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Ebulum GC, Eze JE, Ezeihuoma OP, Njoku C, Chukwuorji JC. Roles of Loneliness, Stress, and Religiosity in Suicide Ideation Among Nigerian Older Adults. Int J Aging Hum Dev 2024:914150241268006. [PMID: 39105289 DOI: 10.1177/00914150241268006] [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: 08/07/2024]
Abstract
Suicidal behavior in older adults is a fundamental public health problem globally and the highest suicide rates occur in low- and middle-income countries (LMICs). However, there is limited research on suicidality among older adults, especially in sub-Saharan Africa. We sought to find out whether loneliness, stress and religiosity would be associated with suicide ideation in a sample of sub-Saharan African older adults (N = 500; aged 51-70 years, Mage = 58.97, SD = 6.16; 45.6% women). They completed the Beck Suicidal Ideation Scale, the UCLA Loneliness Scale-version 3, Perceived Stress Scale, and Religiosity Scale. Regression results showed that whereas suicidal ideation could be increased by loneliness and stress, religious older adults were less likely to report suicidal ideation. Interventions aimed at managing and protecting the mental health of older adults during their transition to late adulthood should guard them against loneliness and buffer their resilience and coping strategies with the connectedness that religiosity offers.
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Affiliation(s)
- Genevieve Chimaoge Ebulum
- Department of Community Medicine, David Umahi Federal University of Health Sciences, Uburu, Ebonyi, Nigeria
| | - John E Eze
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
| | | | - Crystal Njoku
- Department of Medicine, American University of Antigua College of Medicine, Osbourn, Antigua & Barbuda
| | - JohnBosco Chika Chukwuorji
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, Flint, MI, USA
- Promotion of Health and Innovation Lab, International Network for Well-being, Enugu, Nigeria
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2
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Saunders N, Strauss R, Swayze S, Kopp A, Kurdyak P, Furqan Z, Malick A, Husain MI, Sinyor M, Zaheer J. Suicide and Self-Harm Among Immigrant Youth to Ontario, Canada From Muslim Majority Countries: A Population-Based Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:755-765. [PMID: 37038714 PMCID: PMC10517651 DOI: 10.1177/07067437231166840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
OBJECTIVE To examine the association between Muslim religious affiliation and suicide and self-harm presentations among first- and second-generation immigrant youth. METHODS We performed a population-based cohort study involving individuals aged 12 to 24 years, living in Ontario, who immigrated to Canada between 1 January 2003 and 31 May 2017 (first generation) and those born to immigrant mothers (second generation). Health administrative and demographic data were used to analyze suicide and self-harm presentations. Sex-stratified logistic regression models generated odds ratios (OR) for suicide and negative binomial regression models generated rate ratios (aRR) for self-harm presentations, adjusting for refugee status and time since migration. RESULTS Of 1,070,248 immigrant youth (50.1% female), there were 129,919 (23.8%) females and 129,446 (24.2%) males from Muslim-majority countries. Males from Muslim-majority countries had lower suicide rates (3.8/100,000 person years [PY]) compared to males from Muslim-minority countries (5.9/100,000 PY) (OR: 0.62, 95% CI, 0.42-0.92). Rates of suicide between female Muslim-majority and Muslim-minority groups were not different (Muslim-majority 1.8/100,000 PY; Muslim-minority 2.2/100,000 PY) (OR: 0.82, 95% CI, 0.46-1.47). Males from Muslim-majority countries had lower rates of self-harm presentations than males from Muslim-minority (<10%) countries (Muslim majority: 12.2/10,000 PY, Muslim-minority: 14.1/10,000 PY) (aRR: 0.82, 95% CI, 0.75, 0.90). Among female immigrants, rates of self-harm presentations were not different among Muslim-majority (30.1/10,000 PY) compared to Muslim-minority (<10%) (32.9/10,000 PY) (aRR: 0.93, 95% CI, 0.87-1.00) countries. For females, older age at immigration conferred a lower risk of self-harm presentations. CONCLUSION Being a male from a Muslim-majority country may confer protection from suicide and self-harm presentations but the same was not observed for females. Approaches to understanding the observed sex-based differences are warranted.
