Emotional and Social Loneliness as Predictors of Suicidal Ideation in Different Age Groups

Exploring adolescent suicidal trajectories: The intersection of race/ethnicity, gender, and social connectedness

INTRODUCTION

Understanding adolescent racial/ethnic and gender disparities in suicidal ideation and attempts longitudinally can help curb future suicidal risk.

METHODS

Survey data (1994-2008) from the Longitudinal Study of Adolescent to Adult Health (Add Health study, n = 18,887) examined racial/ethnic and gender ideation and attempt disparities over four waves of data from across the United States (51% female; 51% White; Mage = 17.43 years at Wave 1). Repeated-measures latent class analyses described how ideation and attempt patterns present longitudinally and how racial/ethnic minority groups predict different classes based on each wave and age-appropriate social supports (i.e., parents, peers).

RESULTS

Those most at-risk disclosed ideation and some attempt risk in early adolescence (Waves 1 and 2) and mostly identified as female. The second most prevalent group first disclosed ideation in their 20s and predominately identified as non-Hispanic White females. Peer connections were not significant for most groups except for non-Hispanic White males in Wave 3, while Black females who reported stronger school connections had decreased ideation and attempt rates in Wave 1 but not 2 (just 1 year later). A negative link between social supports and high-risk ideation and attempt classes was found among Black females, non-Hispanic Whites, and Latinos overall.

CONCLUSIONS

As the United States becomes more diverse, understanding the unique ideation and attempt disparities are crucial. Tailoring interventions to include risk and protective mechanisms among intersectional communities could eradicate disparities. Longitudinal studies can illuminate how protective and risk factors can change over time and even within and among racial/ethnic and gender groups.

Objective and Subjective Sleep Measures Are Related to Suicidal Ideation and Are Transdiagnostic Features of Major Depressive Disorder and Social Anxiety Disorder

Suicide is a major public health problem and previous studies in major depression and anxiety show problematic sleep is a risk factor for suicidal ideation (SI). However, less is known about sleep and SI in social anxiety disorder (SAD), despite the pervasiveness of SAD. Therefore, the current study comprised participants with major depressive disorder (MDD) (without comorbid SAD) (n = 26) and participants with SAD (without comorbid MDD) (n = 41). Wrist actigraphy was used to estimate sleep duration, wake after sleep onset, and sleep efficiency; sleep quality was evaluated with self-report. Self-report was also used to examine SI. These measures were submitted to independent t-tests and multiple regression analysis. t-test results revealed sleep and SI did not differ between MDD and SAD groups. Multiple regression results showed shorter sleep duration and worse sleep quality related to greater SI when taking symptom severity and age into account. Post-hoc partial correlational analysis showed these sleep-SI relationships remained significant after controlling for symptom severity and age. Preliminary findings indicate sleep and SI may be transdiagnostic features of MDD and SAD. Evidence of distinct sleep-SI relationships are consistent with previous reports showing that sleep difficulties contribute to SI. Altogether, improving sleep duration and sleep quality may reduce the risk of SI.

Suicidal Ideation among University Students: A Moderated Mediation Model Considering Attachment, Personality, and Sex

The present study aimed to examine the link between attachment, personality traits, and suicidal ideation with consideration of the potential moderating role of age and sex. The Suicidal History Self-Rating Screening Scale, the Personality Inventory for DSM-5-Brief Form, and the Attachment Style Questionnaire were administered to 183 students. There was a significant indirect effect of need for approval on suicidal ideation via detachment. Moreover, the moderated mediation models of need for approval and preoccupation with relationships on suicidality via negative affectivity were significant in men, but not women, whereas the moderated mediation model of need for approval on suicidality via detachment was significant in women, but not men. Young men and women seem at risk for increased suicidal ideation based on specific attachment and personality characteristics, which should be considered for the development of prevention and therapeutic interventions.

Evaluation of the Efficacy of Two Internet-based Self-help Interventions for Chronic Loneliness: Study Protocol for a Three-arm Randomized Controlled Trial (Preprint)

Background

Loneliness, or perceived social isolation, is prevalent in both the general population and clinical practice. Although loneliness has repeatedly been associated with mental and physical health, research on interventions that reduce loneliness effectively is still rather scarce.

