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Edwards AC, Abrahamsson L, Crump C, Sundquist J, Sundquist K, Kendler KS. Alcohol use disorder and risk of specific methods of suicide death in a national cohort. Acta Psychiatr Scand 2024; 149:479-490. [PMID: 38556255 PMCID: PMC11065572 DOI: 10.1111/acps.13683] [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: 01/25/2024] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Alcohol use disorder (AUD) is among the strongest correlates of suicide death, but it is unclear whether AUD status is differentially associated with risk of suicide by particular methods. METHODS The authors used competing risks models to evaluate the association between AUD status and risk of suicide by poisoning, suffocation, drowning, firearm, instruments, jumping, or other means in a large Swedish cohort born 1932-1995 (total N = 6,581,827; 48.8% female). Data were derived from Swedish national registers, including the Cause of Death Register and a range of medical registers. RESULTS After adjusting for sociodemographic factors and familial liability to suicidal behavior, AUD was positively associated with risk of suicide for each method evaluated (cumulative incidence differences: 0.006-1.040 for females, 0.046-0.680 for males), except the association with firearm suicide in females. AUD was most strongly associated with risk of suicide by poisoning. Sex differences in the effects of AUD and family liability were observed for some, but not all, methods. Furthermore, high familial liability for suicidal behavior exacerbated AUD's impact on risk for suicide by poisoning (both sexes) and suffocation and jumping (males only), while the inverse interaction was observed for firearm suicide (males only). CONCLUSIONS AUD increases risk of suicide by all methods examined and is particularly potent with respect to risk of suicide by poisoning. Differences in risk related to sex and familial liability to suicidal behavior underscore AUD's nuanced role in suicide risk. Future research should investigate targeted means restriction effectiveness among persons with AUD.
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Affiliation(s)
- Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, US
| | - Linda Abrahamsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Casey Crump
- Departments of Family and Community Medicine and of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center, Houston, TX, US
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | | | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, US
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Lieberman A, Gai AR, Rogers ML, Jobes DA, David Rudd M, Chalker SA, Brenner JT, Joiner TE. Targeting Perceived Burdensomeness to Reduce Suicide Risk. Behav Ther 2023; 54:696-707. [PMID: 37330258 DOI: 10.1016/j.beth.2022.12.002] [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: 02/10/2022] [Revised: 08/15/2022] [Accepted: 12/11/2022] [Indexed: 12/25/2022]
Abstract
Perceived burdensomeness (PB), defined by an intractable perception of burdening others, often reflects a false mental calculation that one's death is worth more than one's life and has been supported as a significant risk factor for suicide. Because PB often reflects a distorted cognition, it may serve as a corrective and promising target for the intervention of suicide. More work on PB is needed in clinically severe and in military populations. Sixty-nine (Study 1) and 181 (Study 2) military participants at high baseline suicide risk engaged in interventions targeting constructs relating to PB. Baseline and follow-up measures (at 1, 6, 12, 18, and 24 months) of suicidal ideation were administered, and various statistical approaches-including repeated-measures ANOVA, mediation analyses, and correlating standardized residuals-explored whether suicidal ideation decreased specifically by way of PB. In addition to utilizing a larger sample size, Study 2 included an active PB-intervention arm (N = 181) and a control arm (N = 121), who received robust care as usual. In both studies, participants improved considerably regarding baseline to follow-up suicidal ideation. The results of Study 2 mirrored those of Study 1, corroborating a potential mediational role for PB in treatment-related improvements in suicidal ideation in military participants. Effect sizes ranged from .07-.25. Interventions tailored at decreasing levels of perceived burdensomeness may be uniquely and significantly effective in reducing suicidal thoughts.