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Affiliation(s)
- Natasha Saunders
- The Hospital for Sick Children, Toronto, Canada
- Department of Pediatrics, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Canada
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Canada
| | | | | | | | - Paul Kurdyak
- ICES, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Zainab Furqan
- Department of Psychiatry, University of Toronto, Toronto, Canada
- University Health Network, Toronto, Canada
| | - Arfeen Malick
- The Hospital for Sick Children, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Muhammad Ishrat Husain
- Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Mark Sinyor
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Juveria Zaheer
- ICES, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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3
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Exploring the Relationship Between Moral Injury and PTSD Symptoms in Suicide Attempt Survivors. COGNITIVE THERAPY AND RESEARCH 2023. [DOI: 10.1007/s10608-023-10356-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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4
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Ghossoub E, Kassir G, El Bashour J, Saneh W. Associations between religiosity, aggression and crime: results from the National Survey on Drug Use and Health. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1829-1838. [PMID: 34767034 DOI: 10.1007/s00127-021-02181-y] [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: 11/22/2020] [Accepted: 10/31/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To explore the association between religiosity, aggression (self- and other-directed) and law-breaking behaviors. METHODS We used data from the National Survey on Drug Use and Health (NSDUH) in the United States of America across 2008-2014, with a pooled sample of 270,227 adult respondents. We categorized respondents as religious if they considered religious beliefs to be important parts of their lives and/or to be influential in making decisions and/or if they considered it important that friends share their beliefs and/or if they reported attending at least one service over the past 12 months. We used regression models to calculate the odds ratio for committing different forms of aggression and for breaking the law when measuring positively on religiosity and its parameters. RESULTS More than 85% of our sample qualified as religious. A positive religiosity was correlated with a statistically significant lower risk of self-directed aggression [aOR = 0.83, 95% CI (0.69-0.99)]. Importance of religious beliefs and influence of religious beliefs were inversely correlated to perpetration of self-directed aggression [aOR = 0.81, 95% CI (0.70-0.95)] and [aOR = 0.82, 95% CI (0.70-0.96)], respectively. Positive religiosity was not significantly correlated to lower odds of other-directed aggression. All religiosity parameters were associated with significantly reduced odds of breaking the law, except for infrequent service attendance which was associated with a significantly higher risk of breaking the law [aOR = 1.07, 95% CI (1.03-1.12)]. CONCLUSION Religiosity has components with a differential impact on aggressive and law-breaking behaviors. Future longitudinal studies are needed to analyze whether religiosity protects against suicidality and promotes pro-social actions.
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Affiliation(s)
- Elias Ghossoub
- Department of Psychiatry, American University of Beirut Medical Center, Cairo Street, Riad El-Solh, P.O. Box: 11-0236, Beirut, 1107 2020, Lebanon.
| | - Ghida Kassir
- Department of Psychiatry, American University of Beirut Medical Center, Cairo Street, Riad El-Solh, P.O. Box: 11-0236, Beirut, 1107 2020, Lebanon
| | | | - Wafic Saneh
- American University of Beirut, Bliss Street, Beirut, Lebanon
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Kim SW, Park WY, Kim H, Jhon M, Kim JW, Kang HJ, Kim SY, Ryu S, Lee JY, Shin IS, Kim JM. Development of a Checklist for Predicting Suicidality Based on Risk and Protective Factors: The Gwangju Checklist for Evaluation of Suicidality. Psychiatry Investig 2022; 19:470-479. [PMID: 35753686 PMCID: PMC9233948 DOI: 10.30773/pi.2022.0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 04/26/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The aim of the study was to develop a checklist for mental health clinicians to predict and manage suicidality. METHODS A literature review of the risk and protective factors for suicide was conducted to develop a checklist for evaluating suicidality. RESULTS The fixed risk factors included sex (male), age (older individuals), history of childhood adversity, and a family history of suicide. Changeable risk factors included marital status (single), economic status (poverty), physical illness, history of psychiatric hospitalization, and history of suicide attempts. Recent discharge from a mental hospital and a recent history of suicide attempts were also included. Manageable risk factors included depression (history and current), alcohol problems (frequent drinking and alcohol abuse), hopelessness, agitation, impulsivity, impaired reality testing, and command hallucinations. Protective factors included responsibility to family, social support, moral objections to suicide, religiosity, motivation to get treatment, ability to cope with stress, and a healthy lifestyle. A final score was assigned based on the sum of the risk and protective factor scores. CONCLUSION We believe that the development of this checklist will help mental health clinicians to better assess those at risk for suicidal behavior. Further studies are necessary to validate the checklist.