Objective

This study aims to evaluate the efficacy of a guided and an unguided version of the same internet-based cognitive behavioral self-help program for loneliness (SOLUS-D) for adults.

Methods

A total of 250 participants will be randomly assigned to 1 of 2 intervention groups (SOLUS-D with guidance or SOLUS-D without guidance) or a wait-list control group (2:2:1 allocation ratio). Adult participants experiencing high levels of loneliness will be recruited from the general population. Individuals currently experiencing at least moderately severe depressive symptoms, an ongoing severe substance use disorder, previous or current bipolar or psychotic disorder, or acute suicidality will be excluded from the trial. Assessments will take place at baseline, 5 weeks (midassessment), and 10 weeks (postassessment). The primary outcome is loneliness assessed using the 9-item University of California, Los Angeles Loneliness Scale at the posttreatment time point. Secondary outcomes include depressive symptoms, symptoms of social anxiety, satisfaction with life, social network size, and variables assessing cognitive bias and social behavior. The maintenance of potentially achieved gains will be assessed and compared at 6 and 12 months after randomization in the 2 active conditions. Potential moderators and mediators will be tested exploratorily. Data will be analyzed on an intention-to-treat basis.

Results

Recruitment and data collection started in May 2021 and are expected to be completed by 2022, with the 12-month follow-up to be completed by 2023. As of the time of submission of the manuscript, 134 participants were randomized.

Conclusions

This 3-arm randomized controlled trial will add to the existing research on the efficacy of loneliness interventions. Furthermore, it will shed light on the role of human guidance in internet-based treatments for individuals with increased levels of loneliness and the possible mechanisms of change. If SOLUS-D proves effective, it could provide a low-threshold, cost-efficient method of helping and supporting individuals with increased levels of loneliness.

Trial Registration

ClinicalTrials.gov NCT04655196; https://clinicaltrials.gov/ct2/show/NCT04655196

International Registered Report Identifier (IRRID)

DERR1-10.2196/36358

Establishment and psychometric characteristics of emotional words list for suicidal risk assessment in speech emotion recognition

BACKGROUND

Emotional disturbance is an important risk factor of suicidal behaviors. To ensure speech emotion recognition (SER), a novel technique to evaluate emotional characteristics of speech, precision in labeling emotional words is a prerequisite. Currently, a list of suicide-related emotional word is absent. The aims of this study were to establish an Emotional Words List for Suicidal Risk Assessment (EWLSRA) and test the reliability and validity of the list in a suicide-related SER task.

METHODS

Suicide-related emotion words were nominated and discussed by 10 suicide prevention professionals. Sixty-five tape-recordings of calls to a large psychological support hotline in China were selected to test psychometric characteristics of the EWLSRA.

RESULTS

The results shows that the EWLSRA consists of 11 emotion words which were highly associated with suicide risk scores and suicide attempts. Results of exploratory factor analysis support one-factor model of this list. The Fleiss' Kappa value of 0.42 indicated good inter-rater reliability of the list. In terms of criteria validities, indices of despair (Spearman ρ = 0.54, P < 0.001), sadness (ρ = 0.37, P = 0.006), helplessness (ρ = 0.45, P = 0.001), and numbness (ρ = 0.35, P = 0.009) were significantly associated with suicidal risk scores. The index of the emotional word of numbness in callers with suicide attempt during the 12-month follow-up was significantly higher than that in callers without suicide attempt during the follow-up (P = 0.049).

CONCLUSION

This study demonstrated that the EWLSRA has adequate psychometric performance in identifying suicide-related emotional words of recording of hotline callers to a national wide suicide prevention line. This list can be useful for SER in future studies on suicide prevention.

Emotionally focused therapy: Attachment, connection, and health

In this review, we suggest attachment science as a framework for understanding the negative impact of loneliness and social disconnection on mental and physical health and for guiding the interventions of clinicians. We provide an overview of current findings linking loneliness and social isolation to mental health problems such as depression and anxiety, as well as to physical illnesses such as heart disease. We propose emotionally focused therapy for couples, families, and individuals to enhance the quality of people's emotional ties to significant others and their subjective sense of social connectedness. We conclude by suggesting that the strengthening of emotional, interpersonal bonds, which is the primary focus of all forms of emotionally focused therapy, can help restore emotional balance, thereby protecting people from chronic feelings of isolation and the host of health problems that they can cause.