Temperament and character profile of college students who have suicidal ideas or have attempted suicide

Differences in temperament and character inventory (TCI) profile between suicidal and nonsuicidal psychiatric outpatients

The purpose of this study was to identify personality traits associated with suicide attempt in a clinical sample. Temperament and character inventory (TCI) profiles of 759 patients who met the inclusion criteria among 1000 randomly selected hospital records collected. Of these 759 patients, 103 had a history of at least 1 actual suicide attempt (suicidal group) whereas 656 had no such history (nonsuicidal group). The suicidal group showed higher scores of novelty seeking (mean ± SD: 36.1 ± 1.2 vs 33.3 ± 0.5; P = .026) and harm avoidance (57.1 ± 1.5 vs 53.0 ± 0.6; P = .01) but lower scores of self-directedness (27.5 ± 1.5 vs 34.4 ± 0.6; P < .001) than the nonsuicidal group. Higher novelty seeking (OR [95% CI]: 1.031 [1.008-1.054]; P = .007) and lower self-directedness: 0.955 [0.927-0.983]; P = .002 were also associated with suicide attempts in the analysis of 7 personality scales. These findings suggest that patients who attempt suicide differ from nonattempters in terms of personality traits, especially in novelty seeking (NS), harm avoidance (HA), and self-directedness (SD). It is noteworthy that this study contains data from actual visits to the emergency room to evaluate suicide attempts. Abbreviations: CO = cooperativeness, Ha = harm avoidance, NS = novelty seeking, PS = persistence, RD = reward dependence, SD = self-directedness, ST = self-transcendence, TCI = temperament and character inventory.

Temperament and Character of High Suicide Risk Group Among Psychiatric Patients

OBJECTIVE

The purpose of this study was to classify patients with suicidal tendencies into suicide attempts (SA), suicidal ideation (SI), and non-suicidal self-injury (NSSI) and to identify differences in temperaments and characters of the groups. It also aimed to identify difference between the groups and non-suicidal tendencies.

METHODS

Using psychiatric diagnostic data of 195 patients, temperaments and characters were measured with the Temperament and Character Inventory, and the level of depression was measured with the Beck Depression Inventory. The subjects were classified into SA, SI, NSSI, psychiatric patients without suicidal tendencies (PP), and non-patient (Normal) groups, and multivariate analysis of variance and multinomial logistic regression were conducted.

RESULTS

The NSSI group had higher novelty seeking compared to the SI group, while having higher harm avoidance, lower persistence, and lower self-directedness compared to the SA group. Furthermore, low persistence was a better predictor for the SA group between SA and NSSI groups, and low novelty seeking was found to be a better predictor for the SI group between the SI and NSSI groups.

CONCLUSION

As a result, the group differences in temperaments and characters were found, which would be useful to identify patients with suicidal tendencies and provide appropriate interventions tailored to the temperaments and characters of each group.

Network modeling of anxiety and psychological characteristics on suicidal behavior: Cross-sectional study

BACKGROUND

Suicide is influenced by complex interactions among various psychopathological features. We aimed to examine the relationship between suicide risk and psychological risk factors such as defense mechanisms, personality, and anxiety.

METHODS

We established a psychiatric database by utilizing the Observational Medical Outcomes Partnership Common Data Model. We conducted a 1:1 propensity score matching with age, sex, and depression severity, and identified a sample (n = 258) with two groups: those with suicidal behavior and those with non-suicidal behavior. Using principal component analysis, we extracted nine psychological scales and applied network analysis to compare relationships among psychological factors between the two groups.

RESULTS

Patients with non-suicidal behaviors showed associations between trait anxiety and defense mechanisms, while those with suicidal behaviors did not. For patients with suicidal ideation there was an association between somatization and trait anxiety. Patients with suicide attempts showed associations between paranoia and dissociation connected to trait anxiety.

LIMITATIONS

Longitudinal research is required to fully observe transitions from suicidal ideation to attempts and recurrent suicidal events. In addition, these networks may not generalize suicidal behaviors because the group participants are not homogeneous. Lastly, data from self-report questionnaires limits the reliability of responses.

CONCLUSIONS

We presented important new insights on suicidal behavior by estimating psychological networks. Patients with non-suicidal behavior may exhibit discrete relationships between defense mechanisms and anxiety, compared to those with suicidal behavior. Patients with suicidal ideation and suicide attempts may show distinct associations between anxiety and psychopathological features.

