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Dalve K, Ellyson AM, Bowen D, Rhew IC, Rivara FP, Rowhani-Rahbar A. Violent deaths among individuals subject to domestic violence protection orders in King County, Washington, USA, 2014-2020. Inj Prev 2024:ip-2023-045189. [PMID: 39084700 DOI: 10.1136/ip-2023-045189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 05/09/2024] [Accepted: 07/18/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVES Individuals (ie, respondents) subject to domestic violence protection orders have threatened or engaged in one form of violence perpetration and may be at increased risk for experiencing others forms of violence, including violent death. METHODS Using a cohort of granted domestic violence protection orders in King County, Washington, USA, from 2014 to 2020 (n=3543), we calculated standardised mortality ratios for violent death, including suicide, homicide, legal intervention and undetermined intent, comparing domestic violence protection order respondents to King County residents adjusting for year, age, sex, and race and ethnicity through indirect standardisation. RESULTS There were 66 deaths among domestic violence protection order respondents; 25.8% were violent deaths and 52.9% of violent deaths involved firearms. The standardised mortality ratio for violent death was 3.71 (95% CI: 2.16 to 5.93) among domestic violence protection order respondents compared with King County residents. CONCLUSION The domestic violence protection order process may provide an opportunity for referrals to services to address shared risk factors for violence perpetration and victimisation.
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Affiliation(s)
- Kimberly Dalve
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
| | - Alice M Ellyson
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Deidre Bowen
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- School of Law, Seattle University, Seattle, Washington, USA
| | - Isaac C Rhew
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Frederick P Rivara
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Ali Rowhani-Rahbar
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
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Jeremic JV, Mihaljevic JM, Radosavljevic ILJ, Jurisic MM, Suđecki BJ, Stojicic MT, Jovanović MD, Pavlovic Z, Radenovic KG, Milic NV, Pavlovic V, Milic NM, Jovic MS. Trend of suicide by self-immolation in a 13-year timeline: was the COVID-19 pandemic a potentially important stressor? Front Public Health 2024; 12:1234584. [PMID: 38450141 PMCID: PMC10914977 DOI: 10.3389/fpubh.2024.1234584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 01/31/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Self-immolation is an uncommon way of attempting and committing a suicide, with a fatality rate of 80%. The risk factors in self-immolation victims vary depending on demographic characteristics, socio-economic and cultural factors as well as religious beliefs. Whether the COVID-19 pandemic was a potentially important stressor for self-immolation is still unknown, with insufficient studies examining this issue. Therefore, in this study, we aimed to examine the trend of self-immolation in a 13-year timeline, and the potential association of COVID-19 pandemic with the increase in the incidence and severity of self-immolation injuries in Serbia in 2021. Materials and methods The study included hospitalized patients due to intentional burns caused by self-immolation in the period from January 1, 2008 to December 31, 2021. Joinpoint regression analysis was used for the analysis of continuous linear trends of self-immolation cases with change points. Results While a rising trend was observed in the 2008-2013 time segment, followed by a decline in the upcoming 2013-2016 time segment, a significant increase reached its maximum during COVID-19 pandemic (2021), with annual percent change of 37.1% (p = 0.001). A significant increase in the median number of cases per year was observed during 2021 compared to the previous periods (7.5 vs. 2). Frequency of patients with a psychiatric diagnosis vs. those without a psychiatric diagnosis was significantly higher during than before the COVID-19 period (66.7 vs. 36.1%, p = 0.046). Conclusion In our study, a significant increase in the frequency of suicide attempts by self-immolation during COVID-19 pandemic was noticed. There was also an increased frequency of pre-existing psychiatric illness among patients during the pandemic period. With limited high-quality data available, the study adds to a rising body of evidence for assessment of outcomes of the pandemic on mental health and recognition of stressors for self-immolation.
