1
|
Mitchell S, Marvin C, Mitaj D, Rogers ML. Identifying latent classes of suicidal ambivalence: Associations with suicide risk correlates and outcomes. Suicide Life Threat Behav 2024. [PMID: 38994902 DOI: 10.1111/sltb.13111] [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: 01/08/2024] [Revised: 05/30/2024] [Accepted: 06/28/2024] [Indexed: 07/13/2024]
Abstract
INTRODUCTION Research has largely conceptualized suicidal ambivalence as the difference between one's wish to live and wish to die without fully considering other suicide ideation (SI) experiences included on measures like the Beck Scale for Suicide Ideation (BSS). We utilized BSS items to identify SI latent classes and examined relevant correlates and outcomes. METHODS We collected self-report data from two samples of US adults who: (1) self-identified as LGBTQ+ (N = 349; cross-sectional) and (2) self-reported past-week SI (BSS score ≥ 11; N = 133; 3 timepoints). RESULTS Latent class analyses supported three-class (Sample 1) and four-class solutions (Sample 2), which included ambivalent classes. In Sample 1, sexual orientation, gender, depression, anxiety, SI, and suicide-specific rumination were concurrently associated with class membership. In Sample 2, depression, SI, suicide-specific rumination, and physical/psychological distance from suicide methods were concurrently associated with class membership. In Sample 2, at both follow-ups, suicide plans/preparations and Acute Suicidal Affective Disturbance symptom frequencies were provided by class membership, and suicidal intent significantly differed by class membership. CONCLUSIONS SI classes differed by sample and evidenced nuances in SI and suicidal ambivalence. Risk factors and suicide-related outcomes also differed by class membership. Implications and limitations are discussed.
Collapse
Affiliation(s)
- Sean Mitchell
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Cole Marvin
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Dea Mitaj
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Megan L Rogers
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| |
Collapse
|
2
|
Hensel LM, Forkmann T, Teismann T. Suicide-specific rumination as a predictor of suicide planning and intent. Behav Res Ther 2024; 180:104597. [PMID: 38905955 DOI: 10.1016/j.brat.2024.104597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/23/2024] [Accepted: 06/12/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Suicide-specific rumination (SSR), that is repetitive negative thinking about suicide, has been proposed as a risk factor for suicidal behavior. Yet, few studies have investigated associations between SSR and suicide intent and planning in a longitudinal study design. The purpose of the present study was to investigate the association between SSR, suicide intent, suicide planning and suicide attempts in a sample of adult outpatients undergoing psychotherapy. METHOD Data from N = 637 patients (58.4% female, 41.6% male; Mage = 35.81, SDage = 13.50, range: 18-79 years) who started therapy at an outpatient clinic were collected. A subsample of n = 335 patients (n = 335; 56,4% female, 43,6% male; Mage = 35.4, SDage = 13.1, range: 18-73 years) also took part in a post-treatment assessment after twelve therapy sessions. RESULTS SSR differentiated lifetime suicide attempters from suicide ideators. Furthermore, SSR was associated with lifetime suicide attempt status above age, sex, suicide ideation, depression, anxiety, and stress. Finally, SSR served as a prospective predictor of both suicide planning and suicide intent. CONCLUSION The results emphasize the key role of SSR in understanding the suicidal process.
Collapse
Affiliation(s)
- Lena Marie Hensel
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany.
| | - Thomas Forkmann
- Department of Clinical Psychology and Psychotherapy, University of Duisburg-Essen, Germany.
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany.
