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Heuschen CBBCM, Bolhuis K, Zantvoord JB, Bockting CL, Denys DAJP, Lok A, Arango C, Arrojo M, Bernardo M, Bobes J, Del-Ben CM, Di Forti M, Gayer-Anderson C, Jones PB, Jongsma HE, Kirkbride JB, La Cascia C, Lasalvia A, Tosato S, Llorca PM, Menezes PR, Murray RM, Quattrone D, Rutten BP, Sanjuán J, Selten JP, Szöke A, Tarricone I, Tortelli A, Velthorst E, de Haan L, Schirmbeck F. Self-reported suicidal ideation among individuals with first episode psychosis and healthy controls: Findings from the international multicentre EU-GEI study. Schizophr Res 2024; 270:339-348. [PMID: 38968805 DOI: 10.1016/j.schres.2024.06.041] [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: 03/24/2023] [Revised: 04/24/2024] [Accepted: 06/22/2024] [Indexed: 07/07/2024]
Abstract
INTRODUCTION Suicidal ideation is common among individuals with first episode psychosis (FEP), with prevalence estimates up to 56.5 %. Despite its high prevalence, relatively little is known about how sociodemographic, clinical and/or developmental characteristics contribute to the experience of suicidal ideation in individuals with FEP. METHODS In this cross-sectional study (FEP n = 551 and controls n = 857), univariate logistic regression analyses were performed to study the associations of sociodemographic, clinical, and developmental factors with suicidal ideation in individuals with FEP as well as controls. Suicidal ideation was assessed using the Community Assessment of Psychic Experiences (CAPE). In addition, multivariate logistic regression analyses were conducted based on a stepwise approach. RESULTS In FEP, only depressive symptoms remained significantly associated with suicidal ideation when all correlates were integrated into one model. In the multivariate model in controls, depressive symptoms, positive symptoms, and traumatic childhood experiences were significantly associated with suicidal ideation. CONCLUSIONS This study showed that depressive symptoms are an important factor relating to suicidal ideation in individuals with FEP, over and above other clinical, sociodemographic, and developmental factors. This underscores the relevance of screening for suicidal ideation in individuals with FEP, and highlights the need for a better understanding of the diagnostic uncertainty and course of mood symptoms in early psychosis. LIMITATIONS Cross-sectional study design, self-reported questionnaires.
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Affiliation(s)
- C B B C M Heuschen
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands.
| | - K Bolhuis
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - J B Zantvoord
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - C L Bockting
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - D A J P Denys
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - A Lok
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - C Arango
- Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañon, Universidad Complutense de Madrid, Spain
| | - M Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Spain; Complejo Hospitalario Universitario de Santiago de Compostela, Servizo de Psiquiatría Santiago de Compostela, Galicia, Spain
| | - M Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Department of Psychiatry and Psychology, Barcelona, Spain; Clinical Institute of Neuroscience, University of Barcelona, CIBERSAM, ISCIII, Barcelona, Spain
| | - J Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - C M Del-Ben
- Neuroscience and Behavior Department, Ribeirão Preto Medical School, University of São Paulo, Campus de Ribeirao Preto, Ribeirao Preto, Brazil
| | - M Di Forti
- Social Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - C Gayer-Anderson
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; ESRC Centre for Society and Mental Health, King's College London, London, United Kingdom
| | - P B Jones
- Department of Psychiatry, University of Cambridge, CAMEO, Cambridge shire & Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - H E Jongsma
- Centre for Transcultural Psychiatry 'Veldzicht', Balkbrug, the Netherlands; Psychosis Group, University Centre for Psychiatry, University Medical Centre Groningen, Groningen, the Netherlands
| | - J B Kirkbride
- Division of Psychiatry, University College London, London, United Kingdom
| | - C La Cascia
- Dept. Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - A Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - S Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - P M Llorca
- University Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Clermont-Ferrand, France; Institute Pascal, F-63000 Clermont-Ferrand, France
| | - P R Menezes
- Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - R M Murray
- Institute of Psychiatry, Psychology and Neuroscience, King's College, De Crespigny Park, London SE5 8AF, United Kingdom
| | - D Quattrone
- Social Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, United Kingdom
| | - B P Rutten
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences Brain and Nerve Centre, Department of Psychiatry & Neuropsychology, Maastricht University, MUMC+, Maastricht, the Netherlands
| | - J Sanjuán
- Faculty of Medicine, Psychiatry, Valencia, Spain
| | - J P Selten
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences Brain and Nerve Centre, Department of Psychiatry & Neuropsychology, Maastricht University, MUMC+, Maastricht, the Netherlands; Rivierduinen Psychiatric Institute, Sandifortdreef 19, 2333 ZZ Leiden, the Netherlands
| | - A Szöke
- Paris University Hospital Group for Psychiatry and Neurosciences, University Paris, Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires, DMU IMPACT, Fondation Fondamental, F-94010 Creteil, France
| | - I Tarricone
- University of Bologna, Department of Medical and Surgical Sciences, Psychiatry Unit, Alma Mater Studiorum, Viale Pepoli 5, Bologna, Italy
| | - A Tortelli
- Etablissement Public de Sante Maison Blanche, GHU Psychiatrie Neurosciences Paris, INSERM U-955, Paris, France
| | - E Velthorst
- Community Mental Health Department, GGZ Noord-Holland-Noord, Heerhugowaard, the Netherlands
| | - L de Haan
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - F Schirmbeck
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Richardson R, Connell T, Foster M, Blamires J, Keshoor S, Moir C, Zeng IS. Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis. J Youth Adolesc 2024; 53:1301-1322. [PMID: 38564099 PMCID: PMC11045640 DOI: 10.1007/s10964-024-01969-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 03/02/2024] [Indexed: 04/04/2024]
Abstract
Suicide remains the second most common cause of death in young people aged 10-24 years and is a growing concern globally. The literature reports a vast number of factors that can predispose an adolescent to suicidality at an individual, relational, community, or societal level. There is limited high-level research identifying and understanding these risk and protective factors of adolescent suicidality. The present study used an umbrella review and meta-analysis to synthesize evidence from the review literature in the past 20 years on risk and protective factors of self-harm and suicidality (behavior and ideation) in adolescents. The umbrella review included 33 quantitative reviews with 1149 individual studies on suicidality and self-harm. Based on the data synthesis, it compared the public health impact of exposure on the population of the identified exposure. Bullying victimization was the most attributed environmental exposure for suicidality. The other identified significant school and individual factors were sleeping disturbance, school absenteeism, and exposure to antidepressants. Several significant vulnerable young populations were identified with significantly higher prevalence of suicidality, including lesbian, gay, bisexual, transgender, queer (or questioning) youth and those with mental health disorders, problem behaviors, previous suicidality, self-harm, and gender (female). A person-centered approach emphasizing connectedness and bully-free school environments should be a priority focus for schools, health professionals, and public health policymakers.
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Affiliation(s)
- Rebecca Richardson
- Faculty of Health and Environmental Science, Research Office, Department of Biostatistics and Epidemiology, Auckland University of Technology, Auckland, New Zealand
- Faculty of Culture and Society, School of Social Sciences and Public Policy, Auckland University of Technology, Auckland, New Zealand
| | - Tanya Connell
- Faculty of Health and Environmental Science, School of Nursing, Auckland University of Technology, Auckland, New Zealand
| | - Mandie Foster
- Faculty of Health and Environmental Science, School of Nursing, Auckland University of Technology, Auckland, New Zealand
- School of Midwifery and Nursing, Edith Cowan University, Perth, WA, Australia
| | - Julie Blamires
- Faculty of Health and Environmental Science, School of Nursing, Auckland University of Technology, Auckland, New Zealand
| | - Smita Keshoor
- Faculty of Health and Environmental Science, School of Oral Health, Auckland University of Technology, Auckland, New Zealand
| | - Chris Moir
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
| | - Irene Suilan Zeng
- Faculty of Health and Environmental Science, Research Office, Department of Biostatistics and Epidemiology, Auckland University of Technology, Auckland, New Zealand.