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Wang P, Ouyang M, Yin Y, Li B. Mother phubbing and adolescents' problematic SNS use: the mediating role of perceived burdensomeness and the moderating role of need to belong. Front Psychol 2023; 14:1098707. [PMID: 37359861 PMCID: PMC10289230 DOI: 10.3389/fpsyg.2023.1098707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/24/2023] [Indexed: 06/28/2023] Open
Abstract
There is a rapidly growing academic interest on parental phubbing, however, little research has explored the association between mother phubbing and adolescent problematic social networking sites use (PSNSU), the underlying mediating and moderating effects in this relationship are also in need to be uncovered. The present study examined whether mother phubbing would be positively related to adolescent PSNSU, whether perceived burdensomeness would mediate this relationship, and whether need to belong would moderate the associations between mother phubbing and adolescent PSNSU. The hypothesized research model was examined among 3,915 Chinese adolescents (47% of them were boys, mean age = 16.42 ± 0.77 years). The results showed that mother phubbing was positively associated with adolescent PSNSU and perceived burdensomeness mediated this association. Furthermore, need to belong moderated the relationship between perceived burdensomeness and PSNSU, the relationship between mother phubbing and perceived burdensomeness, and the relationship between mother phubbing and PSNSU.
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Affiliation(s)
| | - Mingkun Ouyang
- School of Education Science, Guangxi University for Nationalities, Nanning, Guangxi, China
| | - Yulong Yin
- School of Psychology, Northwest Normal University, Lanzhou, Gansu, China
| | - Biao Li
- School of Journalism and Communication, Faculty of Social Sciences, Renmin University of China, Beijing, China
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Suicidal Ideation in Major Depressed Individuals: Role of Type D Personality. J Clin Med 2022; 11:jcm11226611. [PMID: 36431087 PMCID: PMC9696109 DOI: 10.3390/jcm11226611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/02/2022] [Accepted: 11/06/2022] [Indexed: 11/09/2022] Open
Abstract
Major depressed individuals are a subpopulation at high-risk of suicide. However, despite the evidence for a particular relationship between suicidal ideation (SI) and type D personality, few studies have investigated the role played by this personality structure in the occurrence of SI in major depressed individuals. Data from 318 major depressed individuals recruited from the clinical database of the Sleep Laboratory were analysed. Suicidal ideation was considered present if the score in item 9 of the Beck Depression Inventory (BDI-II) was ≥1 and/or if they were highlighted during the systematic psychiatric assessment conducted on admission to the Sleep Laboratory. Logistic regression analyses were used to determine the risk of SI associated with type D personality in major depressed individuals. The prevalence of suicidal ideation was 38.4% in our sample of major depressed individuals. After adjusting for major confounding factors, multivariate logistic regression analyses demonstrated that type D personality was a risk factor for SI in major depressed individuals. Thus, given the potential role played by type D personality in the occurrence of SI in major depressed individuals, it seems necessary to more systematically research and adequately manage this personality structure to allow for a better prevention of suicidal behaviours in this subpopulation.
