101
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Hollingsworth DW, Slish ML, Wingate LR, Davidson CL, Rasmussen KA, O'Keefe VM, Tucker RP, Grant DM. The indirect effect of perceived burdensomeness on the relationship between indices of social support and suicide ideation in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2018; 66:9-16. [PMID: 28812441 DOI: 10.1080/07448481.2017.1363764] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Research has demonstrated that a lack of social support is related to suicide risk. This study examines perceived burdensomeness and thwarted belongingness, of the Interpersonal Theory of Suicide, as mechanisms of the social support-suicide relationship in college students. METHOD The study consisted of 207 students from a Midwestern university. Data were collected from 2007 to 2008. Two multiple mediation analyses were conducted to examine whether perceived burdensomeness and thwarted belongingness mediated the relationship between indices of social support and suicide ideation. RESULTS Perceived burdensomeness mediated the relationships between perceived social support and suicide ideation (95% confidence interval [CI] -.02 to -.00, effect size = -.01) and social connectedness and suicide ideation (95% CI -.03 to -.00, effect size = -.03). Thwarted belongingness did not mediate either relationship. CONCLUSIONS Results suggest that a lack of social support could lead to perceptions of being a burden on others, which could lead to suicide ideation.
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Affiliation(s)
| | - Meredith L Slish
- b Psychology Service, Oklahoma City Veteran Affairs Medical Center , Oklahoma City , Oklahoma , USA
| | - LaRicka R Wingate
- c Department of Psychology , Oklahoma State University , Stillwater , Oklahoma , USA
| | - Collin L Davidson
- d Department of Psychology, Hennepin County Medical Center , Minneapolis , Minnesota , USA
| | - Kathy A Rasmussen
- e Home Basic Primary Care, VA Palo Alto Health Care System , Modesto , California , USA
| | - Victoria M O'Keefe
- f Department of International Health, Center for American Indian Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA
| | - Raymond P Tucker
- g Department of Psychology , Louisiana State University , Baton Rouge , Louisiana , USA
| | - DeMond M Grant
- c Department of Psychology , Oklahoma State University , Stillwater , Oklahoma , USA
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102
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Chesin MS, Galfavy H, Sonmez CC, Wong A, Oquendo MA, Mann JJ, Stanley B. Nonsuicidal Self-Injury Is Predictive of Suicide Attempts Among Individuals with Mood Disorders. Suicide Life Threat Behav 2017; 47:567-579. [PMID: 28211201 PMCID: PMC5724372 DOI: 10.1111/sltb.12331] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 08/06/2016] [Indexed: 11/28/2022]
Abstract
Nonsuicidal self-injury (NSSI) prior to age 18 was evaluated as a risk factor for adulthood suicide attempt (SA). Archival data from 222 mood-disordered participants were analyzed using multivariate Cox proportional hazards analysis. Participants with a youth SA were excluded. The hazards of SA among adult participants with a history of youth NSSI were twice than those of mood-disordered participants without youth NSSI (hazard ratio = 2.00, 95% confidence interval = 1.16-3.44, p = .01). Moreover, participants who had both youth and adult NSSI attempted suicide significantly earlier than participants who began NSSI as an adult. Youth NSSI is associated with persistent, elevated SA risk in adulthood.
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Affiliation(s)
- Megan S Chesin
- Department of Psychology, William Paterson University, Wayne, NJ, USA
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA
| | - Hanga Galfavy
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA
| | | | - Amanda Wong
- Department of Psychology, Rutgers University, New Brunswick, NJ, USA
| | - Maria A Oquendo
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA
| | - J John Mann
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA
| | - Barbara Stanley
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA
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103
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Liu RT, Trout ZM, Hernandez EM, Cheek SM, Gerlus N. A behavioral and cognitive neuroscience perspective on impulsivity, suicide, and non-suicidal self-injury: Meta-analysis and recommendations for future research. Neurosci Biobehav Rev 2017; 83:440-450. [PMID: 28928071 DOI: 10.1016/j.neubiorev.2017.09.019] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 08/16/2017] [Accepted: 09/15/2017] [Indexed: 12/13/2022]
Abstract
We conducted a meta-analysis of neurobehavioral and neurocognitive indices of impulsivity in relation to suicidal thoughts and behaviors, as well as non-suicidal self-injury (NSSI). In our systematic review, 34 studies were identified and submitted to a random-effects meta-analysis. A small pooled effect size was observed for the association between behavioral impulsivity and NSSI (OR=1.34, p<0.05). A small-to-medium pooled effect size (OR=2.23, p<0.001) was found for the association between behavioral impulsivity and suicide attempts, and a medium-to-large pooled effect size was observed for this outcome in relation to cognitive impulsivity (OR=3.14, p<0.01). Length of time between suicide attempt and impulsivity assessment moderated the strength of the relation between impulsivity and attempts, with a large pooled effect size (OR=5.54, p<0.001) evident when the suicide attempt occurred within a month of behavioral impulsivity assessment. Studies of clinically significant NSSI temporally proximal to impulsivity assessment are needed. Longitudinal research is required to clarify the prognostic value of behavioral and cognitive impulsivity for short-term risk for self-harm.
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Affiliation(s)
- Richard T Liu
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States.
| | - Zoë M Trout
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States
| | - Evelyn M Hernandez
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States
| | - Shayna M Cheek
- Department of Psychology and Neuroscience, Duke University, United States
| | - Nimesha Gerlus
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, United States
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104
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Phillips CJ, LeardMann CA, Vyas KJ, Crum-Cianflone NF, White MR. Risk Factors Associated With Suicide Completions Among US Enlisted Marines. Am J Epidemiol 2017; 186:668-678. [PMID: 28595355 DOI: 10.1093/aje/kwx117] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 10/27/2016] [Indexed: 01/23/2023] Open
Abstract
US enlisted Marines have experienced a substantial increase in suicide rates. We sought to identify risk factors for suicide completions among male Marines who entered basic training in San Diego, California, between June 2001 and October 2010. Suicides that occurred during active-duty military service were counted from June 1, 2001, through June 30, 2012. A total of 108,930 male Marines (66,286 deployers and 42,644 never deployed) were followed for 467,857 person-years of active-duty service time. Of the 790 deaths, 123 (15.6%) were suicides. In the final multivariate hazard model, preservice characteristics of not being a high-school graduate (hazard ratio (HR) = 2.17, 95% confidence interval (CI): 1.28, 3.68) and being a smoker at the time of enlistment (HR = 1.91, 95% CI: 1.32, 2.76) were significantly associated with a higher risk for suicide completion. Diagnosed with traumatic brain injury (HR = 4.09, 95% CI: 2.08, 8.05), diagnosed with depression (HR = 2.36, 95% CI: 1.22, 4.58), and received relationship counseling (HR = 3.71, 95% CI: 1.44, 9.54) during military service were significant risks for suicide death. Deployment alone was not significantly associated with a risk for suicide death (HR = 0.53, 95% CI: 0.26, 1.05).
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105
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An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health 2017; 152:157-171. [PMID: 28915435 DOI: 10.1016/j.puhe.2017.07.035] [Citation(s) in RCA: 1018] [Impact Index Per Article: 145.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/27/2017] [Accepted: 07/29/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Social isolation and loneliness have been associated with ill health and are common in the developed world. A clear understanding of their implications for morbidity and mortality is needed to gauge the extent of the associated public health challenge and the potential benefit of intervention. STUDY DESIGN A systematic review of systematic reviews (systematic overview) was undertaken to determine the wider consequences of social isolation and loneliness, identify any differences between the two, determine differences from findings of non-systematic reviews and to clarify the direction of causality. METHODS Eight databases were searched from 1950 to 2016 for English language reviews covering social isolation and loneliness but not solely social support. Suitability for inclusion was determined by two or more reviewers, the methodological quality of included systematic reviews assessed using the a measurement tool to assess systematic reviews (AMSTAR) checklist and the quality of evidence within these reviews using the grading of recommendations, assessment, development and evaluations (GRADE) approach. Non-systematic reviews were sought for a comparison of findings but not included in the primary narrative synthesis. RESULTS Forty systematic reviews of mainly observational studies were identified, largely from the developed world. Meta-analyses have identified a significant association between social isolation and loneliness with increased all-cause mortality and social isolation with cardiovascular disease. Narrative systematic reviews suggest associations with poorer mental health outcomes, with less strong evidence for behavioural and other physical health outcomes. No reviews were identified for wider socio-economic or developmental outcomes. CONCLUSIONS This systematic overview highlights that there is consistent evidence linking social isolation and loneliness to worse cardiovascular and mental health outcomes. The role of social isolation and loneliness in other conditions and their socio-economic consequences is less clear. More research is needed on associations with cancer, health behaviours, and the impact across the life course and wider socio-economic consequences. Policy makers and health and local government commissioners should consider social isolation and loneliness as important upstream factors impacting on morbidity and mortality due to their effects on cardiovascular and mental health. Prevention strategies should therefore be developed across the public and voluntary sectors, using an asset-based approach.
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106
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Abstract
Suicide is the second leading cause of death among adolescents, and impulsivity has emerged as a promising marker of risk. The present study tested whether distinct domains of impulsivity are differentially associated with suicide ideation, plans, and attempts. Adolescents (n = 381; boys = 106, girls = 275) aged 13-19 years (M = 15.62, SD = 1.41) were recruited from an acute, residential treatment program. Within 48 h of admission to the hospital, participants were administered structured clinical interviews assessing mental health disorders and suicidality. Following these interviews, participants completed self-report questionnaires assessing symptom severity and impulsivity. Consistent with past research, an exploratory factor analysis of our 90-item impulsivity instrument resulted in a three-factor solution: Pervasive Influence of Feelings, Feelings Trigger Action, and Lack of Follow-Through. Concurrent analysis of these factors confirmed hypotheses of unique associations with suicide ideation and attempts in the past month. Specifically, whereas Pervasive Influence of Feelings (i.e., tendency for emotions to shape thoughts about the self and the future) is uniquely associated with greater suicidal ideation, Feelings Trigger Action (i.e., impulsive behavioral reactivity to emotions) is uniquely associated with the occurrence of suicide attempts, even after controlling for current psychiatric diagnoses and symptoms. Exploratory gender analyses revealed that these effects were significant in female but not male adolescents. These findings provide new insight about how specific domains of impulsivity differentially increase risk for suicide ideation and attempts. Implications for early identification and prevention of youth suicide are discussed.