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Affiliation(s)
- Jelena V. Jeremic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Jovan M. Mihaljevic
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Ivan L. J. Radosavljevic
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milana M. Jurisic
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Branko J. Suđecki
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milan T. Stojicic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milan D. Jovanović
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Zorana Pavlovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Psychiatry, University Clinical Center of Serbia, Belgrade, Serbia
| | - Kristina G. Radenovic
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Nikola V. Milic
- Department of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vedrana Pavlovic
- Department of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Natasa M. Milic
- Department of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marko S. Jovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
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3
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Baser O, Rodchenko K, Zeng Y, Endrizal A. Mental health disparities in young adults with arrest history: a survey-based, cross-sectional analysis. HEALTH & JUSTICE 2024; 12:1. [PMID: 38165523 PMCID: PMC10759331 DOI: 10.1186/s40352-023-00257-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Over 4.53 million arrests were made in 2021 in the United States. People under 26 years of age were more likely to be arrested than older people. Although mental health disparities are prominent in the incarcerated population, the subject has not been closely examined among young adults specifically. OBJECTIVES This study examines how criminal justice involvement, specifically arrests, affects the mental health of adults between 18 and 25 years of age. METHODS We analyzed secondary data using the 2021 National Survey on Drug Use and Health (NSDUH). The study used a subsample of 13,494 people aged 18 to 25 years, including 7,330 women and 6,164 men. History of arrest was the key independent variable. Depression, serious mental illness (SMI), substance use, suicidal ideation, and suicide attempt were the outcome variables. We performed five multivariate logistic regression models for each outcome variable, controlling for race/ethnicity, income, and education level for men and women separately. RESULTS Of 13,494 respondents, 6.63% had a history of arrest. Among young women, a history of arrest was associated with significantly higher adjusted odds ratios for all mental health concerns. Most notably, a history of arrest increased the likelihood of substance use by a factor of 15.19, suicide attempts by 2.27, SMI by 1.79, suicidal ideation by 1.75, and depression by 1.52. Among young men, a history of arrest was associated with increased adjusted odds ratios (AORs) for substance use (AOR, 13.37; p < .001), suicidal ideation (AOR, 1.45; p = .011), and suicide attempt (AOR, 1.82; p = .044). CONCLUSIONS We found a strong relationship between young people having an arrest history and mental health concerns. More specifically, a history of arrest was associated with all mental health concerns among young women, while it was associated with only substance use and suicide among young men. Providing arrestees with appropriate mental health care would benefit them and the criminal justice system by decreasing the odds of recidivism.
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Affiliation(s)
- Onur Baser
- Department of Economics, Bogazici University, Istanbul, Türkiye.
- Graduate School of Public Health, City University of New York, New York, NY, USA.
- University of Michigan Medical School, Ann Arbor, MI, USA.
| | | | - Yixuan Zeng
- Columbia Data Analytics, New York, NY, USA
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
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Boyas JF, McCoy LM, Woodiwiss JL, Adams JE. Applying the Stress Process Theory to Assess Correlates of Suicide Ideation-to-Action Among Persons on Parole in the United States. Community Ment Health J 2022; 59:664-679. [PMID: 36378459 PMCID: PMC9664423 DOI: 10.1007/s10597-022-01047-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 10/20/2022] [Indexed: 11/16/2022]
Abstract
There is limited knowledge regarding precipitating factors associated with suicidality among persons on parole. Pairing the suicide ideation-to-action framework and stress process theory, the present study aimed to characterize sources of major stress (drug use, physical health, and mental health) and their associations to suicide ideation, planning, and attempt among a national sample of persons on parole. This study included a subsample of persons on parole (N = 1725) using pooled national data from the National Survey on Drug Use and Health (2015-2019). A series of logistic regression results indicate that various drug use, physical health, and mental health factors significantly influenced all three suicidality measures. Due to this population's unique experiences and numerous barriers following release from prison, it is essential to personalize interventions geared toward this population to meet their specific needs and address suicidality based on where they fall on this continuum.
