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Peng J, Chang W, Ran H, Fang D, Che Y, He Y, Liu S, Zheng G, Xiang Y, Lu J, Xiao Y. Childhood maltreatment associated suicidal risk in Chinese children and adolescents: a mediation of resilience. BMC Public Health 2024; 24:2114. [PMID: 39103857 DOI: 10.1186/s12889-024-19629-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 07/29/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Existing evidence suggests that children and adolescents who had experienced childhood maltreatment (CM) are at higher suicidal risk. However, the mediation role of resilience in this association remains unclear. We aim to investigate the mediation via resilience in the associations between CM and three suicidal risk indicators (suicidal ideation, SI; suicidal plan, SP; suicidal attempt, SA) among a large sample of Chinese children and adolescents. METHODS A population-based cross-sectional survey was conducted in southwestern China Yunnan province. A total of 9723 children and adolescents were included and analyzed by using a multi-stage stratified cluster sampling design. Univariate and multivariate logistic regression models were fitted to explore the associations between CM, resilience, and the three suicidal risk indicators, dose-response trends further elucidated by using the restricted cubic splines. Path models were adopted to estimate the mediation of resilience. RESULTS The estimated prevalence rates for one-year SI, SP and SA were 32.86% (95% CI: 31.93-33.80%), 19.36% (95% CI: 18.57-20.16%) and 9.07% (95% CI: 8.51-9.66%). After adjustment, CM significantly associated with all 3 suicidal risk indicators, and the odds ratios (ORs) were 2.13 (95% CI: 1.91-2.37), 2.45 (95% CI: 2.13-2.81), and 3.61 (95% CI: 2.90-4.52) for one-year SI, SP, and SA, respectively. Path models revealed that resilience significantly mediated the associations between CM and the three suicidal risk indicators, and among all dimensions of resilience, family support presented the strongest mediation consistently. CONCLUSIONS Our study results suggest that intervention measures which focusing on improving psychological resilience might be effective in reducing suicidal risk for children and adolescents who had experienced maltreatment. Prospective studies should be done to corroborate our findings.
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Affiliation(s)
- Junwei Peng
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, 1168 West Chunrong Road, Chenggong District, Kunming, Yunnan, 650500, China
| | - Wei Chang
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, 1168 West Chunrong Road, Chenggong District, Kunming, Yunnan, 650500, China
| | - Hailiang Ran
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, 1168 West Chunrong Road, Chenggong District, Kunming, Yunnan, 650500, China
| | - Die Fang
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, 1168 West Chunrong Road, Chenggong District, Kunming, Yunnan, 650500, China
| | - Yusan Che
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, 1168 West Chunrong Road, Chenggong District, Kunming, Yunnan, 650500, China
| | - Yandie He
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, 1168 West Chunrong Road, Chenggong District, Kunming, Yunnan, 650500, China
| | - Shuqing Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, 1168 West Chunrong Road, Chenggong District, Kunming, Yunnan, 650500, China
| | - Guiqing Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, 1168 West Chunrong Road, Chenggong District, Kunming, Yunnan, 650500, China
| | - Yi Xiang
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, 1168 West Chunrong Road, Chenggong District, Kunming, Yunnan, 650500, China
| | - Jin Lu
- Psychiatry Department, The First Affiliated Hospital, Kunming Medical University, 295 Xichang Road, Wuhua District, Kunming, Yunnan, 650032, China.
- The First Affiliated Hospital, Mental Health Institute of Yunnan, Kunming Medical University, Kunming, Yunnan, China.
- Yunnan Clinical Research Center for Mental Health, Kunming, Yunnan, China.
| | - Yuanyuan Xiao
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, 1168 West Chunrong Road, Chenggong District, Kunming, Yunnan, 650500, China.
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Vidal-Ribas P, Govender T, Yu J, Livinski AA, Haynie DL, Gilman SE. The developmental origins of suicide mortality: a systematic review of longitudinal studies. Eur Child Adolesc Psychiatry 2024; 33:2083-2110. [PMID: 36205791 PMCID: PMC10207387 DOI: 10.1007/s00787-022-02092-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 09/23/2022] [Indexed: 11/30/2022]
Abstract
Suicide prevention efforts generally target acute precipitants of suicide, though accumulating evidence suggests that vulnerability to suicide is partly established early in life before acute precipitants can be identified. The aim of this systematic review was to synthesize evidence on early life vulnerability to suicide beginning in the prenatal period and extending through age 12. We searched PubMed, Embase, PsycNet, Web of Science, Scopus, Social Services Abstracts, and Sociological Abstracts for prospective studies published through January 2021 that investigated early life risk factors for suicide mortality. The search yielded 13,237 studies; 54 of these studies met our inclusion criteria. Evidence consistently supported the link between sociodemographic (e.g., young maternal age at birth, low parental education, and higher birth order), obstetric (e.g., low birth weight), parental (e.g., exposure to parental death by external causes), and child developmental factors (e.g., exposure to emotional adversity) and higher risk of suicide death. Among studies that also examined suicide attempt, there was a similar profile of risk factors. We discuss a range of potential pathways implicated in these associations and suggest that additional research be conducted to better understand how early life factors could interact with acute precipitants and increase vulnerability to suicide.
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Affiliation(s)
- Pablo Vidal-Ribas
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
| | - Theemeshni Govender
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Jing Yu
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Alicia A Livinski
- Office of Research Services, National Institutes of Health Library, OD, NIH, Bethesda, MD, USA
| | - Denise L Haynie
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Stephen E Gilman
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Schiff SJ, Meza J, Bath E, Lee SS. Commercially Sexually Exploited Adolescent Girls: The Association Between Externalizing Disorders and Parental Incarceration with Suicide Attempts. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01730-1. [PMID: 38935209 DOI: 10.1007/s10578-024-01730-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
Commercial sexual exploitation (CSE) is a significant public health concern disproportionately affecting ethnoracially minoritized girls. Despite strong associations of CSE with suicide attempts, little is known about correlates of suicide among girls with CSE histories. Elevated rates of externalizing disorders (i.e., attention-deficit/hyperactivity disorder [ADHD], disruptive behavior disorders [DBD], conduct disorder [CD]) were observed among CSE youth, particularly in ethnoracially minoritized samples. Youth with CSE histories are frequently affected by parental incarceration, which is correlated with risk for suicide attempts. We tested cross-sectional simultaneous associations of externalizing disorders and parental incarceration with number of suicide attempts among 360 ethnoracially diverse girls affected by CSE (Mean age = 18.86). ADHD, DBD, and maternal incarceration were positively associated with number of suicide attempts. Findings implicate clinical/familial correlates of suicide attempts in this marginalized group, suggesting early suicide prevention efforts may improve traction on this problem by focusing on individual and family level factors.
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Affiliation(s)
- Sara J Schiff
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Franz Hall, Los Angeles, CA, 90095-1563, USA.
| | - Jocelyn Meza
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Eraka Bath
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Steve S Lee
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Franz Hall, Los Angeles, CA, 90095-1563, USA
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Wei M, Liu J. Middle school students' psychological health on suicide ideation: based on latent profile analysis. Front Public Health 2024; 12:1390682. [PMID: 38883195 PMCID: PMC11176506 DOI: 10.3389/fpubh.2024.1390682] [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: 02/23/2024] [Accepted: 05/23/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction This study identifies potential categories of mental health for adolescents in different school years and further analyzes the relationship between these categories and suicidal ideation. Methods A total of 1944 middle school students completed SCL-90 and Self-rating Idea of Suicide Scale on November 29, 2022, selecting via a whole-group sampling method. Latent profile analysis was used to analyze the psychological health subtypes of students from a middle school in Southwest China. The R3step method and the DU3step method were conducted to analyze the predictive role of demographic variables and the effects of different profiles on suicidal ideation. Results Different potential categories of psychological health were observed among middle school students. Junior middle school students can be classified into three types: Psychological Health Type (62.3%), Low-risk Type (27.1%) and High-risk Type (10.7%). Senior middle school students can be classified into four types: Psychological Health Type (43.3%), Low-risk Type (33.9%), Medium -risk Type (16.8%), and High-risk Type (6.0%). Gender and subjective family atmosphere are predictors of psychological health, and they also influence the population distribution of psychological health patterns in different sections of middle school students. Girls and students with poor subjective family atmosphere are more prone to experiencing psychological problems. There were significant differences in suicidal ideation among different potential categories of psychological health of different sections middle school students (χ 2 = 1178.71, 1174.85, p<0.001). Among senior high school students classified as High-risk Type, they exhibited the highest score for suicidal ideation. Conclusion There is obvious group heterogeneity in psychological health of different sections middle school students. Older students are more likely to have suicidal thoughts.
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Affiliation(s)
- Meiting Wei
- Faculty of Education, Yunnan Normal University, Kunming, China
| | - Jiang Liu
- Faculty of Education, Yunnan Normal University, Kunming, China
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Gong X, Zhang L. Childhood Maltreatment and Non-Suicidal Self-Injury in Adolescents: Testing a Moderated Mediating Model. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:925-948. [PMID: 38229266 DOI: 10.1177/08862605231197747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
There is a wealth of evidence to suggest that childhood maltreatment is a major risk factor contributing to non-suicidal self-injury (NSSI) among adolescents. However, how and under what conditions childhood maltreatment is related to NSSI remains largely unclear. This study examined the indirect effect of depressive symptoms in the relation between childhood maltreatment and non-suicidal self-injury, as well as the moderating role of cognitive reappraisal and emotion reactivity in those associations. A sample of 1,984 Chinese adolescents (Mage = 12.84, SD = 1.27, 47.9% girls) completed self-report questionnaires. The results of path analysis showed that childhood maltreatment was significantly related to NSSI and that depressive symptoms play an indirect effect in the relation between them. Cognitive reappraisal mitigated the effect of childhood maltreatment on depressive symptoms, and emotion reactivity strengthened the effect of depressive symptoms on non-suicidal self-injury. The results further showed that the indirect effect of depressive symptoms was more prominent for youths with lower levels of cognitive reappraisal and greater emotion reactivity. Interventions that enhance cognitive reappraisal and reduce emotion reactivity may interrupt the pathway from childhood maltreatment to NSSI via depressive symptoms.
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Cen Y, He J, Zhong Y, Zhou J, Zeng J, Huang G, Luo J. The mediating role of sleep problems and depressed mood between psychological abuse/neglect and suicidal ideation in adolescent childhood: a multicentred, large sample survey in Western China. BMC Psychiatry 2024; 24:64. [PMID: 38262997 PMCID: PMC10804755 DOI: 10.1186/s12888-024-05503-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 01/06/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Adolescent suicidal ideation are associated with factors including psychological abuse/neglect, sleep problems, and depressed mood, but the systematic effects of these factors on suicidal ideation remain unclear, which is a research gap this work aims to fill. METHODS A multi-center, the cluster sampling method was employed to collect general demographic data, such as age, gender, the experience of being left behind, and parents' marital status, from 12,192 students across 17 secondary schools in China. The Child Psychological Abuse and Neglect Scale (CPANS), Pittsburgh Sleep Quality Index (PSQI), the Chinese version of the Depressed mood, Anxiety and Stress Scale - 21 Items (DASS-21) and Chinese version of Positive and Negative Suicide Ideation Inventory (PANSI) were utilized. Data were analyzed using t-tests, chi-square tests, correlation analyses, and structural equation modeling mediation analyses. RESULTS The prevalence of psychological abuse/neglect and adolescent suicidal ideation was 34.8% and 13%, respectively. This mediation analysis suggests that, in the relationship between psychological abuse/neglect and suicidal ideation, sleep problems and depressed mood play both parallel and sequential mediating roles. CONCLUSION Sleep problems and depressed mood play a mediating role in the development of suicidal ideation in adolescents. Good sleep habits and depressed mood interventions help reduce the risk of suicidal ideation in adolescents who experience psychological neglect/abuse.