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Affiliation(s)
- Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Woo-Young Park
- Department of Psychiatry, Gwangju Veterans Hospital, Gwangju, Republic of Korea
| | - Honey Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seon-Young Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seunghyoung Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Gwangju Metropolitan Mental Health Welfare Center, Gwangju, Republic of Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
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6
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Kustov GV, Zinchuk MS, Gersamija AG, Voinova NI, Yakovlev AA, Avedisova AS, Guekht AB. [Psychometric properties of the Russian version of the brief «Reasons for Living Inventory»]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:87-94. [PMID: 34874661 DOI: 10.17116/jnevro202112110187] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate psychometric properties of the Russian version of the brief Reasons for Living Inventory (bRFL) in patients with non-psychotic mental disorders (NPMD) and to define its association with current suicide ideation. MATERIAL AND METHODS Six hundred and 15 consecutive patients with NPMD were included. The median age was 27 (19) years; 403 (65.5%) were female. Cronbach's alpha, Cronbach's alpha coefficient if an item is deleted and corrected item-total correlation were used for the internal consistency evaluation. The internal structure assessment was based on the exploratory and confirmatory factor analysis. To identify an association of bRFL with current suicidal ideation, MANCOVA was used. RESULTS An internal consistency of bRFL was good (Cronbach's Alpha-0.856). The exploratory factor analysis revealed a 6-factor model, explaining 80.22% of variance. These factors were: «survival and coping beliefs», «responsibility to family», «child related concerns», «fear of suicide», «fear of social disapproval» and «moral objections». The confirmatory factor analysis indicated a good agreement of the 6-factor model with an empirical data (CMIN/DF - 2.98, CFI - 0.956, SRMR - 0.05, RMSEA - 0.057, PNFI - 0.497). Regardless of gender and age, the total scores of bRFL and its subscales were significantly lower in patients with suicide ideation (p<0.01). CONCLUSION The Russian version of bRFL is a reliable and valid tool for the assessment of the adaptive beliefs and expectations that form an anti-suicidal barrier.
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Affiliation(s)
- G V Kustov
- Solovyov Scientific and Practical Psychoneurological Center DZM, Moscow, Russia
| | - M S Zinchuk
- Solovyov Scientific and Practical Psychoneurological Center DZM, Moscow, Russia
| | - A G Gersamija
- Solovyov Scientific and Practical Psychoneurological Center DZM, Moscow, Russia
| | - N I Voinova
- Solovyov Scientific and Practical Psychoneurological Center DZM, Moscow, Russia
| | - A A Yakovlev
- Solovyov Scientific and Practical Psychoneurological Center DZM, Moscow, Russia.,Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia
| | - A S Avedisova
- Solovyov Scientific and Practical Psychoneurological Center DZM, Moscow, Russia.,Serbsky National Medical Research Center of Psychiatry and Narcology Ministry of Health of Russia, Moscow, Russia
| | - A B Guekht
- Solovyov Scientific and Practical Psychoneurological Center DZM, Moscow, Russia.,Pirogov Russian National Research Medical University, Moscow, Russia
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7
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Religious Coping, Hopelessness, and Suicide Ideation in Subjects with First-Episode Major Depression: An Exploratory Study in the Real World Clinical Practice. Brain Sci 2020; 10:brainsci10120912. [PMID: 33260812 PMCID: PMC7760269 DOI: 10.3390/brainsci10120912] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the potential relationships between religious coping, hopelessness, and suicide ideation in adult outpatients with the first episode of major depressive disorder (MDD). METHODS Ninety-four adult outpatients with MDD were assessed through the Hamilton Depression Rating Scale (HAM-D), the Beck Hopelessness Scale (BHS), and the Scale of Suicide Ideation (SSI). Religious coping was assessed with the Italian version of the Brief RCOPE scale, consisting of seven positive coping items (PosCop) and seven negative coping items (NegCop). RESULTS The results showed that the Brief RCOPE PosCop scale exhibited a strong inverse correlation with HAM-D, BHS, and SSI, whereas HAM-D and BHS were positively correlated with SSI. Brief RCOPE NegCop scores were positively correlated only with SSI. Regression analysis with SSI as the dependent variable showed that higher Brief RCOPE PosCop scores were associated with lower suicide ideation, whereas higher HAM-D and BHS scores were associated with higher suicide ideation. CONCLUSION Positive religious coping may be a protective factor against the development of suicide ideation, perhaps counteracting the severity of depressive symptoms and hopelessness. The evaluation of religious coping should be performed in all subjects with MDD in everyday clinical practice. However, this study was preliminary, and limitations must be considered.
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8
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Chen JI, Osman A, Freedenthal SL, Gutierrez PM. An Examination of the Psychometric Properties of the Reasons for Living Inventory within a Male Veteran Clinical Sample. Arch Suicide Res 2020; 24:204-230. [PMID: 30636520 DOI: 10.1080/13811118.2018.1563576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Elevated suicide risk among veteran populations remains a significant public health concern. However, few suicide assessment measures have been validated for veterans. The current study evaluated the reliability and validity of the Reasons for Living Inventory (RFL) scores among veteran populations. The participants included male veterans (N = 421) from a broad range of ages, combat exposures, and history of suicide attempts. Participants completed the RFL and a set of additional self-report measures of relevant constructs in a cross-sectional design. Estimates of internal consistency reliability were adequate for scores on all the original RFL subscale scores. Exploratory factor analysis (EFA) and exploratory bifactor (bi-factor EFA) analyses provided detailed information regarding the 6-factor solution from the original validation studies with the RFL. Additional analyses identified potential correlates for the RFL total and subscale scores. Secondary analyses showed support for evidence of known-groups validity for the RFL total scale score. Overall, this study provides initial support for the RFL as a reliable and valid measure of protective factors in veterans. Future studies may wish to consider further validation of the current findings.
