed to explore the psychosocial challenges and support needs of young people after suicide attempt. In the research, the phenomenological approach was used. Semi-structured interviews were held with 16 young people shortly after suicide attempt. Data were analysed via content analysis. The data were categorized into five themes: effort to return to the old normal, living with remains, need for support, barriers to seeking help, and awareness. Understanding the psychological challenges and support needs of young people who have attempted suicide will facilitate future research and practice. To support young people in the acute period following the intervention, supportive interventions at the individual, social and political levels need to be established. These findings shed light into the structuring of supportive interventions to be applied to young people following a suicide attempt.
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Affiliation(s)
- Erkan Ünsal
- Ege University, Faculty of Nursing, Mental Health and Diseases Nursing Department, 35030 Bornova, İZMİR, Turkey; Institute of Health Sciences Dokuz Eylül University, İzmir, Turkey.
| | - Figen Şengün İnan
- Gazi University, Faculty of Nursing, Mental Health and Diseases Nursing Department, 06490 Çankaya, ANKARA, Turkey.
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Pharr JR, Chien LC, Gakh M, Flatt JD, Kittle K, Terry E. Moderated Mediation Analysis of Structural Stigma and Suicidal Ideation and Behaviors Among Sexual and Gender Minority Adults. LGBT Health 2024; 11:239-248. [PMID: 38285526 DOI: 10.1089/lgbt.2022.0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024] Open
Abstract
Purpose: This study aimed to conduct a moderated mediation analysis to understand further the complex pathways through which structural stigma in the form of transgender sports bans was associated with suicidal ideation and behaviors among sexual and gender minority (SGM) adults. Methods: A cross-sectional survey of 1033 adults who identified as SGM from across the 50 U.S. states and Washington, DC was conducted between January 28 and February 7, 2022. Distal discrimination distress was the mediation variable; individual resilience and social resources were the moderation variables. Familiarity with transgender sports bans represented structural stigma. The conditional process analysis was applied to build a moderated mediation model. Both conditional direct and indirect effects were computed by estimated coefficients. All models were based on linear regression. Results: Our final model explained nearly half (46%) of the variation in suicidal ideation and behaviors between those SGM adults familiar and those not familiar with transgender sports bans. Social resources significantly moderated the conditional indirect effect of distal discrimination distress (adjusted estimate = -0.23; 95% confidence interval = -0.37 to -0.08). Conclusion: Both discrimination distress and social resources influenced the association between structural stigma as measured by familiarity with transgender sports bans and suicidal ideation and behaviors among SGM adults. Findings support the need for future research examining the pathway between structural stigma and suicidal ideation and behaviors among SGM adults and how minority stress, social safety, and other constructs shape this pathway.
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Affiliation(s)
- Jennifer R Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Maxim Gakh
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Jason D Flatt
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Krystal Kittle
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
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Ingram M, Letourneau EJ, Nestadt PS. Themes Associated with Suicidal Ideation and Behavior Among People Attracted to Children. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1343-1360. [PMID: 38200329 DOI: 10.1007/s10508-023-02770-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/20/2023] [Accepted: 11/28/2023] [Indexed: 01/12/2024]
Abstract
Suicide represents a significant public health problem, with around 800,000 deaths per year worldwide and up to 20 times as many episodes of self-harm and suicide attempts. Members of stigmatized groups may experience increased risk of suicide due in part to stigma-related factors, such as expectations of rejection, internalization of negative stereotypes, or potential for greater social isolation. Research suggests that adults who are attracted to children face extreme stigma, even those who do not commit sexual crimes involving children. Adults who are attracted to children also experience significantly increased risk for suicidal ideation and behavior (SIB) compared to general population samples. The current study sought to explore experiences with SIB among adults attracted to children to better understand factors underlying suicidality in this population. The lead author conducted semi-structured interviews in a community sample of 15 adults attracted to children who self-reported some form of SIB in their lifetime. Using interpretative phenomenological analysis, the lead author explored and interpreted interview data to generate themes driven by respondents' characterizations of their SIB. Superordinate themes related to suicidality in this sample included low self-esteem or self-worth, cumulative impacts of the attraction and other stressors, and concerns about the ability to have a positive future due to the attraction. Findings underscore the importance of addressing internalized stigma, treating problems like depression and social isolation, and instilling hope for the future to promote mental health and prevent SIB among adults attracted to children.