| |
Collapse
|
3
|
Rogers ML, Law KC, Lawrence OC, Mandel AA. Perseveration on suicidal thoughts and images in daily life: An examination of the cognitive model of suicide through a dynamic systems lens. Behav Res Ther 2024; 177:104524. [PMID: 38583292 DOI: 10.1016/j.brat.2024.104524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/02/2024] [Accepted: 03/20/2024] [Indexed: 04/09/2024]
Abstract
According to the cognitive model of suicide, interactions between hopelessness and attentional biases toward suicidal information create a narrowed attentional focus on suicide as a viable solution, particularly in the presence of life stress, leading to increased suicide risk. This study used a dynamic systems approach to examine the short-term temporal patterns between stress, hopelessness, suicide-specific rumination, and suicidal intent. Adults (N = 237; M = 27.12 years; 62% cisgender women; 87% White/European American) with elevated suicidal ideation completed ecological momentary assessments six times a day for 14 days. A multilevel model approach informed by dynamic systems theory was used to simultaneously assess stable and dynamic temporal processes underlying perceived stress, hopelessness, suicide-specific rumination, and suicidal intent. Each variable demonstrated temporal stability. In support of the cognitive model of suicide, we observed (1) a reciprocal relationship between stress and hopelessness such that stress and hopelessness amplified each other (early-stage processes), and (2) reinforcing loops such that hopelessness, suicide-specific rumination, and suicidal intent amplified each other (later-stage processes). A dynamic systems modeling approach underscored the negative impact of a perpetuating cycle of suicide-specific rumination, deepening hopelessness, and escalating suicidal intent on increasing suicide risk, which may be targets for intervention.
Collapse
Affiliation(s)
- Megan L Rogers
- Department of Psychology, Texas State University, San Marcos, TX, USA.
| | - Keyne C Law
- Department of Psychology, Seattle Pacific University, Seattle, WA, USA
| | | | - Abby A Mandel
- Department of Psychology, Catholic University of America, Washington, DC, USA
| |
Collapse
|
4
|
Confirmatory factor analysis of Acute Suicidal Affective Disturbance in a sample of treatment-seeking eating disorder patients. J Affect Disord 2023; 326:155-162. [PMID: 36724842 DOI: 10.1016/j.jad.2023.01.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 12/29/2022] [Accepted: 01/25/2023] [Indexed: 01/31/2023]
Abstract
INTRODUCTION We examined the factor structure of Acute Suicidal Affective Disturbance (ASAD) in individuals with eating disorders. ASAD is a proposed diagnosis with four symptoms: rapidly increasing suicidal intent, social or self-alienation, hopelessness regarding the previous symptoms, and overarousal. METHODS Patients with eating disorders (N = 378) completed self-report symptom questionnaires at admission to a partial hospitalization program for eating disorders. Using proxy measures, we conducted a confirmatory factor analysis (CFA) of the one-factor model of ASAD. RESULTS Initial model fit was poor. We iteratively revised the model to include theoretically-justified correlated residuals (i.e., those between items intended to measure the same ASAD symptom). After these modifications, model fit remained mediocre. We next conducted a multiple-group CFA to compare ASAD between individuals with the restricting subtype of anorexia nervosa (the "ANR" model, n = 145) and individuals with binge/purge disorders (i.e., bulimia nervosa and the binge-purge subtype of anorexia nervosa; the "BP" model, n = 234). The final model had mediocre fit with partial invariance between subgroups; the ASAD factor mean was higher in the BP model. We additionally tested a bifactor model, with similar findings. LIMITATIONS Our use of proxy measures of ASAD items may have resulted in imprecise measurement of ASAD symptoms, pointing to the importance of future research using validated measures of ASAD. CONCLUSIONS We found moderate support for ASAD in an eating disorder sample, with invariance between eating disorder phenotypes. Our findings suggest that the ASAD diagnosis may not fully generalize to eating disorder samples.
Collapse
|
5
|
Forkmann T, Knorr A, Gerdes C, Vüst B, Hamacher D, Teismann T. Metacognitions about suicidal thoughts. J Psychiatr Res 2023; 161:199-205. [PMID: 36933446 DOI: 10.1016/j.jpsychires.2023.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/23/2023] [Accepted: 03/08/2023] [Indexed: 03/20/2023]
Abstract
BACKGROUND Rumination about suicide has recently been identified as a risk factor for suicidal behavior. According to the metacognitive model of emotional disorders, the activation and maintenance of rumination is dependent on specific metacognitive beliefs. On this background, the current study is concerned with the development of a questionnaire to assess suicide-specific positive and negative metacognitive beliefs. METHODS Factor structure, reliability and validity of the Scales for Suicide-related Metacognitions (SSM) were investigated in two samples comprised of participants suffering from lifetime suicide ideation. Participants of sample 1 (N = 214; 81.8% female; Mage = 24.9, SDage = 4.0) took part in a single assessment using an online survey. Participants of sample 2 (N = 56; 71.4% female; Mage = 33.2, SDage = 12.2) took part in two online assessments within a two week time-period. To establish convergent validity questionnaire-based assessments of suicidal ideation, general and suicide specific rumination and depression were used. Furthermore, it was analyzed whether suicide-related metacognitions predict suicide-specific rumination cross-sectionally and prospectively. RESULTS Factor analyses revealed a two-factor structure of the SSM. Results indicated good psychometric properties, and provided evidence for construct validity and stability of the subscales. Positive metacognitions predicted concurrent and prospective suicide-specific rumination beyond the effect of suicide ideation and depression and rumination predicted concurrent and prospective negative metacognitions. CONCLUSION Taken together the results provide initial evidence that the SSM is a valid and reliable measure of suicide-related metacognitions. Furthermore, findings are in line with a metacognitive conceptualization of suicidal crises and provide first indications of factors that might be relevant for the activation and maintenance of suicide-specific rumination.
