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Keefner T, Minton M. Acquired Capability for Suicide: An Evolutionary Concept Analysis. Issues Ment Health Nurs 2024; 45:734-745. [PMID: 38718381 DOI: 10.1080/01612840.2024.2346594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
While virtually all suicide attempters experience ideations, not all who think about suicide will attempt or die by suicide. The ideation-to-action framework has led to new theories distinguishing suicide ideators from suicide attempters. The framework suggests that suicide progresses on a spectrum of thoughts and behaviors with different identifiers and explanations. The concept of acquired capability for suicide (ACS), conceptualized by the Interpersonal Psychological Theory of Suicide, is the first to explain the movement from ideation to action. This concept analysis of ACS is timely and relevant for greater clarification of the role ACS has in the movement from ideation to action. Rodgers' evolutionary concept analysis method is used. The six-step evolutionary method highlights the concept's attributes, antecedents, and consequences and provides a basis for further inquiry and development rather than a final definition.
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Affiliation(s)
- Tamara Keefner
- Department of Nursing, University of South Dakota, Vermillion, South Dakota, USA
| | - Mary Minton
- South Dakota State University, Brookings, South Dakota, USA
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2
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Kirshenbaum JS, Pagliaccio D, Bitran A, Xu E, Auerbach RP. Why do adolescents attempt suicide? Insights from leading ideation-to-action suicide theories: a systematic review. Transl Psychiatry 2024; 14:266. [PMID: 38937430 PMCID: PMC11211511 DOI: 10.1038/s41398-024-02914-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 06/29/2024] Open
Abstract
Suicide is a leading cause of death among adolescents, and recent suicide theories have sought to clarify the factors that facilitate the transition from suicide ideation to action. Specifically, the Interpersonal Theory of Suicide (IPTS), Integrated Motivational-Volitional Model (IMV), and Three Step Theory (3ST) have highlighted risk factors central to the formation of suicidal ideation and suicidal behaviors, which is necessary for suicide death. However, these models were initially developed and tested among adults, and given core socioemotional and neurodevelopmental differences in adolescents, the applicability of these models remains unclear. Directly addressing this gap in knowledge, this systematic review aimed to (1) describe the evidence of leading ideation-to-action theories (i.e., IPTS, IMV, 3ST) as they relate to suicide risk among adolescents, (2) integrate ideation-to-action theories within prevailing biological frameworks of adolescent suicide, and (3) provide recommendations for future adolescent suicide research. Overall, few studies provided a complete test of models in adolescent samples, and empirical research testing components of these theories provided mixed support. Future research would benefit from integrating neurodevelopmental and developmentally sensitive psychosocial frameworks to increase the applicability of ideation-to-action theories to adolescents. Further, utilizing real-time monitoring approaches may serve to further clarify the temporal association among risk factors and suicide.
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Affiliation(s)
- Jaclyn S Kirshenbaum
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Alma Bitran
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Elisa Xu
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA.
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
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Doyle RL, Fite PJ. Informant Discrepancies in Suicidality Screening Tools Among School Age Youth. Child Psychiatry Hum Dev 2024; 55:394-404. [PMID: 35980493 DOI: 10.1007/s10578-022-01412-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 02/22/2022] [Accepted: 08/02/2022] [Indexed: 11/03/2022]
Abstract
As the rate of death by suicide in youth ages 6 to 12 rises, it is imperative to better understand informant discrepancies when screening for suicidality. Accordingly, this study investigated associations among youth-, caregiver-, and clinician-reports of youth's suicidality and their associations with youth- and caregiver-reports of youth's depressive symptoms. Participants were 161 6- to 12-year-old youth presenting for outpatient psychological services at a Midwest training clinic between 2014 and 2019. More than 1 in 4 youth had at least one informant report some suicidal concerns. Results indicated that all informants' reports of suicidality were correlated with one another, with youth- and clinician-report being most strongly linked and caregiver- and clinician-report having the weakest correlation. Clinician- and youth-reports of suicidality were associated with youth-report, (but not caregiver-report) of depressive symptoms. Caregiver-report of suicidality was not associated with youth- or caregiver-report of depressive symptoms. When youth-report of depressive symptoms was regressed on sex, age, and youth-, caregiver-, and clinician-reports of suicidality, there was a trend that youth-report of suicidality was positively associated with youth-report of depressive symptoms. No informant's report of suicidality was uniquely associated with caregiver-report of depressive symptoms. Findings indicate that youth- and clinician-reports at intake are more strongly linked with one another than with caregiver-reports. Further, youth-reports on suicidality screening tools are more strongly associated with depressive symptoms than caregiver-report, suggesting that caregiver-reports are insufficient to assess concerns of suicidality at intake among school age youth.
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Affiliation(s)
- Rachel L Doyle
- Clinical Child Psychology Program, University of Kansas, 1000 Sunnyside Avenue Dole HDC Rm 2006, 66045, Lawrence, KS, USA.
| | - Paula J Fite
- Clinical Child Psychology Program, University of Kansas, 1000 Sunnyside Avenue Dole HDC Rm 2006, 66045, Lawrence, KS, USA
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Deckert A, Runge-Ranzinger S, Banaschewski T, Horstick O, Elwishahy A, Olarte-Peña M, Faber C, Müller T, Brugnara L, Thom J, Mauz E, Peitz D. Mental health indicators for children and adolescents in OECD countries: a scoping review. Front Public Health 2024; 11:1303133. [PMID: 38414565 PMCID: PMC10898649 DOI: 10.3389/fpubh.2023.1303133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/19/2023] [Indexed: 02/29/2024] Open
Abstract
Background This scoping review is a further step to build up the Mental Health Surveillance System for Germany. It summarizes and analyzes indicators used or described in Organization for Economic Co-operation and Development (OECD) countries for public mental health monitoring in children and adolescents aged 0-18 years. Methods We searched PubMed-MEDLINE, PsycINFO, Cochrane Databases, and Google Scholar from 2000 to September 2022. The search used five general keyword categories: 1) "indicators/monitoring/surveillance" at the population level, 2) "mental/psychological," 3) "health/disorders," 4) "children and adolescents," and 5) 38 OECD countries. The search was complemented with an extensive grey literature search, including OECD public health institutions and an internet search using Google. A predefined set of inclusion and exclusion criteria was applied. Results Over 15,500 articles and documents were screened (scientific search N = 10,539, grey literature search more than 5,000). More than 700 articles and documents have been full-text assessed, with 382 being ultimately included. Out of 7,477 indicators extracted, an initial set of 6,426 indicators met our inclusion criteria for indicators. After consolidating duplicates and similar content, this initial set was categorized into 19 topics, resulting in a final set of 210 different indicators. The analysis highlighted an increasing interest in the topic since 2008, but indicators for the younger age, particularly those aged 0 to 2 years, were less readily available. Conclusion Our research provides a comprehensive understanding of the current state of mental health indicators for children and adolescents, identifying both (1) indicators of public mental health noted in a previous scoping review on adults and (2) new indicators specific to this age group. These findings contribute to the development of effective public health surveillance strategies for children and adolescents and inform future research in this field.
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Affiliation(s)
- Andreas Deckert
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Silvia Runge-Ranzinger
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Tobias Banaschewski
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters Zentralinstituts für Seelische Gesundheit, Mannheim, Germany
| | - Olaf Horstick
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Abdelrahman Elwishahy
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Margarita Olarte-Peña
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
- evaplan GmbH am Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Claudia Faber
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Müller
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Lucia Brugnara
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
- evaplan GmbH am Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Julia Thom
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Elvira Mauz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Diana Peitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Sadath A, Kavalidou K, McMahon E, Malone K, McLoughlin A. Associations between humiliation, shame, self-harm and suicidality among adolescents and young adults: A systematic review. PLoS One 2024; 19:e0292691. [PMID: 38329967 PMCID: PMC10852296 DOI: 10.1371/journal.pone.0292691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/26/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Suicide is the second leading cause of death among young people worldwide. Research indicates that negative social contexts involving familial and peer relationships have far-reaching influences on levels of suicidality in later life. While previous systematic reviews have focused on evaluating associations between negative life events such as abuse and bullying in childhood and subsequent suicidality, this systematic review examines the prevalence of, and association between the processes of humiliation and shame in later self-harm, suicidal ideation, and suicide among adolescents and young adults. METHODS A systematic literature search of databases including MEDLINE, Web of Science Core Collection, CINAHL, PsycINFO, and Embase was conducted to identify potential studies. ProQuest was searched to identify relevant grey literature research. A combination of MESH terms and keywords was used. All original quantitative studies published in English that examined the prevalence, or association between humiliation or shame and suicidal behaviours and/or death by suicide were included. Studies were assessed for methodological quality using Joanna Briggs Institute critical appraisal tools. The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) [CRD42022289843]. RESULTS Narrative synthesis was performed. A total of 33 studies reporting the prevalence of, or association between humiliation (n = 10) or shame (n = 23) and suicidal thoughts/behaviours were included. The prevalence of humiliation among those with any suicidality ranged from 18% to 28.1%, excluding an outlier (67.1%), with two studies presenting a significant association between humiliation and self-harm in their fully adjusted analyses. The studies that outlined humiliation and suicidal thinking (intent/suicide plan) had no association after adjustment for confounders. For shame, half of the studies found an association in adjusted models (n = 10), and this was evident for both suicidal ideation and self-harm. CONCLUSION To our knowledge, this is the first study to attempt a systematic review on this topic. The dearth of research in this field of enquiry is reflective of unique challenges associated with assessments of humiliation and shame in various clinical settings amongst adolescent and young adult populations. Nonetheless, given the importance and relevance of the psychological imprint of humiliation in youth morbidity and mortality in the field of mental health, it is timely to attempt such a systematic review. In light of the associated role of humiliation and shame in self-harm and suicidality among young people, we recommend that these processes need to be explored further via prospective studies and assessed as part of a comprehensive bio-psycho-social assessment when focusing on life stressors for adolescent and young adults presenting with suicidality to emergency departments and mental health services.
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Affiliation(s)
- Anvar Sadath
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Katerina Kavalidou
- National Suicide Research Foundation, University College Cork, Cork, Ireland
- National Clinical Programme, Health Service Executive (HSE), Dublin, Ireland
| | - Elaine McMahon
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Kevin Malone
- Department of Psychiatry and Mental Health Research, St. Vincent’s University Hospital, University College Dublin, Dublin, Ireland
| | - Aoibheann McLoughlin
- Department of Psychiatry and Mental Health Research, St. Vincent’s University Hospital, University College Dublin, Dublin, Ireland
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Caro-Cañizares I, Vila MM, Durán Pacheco JI, Carballo JJ. Interpersonal theory of suicide and stressful life events in a clinical sample of adolescents in Spain. Early Interv Psychiatry 2024; 18:113-121. [PMID: 37201918 DOI: 10.1111/eip.13438] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/30/2023] [Accepted: 05/05/2023] [Indexed: 05/20/2023]
Abstract
AIMS The interpersonal theory of suicide (ITPS) provides a theoretical model for suicidal behaviour. It includes two interpersonal variables, thwarted belongingness (TB) and perceived burdensomeness (PB). This study tested the relationship between ITPS interpersonal variables and suicide risk (presence/absence of suicidal ideation and suicide attempts throughout life) in a clinical sample of Spanish adolescents. We also assessed the potential mediation effect of these variables in the well-established relationship between stressful life events (SLE) and suicide risk. METHODS We recruited 147 adolescents aged 11-17 from the Child and Adolescent Mental Health Outpatient Services of the Jiménez Díaz Foundation (Madrid, Spain). Different questionnaires were administered to assess suicidal behaviour and SLE (SITBI, The Stressful Life Events Scale) and to calculate proxy measures for ITPS interpersonal factors (SDQ, STAXI-NA, CDI). RESULTS TB and PB significantly correlated with suicide risk. PB played a mediating role in the relationship between SLE and suicide risk: adolescents reporting SLE were more likely to enact suicide behaviours when they experienced higher PB. Patients scoring higher PB were more likely to receive more intense treatment but tended to abandon intervention promptly. CONCLUSIONS ITPS seems useful for predicting suicide risk in an adolescent clinical sample. The results suggest an important role for PB in the SLE-suicide risk relationship and may impact the treatment process. Our exploratory findings should be addressed in future studies.