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Affiliation(s)
- Maggie Ingram
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 415 N. Washington St., Baltimore, MD, 21231, USA.
| | - Elizabeth J Letourneau
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 415 N. Washington St., Baltimore, MD, 21231, USA
| | - Paul S Nestadt
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 415 N. Washington St., Baltimore, MD, 21231, USA
- Department of Psychiatry and Behavioral Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Ernst M, Schwinn T, Hirschmiller J, Cleare S, Robb KA, Brähler E, Zwerenz R, Wiltink J, O'Connor RC, Beutel ME. To what extent are psychological variables considered in the study of risk and protective factors for suicidal thoughts and behaviours in individuals with cancer? A systematic review of 70 years of research. Clin Psychol Rev 2024; 109:102413. [PMID: 38518584 DOI: 10.1016/j.cpr.2024.102413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/29/2023] [Accepted: 03/08/2024] [Indexed: 03/24/2024]
Abstract
Psychological variables substantially shape the risk of suicidal thoughts and behaviours (STBs). However, it is unclear to what extent they are considered in individuals with cancer. We synthesized the quantitative research landscape concerning psychological risk/protective factors of STBs in the (psycho-) oncological context. This pre-registered review (PROSPERO-ID CRD42022331484) systematically searched the databases PubMed/Medline, CINAHL, PsycInfo, Cochrane Library, and Web of Science (as well as the grey literature and preprints). Risk of bias (RoB) was estimated using the ROBINS-I tool. Of 11,159 retrieved records, 319 studies were eligible for inclusion. Of those, 163 (51.1%) had investigated psychological factors (affective: n = 155; social: n = 65; cognitive: n = 63; personality/individual differences: n = 37; life events: n = 6), in a combined 3,561,741 participants. The most common STBs were suicidal ideation (n = 107) or death wishes (n = 20) rather than behaviour (suicide deaths: n = 26; attempts: n = 14). Most studies had a serious RoB. Thus, a large body of research investigated STBs in cancer patients/survivors, but it rarely aligned with the theoretical or clinical developments in suicide research. We propose a conceptual model of STBs in cancer delineating moderation and mediation effects to advance the integration of the fields, and to inform future research and practice.
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Affiliation(s)
- Mareike Ernst
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria; Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Tamara Schwinn
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Judith Hirschmiller
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Seonaid Cleare
- Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Kathryn A Robb
- Cancer Behaviour Research Group, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Department of Medical Psychology and Medical Sociology, University Hospital Leipzig, Leipzig, Germany
| | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Pitman A, McDonald K, Logeswaran Y, Lewis G, Cerel J, Lewis G, Erlangsen A. The role of depression and use of alcohol and other drugs after partner suicide in the association between suicide bereavement and suicide: cohort study in the Danish population. Psychol Med 2024:1-10. [PMID: 38465667 DOI: 10.1017/s0033291724000448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
BACKGROUND Although suicide bereavement is associated with suicide and self-harm, evidence regarding mechanisms is lacking. We investigated whether depression and substance use (alcohol and/or other drugs) explain the association between partner suicide bereavement and suicide. METHODS Linkage of nationwide, longitudinal data from Denmark for the period 1980-2016 facilitated a comparison of 22 668 individuals exposed to bereavement by a partner's suicide with 913 402 individuals bereaved by a partner's death due to other causes. Using causal mediation models, we estimated the degree to which depression and substance use (considered separately) mediated the association between suicide bereavement and suicide. RESULTS Suicide-bereaved partners were found to have a higher risk of suicide (HRadj = 1.59, 95% CI 1.36-1.86) and of depression (ORadj 1.16, 95% CI 1.09-1.25) when compared to other-bereaved partners, but a lower risk of substance use (ORadj 0.83; 95% CI 0.78-0.88). An increased risk of suicide was found among any bereaved individuals with a depression diagnosis recorded post-bereavement (ORadj 3.92, 95% CI 3.55-4.34). Mediation analysis revealed that depression mediated 2% (1.68%; 95% CI 0.23%-3.14%; p = 0.024) of the association between suicide bereavement and suicide in partners when using bereaved controls. CONCLUSIONS Depression is a partial mediator of the association between suicide bereavement and suicide. Efforts to prevent and optimize the treatment of depression in suicide-bereaved people could reduce their suicide risk. Our findings might be conservative because we did not include cases of depression diagnosed in primary care. Further work is needed to understand this and other mediators.