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Affiliation(s)
- Jason I Chen
- VA Portland Health Care System, Portland, OR, USA
| | - Augustine Osman
- Department of Psychology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Stacey L Freedenthal
- Department of Psychology, University of Denver Graduate School of Social Work, Denver, CO, USA
| | - Peter M Gutierrez
- Rocky Mountain Mental Illness Research, Education and Clinical Center at the Denver VA Medical Center, Aurora, CO, USA.,Department of Psychology, University of Colorado School of Medicine, Aurora, CO, USA
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9
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Cureton JL, Fink M. SHORES: A Practical Mnemonic for Suicide Protective Factors. JOURNAL OF COUNSELING AND DEVELOPMENT 2019. [DOI: 10.1002/jcad.12272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jenny L. Cureton
- Department of Counselor Education and SupervisionKent State University
| | - Matthew Fink
- Department of Counselor Education and SupervisionKent State University
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10
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Jongkind M, van den Brink B, Schaap-Jonker H, van der Velde N, Braam AW. Dimensions of Religion Associated with Suicide Attempt and Suicide Ideation in Depressed, Religiously Affiliated Patients. Suicide Life Threat Behav 2019; 49:505-519. [PMID: 29676507 DOI: 10.1111/sltb.12456] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/20/2017] [Indexed: 11/29/2022]
Abstract
There is substantial evidence to support the claim that religion can protect against suicide ideation, suicide attempts, and completed suicide. There is also evidence that religion does not always protect against suicidality. More insight is needed into the relationship between suicidal parameters and dimensions of religion. A total of 155 in- and outpatients with major depression from a Christian Mental Health Care institution were included. The following religious factors were assessed: religious service attendance, frequency of prayer, religious salience, type of God representation, and moral objections to suicide (MOS). Multiple regression analyses were computed. MOS have a unique and prominent (negative) association with suicide ideation and the lifetime history of suicide attempts, even after controlling for demographic features and severity of depression. The type of God representation is an independent statistical predictor of the severity of suicide ideation. A positive-supportive God representation is negatively correlated with suicide ideation. A passive-distressing God representation has a positive correlation with suicide ideation. High MOS and a positive-supportive God representation in Christian patients with depression are negatively correlated with suicide ideation. Both are likely to be important markers for assessment and further development of therapeutic strategies.
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Affiliation(s)
- Matthias Jongkind
- Eleos - Christian Centre for Mental Health Care, Amersfoort, The Netherlands.,KICG-Centre for Research and Innovation in Christian Mental Health Care, Amersfoort, The Netherlands
| | - Bart van den Brink
- Eleos - Christian Centre for Mental Health Care, Amersfoort, The Netherlands.,KICG-Centre for Research and Innovation in Christian Mental Health Care, Amersfoort, The Netherlands
| | - Hanneke Schaap-Jonker
- Eleos - Christian Centre for Mental Health Care, Amersfoort, The Netherlands.,KICG-Centre for Research and Innovation in Christian Mental Health Care, Amersfoort, The Netherlands
| | - Nathan van der Velde
- Eleos - Christian Centre for Mental Health Care, Amersfoort, The Netherlands.,KICG-Centre for Research and Innovation in Christian Mental Health Care, Amersfoort, The Netherlands
| | - Arjan W Braam
- Department of Emergency Psychiatry and Department of Specialist Training, Altrecht Mental Health Care, Utrecht, The Netherlands.,Department of Humanist Counseling, University for Humanistic Studies, Utrecht, The Netherlands
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11
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van den Brink B, Schaap H, Braam AW. Moral Objections and Fear of Hell: An Important Barrier to Suicidality. JOURNAL OF RELIGION AND HEALTH 2018; 57:2301-2312. [PMID: 29423644 DOI: 10.1007/s10943-018-0573-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This review explores the literature to test the hypothesis that 'moral objections to suicide (MOS), especially the conviction of going to hell after committing suicide, exert a restraining effect on suicide and suicidality.' Medline and PsycInfo were searched using all relevant search terms; all relevant articles were selected, rated and reviewed. Fifteen cross-sectional studies were available on this topic, and raise sufficient evidence to confirm a restraining effect of MOS, and sparse data on fear of hell. MOS seem to counteract especially the development of suicidal intent and attempts, and possibly the lethality of suicidal attempts. A differential pattern of influence of MOS on the suicidal continuum is suggested.