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Affiliation(s)
- Yu Cen
- Mental Health Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jinlong He
- Mental Health Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Yunling Zhong
- Mental Health Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jinhui Zhou
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jiaxin Zeng
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Guoping Huang
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jiaming Luo
- Mental Health Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
- School of Psychiatry, North Sichuan Medical College, Nanchong, China.
- Department of Psychiatry, Nanchong Psychosomatic Hospital, Nanchong, China.
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Nezu AM, Nezu CM, Stern J, Woods AP. Social problem solving moderates emotion reactivity in predicting suicide ideation among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-7. [PMID: 37943518 DOI: 10.1080/07448481.2023.2277860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 10/20/2023] [Indexed: 11/10/2023]
Abstract
Objective: To evaluate the hypothesis that social problem solving (SPS) moderates strong emotion reactivity (ER) to stressful events in predicting suicide ideation (SI). Participants: 200 college students: mean age = 20.33; 75% women; 58% white. Methods: Participants completed the following self-report inventories: Beck Scale for Suicide Ideation, Emotion Reactivity Scale, and Social Problem-Solving Inventory-Revised. Results: Regression and slope analyses found SPS to moderate the association between ER and SI. Specifically, (a) as ER increased, SI increased significantly less for average problem solvers as compared to ineffective problem solvers, and (b) SI increased only slightly for effective problem solvers as ER increased. A secondary exploratory analysis found 20 college students who previously attempted suicide reported more negative ER, less effective SPS, and higher SI, as compared to a group of 20 sex-and age-matched peers. Conclusions: Effective social problem solving serves to decrease the likelihood that college students will experience higher levels of suicide ideation even when their negative emotion reactivity is high. Clinical implications for treatment and prevention are discussed.
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Affiliation(s)
- Arthur M Nezu
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Christine Maguth Nezu
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Jessica Stern
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, NYU Langone Health, New York, New York, USA
| | - Alexandra P Woods
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Weill Cornell Medical College, White Plains, New York, USA
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Zheng Y, Wang J, Jiang Q, Liao M, Huang F. Non-suicidal self-injury and suicidal ideation among adolescents: the chain-mediating role of rumination and decentering. Front Psychiatry 2023; 14:1179518. [PMID: 37779633 PMCID: PMC10540194 DOI: 10.3389/fpsyt.2023.1179518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/25/2023] [Indexed: 10/03/2023] Open
Abstract
Objective To explore the relationship between non-suicidal self-injury and suicidal ideation in adolescents and examine the roles of rumination and decentering in that relationship. Method By means of a questionnaire, 175 adolescent patients in a psychiatric hospital in Fujian Province were given the Functional Assessment of Self-Mutilation: Chinese Version, Positive and Negative Suicide Ideation, Ruminative Response Scale: Chinese Version, and Experiences Questionnaire: Decentering Scale. Results (1) Adolescent non-suicidal self-injury was significantly positively related to suicidal ideation and rumination and significantly negatively related to decentering. Suicidal ideation was significantly positively related to rumination and significantly negatively related to decentering. Rumination was significantly negatively related to decentering. (2) Rumination and decentering played a complete chain-mediating role between non-suicidal self-injury and suicidal ideation. Non-suicidal self-injury was found to indirectly affect suicidal ideation along three pathways: the independent mediating role of rumination (the mediating effect accounted for 40.166%), independent mediating role of decentering (the mediating effect accounted for 41.274%), and chain-mediating role of rumination and decentering (the mediating effect accounted for 14.958%). Conclusion Adolescent non-suicidal self-injury can indirectly affect suicidal ideation through rumination and decentering. In the future, mindfulness and other methods should be used to improve individuals' levels of decentering and cultivate emotional regulation abilities, so as to reduce the incidence of non-suicidal self-injury and suicide in adolescents.
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Affiliation(s)
| | | | | | - Meiling Liao
- School of Health, Fujian Medical University, Fuzhou, China
| | - Fajie Huang
- School of Health, Fujian Medical University, Fuzhou, China
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Laporte N, Ozolins A, Westling S, Westrin Å, Wallinius M. Adverse childhood experiences as a risk factor for non-suicidal self-injury and suicide attempts in forensic psychiatric patients. BMC Psychiatry 2023; 23:238. [PMID: 37038150 PMCID: PMC10084684 DOI: 10.1186/s12888-023-04724-w] [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: 09/30/2022] [Accepted: 03/28/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Exposure to adverse childhood experiences (ACE) have been found to have profound negative consequences on an individuals' health. Non-suicidal self-injury (NSSI) is a clinically complex and serious global health issue and is closely related to suicide attempts. Previous research has found associations between ACE and NSSI and suicide attempts in clinical samples. However, this association has to our knowledge not been studied to this extent in a sample of forensic psychiatric patients. The aim of this study was therefore to describe the prevalence of adverse childhood experiences (ACE) and their associations with non-suicidal self-injury (NSSI) and/or suicide attempts in forensic psychiatric patients. METHODS The current study is a cross-sectional study of a consecutive cohort of 98 forensic psychiatric patients (86.7% male) in Sweden. We invited 184 patients with a predicted stay of > 8 weeks who had been cleared for participation by their treating psychiatrist. Of these, 83 declined and 98 eligible patients provided informed consent. Information on ACE, NSSI, and suicide attempts derived from files, self-reports (Childhood Trauma Questionnaire-Short Form; CTQ-SF), and interviews were compared separately among participants with and without NSSI or suicide attempts using t-tests. The dose-response association between ACE and NSSI/suicide attempts was analysed using binary logistic regression. RESULTS In file reviews, 57.2% of participants reported physical abuse, 20% sexual abuse, and 43% repeated bullying by peers during childhood. NSSI and suicide attempts were associated significantly with CTQ-SF total scores, with medium effect sizes (d = .60 to .63, p < .01), and strongly with several CTQ-SF subscales. Parental substance abuse was also associated with NSSI (p = .006, OR = 3.23; 95% confidence interval [CI] = 1.36 to 7.66) and suicide attempts (p = .018, OR = 2.75; 95% CI = 1.18 to 6.42). Each additional ACE factor predicted an increased probability of NSSI (p = .016, OR = 1.29; CI = 1.04 to 1.59) but not of suicide attempts. When anxiety and depressive disorders were included in the model, ACE remained a significant predictor of NSSI. CONCLUSIONS We report extensive ACE, from both files and self-reports. When comparing groups, correlations were found between ACE and NSSI, and ACE and suicide attempts among forensic psychiatric patients. ACE seem to predict NSSI but not suicide attempts in this group, even when controlling for affective and anxiety disorders. Early ACE among forensic psychiatric patients, especially physical and emotional abuse and parental substance abuse, have important impacts on self-harming behaviours that must be acknowledged both by the institutions that meet them as children and in their later assessment and treatment.
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Affiliation(s)
- Natalie Laporte
- Evidence-based forensic psychiatry, Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden.
- Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden.
| | - Andrejs Ozolins
- Department of Psychology, Linnaeus University, Växjö, Sweden
| | - Sofie Westling
- Department of Clinical Sciences Malmö, Psychiatry, Lund University, Lund, Sweden
- Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Region Skåne, Sweden
| | - Åsa Westrin
- Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden
- Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Region Skåne, Sweden
| | - Märta Wallinius
- Evidence-based forensic psychiatry, Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden
- Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
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Zhou J, Gong X. Longitudinal relation between maladaptive parenting and nonsuicidal self-injury among Chinese early adolescents: The roles of internalizing symptoms and FKBP5 gene variation. J Affect Disord 2023; 331:33-42. [PMID: 36934853 DOI: 10.1016/j.jad.2023.03.034] [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: 11/11/2022] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 03/21/2023]
Abstract
BACKGROUND While increasing research has effectively documented that maladaptive parenting is a significant risk factor for adolescent nonsuicidal self-injury, the process mechanism and gene-by-environment interaction in this relation among Chinese early adolescents are still poorly understood. METHODS In this study, a multi-informant longitudinal design was applied to investigate the indirect effect of internalizing symptoms in the relation between maladaptive parenting and nonsuicidal self-injury, and to examine how FKBP5 gene variation moderates these association. A total of 1718 Chinese Han early adolescents (44.30 % girls; Mage at Wave 1 = 10.35) and their parents participated this study. RESULTS The results showed that maladaptive parenting significantly predicts adolescent nonsuicidal self-injury after six months. Maladaptive parenting was also indirectly related to nonsuicidal self-injury via internalizing symptoms. Moreover, using a cumulative genetic score approach, the results showed that FKBP5 gene variation moderates the predictive effect of maladaptive parenting on internalizing symptoms and also moderates the indirect effect of internalizing symptoms between maladaptive parenting and nonsuicidal self-injury. These effects were more salient among adolescents with high (versus low) FKBP5 gene related cumulative genetic score linked to heightened stress reactivity. LIMITATIONS Our study only obtained two waves of data. Three waves of data would be more suitable for examining a mediation model. CONCLUSION This study reveals the process mechanism between maladaptive parenting and nonsuicidal self-injury and highlights the significance of gene-by-environment interaction to explain the emergence of nonsuicidal self-injury among adolescents.
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Affiliation(s)
- Jianhua Zhou
- School of Psychology, Northwest Normal University, Lanzhou, People's Republic of China
| | - Xue Gong
- Department of Psychology, Normal College, Qingdao University, Qingdao, People's Republic of China.
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Lannoy S, Mars B, Heron J, Edwards AC. Suicidal ideation during adolescence: The roles of aggregate genetic liability for suicide attempts and negative life events in the past year. J Child Psychol Psychiatry 2022; 63:1164-1173. [PMID: 35766310 PMCID: PMC9912194 DOI: 10.1111/jcpp.13653] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND Suicidal thoughts and behaviors (STB) constitute a central public health concern in adolescence. Previous studies emphasized the difficulty to cope with negative life events during adolescence as a risk factor for STB. Familial and genetic liability has also been documented to explain STB risk. Nevertheless, less is known about aggregate genetic liability and its possible interaction with negative life events. Moreover, information is needed to understand how these factors differently affect STB in boys and girls. METHODS We evaluated suicidal ideation at 17 years old and examined the role of aggregate genetic liability, negative life events, and their interaction in a sample of 2,571 adolescents. Aggregate genetic liability was measured using a polygenic score (PGS) for suicide attempts. Negative life events were assessed in the past year and included parental divorce and hospitalizations, death of friends and relatives, bullying, failure-related events, and involvement with drugs. We conducted univariable and multivariable general linear models stratified by sex and evaluated the interactions between PGS and negative life events in subsequent models. RESULTS Analyses showed that suicidal ideation in boys is associated with failure to achieve something important (estimate = 0.198), bullying (estimate = 0.285), drug use (estimate = 0.325), and parental death (estimate = 0.923). In girls, both aggregate genetic liability (estimate = 0.041) and negative life events (failure at school [estimate = 0.120], failure to achieve something important [estimate = 0.279], drug use [estimate = 0.395], and bullying [estimate = 0.472]) were associated with suicidal ideation. Interaction analyses suggested that PGS interacted with drug use and failures at school, though this would need additional support. CONCLUSIONS These findings represent significant contributions to the fundamental understanding of STB in adolescence, suggesting to monitor the impact of negative life events during adolescence to better prevent suicide risk. Genetic liability is also of importance in girls and might influence the way they respond to environmental threats.