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Affiliation(s)
- Alexandra Pitman
- UCL Division of Psychiatry, 149 Tottenham Court Rd, LondonW1T 7AD, UK
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, St Pancras Way, LondonNW1 0PE, UK
| | - Keltie McDonald
- UCL Division of Psychiatry, 149 Tottenham Court Rd, LondonW1T 7AD, UK
| | | | - Glyn Lewis
- UCL Division of Psychiatry, 149 Tottenham Court Rd, LondonW1T 7AD, UK
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, St Pancras Way, LondonNW1 0PE, UK
| | - Julie Cerel
- Suicide Prevention & Exposure Lab, College of Social Work, University of Kentucky, Lexington, USA
| | - Gemma Lewis
- UCL Division of Psychiatry, 149 Tottenham Court Rd, LondonW1T 7AD, UK
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention - DRISP, Psychiatric Center Copenhagen, Copenhagen, Denmark
- Copenhagen Research Centre for Mental Health, Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, USA
- Centre for Mental Health Research, The National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, Australia
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Haghish EF, Nes RB, Obaidi M, Qin P, Stänicke LI, Bekkhus M, Laeng B, Czajkowski N. Unveiling Adolescent Suicidality: Holistic Analysis of Protective and Risk Factors Using Multiple Machine Learning Algorithms. J Youth Adolesc 2024; 53:507-525. [PMID: 37982927 PMCID: PMC10838236 DOI: 10.1007/s10964-023-01892-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/17/2023] [Indexed: 11/21/2023]
Abstract
Adolescent suicide attempts are on the rise, presenting a significant public health concern. Recent research aimed at improving risk assessment for adolescent suicide attempts has turned to machine learning. But no studies to date have examined the performance of stacked ensemble algorithms, which are more suitable for low-prevalence conditions. The existing machine learning-based research also lacks population-representative samples, overlooks protective factors and their interplay with risk factors, and neglects established theories on suicidal behavior in favor of purely algorithmic risk estimation. The present study overcomes these shortcomings by comparing the performance of a stacked ensemble algorithm with a diverse set of algorithms, performing a holistic item analysis to identify both risk and protective factors on a comprehensive data, and addressing the compatibility of these factors with two competing theories of suicide, namely, The Interpersonal Theory of Suicide and The Strain Theory of Suicide. A population-representative dataset of 173,664 Norwegian adolescents aged 13 to 18 years (mean = 15.14, SD = 1.58, 50.5% female) with a 4.65% rate of reported suicide attempt during the past 12 months was analyzed. Five machine learning algorithms were trained for suicide attempt risk assessment. The stacked ensemble model significantly outperformed other algorithms, achieving equal sensitivity and a specificity of 90.1%, AUC of 96.4%, and AUCPR of 67.5%. All algorithms found recent self-harm to be the most important indicator of adolescent suicide attempt. Exploratory factor analysis suggested five additional risk domains, which we labeled internalizing problems, sleep disturbance, disordered eating, lack of optimism regarding future education and career, and victimization. The identified factors provided stronger support for The Interpersonal Theory of Suicide than for The Strain Theory of Suicide. An enhancement to The Interpersonal Theory based on the risk and protective factors identified by holistic item analysis is presented.
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Affiliation(s)
- E F Haghish
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Ragnhild Bang Nes
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Milan Obaidi
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychology, Copenhagen University, Copenhagen, Denmark
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Line Indrevoll Stänicke
- Department of Psychology, University of Oslo, Oslo, Norway
- Nic Waals Institute, Lovisenberg hospital, Oslo, Norway
| | - Mona Bekkhus
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Bruno Laeng
- Department of Psychology, University of Oslo, Oslo, Norway
- RITMO Centre for Interdisciplinary Studies in Rhythm, Time and Motion, University of Oslo, Oslo, Norway
| | - Nikolai Czajkowski
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
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Schantell M, Taylor BK, Mansouri A, Arif Y, Coutant AT, Rice DL, Wang YP, Calhoun VD, Stephen JM, Wilson TW. Theta oscillatory dynamics serving cognitive control index psychosocial distress in youth. Neurobiol Stress 2024; 29:100599. [PMID: 38213830 PMCID: PMC10776433 DOI: 10.1016/j.ynstr.2023.100599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/09/2023] [Accepted: 12/10/2023] [Indexed: 01/13/2024] Open
Abstract
Background Psychosocial distress among youth is a major public health issue characterized by disruptions in cognitive control processing. Using the National Institute of Mental Health's Research Domain Criteria (RDoC) framework, we quantified multidimensional neural oscillatory markers of psychosocial distress serving cognitive control in youth. Methods The sample consisted of 39 peri-adolescent participants who completed the NIH Toolbox Emotion Battery (NIHTB-EB) and the Eriksen flanker task during magnetoencephalography (MEG). A psychosocial distress index was computed with exploratory factor analysis using assessments from the NIHTB-EB. MEG data were analyzed in the time-frequency domain and peak voxels from oscillatory maps depicting the neural cognitive interference effect were extracted for voxel time series analyses to identify spontaneous and oscillatory aberrations in dynamics serving cognitive control as a function of psychosocial distress. Further, we quantified the relationship between psychosocial distress and dynamic functional connectivity between regions supporting cognitive control. Results The continuous psychosocial distress index was strongly associated with validated measures of pediatric psychopathology. Theta-band neural cognitive interference was identified in the left dorsolateral prefrontal cortex (dlPFC) and middle cingulate cortex (MCC). Time series analyses of these regions indicated that greater psychosocial distress was associated with elevated spontaneous activity in both the dlPFC and MCC and blunted theta oscillations in the MCC. Finally, we found that stronger phase coherence between the dlPFC and MCC was associated with greater psychosocial distress. Conclusions Greater psychosocial distress was marked by alterations in spontaneous and oscillatory theta activity serving cognitive control, along with hyperconnectivity between the dlPFC and MCC.