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Affiliation(s)
- Irene Caro-Cañizares
- Psychology Department, Health Science School, Universidad a Distancia de Madrid UDIMA, Madrid, Spain
| | - María Marín Vila
- Psychiatry Department, Puerta de Hierro University Hospital, Madrid, Spain
| | - Juan I Durán Pacheco
- Social Psychology and Methodology Department, Psychology School, Universidad Autónoma de Madrid, Madrid, Spain
| | - Juan J Carballo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón, IISGM. Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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Sumlin E, Hill R, Asim N, Busby D, Brown JL, Sharp C. Quantifying the Representation of Black Adolescents in Suicide Intervention Research. Res Child Adolesc Psychopathol 2024; 52:159-168. [PMID: 37702875 DOI: 10.1007/s10802-023-01113-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 09/14/2023]
Abstract
This systematic review aimed to quantify the representation of Black youth in U.S. suicide intervention research. Specifically, we sought to evaluate Black youth representation in terms of (a) equity of inclusion (i.e., the inclusion of Black youth in research study samples at a rate consistent with the overall national rate of Black adolescents in the US) and (b) equity of intervention efficacy (i.e., evaluating the presence of racial disparities in intervention efficacy/effect sizes). In addition, we aimed to evaluate whether an association existed between funding status of research and representation of Black youth in studies, and to provide recommendations for future research in this area. To this end, the present study extracted and analyzed demographic information of studies included in recent meta-analyses conducted by Robinson and colleagues (2018), which were not previously analyzed, in addition to new literature published between September 2017 and January 2021. Results showed that the prevalence of Black youth included in studies was representative (14.67%; ntotal = 4451, nBlack = 664), with a median inclusion rate of 13%; however, absolute sample and group sizes were so small that it precluded comparison of differential treatment outcomes for Black youth. Thus, out of 22 studies identified, only one was able to investigate treatment outcomes for suicide in Black youth specifically. This study points to the conclusion that without adequately powered studies, disparities in treatment efficacy for Black youth cannot be compared or addressed, and the existing disparity in suicidal outcomes for Black youth will grow even larger.
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Affiliation(s)
- E Sumlin
- University of Houston, Houston, TX, USA
| | - R Hill
- Louisiana State University, Baton Rouge, LA, USA
| | - N Asim
- University of Houston, Houston, TX, USA
| | - D Busby
- University of Texas Medical Branch Galveston, Galveston, TX, USA
| | - J L Brown
- Purdue University, Lafayette, IN, USA
| | - C Sharp
- University of Houston, Houston, TX, USA.
- University of the Free State, Bloemfontein, South Africa.
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Hill RM, Busby D, Brown JL, Sumlin E, Fernandez E, Sharp C. Cultural Consensus Modeling to identify culturally relevant reasons for and against suicide among Black adolescents. Suicide Life Threat Behav 2023:10.1111/sltb.13000. [PMID: 37681310 PMCID: PMC10920392 DOI: 10.1111/sltb.13000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 07/28/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023]
Abstract
INTRODUCTION The development of evidence-based treatments relies on accurate theoretical frameworks sensitive to the lived realities of the populations from which they are derived. Yet, the perspectives of Black youth are vastly underrepresented in extant theories of suicidal behavior. Cultural Consensus Modeling provides an evidence-based approach for developing a culturally informed understanding of suicide risk among Black youth. METHOD Participants were 50 Black adolescents (Mage = 16.20 years; 76.0% male) who completed Phase 1 of a Cultural Consensus Modeling study. Participants freely listed reasons for suicide and reasons for living among similar peer Black youth. Responses were synthesized and coded for major themes. RESULTS The most common reasons for suicide were racism (40%), depression (32%), poverty (26%), and bullying (22%). The most common reasons for living were family (58%), having a purpose or goals (36%), friends (30%), and hope for a better future (26%). CONCLUSION Responses highlighted issues of racism and social justice, depression, and poverty, as well as the protective role of relationships, living for the future, and contributing to Black empowerment. Future research should utilize Cultural Consensus Modeling to elevate the voices of Black youth, improving extant theories of suicide, and identifying unique mechanisms or opportunities for prevention.
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Affiliation(s)
- Ryan M. Hill
- Department of Psychology, Louisiana State University, Baton Rouge, LA
| | - Danielle Busby
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, TX
| | - Jennifer L. Brown
- Department of Psychological Sciences, Purdue University, West Lafayette, IN
| | - Eric Sumlin
- Department of Psychology, University of Houston, Houston, TX
| | | | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX
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Saarijärvi P, Salmivalli C, Helmi S, Karukivi M. Early maladaptive schemas are associated with self-injury thoughts and behavior in adolescents. BMC Psychiatry 2023; 23:632. [PMID: 37644535 PMCID: PMC10466884 DOI: 10.1186/s12888-023-05127-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Early maladaptive schemas (EMSs) and self-harm have been firmly linked in adults, but research on these associations in adolescents remains scarce. Additionally, the links between EMSs and functions of self-injury has not been previously studied in this age group. Thus, the aim of the present study was to investigate the associations of EMSs with self-harm thoughts and behavior, as well as with self-harm functions, among adolescents in specialized health care. METHODS The participants were recruited from first-visit 12-22-year-old adolescent patients entering specialized mental health care or pediatric care. For 118 participants, complete data were available for the Young Schema Questionnaire Short Form 2-Extended (YSQ) when entering care and the Ottawa Self-Injury Inventory Functions scale (OSI-F) one year later. YSQ was used to measure the participants' EMSs and OSI-F their self-harm thoughts and behavior. The associations of EMSs and self-harm were investigated in three groups: no self-harm, self-harm thoughts only, and both self-harm thoughts and behavior. The associations of EMSs with self-injury behavior functions were assessed in four categories: Internal Emotional Regulation, External Emotional Regulation, Social Influence, and Sensation Seeking. Additionally, EMSs' associations with addictive features of self-injury behavior were assessed. The magnitudes of effect sizes of differences between the self-harm groups were evaluated with Cliff's Delta. The associations of EMSs with self-injury functions were analyzed with general linear modeling and with self-injury addictive features using logistic regression. RESULTS The differences between the self-harm groups were significant for the majority of the EMSs. The stronger the EMSs were, the more severe the manifestations of self-harm. The effect sizes ranged from small to large depending on the EMS. Considering self-injury functions, Internal Emotional Regulation was associated with Self-Sacrifice EMS (p = 0.021), and External Emotional Regulation both with Abandonment (p = 0.040) and Unrelenting Standards (p = 0.012) EMSs. Being addicted to self-injury was associated with Abandonment (p = 0.043) and Dependence (p = 0.025) EMSs. CONCLUSIONS The present study shows that significant associations between EMSs and both self-harm thoughts and behavior exist also in adolescents. Stronger EMSs are linked to more severe self-harm. Knowledge of these associations may help to improve the understanding and treatment of adolescents suffering from self-harm.
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Affiliation(s)
- Pauliina Saarijärvi
- Department of Psychology and Speech-Language Pathology, University of Turku, Publicum building, 4th floor, 20014, Turku, Finland
- Department of Psychiatry, HUS Helsinki University Hospital and University of Helsinki, Adolescent Psychiatry, Finland
- Psychiatric Care Division, Satasairaala Hospital, Pori, Finland
- University of Turku, INVEST Research Flagship, Publicum building, 4th floor, 20014, Turku, Finland
| | - Christina Salmivalli
- Department of Psychology and Speech-Language Pathology, University of Turku, Publicum building, 4th floor, 20014, Turku, Finland
- University of Turku, INVEST Research Flagship, Publicum building, 4th floor, 20014, Turku, Finland
| | - Saija Helmi
- Faculty of Social Sciences (SOC), Tampere University, Welfare Sciences, Psychology, 33014, Finland
| | - Max Karukivi
- Psychiatric Care Division, Satasairaala Hospital, Pori, Finland.
- Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Kunnallissairaalantie 20, Turku, 20700, Finland.
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Eugene DR, Blalock C, Nmah J, Baiden P. Suicidal Behaviors in Early Adolescence: The Interaction Between School Connectedness and Mental Health. SCHOOL MENTAL HEALTH 2023; 15:444-455. [PMID: 38186858 PMCID: PMC10768848 DOI: 10.1007/s12310-022-09559-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 11/26/2022]
Abstract
Previous research has identified mental health symptoms such as depression and aggression as contributing factors associated with suicidal ideation and attempts in adolescence. However, much of this work has focused on older adolescents (ages > 14) resulting in a dearth of knowledge about early adolescents under 12 years. Moreover, much less is known about school connectedness as a protective factor in the relationship between mental health symptoms and suicidal behaviors. This study examined the interaction effect between school connectedness and mental health symptoms on suicidal behaviors among early adolescents aged 9-12 years. Data were drawn from the Fragile Families and Child Wellbeing Study and yielded an analytic sample (n = 2826) that was majority male (52%), Black (53%), and with an average age of 9.3 years. Data were analyzed using multivariate logistic regression. Among participants, 2% experienced suicidal ideation, and 2% experienced suicide attempts. Black adolescents were more than five times more likely to experience a suicide attempt compared to their White peers (AOR = 5.37; 95% CI = 1.71-16.95; p = .004). There was a significant interaction effect between withdrawn depressed symptoms and school connectedness (AOR = .95; 95% CI = .91-98; p = .006), and between aggressive behavior and school connectedness (AOR = 1.02; 95% CI = 1.01-1.03; p = .001) on suicide attempts. School connectedness did not moderate the relationship between mental health symptoms and suicidal ideation. The findings have important practical implications, which are discussed.
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Affiliation(s)
- Danielle R. Eugene
- School of Social Work, University of Texas at Arlington, 211 S. Cooper St., Box 19129, Arlington, TX 76019, USA
| | - Cristin Blalock
- School of Social Work, University of Texas at Arlington, 211 S. Cooper St., Box 19129, Arlington, TX 76019, USA
| | - Juterh Nmah
- School of Social Sciences and Education, California State University, 9001 Stockdale Hwy, Mail Stop: 22 EDUC, Bakersfield, CA 93311, USA
| | - Philip Baiden
- School of Social Work, University of Texas at Arlington, 211 S. Cooper St., Box 19129, Arlington, TX 76019, USA
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Hou H, Yu B, He C, Li G, Pei Y, Wang J, Tang J, Chen X, Gao X, Wang W. Secular trends of suicide risk for residents in mainland China (2004 to 2019): An updated age-period-cohort analysis. J Affect Disord 2023; 329:235-242. [PMID: 36849004 DOI: 10.1016/j.jad.2023.02.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND The overall suicide rate in China has dropped substantially since the 1990s, but a slowdown in the decrease and even a reversing trend was observed in specific groups in recent years. This study aims to investigate the latest suicide risk in mainland China by using the age-period-cohort (APC) analysis. METHOD This population-based multiyear cross-sectional study included Chinese ages 10 to 84 years using data from the China Health Statistical Yearbook (2005-2020). Data were analyzed by the APC analysis and intrinsic estimator (IE) technique. RESULTS The data satisfactorily fit the constructed APC models. The cohort effect indicated a high risk of suicide among people birth in 1920-1944 and a sharp decline in the 1945-1979 cohort. The lowest risk occurred in the 1980-1994 cohort before a sharp increase in generation Z (birth years in 1995-2009). The period effect showed a declining trend since 2004. The age effect indicated that the suicide risk increased over time, except for a gradual decline from age 35 to 49. The suicide risk increased greatly in adolescents and reached the highest among the elderly. LIMITATIONS The aggregated population-level data and the non-identifiability of the APC model could result in bias in the accuracy of results in this study. CONCLUSIONS This study successfully updated the Chinese suicide risk from the age, period and cohort perspective using the latest available data (2004-2019). The findings enhance the understanding of suicide epidemiology and provide evidence supporting policies and strategies at the macro-level for suicide prevention and management. Immediate action is needed to focus on a national suicide prevention strategy that targets generation Z, adolescents and the elderly which will require a collaborative effort by government officials, public/community health planners and health care agencies.
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Affiliation(s)
- Hao Hou
- School of Public Health, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China; School of Public Health, Wuhan University, Wuhan 430064, Hubei, China
| | - Bin Yu
- School of Public Health, Wuhan University, Wuhan 430064, Hubei, China
| | - Chenlu He
- School of Public Health, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Guiyuan Li
- School of Public Health, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Yifei Pei
- School of Public Health, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Jingjing Wang
- School of Public Health, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Jie Tang
- School of Public Health, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Xinguang Chen
- Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, USA
| | - Xiuyin Gao
- School of Public Health, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Wei Wang
- School of Public Health, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China; Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China; Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China.