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Affiliation(s)
- Séverine Lannoy
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral GeneticsVirginia Commonwealth University School of MedicineRichmondVAUSA
| | - Becky Mars
- Population Health SciencesUniversity of BristolBristolUK
| | - Jon Heron
- Population Health SciencesUniversity of BristolBristolUK
| | - Alexis C. Edwards
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral GeneticsVirginia Commonwealth University School of MedicineRichmondVAUSA
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Dewar C, Heggs DA, Davies J. Exploring the Relationship Between Domestic Violence Perpetration and Suicidal Behavior in Male Prisoners. Arch Suicide Res 2022; 26:1831-1846. [PMID: 34162317 DOI: 10.1080/13811118.2021.1939207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study is the first to explore the relationship between domestic violence perpetration and suicidal behavior in prisoners in England and Wales. The nature of this relationship is unclear, however, understanding and reducing suicide in prisons is a critical issue for frontline staff and policy makers. Eight participants with a history of suicide attempts and domestic violence perpetration were interviewed. Five key themes were identified through thematic analysis; "Trauma, victimization and life struggles," "Relationship ideals versus relationship reality", "Explaining domestic violence", "The impact of prison" and "Suicide as a coping strategy". This study shows that the relationship between domestic violence and suicide risk in prisoners may be better understood through a pathway of experiences rather than individual risk factors. Further research is needed to test the replicability of this pathway in other samples.
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Impulsivity as a mediator between childhood maltreatment and suicidal behavior: A systematic review and meta-analysis. J Psychiatr Res 2022; 151:95-107. [PMID: 35477079 DOI: 10.1016/j.jpsychires.2022.04.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/28/2022] [Accepted: 04/18/2022] [Indexed: 01/15/2023]
Abstract
Childhood maltreatment is a known risk factor for the development of suicidal behavior. Possible mediators of the association between childhood maltreatment and suicide have been analyzed. Some studies have considered impulsivity as one of these mediators, but there are no previous reviews on this topic. We, therefore, present a systematic review and mediation meta-analysis of the literature summarizing the evidence on impulsivity as a mediator of the relationship between childhood maltreatment and lifetime suicidal behavior. This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The review was registered in the PROSPERO database. We searched PubMed, PsycINFO, WebOfScience, and EMBASE databases up to February 2021 to identify studies exploring the association between childhood maltreatment and suicide through impulsivity. Fourteen articles met the selection criteria and were included in the review. Seven articles could be included in the mediation meta-analysis. Impulsivity was a significant mediator of the relationship between childhood maltreatment and suicidal behavior in ten of the fourteen included studies. This result was confirmed using mediation meta-analysis (β = .06, 95% CI 0.03-0.10). Studies suggest that exposure to traumatic situations in childhood affects the proper neurobiological, cognitive, and affective development of individuals. This may increase impulsivity, which in turn would be related to an increased risk of suicide. The effects of childhood maltreatment and impulsivity may be both therapeutic targets of interest to reduce suicide rates.
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14
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Argabright ST, Visoki E, Moore TM, Ryan DT, DiDomenico GE, Njoroge WFM, Taylor JH, Guloksuz S, Gur RC, Gur RE, Benton TD, Barzilay R. Association Between Discrimination Stress and Suicidality in Preadolescent Children. J Am Acad Child Adolesc Psychiatry 2022; 61:686-697. [PMID: 34425231 PMCID: PMC8917360 DOI: 10.1016/j.jaac.2021.08.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/17/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Youth suicide rates in the United States have been increasing in recent years, especially in Black Americans, the reasons for which are unclear. Environmental adversity is key in youth suicidality; hence there is a need to study stressors that have a disproportionate impact on Black youths. We aimed to disentangle the unique contribution of racial/ethnic discrimination from other adversities associated with childhood suicidal ideation and attempts (suicidality). METHOD We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, which included a large, diverse sample of US children (N = 11,235, mean age 10.9 years, 20.2% Black), assessed for multiple environmental adversities including discrimination. Multivariate regression models tested the association of self-reported racial/ethnic discrimination with suicidality, covarying for multiple confounders including other discrimination types (toward non-US-born individuals, sexual orientation-based, and weight-based). Matched analyses contrasted effects of racial/ethnic discrimination and racial identity on suicidality. RESULTS Black youths reported more discrimination and higher suicidality rates than non-Black youths. High racial/ethnic discrimination was positively and significantly associated with suicidality, adjusting for other discrimination types (odds ratio = 2.6, 95% CI = 2.1-3.2). Findings remained significant after adjusting for multiple suicidality risk factors. Once experienced, racial/ethnic discrimination was similarly associated with suicidality in White, Black, and Hispanic youths. Matched analyses revealed that racial/ethnic discrimination was associated with suicidality (relative risk = 2.7, 95% CI = 2-3.5), whereas Black race was not (relative risk = 0.9, 95% CI = 0.7-1.2). CONCLUSION Racial/ethnic discrimination is disproportionately experienced by Black children, and is associated with preadolescent suicidality, over and above other adversities. Findings highlight the need to address discrimination as part of suicide prevention strategies. Cross-sectional design hampers causal inferences.
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Affiliation(s)
- Stirling T Argabright
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania
| | - Elina Visoki
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania
| | - Tyler M Moore
- Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Dallas T Ryan
- Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania
| | - Grace E DiDomenico
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania
| | - Wanjikũ F M Njoroge
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Jerome H Taylor
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Sinan Guloksuz
- School for Mental Health and Neuroscience, Maastricht University Medical Centre, the Netherlands; Yale University School of Medicine, New Haven, Connecticut
| | - Ruben C Gur
- Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Raquel E Gur
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Tami D Benton
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ran Barzilay
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia.
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15
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Argabright ST, Visoki E, Moore TM, Ryan DT, DiDomenico GE, Njoroge WFM, Taylor JH, Guloksuz S, Gur RC, Gur RE, Benton TD, Barzilay R. Association Between Discrimination Stress and Suicidality in Preadolescent Children. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:252-262. [PMID: 37153135 PMCID: PMC10153507 DOI: 10.1176/appi.focus.22020005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 05/09/2023]
Abstract
Objective Youth suicide rates in the United States have been increasing in recent years, especially in Black Americans, the reasons for which are unclear. Environmental adversity is key in youth suicidality; hence there is a need to study stressors that have a disproportionate impact on Black youths. We aimed to disentangle the unique contribution of racial/ethnic discrimination from other adversities associated with childhood suicidal ideation and attempts (suicidality). Method We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, which included a large, diverse sample of US children (N = 11,235, mean age 10.9 years, 20.2% Black), assessed for multiple environmental adversities including discrimination. Multivariate regression models tested the association of self-reported racial/ethnic discrimination with suicidality, covarying for multiple confounders including other discrimination types (toward non-US-born individuals, sexual orientation-based, and weight-based). Matched analyses contrasted effects of racial/ethnic discrimination and racial identity on suicidality. Results Black youths reported more discrimination and higher suicidality rates than non-Black youths. High racial/ethnic discrimination was positively and significantly associated with suicidality, adjusting for other discrimination types (odds ratio = 2.6, 95% CI = 2.1-3.2). Findings remained significant after adjusting for multiple suicidality risk factors. Once experienced, racial/ethnic discrimination was similarly associated with suicidality in White, Black, and Hispanic youths. Matched analyses revealed that racial/ethnic discrimination was associated with suicidality (relative risk = 2.7, 95% CI = 2-3.5), whereas Black race was not (relative risk = 0.9, 95% CI = 0.7-1.2). Conclusion Racial/ethnic discrimination is disproportionately experienced by Black children, and is associated with preadolescent suicidality, over and above other adversities. Findings highlight the need to address discrimination as part of suicide prevention strategies. Cross-sectional design hampers causal inferences.Reprinted from J Am Acad Child Adolesc Psychiatry, Argabright et al., Association Between Discrimination Stress and Suicidality in Preadolescent Children, S0890-8567(21)01355-1, copyright 2021, with permission from Elsevier.
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16
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Rowell T, Neal-Barnett A. A Systematic Review of the Effect of Parental Adverse Childhood Experiences on Parenting and Child Psychopathology. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:167-180. [PMID: 35222782 PMCID: PMC8837768 DOI: 10.1007/s40653-021-00400-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 05/22/2023]
Abstract
Adverse childhood experiences (ACEs) are defined as early exposure to maltreatment and household dysfunction. Researchers have demonstrated the link between ACEs and negative psychological, behavioral, interpersonal, and health outcomes. A growing area of interest in the ACE literature concerns the relationship between ACEs, parenting, and child psychopathology due to the intergenerational effect of ACEs. Emotional availability and discipline strategies are two domains of parenting that can increase understanding of the associations between ACEs, parenting, and child psychopathology from an attachment framework because they are both salient during early childhood and directly influence a child's later behavior. This paper utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to elucidate the relationships between parental ACEs, parents' emotional availability and discipline strategies, and children's psychopathology. PubMed, PSYCINFO, and Psychology and Behavioral Sciences Collection were used to access the literature on June 16, 2020, and 26 studies met the inclusion criteria. Results from this review suggested that there is a direct association between ACEs and parental emotional availability and discipline techniques. Depression and dissociation were identified as potential mediators. There was support for the direct association between parental ACEs and children's internalizing and externalizing difficulties. Maternal anxiety and depressive symptoms, emotional availability, attachment, and children's maltreatment experiences were found to be possible mediators. Recommendations are proposed to address limitations within the literature to further expand upon the research of ACEs, parenting, and child psychopathology.
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Affiliation(s)
- Tiffany Rowell
- Department of Psychological Sciences, Kent State University, 600 Hilltop Drive, Kent, OH 44240 USA
| | - Angela Neal-Barnett
- Department of Psychological Sciences, Kent State University, 600 Hilltop Drive, Kent, OH 44240 USA
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17
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Taşören AB. Childhood maltreatment and emotional distress: The role of beliefs about emotion and psychological inflexibility. CURRENT PSYCHOLOGY 2022; 42:1-12. [PMID: 35039733 PMCID: PMC8754519 DOI: 10.1007/s12144-021-02594-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 11/26/2022]
Abstract
The current study aimed to investigate the mediating role of negative beliefs about emotion and psychological inflexibility on the relationship between childhood maltreatment and emotional distress. A total of 519 participants completed the Childhood Trauma Questionnaire (CTQ), Depression Anxiety Stress Scale-21 (DASS-21), the Leahy Emotional Schema Scale II (LESS-II), and the Acceptance and Action Questionnaire-II (AAQ-II). All scales were significantly correlated. Two mediation analyses were tested. In the first model negative beliefs about emotion and psychological inflexibility mediated the relationship between childhood maltreatment and emotional distress measured by DASS-21 total score. In the second model, negative beliefs about emotion and psychological inflexibility mediated the relationship between childhood maltreatment and depression, anxiety, and stress measured by the subscales of DASS-21. Results suggest that maltreatment in childhood is associated with the individuals' approaches, plans and strategies in response to emotions, and psychological inflexibility which together further determine emotional distress.