Collapse
Affiliation(s)
- Thomas Forkmann
- Department of Clinical Psychology and Psychotherapy, University of Duisburg-Essen, Germany.
| | - Anna Knorr
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Germany
| | - Christiane Gerdes
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Germany
| | - Björn Vüst
- Department of Clinical Psychology and Psychotherapy, University of Duisburg-Essen, Germany
| | - Dennis Hamacher
- Department of Clinical Psychology and Psychotherapy, University of Duisburg-Essen, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Germany
| |
Collapse
|
6
|
Kinkel-Ram SS, Grunewald W, Bodell LP, Smith AR. Unsound sleep, wound-up mind: a longitudinal examination of acute suicidal affective disturbance features among an eating disorder sample. Psychol Med 2023; 53:1518-1526. [PMID: 34348803 DOI: 10.1017/s003329172100310x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Suicide is one of the most commonly reported causes of death in individuals with eating disorders. However, the mechanisms underlying the suicide and disordered eating link are largely unknown, and current assessments are still unable to accurately predict future suicidal thoughts and behaviors. The purpose of this study is to test the utility of two promising proximal risk factors, sleep quality and agitation, in predicting suicidal ideation in a sample of individuals with elevated suicidal thoughts and behaviors, namely those with eating disorders. METHODS Women (N = 97) receiving treatment at an eating disorder treatment center completed weekly questionnaires assessing suicidal ideation, agitation, and sleep. General linear mixed models examined whether agitation and/or sleep quality were concurrently or prospectively associated with suicidal ideation across 12 weeks of treatment. RESULTS There was a significant interaction between within-person agitation and sleep quality on suicidal ideation [B(s.e.) = -0.02(0.01), p < 0.05], such that on weeks when an individual experienced both higher than their average agitation and lower than their average sleep quality, they also experienced their highest levels of suicidal ideation. However, neither agitation nor sleep quality prospectively predicted suicidal ideation. CONCLUSIONS This study was the first to examine dynamic associations between interpersonal constructs and suicidal ideation in individuals with eating disorders. Results suggest that ongoing assessment for overarousal symptoms, such as agitation and poor sleep quality, in individuals with eating disorders may be warranted in order to manage suicidal ideation among this vulnerable population.
Collapse
Affiliation(s)
| | | | - Lindsay P Bodell
- Department of Psychology, Western University, London, Ontario, Canada
| | - April R Smith
- Department of Psychology, Auburn University, Auburn, Alabama, USA
| |
Collapse
|
7
|
Sahlan RN, Grunewald W, Smith AR. Validations of the Farsi versions of the depressive symptom inventory suicidality subscale (F-DSI-SS) and suicide rumination scale (F-SRS) among Iranian college students. Suicide Life Threat Behav 2023; 53:16-28. [PMID: 36029097 DOI: 10.1111/sltb.12917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Suicidal thoughts are relatively common among college students in Iran. However, measures frequently used to assess suicidality or specific aspects of suicidal ideation in the United States have yet to be validated in Iran. Thus, the present study validated Farsi versions of the Depressive Symptom Inventory Suicidality Subscale (F-DSI-SS) and Suicide Rumination Scale (F-SRS) among Iranian college students. METHODS College students (N = 1043; 88.1% women) completed the F-DSI-SS. Forty-six percent (n = 481) of participants reported the presence of suicidal thoughts and were eligible to fill out the F-SRS. Analyses focused on validating the factor structure, construct, and convergent validity of the F-DSI-SS and F-SRS among college students, as well as testing measurement invariance by gender of the F-DSI-SS. RESULTS Confirmatory factor analysis (CFA) indicated that the F-DSI-SS and F-SRS had good fit to the data and each displayed a one-factor structure. Furthermore, the F-DSI-SS showed strong measurement invariance across genders. Internal consistency of the F-DSI-SS and F-SRS was good. Lastly, the F-DSI-SS and F-SRS's items and their total scores were intercorrelated and demonstrated good convergent validity. CONCLUSION Findings suggest that the F-DSI-SS and F-SRS will enable researchers to examine suicidal thoughts and suicide-specific rumination in Iran.