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12
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Huang D, Zhong S, Yan H, Lai S, Lam M, Jia Y. Association between serum zinc levels and suicidal ideation in US adults: A population-based cross-sectional study. J Affect Disord 2023; 329:359-368. [PMID: 36801424 DOI: 10.1016/j.jad.2023.02.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/06/2023] [Accepted: 02/11/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND Evidence suggests that the homeostatic disruption of zinc, copper, and selenium might contribute to the pathophysiology of mental disorders. However, the specific relationship between the serum levels of these trace elements with suicidal ideation remains poorly understood. This study aimed to investigated the association among suicidal ideation on serum levels of zinc, copper, and selenium. METHODS The cross-sectional study was conducted using data from a nationally representative sample of the National Health and Nutrition Examination Survey (NHANES) 2011-2016. Suicidal ideation was assessed using Item #9 of the Patient Health Questionnaire-9 Items. Multivariate regression models and restricted cubic splines were performed and E-value was calculated. RESULTS A total of 4561 participants aged 20 years and older were analyzed, of whom 4.08 % had suicidal ideation. The serum zinc levels were lower in the suicidal ideation group than in the non-suicidal ideation group (P = 0.021). In Crude Model, the serum zinc levels were associated with a higher suicidal ideation risk in the second quartile compared with the highest quartile [odds ratio (OR) = 2.63; 95 % confidence interval (CI): 1.53-4.53]. The association persisted (OR = 2.35; 95 % CI: 1.20-4.58) after full adjustment, with E-value 2.44. A nonlinear relationship was observed between serum zinc levels and suicidal ideation (P = 0.028). No relationship was observed between suicidal ideation and serum copper or selenium levels (all P > 0.05). CONCLUSIONS Decreased serum zinc levels may increase susceptibility to suicidal ideation. Future studies are needed to validate the findings of this study.
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Affiliation(s)
- Dong Huang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hong Yan
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Meifong Lam
- Psychiatric service of the Centro Hospitalar Conde de São Januário, Macao 999078, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
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13
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Chu J, Ganson KT, Baker FC, Testa A, Jackson DB, Murray SB, Nagata JM. Screen time and suicidal behaviors among U.S. children 9-11 years old: A prospective cohort study. Prev Med 2023; 169:107452. [PMID: 36805495 PMCID: PMC10829425 DOI: 10.1016/j.ypmed.2023.107452] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/04/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023]
Abstract
Suicide is a leading cause of death among adolescents. Emerging literature has described relationships between excessive screen time and suicidal behaviors, though findings have been mixed. The objective of this study is to determine the prospective associations between screen time and suicidal behaviors two-years later in a national (U.S.) cohort of 9-11-year-old-children. We analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 11,633). Logistic regression analyses were estimated to determine the associations between baseline self-reported screen time (exposure) and suicidal behaviors (outcome) based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) at two-year-follow-up. Participants reported an average of 4.0 h of total screen time per day at baseline. At two-year-follow-up, 1.38% of the sample reported at least one suicidal behavior. Each additional hour of total screen time was prospectively associated with 1.09 higher odds of suicidal behaviors at 2-year-follow-up (95% CI 1.03-1.14), after adjusting for covariates. For specific screen time modalities, each additional hour of texting (aOR 1.36, 95% CI 1.06-1.74), video chatting (aOR 1.30, 95% CI 1.03-1.65), watching videos (aOR 1.21, 95% CI 1.04-1.39), and playing video games (aOR 1.18, 95% CI 1.01-1.38) was associated with higher odds of subsequent suicidal behaviors. Higher screen time is associated with higher odds of reporting suicidal behaviors at two-year-follow-up. Future research should seek to identify how specific screen time experiences may influence suicidal behaviors.
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Affiliation(s)
- Jonathan Chu
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Fiona C Baker
- Biosciences Division, Center for Health Sciences, SRI International, Menlo Park, CA, USA; Department of Physiology, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Stuart B Murray
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Jason M Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
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14
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Wahid SS, Ottman K, Bohara J, Neupane V, Fisher HL, Kieling C, Mondelli V, Gautam K, Kohrt BA. Adolescent perspectives on depression as a disease of loneliness: a qualitative study with youth and other stakeholders in urban Nepal. Child Adolesc Psychiatry Ment Health 2022; 16:51. [PMID: 35739569 PMCID: PMC9229752 DOI: 10.1186/s13034-022-00481-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/19/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND There is a lack of research on the adolescent experience of depression in low- and middle-income countries. Criteria derived from research conducted primarily among adult Western populations inform current diagnostic standards for depression. These clinical categories are often used without exploration of their relevance to adolescent experience. Also, reliance on these categories may overlook other symptoms of depression that manifest in non-western settings. Cross-cultural qualitative work with adults in non-Western settings has suggested some differences with experience of depression and symptoms that are most relevant to service users. Research into adolescent experiences of depression is warranted to inform the development of effective interventions. METHODS Qualitative interviews were conducted in Nepal with adolescents with depressive symptoms (n = 9), healthy adolescents (n = 3), parents (n = 6), teachers (n = 10), social workers (n = 14), primary (n = 6) and mental (n = 6) healthcare providers, and policymakers (n = 6). Two focus groups were conducted with parents (n = 12) of depressed and non-depressed adolescents. Data were analyzed according to the framework approach methodology. RESULTS Loneliness was the hallmark experience that stood out for all adolescents. This was connected with 5 other clusters of symptoms: low mood and anhedonia; disturbances in sleep and appetite, accompanied by fatigue; irritability and anger; negative self-appraisals including hopelessness and self-doubt; and suicidality. Adolescents distinguished depression from other forms of stress, locally referred to as tension, and described depression to involve having "deep tension." Perceived causes of depression included (1) Family issues: neglectful or absent parents, relationship problems, and family discord; (2) Peer relationships: romantic problems, bullying, and friendship problems; and (3) Social media: social comparison, popularity metrics, cyberbullying, and leaking of personal information. CONCLUSIONS Consistent with other cross-cultural studies, loneliness was a core element of the adolescent experience of depression, despite its absence as a primary symptom in current psychiatric diagnostic classifications. It is important to note that among youth, symptoms were clustered together and interrelated (e.g., sleep and appetite changes were connected with fatigue). This calls for the need for more cross-cultural qualitative research on experience of depression among adolescents, and potential for modification of diagnostic criteria and prevention and treatments to focus on the experience of loneliness.
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Affiliation(s)
- Syed Shabab Wahid
- grid.213910.80000 0001 1955 1644Department of International Health, Georgetown University, Washington, DC USA
| | - Katherine Ottman
- grid.253615.60000 0004 1936 9510Division of Global Mental Health, George Washington University, Washington, DC USA
| | - Jyoti Bohara
- Transcultural Psychosocial Organization Nepal (TPO Nepal), Baluwatar, Kathmandu, Nepal
| | - Vibha Neupane
- Transcultural Psychosocial Organization Nepal (TPO Nepal), Baluwatar, Kathmandu, Nepal
| | - Helen L. Fisher
- grid.13097.3c0000 0001 2322 6764Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,grid.13097.3c0000 0001 2322 6764ESRC Centre for Society and Mental Health, King’s College London, London, UK
| | - Christian Kieling
- grid.414449.80000 0001 0125 3761Department of Psychiatry, Universidade Federal do Rio Grande do Sul and Child & Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS Brazil
| | - Valeria Mondelli
- grid.13097.3c0000 0001 2322 6764Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King’s College London, London, UK
| | - Kamal Gautam
- Transcultural Psychosocial Organization Nepal (TPO Nepal), Baluwatar, Kathmandu, Nepal.
| | - Brandon A. Kohrt
- grid.253615.60000 0004 1936 9510Division of Global Mental Health, George Washington University, Washington, DC USA
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15
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Shim SH, Kwon YJ, Lee D, Lee HS, Jin MJ, Kim JS. Impact of Interpersonal Relationships and Acquired Capability for Suicide on Suicide Attempts: A Cross-Sectional Study. Psychiatry Investig 2022; 19:362-370. [PMID: 35620821 PMCID: PMC9136520 DOI: 10.30773/pi.2021.0379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/30/2022] [Accepted: 03/07/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study examined the path model predicting suicide attempts (SA) by interpersonal need for suicide desire, acquired capability for suicide, the emotion dysregulation, and depression symptoms in people admitted to hospitals for medical treatment. METHODS A total of 344 participants (200 depressed patients with attempted suicide, 144 depressed patients with suicidal ideation) were enrolled for this study. Depression, anxiety, emotion regulation, interpersonal needs, and acquired capability for suicide were evaluated. A model with pathways from emotion regulation difficulties and interpersonal needs to SA was proposed. Participants were divided into two groups according to the presence of SA or suicidal ideation. RESULTS Acquired capability for suicide mediated the path from depression to SA. In the path model, difficulties in emotion regulation and interpersonal needs predicted depression significantly. Although depression itself was not significantly related to acquired capability for suicide, depression was significantly related to acquired capability for suicide in suicide attempter group. CONCLUSION Interventions with two factors affecting SA will clarify the suicide risk and contribute to finding risk factors.
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Affiliation(s)
- Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Young Joon Kwon
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Dongwook Lee
- Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Ho Sung Lee
- Department of Pulmonology and Allergy, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Min Jin Jin
- Division of Liberal Arts, Kongju National University, Gongju, Republic of Korea
| | - Ji Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
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16
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Castro-Osorio R, Maldonado-Avendaño N, Cardona-Gómez P. Proposal for a Model of Suicidal Ideation in Medical Students in Colombia: A Simulation Study. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:17-24. [PMID: 35216953 DOI: 10.1016/j.rcpeng.2020.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/09/2020] [Indexed: 06/14/2023]
Abstract
Suicidal behaviour is a global public health problem, and one population group with high prevalence rates is medical students, especially in the ideation component. Various models have tried to explain it, but there are few inferential studies in the Colombian population. The structural equation models used in controlled social sciences to explain this problem and their analytical power allow generalisations to be made with a certain degree of precision. These analyses require a large amount of data for robust estimation, which limits their usability when there are restrictions to access the data, as is the case today due to Covid-19, and a question that stands out in these models is the evaluation of the fit. Through a set of 1,200 simulated data, an appropriate model fit was found (x5242 = 1.732,300, p < 0,001, CFI = 0.97, GFI = 0.97, TLI = 0.97, RMSEA = 0.04[0.042-o.046], SRMR = 0.06) for the predictors of depression and perceived burdensomeness, which were analysed using the JASP program. The role of thwarted belongingness is discussed, as well as the appropriateness of the assessment instrument used to evaluate it an considerations regarding suicidal ideation monitoring, evaluation and intervention in medical students.
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17
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Van Meter A, Agrawal N. LovesCompany: evaluating the safety and feasibility of a mental health-focused online community for adolescents. J Child Adolesc Ment Health 2022; 34:83-100. [PMID: 38504652 DOI: 10.2989/17280583.2023.2283030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Background: Adolescents are at risk for mental health (MH) disorders but are unlikely to seek services and may be reluctant to talk about their MH. An anonymous, online MH-focused community could help reduce suffering. However, online forums can also promote negative behaviours such as cyberbullying. This study aimed to evaluate the safety and feasibility of an online community - LovesCompany - to improve MH outcomes for adolescents.Methods: American adolescents (14-17 years) were recruited through social media. Eligible participants were randomised to LovesCompany or a placebo MH resource site. Outcomes were assessed every other week for six months, and at twelve months. Multilevel models assessed group differences in depression, anxiety, and suicidal ideation. A subgroup of participants participated in qualitative interviews.Results: Participants (N = 202) were mostly female (70%), White non-Hispanic (69%), and cisgender (80%). There were no instances of inappropriate behaviour such as bullying or posting explicit content. Symptoms for both groups improved over time. Participants appreciated hearing others' experiences and valued the opportunity to offer support.Conclusion: Although adolescents are often resistant to MH treatment, they appear to be interested in anonymous, online, MH-focused conversation, and can benefit from giving and seeking support. Finding a balance between an appealing user experience, ethical considerations, and resource needs is challenging.