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Affiliation(s)
- Aslı Burçak Taşören
- Istanbul Medipol Universitesi Guney Kampus, Goztepe Mah. Kavacik, Beykoz, Istanbul, Turkey
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18
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Vidal-Ribas P, Govender T, Sundaram R, Perlis RH, Gilman SE. Prenatal origins of suicide mortality: A prospective cohort study in the United States. Transl Psychiatry 2022; 12:14. [PMID: 35013255 PMCID: PMC8748551 DOI: 10.1038/s41398-021-01777-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/07/2021] [Accepted: 12/20/2021] [Indexed: 12/01/2022] Open
Abstract
Most suicide research focuses on acute precipitants and is conducted in high-risk populations. Yet, vulnerability to suicide is likely established years prior to its occurrence. In this study, we aimed to investigate the risk of suicide mortality conferred by prenatal sociodemographic and pregnancy-related factors. Offspring of participants (N = 49,853) of the Collaborative Perinatal Project, a U.S. population-based cohort of pregnancies enrolled between 1959 and 1966, were linked to the U.S. National Death Index to determine their vital status by the end 2016. We examined associations between sociodemographic factors during pregnancy, pregnancy complications, labor and delivery complications, and neonatal complications with suicide death coded according to ICD-9/10 criteria. By the end of 2016, 3,555 participants had died. Of these, 288 (214 males, 74 females) died by suicide (incidence rate = 15.6 per 100,000 person-years, 95% Confidence Interval [CI] = 13.9-17.5). In adjusted models, male sex (Hazard Ratio [HR] = 2.98, CI: 2.26-3.93), White race (HR = 2.14, CI = 1.63-2.83), low parental education (HR = 2.23, CI = 1.38-3.62), manual parental occupation (HR = 1.38, CI = 1.05-1.82), being a younger sibling (HR = 1.52, CI = 1.10-2.11), higher rates of pregnancy complications (HR = 2.36, CI = 1.08-5.16), and smoking during pregnancy (HR = 1,28, CI = 0.99-1.66) were independently associated with suicide risk, whereas birth and neonatal complications were not. Consistent with the developmental origins of psychiatric disorders, vulnerability to suicide mortality is established early in development. Both sociodemographic and pregnancy factors play a role in this risk, which underscores the importance of considering life course approaches to suicide prevention, possibly including provision of high-quality prenatal care, and alleviating the socioeconomic burdens of mothers and families.
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Affiliation(s)
- Pablo Vidal-Ribas
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
| | - Theemeshni Govender
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Roy H Perlis
- Center for Quantitative Health, Center for Genomic Medicine and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Stephen E Gilman
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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19
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Paul E, Fancourt D. The interaction between social factors and adversities on self-harm during the COVID-19 pandemic: longitudinal analysis of 49 227 UK adults. BJPsych Open 2022; 8:e12. [PMID: 34931147 PMCID: PMC8674193 DOI: 10.1192/bjo.2021.1071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 11/01/2021] [Accepted: 11/19/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Little is known about which factors exacerbate and buffer the impact of coronavirus disease 2019 (COVID-19)-related adversities on changes in thinking about and engaging in self-harm over time. AIMS To examine how changes in four social factors contribute to changes in self-harm thoughts and behaviours over time and how these factors in turn interact with adversities and worries about adversities to increase risk for these outcomes. METHOD Data from 49 227 UK adults in the UCL COVID-19 Social Study were analysed across the first 59 weeks of the pandemic. Fixed-effects logistic regressions examined time-varying associations between social support quality, loneliness, number of days of face-to-face contact for >15 min and number of days phoning/video calling for ≥15 min with self-harm thoughts and behaviours. We then examined how these four factors in turn interacted with the total number of adversities and worries about adversity and how this affected outcomes. RESULTS Increases in the quality of social support were associated with decreases in the likelihood of both outcomes, whereas greater loneliness was associated with an increase in their likelihood. Associations were less clear for telephone/video contact and face-to-face contact with outcomes. Social support buffered and loneliness exacerbated the impact of adversity experiences on self-harm behaviours. CONCLUSIONS These findings suggest the importance of the quality of one's social support network, rather than the mere presence of contact, for reducing the likelihood of self-harm behaviours in the context of COVID-19 pandemic-related adversity and worry.
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Affiliation(s)
- Elise Paul
- Department of Behavioural Science and Health, University College London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, UK
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20
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Liu J, Liu X, Wang H, Gao Y. Harsh parenting and non-suicidal self-injury in adolescence: the mediating effect of depressive symptoms and the moderating effect of the COMT Val158Met polymorphism. Child Adolesc Psychiatry Ment Health 2021; 15:70. [PMID: 34814943 PMCID: PMC8611980 DOI: 10.1186/s13034-021-00423-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/15/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Previous studies have suggested that negative parenting environments, especially harsh parenting, are a specific risk factor for non-suicidal self-injury (NSSI). However, the potential mechanism between harsh parenting and NSSI has not been explored. Based on the experiential avoidance model and empirical research, we aimed to examine whether depressive symptoms are a mediator between harsh parenting and NSSI. Moreover, the catechol-O-methyltransferase (COMT) Val158Met polymorphism related to depressive symptoms may also exert a moderating effect on NSSI; thus, the interaction between harsh parenting and COMT was also considered in our study. METHODS A total of 373 junior high school students were recruited for the study by using a longitudinal design. The adolescents answered self-report questionnaires and provided saliva samples for DNA genotyping. RESULTS The results revealed that harsh parenting was positively associated with NSSI after 24 months, and this association was mediated by depressive symptoms. Moreover, the moderating role of COMT in the direct and indirect effects of harsh parenting on NSSI was observed only among adolescents with two Val alleles and the relationship was not significant for Met carriers. CONCLUSIONS Genetic variations of COMT Val158Met may be a critical candidate in understanding the development of depression and NSSI. We conclude that Val homozygotes of the COMT Val158Met polymorphism play a role in susceptibility to both depressive symptoms and NSSI.
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Affiliation(s)
- Jinmeng Liu
- grid.20513.350000 0004 1789 9964Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875 China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875, China.
| | - Hui Wang
- grid.20513.350000 0004 1789 9964Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875 China
| | - Yemiao Gao
- grid.20513.350000 0004 1789 9964Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875 China
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21
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Gromatsky M, Edwards ER, Sullivan SR, Goodman M, Hazlett EA. Distinguishing veterans with suicidal ideation from suicide attempt history: The role of emotion reactivity. Suicide Life Threat Behav 2021; 51:572-585. [PMID: 33665891 DOI: 10.1111/sltb.12744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/11/2020] [Accepted: 10/02/2020] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Growing evidence suggests emotion reactivity-sensitivity and intensity of emotional experience-may represent a diathesis for suicide risk. However, our understanding of its ability to differentiate risk for suicidal ideation (SI) from suicide attempt (SA) is limited. METHOD This study compares Veterans with SI (n = 81) to Veterans with SA (n = 177) history on factors relevant to emotion reactivity to determine which variable(s) best differentiate groups. Variables examined are multimodal: (a) self-report: childhood trauma, combat exposure; (b) clinician-assessed: non-suicidal self-injury (NSSI), structured diagnostic interview of psychopathology; and (c) psychophysiological: affect-modulated startle (AMS; proxy for amygdala reactivity and emotion reactivity) to unpleasant pictures was examined in a subset (n = 90). RESULTS SA history was independently predicted by NSSI history, MDD, PTSD, and SUD diagnosis. Childhood trauma and combat exposure did not differentiate groups. The composite risk index demonstrated good accuracy (AUC=0.71, sensitivity=0.90, specificity=0.49). Only AMS independently predicted SA history when added to the model and accuracy was improved (AUC=0.82, sensitivity=0.85, specificity=0.56). CONCLUSION NSSI history, MDD, PTSD, and SUD diagnosis may be salient risk factors for this population. However, emotion reactivity is a more parsimonious predictor of SA history among Veterans suggesting it is an important treatment target among Veterans with SI.
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Affiliation(s)
- Molly Gromatsky
- VISN 2 Mental Illness Research Education and Clinical Center (MIRECC), Bronx, NY, USA
| | - Emily R Edwards
- VISN 2 Mental Illness Research Education and Clinical Center (MIRECC), Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sarah R Sullivan
- VISN 2 Mental Illness Research Education and Clinical Center (MIRECC), Bronx, NY, USA
| | - Marianne Goodman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Erin A Hazlett
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
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22
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Denton EGD. Community-based participatory research: Suicide prevention for youth at highest risk in Guyana. Suicide Life Threat Behav 2021; 51:189-196. [PMID: 33876491 DOI: 10.1111/sltb.12693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
UNLABELLED Studied mostly in developed countries, the increased prevalence of suicide among youth, worldwide, is a preventable public health concern. Guyana, a developing country in South America, has the highest rate of youth death by suicide. Based on the diathesis-stress model, this community-based study aimed to identify both psychiatric and biological factors associated with repeated suicide attempts among high-risk youth. OBJECTIVE We measured psychiatric symptoms, childhood traumas, and cortisol to identify correlates with recurrent suicide attempts. METHOD Poisson regression tested the association between psychiatric symptoms, trauma, and cortisol levels on number of suicide attempts among 50 youths from three child welfare orphanages in Guyana. Sixty-six percent were female, and the average age was 14 years. DSM-5 symptom measure was administered and saliva samples collected. RESULTS Fifty percent of the youth endorsed suicide attempt. Within this subsample, a minimum of one and maximum of five suicide attempts were self-reported. Participants' number of suicide attempts was positively associated with number of past traumas, psychosis, and depression symptoms. CONCLUSION Suicide prevention screening among at-risk youth should target severity of psychosis and depression reports and number of traumatic life experiences.
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Affiliation(s)
- Ellen-Ge D Denton
- Department of Psychology, City University of New York College of Staten Island, 2800 Victory Blvd, Building 4S, Staten Island, NY, 10314, USA
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23
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Shafti M, Taylor PJ, Forrester A, Pratt D. The Co-occurrence of Self-Harm and Aggression: A Cognitive-Emotional Model of Dual-Harm. Front Psychol 2021; 12:586135. [PMID: 33716854 PMCID: PMC7946988 DOI: 10.3389/fpsyg.2021.586135] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/29/2021] [Indexed: 11/29/2022] Open
Abstract
There is growing evidence that some individuals engage in both self-harm and aggression during the course of their lifetime. The co-occurrence of self-harm and aggression is termed dual-harm. Individuals who engage in dual-harm may represent a high-risk group with unique characteristics and pattern of harmful behaviours. Nevertheless, there is an absence of clinical guidelines for the treatment and prevention of dual-harm and a lack of agreed theoretical framework that accounts for why people may engage in this behaviour. The present work aimed to address this gap in the literature by providing a narrative review of previous research of self-harm, aggression and dual-harm, and through doing so, presenting an evidence-based theory of dual-harm – the cognitive-emotional model of dual-harm. This model draws from previous studies and theories, including the General Aggression Model, diathesis-stress models and emotional dysregulation theories. The cognitive-emotional model highlights the potential distal, proximal and feedback processes of dual-harm, the role of personality style and the possible emotional regulation and interpersonal functions of this behaviour. In line with our theory, various clinical and research implications for dual-harm are suggested, including hypotheses to be tested by future studies.
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Affiliation(s)
- Matina Shafti
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Peter James Taylor
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Andrew Forrester
- Division of Psychological Medicine and Clinical Neuroscienecs, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
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24
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Gao Y, Xiong Y, Liu X, Wang H. The Effects of Childhood Maltreatment on Non-Suicidal Self-Injury in Male Adolescents: The Moderating Roles of the Monoamine Oxidase A (MAOA) Gene and the Catechol-O-Methyltransferase (COMT) Gene. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052598. [PMID: 33807669 PMCID: PMC7967505 DOI: 10.3390/ijerph18052598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 01/12/2023]
Abstract
(1) Background: Numerous studies suggest strong associations between childhood maltreatment and nonsuicidal self-injury (NSSI); this is also true for the roles of dopaminergic genes in the etiology of some psychopathologies related to NSSI. Investigating the interactions of environments and genes is important in order to better understand the etiology of NSSI. (2) Methods: Within a sample of 269 Chinese male adolescents (Mage = 14.72, SD = 0.92), childhood maltreatment and NSSI were evaluated, and saliva samples were collected for MAOA T941G and COMT Val158Met polymorphism analyses. (3) Results: The results revealed no primary effects attributable to MAOA T941G and COMT Val158Met polymorphism on NSSI. However, there was a significant three-way interaction between MAOA, COMT, and child abuse (β = −0.34, p < 0.01) in adolescent NSSI. Except for carriers of the T allele of MAOA and the Met allele of COMT, all studied male adolescents displayed higher NSSI scores when exposed to a higher level of child abuse. A similar three-way interaction was not observed in the case of child neglect. (4) Conclusions: The results indicate that the MAOA gene and COMT gene play moderating roles in the association between child abuse and NSSI of male adolescents and suggest the polygenic underpinnings of NSSI.
