Positive mental health, positive affect and suicide ideation

Beyond one-size-fits-all suicide prediction: Studying idiographic associations of risk factors for suicide in a psychiatric sample using ecological momentary assessment

The Interpersonal Psychological Theory of Suicide (IPTS) states that thwarted belongingness (TB), perceived burdensomeness (PB), and hopelessness are risk factors for suicidal ideation. This ecological momentary assessment (EMA) study aimed to (1) demonstrate that there is substantial between-person variability in the association between IPTS predictors and suicidal ideation, (2) identify clusters of patients for which the predictors differently predict suicidal ideation, and (3) examine whether identified clusters are characterized by specific patient characteristics. EMA data were collected ten times per day for six days in 74 psychiatric inpatients and was analyzed with dynamic structural equation modelling. Idiographic associations were obtained and clustered using k-means clustering. We found substantial between-person variability in associations between IPTS predictors and suicidal ideation. Four distinct clusters were identified and different risk factors were relevant for different clusters. In the largest cluster (n = 36), none of the IPTS predictors predicted suicidal ideation. Clusters in which associations between IPTS variables and suicidal ideation were stronger showed higher suicidal ideation, depression, and lower positive affect. These findings suggest that a one-size-fits-all model may not adequately reflect idiosyncratic processes leading to suicidal ideation. A promising avenue might be to use idiographic approaches to personalize prediction and interventions.

Teachers' competence: How to protect teachers' mental health from the burden caused by students' private in-class use of technical devices?

The current study investigated how students' private in-class use of technical devices is associated with teachers' mental health. Data of 361 teachers from primary and secondary schools in Germany were assessed via online surveys. The present cross-sectional results show a positive association between burden caused by the students' private in-class use of technical devices and teachers' depression symptoms. Both were negatively linked to teachers' positive mental health (PMH) and teachers' competence in handling students' private in-class use of technical devices. In a moderated mediation analysis, the association between burden and depression symptoms was mediated by PMH. Teachers' competence moderated the link between PMH and depression symptoms. Specifically, the higher the competence, the weaker the relationship between both variables. Thus, the protective effect of teachers' competence could be especially important in persons with low PMH. Competence training in handling students' use of technical devices is discussed as a potential step that could protect teachers' mental health.

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.

Psychometric properties of the positive mental health questionnaire: short form (PMHQ-SF18) in young adults

Introduction

Positive Mental Health (PMH) plays a pivotal role in the promoting of mental health. Assessing this phenomenon is essential for early recognition and intervention in mental health. To date, only one tool was validated with 39 items to assess PMH among Portuguese young adults.

Method

This study sought to examine the psychometric properties of the short version of the Positive Mental Health Questionnaire (PMHQ) among Portuguese university students. The PMHQ Short Form was administered to a sample of 3,647 university students via an online platform. Exploratory and confirmatory factor analyses were performed. The principal factor solution was employed because some items showed higher levels of kurtosis. Multivariate analysis was tested using the Mardia's Test, Henze-Zirkler, and Royston. Findings of content, construct validity tests, and Cronbach's alfa demonstrated the satisfactory validity and suitable reliability of the PMHQ-Short Form (PMHQ-SF).

Results and discussion

The exploratory factor analysis produced six dimensions of the PMHQ-SF with three items in each factor demonstrating adequate internal reliability. The global internal consistency was 0.92, with factors ranging between 0.60 to 0.82. The results suggest that the PMHQ-SF is reliable, easier, and more practical to complete by university students due to the shortening of the number of items. The PMHQ-SF is useful for assessing positive mental health in young adults. The final version of the instrument contains from 32 to 18 items.