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Haghish EF, Nes RB, Obaidi M, Qin P, Stänicke LI, Bekkhus M, Laeng B, Czajkowski N. Unveiling Adolescent Suicidality: Holistic Analysis of Protective and Risk Factors Using Multiple Machine Learning Algorithms. J Youth Adolesc 2024; 53:507-525. [PMID: 37982927 PMCID: PMC10838236 DOI: 10.1007/s10964-023-01892-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/17/2023] [Indexed: 11/21/2023]
Abstract
Adolescent suicide attempts are on the rise, presenting a significant public health concern. Recent research aimed at improving risk assessment for adolescent suicide attempts has turned to machine learning. But no studies to date have examined the performance of stacked ensemble algorithms, which are more suitable for low-prevalence conditions. The existing machine learning-based research also lacks population-representative samples, overlooks protective factors and their interplay with risk factors, and neglects established theories on suicidal behavior in favor of purely algorithmic risk estimation. The present study overcomes these shortcomings by comparing the performance of a stacked ensemble algorithm with a diverse set of algorithms, performing a holistic item analysis to identify both risk and protective factors on a comprehensive data, and addressing the compatibility of these factors with two competing theories of suicide, namely, The Interpersonal Theory of Suicide and The Strain Theory of Suicide. A population-representative dataset of 173,664 Norwegian adolescents aged 13 to 18 years (mean = 15.14, SD = 1.58, 50.5% female) with a 4.65% rate of reported suicide attempt during the past 12 months was analyzed. Five machine learning algorithms were trained for suicide attempt risk assessment. The stacked ensemble model significantly outperformed other algorithms, achieving equal sensitivity and a specificity of 90.1%, AUC of 96.4%, and AUCPR of 67.5%. All algorithms found recent self-harm to be the most important indicator of adolescent suicide attempt. Exploratory factor analysis suggested five additional risk domains, which we labeled internalizing problems, sleep disturbance, disordered eating, lack of optimism regarding future education and career, and victimization. The identified factors provided stronger support for The Interpersonal Theory of Suicide than for The Strain Theory of Suicide. An enhancement to The Interpersonal Theory based on the risk and protective factors identified by holistic item analysis is presented.
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Affiliation(s)
- E F Haghish
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Ragnhild Bang Nes
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Milan Obaidi
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychology, Copenhagen University, Copenhagen, Denmark
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Line Indrevoll Stänicke
- Department of Psychology, University of Oslo, Oslo, Norway
- Nic Waals Institute, Lovisenberg hospital, Oslo, Norway
| | - Mona Bekkhus
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Bruno Laeng
- Department of Psychology, University of Oslo, Oslo, Norway
- RITMO Centre for Interdisciplinary Studies in Rhythm, Time and Motion, University of Oslo, Oslo, Norway
| | - Nikolai Czajkowski
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
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Bakken V, Lydersen S, Skokauskas N, Sund AM, Kaasbøll J. Protective factors for suicidal ideation: a prospective study from adolescence to adulthood. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02379-w. [PMID: 38356041 DOI: 10.1007/s00787-024-02379-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: 08/17/2023] [Accepted: 01/08/2024] [Indexed: 02/16/2024]
Abstract
Adolescent suicidality is associated with negative outcomes in adulthood. Suicide prevention has traditionally focused on identifying risk factors, yet suicide rates have remained stable. With suicidality often going undetected-especially suicidal ideation, further knowledge about protective factors is needed. The main objective of this study was to investigate potential protective factors for suicidal ideation from adolescence to adulthood. The study employed longitudinal population survey data, "Youth and Mental Health Study" consisting of self-reports at two-time points (mean age 14.9, SD = 0.6 and 27.2, SD = 0.6) (n = 2423 and n = 1198). Protective factors (at individual, social and environmental level) were selected based on a priori knowledge. Internal consistency of scales was analyzed using McDonald's omega. We used a linear mixed model with suicidal ideation as the dependent variable, time-points, a protective factor variable and their interaction as covariates, and individual participant as random effects. We adjusted for sex and also conducted separate analyses for males and females. The Benjamini-Hochberg procedure was used to adjust p-values for multiple hypotheses. Investigated protective factors were associated with temporal change in suicidal ideation (significant interactions). For both sexes, less emotion-orientated coping, higher self-perception scores, greater levels of physical activity and higher school wellbeing/connectedness were protective factors for suicidal ideations. Secure attachment and higher family function were protective factors for females only. The effects in adolescence were mostly maintained in adulthood. In this study, several protective factors for suicidal ideation persisted into adulthood, with distinct differences between males and females.
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Affiliation(s)
- Victoria Bakken
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Norbert Skokauskas
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Anne Mari Sund
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Jannike Kaasbøll
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Health Research, SINTEF, Trondheim, Norway
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Terry E, Pharr JR, Batra R, Batra K. Protective and Risk Factors for Suicidal Ideation and Behavior Among Sexual Minority Women in the United States: A Cross-Sectional Study. LGBT Health 2024. [PMID: 38324060 DOI: 10.1089/lgbt.2023.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Purpose: The purpose of this study was to understand the factors associated with suicidal ideation and behavior and serious suicidal ideation and behavior among sexual minority women (SMW), including resilience, discrimination, mental health, and sociodemographic characteristics. Methods: Web-based surveys were conducted with SMW from across the United States during January-February, 2022 using psychometric valid tools. Bivariate, hierarchical regression, and logistic regression analyses were used to analyze the data. Results: Of 497 participants, 70% were identified as bisexual and 30% as lesbian. The mean scores for anxiety, depression, and stress were significantly higher among bisexual women compared to their lesbian counterparts (p < 0.05). The proportion of serious suicidal ideation and behavior was higher among bisexual women compared to lesbian women (53.9% vs. 41.2%, p = 0.012). Conversely, the mean scores of resilience were lower among bisexual women compared to lesbian women (139.7 ± 33.4 vs. 147.5 ± 33.6, p = 0.024). Lesbian women had nearly 57.4% lower odds of having serious suicidal ideation and behavior as compared to bisexual women (adjusted odds ratio = 0.426; p = 0.023). Experiencing anxiety, depression, victimization distress, and family discrimination distress were positively associated with serious suicidal ideation and behavior, whereas personal resilience and family cohesion were negatively associated with serious suicidal ideation and behavior. Conclusions: Tackling structural inequities such as racism and homophobia remains vital to improving the mental health of SMW. Interventions to strengthen social and familial supports may be particularly impactful, especially at the family level.
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Affiliation(s)
- Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Jennifer R Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Ravi Batra
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
- Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
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Zhu J, Xie P, Zhang X. Social exclusion and suicide intention in Chinese college students: a moderated mediation model. Front Psychol 2024; 15:1354820. [PMID: 38371706 PMCID: PMC10869458 DOI: 10.3389/fpsyg.2024.1354820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/16/2024] [Indexed: 02/20/2024] Open
Abstract
Given the growing incidence rates of suicide among college students and the potential lifelong consequences of suicide, it is imperative to better understand the factors that reduce the rates at which college students in a clinical sample engage in suicide. This study examines the relationship between social exclusion and suicide intention, the mediating effect of depression, and the moderating effect of meaning in life. Two hundred and ninety-nine Chinese college students, aged from 18 to 22 years (56.86% female, M age = 20.14, SD = 1.27) completed questionnaires assessing their social exclusion, suicide intention, depression, and meaning in life. The result revealed that social exclusion was positively associated with suicide intention, and depression mediated this relationship. In addition, this mediating effect of depression was moderated by meaning in life. That is, the mediation effect was stronger for students with a higher level of meaning in life. These findings provide educational suggestions for preventing and intervening in suicide intention among college students.
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Affiliation(s)
- Juncheng Zhu
- Hunan Key Laboratory of Children’s Psychological Development and Brain Cognitive Science, Department of Education, Hunan Frist Normal University, Hunan, Changsha, China
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Tran T, Nguyen H, Shochet I, Nguyen N, La N, Wurfl A, Orr J, Nguyen H, Stocker R, Fisher J. Coping Self-Efficacy and Thoughts of Self-Harm Among Adolescents in Vietnam: A Longitudinal Study. Arch Suicide Res 2023:1-13. [PMID: 37837377 DOI: 10.1080/13811118.2023.2265444] [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] [Indexed: 10/16/2023]
Abstract
We aimed to determine the effect of coping self-efficacy on thoughts of self-harm among adolescents attending high school in Hanoi, Vietnam. Longitudinal data were collected using the Center for Epidemiologic Studies Depression Scale Revised and the Coping Self-Efficacy Scale among 552 Year 10 students. The prevalence of thoughts of death and/or self-injury on at least 1 day in the past week was 16.9% at baseline and 14.5% at 8-month follow-up. When baseline coping self-efficacy was greater by one standard deviation, the odds of having thoughts of self-harm at follow-up were reduced by 42%. Our findings suggest that school-based programs that aim to strengthen coping strategies may be useful in preventing self-harm among adolescents.