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Affiliation(s)
- Anna Van Meter
- Department of Child and Adolescent Psychiatry, Grossman School of Medicine, New York University Langone Health, New York, USA
- Feinstein Institutes for Medical Research, Institute for Behavioral Science, Manhasset, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, USA
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA
| | - Neha Agrawal
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA
- Community West Treatment Center, Los Angeles, USA
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18
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Bukuluki P, Kisaakye P, Wandiembe SP, Besigwa S. Suicide ideation and psychosocial distress among refugee adolescents in Bidibidi settlement in West Nile, Uganda. DISCOVER PSYCHOLOGY 2021. [PMCID: PMC8488914 DOI: 10.1007/s44202-021-00003-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
This study investigated the factors associated with suicidal ideation and psychological distress among Sudanese refugees (aged 10–19 years) in Bidibidi refugee settlement, Yumbe district, Uganda. The analysis is based on cross-sectional data collected as part of the implementation of a project on sexual and reproductive health in Bidibidi refugee settlement. Data were collected from 284 South Sudanese adolescents in July 2020. We estimated the prevalence of psychological distress and suicidal ideation, and their associated profiles. Odds ratios and their 95% Confidence Intervals based on a logistic regression model were used to assess the effect of different potential factors on the risk profiles for suicidal ideation and psychological distress. The prevalence of psychological distress (on KS-6 scale) was estimated to be 12.3% (95%CI: 8.7, 16.7%). The risk for psychological distress is low among male adolescents (AOR = 0.51; 95%CI: 0.23, 1.02), older adolescents, (AOR = 0.12; 95%CI: 0.04, 0.40), and adolescents with a friend or family members they can confide in (AOR = 0.33; 95%CI: 0.11, 0.96). Both suicidal ideation and psychological distress are very high among the female adolescents. Familial and individual interventions can be potentially useful for female adolescents who have a high risk of suicide and psychological distress.
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Affiliation(s)
- Paul Bukuluki
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
| | - Peter Kisaakye
- Department of Population Studies, School of Statistics and Planning, Mathematics Building, Makerere University Main Campus, P O Box 7062, Kampala, Uganda
| | - Symon Peter Wandiembe
- Department of Statistical Methods, School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Samuel Besigwa
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
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19
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van Alphen RHB, Schout G, Koudstaal AJ, de Vreugd M, Abma T, Vermeiren RRJM. Family group conferences for suicidal adolescents: Promising results from naturalistic case study research. DEATH STUDIES 2021; 46:2445-2455. [PMID: 34549666 DOI: 10.1080/07481187.2021.1967514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Can thwarted belongingness and perceived burdensomeness, risk factors for suicidal adolescents, be turned around by family group conferences? In this case study on Nick, a 17-year-old who undertook six suicide attempts, we (including Nick) share insights and learning opportunities on how family group conferences can be used. The thematic analysis suggests that family group conferences might be a promising intervention for suicidal adolescents. For Nick, the conference was a turning point in his life, correcting perceptions of being a burden, pushing back passiveness, and boosting connection with and support from the broad social network.
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Affiliation(s)
- Roosmarijn H B van Alphen
- Department of Child and Adolescent Psychiatry, Leiden University Medical Center-Curium, Leiden, The Netherlands
| | - Gert Schout
- Department of Medical Humanities, VU University Medical Centre, Amsterdam, The Netherlands
| | - Agaath J Koudstaal
- Department of Child and Adolescent Psychiatry, Leiden University Medical Center-Curium, Leiden, The Netherlands
| | - Martin de Vreugd
- Department of Child and Adolescent Psychiatry, Leiden University Medical Center-Curium, Leiden, The Netherlands
| | - Tineke Abma
- Department of Medical Humanities, VU University Medical Centre, Amsterdam, The Netherlands
| | - Robert R J M Vermeiren
- Department of Child and Adolescent Psychiatry, Leiden University Medical Center-Curium, Leiden, The Netherlands
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20
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Fumero A, Marrero RJ, Pérez-Albéniz A, Fonseca-Pedrero E. Adolescents' Bipolar Experiences and Suicide Risk: Well-being and Mental Health Difficulties as Mediators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063024. [PMID: 33804197 PMCID: PMC7998787 DOI: 10.3390/ijerph18063024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/18/2021] [Accepted: 03/05/2021] [Indexed: 12/22/2022]
Abstract
Bipolar disorder is usually accompanied by a high suicide risk. The main aim was to identify the risk and protective factors involved in suicide risk in adolescents with bipolar experiences. Of a total of 1506 adolescents, 467 (31%) were included in the group reporting bipolar experiences or symptoms, 214 males (45.8%) and 253 (54.2%) females. The mean age was 16.22 (SD = 1.36), with the age range between 14 and 19. Suicide risk, behavioral and emotional difficulties, prosocial capacities, well-being, and bipolar experiences were assessed through self-report. Mediation analyses, taking gender as a moderator and controlling age as a covariate, were applied to estimate suicide risk. The results indicated that the effect of bipolar experiences on suicide risk is mediated by behavioral and emotional difficulties rather than by prosocial behavior and subjective well-being. Specifically, emotional problems, problems with peers, behavior problems, and difficulties associated with hyperactivity were the most important variables. This relationship was not modulated by gender. However, the indirect effects of some mediators varied according to gender. These results support the development of suicide risk prevention strategies focused on reducing emotional difficulties, behavioral problems, and difficulties in relationships with others.
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Affiliation(s)
- Ascensión Fumero
- Department of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, 38200 La Laguna, Tenerife, Spain;
- Correspondence: ; Tel.: +34-922-317-960
| | - Rosario J. Marrero
- Department of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, 38200 La Laguna, Tenerife, Spain;
| | - Alicia Pérez-Albéniz
- Department of Educational Sciences, University of La Rioja, 26002 Logroño, La Rioja, Spain; (A.P.-A.); (E.F.-P.)
| | - Eduardo Fonseca-Pedrero
- Department of Educational Sciences, University of La Rioja, 26002 Logroño, La Rioja, Spain; (A.P.-A.); (E.F.-P.)
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21
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Howe SJ, Hewitt K, Baraskewich J, Cassidy S, McMorris CA. Suicidality Among Children and Youth With and Without Autism Spectrum Disorder: A Systematic Review of Existing Risk Assessment Tools. J Autism Dev Disord 2020; 50:3462-3476. [PMID: 32100237 DOI: 10.1007/s10803-020-04394-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Individuals with autism are at heightened risk for experiencing suicidality compared to those without autism. Despite this, it is unknown what tools are used to assess suicide risk in research and clinical practice among children and youth with autism. This systematic review examined tools commonly used to measure suicidality in children and youth with and without autism spectrum disorder. Four databases were searched. We identified five tools (C-SSRS, PSS, SITBI, SIQ-JR, BSS) commonly used with youth in the general population; however, we did not identify any tools that were commonly used autistic children and youth. Results highlight the lack of available tools utilized to measure suicidality in autistic children and youth. We propose a framework to facilitate research to fill this gap.
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Affiliation(s)
- Stephanie J Howe
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Katie Hewitt
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Jessica Baraskewich
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Sarah Cassidy
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Carly A McMorris
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada. .,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
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22
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Castro-Osorio R, Maldonado-Avendaño N, Cardona-Gómez P. Proposal for a Model of Suicidal Ideation in Medical Students in Colombia: A Simulation Study. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 51:S0034-7450(20)30081-0. [PMID: 33735048 PMCID: PMC7947645 DOI: 10.1016/j.rcp.2020.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/09/2020] [Indexed: 11/24/2022]
Abstract
Suicidal behaviour is a global public health problem, and one population group with high prevalence rates is medical students, especially in the ideation component. Various models have tried to explain it, but there are few inferential studies in the Colombian population. The structural equation models used in controlled social sciences to explain this problem and their analytical power allow generalisations to be made with a certain degree of precision. These analyses require a large amount of data for robust estimation, which limits their usability when there are restrictions to access the data, as is the case today due to Covid-19, and a question that stands out in these models is the evaluation of the fit. Through a set of 1,200 simulated data, an appropriate model fit was found (x5242=1.732,300;p<0,001, CFI = 0.97, GFI = 0.97, TLI = 0.97, RMSEA = 0.04[0.042-0.046], SRMR = 0.06) for the predictors of depression and perceived burdensomeness, which were analysed using the JASP program. The role of thwarted belongingness is discussed, as well as the appropriateness of the assessment instrument used to evaluate it an considerations regarding suicidal ideation monitoring, evaluation and intervention in medical students.
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23
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Keefner TP, Stenvig T. Searching for a Sense of Place: The Process of How Adolescent Girls Overcome Suicidality. Issues Ment Health Nurs 2020; 41:855-872. [PMID: 32584624 DOI: 10.1080/01612840.2020.1749915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Adolescent suicide is a preventable health problem; however, warning signs are often missed. In this study we developed a grounded theory to explore the process of how adolescent girl suicide attempters escape suicide in a sample of 12 young female adults ages 18-25. Using grounded theory methods of constant comparison, memo-writing, axial, and theoretical coding, searching for a sense of place emerged as the core process encompassing social process stages of: (1) existing in a toxic environment; (2) seeing suicide as the only way out; (3) seeing new ways to escape. Implications for nursing practice, education, and research are discussed.
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Affiliation(s)
- Tamara Pike Keefner
- College of Nursing, Nursing, South Dakota State University, Rapid City, South Dakota, USA
| | - Thomas Stenvig
- College of Nursing, Graduate Nursing, South Dakota State University, Brookings, South Dakota, USA
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24
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Fulginiti A, Goldbach JT, Mamey MR, Rusow J, Srivastava A, Rhoades H, Schrager SM, Bond DW, Marshal MP. Integrating Minority Stress Theory and the Interpersonal Theory of Suicide among Sexual Minority Youth Who Engage Crisis Services. Suicide Life Threat Behav 2020; 50:601-616. [PMID: 32048340 DOI: 10.1111/sltb.12623] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 10/28/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The present study sought to integrate minority stress theory (MST) and the interpersonal theory of suicide (ITS) to better understand high rates of suicide among sexual minority youth (SMY). To date, the ITS and MST have largely advanced independently from one another even though the research base for each theory contains gaps that the other theory may help fill. METHOD Using data from a national sample of 564 SMY (aged 12-24) recruited from an LGBTQ youth-focused suicide crisis prevention provider, we examined structural equation models to understand how perceived burdensomeness and thwarted belongingness mediate the relationship between minority stress and suicidal ideation and attempt. RESULTS Sexual minority stress was significantly associated with both perceived burdensomeness and thwarted belongingness in models predicting suicidal ideation and attempt. Moreover, minority stress had a direct effect on suicide attempt and an indirect effect on both suicidal ideation and suicide attempt through burdensomeness. CONCLUSIONS Given that minority stress is associated with greater thwarted belongingness, perceived burdensomeness, and suicide attempts, there should be greater demand for continuing education centered on sexual minority populations and population-specific services. Identifying burdensomeness as a minority stress-suicide mechanism highlights the potential gains of piloting recently developed burdensomeness interventions among SMY.