Collapse
Affiliation(s)
- Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - William Grunewald
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - April R Smith
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| |
Collapse
|
8
|
Oh Y, Lee S, Rogers ML, You S. Assessment of acute and non-acute suicide crisis symptoms: Validation of the Korean version of the acute suicidal affective disturbance inventory. Front Psychol 2022; 13:1034130. [DOI: 10.3389/fpsyg.2022.1034130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/02/2022] [Indexed: 11/19/2022] Open
Abstract
Suicide risk assessment is predominantly based on assessing current/recent suicidal ideation and past suicidal behavior. However, suicidal ideation and lifetime suicide attempt are poor predictors of imminent suicide risk or crisis. The acute suicidal affective disturbance inventory-lifetime (ASADI-L) was developed to assess symptoms of acute suicidal affective disturbance, which includes a drastic increase in suicidal intent, perceptions of social and/or self-alienation, hopelessness, and overarousal. However, the ASADI-L has not yet been validated in a Korean population. Also, the ASADI-L has only been validated for people who experience a drastic increase in suicidal intention over the course of hours or days (i.e., the acute suicidal intention group) and not validated for those who experience suicidal intention for a longer period (i.e., the non-acute suicidal intention group). Thus, the aims of this study were to (1) validate the ASADI-L in a sample of Korean community adults; and (2) compare clinical characteristics of the acute and non-acute suicidal intention groups. Among 1,675 community adults, data from 682 participants who reported a lifetime drastic increase in suicidal intent were analyzed. Results indicated that the ASADI-L has relevant reliability, validity, and a unidimensional factor structure. The acute suicidal intention group had higher ASAD symptoms as well as clinical symptoms than the non-acute group, but the two groups did not differ in history of suicide attempt. Overall, these findings suggest that the ASADI-L is a valid measure of acute and non-acute suicidal affective disturbance among Korean adults. Further investigation of the differences in acute and non-acute suicide risk is warranted.
Collapse
|
9
|
Anvar S, Swerdlow BA, Jobes D, Timpano KR, Mandel AA, Kleiman E, Joiner T, Johnson SL. Emotion-related impulsivity and suicidal ideation: Towards a more specific model. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:1219-1235. [PMID: 35912940 PMCID: PMC9560962 DOI: 10.1111/bjc.12383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/22/2022] [Accepted: 07/04/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Suicidal ideation is a pervasive and painful experience that varies considerably in its phenomenology. Here, we consider how one key risk variable might inform our understanding of variation in suicidal ideation: emotion-related impulsivity, the trait-like tendency towards unconstrained speech, behaviour, and cognition in the face of intense emotions. We hypothesized that emotion-related impulsivity would be tied to specific features, including severity, perceived lack of controllability, more rapidly fluctuating course, higher scores on a measure of acute suicidal affective disturbance, and more emotional and cognitive disturbance as antecedents. METHODS We recruited two samples of adults (Ns = 421, 221) through Amazon Mechanical Turk (MTurk), with oversampling of those with suicidal ideation. Both samples completed psychometrically sound self-report measures online to assess emotion- and non-emotion-related dimensions of impulsivity and characteristics of suicidal ideation. RESULTS One form of emotion-related impulsivity related to the severity, uncontrollability, dynamic course, and affective and cognitive precursors of ideation. CONCLUSIONS Despite limitations of the cross-sectional design and self-report measures, the current findings highlight the importance of specificity in considering key dimensions of impulsivity and suicidal ideation.