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Lai S, Su C, Song S, Yan M, Tang C, Zhang Q, Yin F, Liu Q. Depression and Deliberate Self-Harm Among Rural Adolescents of Sichuan Province in Western China: A 2-Year Longitudinal Study. Front Psychiatry 2021; 12:605785. [PMID: 34589002 PMCID: PMC8473622 DOI: 10.3389/fpsyt.2021.605785] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 08/16/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: To explore the change in the prevalence and association of depression and deliberate self-harm and their common and independent influencing factors among western Chinese rural adolescents. Methods: A total of 2,744 junior and senior high school students from two rural schools in Sichuan Province, China, participated in the baseline survey and were invited to participate in two follow-up surveys. The Center for Epidemiologic Studies-Depression Scale, a deliberate self-harm item, the Social Support Rating Scale, the Rosenberg Self-esteem Scale and the Connor-Davidson Resilience Scale were administered. A bivariate four-level logistic regression model was used for analysis. Results: The prevalence of depression and deliberate self-harm were 39.6 and 21.2%, respectively. Regular physical exercise, a good relationship with parents, high resilience, and high self-esteem were common protective factors for both depression and deliberate self-harm. Feeling disliked by teachers was a common risk factor for both. Being female, having a mother who emigrated as a migrant worker before the student was 3 years old, feeling disliked by classmates and having a poor family economic status were associated only with an increased risk of depression. Participants with medium social support were less likely to report deliberate self-harm than those with low or high support. Depression and deliberate self-harm were clustered at the class level. Conclusions: The comorbidity of depression and deliberate self-harm in rural adolescents should be given ample attention. Interventions should consider the class clustering of depression and deliberate self-harm and their common and unique influencing factors.
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Affiliation(s)
- Shimin Lai
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China.,Department of Medical Administration, West China Tianfu Hospital, Sichuan University, Chengdu, China
| | - Chang Su
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
| | - Shasha Song
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
| | - Mingxia Yan
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
| | - Chengmeng Tang
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
| | - Qiang Zhang
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
| | - Fei Yin
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Qiaolan Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
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Sokolowski M, Wasserman D. Genetic origins of suicidality? A synopsis of genes in suicidal behaviours, with regard to evidence diversity, disorder specificity and neurodevelopmental brain transcriptomics. Eur Neuropsychopharmacol 2020; 37:1-11. [PMID: 32636053 DOI: 10.1016/j.euroneuro.2020.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 06/08/2020] [Indexed: 12/17/2022]
Abstract
With regard to suicidal behavior (SB) genetics, many novel genes have been implicated over the years, in particular by a variety of hypothesis-free genomic methods (e.g. GWAS and exome sequencing). In addition, many novel SB gene findings appear enigmatic in their biological relevance and have weak statistical support, e.g. lack direct replications. Adding to this is the comorbidity between psychiatric disorders and SB. Here we provide a synopsis of SB genes, by prioritization of 106 (out of ~2500) genes based on their highest level of evidence diversity across mainly five genetic evidence types (candidate/GWAS SNP, CNV, linkage and whole exome sequencing), supplemented by three functional categories. This is a representative set of both old and new SB gene candidates, implicated by all kinds of evidence. Furthermore, we define a subset of 40 SB "specific" genes, which are not found among ~3900 genes implicated in other neuropsychiatric disorders, e.g. Autism spectrum disorders (ASD) or Schizophrenia. Biological research of suicidality contains a major developmental focus, e.g. with regard to the gene-environment interactions and epigenetic effects during childhood. Less is known about early (fetal) development and SB genes. Inspired by huge efforts to understand the role early (fetal) neurodevelopment in e.g. ASD by using brain transcriptomic data, we here also characterize the 106 SB genes. We find interesting spatiotemporal expression differences and similarities between SB specific and non-specific genes during brain neurodevelopment. These aspects are of interest to investigate further, to better understand and counteract the genetic origins suicidality.
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Affiliation(s)
- Marcus Sokolowski
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute (KI), Stockholm, Sweden.
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute (KI), Stockholm, Sweden; WHO collaborating Centre for research, methods, development and training in suicide prevention, Sweden
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Childhood predictors and moderators of lifetime risk of self-harm in girls with and without attention-deficit/hyperactivity disorder. Dev Psychopathol 2020; 33:1351-1367. [DOI: 10.1017/s0954579420000553] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is associated with self-harm during adolescence and young adulthood, especially among females. Yet little is known about the developmental trajectories or childhood predictors/moderators of self-harm in women with and without childhood histories of ADHD. We characterized lifetime risk for nonsuicidal self-injury (NSSI), suicidal ideation (SI), and suicide attempts (SA), comparing female participants with (n = 140) and without (n = 88) childhood ADHD. We examined theory-informed childhood predictors and moderators of lifetime risk via baseline measures from childhood. First, regarding developmental patterns, most females with positive histories of lifetime self-harm engaged in such behaviors in adolescence yet desisted by adulthood. Females with positive histories of self-harm by late adolescence emanated largely from the ADHD-C group. Second, we found that predictors of NSSI were early externalizing symptoms, overall executive functioning, and father's negative parenting; predictors of SI were adverse childhood experiences and low self-esteem; and predictors of SA were early externalizing symptoms, adverse childhood experiences, and low self-esteem. Third, receiver operating characteristics analyses helped to ascertain interactive sets of predictors. Findings indicate that pathways to self-harm are multifaceted for females with ADHD. Understanding early childhood predictors and moderators of self-harm can inform both risk assessment and intervention strategies.
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Yin H, Galfalvy H, Zhang B, Tang W, Xin Q, Li E, Xue X, Li Q, Ye J, Yan N, Mann JJ. Interactions of the GABRG2 polymorphisms and childhood trauma on suicide attempt and related traits in depressed patients. J Affect Disord 2020; 266:447-455. [PMID: 32056912 DOI: 10.1016/j.jad.2020.01.126] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/28/2019] [Accepted: 01/20/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Previously, we reported that the longest variant of the GABA A receptor γ2 subunit (GABRG2) was associated with suicidal behavior. The present study therefore aimed to determine whether polymorphisms near the alternatively spliced exon of GABRG2 are associated with suicide attempt (SA) and its related traits, and how these variants might interact with reported childhood trauma (CT) in their association with suicidal behavior. METHODS We examined 5 single nucleotide polymorphisms (SNPs) of GABRG2. Subjects were suicide Attempters (N = 94), non-suicide attempters (N = 168) with MDD or Bipolar depression, and healthy volunteers (N = 100). Data on demographics, depression severity and suicide attempts were collected. Participants also completed a set of instruments assessing CT, and lifetime aggression and impulsivity.. GABRG2 polymorphisms were genotyped using Sanger sequencing. RESULTS Allele A of rs211034 was a protective factor for SA (OR = 0.50 (0.32, 0.80), p = 0.003), and had an interaction effect with emotional neglect (OR = 0.89 (0.82, 0.97), p = 0.006) on depression. One haploblock (consisting of rs211035 and rs211034) was identified within these SNPs, and subjects with haplotype GA (frequency = 7.3%), had lower rate of SA (OR=0.26(0.10, 0.67), p = 0.006). Cognitive impulsivity (OR=1.38)1.24,1.55), p < 0.001), non-planning impulsivity (OR = 1.18 (1.10,1.25), p < 0.001), anger (OR = 1.13 (1.07,1.19), p < 0.001), impulsivity total score (OR = 1.10(1.06,1.15), p < 0.001), hostility (OR = 1.10 (1.04, 1.15), p < 0.001), aggression total score (OR = 1.05 (1.03,1.07), p < 0.001) were associated with depression, meanwhile, hopelessness (OR = 2.18 (1.56, 3.04), p < 0.001) and impulsivity total score (OR = 1.05 (1.02,1.08), p < 0.001) were associated with the risk of SA, adjusted by age and gender. There was no mediation effect in the relationship among CT, gene polymorphisms and SA or depression through increased impulsivity or aggression. LIMITATIONS The main limitation of this study is its modest sample size. More genetic variants as well as epigenetic markers should be examined in future studies. CONCLUSIONS These findings add to evidence for the involvement of GABRG2 and impulsivity and hopelessness in SA independent from their association with depression. More research is needed on possible mediators of the relationship between GABA-related gene and SA.
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Affiliation(s)
- Honglei Yin
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China.
| | - Hanga Galfalvy
- Department of Psychiatry, Columbia University, New York, NY
| | - Bin Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Weiwei Tang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Qianqian Xin
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Enze Li
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Xiang Xue
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Qiyang Li
- Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Junping Ye
- Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Na Yan
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - J John Mann
- Department of Psychiatry, Columbia University, New York, NY; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York.
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Alberdi-Paramo I, Saiz-Gonzalez MD, Diaz-Marsa M, Carrasco-Perera JL. Bullying and childhood trauma events as predictive factors of suicidal behavior in borderline personality disorder: Preliminary findings. Psychiatry Res 2020; 285:112730. [PMID: 31831199 DOI: 10.1016/j.psychres.2019.112730] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 11/26/2022]
Abstract
Traumas in childhood could present a significant association with suicidal behavior in BPD. The aim of the report is to study the link between a traumatic childhood involving school bullying and the different forms and degrees of suicidal behavior in BPD. A cross-sectional study was carried out on a sample of 109 BPD patients. It is divided into two groups whether or not there is a history of suicidal behavior. The clinical variables are compared with Chi square and Student's T tests. Traumatic childhood history and bullying, in particular, showed a statistically significant association with the incidence of suicidal behaviors.
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Affiliation(s)
| | | | - Marina Diaz-Marsa
- Department of Psychiatry, Hospital Clinico San Carlos, Madrid, Spain; Department of Psychiatry, School of Medicine, Universidad Complutense de Madrid. Centro de Investigacion Biomédica en Red de Salud Mental, Cibersam, Spain
| | - Jose Luis Carrasco-Perera
- Department of Psychiatry, Hospital Clinico San Carlos, Madrid, Spain; Department of Psychiatry, School of Medicine, Universidad Complutense de Madrid. Centro de Investigacion Biomédica en Red de Salud Mental, Cibersam, Spain
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Carballo JJ, Llorente C, Kehrmann L, Flamarique I, Zuddas A, Purper-Ouakil D, Hoekstra PJ, Coghill D, Schulze UME, Dittmann RW, Buitelaar JK, Castro-Fornieles J, Lievesley K, Santosh P, Arango C. Psychosocial risk factors for suicidality in children and adolescents. Eur Child Adolesc Psychiatry 2020; 29:759-776. [PMID: 30684089 PMCID: PMC7305074 DOI: 10.1007/s00787-018-01270-9] [Citation(s) in RCA: 151] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/20/2018] [Indexed: 12/28/2022]
Abstract
Suicidality in childhood and adolescence is of increasing concern. The aim of this paper was to review the published literature identifying key psychosocial risk factors for suicidality in the paediatric population. A systematic two-step search was carried out following the PRISMA statement guidelines, using the terms 'suicidality, suicide, and self-harm' combined with terms 'infant, child, adolescent' according to the US National Library of Medicine and the National Institutes of Health classification of ages. Forty-four studies were included in the qualitative synthesis. The review identified three main factors that appear to increase the risk of suicidality: psychological factors (depression, anxiety, previous suicide attempt, drug and alcohol use, and other comorbid psychiatric disorders); stressful life events (family problems and peer conflicts); and personality traits (such as neuroticism and impulsivity). The evidence highlights the complexity of suicidality and points towards an interaction of factors contributing to suicidal behaviour. More information is needed to understand the complex relationship between risk factors for suicidality. Prospective studies with adequate sample sizes are needed to investigate these multiple variables of risk concurrently and over time.