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Affiliation(s)
- Mikki Schantell
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
- Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Brittany K. Taylor
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE, USA
- Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE, USA
| | - Amirsalar Mansouri
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Yasra Arif
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Anna T. Coutant
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Danielle L. Rice
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Yu-Ping Wang
- Department of Biomedical Engineering, Tulane University, New Orleans, LA, USA
| | - Vince D. Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging & Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | | | - Tony W. Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
- Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE, USA
- Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE, USA
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Spahn C, Spangenberg L, Teismann T, Forkmann T, Schönfelder A, Schreiber D, Paashaus L, Stengler K, Glaesmer H. [Utilization of Outpatient Psychotherapy and Outpatient Psychiatric Treatment by Men and Women after Inpatient Treatment due to Suicide Attempt or Acute Suicidal Crisis]. PSYCHIATRISCHE PRAXIS 2024; 51:99-103. [PMID: 37813362 DOI: 10.1055/a-2163-1448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
OBJECTIVE The strongest predictor of suicide attempts is a previous suicide attempt. Individuals hospitalized for suicidal ideation and behavior face an increased risk of suicide following discharge. This study investigates the extent to which outpatient treatment services are utilized the first 6 months after discharge and whether men and women differ in this regard. METHOD The study examines data of 124 individuals (with suicide attempts (lifetime), 59.7% female) on the use of outpatient treatment services in the 6 months after inpatient treatment. RESULTS 37.9% (N=47) of individuals reported not having used any treatment services at all. Men were significantly less likely to make use of the services. CONCLUSION Members of a group with an increased risk of suicide, to a large extent, fail to make use of outpatient treatment services. Discharge management should increasingly focus on (gender-specific) barriers and pave the way for treatment in outpatient.
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Affiliation(s)
- Cora Spahn
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - Lena Spangenberg
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - Tobias Teismann
- Forschungs- und Behandlungszentrum für psychische Gesundheit, Fakultät für Psychologie, Ruhr-Universität Bochum
| | - Thomas Forkmann
- Abteilung für Klinische Psychologie und Psychotherapie, Universität Duisburg-Essen
| | - Antje Schönfelder
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - Dajana Schreiber
- Abteilung für Klinische Psychologie und Psychotherapie, Universität Duisburg-Essen
| | - Laura Paashaus
- Abteilung für Klinische Psychologie und Psychotherapie, Universität Duisburg-Essen
| | | | - Heide Glaesmer
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
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Zheng H, Gao H, Li J, Li S, Chen L, Li Z, Chen X, Sun Y, Wang C, Liu J, Zhuang J. Social support systems involved in suicide prevention and intervention among adolescents: A Delphi study in Shanghai. Prev Med Rep 2024; 39:102654. [PMID: 38384963 PMCID: PMC10879809 DOI: 10.1016/j.pmedr.2024.102654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 02/23/2024] Open
Abstract
The rotes of attempted and completed suicide among adolescents are increasing globally. Social support can help decrease the risk of adolescent suicide, but this aspect has been rarely studied in China. The present study aimed to use the Delphi methodology to establish a set of guidelines for the development of social support resources, with the goal of collectively reducing suicide risks among adolescents in Shanghai. We commenced the study in April 2021, established a research team, searched the keywords using Web of Science from 2016 to 2021 and ultimately designed a pre-evaluation index. Next, following Donabedian's Structure-Process-Outcome model, the research developed a questionnaire comprising 3 level-1, 12 level-2, and 73 level-3 indicators. Ten experts were enlisted to conduct three rounds of e-mail inquiries in order to finalize the indicator system, resulting in 2 level-1, 11 level-2, and 52 level-3 indicators, as well as expert consensus. Our findings indicate that the social support systems should include parents, schools, psychiatric hospitals, social organizations, and government departments, with the government sector being the most important ((M = 9.4). Furthermore, our study revealed that school counselors and psychologists play similar roles to psychiatrists within the interdisciplinary team (M ± S = 9.2 ± 1.1). As per the expert consensus, social support systems should strengthen government-led and interdisciplinary collaboration, prioritize suicide prevention in schools and encourage greater involvement from social organizations.