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Rudman JS, Farcas A, Salazar GA, Hoff JJ, Crowe RP, Whitten-Chung K, Torres G, Pereira C, Hill E, Jafri S, Page DI, von Isenburg M, Haamid A, Joiner AP. Diversity, Equity, and Inclusion in the United States Emergency Medical Services Workforce: A Scoping Review. PREHOSP EMERG CARE 2022; 27:385-397. [PMID: 36190493 DOI: 10.1080/10903127.2022.2130485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Emergency medical services (EMS) workforce demographics in the United States do not reflect the diversity of the population served. Despite some efforts by professional organizations to create a more representative workforce, little has changed in the last decade. This scoping review aims to summarize existing literature on the demographic composition, recruitment, retention, and workplace experience of underrepresented groups within EMS. METHODS Peer-reviewed studies were obtained from a search of PubMed, CINAHL, Web of Science, ProQuest Thesis and Dissertations, and non-peer-reviewed ("gray") literature from 1960 to present. Abstracts and included full-text articles were screened by two independent reviewers trained on inclusion/exclusion criteria. Studies were included if they pertained to the demographics, training, hiring, retention, promotion, compensation, or workplace experience of underrepresented groups in United States EMS by race, ethnicity, sexual orientation, or gender. Studies of non-EMS fire department activities were excluded. Disputes were resolved by two authors. A single reviewer screened the gray literature. Data extraction was performed using a standardized electronic form. Results were summarized qualitatively. RESULTS We identified 87 relevant full-text articles from the peer-reviewed literature and 250 items of gray literature. Primary themes emerging from peer-reviewed literature included workplace experience (n = 48), demographics (n = 12), workforce entry and exit (n = 8), education and testing (n = 7), compensation and benefits (n = 5), and leadership, mentorship, and promotion (n = 4). Most articles focused on sex/gender comparisons (65/87, 75%), followed by race/ethnicity comparisons (42/87, 48%). Few articles examined sexual orientation (3/87, 3%). One study focused on telecommunicators and three included EMS physicians. Most studies (n = 60, 69%) were published in the last decade. In the gray literature, media articles (216/250, 86%) demonstrated significant industry discourse surrounding these primary themes. CONCLUSIONS Existing EMS workforce research demonstrates continued underrepresentation of women and non-White personnel. Additionally, these studies raise concerns for pervasive negative workplace experiences including sexual harassment and factors that negatively affect recruitment and retention, including bias in candidate testing, a gender pay gap, and unequal promotion opportunities. Additional research is needed to elucidate recruitment and retention program efficacy, the demographic composition of EMS leadership, and the prevalence of racial harassment and discrimination in this workforce.
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Affiliation(s)
- Jordan S Rudman
- Harvard Affiliated Emergency Medicine Residency, Beth Israel Deaconess Medical Center, Boston, MA
| | - Andra Farcas
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Gilberto A Salazar
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - J J Hoff
- Department of Emergency Medicine, Duke University School of Medicine, Durham, NC
| | | | | | | | | | - Eric Hill
- Department of Emergency Medicine, Medical Center of Aurora, Aurora, CO
| | | | - David I Page
- Prehospital Care Research Forum, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA
| | | | - Ameera Haamid
- Section of Emergency Medicine, University of Chicago Medicine, Chicago, IL
| | - Anjni P Joiner
- Department of Emergency Medicine, Duke University School of Medicine, Durham, NC
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6
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Baer MM, Tull MT, Gratz KL. Substance Use Frequency Relates to Suicidal Ideation Through Perceived Burdensomeness and to Suicide Attempts Through Capability for Suicide. Arch Suicide Res 2022; 26:1520-1540. [PMID: 34529923 DOI: 10.1080/13811118.2021.1931595] [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] [Indexed: 10/20/2022]
Abstract
BACKGROUND Although substance use has been linked to both suicidal ideation and suicide attempts, the factors underlying these relations remain unclear. The Interpersonal-Psychological Theory of Suicide (ITS) provides a framework for understanding how substance use may increase suicide risk. The purpose of the current study was to examine if frequency of substance use is indirectly related to suicidal ideation and suicide attempts through core ITS variables (i.e., burdensomeness, thwarted belongingness, and suicide capability). METHODS An online sample of Mechanical Turk workers (N = 365) completed measures assessing substance use frequency, burdensomeness, thwarted belongingness, suicide capability, suicidal ideation, and suicide attempts. RESULTS After controlling for relevant clinical and demographic covariates, substance use frequency was indirectly related to suicidal ideation through burdensomeness but not thwarted belongingness. Substance use frequency was indirectly related to suicide attempts through suicide capability only. LIMITATIONS The cross-sectional design precludes conclusions about the precise nature and direction of the relations examined. The use of a community sample limits generalizability to more severe substance using samples. CONCLUSIONS Results highlight the relevance of distinct ITS factors in the relation between substance use frequency and both suicidal ideation and suicide attempts. Results may inform specific targets for novel interventions aimed at reducing suicide risk among substance-using individuals.HighlightsSubstance use frequency was indirectly related to SI through burdensomeness.Substance use frequency was not indirectly related to SI through thwarted belongingness.Substance use frequency was indirectly related to SA only through suicide capability.