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Affiliation(s)
- J. J. Carballo
- grid.4795.f0000 0001 2157 7667Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - C. Llorente
- grid.4795.f0000 0001 2157 7667Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - L. Kehrmann
- grid.4795.f0000 0001 2157 7667Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - I. Flamarique
- grid.410458.c0000 0000 9635 9413Child and Adolescent Psychiatry and Psychology Department, 2014SGR489, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, Barcelona, Spain
| | - A. Zuddas
- grid.7763.50000 0004 1755 3242Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, and “A. Cao” Paediatric Hospital, “G. Brotzu” Hospital Trust, Cagliari University Hospital, Cagliari, Italy
| | - D. Purper-Ouakil
- grid.414352.5CHRU Montpellier, Hôpital Saint Eloi, Médecine Psychologique de l’Enfant et de l’Adolescent, Montpellier, France
| | - P. J. Hoekstra
- grid.4494.d0000 0000 9558 4598Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - D. Coghill
- grid.1008.90000 0001 2179 088XDepartment of Paediatrics, School of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Psychiatry, School of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia ,grid.1058.c0000 0000 9442 535XMurdoch Children’s Research Institute, Melbourne, Australia ,grid.8241.f0000 0004 0397 2876Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK
| | - U. M. E. Schulze
- grid.6582.90000 0004 1936 9748Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - R. W. Dittmann
- grid.7700.00000 0001 2190 4373Paediatric Psychopharmacology, Department of Child and Adolescent Psychiatry, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - J. K. Buitelaar
- grid.10417.330000 0004 0444 9382Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, and Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - J. Castro-Fornieles
- grid.410458.c0000 0000 9635 9413Child and Adolescent Psychiatry and Psychology Department, 2014SGR489, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, Barcelona, Spain ,grid.418264.d0000 0004 1762 4012Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain
| | - K. Lievesley
- grid.13097.3c0000 0001 2322 6764Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Foundation Trust, London, UK ,HealthTracker Ltd, Gillingham, Kent UK
| | - Paramala Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK. .,Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Foundation Trust, London, UK. .,HealthTracker Ltd, Gillingham, Kent, UK.
| | - C. Arango
- grid.4795.f0000 0001 2157 7667Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
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Grendas LN, Rojas SM, Rodante DE, Puppo S, Vidjen P, Portela A, Daray FM. Differential Impact of Child Sexual Abuse and Family History of Suicidal Behavior in High-Risk Suicidal Patients. Arch Suicide Res 2020; 24:S251-S263. [PMID: 30955484 DOI: 10.1080/13811118.2019.1592040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The current study aimed to compare suicide-related variables as a function of 1) family history of suicidal behavior and 2) child sexual abuse among patients hospitalized for a suicide attempt or active suicidal ideation. Family history of suicidal behavior and child sexual abuse were examined independently and in combination as a diathesis for a high-risk suicidal phenotype. A multicenter cross-sectional study was designed to compare data obtained from 292 patients hospitalized for suicidal behavior. Demographic and clinical variables were compared among Group 1 (patients who reported both family history of suicidal behavior and child sexual abuse), Group 2 (patients who reported only family history of suicidal behavior), Group 3 (patients who reported only child sexual abuse), and Group 4 (patients who did not report family history of suicidal behavior or childhood sexual abuse). A multinomial logistic regression was used to examine suicide-related variables associated with each group and to compare differences between groups. Group 1 and 3 endorsed a higher number of previous suicide attempts and were more likely to be younger at the first suicide attempt compared to Group 4. Group differences remained after adjustment in a multinomial regression model. The current findings suggest that child sexual abuse may be more strongly related to suicide risk among high risk patients than family history of suicidal behavior.
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Affiliation(s)
- Leandro N Grendas
- Institute of Pharmacology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.,"Dr. Teodoro Álvarez" General Hospital. Dr. Juan Felipe Aranguren 2701, Buenos Aires, Argentina
| | - Sasha M Rojas
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
| | - Demián E Rodante
- Institute of Pharmacology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.,"Dr. Braulio A. Moyano" Neuropsychiatric Hospital, Buenos Aires, Argentina
| | - Soledad Puppo
- "José de San Martín" Hospital, Buenos Aires, Argentina
| | | | | | - Federico M Daray
- Institute of Pharmacology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.,"Dr. Braulio A. Moyano" Neuropsychiatric Hospital, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
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32
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Gawęda Ł, Pionke R, Krężołek M, Frydecka D, Nelson B, Cechnicki A. The interplay between childhood trauma, cognitive biases, psychotic-like experiences and depression and their additive impact on predicting lifetime suicidal behavior in young adults. Psychol Med 2020; 50:116-124. [PMID: 30626466 DOI: 10.1017/s0033291718004026] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Childhood trauma, psychosis risk, cognition, and depression have been identified as important risk markers for suicidal behaviors. However, little is known about the interplay between these distal and proximal markers in influencing the risk of suicide. We aim to investigate the interplay between childhood trauma, cognitive biases, psychotic-like experiences (PLEs) and depression in predicting suicidal behaviors in a non-clinical sample of young adults. METHODS In total, 3495 young adults were recruited to an online computer-assisted web interview. We used the Prodromal Questionnaire to assess PLEs. Childhood trauma was assessed with the Traumatic Experience Checklist (three items) and Childhood Experience of Care and Abuse Questionnaire (CECA.Q, three items). Cognitive biases were assessed with a short version of the Davos Assessment of Cognitive Biases Scale. Suicidality, psychiatric diagnoses, and substance use were screened with a self-report questionnaire. RESULTS Childhood trauma, as well as PLEs, was associated with an approximately five-fold increased risk of suicidal thoughts and plans as well as suicide attempts. Participants with depression were six times more likely to endorse suicidal behaviors. Path analysis revealed that PLEs, depression and cognitive biases are significant mediators of the relationship between trauma and suicidal behaviors. The model explained 44.6% of the variance in lifetime suicidality. CONCLUSIONS Cognitive biases, PLEs, and depression partially mediate the relationship between childhood trauma and suicidal behaviors. The interplay between distal and proximal markers should be recognized and become part of clinical screening and therapeutic strategies for preventing risk of suicidality.
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Affiliation(s)
- Łukasz Gawęda
- Psychopathology and Early Intervention Lab, II Department of Psychiatry, the Medical University of Warsaw, Warsaw, Poland
| | - Renata Pionke
- Psychopathology and Early Intervention Lab, II Department of Psychiatry, the Medical University of Warsaw, Warsaw, Poland
| | - Martyna Krężołek
- Psychopathology and Early Intervention Lab, II Department of Psychiatry, the Medical University of Warsaw, Warsaw, Poland
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrzej Cechnicki
- Department of Community Psychiatry, Chair of Psychiatry, Medical College Jagiellonian University, Krakow, Poland
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Baharikhoob P, Kolla NJ. Microglial Dysregulation and Suicidality: A Stress-Diathesis Perspective. Front Psychiatry 2020; 11:781. [PMID: 32848946 PMCID: PMC7432264 DOI: 10.3389/fpsyt.2020.00781] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/22/2020] [Indexed: 12/11/2022] Open
Abstract
According to the stress-diathesis model of suicidal behavior, completed suicide depends on the interaction between psychosocial stressors and a trait-like susceptibility. While there are likely multiple biological processes at play in suicidal behavior, recent findings point to over-activation of microglia, the resident macrophages of the central nervous system, as implicated in stress-induced suicidal behavior. However, it remains unclear how microglial dysregulation can be integrated into a clinical model of suicidal behavior. Therefore, this narrative review aims to (1) examine the findings from human post-mortem and neuroimaging studies that report a relationship between microglial activation and suicidal behavior, and (2) update the clinical model of suicidal behavior to integrate the role of microglia. A systematic search of SCOPUS, PubMed, PsycINFO, and Embase databases revealed evidence of morphological alterations in microglia and increased translocator protein density in the brains of individuals with suicidality, pointing to a positive relationship between microglial dysregulation and suicidal behavior. The studies also suggested several pathological mechanisms leading to suicidal behavior that may involve microglial dysregulation, namely (1) enhanced metabolism of tryptophan to quinolinic acid through the kynurenine pathway and associated serotonin depletion; (2) increased quinolinic acid leading to excessive N-methyl-D-aspartate-signaling, resulting in potential disruption of the blood brain barrier; (3) increased quinolinic acid resulting in higher neurotoxicity, and; (4) elevated interleukin 6 contributing to loss of inhibition of glutamatergic neurons, causing heightened glutamate release and excitotoxicity. Based on these pathways, we reconceptualized the stress-diathesis theory of suicidal behavior to incorporate the role of microglial activity.
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Affiliation(s)
- Paria Baharikhoob
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health (CAMH) Research Imaging Centre and Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Violence Prevention Neurobiological Research Unit, CAMH, Toronto, ON, Canada
| | - Nathan J Kolla
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health (CAMH) Research Imaging Centre and Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Violence Prevention Neurobiological Research Unit, CAMH, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Waypoint Centre for Mental Health Care, Waypoint Research Institute, Penetanguishene, ON, Canada
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Paul E, Ortin A. Psychopathological mechanisms of early neglect and abuse on suicidal ideation and self-harm in middle childhood. Eur Child Adolesc Psychiatry 2019; 28:1311-1319. [PMID: 30783774 DOI: 10.1007/s00787-019-01287-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 02/04/2019] [Indexed: 10/27/2022]
Abstract
Informed by diathesis-stress models of suicide risk, this longitudinal study examines the psychopathological mechanisms through which early maltreatment increases the risk for suicidal ideation and self-harm in middle childhood. The sample included 2958 families from the Fragile Families and Child Wellbeing Study, who participated in interviews at child's ages of 3 and/or 5, and 9. Via the Child Behavior Checklist, primary caregivers reported on the child's suicidal ideation and self-harm at age 9 and on clinically elevated depressive/anxious symptoms, aggressive behaviors, attention problems, and comorbid aggression and depressive/anxious symptoms at age 5. Past year neglect and physical/psychological abuse were measured via the Parent-Child Conflict Tactics Scale at age 3. Multivariate structural equation models indicated that early neglect had a significant indirect effect on suicidal ideation via clinically elevated depressive/anxious symptoms (OR = 1.57, 95% CI 1.09-2.25) and comorbid symptomatology (OR = 1.28, 95% CI 1.02-1.62), and on self-harm also via clinically elevated depressive/anxious symptoms (OR = 1.39, 95% CI 1.04-1.84) and comorbid symptomatology (OR = 1.20, 95% CI 1.01-1.43). Early physical/psychological abuse had a significant indirect effect on self-harm via clinically elevated attention problems (OR = 1.09, 95% CI 1.01-1.21). Unique developmental pathways for suicidal ideation and self-harm emerged among children exposed to abuse or neglect. For those exposed to early neglect, interventions should target depressive/anxious symptoms, especially when comorbid with aggression, to prevent suicidal ideation and self-harm. For children exposed to early physical/psychological abuse, problems with attention and impulsivity may be targets for reducing the risk for self-harm.