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Affiliation(s)
- Hong Zheng
- Shanghai Changning Mental Health Center, Shanghai, 200335, China
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062, China
| | - Hui Gao
- Shanghai Changning District Center for Disease Control and Prevention, Shanghai, 200051, China
| | - Jiahui Li
- Fengxian Hospital Affiliated with Anhui University of Science and Technology, Shanghai, 201499, China
| | - Su Li
- School of Journalism and Communication, Wuhan University, Wuhan Province, 430072, China
| | - Liangliang Chen
- Shanghai Changning Mental Health Center, Shanghai, 200335, China
| | - Ziyan Li
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062, China
| | - Xuanxuan Chen
- Shanghai Changning Mental Health Center, Shanghai, 200335, China
| | - Yiting Sun
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062, China
| | - Chenyu Wang
- Shanghai Changning Mental Health Center, Shanghai, 200335, China
| | - Junsheng Liu
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062, China
| | - Jianlin Zhuang
- Shanghai Changning District Center for Disease Control and Prevention, Shanghai, 200051, China
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Gifuni AJ, Pereira F, Chakravarty MM, Lepage M, Chase HW, Geoffroy MC, Lacourse E, Phillips ML, Turecki G, Renaud J, Jollant F. Perception of social inclusion/exclusion and response inhibition in adolescents with past suicide attempt: a multidomain task-based fMRI study. Mol Psychiatry 2024:10.1038/s41380-024-02485-w. [PMID: 38424142 DOI: 10.1038/s41380-024-02485-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
The occurrence of suicidal behaviors increases during adolescence. Hypersensitivity to negative social signals and deficits in cognitive control are putative mechanisms of suicidal behaviors, which necessitate confirmation in youths. Multidomain functional neuroimaging could enhance the identification of patients at suicidal risk beyond standard clinical measures. Three groups of adolescents (N = 96; 78% females, age = 11.6-18.1) were included: patients with depressive disorders and previous suicide attempts (SA, n = 29); patient controls with depressive disorders but without any suicide attempt history (PC, n = 35); and healthy controls (HC, n = 32). We scanned participants with 3T-MRI during social inclusion/exclusion (Cyberball Game) and response inhibition (Go-NoGo) tasks. Neural activation was indexed by the blood-oxygenation-level dependent (BOLD) of the hemodynamic response during three conditions in the Cyberball Game ("Control condition", "Social Inclusion", and "Social Exclusion"), and two conditions in Go-NoGo task ("Go" and "NoGo" blocks). ANCOVA-style analysis identified group effects across three whole-brain contrasts: 1) NoGo vs. Go, 2) Social inclusion vs. control condition, 3) Social exclusion vs. control condition. We found that SA had lower activation in the left insula during social inclusion vs. control condition compared to PC and HC. Moreover, SA compared to PC had higher activity in the right middle prefrontal gyrus during social exclusion vs. control condition, and in bilateral precentral gyri during NoGo vs. Go conditions. Task-related behavioral and self-report measures (Self-reported emotional reactivity in the Cyberball Game, response times and number of errors in the Go-NoGo Task) did not discriminate groups. In conclusion, adolescent suicidal behaviors are likely associated with neural alterations related to the processing of social perception and response inhibition. Further research, involving prospective designs and diverse cohorts of patients, is necessary to explore the potential of neuroimaging as a tool in understanding the emergence and progression of suicidal behaviors.
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Affiliation(s)
- Anthony J Gifuni
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
- Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada
| | - Fabricio Pereira
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
- Service de psychiatrie, CHU Nîmes, Nîmes, France
- MIPA, University of Nîmes, Nîmes, France
| | | | - Martin Lepage
- Department of Psychiatry, McGill University, Montréal, Canada
| | - Henri W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Marie-Claude Geoffroy
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Canada
| | - Eric Lacourse
- Department of Sociology, Université de Montréal, Montréal, Canada
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
| | - Johanne Renaud
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
- Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada
| | - Fabrice Jollant
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada.
- Department of Psychiatry, McGill University, Montréal, Canada.
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France.
- Service de psychiatrie, CHU Nîmes, Nîmes, France.
- Université Paris-Saclay, Faculté de médecine, Le Kremlin-Bicêtre, France.
- Service de psychiatrie, Hôpital Bicêtre, APHP, Le Kremlin-Bicêtre, France.
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Toukhy N, Gvion Y, Barzilay S, Apter A, Haruvi-Catalan L, Lavidor M, Benaroya-Milshtein N, Fennig S, Hamdan S. Implicit or explicit self-associations with life and death? Predicting short-term self-injurious thoughts and behaviors among adolescents. DEATH STUDIES 2024:1-12. [PMID: 38393677 DOI: 10.1080/07481187.2024.2318601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Implicit self-association with death, measured by the Death/Suicide-Implicit Association Test (D/S-IAT), predicts short-term Self-Injurious Thoughts and Behaviors (SITBs) among adolescents. However, comparing the predictive utility of the D/S-IAT with explicit (i.e. self-report) self-association with life and death was not examined previously. The current study sought to examine whether the D/S-IAT and explicit self-association with life and death predict current and prospective SITBs, and to examine the association between the two measures. One-hundred and thirty-one Jewish Israeli adolescents with SITBs, aged 10-18 years (74.8% female) were assessed at clinic intake. Participants completed D/S-IAT, depression, attitudes toward life and death and suicide risk assessment at intake and one-month follow-up. Implicit, rather than explicit, attitudes toward life and death predicted SITBs at one-month follow-up, beyond depression and past SITBs. The implicit and explicit measures were not significantly related at intake, indicating that they might capture different aspects of SITBs.
