The relationship of suicidal ideation with psychological pain and anger rumination in patients with major depressive disorder

The relationship between psychological pain and suicidality in patients with major depressive disorder: A meta-analysis

OBJECTIVE

To systematically review the association between psychological pain and suicidality in patients with major depressive disorder (MDD).

METHOD

The databases of PubMed, Web of Science and PsycINFO were used to search and articles were screened for inclusion and exclusion criteria until February 2022. Two researchers independently screened the papers, extracted data, and evaluated the risk of bias of the included studies. Comprehensive Meta-Analysis software (CMA) was used for meta-analysis and the combined OR (95 % CI) values were calculated.

RESULTS

A total of 7 articles were included, with a sample size of 1364. The present study showed that psychological pain was a risk factor for suicidality in patients with MDD (OR = 1.322, 95 % CI:1.165-1.500). After Duval and Tweedie trim and fill to rectify potential publication bias, psychological pain was still a risk factor for suicidality in patients with MDD [OR = 1.196 (95 % CI: 1.030-1.388), P < 0.001]. Subgroup analyses showed that average age ≥ 40 [r = 0.57 (95 % CI: 0.32-0.81), P < 0.001] was moderating variable for psychological pain and suicidality.

CONCLUSIONS

Reducing psychological pain in MDD patients is somewhat important for preventing their suicidality, especially for the patients with advancing age.

Individuals with higher suicide risk showed more anger and disgust during rest

Previous research showed that suicide risk was associated with the anger trait and the facial expression of anger when advising on life dilemmas. We investigated if suicide risk was associated with the facial expression of anger during rest, a state when individuals often reflect upon their lives. Participants took a 1-min rest before being assessed for suicide risk. We measured 147 participants' frontal-view facial expressions during their rest 1475-3694 times using automated facial expression analysis technology. Participants' suicide risk was significantly positively correlated with their anger and disgust during the rest, which may be related to psychological pain and death-related thoughts among individuals with suicide risk. Therefore, rest for clinical patients should not be seen simply as a "rest" for the mind. Rather, for counselors, rest may open a window to look into patients' inner thoughts that may be important to their lives.

Time Perspective, Working Memory, and Depression in Non-Clinical Samples: Is There a Link?

Non-clinical depression is a major issue on college campuses, with some surveys estimating that 30% of college students have experienced a major depressive episode. One theoretical framework of depression is Zimbardo and Boyd (1999) time perspective model, which posits that our perspectives on time impact different aspects of life including our emotions, judgments, and decision making. The current study seeks to determine the role of this time perspectives model and a range of cognitive constructs including hope, rumination, and working memory on their influence in depression. Currently enrolled college students and participants not currently enrolled in college completed the Center for Epidemiologic Studies Depression Scale, the Zimbardo Time Perspective Inventory, the Adult Hope Scale, the Rumination Reflection Questionnaire, and the Automated Working Memory Assessment. Linear regression analysis revealed that, for the college students, Rumination and Past Negative scores predicted depressive symptoms. For the non-college students, Rumination, Present Fatalism, Hope Agency and Verbal Working Memory scores predicted depressive symptoms. The current results reiterate the importance of rumination in depression symptomology and that current cognitive depression models and treatments may benefit from including time perspective measures. Further implications of the results are discussed.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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