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Affiliation(s)
- Javier F Boyas
- School of Social Work and Human Services, Troy University, 211D Wright Hall, Troy, AL, 36082, USA.
| | - Leah M McCoy
- School of Social Work, The University of Georgia, 279 Williams St, Athens, GA, 30602, USA
| | - Jana L Woodiwiss
- School of Social Work, The University of Georgia, 279 Williams St, Athens, GA, 30602, USA
| | - Jacqueline E Adams
- School of Social Work, The University of Georgia, 279 Williams St, Athens, GA, 30602, USA
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5
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Steel CMS, Newman E, O’Rourke S, Quayle E. Suicidal ideation in offenders convicted of child sexual exploitation material offences. BEHAVIORAL SCIENCES & THE LAW 2022; 40:365-378. [PMID: 35043473 PMCID: PMC9541809 DOI: 10.1002/bsl.2560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/07/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Abstract
Understanding the prevalence of suicidal ideation in Child Sexual Exploitation Material (CSEM) offenders and their psychological concerns provides the basis for early treatment and intervention. This research solicited responses (n = 78) via an anonymous, web-based survey from adults in the United States previously convicted of CSEM offences. Significant suicidal ideation was present in 73% of respondents (n = 57), and 19% (n = 15) reported attempting suicide after they were made aware of an investigation, with 41% (n = 32) stating they would have been likely to seek counselling if provided a contact. Most of the respondents felt they were not treated with fairness, understanding, and compassion by investigators, and that their primary psychological strains were going to jail and their families finding out. This research highlights the need for more empathetic investigative approaches, as well as the need for more rapid assessment and treatment of proximal suicide risk in this population.
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Affiliation(s)
- Chad M. S. Steel
- University of EdinburghEdinburghUK
- MS 2B5George Mason UniversityFairfaxVirginiaUSA
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6
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Bryson WC, Piel J, Thielke SM. Arrest and non-fatal suicide attempts among men: analysis of survey data from the National Survey on Drug Use and Health. BMC Psychiatry 2021; 21:537. [PMID: 34711202 PMCID: PMC8555258 DOI: 10.1186/s12888-021-03544-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 10/08/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Studies have found an association between recent arrest and suicide attempts, but the population-level significance of this link has not been reported. We estimated the population attributable risk percent (PAR%) of self-reported non-fatal suicide attempts based on recent arrest in a national sample of adult men. METHODS This study included men aged ≥18 who completed the 2008-2019 National Surveys on Drug Use and Health. The outcome measure was any non-fatal suicide attempts in the past year. The primary independent variable was any arrest in the past year. Major depression and substance use disorders were also included as independent variables for comparison. Descriptive statistics and multivariate logistic regression with postestimation marginal effects ascertained the PAR% of non-fatal suicide attempts for arrest, major depression, and substance use disorders, while controlling for sociodemographic covariates. All analyses applied survey weights. We disaggregated analyses by race/ethnicity. RESULTS In the sample of 220,261 men, arrest accounted for 8.9% (99% CI 5.1 to 12.6%, p < 0.001) of non-fatal suicide attempts, while major depression accounted for 40.3% (99% CI 35.0 to 45.1%. p < 0.001) and substance use disorders for 24.1% (99% CI 17.6 to 30.2%, p < 0.001). After disaggregating by race/ethnicity, arrest accounted for 9.5% (99% CI 4.5 to 14.3%, p < 0.001) of suicide attempts among Non-Hispanic White men and fell short of statistical significance for Non-Hispanic Black men (10.2, 99% CI - 3.0 to 21.6%, p = 0.043) and Hispanic men (8.1, 99% CI - 0.5 to 15.9%, p = 0.016). CONCLUSIONS Arrest accounted for nearly one in eleven non-fatal suicide attempts in a national sample of American men, which is by extension about 50,000 suicide attempts per year. Results were similar for Non-Hispanic White, Non-Hispanic Black, and Hispanic men, although there were differences in prevalence of arrest and suicide attempts. Unlike major depression, arrest is an easily identifiable event, and the period after arrest might provide an opportunity to support mental health and coping.