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Affiliation(s)
- N Toukhy
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - Y Gvion
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - S Barzilay
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - A Apter
- Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - L Haruvi-Catalan
- Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - M Lavidor
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | | | - S Fennig
- Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - S Hamdan
- School of Behavioral Sciences, Academic College of Tel-Aviv Yaffo (MTA), Tel Aviv- Yaffo, Israel
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45
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Sadath A, Kavalidou K, McMahon E, Malone K, McLoughlin A. Associations between humiliation, shame, self-harm and suicidality among adolescents and young adults: A systematic review. PLoS One 2024; 19:e0292691. [PMID: 38329967 PMCID: PMC10852296 DOI: 10.1371/journal.pone.0292691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/26/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Suicide is the second leading cause of death among young people worldwide. Research indicates that negative social contexts involving familial and peer relationships have far-reaching influences on levels of suicidality in later life. While previous systematic reviews have focused on evaluating associations between negative life events such as abuse and bullying in childhood and subsequent suicidality, this systematic review examines the prevalence of, and association between the processes of humiliation and shame in later self-harm, suicidal ideation, and suicide among adolescents and young adults. METHODS A systematic literature search of databases including MEDLINE, Web of Science Core Collection, CINAHL, PsycINFO, and Embase was conducted to identify potential studies. ProQuest was searched to identify relevant grey literature research. A combination of MESH terms and keywords was used. All original quantitative studies published in English that examined the prevalence, or association between humiliation or shame and suicidal behaviours and/or death by suicide were included. Studies were assessed for methodological quality using Joanna Briggs Institute critical appraisal tools. The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) [CRD42022289843]. RESULTS Narrative synthesis was performed. A total of 33 studies reporting the prevalence of, or association between humiliation (n = 10) or shame (n = 23) and suicidal thoughts/behaviours were included. The prevalence of humiliation among those with any suicidality ranged from 18% to 28.1%, excluding an outlier (67.1%), with two studies presenting a significant association between humiliation and self-harm in their fully adjusted analyses. The studies that outlined humiliation and suicidal thinking (intent/suicide plan) had no association after adjustment for confounders. For shame, half of the studies found an association in adjusted models (n = 10), and this was evident for both suicidal ideation and self-harm. CONCLUSION To our knowledge, this is the first study to attempt a systematic review on this topic. The dearth of research in this field of enquiry is reflective of unique challenges associated with assessments of humiliation and shame in various clinical settings amongst adolescent and young adult populations. Nonetheless, given the importance and relevance of the psychological imprint of humiliation in youth morbidity and mortality in the field of mental health, it is timely to attempt such a systematic review. In light of the associated role of humiliation and shame in self-harm and suicidality among young people, we recommend that these processes need to be explored further via prospective studies and assessed as part of a comprehensive bio-psycho-social assessment when focusing on life stressors for adolescent and young adults presenting with suicidality to emergency departments and mental health services.
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Affiliation(s)
- Anvar Sadath
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Katerina Kavalidou
- National Suicide Research Foundation, University College Cork, Cork, Ireland
- National Clinical Programme, Health Service Executive (HSE), Dublin, Ireland
| | - Elaine McMahon
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Kevin Malone
- Department of Psychiatry and Mental Health Research, St. Vincent’s University Hospital, University College Dublin, Dublin, Ireland
| | - Aoibheann McLoughlin
- Department of Psychiatry and Mental Health Research, St. Vincent’s University Hospital, University College Dublin, Dublin, Ireland
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46
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Kissane DW. Education and assessment of psycho-existential symptoms to prevent suicidality in cancer care. Psychooncology 2024; 33:e5519. [PMID: 33463852 DOI: 10.1002/pon.5519] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 11/06/2022]
Affiliation(s)
- David W Kissane
- University of Notre Dame Australia and Cunningham Centre for Palliative Care Research, St Vincent's Sydney, Sydney, Australia
- Cabrini Health Psycho-oncology and Palliative Care, Monash University, Melbourne, Australia
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Tate M, Sinha R, Wemm S. Cumulative adversity and emotion dysregulation effects on suicidal ideation and attempts in a community sample. J Psychiatr Res 2024; 170:277-282. [PMID: 38183699 DOI: 10.1016/j.jpsychires.2023.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 01/08/2024]
Abstract
Adversity, trauma, and emotion dysregulation are commonly cited risk factors for suicidal thoughts and behaviors. Thus, the role of these factors in conferring risk for suicidal ideation (SI) and suicide attempts (SA) amongst community adults was assessed. A cross-sectional cohort-based study with community adults (n=757; female=55.0%) assessed emotion dysregulation, cumulative adversity including highly stressful and traumatic events, as well as other known risk factors for suicidality (e.g., self-reported depression and anxiety history) to predict a lifetime history of SI or SA, SI but no SA, or SI and SA. Higher cumulative stress and trauma scores conferred risk for SI, specifically on the subscales major life events, recent life events, and chronic stressors. Higher emotion dysregulation was associated with an increased risk for a SA relative to no SI or SA, particularly nonacceptance of emotional responses. Lifetime trauma was the only predictor of SA relative to SI. Nonacceptance of emotions significantly mediated the association between life traumas and suicidality. Cumulative adversity and emotion dysregulation confer risk for suicidal ideation and attempts, and higher lifetime trauma predicted attempts over ideation. These findings suggest that targeting emotion dysregulation, and specifically nonacceptance of difficult emotions, may be a useful strategy in reducing suicidal behaviors in individuals with trauma history and concurrent suicidal ideation.