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Silke C, Brady B, Devaney C, O'Brien C, Durcan M, Bunting B, Heary C. Youth Suicide and Self-Harm: Latent Class Profiles of Adversity and the Moderating Roles of Perceived Support and Sense of Safety. J Youth Adolesc 2023; 52:1255-1271. [PMID: 36964434 PMCID: PMC10121538 DOI: 10.1007/s10964-023-01762-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/02/2023] [Indexed: 03/26/2023]
Abstract
Research suggests that exposure to adversity can lead to an increased risk of experiencing suicidal and self-injurious thoughts or behaviours, but few studies have examined whether different patterns of adversity are differentially associated with youth suicide/self-harm. The current study aims to explore the relationship between exposure to adversity across various social domains and youth self-harm and suicidality, using a person centred approach, and examines whether access to social support and a sense of safety across home, peer or school settings buffer the relationship between adversity and self-harm/suicidality. Secondary data analyses were carried out on cross-sectional self-report data collected from 4848 (Mage=15.78, SD = 0.59; 50% female) adolescents who participated in the Irish Planet Youth survey. Latent Class Analyses identified four distinct profiles of adversity; low-adversity (n = 2043, 42%); peer-adversity (n = 972, 20%); parental-adversity (n = 1189, 25%); and multiple-adversity (n = 644, 13%). Findings from logistic moderated regressions indicated that there were significant differences in self-harm and suicidality across the adversity classes. Although parental support and perceived safety at school were negatively associated with suicidality and self-harm outcomes, no significant moderation effects were observed. These findings suggest that youth who experience adversity across multiple social domains are more likely to report suicidal and self-harm thoughts and behaviours, and should be key targets for intervention/prevention efforts. While parental support and school safety may act as significant compensatory factors, further work is needed to identify the social resources that can offset the risk imposed by youth's adverse experiences.
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Affiliation(s)
- Charlotte Silke
- UNESCO Child & Family Research Centre, University of Galway, Galway, Ireland.
| | - Bernadine Brady
- UNESCO Child & Family Research Centre, University of Galway, Galway, Ireland
| | - Carmel Devaney
- UNESCO Child & Family Research Centre, University of Galway, Galway, Ireland
| | | | - Micheal Durcan
- Western Region Drugs & Alcohol Task Force, Galway, Ireland
| | | | - Caroline Heary
- School of Psychology, University of Galway, Galway, Ireland
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Zhang N, Sandler I, Tein JY, Wolchik S. Reducing suicide risk in parentally bereaved youth through promoting effective parenting: testing a developmental cascade model. Dev Psychopathol 2023; 35:433-446. [PMID: 34872628 PMCID: PMC9170840 DOI: 10.1017/s0954579421001474] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Children who experience parental death are at increased risk for suicide. The Family Bereavement Program (FBP) is an upstream preventive intervention for parentally bereaved families that was found to reduce suicide risk in parentally bereaved youth up to 6 and 15 years later. We tested whether FBP-induced improvements in effective parenting led to changes in multiple proximal factors that prior theory and research implicated in the cascading pathway to suicide risk, namely, aversive self-views, caregiver connectedness, peer connectedness, complicated grief, depressive symptoms, and emotion suppression. The sample was 244 bereaved youth and their surviving caregiver from 156 families. Families were randomized into the FBP (12 group-based sessions for parents, youth, and two joint sessions) or a literature control condition. Multimethod and multiinformant data were collected at baseline, posttest, 6-year and 15-year follow-up assessments. Results showed that program-induced improvements in effective parenting at posttest were associated with reduced aversive self-views and increased caregiver connectedness at the 6-year follow-up, and each mediator was in turn associated with reduced suicide risk at the 6- and 15-year follow-up. The mediated pathways via aversive self-views remained significant while controlling for caregiver connectedness. Self-related concepts may be important targets in upstream suicide prevention for at-risk youth.
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Affiliation(s)
- Na Zhang
- Department of Human Development and Family Sciences, University of Connecticut, Stamford, CT, USA
| | - Irwin Sandler
- REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Jenn-Yun Tein
- REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Sharlene Wolchik
- REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
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Pharr JR, Chien LC, Gakh M, Flatt JD, Kittle K, Terry E. Moderating Effect of Community and Individual Resilience on Structural Stigma and Suicidal Ideation among Sexual and Gender Minority Adults in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14526. [PMID: 36361405 PMCID: PMC9656182 DOI: 10.3390/ijerph192114526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Structural stigma in the form of discriminatory laws and policies impacts the mental health of sexual and gender minorities, especially with regard to suicidality. However, this relationship could be moderated by resilience. The past two years has brought anti-SGM legislation, particularly transgender sports bans, at the state level in the United States into focus. This study aims to understand if the relationship between familiarity with transgender sports bans (proposed or enacted) and suicidality was moderated by individual or community resilience. METHODS This was a cross-sectional study of survey data collected from a national sample of 1033 SGM adults in the United States between 28 January and 7 February 2022. Univariate and multivariate moderation analyses were used. RESULTS In the univariate analyses and the final model, community resilience moderated the relationship between structural stigma and suicidality (p = 0.0002); however, individual resilience did not (p = 0.0664). CONCLUSION Interventions to bolster community resilience may attenuate the negative mental health impacts of structural stigma and are warranted, along with concerted efforts to minimize structural stigma in the form of discriminatory laws and policies targeting people who are SGM.
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Affiliation(s)
- Jennifer R. Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Maxim Gakh
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Jason D. Flatt
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Krystal Kittle
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
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11
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Li L, Xu G, Zhou D, Song P, Wang Y, Bian G. Prevalences of Parental and Peer Support and Their Independent Associations With Mental Distress and Unhealthy Behaviours in 53 Countries. Int J Public Health 2022; 67:1604648. [PMID: 36299408 PMCID: PMC9588916 DOI: 10.3389/ijph.2022.1604648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 09/27/2022] [Indexed: 11/23/2022] Open
Abstract
Objective: Parental and peer support are both associated with mental distress and unhealthy behaviour indices in adolescents. Methods: We used the Global School-Based Student Health Survey data (n = 192,633) from 53 countries and calculated the weighted prevalence of individual and combined parental and peer support. Multiple logistic regression analysis was used to estimate the adjusted associations between combined parental and peer support with mental distress and unhealthy behaviours. Results: The prevalence figures for having all four categories of parental support and two peer-support were 9.7% and 38.4%, respectively. Compared with no parental support, adolescents with all four parental support negatively associated with all five mental distress and eight unhealthy behaviours factors, and the ORs ranged from 0.19 to 0.75. Additionally, adolescents with two peer support were negative association with all mental distress and four health risk behaviours, and positively associated with a sedentary lifestyle. Conclusion: Parental and peer support were lacking in some countries, while greater parental and peer support were negative associated with mental distress and most unhealthy behaviours in adolescents, and the relationships were independent.