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Affiliation(s)
- William C. Bryson
- grid.34477.330000000122986657Departtment of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA ,grid.413919.70000 0004 0420 6540VA Puget Sound Health Care System, Outpatient Mental Health Service, Seattle, WA USA
| | - Jennifer Piel
- grid.34477.330000000122986657Departtment of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA ,grid.413919.70000 0004 0420 6540VA Puget Sound Health Care System, Outpatient Mental Health Service, Seattle, WA USA
| | - Stephen M. Thielke
- grid.34477.330000000122986657Departtment of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
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7
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Bryson WC, Piel J, Thielke S. Associations Between Parole, Probation, Arrest, and Self-reported Suicide Attempts. Community Ment Health J 2021; 57:727-735. [PMID: 32860595 DOI: 10.1007/s10597-020-00704-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/21/2020] [Indexed: 11/30/2022]
Abstract
This study estimated the associations between three categories of recent community criminal justice (CJ) involvement (arrest, parole, and probation) and suicide attempts, while accounting for how the categories overlap. Participants included adults aged ≥ 18 who completed the 2008-2014 National Surveys on Drug Use and Health. The outcome was self-reported suicide attempt(s) in the past 12 months (in the community or while incarcerated). Community CJ involvement included parole, probation, and/or arrest(s) during the past 12 months. Controls with no recent CJ involvement were matched to those with any recent involvement on demographics and education. We calculated the 12-month prevalence of suicide attempts for those reporting recent parole, probation, and arrest, including their overlaps. Logistic regression models estimated the associations between each category of recent CJ involvement and suicide attempts, controlling for their overlapping and covariates. There were 15,462 participants with recent community CJ involvement and 248,520 matched controls. The 12-month prevalence of suicide attempts was 3.2% for those with recent parole, 2.7% for probation, and 3.3% for arrest, which were all greater than the matched controls (1.0%, p < 0.001 for each). After controlling for overlapping and covariates, arrest was associated with suicide attempts (RR = 1.80, 99% CI 1.47-2.19), but neither parole (RR = 1.00, 99% CI 0.64-1.56) nor probation (RR = 0.81, 99% CI 0.61-1.08) were. Adults with recent arrest had higher risk of suicide attempts than those with parole, probation, or matched controls with no CJ involvement. Recent arrest may signify elevated risk and warrant increased screening and intervention.
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Affiliation(s)
- William C Bryson
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA. .,Mental Health Service, VA Puget Sound Health Care System, Seattle, WA, USA.
| | - Jennifer Piel
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.,Mental Health Service, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Stephen Thielke
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.,Geriatric Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
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8
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Mitchell SM, Brown SL, Görgülü T, Conner KR, Swogger MT. Substance use, current criminal justice involvement, and lifetime suicidal thoughts and behaviors history: The moderating role of thwarted belonging. Suicide Life Threat Behav 2021; 51:237-246. [PMID: 33876498 PMCID: PMC8128077 DOI: 10.1111/sltb.12699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Criminal justice involvement, substance use, and suicide pose significant public health concerns; however, the unique and synergistic effects of these experiences among high-risk individuals remain understudied. We hypothesized positive main effects for alcohol-related severity, drug-related severity, current criminal justice involvement, and thwarted belonging (TB) on suicide ideation history (SIH) and suicide attempt history (SAH) and that TB would moderate these associations. METHOD We report on cross-sectional analyses of self-report assessments completed by 824 adult residential substance use patients. RESULTS Multinomial logistic regression analyses indicated that as alcohol- and drug-related severity increases, the probability of SIH and SAH increases; however, TB was only associated with a higher SIH probability. Significant two-way interactions (current criminal justice involvement*TB; alcohol-related severity*TB) indicated that (1) those high in TB with current criminal justice involvement were more likely to report a SIH than those without current criminal justice involvement; and (2) those low in TB and alcohol-related severity had the lowest SAH probability, whereas those low in TB and high in alcohol-related severity had the highest SAH probability. CONCLUSION The unique and combined effects of interpersonal and contextual risk factors may improve suicide risk conceptualization and assessment, and allow for tailored treatments for this high-risk population.