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107
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Development of self-inflicted injury: Comorbidities and continuities with borderline and antisocial personality traits. Dev Psychopathol 2017; 28:1071-1088. [PMID: 27739385 DOI: 10.1017/s0954579416000705] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Self-inflicted injury (SII) is a continuum of intentionally self-destructive behaviors, including nonsuicidal self-injuries, suicide attempts, and death by suicide. These behaviors are among the most pressing yet perplexing clinical problems, affecting males and females of every race, ethnicity, culture, socioeconomic status, and nearly every age. The complexity of these behaviors has spurred an immense literature documenting risk and vulnerability factors ranging from individual to societal levels of analysis. However, there have been relatively few attempts to articulate a life span developmental model that integrates ontogenenic processes across these diverse systems. The objective of this review is to outline such a model with a focus on how observed patterns of comorbidity and continuity can inform developmental theories, early prevention efforts, and intervention across traditional diagnostic boundaries. Specifically, when SII is viewed through the developmental psychopathology lens, it becomes apparent that early temperamental risk factors are associated with risk for SII and a range of highly comorbid conditions, such as borderline and antisocial personality disorders. Prevention efforts focused on early-emerging biological and temperamental contributors to psychopathology have great potential to reduce risk for many presumably distinct clinical problems. Such work requires identification of early biological vulnerabilities, behaviorally conditioned social mechanisms, as well as societal inequities that contribute to self-injury and underlie intergenerational transmission of risk.
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108
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Iliceto P, D'Antuono L, Cassarà L, Giacolini T, Sabatello U, Candilera G. Obsessive-Compulsive Tendencies, Self/Other Perception, Personality, and Suicidal Ideation in a Non-clinical Sample. Psychiatr Q 2017; 88:411-422. [PMID: 27448291 DOI: 10.1007/s11126-016-9457-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Research on the risk factors for SI in adults with OC tendencies is limited, and it is still unclear whether the association between OC tendencies and SI in non-clinical individuals exists. The goal of the present study was to test the associations between OC tendencies, self/other perception, personality traits, depressive symptoms and SI among a non-clinical adult population. We investigated an Italian sample of 337 adults, who were administered a set of self-report questionnaires to assess obsessive-compulsive tendencies, depression, self/other perception, personality traits, and hopelessness. Confirmatory factor analyses (CFA) were performed. In the final model we found that personality, obsessive-compulsive factor and suicidal ideation were significantly correlated with each other: personality correlated negatively with obsessive-compulsive factor and suicidal ideation, while obsessive-compulsive factor and suicidal ideation resulted as strongly positively associated. Our results highlight the importance of assessing OC tendencies, negative self/other perception and SI. Understanding their role and interplay will allow for the development and implementation of more advanced prevention and treatment policies.
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Affiliation(s)
- Paolo Iliceto
- S&P Statistics and Psychometrics Ltd, Via Tuscolana, 458, 00181, Rome, Italy.
| | - Laura D'Antuono
- ARPCI, School of Cognitive-Interpersonal, Attachment Theory-based Psychotherapy, Rome, Italy.,Department of Mental Health, ASL 1, Abruzzo, Sulmona, Italy
| | - Luisa Cassarà
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Italy
| | - Teodosio Giacolini
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Italy
| | - Ugo Sabatello
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Italy
| | - Gabriella Candilera
- S&P Statistics and Psychometrics Ltd, Via Tuscolana, 458, 00181, Rome, Italy
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109
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Wong YJ, Wang L, Li S, Liu H. Circumstances preceding the suicide of Asian Pacific Islander Americans and White Americans. DEATH STUDIES 2017; 41:311-317. [PMID: 28010247 DOI: 10.1080/07481187.2016.1275888] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study examined the circumstances preceding suicide among Asian and Pacific Islander Americans (APIAs) and White American decedents using data from the National Violent Death Reporting System in the United States. After controlling for gender and age, APIAs had lower rates of recent disclosure of suicide ideation, recent mental health treatment, recent mental health problems, and intimate partner problems, but higher rates of school problems than White Americans. There were also significant Race × Age moderation effects for recent mental health, financial, and school problems and a significant Race × Gender moderation effect for intimate partner problems.
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Affiliation(s)
- Y Joel Wong
- a Department of Counseling and Educational Psychology , Indiana University Bloomington , Bloomington , Indiana , USA
| | - Lei Wang
- a Department of Counseling and Educational Psychology , Indiana University Bloomington , Bloomington , Indiana , USA
| | - Shaozhuan Li
- a Department of Counseling and Educational Psychology , Indiana University Bloomington , Bloomington , Indiana , USA
| | - Huabing Liu
- b School of Education, Loyola University Chicago , Chicago , Illinois , USA
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110
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Gould TD, Georgiou P, Brenner LA, Brundin L, Can A, Courtet P, Donaldson ZR, Dwivedi Y, Guillaume S, Gottesman II, Kanekar S, Lowry CA, Renshaw PF, Rujescu D, Smith EG, Turecki G, Zanos P, Zarate CA, Zunszain PA, Postolache TT. Animal models to improve our understanding and treatment of suicidal behavior. Transl Psychiatry 2017; 7:e1092. [PMID: 28398339 PMCID: PMC5416692 DOI: 10.1038/tp.2017.50] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 01/16/2017] [Accepted: 02/01/2017] [Indexed: 02/08/2023] Open
Abstract
Worldwide, suicide is a leading cause of death. Although a sizable proportion of deaths by suicide may be preventable, it is well documented that despite major governmental and international investments in research, education and clinical practice suicide rates have not diminished and are even increasing among several at-risk populations. Although nonhuman animals do not engage in suicidal behavior amenable to translational studies, we argue that animal model systems are necessary to investigate candidate endophenotypes of suicidal behavior and the neurobiology underlying these endophenotypes. Animal models are similarly a critical resource to help delineate treatment targets and pharmacological means to improve our ability to manage the risk of suicide. In particular, certain pathophysiological pathways to suicidal behavior, including stress and hypothalamic-pituitary-adrenal axis dysfunction, neurotransmitter system abnormalities, endocrine and neuroimmune changes, aggression, impulsivity and decision-making deficits, as well as the role of critical interactions between genetic and epigenetic factors, development and environmental risk factors can be modeled in laboratory animals. We broadly describe human biological findings, as well as protective effects of medications such as lithium, clozapine, and ketamine associated with modifying risk of engaging in suicidal behavior that are readily translatable to animal models. Endophenotypes of suicidal behavior, studied in animal models, are further useful for moving observed associations with harmful environmental factors (for example, childhood adversity, mechanical trauma aeroallergens, pathogens, inflammation triggers) from association to causation, and developing preventative strategies. Further study in animals will contribute to a more informed, comprehensive, accelerated and ultimately impactful suicide research portfolio.
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Affiliation(s)
- T D Gould
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - P Georgiou
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - L A Brenner
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Rocky Mountain Mental Illness Research Education and Clinical Center, Denver, CO, USA
- Military and Veteran Microbiome Consortium for Research and Education, U.S. Department of Veterans Affairs, Washington, DC, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - L Brundin
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA
| | - A Can
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Psychology, Notre Dame of Maryland University, Baltimore, MD, USA
| | - P Courtet
- Department of Emergency Psychiatry and Post Acute Care, CHU Montpellier, Montpellier, France
- Université Montpellier, Inserm U1061, Montpellier, France
| | - Z R Donaldson
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, CO, USA
- Department of Psychology, University of Colorado, Boulder, Boulder, CO, USA
- Department of Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Y Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - S Guillaume
- Department of Emergency Psychiatry and Post Acute Care, CHU Montpellier, Montpellier, France
- Université Montpellier, Inserm U1061, Montpellier, France
| | - I I Gottesman
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
| | - S Kanekar
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - C A Lowry
- Rocky Mountain Mental Illness Research Education and Clinical Center, Denver, CO, USA
- Military and Veteran Microbiome Consortium for Research and Education, U.S. Department of Veterans Affairs, Washington, DC, USA
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA
- Department of Physical Medicine and Rehabilitation and Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - P F Renshaw
- Rocky Mountain Mental Illness Research Education and Clinical Center, Denver, CO, USA
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - D Rujescu
- Department of Psychiatry, University of Halle-Wittenberg, Halle, Germany
| | - E G Smith
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
| | - G Turecki
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - P Zanos
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - C A Zarate
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - P A Zunszain
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - T T Postolache
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
- Rocky Mountain Mental Illness Research Education and Clinical Center, Denver, CO, USA
- Military and Veteran Microbiome Consortium for Research and Education, U.S. Department of Veterans Affairs, Washington, DC, USA
- VISN 5 Mental Illness Research Education and Clinical Center, Baltimore MD, USA
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111
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Chu C, Buchman-Schmitt JM, Joiner TE, Rudd MD. Personality Disorder Symptoms and Suicidality: Low Desire and High Plans for Suicide in Military Inpatients and Outpatients. J Pers Disord 2017; 31:145-155. [PMID: 26959962 PMCID: PMC5311028 DOI: 10.1521/pedi_2016_30_241] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study characterizes the personality disorder (PD) symptoms of patients who endorse a perplexing combination of low desire and high plans for suicide. Five PD (antisocial, narcissistic, borderline, dependent, avoidant) symptoms were examined at the junction of two suicide risk factors: (a) suicidal desire/ideation and (b) resolved plans/preparations. Participants (N = 250) were recruited from U.S. Army Medical Center affiliated sites, including two outpatient clinics, an inpatient facility, and an emergency room. Self-report measures of PD and suicide symptoms were administered. The interaction of desire and plans was entered into multiple regression equations predicting PD symptoms. Patients endorsing low desire and high plans for suicide reported significantly more antisocial and narcissistic symptoms and fewer borderline, avoidant, and dependent PD symptoms. These findings support the existence of patients who endorse suicide plans in the absence of strong suicidal desire and suggest that they display antisocial and narcissistic personality characteristics. Future directions and clinical implications are discussed.