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Lee M, Lee U, Park JH, Shin YC, Sim M, Oh KS, Shin DW, Jeon SW, Seol J, Cho SJ. The Association Between Alcohol Use and Suicidal Ideation Among Employees. Psychiatry Investig 2021; 18:977-985. [PMID: 34525778 PMCID: PMC8542748 DOI: 10.30773/pi.2021.0122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/31/2021] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE The risk of suicide is assessed by identifying the relationship between alcohol-use patterns and suicidal ideation in Korean employees. METHODS The study involved 13,858 employees who underwent workplace mental health screening at the Workplace Mental Health Institute of Kangbuk Samsung Hospital over a 6-year period between 2014 and 2019. Analysis was performed separately for Alcohol Use Disorders Identification Test-Korea (AUDIT-K) items related to the frequency/volume of alcohol consumption (items 1 to 3, AUDIT-C) and those regarding alcohol dependence/related problems (items 4 to 10, AUDIT-D/P). Subjects were then classified into three groups on the basis of the presence or absence of clinical depression and suicidal ideation. The groups' sociodemographic factors and clinical features of depression, anxiety, and alcohol-use patterns were analyzed with a chi-square test as well as one-way analysis of variance, followed by a post hoc test using the Bonferroni correction. RESULTS AUDIT-K and AUDIT-D/P scores were significantly associated with the presence or absence of clinical depression as well as the presence or absence of suicidal ideation (p<0.05). However, no significant differences were found among the three groups with regard to the AUDIT-C score (p=0.054). CONCLUSION Identifying or treating alcohol dependence/related problems can help lower the occurrence of mental health problems, and suicidal ideation in particular, in employees and reduce social costs.
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Affiliation(s)
- Miji Lee
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ung Lee
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae-Hyun Park
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Young-Chul Shin
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Mikyung Sim
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kang-Seob Oh
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong-Won Shin
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang-Won Jeon
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jinmi Seol
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Joon Cho
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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8
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Mueller AK, Singh A, Webber MP, Hall CB, Prezant DJ, Zeig‐Owens R. PTSD symptoms, depressive symptoms, and subjective cognitive concerns in WTC-exposed and non-WTC-exposed firefighters. Am J Ind Med 2021; 64:803-814. [PMID: 34415073 DOI: 10.1002/ajim.23285] [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: 05/14/2021] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Firefighting has been associated with posttraumatic stress disorder (PTSD) and other mental health conditions. We previously found that among Fire Department of the City of New York (FDNY) responders to the World Trade Center (WTC) disaster, higher-intensity WTC-exposure predicted PTSD symptoms, depressive symptoms, and subjective cognitive concerns. The present study aims to compare these symptoms in the FDNY WTC-exposed cohort versus a comparison cohort of non-FDNY, non-WTC-exposed firefighters. METHODS The study population included WTC-exposed male firefighters from FDNY (N = 8466) and non-WTC-exposed male firefighters from Chicago (N = 1195), Philadelphia (N = 770), and San Francisco (N = 650) fire departments who were employed on 9/11/2001 and completed a health questionnaire between 3/1/2018 and 12/31/2020. Current PTSD symptoms, depressive symptoms, and subjective cognitive concerns were assessed via validated screening instruments. Multivariable linear regression analyses stratified by fire department estimated the impact of covariates on each outcome. RESULTS Adjusted mean PTSD symptom scores ranged from 23.5 ± 0.6 in Chicago firefighters to 25.8 ± 0.2 in FDNY, and adjusted mean depressive symptom scores ranged from 7.3 ± 0.5 in Chicago to 9.4 ± 0.6 in Philadelphia. WTC-exposure was associated with fewer subjective cognitive concerns (β = -0.69 ± 0.05, p < .001) after controlling for covariates. Across cohorts, older age was associated with more cognitive concerns, but fewer PTSD and depressive symptoms. CONCLUSIONS WTC-exposed firefighters had fewer cognitive concerns compared with non-WTC-exposed firefighters. We were unable to estimate associations between WTC exposure and PTSD symptoms or depressive symptoms due to variability between non-WTC-exposed cohorts. Longitudinal follow-up is needed to assess PTSD, depressive, and cognitive symptom trajectories in firefighter populations as they age.
