Positive mental health moderates the association between depression and suicide ideation: A longitudinal study

Association between frailty and suicidal ideation in older adults: A cross-sectional study

OBJECTIVES

This study seeks to investigate the potential correlation between various levels of frailty and suicidal ideation (SI) in older adults from the USA.

METHODS

Our cross-sectional study extracted data on adults ≥60 years from the NHANES in 2005-2018. Frailty levels were assessed by computing the Frailty Index, classifying individuals into robust, prefrail, and frail categories. SI was evaluated utilizing Item #9 of PHQ-9. Logistic regression and restricted cubic splines were employed for analysis.

RESULTS

The analysis comprised 8564 participants, revealing that 3.3% reported experiencing SI. The association between frailty and SI in older adults was statistically significant in crude model (OR: 5.94, 95% CI: 3.46-11.27, P < 0.001). Upon adjusting for baseline characteristics, the association remained robust (AOR: 5.35, 95% CI: 3.09-10.19, P < 0.001). Model II did not substantially alter the association between frailty and SI after further adjustment for lifestyle factors (AOR: 5.23, 95% CI: 3.02-9.98, P < 0.001). In a sensitivity analysis controlling for depression, the association remained statistically significant (AOR:3.62, 95%CI: 1.76-8.75, P = 0.001). Furthermore, the associations between the Frailty Index and SI were pronounced in the restricted cubic spline (RCS) models (P overall < 0.001, P nonlinearity = 0.771).

CONCLUSION

Frailty appears to heighten vulnerability to suicidal ideation in older adults. Training healthcare professionals to identify and address mental health issues related to frailty is crucial. Through comprehensive intervention measures, we can better safeguard the mental well-being of older adults and reduce the risk of suicide.

The association between long working hours, shift work, and suicidal ideation: A systematic review and meta-analyses

OBJECTIVES

The association between occupational psychosocial factors and mental health has been studied in several systematic reviews. However, few systematic reviews exist that specifically address suicidal ideation. Therefore, this systematic review and meta-analysis aimed to examine the associations between long working hours, shift work, and suicidal ideation.

METHODS

We systematically screened and collected studies published between January 1970 and September 2022 from three electronic databases and Google Scholar. We conducted a meta-analysis using a random-effects model and assessed the risk of bias using a navigation guide. Additionally, the grading of recommendations assessment, development and evaluation (GRADE) approach was used to consider five items, including the risk of bias and publication bias.

RESULTS

Twenty-eight articles were included in this meta-analysis. After adjusting for covariates, the overall odds ratio (OR) for long working hours and shift work were 1.44 [95% confidence interval (CI) 1.26-1.63] and 1.34 (95% CI 1.22-1.47), respectively. Compared with those who worked <40 hours per week, those who worked >55 hours per week had a 1.65 (95% CI 1.37-1.98) higher risk of suicidal ideation, and fixed night shift workers had 1.37 (95% CI 1.03-1.83) higher risk than non-shift workers.

CONCLUSIONS

Evidence has shown associations between long working hours, shift work, and suicidal ideation. Implementing evidence-based interventions to address these risk factors may help prevent the progression of suicidal ideation. However, further studies are critically needed, especially those using standardized exposure definitions and longitudinal data.

Psychological Interventions and Those With Elements of Positive Psychology for Child and Youth Mental Health During the COVID-19 Pandemic: Literature Review, Lessons Learned, and Areas for Future Knowledge Dissemination

BACKGROUND

There was a marked decline in child and teenage mental health worldwide during the pandemic, with increasing prevalence of depression, anxiety, and suicide. Research indicates that positive psychological interventions may be beneficial for mental health.

OBJECTIVE

The aims of this review were to evaluate positive psychological interventions for child and youth mental health implemented during the COVID-19 pandemic and assess overall effectiveness for mental health and knowledge.

METHODS

We undertook a literature search of PubMed, MEDLINE, and Google Scholar for all eligible studies on digital and hybrid in-person psychological interventions for youth mental health during the COVID-19 pandemic. A particular emphasis was placed on positive psychological interventions or interventions that had components of positive psychology, including gratitude, acceptance, positive emotions, or resilience building.

RESULTS

A total of 41 interventions were included in this review. Most of the interventions were digital. Overall, most of the interventions assisted with one or more mental health or psychological indicators, such as depression, anxiety, posttraumatic stress disorder, stress, and resilience. However, findings were mixed when it came to targeting both depression and anxiety together. The interventions that promoted youth mental health most often had a range of diverse positive psychology components and were evidence based. Not all studies measured changes in mindfulness. Few studies examined knowledge acquired on mental health self-care, managing mental health problems, knowledge of positive psychological techniques, mindfulness knowledge, or mental health self-efficacy.

CONCLUSIONS

Diverse multicomponent interventions appear to assist with youth mental health overall, although their effects on both depression and anxiety are less clear. There is also a need for more research on knowledge gains to determine whether the interventions improved knowledge on mental health-supportive behaviors, which may be sustained beyond the intervention. Finally, more studies need to evaluate whether the interventions assisted with increasing self-efficacy for practicing positive psychological techniques as well as changes in mindfulness levels. Future studies should not only assess effectiveness for mental health outcomes but also assess knowledge translation, with valid measures of knowledge and self-efficacy for mental health-supportive behaviors and positive psychological skills acquired (eg, the ability to practice mindfulness).

Examination of the Potential Moderating Role of Psychological Wellbeing in the Relationship Between Depression and Thoughts of Self-Harm in Autistic Adolescents and Adults: A Two-Year Longitudinal Study

PURPOSE

Autistic people have a significantly increased risk of death by suicide relative to the general population. In non-autistic samples, psychological wellbeing has been shown to moderate the relationship between depression and suicidal thoughts and behavior. Thoughts of self-harm may provide a useful indicator of suicidal risk. In this longitudinal study we examined (a) the potential role for psychological wellbeing to moderate the relationship between depressive symptoms and thoughts of self-harm and (b) the contribution of autistic traits to thoughts of self-harm.

METHODS

Participants were 209 autistic adolescents and adults aged 15 to 80 years (Mage = 34.20, SD = 15.38 years).

RESULTS

At both baseline and 2-year follow-up, 35% of participants reported recent thoughts of self-harm. Wellbeing was associated with autistic traits (r = - .350 to - 0.404) and depression (r = - .480 to - 0.759). Thoughts of self-harm were positively associated with autistic traits and depression (r = .242 to 0.659), and negatively associated with wellbeing (r = - .287 to - 0.609). Controlling for baseline thoughts of self-harm, depression (β = 0.254, p = .001) and autistic traits (β = 0.162, p = .007) significantly predicted thoughts of self-harm at 2-year follow-up.

CONCLUSION

Despite a lack of support for the hypothesis that wellbeing would moderate the relationship between depression and thoughts of self-harm, correlational data demonstrated significant associations between wellbeing and both depression and thoughts of self-harm. Future research considering psychological wellbeing as a potential protective factor for self-harm in autistic people is warranted.

Suicidal ideation, suicide attempt, and self-injury among American Indian, Alaskan Native, and Native Hawaiian college students in the United States from 2015 to 2019

Background

Suicide is a major driver of mortality among college students and is the leading cause of death among American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH) young adults.

Methods

Data on suicidal ideation, suicide attempt, and self-injury among AI/AN/NH college students (n = 8103) were analyzed via multivariable logistic regressions employing the American College Health Association National College Health Assessment survey from 2015 to 2019. Adjusted odds ratios (aORs) were used to assess how opioid misuse may act as a risk or protective factor for suicidality and self-injury.