Influences of Indoor Air Temperatures on Empathy and Positive Affect

The consequences of climate change are already visible, and yet, its effect on psychosocial factors, including the expression of empathy, affect, and social disconnection, is widely unknown. Outdoor conditions are expected to influence indoor conditions. Therefore, the aim of this study was to investigate the effect of indoor air temperature during work hours on empathy, positive and negative affect, and social disconnection. Participants (N = 31) were exposed, in a cross-over design, to two thermal conditions in a simulated office environment. Questions on empathy and social disconnection were administered before and after the exposure to each condition, while affect was measured throughout the day. Subjective thermal sensation and objective measures of mean skin temperature were considered. The results indicated a significant difference in empathy (F(1, 24) = 5.37, p = 0.03, with an η2 = 0.126) between conditions. Participants reported increases in empathy after exposure to the warm condition compared to the cool condition, in which reductions in empathy were reported. Although the same pattern was observed for positive affect, the difference was smaller and the results were not significant. Thermal sensation had a significant effect on changes in empathy too (F(1, 54) = 7.015, p = 0.01, with an R2 = 0.115), while mean skin temperature had no effect on empathy (F(1, 6) = 0.53, p = 0.89, with an R2 = 0.81). No effects were observed for positive and negative affect and social disconnection. Longitudinal studies are needed to support these findings.

A Moderation Model for Bolstering Resilience to Suicidal Psychopathology: Positive Sociopsychological Constructs and Coping Flexibilities Buffering the Impact of Daily Life Stress Among Medical Students

ABSTRACT

Positive sociopsychological constructs and coping flexibility may be helpful for alleviating suicidal psychopathology, although relatively little research has examined this possibility among medical students. This survey aimed to investigate whether positive sociopsychological constructs and coping flexibility could buffer the negative impact of daily life stress and bolster the resilience to suicidal ideations and attempts among medical students. This cross-sectional model was based on a study of 787 Indian medical students (725 women and 62 men; mean age, 21.08 years; SD = 2.78; range, 19-37 years) who were asked to complete a battery of self-administered questionnaires. For the purpose of determining the independent and interaction impacts of potential variables of influence, hierarchical multiple linear regression models were used. The moderation analysis investigated that the association between daily life stress and suicidal ideation was buffered among the students having higher levels of positive mental health and coping flexibility, whereas this association was no longer significant at the highest level of positive mental health. Furthermore, the relationship between daily life stress and suicidal attempts continued to be buffered by above-average levels of coping flexibility, emotional stability (ES), and optimism. These findings represent that promoting positive mental health, coping flexibility, ES, and optimism may be a promising approach to mitigate suicidal thoughts and attempts in interventions for medical students at high risk. These modifiable moderating factors can be enhanced by empirically supported treatment and prevention efforts to bolster suicidal resilience.

Prevalence of suicide attempts across the African continent: A systematic review and meta-analysis

BACKGROUND

Over 700,000 people worldwide lose their lives through suicide every year. The prevalence of suicide has increased, especially in low- and middle-income countries such as many African countries. For every fatal suicidal attempt, there are approximately 20 other non-fatal suicide attempts within the population. The purpose of this study is to investigate the prevalence of attempts of suicides in the African continent through a systematic review and meta-analysis.

METHODS

To identify relevant sources, the PubMed, Scopus, Web of Science, Embase, ScienceDirect and Google Scholar repositories and databases were systematically searched without a lower time limit and until July 2023. The heterogeneity of the studies was checked with the I2 index, and accordingly random effects model was adopted to perform the analysis. Data analysis was conducted within the Comprehensive Meta-Analysis software (v.2).

RESULTS

In the review of 48 studies with a sample size of 244,701 people, the prevalence of suicide attempts in Africa was found to be 9.9% (95%CI: 8.5%-11.6%). With the increase in the year of study, the prevalence of suicide attempt in the African continent increases. Also, with the increase in the sample size, the prevalence of suicide attempts in Africa decreases. The suicide attempt prevalence among African men and woman slightly differed with 7.6% and 8.2%, respectively.

CONCLUSION

Suicide attempt is an important public health concern in Africa. The findings of this study are important not only for African health policy making, but also to contribute to the accuracy of global estimates with respect to suicide attempts.