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Affiliation(s)
- Lian Li
- Ningbo Kangning Hospital, Ningbo, China
| | - Guodong Xu
- Ningbo Medical Centre Li Huili Hospital, Ningbo, China
| | | | - Ping Song
- Ningbo Kangning Hospital, Ningbo, China
| | - Yucheng Wang
- Ningbo Kangning Hospital, Ningbo, China
- *Correspondence: Yucheng Wang, ; Guolin Bian,
| | - Guolin Bian
- Ningbo Kangning Hospital, Ningbo, China
- *Correspondence: Yucheng Wang, ; Guolin Bian,
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12
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McKoin Owens M, Zickafoose A, Wingenbach G, Haddad S, Freeny J, Engels J. Selected Texan K-12 Educators' Perceptions of Youth Suicide Prevention Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12625. [PMID: 36231925 PMCID: PMC9566514 DOI: 10.3390/ijerph191912625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
K-12 school personnel may be frontline responders for youth contemplating suicide or other harmful behaviors. Therefore, the purpose of this preliminary study was to determine selected K-12 educators' perceptions of youth suicide prevention (YSP) training. A longitudinal trend survey with repeated measures and proportionally stratified random samples of K-12 personnel from nine Texas independent school districts provided data. Participants' perceived knowledge of the YSP content showed significant appreciative gains between pre- and follow-up post-tests. Likewise, their confidence levels for helping students at risk of suicide and approaching other adults to talk about students at risk of suicide rose significantly between pretests and follow-up post-tests. This preliminary study reinforces the value of training educators to acquire content knowledge and confidence boosting opportunities for engagement in difficult dialogue about suicidality. YSP training helped improve educators' confidence to engage with others about students' mental health concerns, calling attention to the importance of identifying early warning signs that may aid in early support and prevention of youth mental health concerns.
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Affiliation(s)
- Melanie McKoin Owens
- Department of Agricultural Leadership, Education and Communications, Texas A&M University, College Station, TX 77843, USA
| | - Alexis Zickafoose
- Department of Agricultural Leadership, Education and Communications, Texas A&M University, College Station, TX 77843, USA
| | - Gary Wingenbach
- Department of Agricultural Leadership, Education and Communications, Texas A&M University, College Station, TX 77843, USA
| | - Sana Haddad
- Mental Health America of Greater Houston, Houston, TX 77098, USA
| | - Jamie Freeny
- Mental Health America of Greater Houston, Houston, TX 77098, USA
| | - Josephine Engels
- Mental Health America of Greater Houston, Houston, TX 77098, USA
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13
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Nugent NR, Armey M, Boker S, Brick L, Knopik V, McGeary JE, Spirito A, Mehl MR. Adolescents hospitalised for suicidality: biomarkers, social and affective predictors: a cohort study. BMJ Open 2022; 12:e056063. [PMID: 36192099 PMCID: PMC9535190 DOI: 10.1136/bmjopen-2021-056063] [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] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The present research examines genomics and in vivo dynamics of family context and experienced affect following discharge from psychiatric hospitalisation for suicidal thoughts and behaviours (STBs). The purpose of this paper is to provide an overview of a new model, description of model-guided integration of multiple methods, documentation of feasibility of recruitment and retention and a description of baseline sample characteristics. DESIGN The research involved a longitudinal, multimethod observational investigation. SETTING Participants were recruited from an inpatient child and adolescent psychiatric hospital. 194 participants ages 13-18 were recruited following hospitalisation for STB. PRIMARY AND SECONDARY OUTCOME MEASURES Participants underwent a battery of clinical interviews, self-report assessments and venipuncture. On discharge, participants were provided with a phone with (1) the electronically activated recorder (EAR), permitting acoustic capture later coded for social context, and (2) ecological momentary assessment, permitting assessment of in vivo experienced affect and STB. Participants agreed to follow-ups at 3 weeks and 6 months. RESULTS A total of 71.1% of approached patients consented to participation. Participants reported diversity in gender identity (11.6% reported transgender or other gender identity) and sexual orientation (47.6% reported heterosexual or straight sexual orientation). Clinical interviews supported a range of diagnoses with the largest proportion of participants meeting criteria for major depressive disorder (76.9%). History of trauma/maltreatment was prevalent. Enrolment rates and participant characteristics were similar to other observational studies. CONCLUSIONS The research protocol characterises in vivo, real-world experienced affect and observed family context as associated with STB in adolescents during the high-risk weeks post discharge, merging multiple fields of study.
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Affiliation(s)
- Nicole R Nugent
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
| | - Michael Armey
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
- Department of Psychosocial Research, Butler Hospital, Providence, Rhode Island, USA
| | - Steven Boker
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - Leslie Brick
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
| | - Valerie Knopik
- Department of Human Development and Family Studies, Purdue University, West Lafayette, Indiana, USA
| | - John E McGeary
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
- Providence VA Medical Center, Providence, Rhode Island, USA
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
| | - Matthias R Mehl
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
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14
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Raffagnato A, Iannattone S, Fasolato R, Parolin E, Ravaglia B, Biscalchin G, Traverso A, Zanato S, Miscioscia M, Gatta M. A Pre-Adolescent and Adolescent Clinical Sample Study about Suicidal Ideation, Suicide Attempt, and Self-Harming. Eur J Investig Health Psychol Educ 2022; 12:1441-1462. [PMID: 36286085 PMCID: PMC9600697 DOI: 10.3390/ejihpe12100100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/30/2022] [Accepted: 09/19/2022] [Indexed: 11/05/2022] Open
Abstract
Suicide is the second cause of death among adolescents, and nonsuicidal self-injury (NSSI) is one of the main risk factors for suicidal behavior. However, the possible variables specifically associated with suicidal ideation and suicide attempt, as well as the psychopathological characteristics linked to the concomitant presence of suicidal ideation/attempt and NSSI are still under-investigated in youth. The current study aimed to address these issues in a sample of 174 young Italian inpatients (Mage = 14.3 years ± 1.93, 78.2% girls). Sociodemographic and clinical variables were assessed through psycho-diagnostic interviews and ad hoc questionnaires. A binomial logistic regression was performed to identify the predictors of suicidal ideation and suicide attempt. Then, Kruskal-Wallis tests were run to analyze the psychopathological differences between patients with suicidal ideation and suicide attempt considering the coexistence of NSSI. The results highlighted that previous access to child mental health services and general psychopathological problems significantly predicted suicidal ideation, while previous hospitalizations, borderline personality functioning, and affective disorders significantly predicted suicide attempt. In general, inpatients with also NSSI reported higher levels of internalizing, somatic and total problems, impulsiveness, alexithymia, and emotional dysregulation. The clinical implications of our findings in terms of primary and secondary preventive programs are discussed.
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Affiliation(s)
- Alessia Raffagnato
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Sara Iannattone
- Department of General Psychology, University of Padua, 35131 Padua, Italy
- Correspondence: ; Tel.: +39-049-827-6918
| | - Rachele Fasolato
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Elisa Parolin
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Benedetta Ravaglia
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Gaia Biscalchin
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Annalisa Traverso
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Silvia Zanato
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Marina Miscioscia
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
- Department of Developmental Psychology and Socialization, University of Padua, 35131 Padua, Italy
| | - Michela Gatta
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
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15
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Çapar A, Çuhadar D. Correlation between psychological resilience and suicide probability in patients with psychiatric disorder. Perspect Psychiatr Care 2022; 58:1442-1448. [PMID: 34523123 DOI: 10.1111/ppc.12948] [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: 07/26/2021] [Accepted: 09/05/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE It was aimed to evaluate the correlation between psychological resilience and possibility of suicide in psychiatric patients. DESIGN AND METHODS The data of the research were collected using "Individual Information Form", "Resilience Scale for Adults (RSA)," and "Suicide Probability Scale (SPS)". FINDINGS It was found that the mean total score of SPS was 70.97 ± 12.82 and moderate risk, the mean total score of RSA was 112.50 ± 25.38, and the levels of psychological resilience were at a good level. It has been determined that patients with low levels of psychological resilience have a higher risk of committing suicide. PRACTICE IMPLICATIONS Findings show that a high level of resilience reduces the risk of suicide. Implementing interventions to improve psychological resilience will help prevent suicide.