Results

Between 2015 and 2019, suicidal ideation was the most prevalent dimension of suicidality affecting AI/AN/NH college students (ranges from 12.69% to 18.35%), followed by self-injury (7.83%-11.41%) and suicide attempt (2.40%-4.10%). AI/AN/NH college students who reported opioid misuse were significantly more likely to experience suicidal ideation (aOR: 1.417; 95% confidence interval [CI]: 1.154-1.740) and self-injury (aOR: 1.684; 95% CI: 1.341-2.116) than those who did not engage in such behavior.

Conclusions

We identified opioid misuse as a potential risk factor for suicidal ideation and intentional self-injury among populations of AI/AN/NH college students. Programs seeking to reduce suicide prevalence among Indigenous college students may benefit from the inclusion of evidence-based interventions that prevent and treat issues related to opioid use.

Positive mental health accounts for the relationship between insomnia symptoms and suicide-related outcomes

Insomnia symptoms have been shown to be associated with suicide ideation/behavior. However, the underlying mechanism is unclear and studies on protective factors that might mitigate the association between sleep-related problems and suicide ideation/behavior are largely missing. On this background the aim of the current study was to investigate, whether positive mental health (PMH) accounts for the association between insomnia symptoms and suicidal ideation/behavior. A total of 913 participants (72.2% women; age: M(SD) = 25.91 (7.08)) completed measures on insomnia symptoms, PMH and suicide ideation/behavior via an online survey. The results reveal a significant association between insomnia symptoms and PMH. Both variables were significantly linked to lifetime suicide ideation/behavior and 12-month suicide ideation. Moreover, the association between insomnia symptoms and suicide-related outcomes was significantly mitigated by PMH. The current findings complement previous studies on the association between insomnia symptoms and suicide ideation/behavior. Furthermore, they demonstrate that PMH can mitigate the risk of suicide-related outcomes. Therapeutic intervention targeting insomnia symptoms and fostering PMH might be useful in the prevention of suicide ideation/behavior.

The "bubbles"-study: Validation of ultra-short scales for the assessment of depression, anxiety and stress symptoms

Depression, anxiety and stress symptoms cause substantial psychological and economic burdens around the globe. To mitigate the negative consequences, the negative symptoms should be identified at an early stage. Therefore, the implementation of very brief valid screening tools in mental health prevention programs and in therapeutic settings is advantageous. In two studies on representative German population samples, we developed and validated three ultra-short scales-the "bubbles"-that consist of only one item based on the Depression Anxiety Stress 21 subscales (DASS-21) for the assessment of depression, anxiety and stress symptoms. The results of Study 1 (N = 1,001) and Study 2 (N = 894) revealed that the bubbles are valid instruments that fit the DASS-21 subscales on the factor level. Moreover, the bubbles replicated the association pattern of the DASS-21 subscales with demographic variables, and with variables that belong to the negative and the positive dimension of mental health. Thus, due to their time- and cost-efficiency, the bubbles can be used as brief screening tools in research (e.g., large-scale studies, longitudinal studies, experience sampling paradigms) and in praxis. Their shortness can prevent fatigue, motivation decrease, and participants' drop-out.

Positive mental imagery and mental health amongst university students in Pakistan

Mental health problems amongst university students pose a major public health challenge, and this is particularly the case in Pakistan. Alongside broader societal and cultural pressures, cognitive factors likely also play a role in the development of and resilience to mental health problems and may provide a feasible target for interventions. The current study built on previous research in primarily European samples investigating the relationship between one cognitive factor, positive future-oriented mental imagery, and mental health, extending this to a sample of university students in Pakistan (N = 1838). In a cross-sectional design, higher vividness of positive future-oriented mental imagery was associated with lower levels of depressive symptoms and higher levels of positive mental health amongst participants completing questionnaire measures on paper (N = 1430) or online (N = 408). In the sample completing the measures on paper, these relationships remained statistically significant even when controlling for socio-demographic and mental health-related variables. The results provide a foundation for further investigating positive mental imagery as a potential mechanism of mental health and intervention target amongst university students in Pakistan.

Depression, PTSD, and suicidal ideation among ex-ultra-Orthodox individuals in Israel

Introduction: Disaffiliating from an ultra-Orthodox society is complex and challenging. The process includes dealing with culture shock, traumatic experiences, education gaps, and disconnection from familiar surroundings. Thus, ex-ultra-Orthodox individuals (ex-ULTOIs) may face loneliness, lack of belongingness, and loss of meaning, which may relate to high psychological distress such as depression and suicide ideation. In the present study, we sought to shed light on the distress of ex-ULTOIs in Israel and to understand the disaffiliation-related characteristics that may relate to their distress levels.Method: The sample comprised 755 participants, aged 19-54, who left their ultra-Orthodox Jewish lifestyle and communities. Participants completed self-report questionnaires tapping depression, anxiety, posttraumatic stress disorder (PTSD) symptoms, suicide ideation and behaviour, as well as demographics and disaffiliation-related characteristics.Results: Nearly half of the sample (N = 332, 45.9%) reported symptom intensity meeting the current criteria for major depressive disorder. Moreover, 46.7% reported symptoms meeting PTSD criteria, and 34.5% reported having suicidal ideations in the past year. Hierarchical regression analyses revealed that the intensity of past negative life events, the nature of motives for disaffiliation, and the longer duration of the disaffiliation process contributed to the severity of distress.Conclusions: The study's findings reveal that ex-ULTOIs suffer from high mental pain levels, particularly depression, PTSD, and suicidal risk. Importantly, experiencing disaffiliation as traumatic and longer durations of the process may facilitate greater mental pain and distress symptoms. These findings emphasize that ex-ULTOIs must be continually assessed, especially when their disaffiliation processes are experienced as traumatic.

A machine learning analysis of risk and protective factors of suicidal thoughts and behaviors in college students

OBJECTIVE

To identify robust and reproducible factors associated with suicidal thoughts and behaviors (STBs) in college students.

METHODS

356 first-year university students completed a large battery of demographic and clinically-relevant self-report measures during the first semester of college and end-of-year (n = 228). Suicide Behaviors Questionnaire-Revised (SBQ-R) assessed STBs. A machine learning (ML) pipeline using stacking and nested cross-validation examined correlates of SBQ-R scores.

RESULTS

9.6% of students were identified at significant STBs risk by the SBQ-R. The ML algorithm explained 28.3% of variance (95%CI: 28-28.5%) in baseline SBQ-R scores, with depression severity, social isolation, meaning and purpose in life, and positive affect among the most important factors. There was a significant reduction in STBs at end-of-year with only 1.8% of students identified at significant risk.

CONCLUSION

Analyses replicated known factors associated with STBs during the first semester of college and identified novel, potentially modifiable factors including positive affect and social connectedness.

Validation of the German Version of the P4 Suicidality Tool

For general practitioners (GPs), it may be challenging to assess suicidal ideation (SI) in patients. Although promising instruments exist for the use in primary care, only a few have been validated in German. The objectives of this study were to examine the validity of the brief P4 screener for assessing SI in a cross-sectional study including outpatients. Inclusion criteria were a PHQ-9 score ≥ 10 or an affirmative answer to its SI item. Construct validity of the P4 was examined by comparison with the four-item Suicide Behaviors Questionnaire-Revised (SBQ-R), the PHQ-9 (convergent), and the positive mental health (PMH) scale (divergent). The study sample included 223 patients (mean age 47.61 ± 15 years; 61.9% women) from 20 primary care practices (104 patients) and 10 psychiatric/psychotherapeutic clinics (119 patients). The first three items of the P4 correlate positively with most of the four items of the reference standard SBQ-R (convergent validity); the fourth item of the P4 (preventive factors) correlates significantly with the PMH scale. The most common preventive factor (67%) is family or friends. The German P4 screener can be used to assess SI in outpatient care. It explores preventive or protective factors of suicide, which may support the GP's decision on treatment. We recommend a further clinical interview for patients flagged by P4 assessment in order to more formally assess suicidal risk.