Sensitivity is the dimension of temperament most associated with the progression from ideation to suicide attempts

BACKGROUND

To analyze the association between temperament (emotional and affective) and scrutinize the progression from suicide ideation to attempt, by using data from a large internet-based sample.

METHODS

It is a cross-sectional study, based on the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP). Temperament was assessed by the Affective and Emotional Composite Temperament Scale (AFECTS), and life-long suicidal behavior was determined by the adapted Suicidal Behaviors Questionnaire (SBQ-17). Odds ratios were obtained through multivariate logistic regression and a multiple linear regression were used in the analysis. According to the "ideation-to-action framework", we performed analyzes using two different reference groups: no suicidal ideation and suicidal ideation.

RESULTS

The affective temperaments that showed the greatest association with suicide attempts were depressive, cyclothymic, and volatile. The temperaments that reflected higher associations for progression from ideation to suicide attempt were cyclothymic, depressive, and euphoric. Sensitivity was manifested as the emotional temperament with the strongest positive association with the severity of suicidal behavior, followed by desire and control. Stability was estimated as the emotional trait with the strongest negative association with the severity of suicidal behavior.

LIMITATIONS

It is not a population based sample. BRAINSTEP is a self-selected sample whose participants are mostly women, who are highly educated and young.

CONCLUSIONS

Our results suggest that temperament assessment using AFECT model may be relevant to assess the risk for the progression from ideation to suicide attempts. These results strengthen the "ideation-to-action" framework that risk factors to suicide ideators can differ from suicide attempters.

Characteristics, causality, and suicidal behavior: a qualitative study of family members with suicide history in Wonogiri, Indonesia

Objective

This study explored the characteristics, causality, and suicidal behavior among family members with suicide history in Wonogiri, Central Java, Indonesia.

Methods

Qualitative semistructured interviews were conducted with 15 family members who had made suicide attempts. The interviews directly explored the relationships among characteristics, causality, and suicidal behavior. The research data were analyzed using the Miles and Huberman approach.

Results

The results indicate that there are relationships among characteristics, causality, and suicidal behaviors. The characteristics contributing to suicide attempts were male gender, age (adolescence and old age), lack of religious activities, introvert nature, low economic status, chronic diseases, unemployment, and a history of family members with suicide attempts. The causality of suicide was joblessness, economic crisis, unemployment, family conditions, personality disorder, depression, sickness, and suicide ideation.

Conclusions

The findings highlight the relationships among characteristics, causality, and suicidal behaviors. Suicide occurs when individuals have some problems that they cannot solve because of the lack of family support. The causal factors were related to one another, which caused the suicidal behavior. One of the most effective suicide prevention strategies is educating the community on how to identify suicidal signs and increase social supports.

Assessment of suicidal risk using Minnesota multiphasic personality inventory-2 restructured form

BACKGROUND

Suicide is a major social issue, affected by both social and psychopathological factors. This study investigated suicide risk assessment using the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF).

METHODS

Data were collected from 7824 college students using the MMPI-2-RF. The participants were classified into high-, moderate-, and low-risk for suicide groups based on their scores on the structured Mini-International Neuropsychiatric Interview (MINI) for comparative analysis. The relationships between scores on the Restructured Clinical (RC) Scales of the MMPI-2-RF and suicide risk level were investigated using a multiple logistic regression.

RESULTS

Out of the 7824 participants, 964 (12.3%) were identified as being at risk of suicide. There were 553 participants considered low-risk, 312 moderate-risk, and 99 at high-risk. Suicide risk in the participants tended to increase as RC scale scores increased. Out of the nine RC scales, the Demoralization (RCd) and Negative Emotions (RC7) scale scores were highest across all risk groups. The results of a multiple logistic regression indicated that the Demoralization (RCd) scores were significantly elevated in all three suicide risk groups. Antisocial Behavior (RC4) and Aberrant Experiences (RC8) scale scores were significantly elevated for the low-risk group, whereas Somatic Complaints (RC1) scores were elevated for the moderate-risk group, and Somatic Complaints (RC1), Low Positive Emotions (RC2), Antisocial Behavior (RC4), and Ideas of Persecution (RC6) scale scores were elevated for the high-risk group.