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Affiliation(s)
- Ahmet Çapar
- Department of Health Care Services, Vocational School of Health Services, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Döndü Çuhadar
- Department of Psychiatric Nursing, Faculty of Health Sciences, Gaziantep University, Gaziantep, Turkey
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16
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Vuscan ME, Faludi C, Rusu SI, Vica ML, Balici S, Siserman CV, Coman HG, Matei HV. Determinants of Suicide Ideation in the Romanian Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10384. [PMID: 36012016 PMCID: PMC9408719 DOI: 10.3390/ijerph191610384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Suicide ideation and behaviors are directly linked to the risk of death by suicide. In Romania, as well as worldwide, increased suicide rates were observed in the recent past, more so in the context of the COVID-19 pandemic. The purpose of this study was to investigate the influence of psychosocial factors, quality of life (QOL), and loneliness dimensions and adverse life antecedents on suicide ideation (SI) and prolonged sadness (PS). METHODS This cross-sectional quantitative research study used a CATI data gathering method to investigate 1102 randomly selected individuals over 18 years of age regarding various determinants of SI and PS. Data were collected in June 2021. Descriptive, inferential, and multivariate statistics were used for data analysis. RESULTS SI was negatively correlated with all the assessed psychosocial factors, more significantly with family relationships, wealth, health, social relationships, and affective life. Stronger correlations were observed when investigating the state of prolonged sadness, sex, and affective lives along with health and income, which were more influential. SI was negatively correlated with QOL and positively correlated with adverse life events and total loneliness scores. Lesser educated youngsters with reduced overall happiness and a history of depression, self-harm, and trauma were at greater risk of developing SI. CONCLUSIONS This is the first national study exploring the suicide ideation and prolonged sadness in relation to psychosocial factors, quality of life, and adverse life events. These results have important implications for suicide prevention programs, which should be designed in accordance with similar studies.
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Affiliation(s)
- Mihaela Elvira Vuscan
- Department of Cellular and Molecular Biology, Iuliu Haṭieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
- Legal Medicine Institute, 400006 Cluj-Napoca, Romania
| | - Cristina Faludi
- Department of Social Work, “Babeṣ Bolyai” University, 400604 Cluj-Napoca, Romania
| | - Sergiu Ionica Rusu
- Doctoral School of Sociology, “Babeṣ Bolyai” University, 400604 Cluj-Napoca, Romania
| | - Mihaela Laura Vica
- Department of Cellular and Molecular Biology, Iuliu Haṭieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
- Legal Medicine Institute, 400006 Cluj-Napoca, Romania
| | - Stefana Balici
- Department of Cellular and Molecular Biology, Iuliu Haṭieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Costel Vasile Siserman
- Legal Medicine Institute, 400006 Cluj-Napoca, Romania
- Department of Legal Medicine, Iuliu Haṭieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Horia George Coman
- Department of Medical Psychology, Iuliu Haṭieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Horea Vladi Matei
- Department of Cellular and Molecular Biology, Iuliu Haṭieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
- Legal Medicine Institute, 400006 Cluj-Napoca, Romania
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17
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The class group counseling on life education improves meaning in life for undergraduate students. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03623-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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18
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López R, Maultsby K, Defayette AB, Whitmyre ED, Wolff J, Spirito A, Esposito-Smythers C. A prospective investigation of the relation between dysfunctional family communication and suicidal ideation severity in a clinical adolescent sample: A serial mediation model. J Affect Disord 2022; 310:241-248. [PMID: 35550827 PMCID: PMC10994189 DOI: 10.1016/j.jad.2022.05.021] [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: 08/24/2021] [Revised: 03/05/2022] [Accepted: 05/05/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Extant research has documented a relation between the quality of family communication and adolescent suicidal ideation. However, few studies have examined this relation longitudinally or explored potential mechanisms of this effect. In the present study, unhealthy family communication was hypothesized to be associated with suicidal ideation severity over 18 months via a serial mediation pathway through emotion regulation difficulties and depressive symptom severity. METHODS The sample consisted of 147 adolescents (Mage = 14.91, SD = 1.51, range = 12-18 years; 76.2% female, 85.5% White) enrolled in a randomized clinical trial. Family communication quality was assessed at baseline using the Family Assessment Device. Emotion regulation difficulties and depressive symptoms were assessed using the Difficulties in Emotion Regulation Scale and Children's Depression Inventory-2, respectively, at baseline, 6-, and 12-months. Suicidal ideation was assessed using the Suicidal Ideation Questionnaire-JR at baseline and 18-months. Path analysis was used to analyze temporal relations between constructs. RESULTS After accounting for participant's age, sex, treatment condition, and baseline levels of variables of interest, analyses supported the indirect relation between baseline family communication and 18-month suicidal ideation severity through 6-month emotion regulation difficulties and 12-month depressive symptom severity. LIMITATIONS Data were exclusively collected via self-report, and the sample was racially homogenous. CONCLUSIONS Treatment aimed at improving family communication may help bolster emotion regulation abilities, lower depressive symptoms, and subsequently, suicide risk.
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Affiliation(s)
- Roberto López
- Department of Psychology, George Mason University, Fairfax, VA, USA.
| | | | | | - Emma D Whitmyre
- Department of Psychology, George Mason University, Fairfax, VA, USA
| | - Jennifer Wolff
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
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19
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Resilience to suicidal behavior in young adults: a cross-sectional study. Sci Rep 2022; 12:11419. [PMID: 35794217 PMCID: PMC9259642 DOI: 10.1038/s41598-022-15468-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 06/24/2022] [Indexed: 02/03/2023] Open
Abstract
Despite decades of research on suicide risk factors in young people, there has been no significant improvement in our understanding of this phenomenon. This study adopts a positive deviance approach to identify individuals with suicide resilience and to describe their associated psychological and sociodemographic profiles. Australian young adults aged 18–25 years with suicidal thoughts (N = 557) completed an online survey covering sociodemographic, mental health status, emotion regulatory and suicide-related domains. Latent class analysis was used to identify the individuals with suicide resilience. The predictors of suicide resilience were assessed using logistic regression models. The results suggested that one in ten (n = 55) met the criteria for suicide resilience. Factors that had a significant association with suicide resilience included greater cognitive flexibility, greater self-efficacy in expressing positive affect, reduced use of digital technology and less self-harm and substance use as a response to emotional distress. This study identified the factors that may protect young adults with suicidal thoughts from progressing to suicide attempts. Suicide prevention programs might be optimised by shifting from a deficit-based to a strength-based approach through promoting cognitive flexibility, self-efficacy and reducing maladaptive coping.
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Massing-Schaffer M, Nesi J, Telzer EH, Lindquist KA, Prinstein MJ. Adolescent Peer Experiences and Prospective Suicidal Ideation: The Protective Role of Online-Only Friendships. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:49-60. [PMID: 32324048 DOI: 10.1080/15374416.2020.1750019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective: This study examined characteristics of online-only friendships among suicidal and non-suicidal adolescents. In addition, the extent to which adolescents' online-only friendships may offer a protective function, buffering the effects of peer stressors (i.e., friendship stress, relational victimization) on prospective suicidal ideation, was examined.Method: Adolescents aged 10 to 14 (n = 630) were assessed at baseline (Time 1) and one-year follow-up (Time 2). Measures of suicidal ideation, sociometric relational victimization, friendship stress, depressive symptoms, online-only friendship status and quality, and online-only friendship quality compared to in-person friendship quality, were obtained at Time 1 using sociometric procedures and self-report questionnaires. Self-report measures of suicidal ideation were collected at Time 2.Results: Descriptive results suggested that online-only friendships are relatively common among youth (38.3%), particularly for those experiencing suicidal ideation (46.3%). Suicidal and non-suicidal adolescents reported comparable levels of intimate disclosure within their online-only friendships. Although adolescents without suicidal ideation endorsed more support from in-person friendships, suicidal adolescents endorsed similar levels of support from their online-only and in-person friendships. Moderation analyses indicated that the association between both relational victimization and friendship stress and prospective suicidal ideation was attenuated among youth who reported having one or more online-only friend.Conclusion: Online-only friendships are common and may offer protective benefits for youth, particularly those experiencing suicidal ideation. Future studies should examine the specific mechanisms by which online-only friendships may confer this benefit.
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Affiliation(s)
- Maya Massing-Schaffer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Jacqueline Nesi
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University
- Bradley Hasbro Research Center, Rhode Island Hospital
| | - Eva H Telzer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Kristen A Lindquist
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
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Abstract
OBJECTIVE Suicide resilience is gaining increasing attention from researchers because of its potential role in preventing suicide. However, it has not been clearly analyzed, and there are various meanings and terms regarding this issue. The purpose of this analysis, therefore, was to conceptualize the concept of suicide resilience. METHODS Walker and Avant's method of concept analysis was used to identify the antecedents, attributes, and consequences of suicide resilience. The literature was searched using PubMed, PsychINFO, Embase, Web of Science, CINAHL, CNKI, and WanFang databases with no limitation on publication date. The search included peer-reviewed journal articles and dissertations related to suicide resilience published in English or Chinese. RESULTS 52 articles were identified to provide information for this concept analysis. Five defining attributes of suicide resilience were identified: social support, coping strategies, psychological capital, meaning in life, and sense of responsibility. Antecedents of suicide resilience were high suicide risk events, and consequences of suicide resilience were keeping vulnerable individuals stay away from or overcoming suicidality. CONCLUSIONS The result of the analysis provided a more clear definition of suicide resilience. The identified defining attributes, antecedents, and consequences can be further tested and used to develop potential interventions. Future research is needed and will help to advance our understanding of the scope.