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Affiliation(s)
- Marshall Tate
- Department of Psychiatry, Yale School of Medicine, 2 Church Street South, Suite 209, New Haven, CT, 06519, USA
| | - Rajita Sinha
- Department of Psychiatry, Yale School of Medicine, 2 Church Street South, Suite 209, New Haven, CT, 06519, USA
| | - Stephanie Wemm
- Department of Psychiatry, Yale School of Medicine, 2 Church Street South, Suite 209, New Haven, CT, 06519, USA.
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48
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Pereira CA, Reis-de-Oliveira G, Pierone BC, Martins-de-Souza D, Kaster MP. Depicting the molecular features of suicidal behavior: a review from an "omics" perspective. Psychiatry Res 2024; 332:115682. [PMID: 38198856 DOI: 10.1016/j.psychres.2023.115682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 12/05/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024]
Abstract
Background Suicide is one of the leading global causes of death. Behavior patterns from suicide ideation to completion are complex, involving multiple risk factors. Advances in technologies and large-scale bioinformatic tools are changing how we approach biomedical problems. The "omics" field may provide new knowledge about suicidal behavior to improve identification of relevant biological pathways associated with suicidal behavior. Methods We reviewed transcriptomic, proteomic, and metabolomic studies conducted in blood and post-mortem brains from individuals who experienced suicide or suicidal behavior. Omics data were combined using systems biology in silico, aiming at identifying major biological mechanisms and key molecules associated with suicide. Results Post-mortem samples of suicide completers indicate major dysregulations in pathways associated with glial cells (astrocytes and microglia), neurotransmission (GABAergic and glutamatergic systems), neuroplasticity and cell survivor, immune responses and energy homeostasis. In the periphery, studies found alterations in molecules involved in immune responses, polyamines, lipid transport, energy homeostasis, and amino and nucleic acid metabolism. Limitations We included only exploratory, non-hypothesis-driven studies; most studies only included one brain region and whole tissue analysis, and focused on suicide completers who were white males with almost none confounding factors. Conclusions We can highlight the importance of synaptic function, especially the balance between the inhibitory and excitatory synapses, and mechanisms associated with neuroplasticity, common pathways associated with psychiatric disorders. However, some of the pathways highlighted in this review, such as transcriptional factors associated with RNA splicing, formation of cortical connections, and gliogenesis, point to mechanisms that still need to be explored.
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Affiliation(s)
- Caibe Alves Pereira
- Laboratory of Translational Neurosciences, Department of Biochemistry, Federal University of Santa Catarina (UFSC), Florianopolis, Santa Catarina, Brazil
| | - Guilherme Reis-de-Oliveira
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Bruna Caroline Pierone
- Laboratory of Translational Neurosciences, Department of Biochemistry, Federal University of Santa Catarina (UFSC), Florianopolis, Santa Catarina, Brazil
| | - Daniel Martins-de-Souza
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil; Instituto Nacional de Biomarcadores Em Neuropsiquiatria (INBION) Conselho Nacional de Desenvolvimento Científico E Tecnológico, São Paulo, Brazil; Experimental Medicine Research Cluster (EMRC), University of Campinas, Campinas, SP, Brazil; D'Or Institute for Research and Education (IDOR), São Paulo, Brazil; INCT in Modelling Human Complex Diseases with 3D Platforms (Model3D), São Paulo, Brazil.
| | - Manuella Pinto Kaster
- Laboratory of Translational Neurosciences, Department of Biochemistry, Federal University of Santa Catarina (UFSC), Florianopolis, Santa Catarina, Brazil.
