Development and Psychometric Evaluation of the Suicide Anger Expression Inventory—28

Anxiety and suicidality in the college student population

Objective: This study examined symptoms of anxiety, depression and suicidality in a national sample of college students. Participants: Using national survey data from the Healthy Minds Study (HMS), a random sample from 184 U.S. campuses from fall 2016 to spring 2019 was analyzed (N = 119,875). Methods: Prevalence rates were examined with the Generalized Anxiety Disorder 7-Item scale, Patient Health Questionnaire-9 and suicidality questions. Relationships between anxiety, depression and suicidality were assessed through Spearman's correlations, the Kruskal-Wallis H test and logistic regressions. Results: Findings revealed that screening only for depression would pick up 23% of suicidal ideation, increasing to 35% when also screening for anxiety. Those with anxiety and no to minimal depression had the second highest likelihood of suicide attempt, following those with anxiety and depression. The symptom "feeling afraid something awful might happen" doubled the odds of suicidal ideation. Conclusions: College campuses may benefit from assessing particular anxiety symptoms in relation to suicide.

Repetitive negative thinking and suicide: a burgeoning literature with need for further exploration

Extant research has found a significant overlap between various repetitive negative thinking (RNT) patterns, such as rumination and worry, across different affective disorders implicating that the process of repetitive negative thinking is likely trans-diagnostic. Furthermore, RNT patterns at the core of psychiatric disorders associated with suicide (e.g., rumination and worry) have been found to be associated with suicide even after accounting for the disorder. A synthesis of existing literature on repetitive negative thoughts suggest that following negative emotional experiences, RNTs may lead to a sense of entrapment and hopelessness that may contribute to the onset of suicidal ideation and then facilitate the transition from thinking about suicide to making a suicide attempt by increasing an individual's capability for suicide through repetitive exposure to violent thoughts and imagery associated with suicide.

The Mindful Attention Awareness Scale: Further Examination of Dimensionality, Reliability, and Concurrent Validity Estimates

We examined the factor structure and psychometric properties of the Mindful Attention Awareness Scale (MAAS) in a sample of 810 undergraduate students. Using common exploratory factor analysis (EFA), we obtained evidence for a 1-factor solution (41.84% common variance). To confirm unidimensionality of the 15-item MAAS, we conducted a 1-factor confirmatory factor analysis (CFA). Results of the EFA and CFA, respectively, provided support for a unidimensional model. Using differential item functioning analysis methods within item response theory modeling (IRT-based DIF), we found that individuals with high and low levels of nonattachment responded similarly to the MAAS items. Following a detailed item analysis, we proposed a 5-item short version of the instrument and present descriptive statistics and composite score reliability for the short and full versions of the MAAS. Finally, correlation analyses showed that scores on the full and short versions of the MAAS were associated with measures assessing related constructs. The 5-item MAAS is as useful as the original MAAS in enhancing our understanding of the mindfulness construct.

Test of the depression distress amplification model in young adults with elevated risk of current suicidality

Suicide is a leading cause of death among young adults and the rate of suicide has been increasing for decades. A depression distress amplification model posits that young adults with comorbid depression and anxiety have elevated suicide rates due to the intensification of their depressive symptoms by anxiety sensitivity cognitive concerns. The current study tested the effects of anxiety sensitivity subfactors as well as the depression distress amplification model in a very large sample of college students with elevated suicide risk. Participants were 721 college students who were at elevated risk of suicidality (scored>0 on the Beck Scale for Suicide Ideation). Consistent with prior work, anxiety sensitivity cognitive concerns, but not physical or social concerns, were associated with suicidal ideation. Consistent with the depression distress amplification model, in individuals high in depression, anxiety sensitivity cognitive concerns predicted elevated suicidal ideation but not among those with low depression. The results of this study corroborate the role of anxiety sensitivity cognitive concerns and the depression distress amplification model in suicidal ideation among a large potentially high-risk group of college students. The depression distress amplification model suggests a specific mechanism, anxiety sensitivity cognitive concerns, that may be responsible for increased suicide rates among those with comorbid anxiety and depression.

Parent-child conflict and suicide rumination in college students: the mediating roles of depressive symptoms and anxiety sensitivity

OBJECTIVE

Parent-child conflict, depressive symptoms, and anxiety sensitivity have each been identified as risk factors for suicide ideation in college students. This study examined the relations among these risk factors and suicide rumination utilizing transition theory to guide the hypothesized relations.

PARTICIPANTS

Undergraduate college students participated in this study in the spring of 2012 (January to May).

METHODS

Participants completed self-report measures of parent-child conflict, depressive symptoms, anxiety sensitivity, and suicide rumination, among other measures. Hypothesized pathways and mediation were tested using path analysis.

RESULTS

Suicide rumination was positively and uniquely predicted by depressive symptoms, anxiety sensitivity, and parent-child conflict. The relation between parent-child conflict and suicide rumination was, in part, accounted for by depressive symptoms and anxiety sensitivity.

CONCLUSIONS

Results suggest that it would be advisable for clinicians to assess for students' conflicts with their parents in conjunction with their levels of depression and anxiety when assessing for suicide risk.