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Affiliation(s)
- Xinlu Wang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Zhongqiu Lu
- Emergency Intensive Care Unit, Emergency Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, China
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22
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Clayton MG, Pollak OH, Owens SA, Miller AB, Prinstein MJ. Advances in Research on Adolescent Suicide and a High Priority Agenda for Future Research. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2021; 31:1068-1096. [PMID: 34820949 DOI: 10.1111/jora.12614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Suicide is the second leading cause of death for adolescents in the United States, yet remarkably little is known regarding risk factors for suicidal thoughts and behaviors (STBs), relatively few federal grants and scientific publications focus on STBs, and few evidence-based approaches to prevent or treat STBs are available. This "decade in review" article discusses five domains of recent empirical findings that span biological, environmental, and contextual systems and can guide future research in this high priority area: (1) the role of the central nervous system; (2) physiological risk factors, including the peripheral nervous system; (3) proximal acute stress responses; (4) novel behavioral and psychological risk factors; and (5) broader societal factors impacting diverse populations and several additional nascent areas worthy of further investigation.
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Szlyk HS. NARRATIVES OF SUICIDALITY, ALTERNATIVE EDUCATION, AND RESILIENCY: IMPLICATIONS FOR SOCIAL WORK PRACTICE AND RESEARCH. JOURNAL OF SYSTEMIC THERAPIES : J.S.T 2021; 40:46-66. [PMID: 38863798 PMCID: PMC11166093 DOI: 10.1521/jsyt.2021.40.4.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
Suicidal behaviors and academic difficulties are characteristics that stigmatize youth as "bad" or "troubled" students. Alternative school programs aim to help students struggling with mental health and academic issues. This study explores how high school students make meaning of experiences of suicidality and resilience with respect to mainstream constructs of mental health, education, and identity. Three cases were selected from a sample of 44 interviews with alternative high school students: an 18-year-old White cisgender hetero-sexual male, a 17-year-old White transgender male (sexuality unspecified), and an 18-year-old Latina cisgender bisexual woman. A preliminary analysis of participant interviews with histories of severe suicidality informed this case selection. Using narrative analysis, common themes emerged: contamination versus redemption, the importance of having space, the physical experience of suicidality, and critical turning points in rejecting stigmatized identities. The findings have implications for practice and research focused on building student resiliency against suicidality.
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Affiliation(s)
- Hannah S Szlyk
- Washington University School of Medicine, St. Louis, Missouri
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Greenfield B, Jolicoeur-Martineau A, Brown M, Kandiyoti A, Henry M, Sasson T, Ahmadi S, Vivani T, Harnden B, de Castro F, Tran B, Boodaghians L, Weiss M, Atsaidis Z, Wazana A. Frequent follow-up of suicidal youth assessed in the emergency room: Long-term trajectory and predictors of suicidality. Prev Med 2021; 152:106737. [PMID: 34538378 DOI: 10.1016/j.ypmed.2021.106737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 07/10/2021] [Accepted: 07/16/2021] [Indexed: 11/18/2022]
Abstract
UNLABELLED Suicide was the second‑leading cause of US deaths in 2018 among 15-24-year-olds. Suicide attempts, a risk factor for completions, and suicide ideation have doubled among pediatric emergency room (ER) patients during the past decade. Borderline Personality Disorder (BPD), a comorbid condition, has a 10% suicide rate. We examined the 4-year outcome of a cohort of suicidal adolescents, many also suffering from BPD and having undergone some form of treatment, to identify baseline factors which could inform intervention that would minimize suicidality 4 years post-discharge. METHODS We conducted a prospective longitudinal study of suicidality at twelve points (four assessment occasions) for 286 suicidal youth presenting to a pediatric ER, most suffering from BPD, with 36 suicide ratings from baseline to 2-, 6- and 48-month follow-up evaluations. We examined the trajectory and predictors of persisting suicidality. RESULTS Suicidality rapidly decreased within 2 months post-ER-discharge, subsequently remaining low throughout 48 months. Baseline functioning, female sex, stressful life events and BPD impulsiveness were most predictive of persisting suicidality at 48-month follow-up. CONCLUSION Most suicidal youth, many meeting BPD criteria, no longer feel suicidal 2 months after ER discharge. Management of participants' baseline poor functioning stressful life events and the impulsiveness component of BPD specifically in females could impact suicidality 4 years later, and guide treatment options. The absence of the BPD cognitive and affective subscales as predictors of suicidality at 4-year follow-up may reflect treatment received. Further investigation of treatment effects is warranted and under way.
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Affiliation(s)
- Brian Greenfield
- Department of Psychiatry, Faculty of Medicine, McGill University, Canada
| | - Alexia Jolicoeur-Martineau
- Mila, University of Montréal, Montréal, QC, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Maria Brown
- Department of Educational & Counselling Psychology, McGill University, Montréal, QC, Canada
| | - Alegra Kandiyoti
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Melissa Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Gerald Bronfman Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada; Segal Cancer Centre, Jewish General Hospital, Canada
| | - Tania Sasson
- Department of Physical Medicine & Rehabilitation, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Tania Vivani
- Department of Psychology, Universite de Quebec a Montreal, Montréal, QC, Canada
| | - Bonnie Harnden
- Department of Creative Arts Therapies, Faculty of Fine Arts, Concordia University, Montréal, QC, Canada
| | - Filipa de Castro
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Brian Tran
- Department of Anesthesia, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Levon Boodaghians
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Margaret Weiss
- Child Psychiatry, Cambridge Health Alliance, Cambridge, MA, USA
| | - Zoe Atsaidis
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Ashley Wazana
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada; Centre for Child Development and Mental Health, Jewish General Hospital, Montréal, QC, Canada.
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Wang D, Jiang Q, Yang Z, Choi JK. The longitudinal influences of adverse childhood experiences and positive childhood experiences at family, school, and neighborhood on adolescent depression and anxiety. J Affect Disord 2021; 292:542-551. [PMID: 34147966 DOI: 10.1016/j.jad.2021.05.108] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/19/2021] [Accepted: 05/30/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Adolescent depression and anxiety are major mental health concerns. Adverse childhood experiences (ACEs) are risk factors for depression and anxiety in adolescence and positive childhood experiences at home, school, and neighborhood are protective factors. Few studies, however, have compared the longitudinal effects of these two sets of contextual risk and protective factors on depression and anxiety among adolescents by framing them together. METHODS This study used data on a subsample of 3426 socioeconomically disadvantaged adolescents collected at their birth, ages one, three, five, nine, and fifteen. Logistic regression was used to examine the longitudinal effects of ACEs, focusing on childhood maltreatment and family dysfunctions, and positive childhood experiences with family, school, and neighborhood on the risks of depression and anxiety. Adolescents' characteristics and their families' socioeconomic status were adjusted. RESULTS In the two ACEs subcategories, childhood maltreatment exposures increased the risks only for later anxiety; family dysfunction increased the risks for both later depression and anxiety. In the three contexts, positive childhood experiences at family and school protected at-risk adolescents against both mental health concerns, whereas neighborhood collective efficacy protected adolescents only against depression. LIMITATIONS Resilience was examined as an outcome only; it can also be examined as a process. Neither teachers' nor grandparents' supports were included. CONCLUSIONS ACEs maltreatment and family dysfunction are two different risk dimensions for adolescent depression and anxiety. Positive childhood experiences at family are the strongest protective factors for children exposed to ACEs, followed by these in school and neighborhood. Early interventions building positive relationships may benefit adolescent mental health.