Collapse
Affiliation(s)
- Sarah Anvar
- University of California, Berkeley, California, USA
| | | | - David Jobes
- American University, Washington, District of Columbia, USA
| | | | | | - Evan Kleiman
- Rutgers University, New Brunswick, New Jersey, USA
| | | | | |
Collapse
|
10
|
Johnson SL, Robison M, Anvar S, Swerdlow BA, Timpano KR. Emotion-related impulsivity and rumination: Unique and conjoint effects on suicidal ideation, suicide attempts, and nonsuicidal self-injury across two samples. Suicide Life Threat Behav 2022; 52:642-654. [PMID: 35257404 PMCID: PMC9378431 DOI: 10.1111/sltb.12849] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/19/2021] [Accepted: 01/16/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Rumination and emotion-related impulsivity predict suicidal ideation, suicide attempts, and nonsuicidal self-injury (NSSI). Because rumination and emotion-related impulsivity, though, are highly correlated, we consider their unique vs. conjoint influence on suicidal ideation and self-harm. METHOD Across two samples of adults (N's = 171 and 191), we examined how rumination and emotion-related impulsivity relate to suicidal ideation, suicide attempts, and NSSI. We assess the more general process of repetitive negative thinking and the more specific process of suicide-related rumination. Participants completed the Three-Factor Impulsivity Index and the self-report Columbia-Suicide Severity Rating Scale. Those in sample 1 completed the Perseverative Thinking Questionnaire and the Deliberate Self-Harm Inventory, and those in Sample 2 completed the Suicide Rumination Scale. RESULTS Emotion-related impulsivity and both forms of rumination showed robust bivariate correlations with suicidal ideation, suicide attempts, and NSSI. Neither rumination or impulsivity related to suicide attempts controlling for ideation or to NSSI. In multivariable analyses, emotion-related impulsivity but not general rumination was tied to suicidal ideation. In contrast, suicide-related rumination was more directly tied to suicidal ideation than was impulsivity. CONCLUSIONS Findings provide support for a more nuanced approach to the forms of impulsivity and rumination related to suicidal ideation.
Collapse
Affiliation(s)
- Sheri L. Johnson
- Department of Psychology, University of California Berkeley, Berkeley, California, USA
| | - Morgan Robison
- Department of Psychology, University of California Berkeley, Berkeley, California, USA
| | - Sarah Anvar
- Department of Psychology, University of California Berkeley, Berkeley, California, USA
| | - Benjamin A. Swerdlow
- Department of Psychology, University of California Berkeley, Berkeley, California, USA
| | - Kiara R. Timpano
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| |
Collapse
|
11
|
Höller I, Teismann T, Forkmann T. Perseverative Thinking about Suicide Questionnaire (PTSQ): Validation of a new measure to assess suicide-specific rumination. Compr Psychiatry 2022; 112:152287. [PMID: 34781079 DOI: 10.1016/j.comppsych.2021.152287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/26/2021] [Accepted: 11/07/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Suicide-specific rumination has been shown to be associated with lifetime suicide attempts as well as suicide intent and might be an important risk factor for the transition from suicidal ideation to suicidal behavior. Based on this background, the wording of the items of an often-used self-report measure assessing core characteristics of rumination was adapted to assess specifically suicide-specific rumination. METHODS The entire study sample comprised N = 1689 participants from the German healthcare sector. A total of 721 participants with a history of suicidal ideation (68% female; Mage = 30.63, SDage = 8.41, range: 18-81 years) who had completed five measures assessing suicide-specific rumination, suicidal ideation, depression, hopelessness, and resilience were included for the present examination. Factorial validity (Exploratory [EFA] to determine the appropriate number of factors and confirmatory factor analyses [CFA] after randomly splitting of the sample to validate the EFA solution), construct validity, and reliability were evaluated. RESULTS The EFA revealed a one-factor solution consisting of four items, which could be confirmed within a CFA (RMSR = 0.006; RMSEA = 0.039; CFI = 0.999; TLI = 0.998). Internal consistency was excellent with Cronbachs α = 0.93. Construct validity was given with moderate to high positive correlations with suicidal ideation (0.76), depression (0.55), and hopelessness (0.38) and negative correlation with resilience (-0.31). Participants with recent suicidal ideation and/or lifetime suicide attempt reported significantly more suicide-specific rumination than those with only lifetime suicidal ideation. CONCLUSION A new 4-item measure for suicide-specific rumination was developed and could be shown to be a reliable and valid instrument in a large German sample. Results emphasize the potential importance of suicide-specific rumination for the understanding of trajectories of suicidal ideation and suicide risk assessments.