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Affiliation(s)
- Sean M. Mitchell
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Sarah L. Brown
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tuğba Görgülü
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Istinye University, Department of Social Work, Istanbul, Turkey
| | - Kenneth R. Conner
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Marc T. Swogger
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
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9
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Abstract
OBJECTIVE Suicide is a serious public health issue that affects individuals, families and societies all over the world. International studies provide consistent evidence that the presence of psychiatrists in a region is associated with lesser suicide rates. However, many psychiatric patients including suicidal patients do not have access to psychiatrists. This indicates that mental health and non-mental health social workers need to be involved in suicide prevention efforts. This paper is the first comprehensive work that discusses how to increase the role of social workers in the area of suicide prevention. METHODS A review of the relevant literature. RESULTS Increasing the role of social workers in suicide prevention efforts may reduce suicide risk in groups and people at elevated risk for suicide, as well as the general population. CONCLUSION Recommendations are provided for how the social work profession can improve upon suicide prevention while incorporating universal, selective and indicated suicide preventive interventions. Social work research efforts should focus on how to increase the role of social workers in suicide prevention and the management of suicidal patients. Social work education programmes should modify their curricula and increase their attention on suicide prevention. Mental health social workers need to educate the patient and their family on suicide risk factors. Furthermore, mental health and non-mental health social workers need to educate the general public on suicide risk factors.
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10
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Ryan EP, Oquendo MA. Suicide Risk Assessment and Prevention: Challenges and Opportunities. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2020; 18:88-99. [PMID: 33162846 DOI: 10.1176/appi.focus.20200011] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Despite increased access to mental health care for the previously uninsured and expanding evidence-based treatments for mood, anxiety, psychotic, and substance use disorders, suicide is on the rise in the United States. Since 1999, the age-adjusted suicide rate in the United States has increased 33%, from 10.5 per 100,000 standard population to 14.0. As of yet, there are no clinically available biomarkers, laboratory tests, or imaging to assist in diagnosis or the identification of the suicidal individual. Suicide risk assessment remains a high-stakes component of the psychiatric evaluation and can lead to overly restrictive management in the name of prevention or to inadequate intervention because of poor appreciation of the severity of risk. This article focuses primarily on suicide risk assessment and management as a critical first step to prevention, given the fact that more research is needed to identify precision treatments and effective suicide prevention strategies. Suicide risk assessment provides the clinical psychiatrist with an opportunity for therapeutic engagement with the ultimate goals of relieving suffering and preventing suicide.