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Affiliation(s)
- Bart van den Brink
- Psychiatric Acute Care Unit, Eleos, Christian Institution for Mental Health Care, Printerweg 21, 3821 AP, Amersfoort, The Netherlands.
- Kennisinstituut christelijke ggz, Center for Christian Mental Health Care, Amersfoort, The Netherlands.
| | - Hanneke Schaap
- Kennisinstituut christelijke ggz, Center for Christian Mental Health Care, Amersfoort, The Netherlands
| | - Arjan W Braam
- University of Humanistic Studies, Utrecht, The Netherlands
- Department of Emergency Psychiatry, Altrecht Mental Health Care, Utrecht, The Netherlands
- Department of Residency Training, Altrecht Mental Health Care, Utrecht, The Netherlands
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12
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Abstract
Suicide rates and risk and protective factors vary across religions. There has been a significant increase in research in the area of religion and suicide since the article, "Religion and Suicide," reviewed these issues in 2009. This current article provides an updated review of the research since the original article was published. PsycINFO, MEDLINE, SocINDEX, and CINAHL databases were searched for articles on religion and suicide published between 2008 and 2017. Epidemiological data on suicidality and risk and protective factors across religions are explored. Updated general practice guidelines are provided, and areas for future research are identified.
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Affiliation(s)
- Robin Edward Gearing
- Graduate College of Social Work, University of Houston, 3511 Cullen Boulevard, 110HA, Houston, TX, 77204, USA.
| | - Dana Alonzo
- Graduate School of Social Service, Fordham University, New York, NY, USA
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13
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Kralovec K, Kunrath S, Fartacek C, Pichler EM, Plöderl M. The Gender-Specific Associations Between Religion/Spirituality and Suicide Risk in a Sample of Austrian Psychiatric Inpatients. Suicide Life Threat Behav 2018; 48:281-293. [PMID: 28370188 DOI: 10.1111/sltb.12349] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 01/17/2017] [Indexed: 11/27/2022]
Abstract
Most studies have found religion/spirituality to be protective against suicide risk, with a stronger effect among women. To understand this effect, theories of suicide and clinical samples are needed, but related studies are lacking. We applied two established suicide models in 753 psychiatric inpatients. Religion/spirituality correlated protectively with components of the suicide models, with stronger associations among women. The protective effect emerged especially for the capability aspect of suicide among men and for the motivational aspect among women, suggesting very different causal mechanisms, but this has to be replicated with longitudinal studies.
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Affiliation(s)
- Karl Kralovec
- Department of Suicide Prevention, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
| | - Sabine Kunrath
- Department of Suicide Prevention, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
| | - Clemens Fartacek
- Department of Suicide Prevention, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.,Department of Clinical Psychology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
| | - Eva-Maria Pichler
- Department of Suicide Prevention, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
| | - Martin Plöderl
- Department of Suicide Prevention, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.,Department of Clinical Psychology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
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Blosnich JR, Lytle MC, Coulter RW, Whitfield DL. Suicide Acceptability and Sexual Orientation: Results from the General Social Survey 2008-2014. Arch Suicide Res 2017; 22:542-554. [PMID: 29111903 PMCID: PMC6169791 DOI: 10.1080/13811118.2017.1377132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Lesbian, gay, and bisexual (LGB) individuals have higher prevalence of lifetime suicide ideation and attempt than their heterosexual peers, but less is known about differences in suicide acceptability (i.e., believing suicide is a viable answer to a problem). The purpose of this study was to examine if LGB adults had greater suicide acceptability than heterosexual adults. A total of 4 items in the General Social Surveys from 2008 to 2014 assessed whether a nationally representative sample of U.S. adult respondents (n = 5,037) thought it acceptable for individuals to kill themselves if one: goes bankrupt, dishonors their family, is tired of living, or has an incurable disease. Multiple logistic regression analyses were used to assess the association of sexual orientation with suicide acceptability items after adjusting for confounding factors. Compared with heterosexuals, lesbians/gays had higher odds of reporting suicide acceptability if one goes bankrupt (OR = 1.92; 95% CI: 1.06, 3.46), dishonors family (OR = 1.83; 95% CI: 1.01, 3.28), or is tired of living (OR = 2.25; 95% CI: 1.30, 3.90). Bisexual and heterosexual groups were largely similar across the 4 suicide acceptability items. No sexual orientation differences were observed for reporting acceptability of suicide in the instance of an incurable disease. Post hoc analyses revealed significant interactions between sex and sexual orientation, such that differences in suicide acceptability seemed to be driven by sexual minority women rather than by sexual minority men. Suicide acceptability differs by sexual orientation, and community-level interventions around changing norms about suicide may be a prevention strategy for sexual minority individuals.