COVID-19-Evidence of the Impact of Literacy and Salutogenic Behaviours in Positive Mental Health: A Cross-Sectional Study

Positive mental health is defined as the ability to perceive and interpret the context of a situation and to adapt to it whenever necessary. Considering the pandemic situation, identifying the factors that may have the greatest impact on quality of life and consequently, on positive mental health is paramount. The objective of this study was to assess the impact of health literacy on the adoption of behaviours that promote positive mental health during COVID-19. A descriptive, cross-sectional and correlational study was conducted on a sample of 770 patients using a questionnaire for sociodemographic characterization, the Positive Mental Health Questionnaire and the Mental Health Knowledge Questionnaire. Concerning health-promoting behaviours, those who sleep enough hours, exercise regularly, eat healthy and are more aware of mental health promotion activities, or have greater mental health literacy, have higher positive mental health scores. Thus, having more knowledge of mental health and adopting health-promoting behaviours improve positive mental health.

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.

COVID-19 infection: Positive mental health, psychological vulnerability and sex: Cross-sectional study

Since mid-March 2020, a state of emergency was decreed in Portugal due to the COVID-19 pandemic and, consequently, measures were implemented to protect public health, such as social isolation, which will certainly have a notable impact on the mental health of the population, especially in the most vulnerable groups. Positive Mental Health (PMH) is essential to deal with adversity, in this case with the pandemic, and to live better and with greater satisfaction. We consider it relevant to investigate how PMH was used as a resource to deal with the pandemic, depending on the level of vulnerability and sex. A, cross-sectional study was carried out whose the aim was to evaluate the levels of PMH and psychological vulnerability in people with COVOD-19 infection and analyze the association between PMH and psychological vulnerability among men and women.

METHODS

The instruments used were a sociodemographic characterization questionnaire, the Positive Mental Health Questionnaire, and the Psychological Vulnerability Scale (PVS), that were sent and filled out online. A quantitative, cross-sectional, descriptive, and correlational study was carried out.

RESULTS

After analyzing the results, it was found that approximately 50.4% of the respondents (n = 387) had global PMH values that place them in quartile 50. There was also a statistically significant difference between female and male PMH, with women showing greater psychological vulnerability and lower overall PMH.

CONCLUSIONS

We conclude that the women present a greater psychological vulnerability and a lower level of PMH when compared to men.

RELEVANCE TO CLINICAL PRACTICE

Considering the study's statistically significant results, when we talk about mental health, we should always consider the sex variable as a vulnerability factor, in a pandemic or non-pandemic phase.

Examining affective reactivity as a link between suicidality and social disconnection

The link between suicidality and social disconnection is well-established. We explored possible mechanisms that may account for this link using a positive and negative valence systems framework in a clinical sample with and without suicidality (i.e., suicidal ideation and/or behaviors in the past month). Participants (N = 228) interacted with a trained confederate during a controlled conversation task designed to generate social affiliation. Participant-rated positive affect (PA) and negative affect (NA) were collected during the task (baseline, anticipation, post). Participant-rated desire for future interaction was collected after the task. We tested if (1) groups with (n = 82) and without (n = 146) suicidality differed in affect during the task and (2) whether affect accounted for the link between suicidality and desire for future interaction. Results revealed that groups differed in PA, but not NA, throughout the task. Participants with suicidality reported no significant changes in PA over the task (ps > .05); and, experienced less PA at post-task compared to those without (p = .003, d = 0.38) whereas participants without suicidality reported increased PA at post-task compared to baseline and anticipation of the task, ps < .001. Mediation analysis suggested blunted post-task PA accounted for the relationship between suicidality and less desire for future interaction, 95%CI [-2.59,-0.51]. Diminished PA reactivity during social affiliation opportunities may help explain the link between suicidality and social disconnection. Preliminary findings highlight PA as a potential mechanistic target for improving social connection for individuals at risk for suicide, though prospective and experimental research is needed.