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112
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Olié E, Jollant F, Deverdun J, de Champfleur NM, Cyprien F, Le Bars E, Mura T, Bonafé A, Courtet P. The experience of social exclusion in women with a history of suicidal acts: a neuroimaging study. Sci Rep 2017; 7:89. [PMID: 28273888 PMCID: PMC5428048 DOI: 10.1038/s41598-017-00211-x] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 02/14/2017] [Indexed: 12/18/2022] Open
Abstract
Suicidal behaviors result from a complex interaction between social stressors and individual vulnerability. However, little is known of the specific neural network supporting the sensitivity to social stressors in patients at risk of suicidal acts. Using functional Magnetic Resonance Imaging, we investigated brain processing of social rejection in suicide attempters. Thirty-six euthymic women with a history of depression and suicidal behavior were compared to 41 euthymic women with a history of depression but no suicidal attempt, and 28 healthy controls. The Cyberball Game was used as a validated social exclusion paradigm. Relative to healthy controls, both patient groups reported higher levels of social distress related to the task, without significant differences according to suicidal status. Compared to patients without any history of suicide attempt and healthy controls, suicide attempters showed decreased contrast in the left insula and supramarginal gyrus during the exclusion vs. inclusion condition, after controlling for number of depressive episodes, medication, mood disorder type or social phobia. Our study highlights impaired brain response to social exclusion in euthymic female suicide attempters in regions previously implicated in pain tolerance and social cognition. These findings suggest sustained brain dysfunctions related to social perception in suicide attempters.
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Affiliation(s)
- Emilie Olié
- Department of Emergency Psychiatry & Post Acute Care, Academic hospital of Montpellier, Montpellier University, & INSERM U1061, Montpellier, France.
| | - Fabrice Jollant
- Department of Psychiatry, Academic hospital of Nimes, Nimes, France
- McGill University, Department of psychiatry, and Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montreal, Québec, Canada
| | - Jeremy Deverdun
- Department of Neuroradiology, Academic hospital of Montpellier & U1051, Institut of Neurosciences of Montpellier, Montpellier, France
| | - Nicolas Menjot de Champfleur
- Department of Neuroradiology, Academic hospital of Montpellier & U1051, Institut of Neurosciences of Montpellier, Montpellier, France
- I2FH & CNRS UMR 5221, University of Montpellier, Montpellier, France
| | - Fabienne Cyprien
- Neurosurgery, Academic Hospital of Montpellier & INSERM U1061, Montpellier, France
| | - Emmanuelle Le Bars
- Department of Neuroradiology, Academic hospital of Montpellier & U1051, Institut of Neurosciences of Montpellier, Montpellier, France
- I2FH & CNRS UMR 5221, University of Montpellier, Montpellier, France
| | - Thibaut Mura
- Center for clinical investigation, Academic hospital of Montpelier, Montpellier University, Montpellier, France
| | - Alain Bonafé
- Department of Neuroradiology, Academic hospital of Montpellier & U1051, Institut of Neurosciences of Montpellier, Montpellier, France
| | - Philippe Courtet
- Department of Emergency Psychiatry & Post Acute Care, Academic hospital of Montpellier, Montpellier University, & INSERM U1061, Montpellier, France
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113
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Morales S, Barros J, Echávarri O, García F, Osses A, Moya C, Maino MP, Fischman R, Núñez C, Szmulewicz T, Tomicic A. Acute Mental Discomfort Associated with Suicide Behavior in a Clinical Sample of Patients with Affective Disorders: Ascertaining Critical Variables Using Artificial Intelligence Tools. Front Psychiatry 2017; 8:7. [PMID: 28210230 PMCID: PMC5289061 DOI: 10.3389/fpsyt.2017.00007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 01/11/2017] [Indexed: 12/30/2022] Open
Abstract
AIM In efforts to develop reliable methods to detect the likelihood of impending suicidal behaviors, we have proposed the following. OBJECTIVE To gain a deeper understanding of the state of suicide risk by determining the combination of variables that distinguishes between groups with and without suicide risk. METHOD A study involving 707 patients consulting for mental health issues in three health centers in Greater Santiago, Chile. Using 345 variables, an analysis was carried out with artificial intelligence tools, Cross Industry Standard Process for Data Mining processes, and decision tree techniques. The basic algorithm was top-down, and the most suitable division produced by the tree was selected by using the lowest Gini index as a criterion and by looping it until the condition of belonging to the group with suicidal behavior was fulfilled. RESULTS Four trees distinguishing the groups were obtained, of which the elements of one were analyzed in greater detail, since this tree included both clinical and personality variables. This specific tree consists of six nodes without suicide risk and eight nodes with suicide risk (tree decision 01, accuracy 0.674, precision 0.652, recall 0.678, specificity 0.670, F measure 0.665, receiver operating characteristic (ROC) area under the curve (AUC) 73.35%; tree decision 02, accuracy 0.669, precision 0.642, recall 0.694, specificity 0.647, F measure 0.667, ROC AUC 68.91%; tree decision 03, accuracy 0.681, precision 0.675, recall 0.638, specificity 0.721, F measure, 0.656, ROC AUC 65.86%; tree decision 04, accuracy 0.714, precision 0.734, recall 0.628, specificity 0.792, F measure 0.677, ROC AUC 58.85%). CONCLUSION This study defines the interactions among a group of variables associated with suicidal ideation and behavior. By using these variables, it may be possible to create a quick and easy-to-use tool. As such, psychotherapeutic interventions could be designed to mitigate the impact of these variables on the emotional state of individuals, thereby reducing eventual risk of suicide. Such interventions may reinforce psychological well-being, feelings of self-worth, and reasons for living, for each individual in certain groups of patients.
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Affiliation(s)
- Susana Morales
- Facultad de Medicina, Departamento de Psiquiatría, Depression and Suicidality Research Group, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Depression and Suicidality Research Group, Santiago, Chile
| | - Jorge Barros
- Facultad de Medicina, Departamento de Psiquiatría, Depression and Suicidality Research Group, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Orietta Echávarri
- Facultad de Medicina, Departamento de Psiquiatría, Depression and Suicidality Research Group, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Depression and Suicidality Research Group, Santiago, Chile
| | - Fabián García
- Independent researcher, Avenida José Manso de Velasco 6968, Santiago, Chile
| | - Alex Osses
- Independent researcher, Isla Darwin 8726, Santiago, Chile
| | - Claudia Moya
- Millennium Institute for Research in Depression and Personality (MIDAP), Depression and Suicidality Research Group, Santiago, Chile
- School of Nursery, Universidad San Sebastián, Santiago, Chile
| | - María Paz Maino
- Facultad de Medicina, Departamento de Psiquiatría, Depression and Suicidality Research Group, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Depression and Suicidality Research Group, Santiago, Chile
| | - Ronit Fischman
- Millennium Institute for Research in Depression and Personality (MIDAP), Depression and Suicidality Research Group, Santiago, Chile
| | - Catalina Núñez
- Millennium Institute for Research in Depression and Personality (MIDAP), Depression and Suicidality Research Group, Santiago, Chile
| | - Tita Szmulewicz
- Facultad de Medicina, Departamento de Psiquiatría, Depression and Suicidality Research Group, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Depression and Suicidality Research Group, Santiago, Chile
| | - Alemka Tomicic
- Millennium Institute for Research in Depression and Personality (MIDAP), Depression and Suicidality Research Group, Santiago, Chile
- School of Psychology, Universidad Diego Portales, Santiago, Chile
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de Lima MM, Tobias-Machado M. Suicide in patients with genitourinary malignancies. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28134462 DOI: 10.1111/ecc.12635] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 09/20/2016] [Accepted: 11/20/2016] [Indexed: 12/21/2022]
Abstract
Genitourinary cancers are significant causes of morbidity and mortality around the world. The present review summarises the current literature on suicide and its risk factors among patients with genitourinary cancers. The review was based on relevant articles published in MEDLINE, ProQuest, PsycINFO, Science Direct and Scopus databases. Patients with prostate cancer represented the most important risk group for suicide, among patients with urogenital cancers. Other risk factors are male gender, older age, white race, advanced disease, living alone and co-existing psychological comorbidities. Findings from the review call for a greater caregiver awareness on psychosocial morbidity and suicidality among genitourinary cancer patients pre- and post-treatment and their early identification, adoption of risk-reduction strategies and prompt referral for expert mental health care.
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Affiliation(s)
- M M de Lima
- Department of Urology, Coronel Mota Hospital, Roraima, Brazil
| | - M Tobias-Machado
- Section of Urologic Oncology, Department of Urology, ABC Medical School, São Paulo, UK
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115
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Snir A, Levi-Belz Y, Solomon Z. Is the war really over? A 20-year longitudinal study on trajectories of suicidal ideation and posttraumatic stress symptoms following combat. Psychiatry Res 2017; 247:33-38. [PMID: 27863316 DOI: 10.1016/j.psychres.2016.10.065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 07/06/2016] [Accepted: 10/29/2016] [Indexed: 11/18/2022]
Abstract
Combat stress reaction (CSR) has widespread long-term consequences, including profound psychopathology in the form of posttraumatic stress disorder (PTSD). Studies have established the link between combat, PTSD, and suicidality. However, little is known about the temporal course of suicidal ideation (SI) in general, specifically among war veterans. We aimed to trace the trajectories of SI in the aftermath of war and to explore the role of CSR and PTSD in SI trajectories. Israeli veterans with CSR (n=164) and a matched control group (NCSR, n=111) were assessed, using self-report measures at three points over the course of 20 years. Veterans with CSR reported significantly higher levels of SI, compared to the NCSR group at all measurement points. Among veterans with CSR, SI increased 2 years after the war and then decreased 20 years following the war. This pattern was particularly characteristic of veterans with chronic PTSD. The results indicate that CSR is a strong predictor of subsequent PTSD and suicidality. These findings highlight the importance of prevention and treatment efforts for these traumatized veterans, who are at risk for suicide even 20 years after the end of the war.
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Affiliation(s)
- Avigal Snir
- The Bob Shappel School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Yossi Levi-Belz
- Department of Behavioral Sciences, Ruppin Academic Center, Emek-Hefer, Israel
| | - Zahava Solomon
- The Bob Shappel School of Social Work, Tel Aviv University, Tel Aviv, Israel
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Granö N, Oksanen J, Kallionpää S, Roine M. Specificity and sensitivity of the Beck Hopelessness Scale for suicidal ideation among adolescents entering early intervention service. Nord J Psychiatry 2017; 71:72-76. [PMID: 27626513 DOI: 10.1080/08039488.2016.1227370] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Previous studies have shown an association between hopelessness and suicidal behaviour in clinical populations. The aim of the study was to investigate sensitivity, specificity, and predictive validity of the Beck Hopelessness Scale (BHS) for suicidal ideation in adolescents who show early risk signs on the psychiatric disorder continuum. Three-hundred and two help-seeking adolescents (mean age = 15.5 years) who were entering an early intervention team at Helsinki University Central Hospital, Finland, completed questionnaires of BHS and suicidal ideation, derived from Beck Depression Inventory (BDI-II). Results suggest that a BHS cut-off score ≥8 (sensitivity = 0.70, specificity = 0.76) or cut-off score ≥9 (sensitivity = 0.63, specificity = 0.80) may be useful to detect suicidal ideation with BHS in help-seeking adolescents population. Results remain mainly the same in a separate analysis with adolescents at risk for psychosis. The results support previous cut-off points for BHS in identification of suicidal ideation. The results suggest also that lower cut-off scores may be useful in sense of sensitivity, especially in clinical settings.