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Affiliation(s)
- Anthony Fulginiti
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Jeremy T Goldbach
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Mary Rose Mamey
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Joshua Rusow
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Ankur Srivastava
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Harmony Rhoades
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Sheree M Schrager
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.,California State University, Northridge, Los Angeles, CA, USA
| | - David W Bond
- Blue Shield of California, San Francisco, CA, USA
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25
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Suicidal ideation, suicide planning, and suicide attempts among adolescents in 59 low-income and middle-income countries: a population-based study. THE LANCET CHILD & ADOLESCENT HEALTH 2020; 3:223-233. [PMID: 30878117 DOI: 10.1016/s2352-4642(18)30403-6] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 12/03/2018] [Accepted: 12/04/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Suicide is a major global health challenge and a leading cause of death among adolescents, but research related to suicide has concentrated on high-income countries. We aimed to estimate the prevalence of suicidal ideation, suicide planning, and suicide attempts in adolescents from 59 low-income and middle-income countries. METHODS In this population-based study, we used data from the Global School-based Student Health Survey of schoolchildren aged 13-17 years between 2003 and 2015, in 59 low-income and middle-income countries across six WHO regions. Using a meta-analysis with random effects, we computed the sex-based and age-based estimates of regional and overall prevalence of suicidal ideation, suicide planning, and suicide attempts. FINDINGS Our sample consisted of 229 129 adolescents (mean age 14·6 [SD 1·18] years; 111 082 [48%] boys and 118 047 [52%] girls). The overall prevalence of suicidal ideation was 16·9% (95% CI 15·0-18·8), suicide planning was 17·0% (14·8-19·2), and suicide attempts was 17·0% (14·7-19·3) in the 12 months preceding survey completion. The African region had the highest prevalence of suicidal ideation (20·4%, 17·3-23·6) and suicide planning (23·7%, 19·1-28·3), and the western Pacific region had the highest prevalence of suicide attempts (20·5%, 14·3-26·7). Southeast Asia had the lowest prevalence of ideation (8·0%, 4·5-11·5), planning (9·9%, 5·0-14·8), and attempts (9·2%, 5·1-13·3). Girls had higher prevalence than boys for suicidal ideation (18·5%, 16·4-20·6 vs 15·1%, 13·4-16·7), suicide planning (18·2%, 15·8-20·6 vs 15·6%, 13·7-17·6), and suicide attempts (17·4%, 15·0-19·8 vs 16·3%, 14·0-18·6). Adolescents aged 15-17 years had higher prevalence than those aged 13-14 years of suicidal ideation (17·8%, 15·8-19·8 vs 15·9%, 14·1-17·6), suicide planning (17·8%, 15·7-20·0 vs 16·3%, 14·7-17·9), and suicide attempts (17·6%, 15·2-20·0 vs 16·2%, 13·8-18·5). INTERPRETATION Suicidal thoughts and behaviours are prevalent among adolescents in low-income and middle-income countries, particularly in the African and the western Pacific regions, and particularly among girls and adolescents aged 15-17 years. Targeted suicide prevention initiatives are needed and should take into account the diverse range of cultural and socioeconomic backgrounds of the countries. FUNDING None.
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26
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Rice S, O'Bree B, Wilson M, McEnery C, Lim MH, Hamilton M, Gleeson J, Bendall S, D'Alfonso S, Russon P, Valentine L, Cagliarini D, Howell S, Miles C, Pearson M, Nicholls L, Garland N, Mullen E, McGorry PD, Alvarez-Jimenez M. Leveraging the social network for treatment of social anxiety: Pilot study of a youth-specific digital intervention with a focus on engagement of young men. Internet Interv 2020; 20:100323. [PMID: 32435600 PMCID: PMC7232094 DOI: 10.1016/j.invent.2020.100323] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/28/2020] [Accepted: 05/04/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The primary objective was to determine the acceptability, feasibility and safety of a novel digital intervention (Entourage) for young people with prominent social anxiety symptoms, with a particular focus on the engagement of young men. The secondary aim was to explore whether the intervention was associated with clinically significant improvements to clinical and social variables known to co-occur with social anxiety. METHOD A multidisciplinary team comprising of mental health clinicians, researchers, young adult fiction writers, a comic artist and young people with a lived experience of social anxiety developed the Entourage platform in collaboration. Entourage combines evidence-based therapeutic techniques for social anxiety with an engaging, social-media-based interface that allows users to build social connections, while also receiving expert clinical moderation and support from peer workers. Acceptability, feasibility and safety outcomes of Entourage were tested in a 12-week pilot study with 89 young people (48.3% male; age M = 19.8 years, SD = 3.3 years). Eligible participants were recruited via liaison with four headspace early-intervention centres in north-western Melbourne. RESULTS 56.8% of the sample reported social anxiety symptoms in the severe or very severe range at baseline. Results demonstrated the Entourage intervention was feasible, safe, and potentially acceptable, with 98.6% of participants reporting they would recommend Entourage to another young person experiencing social anxiety. Usage results were also comparable across male and non-male participants. Results showed that young people reliably and significantly improved on clinical and social variables. In particular, young males showed a clinically significant improvement on social anxiety symptoms (d = 0.79, p < .001), depression (d = 0.71, p < .001), belongingness (d = 0.58, p = .001), increased feelings of social connectedness (d = 0.46, p = .004) and decreased loneliness (d = 0.46, p = .006). Non-male participants also experienced a significant increase in social connectedness (d = 0.76, p < .001), alongside reduced social anxiety (d = 0.78, p < .001) and experiential avoidance (d = 0.81, p < .001). CONCLUSIONS Entourage is a highly engaging and potentially effective intervention that represents a novel combination of features designed both to reduce social anxiety symptoms and improve social connection among young people. Entourage demonstrated some acceptability, feasibility and safety, with encouraging benefits to clinical and social variables. Entourage also showed favorable results for the engagement and support of young men with social anxiety symptoms.
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Affiliation(s)
- Simon Rice
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia,Corresponding author at: 35 Poplar Rd, Parkville, Victoria 3052, Australia.
| | - Bridget O'Bree
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Michael Wilson
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Carla McEnery
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia,Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Michelle H. Lim
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia,Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Matthew Hamilton
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - John Gleeson
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Sarah Bendall
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Simon D'Alfonso
- Orygen, Parkville, Victoria, Australia,School of Computing and Information Systems, University of Melbourne, Parkville, Victoria, Australia
| | - Penni Russon
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Lee Valentine
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Daniela Cagliarini
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Simmone Howell
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Christopher Miles
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | | | | | | | - Patrick D. McGorry
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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Mento C, Silvestri MC, Muscatello MRA, Rizzo A, Celebre L, Bruno A, Zoccali AR. Psychological pain and risk of suicide in adolescence. Int J Adolesc Med Health 2020; 34:/j/ijamh.ahead-of-print/ijamh-2019-0270/ijamh-2019-0270.xml. [PMID: 32304305 DOI: 10.1515/ijamh-2019-0270] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 01/30/2020] [Indexed: 11/15/2022]
Abstract
Psychological pain or psychache is intolerable and unacceptable mental pain. This construct plays a key role in the risk of suicide in adolescence. This is a frequent condition in adolescents with depression; a variety of studies propose a bidirectional relationship between these two circumstances. Adolescents with psychological pain are exposed to the risk of suicidal ideation, and behavior. This review aimed to explore psychological pain in adolescents, and the correlation to the risk of suicide. We have conducted, following PRISMA guidelines, a systematic review for the literature on PubMed. Search terms were "Suicide risk in adolescents" AND "Mental Pain in adolescence" OR "Psychological Pain in adolescence". An initial search identified publications 1189. A total of 15 studies met the predefined inclusion criteria and were analyzed. Mental pain is a stronger factor of vulnerability of suicidal ideation and behavior. Intense negative emotions, such as guilt, shame, hopelessness, may become a psychological pain in adolescence, and many studies showed a relation between psychological pain and capability for suicide.
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Affiliation(s)
- Carmela Mento
- Department of Biomedical and Dental Sciences, Morphofunctional Imaging, University of Messina, Consolare Valeria 1, 98125 Messina, Italy, Phone: +390903489.,University of Messina, BIOMORF, via Consolare Valeria 1 Messina, Italy.,Policlinico Hospital, Psychiatric Unit, Messina, Italy
| | | | - Maria Rosaria Anna Muscatello
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, BIOMORF, Messina, Italy.,Department of Biomedical and Dental Sciences, Morphofunctional Imaging, University of Messina, Consolare Valeria 1, 98125 Messina, Italy
| | - Amelia Rizzo
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, Messina, Italy
| | - Laura Celebre
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, Messina, Italy
| | - Antonio Bruno
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, BIOMORF, Messina, Italy.,Department of Biomedical and Dental Sciences, Morphofunctional Imaging, University of Messina, Consolare Valeria 1, 98125 Messina, Italy
| | - Antonio Rocco Zoccali
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, BIOMORF, Messina, Italy.,Department of Biomedical and Dental Sciences, Morphofunctional Imaging, University of Messina, Consolare Valeria 1, 98125 Messina, Italy
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Abstract
Introduction: Suicide represents a major health problem of great importance for public health in Serbia. In the whole world in last decades, the number of committed suicides is constantly increasing. The most dramatic increase is the number of committed suicides among adolescents, but also among the elderly, over 65 years of age. Serbia ranks 13th in Europe in terms of the number of suicide(13.6/100.000 inhabitants) and Vojvodina is at the top place as region in Serbia (15.3/100.000 inhabitants). It is alarming that suicide attempts are 10-15 times more frequent, as well as that a large number of people who have committed suicide in the last month have reported in medical institutions with various problems. Situations and conditions that increase suicide risk are mental disorders and chronic physical illness, as well as life crises, which include pandemic. Also of great importance is positive heredity, as well as previous suicide attempts. Usually, during crisis, number of suicide attempts and committed suicides decline, but after crisis there is lot of evidence that symptoms of anxious and depressive disorders increase and number of suicide attempts and committed suicides is growing up. Case reports: In presented case reports the rigger for a suicide attempt was the current situation during the covid-19 epidemic. One of the leading reasons for the increase in number of attempted and committed suicides is the unrecognition and lack of treatment of mental disorder symptoms. Most frequently symptoms of depression and severe anxiety result in a suicide attempt. Early recognition and treatment either with psycho and/or pharmacotherapy in a significant percentage can reduce the number of attempted and committed suicides. Conclusion: In current pandemic and in next period, it is necessary for medical staff to look after various, but mostly depressive and anxious symptoms in patients, that frequently result in suicide attempt, if stay unrecognized and untreated. That is the best way to prevent suicide and to improve mental health, as it is very important for national interests.
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29
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Perfectionism Moderates the Relationship between Thwarted Belongingness and Perceived Burdensomeness and Suicide Ideation in Adolescents. Psychiatr Q 2019; 90:671-681. [PMID: 31037588 DOI: 10.1007/s11126-019-09639-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
According to the Interpersonal Theory of Suicide, suicide ideation is associated with thwarted belongingness and perceived burdensomeness. According to the Perfectionism Social Disconnection Model, excessive perfectionism is also considered to be a risk factor for depression and suicide. In the present study, the role of perfectionism as a moderator in the association between interpersonal distress (i.e., perceived burdensomeness, thwarted belongingness, low connectedness to parents and friends) and suicide ideation was examined in a nonclinical sample of adolescents. One-hundred and three adolescents were assessed through self-report instruments. Perceived burdensomeness and thwarted belongingness and disconnectedness to parents and friends were found to correlate with suicide ideation. As predicted, perfectionism was found to moderate the relation between these interpersonal distress variables and suicide ideation. Perfectionism augments the association between interpersonal distress and suicide ideation among adolescents. Interventions should consider that adolescents who face interpersonal challenges are particularly at risk if they tend to be highly perfectionist.
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30
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Family and School Contexts as Predictors of Suicidal Behavior among Adolescents: The Role of Depression and Anxiety. J Clin Med 2019; 8:jcm8122066. [PMID: 31771287 PMCID: PMC6947333 DOI: 10.3390/jcm8122066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/08/2019] [Accepted: 11/20/2019] [Indexed: 11/17/2022] Open
Abstract
Suicide is the highest external cause of death in the majority of developed countries. In adolescents, the prevalence of suicide has increased significantly in recent years, becoming a serious public health concern. The main aim of the present study is to characterize suicidal behavior, and to evaluate the relationship between family and school contexts and suicidal behavior through the possible mediating effects of depression and anxiety. The design of the study is cross-sectional. The sample was composed of 1386 Spanish adolescents from 14 high-schools. Suicidal behavior, anxiety, depression, family function, and school climate were evaluated through self-reported questionnaires. The results obtained show a significant association between adaptive family function and a positive school climate with low levels of depression, anxiety, and suicidal behavior. Mediation analyses revealed a significant full mediating effect of depression on family function and school climate with suicidal behavior. No significant mediating effects were found for anxiety. The results obtained underline the importance of family and school as protective factors for the prevention of suicidal behavior in adolescents, through the main mediating role of depression. Future studies should evaluate the mechanisms underlying the effects of family function and school climate on depression, and therefore, on suicidal behavior in adolescents.