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.

Positive mental health and mindfulness as protective factors against addictive social media use during the COVID-19 outbreak

The outbreak of COVID-19 caused high psychological burden for many people. Some people tend to excessive social media use (SMU) to escape the negative emotions which can foster addictive tendencies. The present study investigated positive mental health (PMH) and mindfulness as protective factors that could reduce the risk for addictive SMU. Data of 1,049 participants from Germany were assessed via online surveys in autumn 2021. The current results reveal a positive relationship between COVID-19 burden and addictive SMU. Both were negatively linked to PMH and mindfulness. In a moderated mediation analysis, the relationship between COVID-19 burden and addictive SMU was mediated by PMH. Mindfulness moderated the association between PMH and addictive SMU. The COVID-19 situation can be burdensome and contribute to dysfunctional coping strategies such as addictive SMU. However, PMH and mindfulness serve as protective factors. The protective effect of mindfulness could be especially important for persons with low PMH.

A Hybrid Deep Learning Model Using Grid Search and Cross-Validation for Effective Classification and Prediction of Suicidal Ideation from Social Network Data

Suicide deaths due to depression and mental stress are growing rapidly at an alarming rate. People freely express their feelings and emotions on social network sites while they feel hesitant to express such feelings during face-to-face interactions with their dear ones. In this study, a dataset comprising 20,000 posts was taken from Reddit and preprocessed into tokens using a variety of effective word2vec techniques. A new hybrid approach is proposed by combining the attention model in a convolutional neural network and long-short-term- memory. The objective of this research is to develop an effective learning model to evaluate the data on social media for the efficient and accurate identification of people with suicidal ideation. The proposed attention convolution long short-term memory (ACL) model uses hyperparameter tuning using a grid search to select optimized hyperparameters. From the experimental evaluation, it is shown that the proposed model, that is, ACL with Glove embedding after hyperparameter tuning gives the highest Accuracy of 88.48%, Precision of 87.36%, F1 score of 90.82% and specificity of 79.23% and ACL with Random embedding gives the highest Recall of 94.94% when compared to the state-of-the-art algorithms.

Internalized Homophobia and Suicide Ideation Among Sexual Minority Adults: The Serial Mediation of Core Self-Evaluations and Depression

Internalized homophobia (IH) is the endorsement of negative attitudes and stereotypes about sexual minority individuals among those who are LGBQ + . However, although IH is associated with suicide ideation, the underlying mechanisms of this association are relatively understudied. To address this limitation, this research investigates Core Self-Evaluation (CSE; one's fundamental evaluations about themselves, their own abilities, and their own control) and depression as underlying mechanisms associating IH with suicide ideation. CSE comprises four traits: self-esteem, locus of control, emotional stability, and generalized self-efficacy. An online survey was completed by 404 sexual minority adults (Mean_age = 27.42 years, %Female = 51.50, %Male = 30.40, %Trans Female = 3.2, %Trans Male = 5.4). Participants were recruited via Prolific, an online crowdsourcing platform. Four serial mediation analyses examined the direct and indirect effects of IH on suicide ideation via each CSE trait and depression symptoms. Results showed support for the CSE-depression mediated pathway. Self-esteem, emotional stability, and general self-efficacy (but not locus of control) mediated the relationship between IH and suicide ideation via depression symptoms. Across three serial mediations, greater IH was associated with lower (1) self-esteem, (2) emotional stability, and (3) self-efficacy; lower self-esteem, emotional stability, and self-efficacy were associated with greater reported depression symptoms, which were then associated with greater suicide ideation. This research has implications for understanding the underlying mechanisms that associate IH with poor mental health among sexual minority adults. Studying the social and psychological mechanisms can help develop therapeutic interventions that target suicide ideation and promote positive self-evaluations among sexual minority individuals.