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Affiliation(s)
- Niklas Granö
- a Department of Psychiatry , Helsinki University Central Hospital , Finland
| | - Jorma Oksanen
- a Department of Psychiatry , Helsinki University Central Hospital , Finland
| | - Santeri Kallionpää
- a Department of Psychiatry , Helsinki University Central Hospital , Finland
| | - Mikko Roine
- a Department of Psychiatry , Helsinki University Central Hospital , Finland
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117
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Ng RMK, Di Simplicio M, McManus F, Kennerley H, Holmes EA. 'Flash-forwards' and suicidal ideation: A prospective investigation of mental imagery, entrapment and defeat in a cohort from the Hong Kong Mental Morbidity Survey. Psychiatry Res 2016; 246:453-460. [PMID: 27792974 DOI: 10.1016/j.psychres.2016.10.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 08/09/2016] [Accepted: 10/15/2016] [Indexed: 10/20/2022]
Abstract
'Flash-forwards' - mental images of suicide - have been reported in selected Caucasian samples. Perceptions of defeat and entrapment are considered to be associated with suicidal ideation. We aimed to investigate (1) the presence of suicidal flash-forwards in people with recent suicidal ideation versus those without such ideation in an Asian sample, and (2) associations between suicidal flash-forwards, and perceptions of entrapment accounting for suicidal ideation. Eighty two suicidal and 80 non-suicidal participants from the Hong Kong Mental Morbidity Survey completed questionnaires including suicidal ideation, presence of suicidal flash-forward images, defeat and entrapment, at baseline and seven weeks later. Suicidal 'flash-forwards' were present only in suicidal cases. People with recent suicidal ideation and suicidal flash-forwards had more severe suicidal ideation than those without flash-forwards. Compared to those without suicidal ideation, people with recent suicidal ideation reported higher entrapment and defeat levels. Resolution of suicidal ideation over time was associated with fewer suicidal flash-forwards and reduced entrapment perceptions. At baseline and seven weeks, suicidal ideation was predicted by an interaction between suicidal flash-forwards presence and perceptions of entrapment. Mental imagery of suicide appears to be associated with suicidal ideation, and may represent a novel target in suicidal risk assessment and prevention.
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Affiliation(s)
- Roger M K Ng
- Department of Psychiatry, Kowloon Hospital, 147A, Argyle Street, Hong Kong.
| | | | - Freda McManus
- Oxford Centre for Cognitive Therapy, University of Oxford, UK.
| | - Helen Kennerley
- Oxford Centre for Cognitive Therapy, University of Oxford, UK.
| | - Emily A Holmes
- MRC Cognition and Brain Sciences Unit, Cambridge, UK and Department of Clinical Neuroscience, Karolinska Institutet, Sweden.
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118
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Lardier DT, Barrios VR, Garcia-Reid P, Reid RJ. Suicidal ideation among suburban adolescents: The influence of school bullying and other mediating risk factors. J Child Adolesc Ment Health 2016; 28:213-231. [DOI: 10.2989/17280583.2016.1262381] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- David T. Lardier
- Department of Family Science and Human Development, Montclair State University, Montclair, NJ, USA
| | - Veronica R. Barrios
- Department of Family Science and Human Development, Montclair State University, Montclair, NJ, USA
| | - Pauline Garcia-Reid
- Department of Family Science and Human Development, Montclair State University, Montclair, NJ, USA
| | - Robert J. Reid
- Department of Family Science and Human Development, Montclair State University, Montclair, NJ, USA
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119
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Kim YJ, Moon SS, Lee JH, Kim JK. Risk Factors and Mediators of Suicidal Ideation Among Korean Adolescents. CRISIS 2016; 39:4-12. [PMID: 27869508 DOI: 10.1027/0227-5910/a000438] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND A significant number of Korean adolescents have suicidal ideations and it is more prevalent among adolescents than any other age group in Korea. AIMS This study was conducted to attain a better understanding of the contributing factors to suicidal ideation among Korean adolescents. METHOD We recruited 569 high school students in Grades 10 and 11 in Pyeongtaek, Korea. The Beck Scale for Suicidal Ideation was used to measure suicidal ideation as the outcome variable. The Interpersonal Needs Questionnaire, the Beck Hopelessness Scale, the School Related Stress Scale, the Olweus Bully/Victim Questionnaire, and the Youth Risk Behavior Surveillance questions were used to measure thwarted belongingness and perceived burdensomeness, hopelessness, school-related stress, bullying, and previous suicidal behaviors, respectively. Data analyses included descriptive statistics and structural equation modeling. RESULTS The findings suggest that perceived burdensomeness, hopelessness, school-related stress, and previous suicidal behaviors have significant direct effects on suicidal ideation. Hopelessness fully mediated the relation between thwarted belongingness and suicidal ideation, and partially mediated between perceived burdensomeness, school-related stress, and suicidal ideation. CONCLUSION These findings provide more specific directions for a multidimensional suicide prevention program in order to be successful in reducing suicide rates among Korean adolescents.
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Affiliation(s)
- Yi Jin Kim
- 1 University of Mississippi, School of Applied Sciences, Department of Social Work, University, MS, USA
| | - Sung Seek Moon
- 2 University of South Carolina, College of Social Work, Columbia, SC, USA
| | - Jang Hyun Lee
- 3 Pyeongtaek University, Department of Child & Youth Welfare, Gyeonggi-do, South Korea
| | - Joon Kyung Kim
- 4 Namseoul University, School of Child Welfare, Chungcheongnam-do, South Korea
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120
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Lee JD, Cho MJ, Sohn JH, Park S, Seong S, Ahn JH, Hahm BJ, Hong JP. Evaluation of a Functional Model of Acquired Capability for Suicide in a Nationwide Sample of Korean Adults. Psychiatry Investig 2016; 13:601-608. [PMID: 27909450 PMCID: PMC5128347 DOI: 10.4306/pi.2016.13.6.601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 07/24/2015] [Accepted: 08/03/2015] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE We examined a functional model of acquired capability for suicide, which was elaborated from the "Interpersonal-Psychological Theory of Suicide". METHODS A total of 6,027 Korean community subjects were recruited from The Korean Epidemiologic Catchment Area study conducted in 2011. The subjects were assessed systematically using the Korean version of the Composite International Diagnostic Interview version 2.1, the Korean version of the Barratt Impulsiveness Scale, and the Korean version of the Mood Disorder Questionnaire. We used structural equation modeling to identify potential factors contributing to a suicide attempt. RESULTS Most aspects of the model were supported by the data and "the short-term enhancer for the acquired capability for suicide" had direct effects on suicide attempts. However, the suicidal planning effects of "the short-term enhancer for the acquired capability for suicide" were eliminated by the rule of parsimony. CONCLUSION The main finding was that "the short-term enhancer for the acquired capability for suicide" is relevant to suicide attempts when it's direct, indirect, and reciprocal effects are tested within a more complete system of relationships than found in existing studies. The implications of these findings are discussed with regard to future conceptual work and empirical research.
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Affiliation(s)
- Joon Deuk Lee
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
| | - Maeng Je Cho
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jee Hoon Sohn
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Subin Park
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sujeong Seong
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Joon Ho Ahn
- Department of Psychiatry, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Bong-Jin Hahm
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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121
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Dutton CE, Rojas SM, Badour CL, Wanklyn SG, Feldner MT. Posttraumatic Stress Disorder and Suicidal Behavior: Indirect Effects of Impaired Social Functioning. Arch Suicide Res 2016; 20:567-79. [PMID: 26984044 DOI: 10.1080/13811118.2016.1158680] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Social functioning is negatively impacted by the presence of PTSD, while increasing risk of suicidal behavior among individuals with PTSD. However, little research has examined the specific role of social functioning in the association between PTSD and suicidal behavior. Parallel multiple indirect effects analyses were performed to understand the unique indirect effects of four aspects of social functioning. Indirect effects of PTSD on suicidal ideation were significant through three pathways: interpersonal conflict, perceived family support, and interpersonal apprehension. Perceived family support was the only indirect pathway significantly associated with suicide attempt. Findings suggest that social functioning should be assessed and potentially targeted during treatment to help modify the risk for suicidal behavior among individuals with PTSD.
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122
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Hetrick SE, Robinson J, Spittal MJ, Carter G. Effective psychological and psychosocial approaches to reduce repetition of self-harm: a systematic review, meta-analysis and meta-regression. BMJ Open 2016; 6:e011024. [PMID: 27660314 PMCID: PMC5051331 DOI: 10.1136/bmjopen-2016-011024] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 08/11/2016] [Accepted: 08/23/2016] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To examine the efficacy of psychological and psychosocial interventions for reductions in repeated self-harm. DESIGN We conducted a systematic review, meta-analysis and meta-regression to examine the efficacy of psychological and psychosocial interventions to reduce repeat self-harm in adults. We included a sensitivity analysis of studies with a low risk of bias for the meta-analysis. For the meta-regression, we examined whether the type, intensity (primary analyses) and other components of intervention or methodology (secondary analyses) modified the overall intervention effect. DATA SOURCES A comprehensive search of MEDLINE, PsycInfo and EMBASE (from 1999 to June 2016) was performed. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials of psychological and psychosocial interventions for adult self-harm patients. RESULTS Forty-five trials were included with data available from 36 (7354 participants) for the primary analysis. Meta-analysis showed a significant benefit of all psychological and psychosocial interventions combined (risk ratio 0.84; 95% CI 0.74 to 0.96; number needed to treat=33); however, sensitivity analyses showed that this benefit was non-significant when restricted to a limited number of high-quality studies. Meta-regression showed that the type of intervention did not modify the treatment effects. CONCLUSIONS Consideration of a psychological or psychosocial intervention over and above treatment as usual is worthwhile; with the public health benefits of ensuring that this practice is widely adopted potentially worth the investment. However, the specific type and nature of the intervention that should be delivered is not yet clear. Cognitive-behavioural therapy or interventions with an interpersonal focus and targeted on the precipitants to self-harm may be the best candidates on the current evidence. Further research is required.