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Affiliation(s)
- John R. Blosnich
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, Pennsylvania 15261
- Center for Health Equity Research and Promotion, VA Pittsburgh Medical Center, University Drive C (151C-U) Building 30, Pittsburgh, Pennsylvania 15240
| | - Megan C. Lytle
- Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642
| | - Robert W.S. Coulter
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, Pennsylvania 15261
- School of Medicine, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, Pennsylvania 15261
| | - Darren L. Whitfield
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, Pennsylvania 15261
- School of Social Work, University of Pittsburgh, 4200 Fifth Avenue, Pittsburgh, Pennsylvania 15260
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Tillman JG, Clemence AJ, Hopwood CJ, Lewis KC, Stevens JL. Suicidality in High-Risk Psychiatric Patients: The Contribution of Protective Factors. Psychiatry 2017; 80:357-373. [PMID: 29466104 DOI: 10.1080/00332747.2017.1296309] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study's objective was determine the incremental association of reasons for living to the lifetime number of suicide attempts in relation to other known risk and protective factors in a sample of psychiatric patients with extensive psychopathology in residential treatment. METHODS Participants (n = 131) completed a demographic questionnaire that also asked for information about lifetime suicide history, psychiatric history, trauma, and abuse history. Additional measures of resilience, reasons for living (RFL), and impulsiveness were completed. RESULTS A history of sexual abuse was associated with an increasing lifetime number of suicide attempts, while a history of physical abuse and trait impulsiveness were not associated with the lifetime number of suicide attempts. Survival and coping beliefs, a subscale of the Reasons for Living Inventory (RFLI), was found to add incremental predictive validity to the number of lifetime suicide attempts. A composite fear variable, combining fear of suicide and fear of social consequences of suicide, was negatively correlated with lifetime number of attempts but did not add incremental validity to the prediction of lifetime number of suicide attempts. CONCLUSION In a sample of participants with significant psychiatric impairment, the protective factor of survival and coping beliefs may be an important barrier to repeated suicide attempts and may be considered a suicide-specific resilience measure. Understanding the psychological processes contributing to the development of such protective factors as resilience, meaning in life, and coping resources is an important area of study and a potential avenue for targeted therapeutic intervention in high-risk populations.
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Abstract
The vast majority of the world's population is affiliated with a religious belief structure, and each of the major faith traditions (in its true form) is strongly opposed to suicide. Ample literature supports the protective effect of religious affiliation on suicide rates. Proposed mechanisms for this protective effect include enhanced social network and social integration, the degree of religious commitment, and the degree to which a particular religion disapproves of suicide. We review the sociological data for these effects and the general objections to suicide held by the faith traditions. We explore how clinicians may use such knowledge with individual patients, including routinely taking a religious/spiritual history. The clinician who is aware of the common themes among the faith traditions in opposition to suicide is better prepared to address religious/spiritual matters, as appropriate, in crisis situations. The clinician who understands the patient's belief system is also better prepared to request consultation with religious professionals when indicated.
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Abstract
We aimed to examine the relationship between religion and suicide attempt and ideation. Three hundred twenty-one depressed patients were recruited from mood-disorder research studies at the New York State Psychiatric Institute. Participants were interviewed using the Structured Clinical Interview for DSM Disorders, Columbia University Suicide History form, Scale for Suicide Ideation, and Reasons for Living Inventory. Participants were asked about their religious affiliation, importance of religion, and religious service attendance. We found that past suicide attempts were more common among depressed patients with a religious affiliation (odds ratio, 2.25; p = 0.007). Suicide ideation was greater among depressed patients who considered religion more important (coefficient, 1.18; p = 0.026) and those who attended services more frequently (coefficient, 1.99; p = 0.001). We conclude that the relationship between religion and suicide risk factors is complex and can vary among different patient populations. Physicians should seek deeper understanding of the role of religion in an individual patient's life in order to understand the person's suicide risk factors more fully.