Longitudinal associations between salivary cortisol to C-reactive protein ratios and psychological well-being in Chinese adults

BACKGROUND

Salivary C-reactive protein (CRP) could be a viable biomarker of inflammation and has been associated with stress outcomes. The hypothalamic-pituitary-adrenal axis can modulate stress-related inflammation. This study aimed to evaluate the interaction effects of immune-endocrine markers on psychological outcomes.

METHODS

The study participants were 52 healthy Chinese adults who collected 10 saliva samples over 2 consecutive days at baseline. The participants completed validated measures on anxiety, depression, positive affect, and sleep disturbance at baseline and 1 month later. The stability and diurnal patterns of salivary cortisol and CRP were investigated via paired t-tests and repeated-measures analyses of variance. Regression analysis was used to examine the longitudinal associations between immune-endocrine markers and their interactions (cortisol [Cort]: morning CRP [CRP_morn] and Cort:CRP_even) and psychological measures.

RESULTS

Salivary cortisol and CRP displayed satisfactory stability over 2 consecutive days and diurnal patterns of abrupt and gradual decline during the day, respectively. Controlling for baseline psychological measures and confounding variables, Cort_morn and diurnal cortisol slope was significantly and negatively associated with anxiety symptoms and positive affect 1 month later, respectively. Cort:CRP_even and Cort:CRP_morn was significantly and positively associated with depressive symptoms and sleep disturbance 1 month later, respectively.

CONCLUSION

These findings offer initial support for the prognostic utility of salivary cortisol and CRP and their balance as determinants of psychological health in healthy adults.

Examining the Interrelationships Among Suicide Cognitions, Suicidal Ideation, and Theoretically Derived Protective Factors

INTRODUCTION

Several protective factors for mitigating suicidal ideation (SI) such as positive affect, reasons for living, purpose in life, meaning in life, gratitude, grit, optimism, social support, and hope have been identified and received empirical support. However, few studies have examined the interrelationships of these protective factors and the identification of protective factors most closely linked to lower levels of SI may be useful for both theory-building initiatives and improvement of suicide-specific interventions. Network analysis offers an approach for testing the relation among these constructs, SI, and suicide risk factors.

METHODS

A sample N = 557 undergraduate students oversampled for lifetime SI completed a cross-sectional, online survey. The data was used to estimate an undirected, cross-sectional network of the aforementioned protective factors.

RESULTS

The resulting inferred network implicates strong negative influence of suicide cognitions, but not recent SI, and the strong positive influence of presence of meaning in life, trait hope, and low negative affect.

CONCLUSIONS

Implications for dimensionality of SI versus suicide cognitions, targeting presence of meaning in life, trait hope, and negative affect in treatment, and cross-cultural variations in reasons for living are discussed. The study is limited by the cross-sectional and convenience sampling methodology.HighlightsProtective factors may have less direct influence on suicidal ideationSuicide cognitions and the suicidal mode may be of phenomenological importancePresence of meaning and trait hope may be primary targets for suicide interventions.

Female Homicide in Italy in 2021: Different Criminological and Psychopathological Perspectives on the Phenomenon

The intentional homicide of female victims, which is most commonly perpetrated by intimate partners or family members, has been recognized in recent years as a matter of grave public concern that needs to be addressed from the cultural and judicial perspectives. To allow an in-depth criminological and psychopathological evaluation of female homicide in Italy in 2021 to be conducted, the authors performed a newspaper report analysis of the phenomenon. All female homicides that occurred in Italy in 2021 (n = 119) were included in the study. The analysis confirmed the low rate of female homicides in Italy when compared with other countries and also showed the phenomenon to be more complex than usually described. The highest rate of homicides was observed in elderly females when compared with other age groups, implying different criminological considerations and suggesting that gender-based violence may only explain some of the identified cases. The high incidence of suicide or attempted suicide among offenders, together with the high incidence of reported mental disorders in that population, suggests that a psychopathological perspective on the phenomenon of female homicide could help with the development and implementation of preventive strategies that focus on managing mental health at a territorial level and intervening in difficult domestic situations.