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Affiliation(s)
- Sarah E Hetrick
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Greg Carter
- Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Newcastle, New South Wales, Australia
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Abstract
Naturalists have not identified suicide in nonhuman species in field situations, despite intensive study of thousands of animal species. In this review, evidence on suicidal behavior among animals is analyzed to discover analogies with human suicidal behavior. Literature was retrieved by exploring Medline/PubMed and PsychINFO databases (1967–2007) and through manual literature searches. Keyword terms were “suicide or suicidal behavior” and “animal or animal behavior.” Few empirical investigations have been carried out on this topic. Nevertheless, sparse evidence supports some resemblance between the self-endangering behavior observed in the animal kingdom, particularly in animals held in captivity or put under pressure by environmental challenges, and suicidal behavior among humans. Animal models have contributed to the study of both normal and pathological human behaviors: discovering some correlates of suicide among animals could be a valid contribution to the field.
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Affiliation(s)
- Antonio Preti
- Department of Psychology, University of Cagliari, Genneruxi Medical Center, Cagliari
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Voracek M, Loibl LM, Egle J, Schleicher S, Sonneck G. Correlates, Item-Sequence Invariance, and Test-Retest Reliability of the Beliefs in the Inheritance of Risk Factors for Suicide Scale (BIRFSS). Psychol Rep 2016; 101:1107-17. [DOI: 10.2466/pr0.101.4.1107-1117] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Genetic contributions to suicide are increasingly recognized. This study further validated the novel 22-item Beliefs in the Inheritance of Risk Factors for Suicide Scale (BIRFSS), which assesses individuals' beliefs about the genetics of suicide. Data from 155 mainly Austrian psychology undergraduates (42 men, 113 women) indicated adequate internal scale consistency and 2-mo. test-retest reliability. Scores were temporally stable and factor analysis of items yielded a dominant first factor. Scores were positively related to general beliefs about genetic determinism and to positive attitudes towards psychiatric genetic research (convergent validity), but unrelated to lay theories of suicide, locus of control, self-reported religiosity and political orientation, religious and spiritual beliefs, and social dominance orientation (discriminant validity). Effects of sex, age, and nationality (Austrian vs other) on scores were negligible. Item statistics corresponded strongly to those obtained from administering the item sequence in reverse order. Item statistics were strongly correlated with those observed in two previous validation studies, suggesting cross-sample robustness of the item-performance indicators of this measure. The scale shows potential for basic research and curriculum evaluation.
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125
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Voracek M, Egle J, Schleicher S, Loibl LM, Sonneck G. The Beliefs in the Inheritance of Risk Factors for Suicide Scale (Birfss): Further Results on Demographic Correlates, Dimensionality, Reliability, and Validity. OMEGA-JOURNAL OF DEATH AND DYING 2016; 55:279-96. [DOI: 10.2190/om.55.4.c] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Convergent lines of evidence from adoption, family, geographical, immigrant, molecular genetic, surname, and twin studies of suicide point to genetic contributions to risk factors for suicidal behavior. Related mental health literacy (knowledge and beliefs) of professionals and laypersons may, however, lag behind this research progress. The purpose of this study was to further validate the 22-item Beliefs in the Inheritance of Risk Factors for Suicide Scale (BIRFSS), a novel instrument for assessing individuals' beliefs in the genetics of suicide. Data from a general population sample of 159 Austrian adults showed adequate internal scale consistency. Due to deliberate content heterogeneity, the instrument has a subscale structure, but factor analysis of items extracted a dominant first factor. BIRFSS scores were positively related to overall and specific knowledge on suicide facts (convergent validity), whereas unrelated to the Big Five personality dimensions, locus of control, social desirability, and verbal intelligence (discriminant validity). Demographic correlates of BIRFSS scores included respondents' age and religiosity (both positive ones), but not respondents' sex, educational level, or political orientation.
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126
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Flynn AB, Johnson RM, Bolton SL, Mojtabai R. Victimization of Lesbian, Gay, and Bisexual People in Childhood: Associations with Attempted Suicide. Suicide Life Threat Behav 2016; 46:457-70. [PMID: 27484047 DOI: 10.1111/sltb.12228] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 10/09/2015] [Indexed: 11/26/2022]
Abstract
Higher rates of attempted suicide have been documented among people who identify themselves as gay, lesbian, and bisexual (LGB) compared with heterosexuals. This study sought to ascertain the association between childhood abuse and neglect and attempted suicide, comparing LGBs and heterosexuals. Childhood sexual abuse among men and childhood sexual and physical abuse among women were found to mediate the association between LGB identity and attempted suicide. The experience of childhood abuse likely plays a significant role in the relationship between LGB identity and attempted suicide, but other factors such as experience of discrimination are also important.
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Affiliation(s)
- Anna B Flynn
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Renee M Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shay-Lee Bolton
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Kanekar S, Bogdanova OV, Olson PR, Sung YH, D'Anci KE, Renshaw PF. Hypobaric hypoxia induces depression-like behavior in female Sprague-Dawley rats, but not in males. High Alt Med Biol 2016; 16:52-60. [PMID: 25803141 DOI: 10.1089/ham.2014.1070] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Rates of depression and suicide are higher in people living at altitude, and in those with chronic hypoxic disorders like asthma, chronic obstructive pulmonary disorder (COPD), and smoking. Living at altitude exposes people to hypobaric hypoxia, which can lower rat brain serotonin levels, and impair brain bioenergetics in both humans and rats. We therefore examined the effect of hypobaric hypoxia on depression-like behavior in rats. After a week of housing at simulated altitudes of 20,000 ft, 10,000 ft, or sea level, or at local conditions of 4500 ft (Salt Lake City, UT), Sprague Dawley rats were tested for depression-like behavior in the forced swim test (FST). Time spent swimming, climbing, or immobile, and latency to immobility were measured. Female rats housed at altitude display more depression-like behavior in the FST, with significantly more immobility, less swimming, and lower latency to immobility than those at sea level. In contrast, males in all four altitude groups were similar in their FST behavior. Locomotor behavior in the open field test did not change with altitude, thus validating immobility in the FST as depression-like behavior. Hypobaric hypoxia exposure therefore induces depression-like behavior in female rats, but not in males.
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Affiliation(s)
- Shami Kanekar
- 1 The Brain Institute, University of Utah , Salt Lake City, Utah
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The role of anxiety sensitivity cognitive concerns in suicidal ideation: A test of the Depression-Distress Amplification Model in clinical outpatients. Psychiatry Res 2016; 238:74-80. [PMID: 27086214 DOI: 10.1016/j.psychres.2016.02.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 12/16/2015] [Accepted: 02/12/2016] [Indexed: 11/23/2022]
Abstract
Suicide constitutes a significant public health burden as global suicide rates continue to increase. Thus, it is crucial to identify malleable suicide risk factors to develop prevention protocols. Anxiety sensitivity, or a fear of anxiety-related sensations, is a potential malleable risk factor for the development of suicidal ideation. The Depression-Distress Amplification Model (DDAM) posits that the anxiety sensitivity cognitive concerns (ASCC) subfactor interacts with depressive symptoms to amplify the effects of depression and lead to suicidal ideation. The current study tested the DDAM across the two most widely-replicated factors of depressive symptoms (cognitive and affective/somatic) in comparison to a risk factor mediation model where ASCC are related to suicidal ideation via depressive symptoms. Participants included 295 clinical outpatients from a community clinic. The interaction between ASCC and depressive symptoms in the prediction of suicidal ideation was not significant for either cognitive or affective/somatic symptoms of depression. However, results revealed a significant indirect effect of ASCC through cognitive symptoms of depression in the prediction of suicidal ideation. These cross sectional findings are not consistent with the DDAM. Rather, the relationship may be better conceptualized with a model in which ASCC is related to suicidal ideation via cognitive symptoms of depression.
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129
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Rogers ML, Stanley IH, Hom MA, Chiurliza B, Podlogar MC, Joiner TE. Conceptual and Empirical Scrutiny of Covarying Depression Out of Suicidal Ideation. Assessment 2016; 25:159-172. [PMID: 27112535 DOI: 10.1177/1073191116645907] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Depression and suicidal ideation are highly intertwined constructs. A common practice in suicide research is to control for depression when predicting suicidal ideation, yet implications of this practice have not been subjected to sufficient empirical scrutiny. We explore what, precisely, is represented in a suicidal ideation variable with depression covaried out. In an adult psychiatric outpatient sample ( N = 354), we computed two variables-depression with suicidal ideation covaried out, and suicidal ideation with depression covaried out-and examined correlations between these residuals, three factors comprising a variegated collection of psychological correlates of suicidal ideation, psychiatric diagnoses, and past suicidal behavior. Findings indicated that suicidal ideation with depression covaried out appears to be characterized by fearlessness about death, self-sacrifice, and externalizing pathology. We propose that suicidal ideation may comprise two distinct components: desire for death (passive ideation and depressive cognitions) and will (self-sacrifice, fearlessness, externalizing behavior). Implications, limitations, and future directions are discussed.
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130
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Sandler I, Tein JY, Wolchik S, Ayers TS. The Effects of the Family Bereavement Program to Reduce Suicide Ideation and/or Attempts of Parentally Bereaved Children Six and Fifteen Years Later. Suicide Life Threat Behav 2016; 46 Suppl 1:S32-8. [PMID: 27094109 PMCID: PMC6108320 DOI: 10.1111/sltb.12256] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Findings concerning the long-term effects of the Family Bereavement Program (FBP) to reduce suicide ideation and/or attempts of parentally bereaved children and adolescents are presented. Parental death is a significant risk factor for suicide among offspring (Guldin et al., 2015). This study is a long-term follow-up of 244 children and adolescents who had participated in a randomized trial of the FBP, examining the intervention effects on suicide ideation and/or attempts as assessed through multiple sources. Results indicate a significant effect of the FBP to reduce suicide ideation and/or attempts at the 6- and 15-year follow-up evaluation. The findings support the potential benefits of further research on "upstream" suicide prevention.