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Luo X, Wang Q, Wang X, Cai T. Reasons for living and hope as the protective factors against suicidality in Chinese patients with depression: a cross sectional study. BMC Psychiatry 2016; 16:252. [PMID: 27439525 PMCID: PMC4955123 DOI: 10.1186/s12888-016-0960-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 07/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The risk factors of suicidal ideation and attempts have been discussed in many researches. Few studies have examined reasons for living and hope as protective factors against suicide in a clinical population. It is unclear if these factors help to reduce suicide rates in patients with depression. The study aimed to assess the role of reasons for living and hope in the identification and reduction of suicidality and explore the influence of reasons for living or hope in the transition from suicidal ideation to suicide attempts. METHODS Patients with depression (N = 115) completed the Beck Depression Inventory, Reasons for Living Inventory, and Adult Suicidal Ideation Questionnaire. RESULTS There were significant correlations among depression, hope, total reasons for living, and suicidal ideation and attempts. Further, after controlling for depression, reasons for living and hope had significant main effects on suicidal ideation. Hope also had a significant predictive effect in the transition of suicidal ideation to suicide attempt. CONCLUSIONS We concluded that reasons for living and hope may protect against suicidal ideation and attempts in patients with depression. Especially hope could reduce the possibility of suicide attempt.
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Affiliation(s)
- Xingwei Luo
- Medical Psychology Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China ,Medical Psychology Institute of Central South University, Changsha, Hunan 410011 China
| | - Qin Wang
- The Third Experimental Primary School, Rizhao, Shandong 276800 China
| | - Xiang Wang
- Medical Psychology Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China ,Medical Psychology Institute of Central South University, Changsha, Hunan 410011 China
| | - Taisheng Cai
- Medical Psychology Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China. .,Medical Psychology Institute of Central South University, Changsha, Hunan, 410011, China. .,Medical Institute of Psychology, Secong Xiangya Hospital of Central South University, 139 Renmin Road, Furong District, Changsha, 410011, China.
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Banta JE, McKinney O. Faith-Based Hospitals and Variation in Psychiatric Inpatient Length of Stay in California, 2002-2011. JOURNAL OF RELIGION AND HEALTH 2016; 55:787-802. [PMID: 26718346 DOI: 10.1007/s10943-015-0175-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We examined current treatment patterns at faith-based hospitals. Psychiatric discharges from all community-based hospitals in California were obtained for 2002-2011 and a Behavioral Model of Health Services Utilization approach used to study hospital religious affiliation and length of stay (LOS). During 10 years there were 1,976,893 psychiatric inpatient discharges, of which 14.3% were from faith-based nonprofit hospitals (eighteen Catholic, seven Seventh-day Adventist, and one Jewish hospital). Modest differences in patient characteristics and shorter LOS (7.5 vs. 8.3 days) were observed between faith-based and other hospitals. Multivariable negative binomial regression found shorter LOS at faith-based nonprofit hospitals (coefficient = -0.1169, p < 0.001, Wald χ (2) = 55) and greater LOS at all nonprofits (coefficient = 1.5909, p < 0.001, Wald χ (2) = 2755) as compared to local government-controlled hospitals. Faith-based hospitals provide a substantial and consistent amount of psychiatric care in California and may have slightly lower LOS after adjusting for patient and other hospital characteristics.
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Affiliation(s)
- Jim E Banta
- Loma Linda University School of Public Health, 24951 North Circle Drive, Loma Linda, CA, 92350, USA.
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Bakhiyi CL, Calati R, Guillaume S, Courtet P. Do reasons for living protect against suicidal thoughts and behaviors? A systematic review of the literature. J Psychiatr Res 2016; 77:92-108. [PMID: 27014850 DOI: 10.1016/j.jpsychires.2016.02.019] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/22/2016] [Accepted: 02/26/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Few studies have investigated protective factors against suicide. OBJECTIVES To identify whether reasons for living (RFL), measured with the Reasons for Living Inventory (RFLI), protect against suicidal ideation (SI), attempts (SA) and suicide death. METHOD This systematic review followed the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) statement guidelines. PubMed database was searched for studies published until October 2015. Studies were eligible if they used RFLI or one of its versions. All eligible studies were included, regardless of study design, quality indicators, and target populations. No publication year limit was imposed. We included 39 studies. RESULTS RFL may protect against SI and SA and yield a predictive value. The role of two specific reasons for living (Moral Objections to Suicide and Survival and Coping Beliefs) was particularly emphasized. No study investigating suicide death was found. CONCLUSION RFL may moderate suicide risk factors and correlate with resilience factors. Moreover, RFL may depend on and interact with numerous factors such as DSM-IV Axis I disorders, personality disorders and features, coping abilities and social support. Clinicians could develop therapeutic strategies aimed at enhancing RFL, like Dialectical Behavior Therapy and Cognitive Behavioral Therapies, to prevent suicidal thoughts and behaviors and improve the care management of suicidal patients.