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Affiliation(s)
- Elise Paul
- G87 Martha van Rensselaer Hall, Cornell University, Ithaca, NY, 14850, USA. .,Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
| | - Ana Ortin
- Department of Psychology, Hunter College, City University of New York, New York City, USA
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Musci RJ, Augustinavicius JL, Volk H. Gene-Environment Interactions in Psychiatry: Recent Evidence and Clinical Implications. Curr Psychiatry Rep 2019; 21:81. [PMID: 31410638 PMCID: PMC7340157 DOI: 10.1007/s11920-019-1065-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW We identify the recent evidence for gene-by-environment interaction studies in relation to psychiatric disorders. We focus on the key genotypic data as well as environmental exposures and how they interact to predict psychiatric disorders and psychiatric symptomatology. We direct our focus on the psychiatric outcomes that were focused on by the Psychiatric Genetics Consortium. RECENT FINDINGS Many of the studies focus on candidate gene approaches, with most of the studies drawing upon previous literature to decide the genes of interest. Other studies used a genome-wide approach. While some studies demonstrated positive replication of previous findings, replication is still an issue within gene-by-environment interaction studies. Gene-by-environment interaction research in psychiatry globally suggests some susceptibility to environmental exposures based on genotype; however, greater clarity is needed around the idea that genetic risk may not be disorder specific.
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Affiliation(s)
- Rashelle J. Musci
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA
| | - Jura L. Augustinavicius
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA
| | - Heather Volk
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA
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Segura AG, Mitjans M, Jiménez E, Fatjó-Vilas M, Ruiz V, Saiz PA, García-Portilla MP, González-Blanco L, Bobes J, Vieta E, Benabarre A, Arias B. Association of childhood trauma and genetic variability of CRH-BP and FKBP5 genes with suicidal behavior in bipolar patients. J Affect Disord 2019; 255:15-22. [PMID: 31195252 DOI: 10.1016/j.jad.2019.05.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/03/2019] [Accepted: 05/07/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Around 8% of bipolar disorder (BD) patients die by suicide every year, accounting for the highest rate among the psychiatric population. Suicidal behavior (SB) is mediated by an intertwining system of extrinsic and intrinsic factors. Childhood trauma (CT) and gene variants of the stress-management hypothalamic-pituitary-adrenal (HPA) axis have been reported as risk factors for SB. The aim of this study was to elucidate the association of CT and HPA axis genetic variants with SB. METHODS 135 BD patients were recruited for clinical assessment of CT and SB by means of the Childhood Trauma Questionnaire (CTQ) and the Columbia Suicide Severity Rating Scale (C-SSRS), respectively. A total of 28 single nucleotide polymorphisms (SNPs) from 8 HPA axis genes (POMC, NR3C2, CRH-BP, NR3C1, FKBP5, CRHR2, CRHR1, and MC2R) were genotyped. RESULTS The analyses showed an association of total CTQ score (p = 0.003), emotional abuse (p = 0.001), sexual abuse (p = 0.005) and emotional neglect (p = 0.005) with SB. CRH-BP rs7728378-C carriers (p = 0.004; OR = 3.05), FKBP5 rs3777747-AA (p = 0.039; OR = 0.34) and FKBP5 rs2766533-GG genotypes (p = 0.001; OR = 2.93) were associated with SB although only rs2766533 survived multiple test correction. No gene-environment interaction was found. LIMITATIONS The relatively small sample size limits the statistical power to detect smaller environmental and genetic effects. Cross-sectional data collection in psychometric assessments can yield biased data. CONCLUSIONS The present study characterizes novel SB risk factors and replicates previous findings in BD patients. CT and variability in CRH-BP and FKBP5 genes should be further studied for a better understanding of SB and ultimately help in suicide prevention.
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Affiliation(s)
- A G Segura
- Departament Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, IBUB, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - M Mitjans
- Departament Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, IBUB, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - E Jiménez
- Bipolar Disorder Unit, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M Fatjó-Vilas
- Departament Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, IBUB, University of Barcelona, CIBERSAM, Barcelona, Spain; FIDMAG Germanes Hospitalaries Research Foundation, CIBERSAM, Barcelona, Spain
| | - V Ruiz
- Institut Clínic de Neurociencies, Hospital Clínic, Barcelona, Spain
| | - P A Saiz
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto de Neurociencias del Principado de Asturias (INEUROPA), Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - M P García-Portilla
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto de Neurociencias del Principado de Asturias (INEUROPA), Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - L González-Blanco
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto de Neurociencias del Principado de Asturias (INEUROPA), Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - J Bobes
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto de Neurociencias del Principado de Asturias (INEUROPA), Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - E Vieta
- Bipolar Disorder Unit, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Benabarre
- Bipolar Disorder Unit, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Arias
- Departament Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, IBUB, University of Barcelona, CIBERSAM, Barcelona, Spain.
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An examination of genes, stress and suicidal behavior in two First Nations communities: The role of the brain-derived neurotropic factor gene. Psychiatry Res 2019; 275:247-252. [PMID: 30933702 DOI: 10.1016/j.psychres.2019.02.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 02/14/2019] [Accepted: 02/15/2019] [Indexed: 12/14/2022]
Abstract
Suicide claims over 800,000 lives each year worldwide. Suicide rates in indigenous populations in Canada are about double that of the national average, making it a serious public health issue. Numerous factors are involved in suicide risk, including genetic factors, as well as various psychosocial stressors, such as historical experience with the Indian Residential School system for Indigenous populations, as well as protective variables such as social support. Here, we report the first genetic study of suicidal behaviors that includes multiple measures of stress and social supports. We investigated the role of the functional Val66Met marker (rs6265) in the Brain-Derived Neurotropic Factor (BDNF) gene in suicidal ideation and suicide attempt in a First Nations community sample (N = 278). We did not find a significant association between the BDNF rs6265 marker and suicidal behaviors. We found childhood adversities, recent life stress, chronic stress, perceived stress, difficulties, and hazardous alcohol use to be associated with both suicidal ideation and suicide attempt. Thus, while additional studies with larger samples are required to elucidate the genetic component of suicide, addressing environmental stressors may be important for suicide prevention.
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38
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Lebowitz ER, Blumberg HP, Silverman WK. Negative peer social interactions and oxytocin levels linked to suicidal ideation in anxious youth. J Affect Disord 2019; 245:806-811. [PMID: 30699863 PMCID: PMC6361537 DOI: 10.1016/j.jad.2018.11.070] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 09/26/2018] [Accepted: 11/05/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Anxious youth are at risk for negative peer interactions including peer victimization, and for suicidal ideation. However, data about the pattern of association between these two factors are scarce. In this study we examined the association between negative peer interactions and suicidal ideation in a sample of children and adolescents with anxiety disorders, and whether oxytocin, which has been shown to enhance the impact of social events, moderates the impact of negative peer interactions on suicidal ideation. METHOD Participants were 168 youths with primary anxiety disorders. All participants were assessed with semi-structured diagnostic interviews, and with self-report measures of suicidal ideation, negative peer interactions, anxiety, and depression. The anxious youths' salivary oxytocin levels were measured with immunoassay. RESULTS Thirty percent of the anxious youths reported suicidal ideation, with suicidal ideation severity associated with negative peer social interactions and depressive symptoms. Consistent with past data indicating that oxytocin enhances the impact of social events, the association between peer negative social interactions and suicidal ideation was stronger in youths with high oxytocin levels than in youths with low levels (i.e., moderation). LIMITATIONS Assessment focused on suicidal ideation and data on suicidal behavior were not available. Limitations inherent to immunoassay measurement of peripheral oxytocin levels are noted. CONCLUSION Negative peer interactions are associated with suicidal ideation in youth with anxiety disorders, and the association is stronger in youth with high oxytocin levels.
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Affiliation(s)
- Eli R Lebowitz
- Child Study Center, Yale School of Medicine, 230 S. Frontage Rd., New Haven, CT 06520, United States.
| | - Hilary P Blumberg
- Child Study Center, Yale School of Medicine, 230 S. Frontage Rd., New Haven, CT 06520, United States; Departments of Psychiatry and Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06520, United States
| | - Wendy K Silverman
- Child Study Center, Yale School of Medicine, 230 S. Frontage Rd., New Haven, CT 06520, United States
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Paul E, Ortin A. Correlates of Suicidal Ideation and Self-harm in Early Childhood in a Cohort at Risk for Child Abuse and Neglect. Arch Suicide Res 2019; 23:134-150. [PMID: 29281595 DOI: 10.1080/13811118.2017.1413468] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES This study provides prevalence and persistence rates of suicidal ideation and self-harm, and examines how child maltreatment types, mental health symptoms, and age 4 suicidal ideation and self-harm are associated with each suicidal outcome among 6-year-old children. METHODS Participants were 1,090 caregivers assessed when their children were 4 and 6 years old from the Longitudinal Studies of Child Abuse and Neglect. Data were collected from the Child Behavior Checklist, Parent-Child Conflict Tactics Scales, and Child Protective Services. RESULTS Persistence rates within each suicidal outcome were high. Failure to provide -a physical neglect subtype- was the only maltreatment type that independently predicted self-harm. Depressive/anxious symptoms and age 4 suicidal ideation were independently associated with age 6 suicidal ideation, whereas attention problems and age 4 self-harm predicted age 6 self-harm. CONCLUSION Our findings align with the consensus emerging from adolescent studies that risk factors associate differentially with suicidal ideation and self-harm.
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Paul E. Proximally-occurring life events and the first transition from suicidal ideation to suicide attempt in adolescents. J Affect Disord 2018; 241:499-504. [PMID: 30149338 DOI: 10.1016/j.jad.2018.08.059] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 07/31/2018] [Accepted: 08/12/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Informed by diathesis-stress models of suicide risk, this paper investigated the role of proximally-occurring stressful life events in the first transition from suicidal ideation to suicide attempt in adolescence. Interactions between stressful life events and psychiatric disorders in relation to this progression were also examined. METHODS Data are from a subsample (N = 928) of adolescents with lifetime suicidal ideation from the National Comorbidity Survey-Adolescent Supplement. Logistic regression analyses compared adolescents who had transitioned to a first suicide attempt (n = 81) in the year prior to the study to adolescents with suicidal ideation only (n = 847). RESULTS Multivariate logistic regressions implicated increased risk for progression from suicidal ideation to a first suicide attempt in the presence of a recent romantic break-up as well as more recent stressful life events. However, among adolescents with suicidal ideation and either a recent romantic break-up or above-average recent stressors, neither a disruptive behavior disorder, mood disorder, nor a substance use disorder intensified the risk for progressing to a first suicide attempt. LIMITATIONS Analyses are cross-sectional and therefore limit causal inferences. CONCLUSIONS Findings underscore the importance of comprehensive suicide risk evaluations that consider proximally-occurring interpersonal stressors which may influence the first transition from thinking about suicide to acting in adolescence.
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Affiliation(s)
- Elise Paul
- Department of Human Development, Cornell University, G78 Martha van Rensselaer Hall, Ithaca, NY 14853, United States.