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Affiliation(s)
- Irwin Sandler
- Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ, USA
| | - Jenn-Yun Tein
- Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ, USA
| | - Sharlene Wolchik
- Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ, USA
| | - Tim S Ayers
- Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ, USA
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131
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Clinical and genetic factors associated with suicide in mood disorder patients. Eur Arch Psychiatry Clin Neurosci 2016; 266:181-93. [PMID: 26626456 DOI: 10.1007/s00406-015-0658-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 11/17/2015] [Indexed: 12/14/2022]
Abstract
Suicidality is a continuum ranging from ideation to attempted and completed suicide, with a complex etiology involving both genetic heritability and environmental factors. The majority of suicide events occur in the context of psychiatric conditions, preeminently major depression and bipolar disorder. The present study investigates clinical factors associated with suicide in a sample of 553 mood disorder patients, recruited within the 'Psy Pluriel' center, Centre Européen de Psychologie Médicale, and the Department of Psychiatry of Erasme Hospital (Brussels). Furthermore, genetic association analyses examining polymorphisms within COMT, BDNF, MAPK1 and CREB1 genes were performed in a subsample of 259 bipolar patients. The presence or absence of a previous suicide attempt and of current suicide risk were assessed. A positive association with suicide attempt was reported for younger patients, females, lower educated, smokers, those with higher scores on depressive symptoms and higher functional disability and those with anxiety comorbidity and familial history of suicidality in first- and second-degree relatives. Anxiety disorder comorbidity was the stronger predictor of current suicide risk. No associations were found with polymorphisms within COMT and BDNF genes, whereas significant associations were found with variations in rs13515 (MAPK1) and rs6740584 (CREB1) polymorphisms. From a clinical perspective, our study proposes several clinical characteristics, such as increased depressive symptomatology, anxiety comorbidity, functional disability and family history of suicidality, as correlates associated with suicide. Genetic risk variants in MAPK1 and CREB1 genes might be involved in a dysregulation of inflammatory and neuroplasticity pathways and are worthy of future investigation.
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132
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Carmel A, Ries R, West II, Bumgardner K, Roy-Byrne P. Suicide risk and associated demographic and clinical correlates among primary care patients with recent drug use. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 42:351-7. [PMID: 26910262 DOI: 10.3109/00952990.2015.1133634] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is an increased need to prepare primary care clinicians to effectively gauge the risk of suicidal behavior occurring within primary care patients who may abuse drugs, especially those served in safety-net settings. OBJECTIVES The objectives of this paper were to explore suicide risk in a population of individuals endorsing recent drug use, and to describe patient demographic, medical, psychiatric, social, and substance use characteristics across different levels of suicide risk. METHODS A total of 867 primary care patients with reported drug use in the previous 90 days were studied. Based upon their responses to two Addiction Severity Index questions, four suicide risk categories were constructed: (1) low risk; (2) moderate-low (suicidal ideation in the past 30 days); (3) moderate-high (history of a lifetime suicide attempt); and (4) high risk (history of a lifetime suicide attempt and suicidal ideation in the past 30 days). The association between suicide risk groups and demographic and clinical variables were assessed. RESULTS A total of 40% of primary care patients endorsing recent drug use reported a lifetime suicide attempt. Compared to individuals in other suicide risk groups, individuals at high suicide risk had higher rates of substance use severity, recently used two or more substances, and were more likely to have a comorbid psychiatric condition. CONCLUSION These findings indicate that the percentage of patients with suicide risk may be higher among patients with recent drug use. Primary care clinicians should be aware that they may be encountering patients with suicide risk among those with recent drug use.
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Affiliation(s)
- Adam Carmel
- a Department of Psychiatry & Behavioral Sciences , University of Washington at Harborview Medical Center , Seattle , WA , USA.,b Massachusetts Mental Health Center, Division of Public Psychiatry, Beth Israel Deaconess Medical Center , Harvard Medical School , Boston , MA , USA
| | - Richard Ries
- a Department of Psychiatry & Behavioral Sciences , University of Washington at Harborview Medical Center , Seattle , WA , USA
| | - Imara I West
- a Department of Psychiatry & Behavioral Sciences , University of Washington at Harborview Medical Center , Seattle , WA , USA
| | - Kristin Bumgardner
- a Department of Psychiatry & Behavioral Sciences , University of Washington at Harborview Medical Center , Seattle , WA , USA
| | - Peter Roy-Byrne
- a Department of Psychiatry & Behavioral Sciences , University of Washington at Harborview Medical Center , Seattle , WA , USA
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133
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Patrick CJ, Hajcak G. RDoC: Translating promise into progress. Psychophysiology 2016; 53:415-24. [DOI: 10.1111/psyp.12612] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 12/22/2015] [Accepted: 12/22/2015] [Indexed: 12/23/2022]
Affiliation(s)
| | - Greg Hajcak
- Department of Psychology; Stony Brook University; Stony Brook New York USA
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134
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Saeedi Saravi SS, Dehpour AR. Potential role of organochlorine pesticides in the pathogenesis of neurodevelopmental, neurodegenerative, and neurobehavioral disorders: A review. Life Sci 2015; 145:255-64. [PMID: 26549647 DOI: 10.1016/j.lfs.2015.11.006] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/01/2015] [Accepted: 11/04/2015] [Indexed: 12/27/2022]
Abstract
Organochlorine pesticides (OCPs) are persistent and bioaccumulative environmental contaminants with potential neurotoxic effects. The growing body of evidence has demonstrated that prenatal exposure to organochlorines (OCs) is associated with impairment of neuropsychological development. The hypothesis is consistent with recent studies emphasizing the correlation of environmental as well as genetic factors to the pathophysiology of neurodevelopmental and neurobehavioral defects. It has been suggested that maternal exposure to OCPs results in impaired motor and cognitive development in newborns and infants. Moreover, in utero exposure to these compounds contributes to the etiology of autism. Although impaired neurodevelopment occurs through prenatal exposure to OCs, breastfeeding causes postnatal toxicity in the infants. Parkinson's disease (PD) is another neurological disorder, which has been associated with exposure to OCs, leading to α-synuclein accumulation and depletion of dopaminergic neurons. The study aimed to review the potential association between pre- and post-natal exposure to OCs and impaired neurodevelopmental processes during pregnancy and neuropsychological diseases such as PD, behavioral alterations, seizures and autism.
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Affiliation(s)
- Seyed Soheil Saeedi Saravi
- Experimental Medicine Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Toxicology-Pharmacology, Faculty of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran
| | - Ahmad Reza Dehpour
- Experimental Medicine Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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135
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Cheavens JS, Cukrowicz KC, Hansen R, Mitchell SM. Incorporating Resilience Factors Into the Interpersonal Theory of Suicide: The Role of Hope and Self-Forgiveness in an Older Adult Sample. J Clin Psychol 2015; 72:58-69. [PMID: 26448342 DOI: 10.1002/jclp.22230] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The interpersonal theory of suicide posits that perceived burdensomeness and thwarted belongingness are risk factors for suicide ideation. To more comprehensively characterize this model, it is important to identify resilience factors. Forgiveness of oneself may attenuate the relation between perceived burdensomeness and suicide ideation. Similarly, hope might weaken the association between thwarted belongingness and suicide ideation. METHOD We examined these relations cross-sectionally in a sample (N = 91) of older adults after including symptoms of depression and demographic variables in the models. RESULTS Self-forgiveness moderated the relation between perceived burdensomeness and suicide ideation. Hope did not moderate the relation between thwarted belongingness and suicide ideation. CONCLUSIONS These findings suggest that including resilience factors (i.e., self-forgiveness) in models of suicide ideation may result in better identification of those most at risk for suicide and may allow for more precise intervention targets.
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136
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Dickstein DP, Puzia ME, Cushman GK, Weissman AB, Wegbreit E, Kim KL, Nock MK, Spirito A. Self-injurious implicit attitudes among adolescent suicide attempters versus those engaged in nonsuicidal self-injury. J Child Psychol Psychiatry 2015; 56:1127-36. [PMID: 25677262 DOI: 10.1111/jcpp.12385] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Suicide is among the most important mental health issues affecting adolescents today despite much research on its detection and prevention. Beyond suicide attempts (SAs), clinicians are increasingly confronted with another, potentially related problem: non-suicidal self-injury (NSSI)-defined as the deliberate destruction of body tissue without intent to die. NSSI may increase risk for making an SA by sevenfold, but many studies examining this link have involved youths engaging in both NSSI and SAs. Thus, there is a need to compare homogeneous groups of adolescents engaged in NSSI-only or SA-only, but not both, to advance what is known about each form of self-harm. The self-injurious implicit association task (SI-IAT) is a particularly important computerized behavioral task to study such adolescents because the SI-IAT provides objective behavioral data about problems for which people may lack insight or be motivated to conceal, such as SAs and NSSI. METHODS We evaluated implicit associations with cutting and death/suicide using the computerized SI-IAT in three mutually exclusive groups: (1) adolescents who made an SA but had never engaged in NSSI (n = 47); (2) adolescents who engaged in NSSI but had never made an SA (n = 46); and (3) typically developing control (TDC) adolescents without history of psychiatric problems (n = 43). RESULTS Nonsuicidal self-injury participants had stronger identification with cutting versus no cutting than either SA or TDC participants. Contrary to our hypothesis, NSSI participants had stronger identification with suicide/death versus life than either SA or TDC participants. CONCLUSIONS Strong implicit attitudes towards suicide/death among adolescents with NSSI without a prior SA suggest that clinicians should not dismiss NSSI as not serious. Further work is required to elucidate the mechanism by which youths engaged in NSSI acquire these stronger identifications and make a first-time SA to develop novel treatment and prevention strategies blocking this transformation, ultimately reducing youth suicide.