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Affiliation(s)
- Eileen P Ryan
- Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine, Columbus (Ryan); and Perelman School of Medicine, University of Pennsylvania, Philadelphia (Oquendo)
| | - Maria A Oquendo
- Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine, Columbus (Ryan); and Perelman School of Medicine, University of Pennsylvania, Philadelphia (Oquendo)
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11
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Harford TC, Chen CM, Kerridge BT, Grant BF. Self- and other-directed forms of violence and their relationship with lifetime DSM-5 psychiatric disorders: Results from the National Epidemiologic Survey on Alcohol Related Conditions-III (NESARC-III). Psychiatry Res 2018; 262:384-392. [PMID: 28939392 PMCID: PMC5849477 DOI: 10.1016/j.psychres.2017.09.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 09/08/2017] [Accepted: 09/08/2017] [Indexed: 11/26/2022]
Abstract
A combined history of violence toward self and others has been reported in clinical and incarcerated populations. Psychiatric disorders have been implicated as risk factors. This study examines the lifetime prevalence of this combined violence in the general population and its associations with DSM-5 psychiatric disorders in comparison with other- and self-directed violence. Data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) were analyzed, including 36,309 U.S. adults ages 18 and older. Violent behavior was defined by suicide attempts; recurrent suicidal behavior; gestures, threats, or self-mutilating behavior (self-directed); and multiple items of violence toward others (other-directed) in four categories: none, self-directed only, other-directed only, and combined self-/other-directed. Multinomial logistic regression examined these violence categories in association with sociodemographics and lifetime DSM-5 psychiatric disorders. Results show that approximately 18.1% of adults reported violent behavior, including self-directed only (4.4%), other-directed only (10.9%), and combined self- and other-directed violence (2.8%). DSM-5 psychiatric disorders significantly associated with the violence typology include alcohol, tobacco, cannabis, and other drug use disorders; mood disorders; posttraumatic stress disorder; and schizotypal, antisocial, and borderline personality disorders. Findings extend the clinical literature regarding the co-occurrence of self- and other-directed violent behaviors to the general population.
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Affiliation(s)
- Thomas C. Harford
- CSR, Incorporated, 4250 N. Fairfax Dr., Suite 500, Arlington, VA,
22203, United States
| | - Chiung M. Chen
- CSR, Incorporated, 4250 N. Fairfax Dr., Suite 500, Arlington, VA,
22203, United States,Corresponding author: CSR, Incorporated, 4250 N. Fairfax Dr.,
Suite 500, Arlington, VA 22203. Tel.: + 1 703 741 7125; fax: + 1 703 312
5230
| | - Bradley T. Kerridge
- Department of Psychiatry, Columbia University, New York State
Psychiatric Institute, 1051 Riverside Drive, Unit 69, New York, NY, 10032,United
States
| | - Bridget F. Grant
- Epidemiology and Biometry Branch, Division of Epidemiology and
Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National
Institutes of Health, Room 3077, 5635 Fishers Lane, M.S. 9304, Bethesda, MD,
20892-9304, United States
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12
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Harford TC, Yi HY, Chen CM, Grant BF. Substance use disorders and self- and other-directed violence among adults: Results from the National Survey on Drug Use And Health. J Affect Disord 2018; 225:365-373. [PMID: 28846958 PMCID: PMC5626648 DOI: 10.1016/j.jad.2017.08.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 05/30/2017] [Accepted: 08/10/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Previous studies have identified a violence typology of self- and other-directed violence. This study examines the extent to which substance use disorders (SUDs) as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), independent of serious psychological distress, major depressive episodes, assault arrest, and criminal justice involvement, are associated with these violence categories. METHOD Data were obtained from the National Survey on Drug Use and Health (NSDUH) pooled across survey years 2008-2015, with a combined sample of 314,881 adult respondents. According to self-report data on suicide attempt (self-directed) and attacking someone with the intent for serious injury (other-directed), violence was categorized in four categories: none, self-directed only, other-directed only, and combined self-/other-directed. Multinomial logistic regression was used to estimate the adjusted odds ratios associated with the risk factors for different forms of violence. RESULTS Nicotine dependence and the number of DSM-IV SUDs criteria (except the criterion of legal problems) for alcohol, marijuana, and pain reliever use disorders are significantly associated with the self-/other-directed violence categories. LIMITATIONS Cross-sectional data do not allow assessment of directionality of important factors. CONCLUSIONS The identification of the combined self- and other-directed violence among adults in the general population extends studies in the adolescent population, and significant correlation between self- and other-directed violence provides additional support for clinical studies that established this association. Findings expand the associated risk factors identified in previous studies for the adult population. Prevention and treatment programs need to address both forms of violence and suicidality.