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31
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King CD, Joyce VW, Kleiman EM, Buonopane RJ, Millner AJ, Nash CC. Relevance of the interpersonal theory of suicide in an adolescent psychiatric inpatient population. Psychiatry Res 2019; 281:112590. [PMID: 31634732 DOI: 10.1016/j.psychres.2019.112590] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 09/27/2019] [Accepted: 09/28/2019] [Indexed: 11/26/2022]
Abstract
The interpersonal theory of suicide (IPTS) has been widely studied in adults, but not adolescent populations at acute risk for suicide. Accordingly, this study aimed to evaluate IPTS clinical utility in a high-risk sample of suicidal adolescent inpatients. We assessed whether constructs of the IPTS (1) are associated with suicidal thoughts and behaviors (STBs) on admission to a psychiatric hospitalization, and (2) prospectively predict suicide attempt (SA) or psychiatric rehospitalization 90 days after discharge. On admission, adolescent patients self-reported recent STBs, perceived burdensomeness (PB), thwarted belongingness (TB), and depression. Parents reported their child's rehospitalization and suicide attempts 90 days after discharge. Generalized linear regression modelling was used to determine how key constructs of the IPTS are associated with STBs prior to admission and whether they prospectively predict SA or rehospitalization 90 days after discharge. IPTS constructs did not predict rehospitalization or SA within 90 days of discharge. Although PB and TB interacted to associate with prehospitalization SI frequency, and PB, TB and NSSI interacted to associate with prehospitalization SA, the nature of these interactions were not as the IPTS predicts. IPTS constructs are relevant proximal predictors of prehospitalization STB in adolescents, but may operate differently than in adults.
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Affiliation(s)
- Christopher D King
- Franciscan Children's, 30 Warren St, Brighton, MA 02135, USA; McLean Hospital, 115 Mill St., Belmont, MA 02478, USA.
| | | | - Evan M Kleiman
- Department of Psychology, Rutgers, The State University of New Jersey, Tillett Hall, Room 627, Piscataway, NJ 08854, USA.
| | - Ralph J Buonopane
- Franciscan Children's, 30 Warren St, Brighton, MA 02135, USA; McLean Hospital, 115 Mill St., Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St. Boston, MA 02115, USA.
| | - Alexander J Millner
- Franciscan Children's, 30 Warren St, Brighton, MA 02135, USA; Department of Psychology, Harvard University, 33 Kirkland St, Cambridge, MA 02138, USA.
| | - Carol C Nash
- Franciscan Children's, 30 Warren St, Brighton, MA 02135, USA.
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32
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Barzilay S, Apter A, Snir A, Carli V, Hoven CW, Sarchiapone M, Hadlaczky G, Balazs J, Kereszteny A, Brunner R, Kaess M, Bobes J, Saiz PA, Cosman D, Haring C, Banzer R, McMahon E, Keeley H, Kahn JP, Postuvan V, Podlogar T, Sisask M, Varnik A, Wasserman D. A longitudinal examination of the interpersonal theory of suicide and effects of school-based suicide prevention interventions in a multinational study of adolescents. J Child Psychol Psychiatry 2019; 60:1104-1111. [PMID: 31512239 DOI: 10.1111/jcpp.13119] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Predictions of two different models for suicide attempts (SA) over 12 months, as differentially impacted by specific school-based suicide prevention interventions, were compared. These were as follows: (a) interpersonal theory (IPTS) and (b) a two-pathway model, one path associated with externalizing symptoms and continuum of self-harm behaviors, and the other with internalizing symptoms. METHODS Self-report questionnaires were completed by 11,110 high school students from ten EU countries enrolled in the Saving and Empowering Young Lives in Europe (SEYLE) study. Baseline measures included perceived burdensomeness, thwarted belongingness from parents and peers, health risk behaviors, self-injury, suicide ideation (SI), and attempts (SA). SI and SA were reassessed at 12-month follow-up. Each model's predictions of SI and SA groups over time (i.e., repeated SA, remitted SA, SA onset, and no SA) were estimated in the no intervention/control group. The superior model was estimated across intervention groups. RESULTS Interpersonal theory showed better fit compared to the two-pathway model. In partial agreement with IPTS predictions, parental low belongingness but not peer belongingness or burdensomeness predicted greater likelihood of SI. The likelihood of repeated SA versus no SA was higher among adolescents who reported SI, self-injury, risk behaviors, and particularly both SI and self-injury. All three interventions attenuated the combined effect of SI and self-injury. Youth Aware of Mental Health Program (YAM) additionally decreased the effect of risk behaviors on the likelihood of repeated SA. CONCLUSIONS Interpersonal theory assumptions were partially supported. Perceived interpersonal difficulties with parents were primarily related with SI, and risk behaviors and self-injury were important predictors of SA. Suicide prevention interventions may be effective by mitigating the hazardous effect of varying self-harm behaviors and may be further advanced by increasing parental involvement.
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Affiliation(s)
- Shira Barzilay
- Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel
| | - Alan Apter
- Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel
| | - Avigal Snir
- Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Christina W Hoven
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Marco Sarchiapone
- Department of Health Sciences, University of Molise, Campobasso, Italy.,National Institute for Health, Migration and Poverty, Rome, Italy.,Kazakh National Medical University, Almaty, Kazakhstan
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Judit Balazs
- Institute of Psychology, Eotvos Lorand University, Budapest, Hungary.,Bjørknes University College, Oslo, Norway
| | - Agnes Kereszteny
- Institute of Psychology, Eotvos Lorand University, Budapest, Hungary
| | - Romuald Brunner
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Michael Kaess
- Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Julio Bobes
- Department of Psychiatry, School of Medicine, Centro de Investigacion Biomedica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain
| | - Pilar A Saiz
- Department of Psychiatry, School of Medicine, Centro de Investigacion Biomedica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain
| | - Doina Cosman
- Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Christian Haring
- Research Division for Mental Health, University for Medical Information Technology (UMIT), Hall in Tirol, Austria
| | | | | | - Helen Keeley
- National Suicide Research Foundation, Cork, Ireland
| | - Jean-Pierre Kahn
- Department of Psychiatry and Clinical Psychology, Centre Hospitalo-Universitaire (CHU) de Nancy, Universite de Lorraine, Nancy, France
| | - Vita Postuvan
- Slovene Center for Suicide Research, UP IAM, University of Primorska, Koper, Slovenia
| | - Tina Podlogar
- Slovene Center for Suicide Research, UP IAM, University of Primorska, Koper, Slovenia
| | - Merike Sisask
- Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn, Estonia.,School of Governance, Law and Society, Tallinn University, Tallinn, Estonia
| | - Airi Varnik
- Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn, Estonia.,School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
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33
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van Schaik P, Peng Y, Ojelabi A, Ling J. Explainable statistical learning in public health for policy development: the case of real-world suicide data. BMC Med Res Methodol 2019; 19:152. [PMID: 31315579 PMCID: PMC6636096 DOI: 10.1186/s12874-019-0796-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 07/04/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND In recent years, the availability of publicly available data related to public health has significantly increased. These data have substantial potential to develop public health policy; however, this requires meaningful and insightful analysis. Our aim is to demonstrate how data analysis techniques can be used to address the issues of data reduction, prediction and explanation using online available public health data, in order to provide a sound basis for informing public health policy. METHODS Observational suicide prevention data were analysed from an existing online United Kingdom national public health database. Multi-collinearity analysis and principal-component analysis were used to reduce correlated data, followed by regression analyses for prediction and explanation of suicide. RESULTS Multi-collinearity analysis was effective in reducing the indicator set of predictors by 30% and principal component analysis further reduced the set by 86%. Regression for prediction identified four significant indicator predictors of suicide behaviour (emergency hospital admissions for intentional self-harm, children leaving care, statutory homelessness and self-reported well-being/low happiness) and two main component predictors (relatedness dysfunction, and behavioural problems and mental illness). Regression for explanation identified significant moderation of a well-being predictor (low happiness) of suicide behaviour by a social factor (living alone), thereby supporting existing theory and providing insight beyond the results of regression for prediction. Two independent predictors capturing relatedness needs in social care service delivery were also identified. CONCLUSIONS We demonstrate the effectiveness of regression techniques in the analysis of online public health data. Regression analysis for prediction and explanation can both be appropriate for public health data analysis for a better understanding of public health outcomes. It is therefore essential to clarify the aim of the analysis (prediction accuracy or theory development) as a basis for choosing the most appropriate model. We apply these techniques to the analysis of suicide data; however, we argue that the analysis presented in this study should be applied to datasets across public health in order to improve the quality of health policy recommendations.
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Affiliation(s)
- Paul van Schaik
- School of Social Sciences, Humanities and Law, Teesside University, Borough Road, Middlesbrough, TS1 3BA UK
| | - Yonghong Peng
- The University of Sunderland, St Peters Campus, St Peters Way, Sunderland, SR6 0DD UK
| | - Adedokun Ojelabi
- The University of Sunderland, St Peters Campus, St Peters Way, Sunderland, SR6 0DD UK
| | - Jonathan Ling
- The University of Sunderland, St Peters Campus, St Peters Way, Sunderland, SR6 0DD UK
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Levi-Belz Y, Gavish-Marom T, Barzilay S, Apter A, Carli V, Hoven C, Sarchiapone M, Wasserman D. Psychosocial Factors Correlated with Undisclosed Suicide Attempts to Significant Others: Findings from the Adolescence SEYLE Study. Suicide Life Threat Behav 2019; 49:759-773. [PMID: 29851140 DOI: 10.1111/sltb.12475] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 02/06/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Suicide attempt (SA) is recognized as one of the risk factors for completed suicides. The concealment of this behavior often hinders detection and management of suicide risk. Thus, in this study, we sought to shed light on adolescents' psychosocial processes that could facilitate disclosure of SAs. Specifically, we sought to identify antecedents of adolescent SAs that had not been revealed to significant others. METHOD A high school sample) N = 990 (completed a self-report questionnaire tapping psychiatric, personal, and interpersonal characteristics, as well as suicidality, as part of the SEYLE project. Twenty-seven adolescents acknowledged having made an SA without disclosing it to parents or to other significant others. They were compared with 47 adolescents who made SAs that were communicated to others and with a control group of 916 adolescents having no history of suicidal behavior. RESULTS Compared with disclosures and controls, non-disclosing suicide attempters were characterized by higher levels of suicide ideation, distress, and victimization. Low levels of self-disclosure and parental support were significantly associated with undisclosed SAs. CONCLUSIONS Interpersonal difficulties may be related to loneliness and a thwarted sense of belongingness, which may explain the failure to disclose SAs. Implications related to assessment and prevention are discussed.
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Affiliation(s)
- Yossi Levi-Belz
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel.,The Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
| | - Timor Gavish-Marom
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
| | - Shira Barzilay
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alan Apter
- The Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel.,The Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden
| | - Cristina Hoven
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Mario Sarchiapone
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy
| | - Dnuta Wasserman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Brunstein Klomek A, Barzilay S, Apter A, Carli V, Hoven CW, Sarchiapone M, Hadlaczky G, Balazs J, Kereszteny A, Brunner R, Kaess M, Bobes J, Saiz PA, Cosman D, Haring C, Banzer R, McMahon E, Keeley H, Kahn JP, Postuvan V, Podlogar T, Sisask M, Varnik A, Wasserman D. Bi-directional longitudinal associations between different types of bullying victimization, suicide ideation/attempts, and depression among a large sample of European adolescents. J Child Psychol Psychiatry 2019; 60:209-215. [PMID: 30024024 DOI: 10.1111/jcpp.12951] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND The association between bullying victimization and depression, suicide ideation and suicide attempts has been studied mainly in cross-sectional studies. This study aims to test the bidirectional effect and the chronicity versus sporadic effect of physical, verbal, and relational bullying victimization on suicidal ideation/attempts and depression. METHODS Longitudinal assessments with an interval of 3- and 12-months were performed within a sample of 2,933 adolescents (56.1% females; mean age 14.78, SD = .89) from 10 European countries, participating in the Saving and Empowering Young Lives in Europe (SEYLE) school-based multicenter control sample. Multilevel Structural Equation Models were used, controlling for sociodemographic variables. Victimization was considered chronic when a student was victimized in the first two time points and sporadic when it was reported only at one point but not in another. RESULTS Bidirectional prospective association between all types of victimization and depression were found. Among participants, who reported victimization once (but not twice), physical victimization, but not verbal and relational, was associated with later suicidal ideation and attempts. Chronic victimization of any type increased likelihood for later depression compared with sporadic and no-victimization. Chronic relational victimization increased the likelihood of later suicidal ideation, and chronic physical victimization increased the likelihood for suicidal attempts. CONCLUSIONS The results support the bidirectional effect of victimization and depression and indicate that there are complex longitudinal associations between victimization and suicidal ideation/attempts. Physical victimization may especially carry effect on suicidal risk over time. Interventions should focus on victimization as a cause of distress but also aim to prevent vulnerable adolescents from becoming targets of victimization.