Positive Mental Health Scale (PMHS) in Parents of Children with Cancer: A Psychometric Evaluation Using Item Response Theory

Mental health is currently a public health issue worldwide. However, evidence is lacking regarding the validity of the instruments used to measure and assess positive mental health in specific populations. The objective of this study was to evaluate the psychometric properties of the PMHS using IRT. A cross-sectional retrospective study with non-probabilistic convenience sampling was conducted with 623 parents of children undergoing cancer treatment at the National Institute of Health in Mexico City. The participants responded to a battery of tests, including a sociodemographic questionnaire, the PMHS, Measurement Scale of Resilience, Beck Depression Inventory, Inventory of Quality of Life, Beck Anxiety Inventory, an interview regarding caregiver burden, and the World Health Organization Well-Being Index. PMHS responses were analyzed using Samejima's graded response model. The PMHS findings indicated that the IRT-based graded response model validated the single latent trait model. The scale scores were independent of depression, anxiety, well-being, caregiver burden, quality of life, and resilience. The PMHS scores were associated with low subjective well-being. The PMHS findings reveal that from an IRT-based perspective, this scale is unidimensional and is a valid, reliable, and culturally relevant instrument for assessing positive mental health in parents of children with chronic diseases.

Validation and psychometric properties of the bangla version of positive mental health scale (PMH-scale)

Positive mental health is crucial to individuals' total well-being and especially to their emotional, psychological, and social functioning. To assess the positive aspects of mental health, the Positive Mental Health Scale (PMH-scale) is being used as one of the most significant and practical short unidimensional psychological tools. However, the PMH-scale has not yet been validated for the Bangladeshi population nor has it been translated into Bangla. Therefore, the purpose of this study was to investigate the psychometric properties of the Bangla version of PMH-scale and validate it with the Brief Aggression Questionnaire (BAQ) and Brunel Mood Scale (BRUMS). The sample of the study consisted of 3145 university students (61.8% men) aged from 17 to 27 (M = 22.07, SD = 1.74) and 298 general population (53.4% men) aged from 30 to 65 (M = 41.05, SD = 7.88) of Bangladesh. The factor structure of the PMH-scale as well as measurement invariance for sex and age (age ≤30 years; age >30 years) were tested, using the confirmatory factor analysis (CFA). The CFA revealed that the originally proposed unidimensional model of PMH-scale had a good fit in the current sample which confirms factorial validity of the Bangla version of PMH-scale. The value of Cronbach's alpha (for both groups combined α = 0.85; for the student sample α = .85; and for the general sample α = .73) ensured the high internal consistency of the items. Concurrent validity of the PMH-scale was confirmed through the expected correlation with aggression (BAQ) and mood (BRUMS). The PMH-scale was also partially invariant over groups (student, general, men and women) indicating that the PMH-scale is equally applicable to student, general, men and women population. Therefore, this study tells us that the Bangla version of PMH-scale is a quick and easy-to-administer tool for assessing positive mental health in different groups of people in Bangladeshi culture. This work will also be useful for mental health studies in Bangladesh.

Social media use, mental health, and suicide-related outcomes in Russian women: A cross-sectional comparison between two age groups

BACKGROUND

Women who belong to the age group "emerging adulthood" (18 to 29 years) are vulnerable to mental health issues and suicide-related outcomes.

OBJECTIVES

This study investigated potential predictors of suicide-related outcomes in females emerging adulthood and compared them to older women.

DESIGN AND METHODS

Data of 2537 women from Russia (group "18 to 29 years": n = 1123; group "> 29 years": n = 1414) on lifetime suicide-related outcomes, (problematic) social media use, daily stress, depression and anxiety symptoms, and positive mental health were assessed via online cross-sectional surveys.

RESULTS

The younger group spent significantly more time on social media use than the older group. It had significantly higher levels of daily stress, problematic social media use, depression and anxiety symptoms, and suicide-related outcomes. The older group showed significantly higher levels of positive mental health. Only in the younger group, problematic social media use significantly mediated the relationship between daily stress and suicide-related outcomes in a moderated mediation analysis. Positive mental health significantly moderated the association between problematic social media use and suicide-related outcomes. Specifically, the higher the positive mental health level, the less close the link between both variables.

CONCLUSION

The current results reveal that young women in Russia could be at enhanced risk for daily stress, problematic social media use, and low levels of mental health. The interaction between these variables could foster suicide-related outcomes. Public governmental communication in Russia should call attention to potential negative impact of intensive social media use.

Mediation effects of post-series depression on the relationship between life satisfaction and positive mental health of Vietnamese: A cross-sectional study in COVID-19 pandemic context

Vietnam, a middle-income country, has been suffering four waves of the Coronavirus disease 2019 (COVID-19) pandemic and a massive lockdown to suppress the spread of this infectious disease. Consequently, COVID-19 has caused psychological ramifications and affected humankind’s life satisfaction. Because of the lockdown period, numerous people had plentiful time. Hence, they found solace in excessive watching of television and movies, which could lead to post-series depression. The purpose of this study is to investigate the relationship between life satisfaction (LS), post-series depression (PSD), and positive mental health (PMH) and inquire about the mediation effect of satisfaction of life and PSD. A total of 2,572 participants who were voluntarily recruited from various media platforms completed self-report questionnaires, including the Satisfaction with life scale, Post-series depression scale, and Positive Mental Health Scale. This study was assessed using the PLS-SEM approach. The findings of this research discovered (i) a significantly positive effect of LS on PMH; (ii) a significantly negative effect of PSD on PMH; (iii) a significantly negative effect of LS on PSD, and (iv) a significant indirect effect of LS on PMH through PSD. The study provided additional evidence to the relationship between life satisfaction and PMH of individuals. Besides, the negative effects of PSD, which is a non-clinical term for feeling down that frequently appears after individuals finish their much-loved film and TV series, on individuals’ PMH is proved, especially in the COVID-19 pandemic context in which Vietnamese people must remain in their current location.

Psychometric properties of a Saudi Arabian version of the Positive Mental Health (PMH) scale

The Positive Mental Health (PMH) scale has been shown to be a reliable and valid tool for assessing positive mental health and well-being in different languages and cultures. However, the PMH scale has not yet been translated into Arabic and validated for the Saudi Arabian population. Therefore, the current study aimed to translate the English version of the PMH scale into Arabic for the Saudi Arabian context and validate the translated scale. A total of 1148 adult participants from Saudi public universities took part in the study. Based on exploratory and confirmatory factor analyses in different subsamples, the results of the current study revealed that the unifactorial model satisfactorily fits the data. Additionally, the Arabic version of the PMH scale demonstrated sufficient levels of reliability and had a high negative correlation with the Beck Depression Inventory-II, indicating convergent validity. Taken together, the findings of the current study suggest that the Arabic version of the PMH scale has appropriate levels of validity and reliability for the Saudi Arabian population.