Addictive social media use during Covid-19 outbreak: Validation of the Bergen Social Media Addiction Scale (BSMAS) and investigation of protective factors in nine countries

Since the Covid-19 outbreak, addictive social media use increased in many countries. To better understand this development, a universal instrument for the assessment of addictive social media use is required. Against this background, we examined the psychometric properties of the Bergen Social Media Addiction Scale (BSMAS) in representative population samples in nine countries (N = 9418, age range: "18 to 24 years" (youngest group), "55 years and older" (oldest group): China, France, Germany, Poland, Russia, Spain, Sweden, U.K., U.S.). Furthermore, we investigated potential factors and mechanisms that could be associated with addictive social media use. Our cross-national findings show that the BSMAS is a unidimensional reliable and valid instrument. Moreover, they reveal that the negative association between positive mental health and addictive social media use is mediated by sense of control in seven of the nine countries (exception: China, Russia). Thus, it can be hypothesized that activities which increase positive mental health could indirectly contribute to the decrease of addictive social media use. We identified conscious engagement in physical activity and a regular sleep rhythm during the pandemic as such potential activities. The fostering of both by governmental programs could enhance positive mental health and reduce addictive social media use.

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.

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.

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.

Impacts of Dual-Income Household Rate on Suicide Mortalities in Japan

To explore impact of enhancing social advancement of females in Japan, this study determined the effects of the dual-income household rate on suicide mortalities disaggregated by attributes of gender, age, and motives between 2009 and 2017 in Japan. This study analysed impact of dual-income household rate, other household-related factors (savings, liabilities and yearly incomes per household, minors and elderly rate per household), and social/employment factors (complete unemployment rate, employment rate, temporary male and female employment rates and certification rate of long-term care insurance) on suicide mortalities disaggregated by attributes of gender, age, and motives using hierarchical linear-regression model. Dual-income household rate was significantly/negatively related to suicide mortality of the working-age female population, but significantly/positively related to that of the elderly female population. Suicide mortalities of the working-age male population and the elderly male population were significantly/positively related to dual-income household rate. Male suicide mortalities caused by family-, health-, economy- and employment-related motives were significantly/positively related to dual-income household rate; however, the dual-income household rate was significantly/positively related to female suicide mortalities caused by family-, health-, economy- and school-related motives, but significantly/negatively related to suicide mortalities caused by romance-related motives. Dual-income households suppress social-isolation and develop economical/psychological independence of females, leading to reduced suicide mortality in working-age females. However, elderly and school-age populations, who are supported by the working-age female, suffer from isolation. Working-age males also suffer from inability to adapt from the traditional concept of work–life and work–family balances to the novel work–family balance concept adapted to dual-income households. These results suggest occurrence of new social/family problems in the 21st century due to vulnerability of traditional Japanese culture and life–working–family balance concepts as well as novel sociofamilial disturbances induced by declining birth rate and ageing population in Japan.

Empathy, Affect and Personality as Predictors of Engagement in Nursing Professionals

BACKGROUND

It seems that personality traits affect engagement and the quality of professional life, which is mediated by the emotional and affective states of nursing personnel. Therefore, the objectives of this study were to analyze the relationships between the components of empathy, affect, personality, and engagement, find personality profiles, identify the variables with the most explanatory value, and analyze the mediating role of the variables susceptible to intervention in the relationship between personality and the components of engagement.

METHODS

A sample of 1268 nurses completed the Utrecht Work Engagement Scale, 10-item Big Five Inventory, Basic Empathy Scale, and Positive and Negative Affect Schedule.

RESULTS

Empathy, affect, and personality influence engagement factors in nurses. The vigor and absorption factors of engagement showed a positive relationship with empathy, positive affect, and all of the Big Five personality factors except neuroticism with which the relationship was negative. Personality affected the vigor, dedication, and absorption factors of engagement, and cognitive empathy mediated this relationship.