Collapse
Affiliation(s)
- Inken Höller
- Department of Clinical Psychology, University of Duisburg-Essen, Germany.
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr University Bochum, Germany
| | - Thomas Forkmann
- Department of Clinical Psychology, University of Duisburg-Essen, Germany
| |
Collapse
|
12
|
Repetitive negative thinking about suicide: Associations with lifetime suicide attempts. CLINICAL PSYCHOLOGY IN EUROPE 2021; 3:e5579. [PMID: 36398103 PMCID: PMC9667229 DOI: 10.32872/cpe.5579] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 06/28/2021] [Indexed: 11/25/2022] Open
Abstract
Background Repetitive negative thinking has been identified as an important predictor of suicide ideation and suicidal behavior. Yet, only few studies have investigated the effect of suicide-specific rumination, i.e., repetitive thinking about death and/or suicide on suicide attempt history. On this background, the present study investigated, whether suicide-specific rumination differentiates between suicide attempters and suicide ideators, is predictive of suicide attempt history and mediates the association between suicide ideation and suicide attempts. Method A total of 257 participants with a history of suicide ideation (55.6% female; Age M = 30.56, Age SD = 11.23, range: 18–73 years) completed online measures on suicidality, general and suicide-specific rumination. Results Suicide-specific rumination differentiated suicide attempters from suicide ideators, predicted suicide attempt status (above age, gender, suicide ideation, general rumination) and fully mediated the association between suicide ideation and lifetime suicide attempts. Conclusion Overall, though limited by the use of a non-clinical sample and a cross-sectional study design, the present results suggest that suicide-specific rumination might be a factor of central relevance in understanding transitions to suicidal behavior. Suicide-specific rumination was investigated in participants with a history of suicide ideation. Suicide-specific rumination differentiated suicide attempters from suicide ideators. Suicide-specific rumination predicted suicide attempt status. Suicide-specific rumination mediated the association between suicide ideation and lifetime suicide attempts. Suicide-specific rumination might be a factor of central relevance in understanding transitions to suicidal behavior.
Collapse
|
13
|
Rogers ML, Gallyer AJ, Joiner TE. The relationship between suicide-specific rumination and suicidal intent above and beyond suicidal ideation and other suicide risk factors: A multilevel modeling approach. J Psychiatr Res 2021; 137:506-513. [PMID: 33812323 DOI: 10.1016/j.jpsychires.2021.03.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 08/17/2020] [Accepted: 03/19/2021] [Indexed: 11/19/2022]
Abstract
Suicide-specific rumination, characterized by perseveration on and difficulties disengaging from suicidal thoughts and ideas, has been linked to increased suicide risk; however, previous studies were limited by the use of a cross-sectional design and relatively lower risk samples. This study aimed to replicate and extend previous findings by examining the short-term longitudinal association between suicide-specific rumination and suicidal intent, controlling for numerous robust covariates, in a sample of community-based adults at high risk for suicide, who were recruited from suicide-related forums online. Ninety-one adults with significant suicidal ideation (Mage = 27.03, SD = 8.64; 53.8% female, 44.0% male, 1.1% non-binary, 1.1% transgender female) completed brief online self-report measures at six time-points, each three days apart. Multilevel modeling analyses indicated that suicide-specific rumination was associated with suicidal intent, above and beyond suicidal ideation, perceived burdensomeness, thwarted belongingness, agitation, insomnia, nightmares, and sociodemographic characteristics. Further, a lagged model demonstrated that suicide-specific rumination predicted subsequent time-point suicidal intent, controlling for current suicidal intent and all other covariates. Overall, these findings suggest that perseverating on one's suicidal thoughts may serve as a proximal factor that increases suicide risk. Future investigations should explore potential mechanisms of this association, as well as interventions that may reduce suicide-specific rumination.