Moral Injury and Suicide Ideation Among Combat Veterans: The Role of Trauma-Related Shame and Collective Hatred

Exposure to potentially morally injurious events (PMIEs) among combat veterans has been acknowledged as a significant stressful combat event that may lead to mental health problems, including suicide ideation (SI). Several studies have examined the risk and protective factors that can explain the conditions in which PMIEs may contribute to the development and maintenance of SI. However, the contribution of social-emotional factors has yet to be examined. In the current study, we examined the association between PMIE-Self and SI among combat veterans and explored the mediating role of trauma-related shame and the moderation role of collective hatred in this association. A volunteer sample of 336 Israeli combat veterans was recruited, completing self-report questionnaires in a cross-sectional study. Results indicated that PMIE-Self was positively associated with SI, and trauma-related shame mediated this association. Moreover, collective hatred moderated both their direct (PMIE-SI) and indirect (PMIE-Shame-SI) association. Notably, collective hatred had an inverse role for each of the associations. Thus, collective hatred was found to comprise both a risk and a protective factor for SI following PMIE-Self. The current findings highlight the crucial contribution of trauma-related shame and collective hatred to the association between moral injury and suicidality. Moreover, the findings demonstrate that even years after their military service release, combat veterans exposed to PMIEs may still feel consumed by painful memories and maintain premonitions of a foreshortened future. Furthermore, the findings help to better understand the dynamics of collective hatred and the challenge of modifying it.

Correlates of suicidality in young people with depressive disorders: A systematic review

OBJECTIVE

Depression is one of the most prevalent and disabling mental health conditions among young people worldwide. The health and economic burdens associated with depressive illness are substantial. Suicide and depression are closely intertwined, yet a diagnosis of depression itself lacks predictive specificity for suicidal behaviour. To better inform suicide prevention and early intervention strategies for young people, improved identification of modifiable intervention targets is needed. The objective of this review was to identify clinical, psychosocial and biological correlates of suicidality in young people diagnosed with a broad range of unipolar and bipolar depressive disorders.

METHOD

Systematic searches were conducted across MEDLINE, Embase and PsycINFO to identify studies of young people aged 15-25 years diagnosed with unipolar or bipolar depressive disorders. An assessment of suicidality was required for inclusion. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 and Synthesis Without Meta-analysis guidelines.

RESULTS

We integrated findings from 71 studies including approximately 24,670 young people with clinically diagnosed depression. We identified 26 clinical, psychosocial and biological correlates of suicidality. Depression characteristics (type and severity), psychiatric comorbidity (particularly anxiety and substance use disorders) and neurological characteristics emerged as having the most evidence for being associated with suicidal outcomes. Our ability to pool data and conduct meaningful quantitative synthesis was hampered by substantial heterogeneity across studies and incomplete reporting; thus, meta-analysis was not possible.

CONCLUSION

Findings of this review reinforce the notion that suicidality is a complex phenomenon arising from the interplay of multiple contributing factors. Our findings question the utility of considering a diagnosis of depression as a specific risk factor for suicidality in young people. Suicidality itself is transdiagnostic; adoption of a transdiagnostic approach to investigating its aetiology and treatment is perhaps warranted. Future research investigating specific symptoms, or symptom networks, might help to further our understanding of suicidality among young people experiencing mental illness.

Mental health and suicidality in Afghan students after the Taliban takeover in 2021

BACKGROUND

On the 15th of August 2021, Kabul was captured by the Taliban, leading to the fall of the Islamic Republic of Afghanistan. The present study investigated PTSD symptoms, depression, suicide risk and facets of positive mental health in the immediate aftermath of the Taliban take-over.

METHODS

A total of 214 Afghan university students (73.7% women; age in years: M(SD) = 23.92 (5.77)) took part in this cross-sectional study between August and November 2021. Self-report measures of PTSD, depression, suicide ideation/behavior, positive mental health, social support, and posttraumatic growth were used.

RESULTS

Severe posttraumatic stress disorders symptoms were reported by 70%, clinically relevant depression symptoms were reported by 69.7% and significant suicide ideation/behavior was reported by 38.6% of the sample. Posttraumatic growth moderated the impact of depression on suicide risk. No interaction effects were found for positive mental health and social support.

LIMITATION

The study focused on a specific group of highly educated and predominantly female Afghan students limiting the generalizability of the findings.

CONCLUSION

PTSD symptoms, depression and suicidality show an alarmingly high prevalence in this specific sample of Afghan students. Various protective factors seem to be insufficient to buffer the association between PTSD, depression and suicide risk.

Subjective Wellbeing and Its Associated Factors among University Community during the COVID-19 Pandemic in Northern Malaysia

Lockdown implementation during COVID-19 pandemic has caused many negative impacts in various aspect of life, including in the academic world. Routine disruption to teaching and learning environment has raised concerns to the wellbeing of university staff and students. This study aimed to examine the subjective wellbeing of the university community in Northern Malaysia during lockdown due to COVID-19 pandemic and the factors affecting it. An online cross-sectional survey involving 1148 university staff and students was conducted between March and April 2020. The research tools include the Personal Wellbeing Index (PWI) to assess subjective wellbeing and the Depression, Anxiety and Stress 21 (DASS-21) scale for psychological distress. While we found the subjective wellbeing score in our study population was stable at 7.67 (1.38), there was high prevalence of anxiety, depression, and stress with 27.4%, 18.4%, and 11.5%, respectively. The students reported higher levels of psychological distress compared to staff. The PWI score was seen to be inversely affected by the depression and stress score with a reduction in the PWI score by 0.022 (95% CI −0.037 to −0.007) and 0.046 (95% CI −0.062 to −0.030) with every one-unit increment for each subscale, respectively. Those who perceived to have more difficulty due to the lockdown also reported low subjective wellbeing. Thus, it is crucial to ensure policies and preventative measures are in place to provide conducive teaching and learning environment. Additionally, the detrimental psychological effects especially among students should be addressed proactively.

Thinking for healing: The role of mentalization deficits as moderator in the link between complicated grief and suicide ideation among suicide-loss survivors

Suicide-loss survivors are an at-risk population for complicated grief and suicide ideation. This study examined mentalization deficits as a possible moderator of the association between complicated grief and suicide ideation. Suicide-loss survivors (N = 152) completed questionnaires on complicated grief, suicide ideation, and mentalization deficits. Mentalization deficits facilitated suicide ideation, beyond the contribution of complicated grief. Complicated grief and suicide ideation were more strongly associated at higher mentalization deficit levels. Limitations include the non-representative cross-sectional nature of the sample and the use of a single item for suicide ideation. The findings highlight the critical link between complicated grief and suicide ideation among suicide-loss survivors and mentalization deficits' role as its possible facilitator.

Physical activity, mental and physical health during the Covid-19 outbreak: longitudinal predictors of suicide ideation in Germany

Aim

Suicide ideation has increased since the outbreak of Covid-19 in many countries. The present longitudinal study investigated potential predictors of suicide ideation.

Subject and methods

Data of 406 participants from Germany (age M = 27.69, SD = 6.88) were assessed via online surveys in spring 2020 (baseline, BL) and in spring 2021 (follow-up, FU).

Results

The current results reveal a significant increase in symptoms of depression, anxiety, and stress between 2020 and 2021. Positive mental health (PMH), sense of control, and physical health significantly decreased. Depression symptoms (BL), PMH (BL), and consciously enhanced physical activity since the pandemic outbreak (FU) significantly predicted 12-month suicide ideation (FU). In a moderated mediation analysis, the positive relationship between depression and suicide ideation was significantly mediated by PMH. Consciously enhanced physical activity significantly moderated the negative association between PMH and suicide ideation.