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Affiliation(s)
- Anat Brunstein Klomek
- Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel.,Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzlyia, Israel
| | - Shira Barzilay
- Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alan Apter
- Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Christina W Hoven
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Marco Sarchiapone
- Department of Health Sciences, University of Molise, Campobasso, Italy.,National Institute for Health, Migration and Poverty, Rome, Italy.,Kazakh National Medical University, Almaty, Kazakhstan
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Judit Balazs
- Vadaskert Child Psychiatry Hospital, Budapest, Hungary.,Institute of Psychology, Eotvos Lorand University, Budapest, Hungary
| | - Agnes Kereszteny
- Vadaskert Child Psychiatry Hospital, Budapest, Hungary.,Institute of Psychology, Eotvos Lorand University, Budapest, Hungary
| | - Romuald Brunner
- Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Julio Bobes
- Department of Psychiatry, School of Medicine, Centro de Investigacion Biomedica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain
| | - Pilar A Saiz
- Department of Psychiatry, School of Medicine, Centro de Investigacion Biomedica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain
| | - Doina Cosman
- Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Christian Haring
- Department Psychiatry and Psychotherapy, State Hospital Hall in Tyrol, Hall in Tyrol, Austria
| | | | | | - Helen Keeley
- National Suicide Research Foundation, Cork, Ireland
| | - Jean-Pierre Kahn
- Department of Psychiatry and Clinical Psychology, Centre Hospitalo-Universitaire (CHU) de Nancy, Universite de Lorraine, Nancy, France
| | - Vita Postuvan
- Slovene Center for Suicide Research, UP IAM, University of Primorska, Koper, Slovenia
| | - Tina Podlogar
- Slovene Center for Suicide Research, UP IAM, University of Primorska, Koper, Slovenia
| | - Merike Sisask
- Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn, Estonia.,School of Governance, Law and Society, Tallinn University, Tallinn, Estonia
| | - Airi Varnik
- Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn, Estonia.,School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
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Ren Y, You J, Zhang X, Huang J, Conner BT, Sun R, Xu S, Lin MP. Differentiating Suicide Attempters from Suicide Ideators: The Role of Capability for Suicide. Arch Suicide Res 2019; 23:64-81. [PMID: 29393828 DOI: 10.1080/13811118.2018.1426507] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examined whether different components of capability for suicide (i.e., fearlessness about death, pain tolerance, pain insensitivity, preparation for suicide, suicide plan, and courage), as well as painful and provocative events, nonsuicidal self-injury, depressive symptoms, and hopelessness, could distinguish between suicide attempters, suicide ideators, and non-suicidal controls. A total of 930 Chinese adolescents completed questionnaires, and a multinomial logistic regression was conducted to identify factors that could distinguish among the 3 groups. We found that higher levels of pain tolerance, more detailed suicide plans, more positive attitudes towards suicide, as well as more painful and provocative experiences and more severe depressive symptoms were positively associated with increased likelihood of the engagement in both suicide ideation and suicide attempts. Only nonsuicidal self-injury increased the likelihood of falling in the suicide attempt group as compared to the suicide ideation group. Findings of this study emphasize the role of nonsuicidal self-injury in intervening suicidality.
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37
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Naidoo S, Collings S. A test of the interpersonal-psychological theory of suicidal behaviour in a sample of mental health outpatients. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2018. [DOI: 10.1177/0081246318811984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Suicidality is a growing mental health problem, with statistics for South Africa being in line with global estimates. There has, however, been relatively little empirical advancement in the conceptualization of suicidal behaviour in recent years. Joiner’s interpersonal-psychological theory of suicidal behaviour is a relatively new theory that appears to hold promise for advancing our understanding of the mechanisms that underlie suicidal behaviour. The theory proposes that people die by suicide because they want to and because they can. This study sought to test two key hypotheses of the interpersonal-psychological theory of suicidal behaviour using a cross-sectional design and a sample of 239 mental health outpatients. Consistent with theoretical predictions, levels of suicidal ideation were significantly predicted by the interactive effects of high levels of thwarted belongingness and perceived burdensomeness in the presence of high levels of hopelessness in relation to both of these distressing states; with estimates of risk for suicide being most strongly predicted by the interactive effects of suicide ideation and an acquired capability for suicide. These findings are discussed in terms of their implications for theory, practice, and future research.
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Collins KRL, Legendre MN, Stritzke WGK, Page AC. Experimentally-enhanced perceptions of meaning confer resilience to the interpersonal adversity implicated in suicide risk. J Behav Ther Exp Psychiatry 2018; 61:142-149. [PMID: 30081255 DOI: 10.1016/j.jbtep.2018.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 07/06/2018] [Accepted: 07/27/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES The interpersonal theory of suicide proposes that perceived burdensomeness and thwarted belongingness (PB-TB) are proximal causes of suicidal desire. Here we test whether experimentally induced perceptions of meaningfulness can confer resilience against interpersonal adversity and enhance persistence, the erosion of which is a potential antecedent to suicide risk. METHODS Undergraduate university students (N = 93) were randomly allocated to complete a team task under conditions of high or low task-extrinsic meaning and high or low PB-TB. Participants in the high task-extrinsic meaning condition were given the opportunity to donate to a charity as part of their experimental participation, whereas those in the low task-extrinsic meaning condition were not. RESULTS Consistent with the buffering hypothesis that suicide resilience is active only when adversity is heightened, participants in the high task-extrinsic meaning condition who reported higher levels of perceived meaningfulness displayed greater willingness to persist in the face of experimentally-induced high PB and TB compared to those in the low task-extrinsic meaning condition and those in conditions where the interpersonal adversity was not induced (low PB and TB). LIMITATIONS The meaning induction was effective only in a subset of participants. The dual induction of PB and TB also precludes inferences about their independent causal effects on willingness to persist. CONCLUSIONS Meaning-making interventions may attenuate the impact of proximal interpersonal antecedents of suicidal desire. Enhancing resilience in this manner can potentially improve the efficacy of prevention efforts beyond the direct amelioration of suicide risk factors.
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Bailey E, Rice S, Robinson J, Nedeljkovic M, Alvarez-Jimenez M. Theoretical and empirical foundations of a novel online social networking intervention for youth suicide prevention: A conceptual review. J Affect Disord 2018; 238:499-505. [PMID: 29936387 DOI: 10.1016/j.jad.2018.06.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/06/2018] [Accepted: 06/08/2018] [Indexed: 01/17/2023]
Abstract
Suicide is a major public health problem and is the second leading cause of death in young people worldwide. Indicating a lack of adequate treatment approaches, recent data suggest a rising suicide rate. Current approaches to suicide prevention do not sufficiently account for the specific needs of young people or the ways in which they engage with the health system, nor are they adequately theory-driven. In this paper, we review an empirically-supported theoretical model of suicide together with the latest evidence in treating young people who are at risk. We discuss the potential efficacy of social-media-based online interventions, with a particular focus on how they may be uniquely placed to target interpersonal risk factors for suicide. We highlight the risks associated with such interventions, including the potential for contagion to occur. Based on prominent theoretical models and gaps in existing treatment approaches, we propose a newly-developed, theory-driven, online social-networking-based intervention for suicide prevention in young people.
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Affiliation(s)
- Eleanor Bailey
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia; Swinburne University of Technology, Melbourne, Australia.
| | - Simon Rice
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | | | - Mario Alvarez-Jimenez
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
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Collins KRL, Stritzke WGK, Page AC, Brown JD, Wylde TJ. Mind full of life: Does mindfulness confer resilience to suicide by increasing zest for life? J Affect Disord 2018; 226:100-107. [PMID: 28968562 DOI: 10.1016/j.jad.2017.09.043] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/21/2017] [Accepted: 09/24/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Mindfulness is a trainable skill that may enhance resilience to suicidality among vulnerable groups such as young people. The current study examined whether mindfulness protects against suicidal desire in the face of heightened risk and adversity by increasing zest for life in a sample of university students. METHODS In a prospective design, participants (N = 233) were assessed at two time points over eight weeks. Online surveys included the Mindful Attention and Awareness Scale, Zest for Life Scale, Interpersonal Needs Questionnaire, Kessler Psychological Distress Scale, and items assessing suicidal ideation and suicidal intent. RESULTS Baseline mindfulness was associated with lower suicidal ideation and intent at follow-up. Moderated mediation analyses confirmed the effects of mindfulness on ideation and intent were mediated by zest for life and these indirect effects were stronger at higher versus lower levels of general (psychological distress) and suicide-specific (perceived burdensomeness and thwarted belongingness) risk. LIMITATIONS Single item assessments of suicidal desire. CONCLUSIONS Findings suggest that mindfulness protects against suicidal desire in conditions of heightened risk and adversity by enhancing one's orientation towards a life worth living. Theories of suicide should consider the dynamic interplay between risk and life-sustaining resilience, while clinicians treating suicidality could use mindfulness strategies to strengthen the desire to (re)engage with life, thereby complementing direct amelioration of suicide risk factors.
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Ethical practices in community-based research in non-suicidal self-injury: A systematic review. Asian J Psychiatr 2017; 30:127-134. [PMID: 28903081 DOI: 10.1016/j.ajp.2017.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/28/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND The growing interest in community-based research on non-suicidal self-injury (NSSI) reflects the high prevalence rates found among vulnerable adolescents and young adults. A significant concern in research with vulnerable populations, and on sensitive topics, is the development of an ethical framework that protects the needs and rights of the participants while responding to researchers' goals and limitations and the broader clinical and public health concerns. AIM The aim of the present study was to review the ethical practices followed in community-based research on NSSI. METHOD A systematic review of literature was conducted, based on PRISMA guidelines, on community-based surveys in NSSI, published between 1995 and 2016. A total of 93 studies were included in the review. RESULTS The results examine a range of ethical issues; the procedures for consent and assent for study participation, protection of confidentiality and the limits of confidentiality, assessment of imminent risk of suicide and subsequent processes, and debriefing measures. The interaction between the study characteristics and the reported ethical procedures has been examined, with a focus on participant age, study design (cross-sectional or longitudinal), survey modality (paper-based survey or online survey) and primary variable/s of interest (only NSSI or NSSI and suicidal ideation/behavior) under study. The review describes the typical ethical practices in community-based research on NSSI, identifies the gaps in the existing literature, and has implications for the formulation of best-practice guidelines.
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Benatov J, Nakash O, Chen-Gal S, Brunstein Klomek A. The Association Between Gender, Ethnicity, and Suicidality Among Vocational Students in Israel. Suicide Life Threat Behav 2017; 47:647-659. [PMID: 28220963 DOI: 10.1111/sltb.12332] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 09/17/2016] [Indexed: 11/27/2022]
Abstract
Gender and ethnicity are significant factors when evaluating suicidal risk, especially among ethnically diverse populations. In the current study we explored the association between gender, ethnicity, and suicide ideation and attempts among Arab and Jewish vocational education and training high school students in Israel. Students (N = 3,554) completed a self-report survey evaluating suicide ideation and attempts, depression, anxiety, somatization, and sense of belonging. Hierarchical generalized linear modeling indicated that female Arab adolescents had elevated levels of suicide ideation, higher rates of suicide attempts, and greater psychological distress than Arab males and Jewish students. Furthermore, female Arab adolescents were found to be more susceptible to suicide ideation when depression levels were high. These results are discussed in the context of the double-jeopardy Arab young women face, as members of a minority ethnic group in Israel and their status as women within the patriarchal Arab culture.
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Affiliation(s)
- Joy Benatov
- Psychology, College of Management Academic Studies, Rishon LeZion, Israel
| | - Ora Nakash
- School of Psychology, Interdisciplinary Center (IDC) Herzliya, Herzliya, Israel
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Hill RM, Hatkevich C, Pettit JW, Sharp C. Gender and the Interpersonal-Psychological Theory of Suicide: A Three-Way Interaction Between Perceived Burdensomeness, Thwarted Belongingness, and Gender. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2017. [DOI: 10.1521/jscp.2017.36.10.799] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Ryan M. Hill
- Baylor College of Medicine/Texas Children's Hospital
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Park Y, Baik SY, Kim HS, Lee SH. The Influence of Traditional Culture and the Interpersonal Psychological Theory on Suicide Research in Korea. Psychiatry Investig 2017; 14:713-718. [PMID: 29209373 PMCID: PMC5714711 DOI: 10.4306/pi.2017.14.6.713] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 03/25/2017] [Indexed: 11/19/2022] Open
Abstract
Korea has the highest suicide rate amongst the OECD countries. Yet, its research on suicidal behaviors has been primitive. While the Interpersonal Psychological Theory of Suicide has gained global attention, there has only been a few researches, which examined its applicability in Korea. In this article, we review the previous studies on suicide and examine the association between the Interpersonal Psychological Theory of Suicide and traditional Korean culture, with an emphasis on Collectivism and Confucianism. We propose that pathways to suicide might vary depending on cultural influences. Clinical implications and suggestions for future research will be discussed.