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Affiliation(s)
- Alexandra K. Mueller
- Fire Department of the City of New York Bureau of Health Services Brooklyn New York USA
- Department of Medicine, Pulmonology Division Montefiore Medical Center Bronx New York USA
| | - Ankura Singh
- Fire Department of the City of New York Bureau of Health Services Brooklyn New York USA
- Department of Medicine, Pulmonology Division Montefiore Medical Center Bronx New York USA
| | - Mayris P. Webber
- Fire Department of the City of New York Bureau of Health Services Brooklyn New York USA
- Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx New York USA
| | - Charles B. Hall
- Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx New York USA
| | - David J. Prezant
- Fire Department of the City of New York Bureau of Health Services Brooklyn New York USA
- Department of Medicine, Pulmonology Division Montefiore Medical Center Bronx New York USA
| | - Rachel Zeig‐Owens
- Fire Department of the City of New York Bureau of Health Services Brooklyn New York USA
- Department of Medicine, Pulmonology Division Montefiore Medical Center Bronx New York USA
- Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx New York USA
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Irizar P, Puddephatt JA, Gage SH, Fallon V, Goodwin L. The prevalence of hazardous and harmful alcohol use across trauma-exposed occupations: A meta-analysis and meta-regression. Drug Alcohol Depend 2021; 226:108858. [PMID: 34214883 DOI: 10.1016/j.drugalcdep.2021.108858] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Trauma exposure is associated with hazardous and/or harmful alcohol use. Occupational groups frequently exposed to trauma may be at risk of alcohol harm. This meta-analysis determined the prevalence of hazardous and harmful alcohol use across trauma-exposed occupations and meta-regressions explored the impact of pre-defined covariates on the variance in prevalence estimates. METHOD Literature was searched from 2000 to March 2020, using Scopus, Web of Science and PsycINFO. Studies were included in the meta-analysis if they used a standardized measure of alcohol use (e.g., Alcohol Use Disorder Identification Test (AUDIT)). Studies were excluded if they measured alcohol use following an isolated sentinel event (e.g., 9/11). The following occupations were included: first responders, health care workers, Armed Forces, war journalists and train drivers. RESULTS 1882 studies were identified; 55 studies were eligible. The pooled prevalence of hazardous use was 22% (95% Confidence Intervals [CI]: 17%-27%) and 11% (95% CI: 8%-14%) for harmful use. Hazardous alcohol use was significantly lower in health care workers (13%; 95% CI: 10%-16%) than first responders (26%; 95% CI: 20%-32%) and Armed Forces (34%; 95% CI: 18%-52%). There was marked heterogeneity across studies and higher prevalence rates in low-quality studies. The meta-regression identified higher proportion of males and younger mean age as predictors of variance. CONCLUSIONS Male-dominated occupations, such as police officers and military personnel, showed higher levels of hazardous and harmful alcohol use, indicating that interventions tailored specifically for these occupational groups may be needed.