Collapse
Affiliation(s)
- Megan L Rogers
- Department of Psychology, Florida State University, USA.
| | | | | |
Collapse
|
14
|
Claus C, Teismann T. Akut suizidal-affektive Störung: Ein systematisches Review. VERHALTENSTHERAPIE 2020. [DOI: 10.1159/000511922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
<b><i>Hintergrund:</i></b> Die Arbeitsgruppe um Thomas Joiner postuliert ein als <i>acute suicidal affective disturbance</i> (ASAD) bezeichnetes Syndrom, welches durch vier Symptomgruppen (Suizidabsicht, Entfremdung, Hoffnungslosigkeit, Übererregung) definiert sein soll. Ziel des vorliegenden Artikels ist, die Literatur zum ASAD-Syndrom zusammenfassend darzustellen und eine Einschätzung vorzunehmen, inwieweit tatsächlich von einem einheitlichen Syndrom ausgegangen werden kann. <b><i>Methoden:</i></b> Im Rahmen einer Literaturrecherche konnten neun Artikel identifiziert werden, die im Zeitraum von 2016 bis 2020 zum Thema publiziert wurden. <b><i>Ergebnisse und Schlussfolgerungen:</i></b> Die Befundlage unterstützt den einheitlichen Störungscharakter und die Abgrenzbarkeit der akut suizidal-affektiven Störung von anderen Störungsbildern. Die Aussagekraft der Befundlage ist dadurch eingeschränkt, dass bislang ausschließlich Querschnittsuntersuchungen durchgeführt wurden und keinerlei Befunde dazu vorliegen, ob ASAD tatsächlich suizidalem Verhalten vorausgeht.
Collapse
|
15
|
Lennon JC. Etiopathogenesis of Suicide: A Conceptual Analysis of Risk and Prevention Within a Comprehensive, Deterministic Model. Front Psychol 2019; 10:2087. [PMID: 31572269 PMCID: PMC6751268 DOI: 10.3389/fpsyg.2019.02087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 08/27/2019] [Indexed: 11/23/2022] Open
Abstract
Suicide is a rising global health concern receiving disproportionate attention in comparison to other health conditions. In spite of substantial technological and scientific advancements, suicide research has continued to move slowly in terms of clinical translation due to the complexity of neural mechanisms, and subjective experiences that seem to underpin this complex human behavior. This paper analyzes the concepts of risk and prevention in the context of suicide in an attempt to bridge the large methodological and theoretical gaps between the biological, psychological, and sociological dimensions. This paper aims to accomplish the following objectives: (1) operationalize the concepts of suicide risk and prevention as they relate to current knowledge and capabilities; (2) synthesize and integrate suicide research across biological, psychological, and sociological dimensions; (3) discuss limitations of each dimension in isolation; (4) suggest a model of etiopathogenesis that incorporates extant literature and bridges unnecessary gaps between dimensions; and (5) suggest future directions for multidimensional research through the inclusion of principles from the physical sciences. Ultimately, this paper provides a basis for a comprehensive model of suicide within a deterministic, chaotic system.
Collapse
Affiliation(s)
- Jack C Lennon
- Department of Psychology, Adler University, Chicago, IL, United States.,Section of Parkinson's Disease and Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States.,Department of Behavioral Sciences, Rush Neurobehavioral Center, Rush University Medical Center, Skokie, IL, United States
| |
Collapse
|
16
|
Rogers ML, Chu C, Joiner T. The necessity, validity, and clinical utility of a new diagnostic entity: Acute suicidal affective disturbance. J Clin Psychol 2019; 75:999-1010. [PMID: 30632615 DOI: 10.1002/jclp.22743] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/31/2018] [Accepted: 12/04/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Here we argue for the necessity, validity, and clinical utility of a new diagnostic entity, acute suicidal affective disturbance (ASAD). METHOD We expand on the conceptual, clinical, and practical rationale for ASAD, propose its defining features, describe research results to date, and suggest avenues for future research. RESULTS There is accruing evidence for the existence of a previously unclassified, rapid-onset mood disturbance that geometrically escalates and regularly results in life-threatening behavior. CONCLUSIONS ASAD research may not only improve the field's understanding of suicidal behavior but also enhance clinical effectiveness and save lives.
Collapse
Affiliation(s)
- Megan L Rogers
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Carol Chu
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Thomas Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida
| |
Collapse
|
17
|
The Relationship Between Negative Cognitive Styles and Lifetime Suicide Attempts is Indirect Through Lifetime Acute Suicidal Affective Disturbance Symptoms. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9968-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|