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49
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Ross EL, Bossarte RM, Dobscha SK, Gildea SM, Hwang I, Kennedy CJ, Liu H, Luedtke A, Marx BP, Nock MK, Petukhova MV, Sampson NA, Zainal NH, Sverdrup E, Wager S, Kessler RC. Estimated Average Treatment Effect of Psychiatric Hospitalization in Patients With Suicidal Behaviors: A Precision Treatment Analysis. JAMA Psychiatry 2024; 81:135-143. [PMID: 37851457 PMCID: PMC10585585 DOI: 10.1001/jamapsychiatry.2023.3994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/17/2023] [Indexed: 10/19/2023]
Abstract
Importance Psychiatric hospitalization is the standard of care for patients presenting to an emergency department (ED) or urgent care (UC) with high suicide risk. However, the effect of hospitalization in reducing subsequent suicidal behaviors is poorly understood and likely heterogeneous. Objectives To estimate the association of psychiatric hospitalization with subsequent suicidal behaviors using observational data and develop a preliminary predictive analytics individualized treatment rule accounting for heterogeneity in this association across patients. Design, Setting, and Participants A machine learning analysis of retrospective data was conducted. All veterans presenting with suicidal ideation (SI) or suicide attempt (SA) from January 1, 2010, to December 31, 2015, were included. Data were analyzed from September 1, 2022, to March 10, 2023. Subgroups were defined by primary psychiatric diagnosis (nonaffective psychosis, bipolar disorder, major depressive disorder, and other) and suicidality (SI only, SA in past 2-7 days, and SA in past day). Models were trained in 70.0% of the training samples and tested in the remaining 30.0%. Exposures Psychiatric hospitalization vs nonhospitalization. Main Outcomes and Measures Fatal and nonfatal SAs within 12 months of ED/UC visits were identified in administrative records and the National Death Index. Baseline covariates were drawn from electronic health records and geospatial databases. Results Of 196 610 visits (90.3% men; median [IQR] age, 53 [41-59] years), 71.5% resulted in hospitalization. The 12-month SA risk was 11.9% with hospitalization and 12.0% with nonhospitalization (difference, -0.1%; 95% CI, -0.4% to 0.2%). In patients with SI only or SA in the past 2 to 7 days, most hospitalization was not associated with subsequent SAs. For patients with SA in the past day, hospitalization was associated with risk reductions ranging from -6.9% to -9.6% across diagnoses. Accounting for heterogeneity, hospitalization was associated with reduced risk of subsequent SAs in 28.1% of the patients and increased risk in 24.0%. An individualized treatment rule based on these associations may reduce SAs by 16.0% and hospitalizations by 13.0% compared with current rates. Conclusions and Relevance The findings of this study suggest that psychiatric hospitalization is associated with reduced average SA risk in the immediate aftermath of an SA but not after other recent SAs or SI only. Substantial heterogeneity exists in these associations across patients. An individualized treatment rule accounting for this heterogeneity could both reduce SAs and avert hospitalizations.
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Affiliation(s)
- Eric L. Ross
- Department of Psychiatry, Larner College of Medicine, University of Vermont, Burlington
| | - Robert M. Bossarte
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa
| | | | - Sarah M. Gildea
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
- Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, New York
| | - Irving Hwang
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Chris J. Kennedy
- Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Howard Liu
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
- Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, New York
| | - Alex Luedtke
- Department of Statistics, University of Washington, Seattle
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Brian P. Marx
- National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
| | - Matthew K. Nock
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Maria V. Petukhova
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Nur Hani Zainal
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Erik Sverdrup
- Graduate School of Business, Stanford University, Stanford, California
| | - Stefan Wager
- Graduate School of Business, Stanford University, Stanford, California
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
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50
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Goodwill JR. Reasons for Suicide in Black Young Adults: A Latent Class Analysis. J Racial Ethn Health Disparities 2024; 11:425-440. [PMID: 36867388 PMCID: PMC9983538 DOI: 10.1007/s40615-023-01530-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/28/2023] [Accepted: 01/31/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND Suicides have increased among Black youth in the US, though it remains unclear if these trends persist into young adulthood. Further, even less is known about the reasons why individuals begin to consider suicide as a viable option. The current study aims to redress these gaps by identifying specific reasons for suicide among a sample of 264 Black young adults who reported experiencing suicidal thoughts within the past 2 weeks. METHODS Participants were recruited from an online panel. Reasons for suicide were measured using eight individual items/indicators. Latent class analysis was used to detect underlying patterns in Black young adults' reasons for considering suicide. RESULTS The most commonly reported reason for considering suicide among the entire sample was feeling hopeless about the future. Black women were more likely to report considering suicide because they could not live up to other's expectations and because they felt lonely and sad. Findings for the 3-class model were retained. The first class is described as the "Somewhat hopeless and other reasons" class (n = 85; 32%). The second class is "Accomplished but extremely lonely and sad" (n = 24; 9%). The third class is described as "Pronounced feelings of failure, hopelessness, being overwhelmed, and lack of accomplishment" and includes 59% of the sample (n = 155). CONCLUSIONS Culturally grounded clinical treatments and interventions are needed to meet the specific mental health needs of Black young adults. A particular focus on identifying factors that drive feelings of hopelessness and failure is warranted.
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Affiliation(s)
- Janelle R Goodwill
- University of Chicago Crown Family School of Social Work, Policy, and Practice, 969 E. 60th St, Chicago, IL, 60637, USA.
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