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Affiliation(s)
| | | | - Chiung M. Chen
- Corresponding author: CSR, Incorporated, 4250 N. Fairfax Dr., Suite 500, Arlington, VA 22203, , Telephone: (703) 741-7125, Fax: (703) 312-5230
| | - Bridget F Grant
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Bethesda, MD 20892, United States
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13
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Steele IH, Thrower N, Noroian P, Saleh FM. Understanding Suicide Across the Lifespan: A United States Perspective of Suicide Risk Factors, Assessment & Management. J Forensic Sci 2017. [PMID: 28639299 DOI: 10.1111/1556-4029.13519] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Suicide is a troubling, preventable phenomenon. Prior to attempts, individuals often seek help, prompting practitioners to perform risk assessments that ideally use evidence-based risk management strategies. A literature review was performed using Harvard Countway Library of Medicine, Google Scholar, PubMed. Key words used were "Forensic Science," "Suicide Risk Management," "Pediatric Suicide Risk Factors," "Adult Suicide Risk Factors," "Geriatric Suicide Risk Factors," "Suicide Risk Assessment." Parameters limited articles to studies/reviews completed in the past twenty years in the United States. Results indicated predictors of suicide in juveniles were insomnia, burdensomeness, and recent conflicts with family or a romantic partner. Adults had greater risk if male, substance abusing, with marital/job loss. Elderly individuals with multiple medical comorbidities, hopelessness, and isolation were at higher risk. Everyone evaluated should be screened for access to firearms. Management of suicide risk involves providing the least restrictive form of treatment which maintains an individual's safety.
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Affiliation(s)
- Ian H Steele
- Harvard Longwood Psychiatry Resident Training Program Beth Israel Deaconess Medical Center, Department of Psychiatry, 330 Brookline Ave, Rabb-2, Boston, MA 02215
| | - Natasha Thrower
- Harvard Longwood Psychiatry Resident Training Program Brigham and Women's Hospital, Department of Psychiatry 221 Longwood Ave, Boston, MA 02115
| | - Paul Noroian
- Forensic Psychiatry Fellowship, Law and Psychiatry Program, Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655
| | - Fabian M Saleh
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115.,Sexual Violence Prevention and Risk Management Program, Department of Psychiatry, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Rabb-2, Boston, MA 02215
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14
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Gates ML, Turney A, Ferguson E, Walker V, Staples-Horne M. Associations among Substance Use, Mental Health Disorders, and Self-Harm in a Prison Population: Examining Group Risk for Suicide Attempt. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030317. [PMID: 28335531 PMCID: PMC5369153 DOI: 10.3390/ijerph14030317] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 03/07/2017] [Accepted: 03/15/2017] [Indexed: 12/22/2022]
Abstract
Substance use disorders (SUD) and mental health disorders are significant public health issues that co-occur and are associated with high risk for suicide attempts. SUD and mental health disorders are more prevalent among offenders (i.e., prisoners or inmates) than the non-imprisoned population, raising concerns about the risk of self-harm. This cross-sectional study examined the population of a state prison system (10,988 out of 13,079) to identify associations among SUD (alcohol, cannabis, intravenous drugs, narcotics, and tobacco smoking), mental health disorders (anxiety, bipolar, depression, and psychotic disorders), and suicide attempts. The primary aim was to determine which groups (SUD, mental health disorders, and co-occurrences) were strongly association with suicide attempts. Groups with a documented SUD or mental health disorders compared to peers without these issues had 2.0 and 9.2 greater odds, respectively, for attempting suicide, which was significant at p < 0.0001 for both conditions. There were also significant differences within SUD and mental health disorders groups in regard to suicide attempts. Groups with the greatest odds for suicide attempts were offenders with comorbid bipolar comorbid and anxiety, alcohol combined with depression, and cannabis co-occurring with depression. Documentation of suicide attempts during imprisonment indicates awareness, but also suggest a need to continue enhancing screening and evaluating environmental settings.