Conclusion

The context of Covid-19 could negatively impact mental health and physical health. This might increase the risk for suicide ideation. However, PMH and physical activity might serve as protective factors. The protective effect of physical activity could be especially important in people with high depression symptoms and low PMH, such as clinical patients. Potential ways of how PMH and physical activity could be enhanced in the Covid-19 context to prevent suicide ideation are discussed.

Assessment and Associations between Quality of Life and Risk of Suicide

Abstract This study aimed to verify the extent to which the levels of quality of life are related to and influence suicide risk indices. A descriptive, correlational, quantitative research was performed. A non-probabilistic sample was used which was composed of 11,863 Brazilian participants all over 18 years old, who responded to the Risk Assessment Suicide Scale (RASS) and the World Health Organization Quality of Life BREF Instrument (WHOQOL-BREF), and whose data were analyzed by using descriptive statistics, the Spearman correlation and multiple linear regression using the Statistical Package for Social Sciences (SPSS). The results identify negative, moderate and significant correlations between the constructs, and that the domains of quality of life influence 47.8% of the variations in the suicide risk indices, confirming that the psychological domain is the most relevant within the explanatory model created. The conclusion is that there is a the need for public policies to improve the quality of life and prevent suicide.

An exploration of the mental health and well-being of postgraduates in pharmacy and pharmaceutical science programs

BACKGROUND

Postgraduate students enrolled at colleges and schools of pharmacy are at an increased risk of experiencing difficulties with mental health and well-being; however, there is minimal work exploring mental health and well-being among postgraduates in pharmacy and pharmaceutical science programs.

OBJECTIVES

(1) to explore the current mental health and well-being of pharmacy postgraduates, (2) to identify factors that promote and hinder mental well-being at the individual and organizational levels, and (3) to explore perspectives regarding organizational priorities, resources, and support tools that may improve the mental health and well-being of postgraduates in pharmacy and pharmaceutical science programs.

METHODS

This study conducted a cross-sectional survey of postgraduates in pharmacy and pharmaceutical science programs. Surveys were distributed electronically via the American Pharmacists Association's (APhA) broadcast e-mail system to postgraduate members and through the professional networks of APhA Academy of Pharmaceutical Research and Science (APhA-APRS) Postgraduate Advisory Committee members. The survey had 3 sections: demographics, current mental health and well-being status, and barriers and facilitators to mental health and well-being. Descriptive statistics and frequencies were generated for quantitative survey responses. Open-ended responses were categorized and presented with each question.

RESULTS

Fifty-one responses were analyzed. The sample had a mean age of 29.0 ± 6.6 years, included 58.8% women or womxn, and most were in doctoral programs (58.8%) for 2.3 ± 2.7 years in various disciplines. There were 27.5% of respondents categorized as having flourishing mental health and 7.8% with languishing mental health. Factors such as practicing self-care or engaging in hobbies (94.1% for each) were most commonly rated as having a positive impact on well-being, and societal racism and discrimination (66.7%) was most commonly reported as having a negative effect on well-being. Top priorities for postgraduates included work-life balance, career prospects, meaningful relationships, and financial concerns.

CONCLUSION

There are a number of organizational and institutional priorities that may improve pharmacy and pharmaceutical science graduate students' mental health and well-being.

The association between COVID-19, personal wellbeing, depression, and suicide risk factors in Australian autistic adults

The COVID-19 pandemic has had a significant impact on the mental health and wellbeing of the world's population, with particularly negative effects on vulnerable populations, including autistic people. Although some consensus regarding specific impact on aspects of wellbeing and mental health in autism is starting to emerge, it is unclear whether the pandemic has increased suicide risk. The goals of this study were to examine (a) potential associations between COVID-19 impact and depression, personal wellbeing, and suicide risk factors in Australian autistic adults and (b) age and gender effects. The COVID-19 Impact Scale (CIS), Personal Wellbeing Index, Patient Health Questionnaire, and the Suicide Behavior Questionnaire, Revised (SBQ-R), were administered to 111 autistic adults aged 20 to 71 years during the second wave of the COVID-19 pandemic in Australia. COVID-19 impact showed small associations with poorer personal wellbeing (r = -0.224, p = 0.023, [-0.409, -0.016]) and higher depressive symptoms (r = 0.268, p = 0.006, [0.056, 0.445]) and was not associated with the SBQ-R suicide risk score (r = 0.081, p = 0.418, [-0.118, 0.264). No significant effects were identified for age. Although model results were similar for women and men, the strength of the associations between personal wellbeing and depression (z = -2.16, p = 0.015), and depression and SBQ-R suicide risk (z = 1.961, p = 0.025), were stronger in women than in men. Qualitative analysis of an open response question from the CIS suggested that the pandemic had both positive and negative impacts on participants. The COVID-19 pandemic has had a large impact on the mental health and wellbeing of the world's population, particularly vulnerable populations such as autistic people. It is not known if these impacts on mental health and wellbeing have increased suicide risk. Our findings suggest that the impact of the COVID-19 pandemic may be associated with poorer wellbeing and higher depression, but is not associated with suicide risk. Overall, autistic people reported both positive and negative impacts of the pandemic on their lives.

Suicide ideation during the COVID-19 outbreak in German university students: Comparison with pre-COVID 19 rates

Introduction

An increase of suicidal thinking within the COVID-19 pandemic has been postulated. Yet, direct comparisons with pre-COVID-19 rates are missing.

Methods

The present study investigated whether levels and rates of suicidal ideation have changed between 2016 and 2020. Data of N = 664 university students (five cohorts: 2016: n = 105, 2017: n = 117, 2018: n = 108, 2019: n = 154, 2020: n = 180) were collected by online surveys.

Results

The rate of students suffering from suicidal ideation was twice as high in 2020 than in previous years. Furthermore, levels of suicidal thinking and of depression were higher in 2020 than in 2019 and 2016.

Limitations

The sample size of the current study was rather modest and suicide ideation was assessed with a single item only.

Conclusions

The rate of students suffering from suicidal ideation was twice as high in 2020 than in previous years. Help-lines and online counselling should be promoted to the public and the possibilities of telepsychotherapy for suicidal people should be used and expanded.

Validation of the Persian version of the Positive Mental Health Scale

BACKGROUND

Positive mental health (PMH) is a factor of far-reaching salutogenetic importance. The present study aimed at validating the Persian version of the Positive Mental Health Scale (PMH-Scale).

METHODS

Reliability and validity of the Persian version of the PMH-Scale were established in an Iranian student sample (N = 573). Internal consistency, convergent and discriminant validity were investigated, and exploratory factor analysis was conducted. Furthermore, it was assessed how PMH scores moderate the association between depressive symptoms and suicide ideation/behavior.

RESULTS

The Persian version of the PMH-Scale  was shown to have a unidimensional structure with excellent internal consistency, as well as good convergent and divergent validity. PMH differentiated between participants with higher vs. lower suicide risk. Furthermore, PMH proved to moderate the association between depressive symptoms and suicide ideation/behavior.

CONCLUSIONS

The results suggest that the PMH-Scale is a brief, reliable, and valid measure of subjective and psychological well-being that can be used in Iranian student samples and research settings.

Role of Personality and Positive and Negative Affects in Coping Strategies of Nurses: A Cross-Sectional Study

Nurses are exposed to many highly stressful events. Individual variables, such as personality and affective state, have been related to vulnerability to maladaptive coping. Therefore, the objectives of this study were to analyze the relationships between the personality, positive and negative affects, and coping strategies of nurses and to establish the mediating role of affective state in the relationship between personality and coping. The sample was made up of 1,268 Spanish nurses aged 22-63 years who completed the Coping Strategies Inventory, the Positive and Negative Affect Schedule, and the 10-item Big Five Inventory. Descriptive analyses, correlations, and mediation models were estimated. The results showed relationships between the Big Five personality factors, positive and negative affects, and coping strategies. Negative affect was confirmed as a mediator between personality and less adaptive strategies and positive affect was confirmed on positive strategies. This study emphasizes the need to develop actions directed at teaching nurses adequate problem-solving strategies and training them in the ability to assign a different emotional value to complex situations.