CONCLUSIONS

This study shows the need to continue investigating the factors that affect and mediate in engagement of nursing professionals.

Depression screening and treatment among uninsured populations in Primary Care

Uninsured populations have poor treatment engagement and are less likely to receive evidence-based interventions for depression. The objective of the current study was to retrospectively examine depression screening, diagnosis, and treatment patterns among uninsured patients in primary care. Study sample included all patients (N = 11,803) seen in nine community-based clinics. Key variables included depression screener and/or a depression diagnosis, anti-depressant initiation, behavioral health visits, and patient follow up measures. Treatment patterns from the subsample of patients diagnosed with depression were analyzed by collecting the number of behavioral health visits and antidepressant use six months (180 days) following the diagnosis. Utilization of the depression screening tool was high (67%, n = 7,935) and 24% (n = 2,789) of the patients had a diagnosis of depression, however, more than half of the patients with a depression diagnosis did not have a recorded treatment plan (n = 1,474). The odds of anti-depressant use and behavioral visits for Hispanic patients were significantly greater than for Non-Hispanic patients. Universal screening with brief measures in primary care is improving, however, guideline-concordant depression treatment remains elusive for uninsured populations.

A longitudinal study on depressive symptoms and physical activity during the Spanish lockdown

Background/Objective: The aim was to evaluate the evolution of depressive symptoms and to explore the influence of physical activity (PA) practice during the home confinement due to the COVID-19 outbreak in Spain. Method: Information was collected from 595 confined participants who reported personal and contextual information, depressive symptoms and PA levels at four time points. Results: The changes in depressive symptoms were analyzed using a linear mixed model with cubic splines. Results showed a significant increase, with a significant rise between T1 and T2 (OR = 2.38, 95% CI = 1.83-3.10). It continued growing until T4 (OR = 2.93, 95% CI = 1.97-4.38). A negative relationship was observed between the increase in depressive symptoms and moderate-to-vigorous physical activity (MVPA) levels, with a significant slope up to 4 hours of MVPA per week (OR = 0.51, 95% CI = 0.29-0.90) that tended to increase until 16 hours per week of MVPA (OR = 0.41, 95% CI = 0.20-0.87). Conclusions: Results from a partition model showed that moderate intensity of PA could be enough to prevent an increase of depressive symptoms during home isolation.

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.

The Common Factors of Grit, Hope, and Optimism Differentially Influence Suicide Resilience

No study to date has simultaneously examined the commonalities and unique aspects of positive psychological factors and whether these factors uniquely account for a reduction in suicide risk. Using a factor analytic approach, the current study examined the relationships between grit, hope, optimism, and their unique and overlapping relationships in predicting suicide ideation. Results of principle axis factor analysis demonstrated close relationships between these variables at both the construct and item level. Item-level analyses supported a five-factor solution (Stick-to-Itiveness, Poor Future, Consistency of Interest, Positive Future, and Poor Pathways). Four of the five factors (excluding Stick-to-Itiveness) were associated with suicide ideation. Additionally, results of a multiple regression analysis indicated that two of the five factors (Consistency of Interest and Positive Future) negatively predicted suicide ideation while Poor Future positively predicted suicide ideation. Implications regarding the interrelationships between grit, hope, and optimism with suicide ideation are discussed.

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.

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.