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Affiliation(s)
- Madison L Gates
- Department of Family Medicine, Medical College of Georgia, Institute of Public and Preventive Health, Augusta University, 1120 15th Street, CJ 2300, Augusta, GA 30912, USA.
| | - Asher Turney
- Centurion, LLC, 53 Century Blvd, Suite 150, Nashville, TN 37214, USA.
| | - Elizabeth Ferguson
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, 997 St. Sebastian Way, Augusta, GA 30912, USA.
| | - Veronica Walker
- Lexington Public Library, 3628 Walden Drive, Lexington, KY 40517, USA.
| | - Michelle Staples-Horne
- Georgia Department of Juvenile Justice, Central Office, 3408 Covington Highway, Decatur, GA 30032, USA.
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15
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Clark CB, Li Y, Cropsey KL. Family Dysfunction and Suicide Risk in a Community Corrections Sample. CRISIS 2016; 37:454-460. [PMID: 27445017 DOI: 10.1027/0227-5910/a000406] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND When comparted with the general population, the suicide rate in correctional populations is elevated. While predictors of suicide are well researched in jail and prison populations, much less work has been done to examine predictors of suicide in community corrections samples where 80% of the US correctional population is currently supervised. AIMS The goal of this study was to determine factors associated with suicide risk in a community corrections sample. METHOD Self-reported current ideation was examined in a sample of 512 individuals under supervision. RESULTS When univariate associations between current suicidal ideation and predictor variables were examined, current suicidal ideation was associated with being female, being White, reporting an increased level of stress, reporting an increased level of depression, meeting criteria for an anxiety disorder, an increased number of physical health complaints, and self-report of family dysfunction. In a multivariate analysis predicting suicide risk, only meeting criteria for an anxiety disorder, an increased number of physical health complaints, and self-report of family dysfunction were significant. CONCLUSION Mental and physical health complaints as well as self-report of family dysfunction are salient predictors of suicide risk in the community corrections population.
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Affiliation(s)
- C Brendan Clark
- 1 Wichita State University, Department of Psychology, Wichita, KS, USA
| | - Ye Li
- 2 University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, Birmingham, AL, USA
| | - Karen L Cropsey
- 2 University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, Birmingham, AL, USA
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16
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Han B, Compton WM, Gfroerer J, McKeon R. Mental health treatment patterns among adults with recent suicide attempts in the United States. Am J Public Health 2014; 104:2359-68. [PMID: 25322299 PMCID: PMC4232111 DOI: 10.2105/ajph.2014.302163] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2014] [Indexed: 12/30/2022]
Abstract
OBJECTIVES We examined mental health treatment patterns among adults with suicide attempts in the past 12 months in the United States. METHODS We examined data from 2000 persons, aged 18 years or older, who participated in the 2008 to 2012 National Survey on Drug Use and Health and who reported attempting suicide in the past 12 months. We applied descriptive analyses and multivariable logistic regression models. RESULTS In adults who attempted suicide in the past year, 56.3% received mental health treatment, but half of those who received treatment perceived unmet treatment needs, and of the 43.0% who did not receive mental health treatment, one fourth perceived unmet treatment needs. From 2008 to 2012, the mental health treatment rate among suicide attempters remained unchanged. Factors associated with receipt of mental health treatment varied by perceived unmet treatment need and receipt of medical attention that resulted from a suicide attempt. CONCLUSIONS Suicide prevention strategies that focus on suicide attempters are needed to increase their access to mental health treatments that meet their needs. To be effective, these strategies need to account for language and cultural differences and barriers to financial and treatment delivery.
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Affiliation(s)
- Beth Han
- Beth Han, Joseph Gfroerer, and Richard McKeon are with Substance Abuse and Mental Health Services Administration, Rockville, MD. Wilson M. Compton is with the National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD
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