Relationship between self-efficacy, social rhythm, and mental health among college students: a 3-year longitudinal study

Although many empirical studies have aimed to find variances in positive mental health among different groups and the relationship between mental health and other variables, few studies examined the developmental trend of mental health levels and the cross-lagged relationship between self-efficacy, social rhythm, and mental health. Furthermore, few of them explored the interrelationship between self-efficacy and social rhythm among college students over time. This study thus aimed to clarify the longitudinal cross-lagged relationship between self-efficacy, social rhythm, and positive mental health among college students. A total of 764 students (627 females, mean age 21.03 ± 0.84 years at T1) participated in a 3-year-long study (T1, T2, T3) and were asked to complete the General Self-Efficacy, the Brief Social Rhythm, and the Positive Mental Health Scales. The results indicate that the development of positive mental health among college students showed an upward trend during those 3 years. There was a significant relationship between positive mental health, social rhythm, and self-efficacy. Positive mental health and social rhythm significantly predicted self-efficacy in the following year. Positive mental health in T2 could predict both T3 social rhythm marginally and T3 self-efficacy significantly. However, T1 social rhythm was not indirectly associated with T3 mental health via T2 self-efficacy, and T1 self-efficacy was not indirectly associated with T3 mental health via T2 social rhythm. This finding clarified the relationship between positive mental health, self-efficacy, and social rhythm, and provided evidence that positive mental health is the basis for self-efficacy and social rhythm among young adults. Therefore, school psychologists in universities should pay close attention to the positive mental health of young adults to form high levels of self-efficacy and social rhythm.

Suicidality in 12-Year-Olds: The Interaction Between Social Connectedness and Mental Health

Suicidal thoughts and behaviors (STB) are a leading cause of death in adolescence. To date, most research with youth has focused on risk factors for suicide; and less attention has been paid to resilience factors. This study examined whether positive beliefs and social connectedness moderate associations between mental health symptoms and STB. A community sample of 12-year-olds (N = 60) completed self-report questionnaires on their STB, mental health symptoms, positive beliefs and social connectedness. Nearly 20% of the adolescents reported STB. STB was associated with increased mental health symptoms and lower scores on the resilience measures. A significant moderating effect of social connectedness showed that youth with a combination of poor mental health and high levels of social support exhibited lower levels of STB. There was no significant moderating effect of positive beliefs. These results indicate that social support should be screened for in primary care and incorporated into youth suicide prevention programs.

Resilience Factors in the Association Between Depressive Symptoms and Suicidality

PURPOSE

To investigate whether life satisfaction and optimism might reduce the risk of suicidal thoughts and behaviors among adolescents with depressive symptoms.

METHODS

Participants were 1,904 youth from the NEXT Generation Health Study, a national sample of U.S. adolescents, followed over 7 years from 2009/2010 to 2015/2016. Longitudinal latent profile analysis and logistic regressions were conducted.

RESULTS

We identified three subgroups of adolescents with different patterns of depressive symptoms across the first six waves: "Low" (40%), "Mild" (42%), and "Moderate to Severe" (18%). The Moderate to Severe (OR = 14.47, 95% CI [6.61, 31.66]) and Mild (OR = 3.90, 95% CI [2.22, 6.86]) depression profiles had significantly higher odds of developing suicidality than the Low depression profile. Both life satisfaction and optimism moderated the association between depressive symptom profile and suicidality. The difference in suicidality risk between the Mild and Low depression profiles was significantly attenuated at high versus low levels of life satisfaction, with a difference of -.08, 95% CI [-.14, -.03]. In addition, the difference in suicidality risk between the Moderate to Severe and Low depression profiles was attenuated at high versus low levels of optimism, with a difference of -.11, 95% CI [-.21, -.01].

CONCLUSIONS

For adolescents transitioning to young adulthood, resilience factors such as life satisfaction and optimism may buffer against suicidality risk in the face of mild or moderate to severe depressive symptoms.

Worldwide prevalence of suicide attempt in pregnant and postpartum women: a meta-analysis of observational studies

PURPOSE

Past suicide attempts (SA) are a major contributor to suicide. The prevalence of SA in pregnant and postpartum women varied significantly across studies. Therefore, this meta-analysis was conducted to examine the prevalence of SA and its mediating factors in this population.

METHODS

Relevant articles published in PubMed, EMBASE, Web of Science, PsycINFO, Medline complete, Chinese National Knowledge Infrastructure database (CNKI), Chinese Wanfang and Chongqing VIP database were systematically searched from inception to March 28, 2019. Titles, abstracts and full texts were reviewed independently by three researchers. Studies were included if they reported data on SA prevalence or provided relevant data that enabled the calculation of SA prevalence. Data were extracted by two researchers and checked by one senior researcher. The random-effects model was used to analyze data by the CMA 2.0 and Stata 12.0, with the high degree of statistical heterogeneity present. The primary outcomes were prevalence of SA with 95% CI during pregnancy and during the first-year postpartum.

RESULTS

Fourteen studies covering 6,406,245 pregnant and postpartum women were included. The pooled prevalence of SA was 680 per 100,000 (95% confidence interval 0.10-4.69%) during pregnancy and 210 per 100,000 (95% confidence interval 0.01-3.21%) during the first-year postpartum. Data source was significantly associated with prevalence of SA in the subgroup analysis (pregnancy, p < 0.001; the first-year postpartum, p = 0.013).

CONCLUSION

The prevalence of SA is not high in pregnant and postpartum women. Due to the potential loss of life and negative impact of SA on health outcomes, however, careful screening and effective preventive measures should be implemented for this population.

Interpersonal predictors of suicide ideation and complicated-grief trajectories among suicide bereaved individuals: A four-year longitudinal study

BACKGROUND

Survivors of suicide loss (suicide survivors) are recognized as an at-risk population for several psychiatric complications, including complicated grief (CG) and suicide ideation (SI). Recent studies have emphasized the contribution of interpersonal factors, such as thwarted belongingness and perceived burdensomeness, on distress and suicidality. However, no longitudinal study has examined the predictive values of these interpersonal factors on CG and SI trajectories among suicide survivors to date. In this 42-month prospective design study, we examined interpersonal variables as predictors of CG and SI over time.

METHOD

Participants were 152 suicide survivors, aged 18-70, who completed questionnaires tapping thwarted belongingness, perceived burdensomeness, CG, and SI at index measurement (T1) and again after 18 months (T2) and 40 months (T3).

RESULTS

The integrated model showed that thwarted belongingness and perceived burdensomeness predicted SI and CG levels over time, both directly and indirectly. Thwarted belongingness was found to have a high predictive value on SI levels, whereas perceived burdensomeness was predictive of CG levels.

LIMITATIONS

The voluntary nature of the participants; self-report measures; lack of pre-suicide-loss assessment.

CONCLUSION

The study's findings highlight the critical role of interpersonal factors in facilitating CG and SI among suicide survivors. Those with higher levels of thwarted belongingness and perceived burdensomeness presented increased prospects of both SI and CG. Theoretical implications relating to healing processes are discussed, as well as focused clinical recommendations, including psychoeducational interventions for addressing PB and TB among suicide survivors.