The Prevalence and Correlates of Suicidal Ideation, Plans and Suicide Attempts among 15- to 69-Year-Old Persons in Eswatini

The study aimed to assess the prevalence and associated factors of ever suicide attempt and past 12-month suicidal ideation, plans and/or attempts among persons aged 15–69 years in Eswatini. Cross-sectional nationally representative data from 3281 persons (33 years median age, range 15–69) of the 2014 Eswatini STEPS Survey were analysed. Results indicate that 3.6% of participants had attempted suicide, and 10.1% engaged in past 12-month suicidal ideation, plan and/or attempts. In adjusted logistic regression analysis, having family members who died from suicide and childhood sexual abuse were associated with ever suicide attempt. In addition, in unadjusted analysis, female sex, adult sexual abuse, threats and family member attempted suicide were associated with ever suicide attempt. In adjusted logistic regression, female sex, childhood sexual abuse, adult sexual abuse, threats, family alcohol problems and having family members who died from suicide were associated with past 12-month suicidal ideation, plan and/or attempts. In addition, in unadjusted analysis, 25–34-year-old participants, unemployed and other, childhood physical abuse, violent injury, family member attempted suicide and having had a heart attack, angina or stroke were associated with past 12-month suicidal ideation, plans and/or attempts. One in ten participants were engaged in suicidal ideation, plans and/or attempts in the past 12 months, and several associated factors were identified that can inform intervention programmes.

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.

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.

Decrease of well-being and increase of online media use: Cohort trends in German university freshmen between 2016 and 2019

Research from the U.S. described a decrease of subjective well-being and an increase of online media use in young adults today. The present study investigated whether similar trends occur in Germany. Data of overall 1985 university freshmen (four cohorts: 2016: N=658, 2017: N=333, 2018: N=562, 2019: N=432) were collected by online surveys in the years 2016 to 2019. The comparison of the four cohorts revealed a significant increase of depression, anxiety and stress symptoms, as well as of the use of social platforms from 2016 to 2019. In contrast, positive mental health (PMH) significantly decreased over the years. No significant changes of the gaming behavior were found. A slight significant positive relationship occurred between the negative variables of well-being and online media use. The association between PMH and online media use was significantly negative. Thus, cohort trends found in the U.S. can at least rudimentarily be replicated in Germany. Young adults in 2019 seem to have lower levels of well-being and to engage in more use of social platforms than older cohorts.

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.

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.

Positive Mental Health, Stressful Life Events, and Suicide Ideation

Background: Stressful life events and suicide ideation regularly occur together. Yet, little is known about factors that buffer individuals against the development of suicide ideation. Aim: In a long-term follow-up study design, it was investigated whether positive mental health, that is, high levels of subjective and psychological well-being, buffers the association between stressful life events and suicide ideation. Method: A total of 126 German students (80.2% female; age: M = 24.29, SD = 5.21) were assessed at a baseline evaluation and again 24 months later. Data were collected using self-report questionnaires. Results: Linear hierarchical regression analysis was used to analyze the data. Positive mental health was considered to moderate the impact of stressful life events on suicide ideation - controlling for age and gender. Limitations: Current results are limited to university students. Conclusions: Positive mental health interacts with stressful life events, such that those with high levels of positive mental health show an attenuated increase in suicide ideation at elevated levels of stress. Positive mental health seems to confer resilience and should be focused on in counseling centers for students.

Salutogenic constructs across Pakistan and Germany: A cross sectional study

Background/Objective

Protective factors are relevant for mental health in general, however, universality of the instruments has been rarely tested. Therefore, the current study aimed to examine psychometric properties and cross-cultural measurement invariance of salutogenic constructs.

Method

Data was collected from university students of Pakistan (n = 1,841) and Germany (n = 7,890). Single-group confirmatory analysis (CFA) and multiple-group CFA was tested to examine the proposed factor structure and measurement invariance of Positive Mental Health Scale, Resilience Scale, Perceived Social Support Questionnaire, and Life Satisfaction Scale across student samples from Pakistan and Germany respectively.

Results

We found strong measurement invariance for the Positive Mental Health Scale, Life Satisfaction Scale, and partial strong measurement for the Resilience Scale, and Perceived Social Support Questionnaire.

Conclusions

The results indicate that these scales could be recommended for the meaningful comparison of latent means across cultures. Understanding these differences would further advance our knowledge about the mechanism underlying positive mental health.