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41
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De Berardis D, Fornaro M, Valchera A, Cavuto M, Perna G, Di Nicola M, Serafini G, Carano A, Pompili M, Vellante F, Orsolini L, Fiengo A, Ventriglio A, Yong-Ku K, Martinotti G, Di Giannantonio M, Tomasetti C. Eradicating Suicide at Its Roots: Preclinical Bases and Clinical Evidence of the Efficacy of Ketamine in the Treatment of Suicidal Behaviors. Int J Mol Sci 2018; 19:E2888. [PMID: 30249029 PMCID: PMC6213585 DOI: 10.3390/ijms19102888] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/19/2018] [Indexed: 12/22/2022] Open
Abstract
Despite the continuous advancement in neurosciences as well as in the knowledge of human behaviors pathophysiology, currently suicide represents a puzzling challenge. The World Health Organization (WHO) has established that one million people die by suicide every year, with the impressive daily rate of a suicide every 40 s. The weightiest concern about suicidal behavior is how difficult it is for healthcare professionals to predict. However, recent evidence in genomic studies has pointed out the essential role that genetics could play in influencing person's suicide risk. Combining genomic and clinical risk assessment approaches, some studies have identified a number of biomarkers for suicidal ideation, which are involved in neural connectivity, neural activity, mood, as well as in immune and inflammatory response, such as the mammalian target of rapamycin (mTOR) signaling. This interesting discovery provides the neurobiological bases for the use of drugs that impact these specific signaling pathways in the treatment of suicidality, such as ketamine. Ketamine, an N-methyl-d-aspartate glutamate (NMDA) antagonist agent, has recently hit the headlines because of its rapid antidepressant and concurrent anti-suicidal action. Here we review the preclinical and clinical evidence that lay the foundations of the efficacy of ketamine in the treatment of suicidal ideation in mood disorders, thereby also approaching the essential question of the understanding of neurobiological processes of suicide and the potential therapeutics.
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Affiliation(s)
- Domenico De Berardis
- National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, "G. Mazzini" Hospital, p.zza Italia 1, 64100 Teramo, Italy.
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University "G. D'Annunzio", 66100 Chieti, Italy.
| | - Michele Fornaro
- Polyedra Research Group, 64100 Teramo, Italy.
- Department of Neuroscience, Reproductive Science and Odontostomatology, School of Medicine 'Federico II' Naples, 80121 Naples, Italy.
| | - Alessandro Valchera
- Polyedra Research Group, 64100 Teramo, Italy.
- Villa S. Giuseppe Hospital, Hermanas Hospitalarias, 63100 Ascoli Piceno, Italy.
| | - Marilde Cavuto
- Department of Theory, Analysis and Composition, Music Conservatory "L. Canepa", 07100 Sassari, Italy.
| | - Giampaolo Perna
- Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, 22032 Como, Italy.
- Department of Psychiatry and Neuropsychology, University of Maastricht, 6221 Maastricht, The Netherlands.
- Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, Coral Gables, FL 33114, USA.
| | - Marco Di Nicola
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, 00118 Rome, Italy.
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy.
| | - Alessandro Carano
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "Madonna Del Soccorso", A.S.U.R. 12, 63074 San Benedetto del Tronto, Italy.
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, 00118 Rome, Italy.
| | - Federica Vellante
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University "G. D'Annunzio", 66100 Chieti, Italy.
| | - Laura Orsolini
- Polyedra Research Group, 64100 Teramo, Italy.
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, College Lane Campus, University of Hertfordshire, Hatfield SG141LZ, UK.
| | - Annastasia Fiengo
- Polyedra Research Group, 64100 Teramo, Italy.
- NHS, Department of Mental Health ASUR Marche AV5, Mental Health Unit, 63100 Ascoli Piceno, Italy.
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, 71121 Foggia, Italy.
| | - Kim Yong-Ku
- Department of Psychiatry, Korea University College of Medicine, Seoul 08826, Korea.
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University "G. D'Annunzio", 66100 Chieti, Italy.
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University "G. D'Annunzio", 66100 Chieti, Italy.
| | - Carmine Tomasetti
- Polyedra Research Group, 64100 Teramo, Italy.
- Department of Neuroscience, Reproductive Science and Odontostomatology, School of Medicine 'Federico II' Naples, 80121 Naples, Italy.
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da Silva AG, Malloy-Diniz LF, Garcia MS, Figueiredo CGS, Figueiredo RN, Diaz AP, Palha AP. Cognition As a Therapeutic Target in the Suicidal Patient Approach. Front Psychiatry 2018; 9:31. [PMID: 29487542 PMCID: PMC5816899 DOI: 10.3389/fpsyt.2018.00031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 01/26/2018] [Indexed: 12/16/2022] Open
Abstract
The current considerations about completed suicides and suicide attempts in different cultures call the attention of professionals to this serious public health problem. Integrative approaches have shown that the confluence of multiple biological and social factors modulate various psychopathologies and dysfunctional behaviors, such as suicidal behavior. Considering the level of intermediate analysis, personality traits and cognitive functioning are also of great importance for understanding the suicide phenomenon. About cognitive factors, we can group them into cognitive schemas of reality interpretation and underlying cognitive processes. On the other hand, different types of primary cognitive alterations are related to suicidal behavior, especially those resulting from changes in frontostriatal circuits. Among such cognitive mechanisms can be highlighted the attentional bias for environmental cues related to suicide, impulsive behavior, verbal fluency deficits, non-adaptive decision-making, and reduced planning skills. Attentional bias consists in the effect of thoughts and emotions, frequently not conscious, about the perception of environmental stimuli. Suicidal ideation and hopelessness can make the patient unable to find alternative solutions to their problems other than suicide, biasing their attention to environmental cues related to such behavior. Recent research efforts are directed to assess the possible use of attention bias as a therapeutic target in patients presenting suicide behavior. The relationship between impulsivity and suicide has been largely investigated over the last decades, and there is still controversy about the theme. Although there is strong evidence linking impulsivity to suicide attempts. Effective interventions address to reduce impulsivity in clinical populations at higher risk for suicide could help in the prevention. Deficits in problem-solving ability also seem to be distorted in patients who attempt suicide. Understanding cognitive changes in patients who attempt suicide open an important perspective in the approach of patients with mental disorders. Identifying cognitive deficits in these patients, along with personality traits, depressive symptoms, and suicidal cognitive schemas may indicate to the psychiatrist the need for emergency care. Behavioral and cognitive interventions have been associated with reductions in suicide ideation, as well as suicide attempts in different populations.
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Affiliation(s)
| | | | - Marina Saraiva Garcia
- Molecular Medicine Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Pan YJ, Juang KD, Lu SR, Chen SP, Wang YF, Fuh JL, Wang SJ. Longitudinal risk factors for suicidal thoughts in depressed and non-depressed young adolescents. Aust N Z J Psychiatry 2017; 51:930-937. [PMID: 28701051 DOI: 10.1177/0004867417717795] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Evidence regarding the role of risk factors in the longitudinal course of suicidal ideation among young adolescents is lacking. We aimed to assess the effects of a range of risk factors, including obesity, academic performance, child-parent relationship, physical maltreatment, and depressive symptoms, on the development of suicidal ideation in young adolescents. METHODS A school cohort of seventh and eighth graders was followed for 1 year and differences in the risk factors distributions were examined between depressed and non-depressed adolescents. We further examined risk factors for newly developed suicidal ideation and persistent suicidal ideation in the groups of adolescents based on the presence of suicidal ideation at baseline. RESULTS A total of 1710 young adolescents were recruited, among whom 8.2% were categorised as having clinically significant depression. For depressed adolescents, being obese was associated with a three-fold increased risk of having suicidal ideation. For non-depressed adolescents, physical maltreatment, a feeling of not being cared about and sub-threshold depressive symptoms were the risk factors. The latter two remained robust in predicting newly developed suicidal ideation. CONCLUSION The current study may shed light on the differential strategies to address suicidal thoughts in depressed and non-depressed adolescents. We emphasise the importance of recognition and management of sub-threshold depressive symptoms and the relevance of obesity, physical maltreatment and a feeling of not being cared about to suicide prevention programmes in early adolescence.
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Affiliation(s)
- Yi-Ju Pan
- 1 Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,2 Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kai-Dih Juang
- 2 Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,3 Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shiang-Ru Lu
- 4 Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shih-Pin Chen
- 2 Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,5 Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yen-Feng Wang
- 2 Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,5 Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jong-Ling Fuh
- 2 Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,5 Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shuu-Jiun Wang
- 2 Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,5 Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
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Bernanke JA, Stanley BH, Oquendo MA. Toward fine-grained phenotyping of suicidal behavior: the role of suicidal subtypes. Mol Psychiatry 2017; 22:1080-1081. [PMID: 28607457 PMCID: PMC5785781 DOI: 10.1038/mp.2017.123] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- J A Bernanke
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - B H Stanley
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - M A Oquendo
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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45
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Choi NG, DiNitto DM, Marti CN, Segal SP. Adverse childhood experiences and suicide attempts among those with mental and substance use disorders. CHILD ABUSE & NEGLECT 2017; 69:252-262. [PMID: 28500922 DOI: 10.1016/j.chiabu.2017.04.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 04/03/2017] [Accepted: 04/24/2017] [Indexed: 06/07/2023]
Abstract
Using the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions data, we examined the associations of ten types of adverse childhood experiences (ACEs) with (1) lifetime suicide attempts and (2) number and age of attempts among U.S. adults aged 18+. In a case-control design, suicide attempters (5.14% of the full sample) were matched with never attempters (matched sample N=3912) on nine mental and substance use disorders. ACE rates were higher among attempters (3.30 [SE=0.07]) than their matched controls (2.19 [SE=0.06]). Results from multivariable logistic regression analyses showed that sexual abuse and parental/other family member's mental illness were associated with increased odds of having attempted suicide among both genders, and emotional neglect was also a factor for men. Population attributable risk fractions for sexual abuse were 25.75% for women and 8.56% for men. Sexual abuse and a higher number of ACEs were also related to repeated suicide attempts. A higher number of ACEs was associated with a younger first attempt age. Gay/bisexual orientation in men and the lack of college education in both genders were significant covariates. In conclusion, this study underscores that ACEs are significantly associated with lifetime suicide attempts even when mental and substance use disorders are controlled.
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Affiliation(s)
- Namkee G Choi
- University of Texas at Austin School of Social Work, 1925 San Jacinto Blvd, Austin, TX 78712, United States.
| | - Diana M DiNitto
- University of Texas at Austin School of Social Work, 1925 San Jacinto Blvd, Austin, TX 78712, United States
| | - C Nathan Marti
- University of Texas at Austin School of Social Work, 1925 San Jacinto Blvd, Austin, TX 78712, United States
| | - Steven P Segal
- Univeristy of California at Berkeley School of Social Welfare, 120 Haviland Hall #7400, Berkeley, CA 94720-7400, United States
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46
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Beutel ME, Tibubos AN, Klein EM, Schmutzer G, Reiner I, Kocalevent RD, Brähler E. Childhood adversities and distress - The role of resilience in a representative sample. PLoS One 2017; 12:e0173826. [PMID: 28296938 PMCID: PMC5351992 DOI: 10.1371/journal.pone.0173826] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 02/26/2017] [Indexed: 12/20/2022] Open
Abstract
While adverse childhood experiences have been shown to contribute to adverse health outcomes in adulthood, specifically distress and somatic symptoms, few studies have examined their joint effects with resilient coping style on adult adjustment. Hence, we aim to determine the association between resilient coping and distress in participants with and without reported childhood adversities. A representative German community sample (N = 2508) between 14–92 years (1334 women; 1174 men) was examined by the short form of the Childhood Trauma Questionnaire, the Brief Resilience Coping Scale, standardized scales of distress and somatoform symptoms. Childhood adversity was associated with reduced adjustment, social support and resilience. It was also strongly associated with increased distress and somatoform complaints. Resilient coping was not only associated with lower distress, it also buffered the effects of childhood adversity on distress. Our study corroborates the buffering effect of resilience in a representative German sample. High trait resilient subjects show less distress and somatoform symptoms despite reported childhood adversities in comparison to those with low resilient coping abilities.
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Affiliation(s)
- Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ana N. Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- * E-mail:
| | - Eva M. Klein
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Gabriele Schmutzer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Iris Reiner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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