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Affiliation(s)
- Daniel P Dickstein
- PediMIND Program, Bradley Hospital, East Providence, RI, USA.,Division of Child and Adolescent Psychiatry, Alpert Medical School, Brown University, East Providence, RI, USA
| | - Megan E Puzia
- PediMIND Program, Bradley Hospital, East Providence, RI, USA.,Division of Child and Adolescent Psychiatry, Alpert Medical School, Brown University, East Providence, RI, USA
| | - Grace K Cushman
- PediMIND Program, Bradley Hospital, East Providence, RI, USA.,Division of Child and Adolescent Psychiatry, Alpert Medical School, Brown University, East Providence, RI, USA
| | - Alexandra B Weissman
- PediMIND Program, Bradley Hospital, East Providence, RI, USA.,Division of Child and Adolescent Psychiatry, Alpert Medical School, Brown University, East Providence, RI, USA
| | - Ezra Wegbreit
- PediMIND Program, Bradley Hospital, East Providence, RI, USA.,Division of Child and Adolescent Psychiatry, Alpert Medical School, Brown University, East Providence, RI, USA
| | - Kerri L Kim
- PediMIND Program, Bradley Hospital, East Providence, RI, USA.,Division of Child and Adolescent Psychiatry, Alpert Medical School, Brown University, East Providence, RI, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Anthony Spirito
- Division of Child and Adolescent Psychiatry, Alpert Medical School, Brown University, East Providence, RI, USA
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137
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Nock MK, Ursano RJ, Heeringa SG, Stein MB, Jain S, Raman R, Sun X, Chiu WT, Colpe LJ, Fullerton CS, Gilman SE, Hwang I, Naifeh JA, Rosellini AJ, Sampson NA, Schoenbaum M, Zaslavsky AM, Kessler RC. Mental Disorders, Comorbidity, and Pre-enlistment Suicidal Behavior Among New Soldiers in the U.S. Army: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Suicide Life Threat Behav 2015; 45:588-599. [PMID: 25622860 PMCID: PMC4515394 DOI: 10.1111/sltb.12153] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 11/03/2014] [Indexed: 11/30/2022]
Abstract
We examined the associations between mental disorders and suicidal behavior (ideation, plans, and attempts) among new soldiers using data from the New Soldier Study (NSS) component of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS; N = 38,507). Most new soldiers with a pre-enlistment history of suicide attempt reported a prior mental disorder (59.0%). Each disorder examined was associated with increased odds of suicidal behavior (ORs = 2.6-8.6). Only PTSD and disorders characterized by irritability and impulsive/aggressive behavior (i.e., bipolar disorder, conduct disorder, oppositional defiant disorder, and attention-deficit/hyperactivity disorder) predicted unplanned attempts among ideators. Mental disorders are important predictors of pre-enlistment suicidal behavior among new soldiers and should figure prominently in suicide screening and prevention efforts.
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Affiliation(s)
- Matthew K. Nock
- Department of Psychology; Harvard University; Cambridge Massachusetts USA
| | - Robert J. Ursano
- Department of Psychiatry; Center for the Study of Traumatic Stress; Uniformed Services University of the Health Sciences; Bethesda Maryland USA
| | - Steven G. Heeringa
- Institute for Social Research; University of Michigan; Ann Arbor Michigan USA
| | - Murray B. Stein
- Department of Psychiatry and Department of Family and Preventive Medicine; VA San Diego Healthcare System; University of California San Diego; La Jolla California USA
| | - Sonia Jain
- Department of Family and Preventive Medicine; VA San Diego Healthcare System; University of California San Diego; La Jolla California USA
| | - Rema Raman
- Department of Family and Preventive Medicine and Department of Neurosciences; VA San Diego Healthcare System; University of California San Diego; La Jolla California USA
| | - Xiaoying Sun
- Department of Family and Preventive Medicine; VA San Diego Healthcare System; University of California San Diego; La Jolla California USA
| | - Wai Tat Chiu
- Department of Health Care Policy; Harvard Medical School; Boston Massachusetts USA
| | - Lisa J. Colpe
- National Institute of Mental Health; Bethesda Maryland USA
| | - Carol S. Fullerton
- Department of Psychiatry; Center for the Study of Traumatic Stress; Uniformed Services University of the Health Sciences; Bethesda Maryland USA
| | - Stephen E. Gilman
- Department of Social and Behavioral Sciences and Department of Epidemiology; Harvard School of Public Health; Boston Massachusetts USA
| | - Irving Hwang
- Department of Health Care Policy; Harvard Medical School; Boston Massachusetts USA
| | - James A. Naifeh
- Department of Psychiatry; Center for the Study of Traumatic Stress; Uniformed Services University of the Health Sciences; Bethesda Maryland USA
| | - Anthony J. Rosellini
- Department of Health Care Policy; Harvard Medical School; Boston Massachusetts USA
| | - Nancy A. Sampson
- Department of Health Care Policy; Harvard Medical School; Boston Massachusetts USA
| | | | - Alan M. Zaslavsky
- Department of Health Care Policy; Harvard Medical School; Boston Massachusetts USA
| | - Ronald C. Kessler
- Department of Health Care Policy; Harvard Medical School; Boston Massachusetts USA
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138
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Westlund Schreiner M, Klimes-Dougan B, Begnel ED, Cullen KR. Conceptualizing the neurobiology of non-suicidal self-injury from the perspective of the Research Domain Criteria Project. Neurosci Biobehav Rev 2015; 57:381-91. [PMID: 26424412 DOI: 10.1016/j.neubiorev.2015.09.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 09/11/2015] [Accepted: 09/24/2015] [Indexed: 12/30/2022]
Abstract
Non-suicidal self-injury (NSSI) commonly starts in adolescence and is associated with an array of negative outcomes. Neurobiological research investigating NSSI is in its early stages and most studies have examined this behavior within the context of specific diagnoses. However, the Research Domain Criteria (RDoC) initiative encourages researchers to examine brain-behavior relationships across diagnoses. This review on the neurobiology associated with NSSI is organized using the domains proposed by RDoC: Negative Valence, Positive Valence, Cognitive, Social Processes, and Arousal/Regulatory Systems. Evidence of neurobiological anomalies is found in each of these domains. We also propose future research directions, especially in regard to human development. Future NSSI studies should address this behavior independent of diagnosis, examine relevant constructs across multiple units of analysis, and assess how systems change across development and course of illness. These advances will be essential for guiding neurobiologically informed intervention and prevention strategies to target NSSI. In doing so, we may prevent the associated negative outcomes across the lifespan.
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Affiliation(s)
- Melinda Westlund Schreiner
- Department of Psychology, University of Minnesota, N218 Elliott Hall, 75 East River Road, Minneapolis, MN 55455, United States.
| | - Bonnie Klimes-Dougan
- Department of Psychology, University of Minnesota, N218 Elliott Hall, 75 East River Road, Minneapolis, MN 55455, United States.
| | - Erin D Begnel
- Department of Psychology, University of Minnesota, N218 Elliott Hall, 75 East River Road, Minneapolis, MN 55455, United States.
| | - Kathryn R Cullen
- Department of Psychiatry, University of Minnesota Medical School, F268 West Building, 2450 Riverside Avenue, Minneapolis, MN 55454, United States.
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139
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Abstract
BACKGROUND Most research on suicide is quantitative, and qualitative research is needed to reveal how individuals subjectively experience and account for suicidal behaviors. AIMS The aim of this study is to learn about the circumstances, motivations and consequences of suicidal behavior among individuals hospitalized for attempted suicide and suicidal ideation during the global economic recession. METHODS In-depth semi-structured interviews were conducted with in-patients hospitalized for suicidal behavior in a state-subsidized public mental hospital and analyzed with framework analysis. RESULTS Interpersonal conflict in the context of severe economic hardship and inadequate mental health care preceded suicidal behavior, rescue and a subsequent respite from desperate situations. Attempted suicide led to increased attention and concern from loved ones and immediate access to mental health care. CONCLUSIONS Government-subsidized funding for outpatient mental health care should be sustained or increased during economic recessions to protect the most vulnerable from suicidal behavior when it is the only viable path toward immediate psychiatric treatment.
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Affiliation(s)
- Marta Elliott
- Department of Sociology, University of Nevada, Reno, Reno, NV, USA
| | - Dara E Naphan
- Interdisciplinary PhD Program in Social Psychology, University of Nevada, Reno, Reno, NV, USA
| | - Barbara L Kohlenberg
- Department of Psychiatry and Behavioral Sciences, University of Nevada School of Medicine, Reno, NV, USA
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140
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Koyawala N, Stevens J, McBee-Strayer SM, Cannon EA, Bridge JA. Sleep problems and suicide attempts among adolescents: a case-control study. Behav Sleep Med 2015; 13:285-95. [PMID: 24654933 PMCID: PMC4170045 DOI: 10.1080/15402002.2014.888655] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study used a case-control design to compare sleep disturbances in 40 adolescents who attempted suicide with 40 never-suicidal adolescents. Using hierarchical logistic regression analyses, we found that self-reported nighttime awakenings were significantly associated with attempted suicide, after controlling for antidepressant use, antipsychotic use, affective problems, and being bullied. In a separate regression analysis, the parent-reported total sleep problems score also predicted suicide attempt status, controlling for key covariates. No associations were found between suicide attempts and other distinct sleep problems, including falling asleep at bedtime, sleeping a lot during the day, trouble waking up in the morning, sleep duration, and parent-reported nightmares. Clinicians should be aware of sleep problems as potential risk factors for suicide attempts for adolescents.
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Affiliation(s)
| | - Jack Stevens
- The Research Institute at Nationwide Children’s Hospital and the Ohio State University College of Medicine, Columbus, OH
| | | | | | - Jeffrey A. Bridge
- The Research Institute at Nationwide Children’s Hospital and the Ohio State University College of Medicine, Columbus, OH
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141
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Venables NC, Sellbom M, Sourander A, Kendler KS, Joiner TE, Drislane LE, Sillanmäki L, Elonheimo H, Parkkola K, Multimaki P, Patrick CJ. Separate and interactive contributions of weak inhibitory control and threat sensitivity to prediction of suicide risk. Psychiatry Res 2015; 226:461-6. [PMID: 25712631 PMCID: PMC4375034 DOI: 10.1016/j.psychres.2015.01.018] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 12/23/2014] [Accepted: 01/06/2015] [Indexed: 11/16/2022]
Abstract
Biobehavioral dispositions can serve as valuable referents for biologically oriented research on core processes with relevance to many psychiatric conditions. The present study examined two such dispositional variables-weak response inhibition (or disinhibition; INH-) and threat sensitivity (or fearfulness; THT+)-as predictors of the serious transdiagnostic problem of suicide risk in two samples: male and female outpatients from a U.S. clinic (N=1078), and a population-based male military cohort from Finland (N=3855). INH- and THT+ were operationalized through scores on scale measures of disinhibition and fear/fearlessness, known to be related to DSM-defined clinical conditions and brain biomarkers. Suicide risk was assessed by clinician ratings (clinic sample) and questionnaires (both samples). Across samples and alternative suicide indices, INH- and THT+ each contributed uniquely to prediction of suicide risk-beyond internalizing and externalizing problems in the case of the clinic sample where diagnostic data were available. Further, in both samples, INH- and THT+ interactively predicted suicide risk, with individuals scoring concurrently high on both dispositions exhibiting markedly augmented risk. Findings demonstrate that dispositional constructs of INH- and THT+ are predictive of suicide risk, and hold potential as referents for biological research on suicidal behavior.