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Affiliation(s)
- Patricia Irizar
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom.
| | - Jo-Anne Puddephatt
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom
| | - Suzanne H Gage
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom
| | - Laura Goodwin
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom
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Tucker RP, Cramer RJ, Langhinrichsen-Rohling J, Rodriguez-Cue R, Rasmussen S, Oakey-Frost N, Franks CM, Cunningham CCA. Insomnia and suicide risk: a multi-study replication and extension among military and high-risk college student samples. Sleep Med 2021; 85:94-104. [PMID: 34298228 DOI: 10.1016/j.sleep.2021.06.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/31/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE/BACKGROUND A clear link between insomnia concerns and suicidal ideation has been shown in a variety of populations. These investigations failed to use a theoretical lens in understanding this relationship. Research within the veteran population has demonstrated that feelings of thwarted belongingness (TB), but not perceived burdensomeness (PB), mediate the insomnia and suicidal ideation relationship. Using two high risk samples, the present investigation replicated and extended this line of inquiry to include interpersonal hopelessness about TB, a key component of the Interpersonal Psychological Theory of Suicide. METHODS/RESULTS/CONCLUSIONS Using medical record review and survey data, study 1 replicated the finding that TB is a stronger explanatory factor of the insomnia to suicidal ideation/suicide risk relationship in a sample of N = 200 treatment-seeking active-duty personnel. Study 2 found that insomnia symptoms had an indirect effect on suicidal ideation through TB and PB but not interpersonal hopelessness in a sample of N = 151 college students with a history of suicidal thoughts and/or behaviors. TB was the only mediator of the insomnia-suicide attempt likelihood link and insomnia to clinically significant suicide risk screening status. Limitations include cross-sectional design of both studies and the lack of formal diagnoses of insomnia. Implications and future research directions are discussed.
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Affiliation(s)
| | | | | | | | | | | | - Capt Michael Franks
- US Public Health Service, Naval Medical Center Psychology Training Programs, Navy Medicine Readiness and Training Command Portsmouth, Portsmouth, VA, 23708, USA
| | - Capt Craig A Cunningham
- Nursing Research and Consultation Services, Navy Medicine Readiness and Training Command Portsmouth, Portsmouth, VA, 23708, USA
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Brief Mental Health Disorder Screening Questionnaires and Use with Public Safety Personnel: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073743. [PMID: 33916659 PMCID: PMC8038412 DOI: 10.3390/ijerph18073743] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 11/16/2022]
Abstract
Brief mental health disorder screening questionnaires (SQs) are used by psychiatrists, physicians, researchers, psychologists, and other mental health professionals and may provide an efficient method to guide clinicians to query symptom areas requiring further assessment. For example, annual screening has been used to help identify military personnel who may need help. Nearly half (44.5%) of Canadian public safety personnel (PSP) screen positive for one or more mental health disorder(s); as such, regular mental health screenings for PSP may be a valuable way to support mental health. The following review was conducted to (1) identify existing brief mental health disorder SQs; (2) review empirical evidence of the validity of identified SQs; (3) identify SQs validated within PSP populations; and (4) recommend appropriately validated brief screening questionnaires for five common mental health disorders (i.e., generalized anxiety disorder (GAD), major depressive depression (MDD), panic disorder, posttraumatic stress disorder, alcohol use disorder). After reviewing the psychometric properties of the identified brief screening questionnaires, we recommend the following four brief screening tools for use with PSP: the Patient Health Questionnaire-4 (screening for MDD and GAD), the Brief Panic Disorder Symptom Screen—Self-Report, the Short-Form Posttraumatic Checklist-5, and the Alcohol Use Disorders Identification Test-Consumption.