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Affiliation(s)
- Dan Wang
- Department of Child, Youth, and Family Studies, University of Nebraska-Lincoln, Lincoln, Nebraska.
| | - Qingyu Jiang
- Department of Child, Youth, and Family Studies, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - Zhenqiao Yang
- Department of Child, Youth, and Family Studies, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - Jeong-Kyun Choi
- Department of Child, Youth, and Family Studies, University of Nebraska-Lincoln, Lincoln, Nebraska
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Shahram SZ, Smith ML, Ben‐David S, Feddersen M, Kemp TE, Plamondon K. Promoting "Zest for Life": A Systematic Literature Review of Resiliency Factors to Prevent Youth Suicide. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2021; 31:4-24. [PMID: 33665921 PMCID: PMC7986824 DOI: 10.1111/jora.12588] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Suicide is a leading cause of death among youth globally. In this critical interpretive synthesis, we examined literature on resiliency factors and suicidality. Systematic searches identified 474 articles, 37 of which were included. Results revealed internal (positive self-appraisal, zest for life, personal traits, and coping skills) and external factors (social support system and inclusive environments) contribute to resilience among youth, with age, sex and gender, and Indigenous identity as important intersecting considerations. Findings validated fostering resilience as primary suicide prevention among youth, with little explanation for how these factors may work to protect youth from suicidality. Continued research in this area requires a focus on how to promote resilience at the community and systems levels.
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Abstract
BACKGROUND Studies focusing on adolescent suicide in Arab countries are particularly scarce, with the few available undertaken from within an epidemiological paradigm. OBJECTIVE This study aimed to understand Jordanian adolescents' perceptions, beliefs, and attitudes toward suicide. METHODS A qualitative design using 12 dual-moderator focus group discussions was conducted in public schools. Participants were selected from the three main regions of the country (rural southern, urban central, and suburban northern). Participants included Jordanian adolescent boys and girls, aged 14-17 years, who reported experiencing mild to moderate depressive symptoms. A relational content analysis approach was used for coding data, and a content analysis was used to identify salient thematic categories. Data were analyzed using NVivo software. RESULTS Four themes emerged, including perceived risk factors, perceived protective factors, active and passive suicidal ideations, and e-games and Internet influences. Main risk factors were depression; anxiety; stigma, shame, and isolation; family issues; life pressures; and guilt. Conversely, religiosity, perceived positive family functioning, and availability of long-term goals seemed to confer resilience to adolescents' suicidal ideation and behavior. Passive suicidality (having death wishes without any plans to complete suicide) was noticed most among participants who feared jeopardizing the family's reputation if they committed suicide. Several boys with active suicidal ideations used the Blue Whale Challenge e-game to learn how to complete suicide and relinquish their problems. DISCUSSION Suicide is a multifactorial problem requiring multimodal strategies. Evidence from this research suggests that those most passionate about the outcome of interest are encouraged to redouble efforts to reduce modifiable risk factors, enrich protective factors, target the underlying psychiatric illness that informs suicidal ideations and behavior, and research the effect of social media and Internet activity more deeply. Parents are advised to monitor the online activities of their children and familiarize themselves with the digital applications they use.
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28
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Kushal SA, Amin YM, Reza S, Shawon MSR. Parent-adolescent relationships and their associations with adolescent suicidal behaviours: Secondary analysis of data from 52 countries using the Global School-based Health Survey. EClinicalMedicine 2021; 31:100691. [PMID: 33554083 PMCID: PMC7846673 DOI: 10.1016/j.eclinm.2020.100691] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Despite the potential benefits of parents-adolescent relationships on suicidal behaviours among adolescents, research on these topics are importantly limited by lack of comprehensiveness, difficulties in cross-country comparisons, and limited generalisability, among others. We aimed to estimate the prevalence of various aspects of parents-adolescent relationships and suicidal behaviours by sex and region, and to investigate their associations. METHODS We used data from the Global School-based Health Survey (GSHS) from 52 countries in 2009-2015 for 120 858 adolescents (53.9% girls) aged 12-15 years. Using meta-analysis with random effects, we estimated the prevalence of parents-adolescent relationships (i.e. understanding problems, monitoring academic and leisure time activities, and respecting privacy) and suicidal behaviours (i.e. suicidal ideation, suicide planning, and suicide attempt). Multi-level mixed-effect logistic regressions were used to investigate their associations. FINDINGS Overall, boys and girls reported similar levels of parental understanding of problems (35.8% vs. 36.8%), monitoring academic activities (41.8% vs. 41.1%), and respecting privacy (69.6% vs. 69.7%), whereas girls reported higher level of parental monitoring of leisure time activities than boys (44.9% vs. 40.0%). Adolescents in the Western Pacific region reported the lowest level of parental understanding of problems and monitoring activities, while those in South-East Asia region least reported that their parents respected their privacy. The overall prevalence of any suicidal behaviour was higher in girls than boys (26.2% vs. 23.0%). Suicidal behaviour was less likely in adolescents if their parents understood their problems (odds ratio, 95% confidence intervals: 0.70, 0.68-0.73), monitored their academic (0.81, 0.78-0.84) and leisure time activities (0.73, 0.71-0.75), and respected their privacy (0.83, 0.80-0.86). There was evidence of heterogeneity in those associations by sex and regions. INTERPRETATIONS Although the prevalence of parents-adolescent relationships and adolescent suicidal behaviours varied particularly by sex and region, there were strong and independent associations among them.
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Affiliation(s)
| | - Yahia Md Amin
- Lifespring, 14th floor, Union heights, 55/2, Panthapath, Dhaka 1205, Bangladesh
| | - Shusama Reza
- Lifespring, 14th floor, Union heights, 55/2, Panthapath, Dhaka 1205, Bangladesh
| | - Md Shajedur Rahman Shawon
- Centre for Big Data Research in Health, UNSW Medicine, Level 2, AGSM Building (G27), UNSW Sydney, NSW 2052, Australia
- Corresponding author.
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Resilience among students at risk of dropout: Expanding perspectives on youth suicidality in a non-clinical setting. SCHOOL MENTAL HEALTH 2020; 12:567-579. [PMID: 33343759 DOI: 10.1007/s12310-020-09366-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
While research supports a strong association between risk of school dropout and suicidality, this youth population remains understudied. This qualitative study addresses this gap by examining self-reported risk and protective factors among 44 alternative high school students who endorsed varying levels of suicidal ideation. Criterion sampling of Suicidal Ideation Questionnaire-JR scores informed student selection for semi-structured interviews. Students were grouped by low, moderate, or high suicidal ideation scores. Transcribed interviews were analyzed using thematic analysis. The findings demonstrate subgroup differences of suicide risk and resiliency among students at risk of dropout and offer points for prevention and intervention. School practitioners can advocate for school-based suicide preventive interventions that are tailored for students who are both at risk of suicide and academic failure.
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30
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Cong CW, Ling WS, Fitriana M. Family functioning, coping strategy, and suicidal ideation among adolescents. J Child Adolesc Ment Health 2020; 32:131-140. [PMID: 33345736 DOI: 10.2989/17280583.2020.1848852] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background and aim: Adolescent suicide has become a central issue around the world, including in Malaysia, which needs attention. The current study investigated the mediating effect of coping strategy in the association between family functioning and suicidal ideation among adolescents in Kuala Lumpur, Malaysia. Method: A total of 852 school-attending adolescents aged 13-17 years were recruited by multistage cluster sampling. The relationships between all the study variables were analysed using Pearson's correlation. Moreover, the mediation model was tested using SPSS PROCESS macro, while sex differences in suicidal ideation were examined using independent samples t-test. Results: Results showed that family cohesion, family flexibility, and problem-focused coping negatively correlated with adolescents' suicidal ideation. Problem-focused coping also mediated the association between family flexibility and suicidal ideation. There was a significant difference in suicidal ideation for males and females. Conclusion: Family functioning and coping strategy are related to adolescents' suicidal ideation, while problem-focused coping plays a crucial role in the relationship between family flexibility and suicidal ideation.