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Affiliation(s)
- Noah C. Venables
- Department of Psychology, Florida State University, Tallahassee, FL, USA,Corresponding author: Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA. Tel.: +1-612-889-1495, 1-850-644-2040;
| | - Martin Sellbom
- Research School of Psychology, The Australian National University, Canberra, Australia
| | - Andre Sourander
- Department of Child Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland,Department of Child Psychiatry, Turku University Hospital, Turku, Finland
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA,Medical College of Virginia/Virginia Commonwealth University, Richmond, VA, USA
| | - Thomas E. Joiner
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Laura E. Drislane
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Lauri Sillanmäki
- Department of Child Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland
| | - Henrik Elonheimo
- Department of Child Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland
| | - Kai Parkkola
- Archipelago Sea Naval Command, Finnish Navy, Finland,University of Oulu, Oulu, Finland
| | - Petteri Multimaki
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland
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142
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Crisis Counselors' Perceptions and Assessment of Suicidal Behavior Among Hurricane Survivors Receiving Crisis Counseling Services. Disaster Med Public Health Prep 2015; 9:291-300. [PMID: 25896292 DOI: 10.1017/dmp.2015.41] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The aims of this study were to assess the awareness of risk for suicidal behaviors and perspectives of Project Recovery counselors who provided crisis counseling services to hurricane survivors. METHODS The Short Posttraumatic Stress Disorder Rating Interview-Extended, a quantitative disaster mental health measure, was used to assess distress and dysfunction to the recent hurricanes. Project Recovery counselor data were collected through a 22-item qualitative interview. RESULTS Seven out of 207 clients (3.4%) endorsed the quantitative item measuring suicidal ideation. Clients who reported suicidal ideation had significantly higher scores on items indicating a loss of enjoyment, feelings of depression, feeling less able to handle stress, and other mental health items. Counselor responses fell into 5 major themes: Assessment and Action, Client Characteristics, Services, Counselor Training and Preparedness, and Future Directions. CONCLUSIONS Suicidal behavior is a serious mental health emergency, yet it remains a challenging issue as suicidal behaviors are complex and disaster survivors with suicidal ideation may experience intense psychological reactions to the event. In order to provide competent care to survivors experiencing suicidal thoughts or behaviors, the need for counselors to receive adequate training in suicide assessment and management is essential.
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143
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Saunders KEA, Hawton K. Suicidal behaviour in bipolar disorder: understanding the role of affective states. Bipolar Disord 2015; 17:24-6. [PMID: 25346260 DOI: 10.1111/bdi.12267] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Kate E A Saunders
- Centre for Suicide Research, Oxford University Department of Psychiatry, Warneford Hospital, Oxford, UK
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145
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Beurel E, Jope RS. Inflammation and lithium: clues to mechanisms contributing to suicide-linked traits. Transl Psychiatry 2014; 4:e488. [PMID: 25514751 PMCID: PMC4270310 DOI: 10.1038/tp.2014.129] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 09/21/2014] [Accepted: 10/26/2014] [Indexed: 12/15/2022] Open
Abstract
Suicide is one of the leading causes of death in the United States, yet it remains difficult to understand the mechanistic provocations and to intervene therapeutically. Stress is recognized as a frequent precursor to suicide. Psychological stress is well established to cause activation of the inflammatory response, including causing neuroinflammation, an increase of inflammatory molecules in the central nervous system (CNS). Neuroinflammation is increasingly recognized as affecting many aspects of CNS functions and behaviors. In particular, much evidence demonstrates that inflammatory markers are elevated in traits that have been linked to suicidal behavior, including aggression, impulsivity and depression. Lithium is recognized as significantly reducing suicidal behavior, is anti-inflammatory and diminishes aggression, impulsivity and depression traits, each of which is associated with elevated inflammation. The anti-inflammatory effects of lithium result from its inhibition of glycogen synthase kinase-3 (GSK3). GSK3 has been demonstrated to strongly promote inflammation, aggressive behavior in rodents and depression-like behaviors in rodents, whereas regulation of impulsivity by GSK3 has not yet been investigated. Altogether, evidence is building supporting the hypothesis that stress activates GSK3, which in turn promotes inflammation, and that inflammation is linked to behaviors associated with suicide, including particularly aggression, impulsivity and depression. Further investigation of these links may provide a clearer understanding of the causes of suicidal behavior and provide leads for the development of effective preventative interventions, which may include inhibitors of GSK3.
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Affiliation(s)
- E Beurel
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA,Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - R S Jope
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA,Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, FL, USA,Miller School of Medicine, University of Miami, 1011 NW 15th Street, Gautier Building Room 416, Miami, FL 33136, USA. E-mail:
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146
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Claassen CA, Harvilchuck-Laurenson JD, Fawcett J. Prognostic models to detect and monitor the near-term risk of suicide: state of the science. Am J Prev Med 2014; 47:S181-5. [PMID: 25145737 DOI: 10.1016/j.amepre.2014.06.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 05/27/2014] [Accepted: 06/02/2014] [Indexed: 11/18/2022]
Abstract
Aspirational Goal 3 of the National Action Alliance for Suicide Prevention's Research Prioritization Task Force research agenda is to "find ways to assess who is at risk for attempting suicide in the immediate future." Suicide risk assessment is the practice of detecting patient-level conditions that may rapidly progress toward suicidal acts. With hundreds of thousands of risk assessments occurring every year, this single activity arguably represents the most broadly implemented, sustained suicide prevention activity practiced in the U.S. Given this scope of practice, accurate and reliable risk assessment capabilities hold a central and irreplaceable position among interventions mounted as part of any public health approach to suicide prevention. Development of more reliable methods to detect and measure the likelihood of impending suicidal behaviors, therefore, represents one of the more substantial advancements possible in suicide prevention science today. Although past "second-generation" risk models using largely static risk factors failed to show predictive capabilities, the current "third-generation" dynamic risk prognostic models have shown initial promise. Methodologic improvements to these models include the advent of real-time, in vivo data collection processes, common data elements across studies and data sharing to build knowledge around key factors, and analytic methods designed to address rare event outcomes. Given the critical need for improved risk detection, these promising recent developments may well foreshadow advancement toward eventual achievement of this Aspirational Goal.
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Affiliation(s)
- Cynthia A Claassen
- Department of Psychiatry, University of North Texas Health Science Center, Fort Worth, Texas.
| | - Judith D Harvilchuck-Laurenson
- The National Action Alliance for Suicide Prevention's Research Prioritization Task Force, Washington, District of Columbia
| | - Jan Fawcett
- Department of Psychiatry, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
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147
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Miguel-Hidalgo JJ, Wilson BA, Hussain S, Meshram A, Rajkowska G, Stockmeier CA. Reduced connexin 43 immunolabeling in the orbitofrontal cortex in alcohol dependence and depression. J Psychiatr Res 2014; 55:101-9. [PMID: 24774648 PMCID: PMC4078739 DOI: 10.1016/j.jpsychires.2014.04.007] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 03/18/2014] [Accepted: 04/04/2014] [Indexed: 11/28/2022]
Abstract
Reduced density of glial cells and low levels of some astrocyte proteins have been described in the orbitofrontal cortex (OFC) in depression and alcoholism, two disorders often comorbid. These regressive changes may also involve the communication between astrocytes via gap junctions and hemichannels, which play important regulatory roles in neurotransmission. We determined levels and morphological immunostaining parameters of connexin 43 (Cx43), the main protein subunit of astrocyte gap junctions/hemichannels, in the OFC of subjects with depression, alcoholism or comorbid depression/alcoholism as compared to non-psychiatric subjects. Postmortem brain samples from 23 subjects with major depressive disorder (MDD), 16 with alcohol dependence, 13 with comorbid MDD and alcohol dependence, and 20 psychiatrically-normal comparison subjects were processed for western blots to determine Cx43 levels. Area fraction of Cx43 immunoreactivity, and density and average size of immunoreactive puncta were measured in histological sections. There was a significant, larger than 60 percent decrease in Cx43 level in the three psychiatric groups as compared to controls. Area fraction of immunoreactivity and immunoreactive punctum size were reduced in all psychiatric groups, but Cx43-immunoreactive puncta density was reduced only in alcohol-dependent subjects. Among psychiatric subjects, no difference in Cx43 levels or immunostaining was found between suicides and non-suicides. The present data suggest that dysfunction of the OFC is accompanied by reduction in the levels of gap junction protein Cx43 in depression and alcoholism, and reduction in density of Cx43 immunoreactive puncta only in alcoholism, pointing to altered gap junction or hemichannel-based communication in the pathophysiology of those disorders.
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Affiliation(s)
- José Javier Miguel-Hidalgo
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216-4505, USA.
| | - Barbara A. Wilson
- Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
| | - Syed Hussain
- Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
| | - Ashish Meshram
- Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
| | - Grazyna Rajkowska
- Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
| | - Craig A. Stockmeier
- Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS,Psychiatry, Case Western Reserve University, Cleveland, OH
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Obsessive Compulsive Symptom Dimensions and Suicide: The Moderating Role of Anxiety Sensitivity Cognitive Concerns. COGNITIVE THERAPY AND RESEARCH 2014. [DOI: 10.1007/s10608-014-9622-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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149
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Victor SE, Klonsky ED. Correlates of suicide attempts among self-injurers: A meta-analysis. Clin Psychol Rev 2014; 34:282-97. [DOI: 10.1016/j.cpr.2014.03.005] [Citation(s) in RCA: 196] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 02/11/2014] [Accepted: 03/25/2014] [Indexed: 12/27/2022]
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150
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Abstract
The causes of suicidal behaviour are not fully understood; however, this behaviour clearly results from the complex interaction of many factors. Although many risk factors have been identified, they mostly do not account for why people try to end their lives. In this Review, we describe key recent developments in theoretical, clinical, and empirical psychological science about the emergence of suicidal thoughts and behaviours, and emphasise the central importance of psychological factors. Personality and individual differences, cognitive factors, social aspects, and negative life events are key contributors to suicidal behaviour. Most people struggling with suicidal thoughts and behaviours do not receive treatment. Some evidence suggests that different forms of cognitive and behavioural therapies can reduce the risk of suicide reattempt, but hardly any evidence about factors that protect against suicide is available. The development of innovative psychological and psychosocial treatments needs urgent attention.
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