Loneliness predicts suicidal ideation and anxiety symptoms in long-term childhood cancer survivors

Long-term childhood cancer survivors (CCS) are at risk for adverse late effects. However, not all of them are well understood. The present study addressed loneliness, a previously under-researched mental health risk in cancer survivor populations. We assessed the prevalence of loneliness and its impact on psychological symptoms over time. Method: A registry-based sample of N = 633 adult long-term CCS underwent medical and psychological assessments and took part in a follow-up survey 2.5 years later. Psychological symptoms (somatic, anxiety, depression symptoms, and suicidal ideation) were measured using the Patient Health Questionnaire. We calculated linear regression models of symptoms at follow-up to investigate the impact of loneliness over time (controlling for symptoms at baseline and relevant confounders). Results: Loneliness was reported by 17.70% of CCS. In multivariate linear regression analyses, loneliness was still predictive of more severe anxiety symptoms and suicidal ideation over two years later. Loneliness did not predict somatic and depression symptoms at follow-up (which increased with age). Conclusions: Loneliness affected a significant number of CCS and was a risk factor for persistent anxiety symptoms and suicidal ideation. The extent to which young cancer patients’ re-integration into society is successful could thus have important implications for well-being in adulthood.

Suicidal Ideation Mediates the Relationship Between Affect and Suicide Attempt in Adolescents

Suicide, as one of the leading causes of death for the adolescent population, both in Chile and globally, remains a complex and elusive phenomenon. This research studies the association between positive and negative affect in relation with suicidal ideation and suicidal attempt, given that affectivity is a fundamental basis on which people make evaluations on their satisfaction with life. First, it examines the reliability, structure, and validity of Watson's positive and negative affect scale (PANAS) scale in a representative random sample of Chilean high school students (N = 4,568). The scale evidences strong reliability coefficients and a confirmatory factor analysis, excluding one positive (excited) and one negative (nervous) item. The scale shows a satisfactory goodness of fit. Secondly, it investigates the association of PANAS positive and negative affect scores with suicidal ideation as well as reported attempt in adolescents, controlling for the potential effect of age and sex (N = 420 high school students). Low positive and high negative affect, but not sex and age, show a significant association with suicidal ideation. Suicidal ideation totally mediates the association of affect with suicide attempt, as expected. Results are discussed regarding prevention and it considers how positive and negative affect can be relevant as indicators for prevention and treatment using widely available technology.

Behavioral measures to fight COVID-19: An 8-country study of perceived usefulness, adherence and their predictors

Behavioral measures, such as the wearing of facemasks and maintaining of distance to other people, have been central in fighting the COVID-19 pandemic and will continue to be important in curbing its spread. We therefore investigated their perceived usefulness, adherence and their predictors in representative online samples in eight countries (France, Germany, Poland, Russia, Spain, Sweden, U.K., U.S.). Of the 7,658 participants, 77.4% rated governmental measures (highest: Germany, lowest: France) as useful and 91.7% reported adherence to them. Adherence was lowest in Russia and Poland, where people felt particularly left alone and not well supported, and in the U.S. and Sweden, where governments showed ambivalent attitudes towards the measures. The highest adherence was reported in countries with very high mortality (U.K., Spain, France) or very positively perceived government communication (Germany). Female gender, higher age, belonging to a risk group, being affected physically and mentally, perception of governmental communication as guided by the interests of people, feeling of being well informed and the level of positive mental health positively predicted both outcomes, while being affected economically negatively predicted both outcomes. Country-specific results are considered in the light of the protection motivation theory and the theory of planned behavior together with potential ways to improve active participation of the population. Overall, we recommend the governments and authorities to stress that each individual can contribute to the control of the COVID-19 situation by adherence to the measures in the public communication. Moreover, they should emphasize the risk of unconscious infection of older individuals by younger people, as well as the importance of physical activity for the protection of mental and physical health especially during the pandemic.

The broad autism phenotype in real-life: clinical and functional correlates of autism spectrum symptoms and rumination among parents of patients with autism spectrum disorder

OBJECTIVE

Increasing literature reported higher rates of psychiatric disorders in parents of children with autism spectrum disorder (ASD), as well as of autistic-like features in social and cognitive functioning. However, little attention has been paid to the association between autistic traits (AT) and global functioning in this population. The aim of the present work was to investigate clinical and functional correlates of AT among parents of ASD children, with a specific focus on ruminative thinking.

METHODS

One hundred and twenty parents of ASD children were assessed by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the Adult Autism Subthreshold Spectrum (AdAS Spectrum), the Ruminative Response Scale (RRS), the Social and Occupational Functioning Assessment Scale (SOFAS).

RESULTS

Subjects with at least 1 psychiatric disorder (39.2%) showed significantly higher AdAS Spectrum and RRS scores. Subjects with a history of school difficulties and with language development alterations scored significantly higher on specific AdAS Spectrum domains. A significant negative correlation was found between SOFAS and AdAS Spectrum scores, as well as between SOFAS and RRS scores. AdAS Spectrum nonverbal communication domain score was identified has a statistically predictive variable for the presence of psychiatric disorders and lower SOFAS scores. Finally, we found a significant indirect effect of AdAS total score on SOFAS score, which was fully mediated by RRS total score.

CONCLUSIONS

AT in parents of ASD children seem to be associated with a higher vulnerability toward psychopathology and with a lower global functioning. Ruminative thinking may play a role in the relationship between AT and functional outcome.

Accurate Diagnosis of Suicide Ideation/Behavior Using Robust Ensemble Machine Learning: A University Student Population in the Middle East and North Africa (MENA) Region

Suicide is one of the most critical public health concerns in the world and the second cause of death among young people in many countries. However, to date, no study can diagnose suicide ideation/behavior among university students in the Middle East and North Africa (MENA) region using a machine learning approach. Therefore, stability feature selection and stacked ensembled decision trees were employed in this classification problem. A total of 573 university students responded to a battery of questionnaires. Three-fold cross-validation with a variety of performance indices was sued. The proposed diagnostic system had excellent balanced diagnosis accuracy (AUC = 0.90 [CI 95%: 0.86-0.93]) with a high correlation between predicted and observed class labels, fair discriminant power, and excellent class labeling agreement rate. Results showed that 23 items out of all items could accurately diagnose suicide ideation/behavior. These items were psychological problems and how to experience trauma, from the demographic variables, nine items from Post-Traumatic Stress Disorder Checklist (PCL-5), two items from Post Traumatic Growth (PTG), two items from the Patient Health Questionnaire (PHQ), six items from the Positive Mental Health (PMH) questionnaire, and one item related to social support. Such features could be used as a screening tool to identify young adults who are at risk of suicide ideation/behavior.

Positive mental health mediates the relationship between physical activity and suicide-related outcomes: a three-year follow-up study

Suicide belongs to the leading causes of death worldwide. The present longitudinal study investigated physical activity (for example jogging, cycling) and positive mental health (PMH) as potential factors that can reduce the risk of suicide ideation and suicidal behavior. Data of 223 participants (79.4% women; Mage(SDage) = 22.85 (4.05)) were assessed at two measurement time points over a three-year period (2016: first measurement = baseline (BL); 2019: second measurement = follow-up (FU)) via online surveys. The results reveal a significant positive relationship between higher physical activity (BL) and higher PMH (BL). Higher scores of both variables were significantly negatively linked to lower suicide-related outcomes (FU). Moreover, the association between higher physical activity (BL) and lower suicide-related outcomes (FU) was significantly mediated by higher PMH (BL). The current findings demonstrate that physical activity in combination with PMH can reduce the risk of suicide-related outcomes. Fostering physical activity and PMH may be relevant strategies in the prevention of suicide ideation and suicide behavior.