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Affiliation(s)
- Chin Wen Cong
- Department of Psychology and Counselling, Faculty of Arts and Social Science, Universiti Tunku Abdul Rahman, Perak, Malaysia
| | - Wu Shin Ling
- Department of Psychology, Sunway University, Selangor, Malaysia
| | - Mimi Fitriana
- Department of Psychology, International University of Malaya-Wales, Kuala Lumpur, Malaysia
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31
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DeMello AS, Yang Y, Schulte J, Wolf DA, Holcomb JB, Bless B, DeMeter K, Wade CE, Drake SA. Learning from suicide deaths in Harris County, Texas. DEATH STUDIES 2020; 46:745-755. [PMID: 32536264 DOI: 10.1080/07481187.2020.1776790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study examined individual and community demographic characteristics surrounding suicides in one of the most populous counties in the United States. We paired medical examiner records with U.S. Census data and analyzed them using geospatial software. The majority of decedents were non-Hispanic, white males who died primarily of gunshot wounds. Salient age characteristics included interpersonal violence and depression among ages younger than 40. Despite lower incomes and education levels, areas with higher population density and racial/ethnic minorities had fewer suicides. Additional research should address depression among males and the elderly, interpersonal violence, firearm access, and culture.
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Affiliation(s)
- Annalyn S DeMello
- The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, Texas, USA
| | - Yijiong Yang
- The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, Texas, USA
| | | | - Dwayne A Wolf
- Harris County Institute of Forensic Sciences, Medical Examiner Investigations Division, Houston, Texas, USA
| | - John B Holcomb
- Department of Surgery, Division of Acute Care Surgery, University of Alabama, Birmingham, Alabama, USA
| | - Bethany Bless
- Harris County Institute of Forensic Sciences, Medical Examiner Investigations Division, Houston, Texas, USA
| | - Kaeleigh DeMeter
- Harris County Institute of Forensic Sciences, Medical Examiner Investigations Division, Houston, Texas, USA
| | - Charles E Wade
- McGovern School of Medicine, Center for Translational Injury Research, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Stacy A Drake
- Texas A&M University, College of Nursing, Center of Excellence in Forensic Nursing, Houston, Texas, USA
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Abstract
Suicide is a major medical and social problem. Decades of suicide research have mostly focused on risk factors for suicidal behaviour while overlooking protective factors such as resilience that may help to address this important public health issue. Resilience is the capacity and dynamic process of adaptively overcoming stress and adversity while maintaining normal psychological and physical functioning. Studies conducted over the past 10-15 years suggest that resilience is a protective factor against suicide risk. Resilience is becoming a focus of suicide research and prevention. Building resilience should be a part of universal, selective, and indicated suicide prevention interventions. Promoting resilience may reduce suicide risk in the general population, in groups at elevated suicide risk, and among high-risk individuals. Building resilience in the general population may reduce the incidence of stress-related disorders and, consequently, suicidal behaviour. Improving resilience should be a part of a treatment plan of every psychiatric patient. Mental health professionals will probably have the best success in reducing suicide risk in psychiatric patients if they actively concentrate on increasing stress resilience using both psychosocial and pharmacological interventions. It is critically important to move forward the development of pharmacological and psychological interventions for enhancing resilience.
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Affiliation(s)
- L Sher
- James J. Peters VA Medical Center, Bronx, NY, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
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33
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Zhu X, Tian L, Huebner ES. Trajectories of Suicidal Ideation from Middle Childhood to Early Adolescence: Risk and Protective Factors. J Youth Adolesc 2019; 48:1818-1834. [PMID: 31346925 DOI: 10.1007/s10964-019-01087-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 07/15/2019] [Indexed: 12/13/2022]
Abstract
Suicidal ideation is considered to be the first step on the pathway to suicide. Despite the fact that suicidal ideation is surprisingly prevalent among preadolescent children in China and elsewhere, and despite its possible increase during the transition into adolescence, its developmental patterns and predictors during this period are unclear, thus precluding a meaningful understanding of its determinants and possible trajectories. Thus, this study aimed to identify suicidal ideation trajectories and multisystemic predictors covering the transition from middle childhood to early adolescence. A total of 715 Chinese elementary school students (Mage = 8.95, SD = 0.71; 54.5% was male) participated in assessments at six time points, using six-month assessment intervals. Growth mixture modeling analyses extracted three distinct trajectories of suicidal ideation: "low-stable" (86.4%), "moderate-increasing" (7.1%) and "high-start" (6.5%). Multivariate logistic regression analyses revealed that social anxiety and academic anxiety served as risk factors for the adverse developmental trajectories of suicidal ideation; whereas self-esteem, life satisfaction, and academic achievement served as protective factors for the positive developmental trajectory of suicidal ideation. The identification of three subgroups with unique predictors highlights the importance of individual difference considerations in understanding the progression of suicidal ideation in childhood and adolescence and the need for specific programs tailored to the unique characteristics of the relevant trajectories. Furthermore, given that suicidal ideation may start in a proportion of middle childhood youths and continue into adolescence, the middle childhood period should provide an important window of opportunity for large-scale screening and prevention of the escalation of suicidality in adolescence.
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Affiliation(s)
- Xinxin Zhu
- School of Psychology, South China Normal University, Guangzhou, 510631, People's Republic of China
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, People's Republic of China
- Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, People's Republic of China
| | - Lili Tian
- School of Psychology, South China Normal University, Guangzhou, 510631, People's Republic of China.
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, People's Republic of China.
- Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, People's Republic of China.
| | - E Scott Huebner
- Department of Psychology, University of South Carolina, Columbia, SC, USA
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Primananda M, Keliat BA. Risk and Protective Factors of Suicidal Ideation in Adolescents. Compr Child Adolesc Nurs 2019; 42:179-188. [DOI: 10.1080/24694193.2019.1578439] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Meulu Primananda
- Faculty of Nursing, Universitas Indonesia, Depok, 16424, Indonesia
| | - Budi Anna Keliat
- Faculty of Nursing, Universitas Indonesia, Depok, 16424, Indonesia
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Abstract
Suicide is the second leading cause of death worldwide for adolescents. Despite decades of research on correlates and risk factors for adolescent suicide, we know little about why suicidal ideation and behavior frequently emerge in adolescence and how to predict, and ultimately prevent, suicidal behavior among youths. In this review, we first discuss knowledge regarding correlates, risk factors, and theories of suicide. We then review why adolescence is a period of unique vulnerability, given changing biology and social network reorganization. Next, we present a conceptual model through which to interpret emerging findings in adolescent suicide research. We suggest that a promising area for future research is to examine adolescent suicide as a failure of biological responses to acute stress in the proximal moments of a suicidal crisis. After reviewing initial evidence for this conceptualization, we review future directions for studies on adolescent suicide.
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Affiliation(s)
- Adam Bryant Miller
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA; ,
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA; ,
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Domínguez-García E, Fernández-Berrocal P. The Association Between Emotional Intelligence and Suicidal Behavior: A Systematic Review. Front Psychol 2018; 9:2380. [PMID: 30555393 PMCID: PMC6284019 DOI: 10.3389/fpsyg.2018.02380] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 11/12/2018] [Indexed: 11/17/2022] Open
Abstract
Background: Some meta-analyses have demonstrated the association between emotional intelligence (EI) and different health indicators. With the increase of suicide cases in the world, more and more professionals have been interested in the link between both variables. Aim: To study all the available evidence on the association between EI and suicidal behavior. Method: We systematically reviewed all available literature (in English or Spanish) on the relationship between both variables through the main databases. Results: Twenty-five articles were included. EI and suicidal behavior correlated inversely in almost all the articles that the Emotional Quotient Inventory (EQ-i), The Emotional Intelligence Test (EIT), The Spanish Wong and Law Emotional Intelligence Scale (WLEIS), and The Schutte Emotional Intelligence Scale (EIS/SSEIT), Barchard's Emotional Intelligence Scale, were used, that is, the higher suicidal behavior level the lower the EI score. The same results were found in two out of four investigations that used the Trait Meta-Mood Scale (TMMS-24) between clarity (emotional understanding) and emotional repair (emotional regulation) and suicidal behavior. Two out of three studies that used the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) found that only the Strategic component of EI (emotional understanding and regulation) was a protective factor. Conclusions: The results appear to indicate that a high level of EI plays an important role in protecting against suicidal behavior, and should thus be integrated into suicide prevention programs.
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Affiliation(s)
- Elena Domínguez-García
- Department of Basic Psychology, Faculty of Psychology, University of Málaga, Málaga, Spain
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