CONCLUSIONS

Compared to the healthy control group, all three suicide risk groups showed elevated scores on the RC Scales overall, suggesting that various psychopathological factors are involved in the etiology of suicide. More psychopathologic factors were found to influence suicide-related issues in the higher risk groups than lower risk groups, suggesting that more risk factors are involved in higher suicide risk groups. Compared to healthy controls, even the low-risk group showed a significant elevation in emotional factors and antisocial behaviors. While the healthy controls and those at risk of suicide differed significantly on both the Demoralization (RCd) and Negative Emotions (RC7) scales, only the Demoralization (RCd) scale appeared to be able to screen for high suicide risk.

Associations Among Monoamine Neurotransmitter Pathways, Personality Traits, and Major Depressive Disorder

Major depressive disorder (MDD) is a complex psychiatric disease requiring multidisciplinary approaches to identify specific risk factors and establish more efficacious treatment strategies. Although the etiology and pathophysiology of MDD are not clear until these days, it is acknowledged that they are almost certainly multifactorial and comprehensive. Monoamine neurotransmitter system dysfunction and specific personality traits are independent risk factors for depression and suicide. These factors also demonstrate complex interactions that influence MDD pathogenesis and symptom expression. In this review, we assess these relationships with the aim of providing a reference for the development of precision medicine.

Associations between depression, anxiety, stress, hopelessness, subjective well-being, coping styles and suicide in Chinese university students

Suicide is a major public health concern worldwide. This study aimed to predict the suicidal behavior of Chinese university students by studying psychological measures such as hopelessness, orientation to happiness, meaning in life, depression, anxiety, stress, and coping styles. In November 2016, a stratified-clustered-random sampling approach was utilized to select subjects from two large public medical-related universities in Shandong province, China. This sample consisted of 2,074 undergraduate students (706 males, 1,368 females; mean age = 19.79±1.39 years). The students’ major risk factors for suicide were depression, anxiety, stress, and hopelessness, and the students’ minor risk factors included orientation to happiness and coping styles (including self-distraction, self-blame and substance use). Notably, the presence of meaning in life had a positive effect on preventing suicide and acted as a protective factor, which suggests that it is important to identify risk factors as well as protective factors relevant to the target population group in order to increase the effectiveness of counseling and suicide prevention programs.

Chronotype and suicide: The mediating effect of depressive symptoms

BACKGROUND

Chronotype is individual characteristic, and people who stay up late are acknowledged to be more likely to experience depressive symptoms as well as impulsivity and suicide. Depression is also associated with suicidality. The purpose of this study was to investigate and analyze the role of depression in its effects on chronotype and suicidality.

METHOD

A total of 5632 university students were recruited as participants. We evaluated their chronotype, depressive symptoms, and suicidality using questionnaires. Correlation analysis, analysis of covariance, and path analysis were performed.

RESULTS

Depressive symptoms and suicidality were higher among individuals with an eveningness chronotype: the greater the depressive symptoms, the higher the suicidality. The results of path analysis showed that the direct effect of suicidality in relation to chronotype was not statistically significant, but the indirect effect of depressive symptoms was statistically significant. This result indicates that depressive symptoms fully mediated the relationship between chronotype and suicidality.

CONCLUSION

Morningness may be a protective factor, not only against depression but also against suicide. To assess the risk of suicide, we must evaluate not only depressive symptoms, but also the effects of chronotype on depressive symptoms.

Mediating Effect of Internet Addiction on the Association between Resilience and Depression among Korean University Students: A Structural Equation Modeling Approach

OBJECTIVE

This study examined the mediating role of internet addiction in the association between psychological resilience and depressive symptoms.

METHODS

837 Korean university students completed a survey with items of demographic information, Connor-Davidson Resilience Scale (CD-RISC), Internet Addiction Test (IAT), and Patient Health Questionnaire (PHQ-9) in 2015. The complex associations among psychological resilience, internet addiction, and depressive symptoms were delineated using structural equation models.

RESULTS

In the most parsimonious model, the total effect and indirect effect of resilience on depressive symptoms via internet addiction, were statistically significant. The goodness of fit of the measurement model was satisfactory with fit indices, normed fit index (NFI) of 0.990, non-normed fit index (NNFI) of 0.997, comparative fit index (CFI) of 0.998, root mean square error (RMSEA) of 0.018 (90%CI=0.001-0.034); and Akaike Information Criterion (AIC) of -21.049.

CONCLUSION

The association between psychological resilience and depressive symptoms was mediated by internet addiction in Korean university students. Enhancement of resilience programs could help prevent internet addiction and reduce the related depression risks.