Suicidal behaviors and depression "among adolescents in Hanoi, Vietnam: A multilevel analysis of data from the Youth Risk Behavior Survey 2019

This study described the prevalence of suicidal behaviors and depression among adolescents in Hanoi, Vietnam, and examines the associated factors. In 2019, a school-based survey was conducted in three high schools in Hanoi and 661 high students were included into the study. We found that the prevalence of 12-month suicidal thoughts, suicide plans, and suicide attempts were 14.2%, 5.5%, and 3.0% respectively. Notably, the depression score mean was 16.1±4.9, among major predictors of suicidal ideation. Therefore, developing psychological care services in school is imperative to the early detection of mental disorders and the prevention of suicidal behaviors for the students.

Does Mental Well-Being Protect against Self-Harm Thoughts and Behaviors during Adolescence? A Six-Month Prospective Investigation

Mental well-being protects against the emergence of suicidal thoughts. However, it is not clear whether these findings extend to self-harm thoughts and behaviors irrespective of intent during adolescence-or why this relationship exists. The current study aimed to test predictions-informed by the integrated motivational-volitional (IMV) model of suicide-concerning the role of perceived defeat and entrapment within the link between mental well-being and self-harm risk. Young people (n = 573) from secondary schools across Scotland completed an anonymous self-report survey at two time points, six months apart, that assessed mental well-being, self-harm thoughts and behaviors, depressive symptomology and feelings of defeat and entrapment. Mental well-being was associated with reduced defeat and entrapment (internal and external) and a decrease in the likelihood that a young person would engage in self-harm thoughts and behaviors. The relationship between mental well-being and thoughts of self-harm was mediated by perceptions of defeat and entrapment (internal and external). Mental well-being was indirectly related to self-harm behaviors via decreased feelings of defeat and internal (but not external) entrapment. Taken together, these findings provide novel insights into the psychological processes linking mental well-being and self-harm risk and highlight the importance of incorporating the promotion of mental well-being within future prevention and early intervention efforts.

Predicting adaptive and maladaptive responses to the Coronavirus (COVID-19) outbreak: A prospective longitudinal study

Background/Objective

The outbreak of COVID-19 and the lack of vaccine made extraordinary actions such as social distancing necessary. While some individuals experience the restrictions on daily life as a heavy burden, others adapt to the situation and try to make the best of it. The present longitudinal study investigated the extent and predictors of the burden induced by the outbreak of COVID-19 in Germany.

Method

Data were assessed in October 2019 using the DASS-21 and the PMH-Scale, and in March 2020 adding a six-item measure of burden and a 2-item rating of sense of control.

Results

In a sample of 436 participants, about 28% stayed in self-quarantine, 22 persons had relevant symptoms and one person was positively tested for COVID-19. Most participants experienced medium to high levels of burden but tried to make the best of it. Stress symptoms in 2019 predicted a higher level of burden and PMH predicted a lower level of burden in March 2020. Remarkably, depression and anxiety symptoms did not significantly predict burden. The protective effect of PMH and the negative impact of stress symptoms were mediated by perceived sense of control.

Conclusions

The results emphasize the protective effect of PMH in extraordinary situations such as the current outbreak of COVID-19.

Verbitterung, Weisheit und Suizidgedanken

Inwieweit Verbitterung mit Suizidgedanken assoziiert ist, wurde bislang nur selten untersucht. Darüber hinaus stellt sich die Frage, ob Weisheit bzw. Weisheitskomponenten den Zusammenhang zwischen Verbitterung und Suizidgedan­ken moderieren, Weisheit also als ein Resilienzfaktor gegenüber Suizidgedanken zu verstehen ist. Insgesamt nahmen 311 Proband*innen (<i>n</i> = 179, 57,6% weiblich; Alter: Mittelwert = 32,63 Jahre, SD = 14,06) an einer internetbasierten Fragebogenstudie teil. Es zeigte sich sowohl, dass Verbitte­rung und Suizidgedanken eng assoziiert sind, als auch, dass dieser Zusammenhang durch die Weisheitskomponente Humor moderiert wird. In Bezug auf weitere Weisheitskomponenten fanden sich keine erwartungskonformen Zusammenhänge. Die Ergebnisse unterstützen aktuelle Befunde zur Bedeutung von Humor als Resilienzfaktor gegenüber suizidalem Erleben.

A comparison between American and Chinese college students on suicide-related behavior parameters

BACKGROUND/OBJECTIVE

The United States (US) and China are the two largest economies, but recent and directly comparable studies on suicide-related behaviors in the two countries are lacking. By using the Suicidal Behaviors Questionnaire-Revised (SBQ-R), item-level comparison was performed in assessing self-reported suicide-related behaviors between the US and Chinese undergraduates.

METHOD

This study involved a total of 3,185 college students aged between 18 to 24 years (1,185 US college students, and 2,000 Chinese students who were randomly selected from a large sample of 11,806 Chinese college students). Participants filled out the 4-item SBQ-R.

RESULTS

Participants' responses were compared by country and sex. There was a higher overall risk of suicide-related behaviors among US students (24.3%) compared to Chinese students (17.0%). US students also reported higher lifetime attempt, past-year ideation, and lifetime threat. US female college students reported the highest suicide-related behaviors compared to other sub-groups.

CONCLUSIONS

There is a need to tailor specific interventions to alleviate college students' suicide-related behaviors in the US and China, with a particular focus on US females.

Psychometric properties and measurement invariance of Depression, Anxiety and Stress Scales (DASS-21) across cultures

Cross-culturally measurement invariant instruments are useful for the assessment of mental symptoms across cultures. The current study aimed to investigate the psychometric properties and measurement invariance of the Depression, Anxiety and Stress Scales (DASS-21) (DASS) across Pakistan and Germany. German participants were recruited through an online survey (N = 1323), while Pakistani participants were recruited through online survey or paper-and-pencil survey (N = 1841). The DASS-21 showed good reliability, construct and structure validity in both countries. The DASS-21 indicated partial weak (stress subscale) and partial strong measurement invariance (depression and anxiety subscales) between both countries. Latent mean comparison of depression and anxiety symptoms between Pakistani and German students indicated that Pakistani university students experience more symptoms of depression and anxiety. Results suggest that the DASS-21 could be used in Pakistan and Germany, but caution should be taken when making direct comparisons between the two countries.

Positive Mental Health Mediates the Relationship Between Facebook Addiction Disorder and Suicide-Related Outcomes: A Longitudinal Approach

Suicide-related outcomes increased among young adults in the last decade. Excessive use of social media was hypothesized to contribute to this development. This longitudinal study aimed to investigate whether Facebook Addiction Disorder (FAD) predicts suicide-related outcomes, and whether Positive Mental Health (PMH) buffers this effect. Data of 209 German Facebook users [M_age(SD_age) = 23.01 (4.45)] were assessed at two measurement time points over a 1-year period (first measurement = T1 and second measurement = T2) through online surveys. FAD was measured with the Bergen Facebook Addiction Scale, PMH was assessed with the PMH-Scale, and suicide-related outcomes were measured with the Suicidal Behaviors Questionnaire-Revised. The significant positive association between FAD (T1) and suicide-related outcomes (T2) was significantly negatively mediated by PMH (T1). These results demonstrate that addictive Facebook use may enhance the risk of suicide-related outcomes. However, PMH contributes to the reduction of this risk. Therefore, addictive Facebook use and PMH should be taken into account when assessing individuals for suicide of risk.