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Affiliation(s)
- Yeonsoo Park
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
- Department of Psychology, Sogang University, Seoul, Republic of Korea
| | - Seung Yeon Baik
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
- Department of Psychology, Sogang University, Seoul, Republic of Korea
| | - Hyang-Sook Kim
- Department of Psychology, Sogang University, Seoul, Republic of Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
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Pelton MK, Cassidy SA. Are autistic traits associated with suicidality? A test of the interpersonal-psychological theory of suicide in a non-clinical young adult sample. Autism Res 2017; 10:1891-1904. [PMID: 28685996 PMCID: PMC5697632 DOI: 10.1002/aur.1828] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 03/28/2017] [Accepted: 06/05/2017] [Indexed: 11/08/2022]
Abstract
Autism spectrum conditions (ASC) has recently been associated with increased risk of suicidality. However, no studies have explored how autistic traits may interact with current models of suicidal behavior in a non-clinical population. The current study therefore explored how self-reported autistic traits interact with perceived burdensomeness and thwarted belongingness in predicting suicidal behavior, in the context of the Interpersonal-Psychological Theory of Suicide (IPTS). 163 young adults (aged 18-30 years) completed an online survey including measures of thwarted belonging and perceived burdensomeness (Interpersonal Needs Questionnaire), self-reported autistic traits (Autism Spectrum Quotient), current depression (Centre for Epidemiological Studies Depression Scale), and lifetime suicidality (Suicide Behavior Questionnaire-Revised). Results showed that burdensomeness and thwarted belonging significantly mediated the relationship between autistic traits and suicidal behavior. Both depression and autistic traits significantly predicted thwarted belonging and perceived burdensomeness. Autistic traits did not significantly moderate the relationship between suicidal behavior and thwarted belonging or perceived burdensomeness. Results suggest that the IPTS provides a useful framework for understanding the influence of autistic traits on suicidal behavior. However, the psychometric properties of these measures need be explored in those with clinically confirmed diagnosis of ASC. Autism Res 2017, 10: 1891-1904. © 2017 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. LAY SUMMARY Recent research has shown that people with high autistic traits are more likely to attempt suicide. However, no studies have explored why. We found that people with high autistic traits were more likely to experience feelings that they do not belong in the world, are a burden on others, and depression, which may increase their likelihood of attempting suicide. These results suggest that promoting inclusion and independence in those with high autistic traits could help prevent people attempting suicide.
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Affiliation(s)
- M. K. Pelton
- Centre for Research in PsychologyBehaviour and Achievement, Coventry UniversityCoventryUK
- School of PsychologyUniversity of BirminghamBirminghamUK
| | - S. A. Cassidy
- Centre for Research in PsychologyBehaviour and Achievement, Coventry UniversityCoventryUK
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Barzilay S, Brunstein Klomek A, Apter A, Carli V, Wasserman C, Hadlaczky G, Hoven CW, Sarchiapone M, Balazs J, Kereszteny A, Brunner R, Kaess M, Bobes J, Saiz P, Cosman D, Haring C, Banzer R, Corcoran P, Kahn JP, Postuvan V, Podlogar T, Sisask M, Varnik A, Wasserman D. Bullying Victimization and Suicide Ideation and Behavior Among Adolescents in Europe: A 10-Country Study. J Adolesc Health 2017; 61:179-186. [PMID: 28391968 DOI: 10.1016/j.jadohealth.2017.02.002] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/08/2017] [Accepted: 02/02/2017] [Indexed: 01/21/2023]
Abstract
PURPOSE To examine risk and protective factors moderating the associations between three types of bullying victimization (physical, verbal, and relational bullying) with suicide ideation/attempts in a large representative sample of European adolescents. METHODS We analyzed cross-sectional data on 11,110 students (mean age = 14.9, standard deviation = .89) recruited from 168 schools in 10 European Union countries involved in the Saving and Empowering Young Lives in Europe study. A self-report questionnaire was used to measure victimization types, depression, anxiety, parental and peer support, and suicide ideation and attempts. For each outcome, we applied hierarchical nonlinear models controlling for sociodemographics. RESULTS Prevalence of victimization was 9.4% physical, 36.1% verbal, and 33.0% relational. Boys were more likely to be physically and verbally victimized, whereas girls were more prone to relational victimization. Physical victimization was associated with suicide ideation, and relational victimization was associated with suicide attempts. Other associations between victimization and suicidality (ideation/attempts) were identified through analysis of interactions with additional risk and protective factors. Specifically, verbal victimization was associated with suicide ideation among adolescents with depression who perceived low parental support. Similarly, low peer support increased the associations between verbal victimization and suicide ideation. Verbal victimization was associated with suicide attempts among adolescents with anxiety who perceived low parental support. CONCLUSIONS Findings support the development of prevention strategies for adolescent victims of bullying who may be at elevated risk for suicide ideation/behavior, by taking into account gender, the type of bullying, symptomatology, and availability of interpersonal support.
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Affiliation(s)
- Shira Barzilay
- Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel; Child and Adolescent Psychiatry, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | - Anat Brunstein Klomek
- Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel; Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzliya, Israel.
| | - Alan Apter
- Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Camilla Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden; Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Christina W Hoven
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Marco Sarchiapone
- Department of Health Sciences, University of Molise, Campobasso, Italy; National Institute for Health, Migration and Poverty, Rome, Italy
| | - Judit Balazs
- Vadaskert Child Psychiatry Hospital, Budapest, Hungary; Institute of Psychology Eotvos Lorand University, Budapest, Hungary
| | - Agnes Kereszteny
- Institute of Psychology Eotvos Lorand University, Budapest, Hungary
| | - Romuald Brunner
- Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Julio Bobes
- Department of Psychiatry, School of Medicine, Centro de Investigacion Biomedica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain
| | - Pilar Saiz
- Department of Psychiatry, School of Medicine, Centro de Investigacion Biomedica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain
| | - Doina Cosman
- Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Christian Haring
- Research Division for Mental Health, University for Medical Information Technology (UMIT), Hall in Tirol, Austria
| | | | | | - Jean-Pierre Kahn
- Department of Psychiatry and Clinical Psychology, Centre Hospitalo-Universitaire (CHU) de Nancy, Universite de Lorraine, Nancy, France
| | - Vita Postuvan
- Slovene Center for Suicide Research, UP IAM, University of Primorska, Koper, Slovenia
| | - Tina Podlogar
- Slovene Center for Suicide Research, UP IAM, University of Primorska, Koper, Slovenia
| | - Merike Sisask
- Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn, Estonia; School of Governance, Law and Society, Tallinn University, Tallinn, Estonia
| | - Airi Varnik
- Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn, Estonia; School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
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May AM, Victor SE. From ideation to action: recent advances in understanding suicide capability. Curr Opin Psychol 2017; 22:1-6. [PMID: 30122270 DOI: 10.1016/j.copsyc.2017.07.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 07/10/2017] [Indexed: 10/19/2022]
Abstract
Suicide capability is one of few risk factors associated with suicide attempts among ideators. In the decade since the Interpersonal Psychological Theory of Suicide introduced the concept of acquired capability (i.e. the ability to face the fear and pain associated with death), understanding of the capability to attempt suicide has grown. Acquired (e.g. NSSI), dispositional (e.g. genetic), and practical contributors (e.g. access to firearms) appear to influence suicide capability via mechanisms such as the fear of death, persistence through pain, and familiarity with suicide methods. Self-report methods have shown mixed results, highlighting the importance of developing behavioral measures of suicide capability.
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Affiliation(s)
- Alexis M May
- University of Utah, Department of Psychology, 380 S 1530 E, Beh S 502, Salt Lake City, UT 84112, USA.
| | - Sarah E Victor
- University of Pittsburgh School of Medicine, Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
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Hall WJ. Psychosocial Risk and Protective Factors for Depression Among Lesbian, Gay, Bisexual, and Queer Youth: A Systematic Review. JOURNAL OF HOMOSEXUALITY 2017; 65:263-316. [PMID: 28394718 PMCID: PMC5634914 DOI: 10.1080/00918369.2017.1317467] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Many lesbian, gay, bisexual, or queer (LGBQ) youth suffer from depression. Identifying modifiable risk and protective factors for depression can inform the development of psychosocial interventions. The aim of this review is to evaluate the methodological characteristics and summarize the substantive findings of studies examining psychosocial risk and protective factors for depression among LGBQ youth. Eight bibliographic databases were searched, and 35 studies that met all inclusion criteria were included for review. Results show that prominent risk factors for depression include internalized LGBQ-related oppression, stress from hiding and managing a socially stigmatized identity, maladaptive coping, parental rejection, abuse and other traumatic events, negative interpersonal interactions, negative religious experiences, school bullying victimization, and violence victimization in community settings. Prominent protective factors include a positive LGBQ identity, self-esteem, social support from friends, and family support. LGBQ youth may face an array of threats to their mental health originating from multiple socioecological levels.
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Affiliation(s)
- William J Hall
- a School of Social Work and Cecil G. Sheps Center for Health Services Research , University of North Carolina , Chapel Hill , North Carolina , USA
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49
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Trakhtenbrot R, Gvion Y, Levi-Belz Y, Horesh N, Fischel T, Weiser M, Treves I, Apter A. Predictive value of psychological characteristics and suicide history on medical lethality of suicide attempts: A follow-up study of hospitalized patients. J Affect Disord 2016; 199:73-80. [PMID: 27085659 DOI: 10.1016/j.jad.2016.03.054] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 03/20/2016] [Accepted: 03/27/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study examined the role of mental pain, communication difficulties, and suicide history in predicting the medical severity of follow-up suicide attempts. METHODS The cohort included 153 consecutive psychiatric in-patients who participated in earlier studies 1-9 years previously. Fifty-three had a history of a medically serious suicide attempt (MSSA), 64 had a history of a medically non-serious suicide attempt (MNSSA), and 36 had no history of suicide. A MSSA was defined as a suicide attempt that warranted hospitalization for at least 24h and extensive medical treatment. Participants completed a battery of instruments measuring mental pain and communication difficulties. Findings were analyzed in relation to follow-up suicide attempts and their severity. RESULTS Fifty-three patients (35.5%) had attempted suicide: 15 (9.9%) a MSSA (including 5 fatalities) and 38 (25%) a MNSSA. The medical severity of the index attempt and level of hopelessness at the index attempt were significantly correlated with medical severity of the follow-up attempt. In younger patients, high levels of depression and self-disclosure predicted the medical severity of the follow-up attempt. In patients with relatively low hopelessness, the medical severity of the attempt increased with the level of self-disclosure. LIMITATIONS (i) Possibly incomplete patient information, as some of the patients who participated in the index studies could not be located. (ii) Relatively small group of patients with an index MSSA. CONCLUSIONS Patients who have made a suicide attempt should be assessed for medical severity of the attempt, hopelessness, and communication difficulties, which are important factors in follow-up attempts.
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Affiliation(s)
- Ruth Trakhtenbrot
- Department of Clinical Psychology, Bar Ilan University, Ramat Gan 5290002, Israel.
| | - Yari Gvion
- Department of Clinical Psychology, Bar Ilan University, Ramat Gan 5290002, Israel; Department of Clinical Psychology, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Jaffa 86162, Israel
| | - Yossi Levi-Belz
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer 40250, Israel
| | - Netta Horesh
- Department of Clinical Psychology, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Tsvi Fischel
- Geha Mental Health Center, Petach Tikva 49100, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Mark Weiser
- The Psychiatric Division, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel
| | - Ilan Treves
- Shalvata Mental Health Center, Hod Hasharon 45100, Israel
| | - Alan Apter
- Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petach Tikva 49202, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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