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12
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Lebeaut A, Zegel M, Leonard SJ, Bartlett BA, Vujanovic AA. Examining Transdiagnostic Factors among Firefighters in Relation to Trauma Exposure, Probable PTSD, and Probable Alcohol Use Disorder. J Dual Diagn 2021; 17:52-63. [PMID: 33308060 DOI: 10.1080/15504263.2020.1854411] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Firefighters represent a distinct group of first responders that are at heightened risk of developing posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Assessing the role of transdiagnostic factors that underlie PTSD-AUD associations can inform specialized interventions among this population. This study included urban firefighters (N = 657) with probable PTSD-AUD (n = 27), probable PTSD-alone (n = 35), probable AUD-alone (n = 125), and trauma-exposure-only (n = 470). Methods: All firefighters completed a self-report, online questionnaire battery. Between group differences in anxiety sensitivity (AS), distress tolerance (DT), mindfulness, and emotional regulation difficulties (ERD) were assessed. It was hypothesized that firefighters with probable PTSD-AUD would endorse elevated AS and ERD, and reduced DT and mindfulness in comparison to all other diagnostic groups. Relationship status was included as a covariate in all comparisons. Results: Firefighters with probable PTSD-AUD endorsed elevated AS and ERD, and reduced DT and mindfulness in comparison to firefighters with trauma-exposure-only and probable AUD-alone. Firefighters with probable PTSD-AUD and probable PTSD-alone did not significantly differ. Conclusions: Given these findings, this line of inquiry has great potential to inform specialized, evidence-based mental health programming among firefighter populations, who represent a unique population susceptible to trauma-exposure, PTSD symptomology, and problematic alcohol use.
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Affiliation(s)
- Antoine Lebeaut
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Maya Zegel
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Samuel J Leonard
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Brooke A Bartlett
- Department of Psychology, University of Houston, Houston, TX, USA.,VA San Diego Healthcare System, San Diego, CA, USA
| | - Anka A Vujanovic
- Department of Psychology, University of Houston, Houston, TX, USA
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13
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Zhornitsky S, Le TM, Dhingra I, Adkinson BD, Potvin S, Li CR. Interpersonal Risk Factors for Suicide in Cocaine Dependence: Association with Self-Esteem, Personality Traits, and Childhood Abuse. Suicide Life Threat Behav 2020; 50:867-883. [PMID: 32030810 PMCID: PMC7518050 DOI: 10.1111/sltb.12621] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 01/10/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Studies have linked cocaine dependence to suicidality. According to the Interpersonal Theory of Suicide, suicidal behavior becomes likely with the simultaneous presence of perceived burdensomeness (PB), lack of (or thwarted) belongingness (TB), and acquired fearlessness about death (FAD). Here, we examined personality and other variables, including depression, self-esteem, childhood abuse, and substance use, as predictors of these risk factors in cocaine-dependent individuals (CDs). METHODS Seventy CDs and 70 healthy controls (HCs) participated. We examined group differences in a group-by-sex analysis of variance and identified predictors of PB, TB, and FAD in stepwise regressions. RESULTS CDs exhibited elevated PB and TB but not FAD, compared to HCs. CDs also exhibited elevated harm avoidance, novelty seeking, depression, and lower self-esteem and reward dependence. Females reported elevated sexual abuse, harm avoidance, reward dependence, depression, but lower FAD, relative to males, among CDs and HCs. Among CDs, PB was predicted by lower self-esteem and greater emotional abuse; TB was predicted by lower self-esteem and reward dependence, as well as greater emotional and sexual abuse; and FAD was predicted by lower harm avoidance and greater physical abuse. CONCLUSIONS Interventions targeting suicidality in cocaine dependence should take into consideration self-esteem, personality traits, and childhood abuse.
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Affiliation(s)
- Simon Zhornitsky
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut
| | - Thang M. Le
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut
| | - Isha Dhingra
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut
| | - Brendan D. Adkinson
- Interdepartmental Neuroscience Program Yale University School of Medicine New Haven Connecticut
| | - Stephane Potvin
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal Montreal QC Canada
- Department of Psychiatry Faculty of Medicine Université de Montréal Montréal QC Canada
| | - Chiang‐shan R. Li
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut
- Interdepartmental Neuroscience Program Yale University School of Medicine New Haven Connecticut
- Department of Neuroscience Yale University School of Medicine New Haven Connecticut
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