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Affiliation(s)
- Camélia Laglaoui Bakhiyi
- Department of Emergency Psychiatry & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; Psychiatric Unit, CHU Casablanca, Hassan II University, Casablanca, Morocco; INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France.
| | - Raffaella Calati
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; FondaMental Foundation, France
| | - Sébastien Guillaume
- Department of Emergency Psychiatry & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; FondaMental Foundation, France
| | - Philippe Courtet
- Department of Emergency Psychiatry & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; FondaMental Foundation, France
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21
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Abstract
Although religion is reported to be protective against suicide, the empirical evidence is inconsistent. Research is complicated by the fact that there are many dimensions to religion (affiliation, participation, doctrine) and suicide (ideation, attempt, completion). We systematically reviewed the literature on religion and suicide over the last 10 years (89 articles) with a goal of identifying what specific dimensions of religion are associated with specific aspects of suicide. We found that religious affiliation does not necessarily protect against suicidal ideation, but does protect against suicide attempts. Whether religious affiliation protects against suicide attempts may depend on the culture-specific implications of affiliating with a particular religion, since minority religious groups can feel socially isolated. After adjusting for social support measures, religious service attendance is not especially protective against suicidal ideation, but does protect against suicide attempts, and possibly protects against suicide. Future qualitative studies might further clarify these associations.
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Shiah YJ, Chang F, Chiang SK, Lin IM, Tam WCC. Religion and health: anxiety, religiosity, meaning of life and mental health. JOURNAL OF RELIGION AND HEALTH 2015; 54:35-45. [PMID: 24132457 DOI: 10.1007/s10943-013-9781-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We examined the association among anxiety, religiosity, meaning of life and mental health in a nonclinical sample from a Chinese society. Four hundred fifty-one Taiwanese adults (150 males and 300 females) ranging in age from 17 to 73 years (M = 28.9, SD = 11.53) completed measures of Beck Anxiety Inventory, Medical Outcomes Study Health Survey, Perceived Stress Scale, Social Support Scale, and Personal Religiosity Scale (measuring religiosity and meaning of life). Meaning of life has a significant negative correlation with anxiety and a significant positive correlation with mental health and religiosity; however, religiosity does not correlate significantly anxiety and mental health after controlling for demographic measures, social support and physical health. Anxiety explains unique variance in mental health above meaning of life. Meaning of life was found to partially mediate the relationship between anxiety and mental health. These findings suggest that benefits of meaning of life for mental health can be at least partially accounted for by the effects of underlying anxiety.
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Affiliation(s)
- Yung-Jong Shiah
- Graduate Institute of Counseling Psychology and Rehabilitation Counseling, National Kaohsiung Normal University, No. 116, Heping 1st Road, Kaohsiung, 802, Taiwan,
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Demyttenaere K, Desaiah D, Raskin J, Cairns V, Brecht S. Suicidal thoughts and reasons for living in hospitalized patients with severe depression: post-hoc analyses of a double-blind randomized trial of duloxetine. Prim Care Companion CNS Disord 2014; 16:13m01591. [PMID: 25317365 DOI: 10.4088/pcc.13m01591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 12/20/2013] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To evaluate suicidal thoughts in relationship to depressive symptom severity and reasons for living in patients hospitalized for major depressive disorder (MDD). METHOD A post hoc analysis was conducted of a randomized, double-blind, parallel-group trial involving hospitalized patients with MDD (DSM-IV criteria) who received duloxetine 60 mg once daily or duloxetine 60 mg twice daily for 8 weeks. After 4 weeks, the dose for nonresponders receiving 60 mg once daily could be increased to 60 mg twice daily (double-blind). The study was conducted between February 9, 2007, and August 26, 2008 at 43 centers in 4 countries across Europe and South Africa. Suicidal thoughts were assessed with Montgomery-Asberg Depression Rating Scale (MADRS) item 10, depression severity was assessed with the 6-item Hamilton Depression Rating Scale and the Clinical Global Impressions-Severity of Illness scale, and protective factors were assessed with the patient-rated Reasons for Living Inventory (RFL) assessing 6 domains. Descriptive statistics, correlation, and linear regression analysis were performed. RESULTS At baseline, patients (N = 336) had varying severity of suicidal thoughts: 18% had a score ≥ 4. The proportion of patients with a score ≥ 4 decreased to 7% at week 1 and 1% at week 8 of treatment. The RFL scores at baseline were lower in patients with higher baseline suicidal thoughts and increased significantly during treatment (P < .0001). A regression model revealed that only 16% of variance in baseline total RFL score is explained by the different MADRS items. Eight patients had suicidal behavior or ideation recorded as an adverse event during the study; no consistent pattern was found in the different psychometric scores either at baseline or at the visit preceding the suicidal behavior/ideation. CONCLUSIONS Suicidality rapidly decreased in hospitalized patients with severe depression treated with duloxetine. The RFL scores were low at baseline but increased during treatment, suggesting that they are at least partially state rather than trait variables. Since RFL scores are lower in depressed inpatients, these scores lose the predictive value that they have in a general population sample. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT00422162.
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Affiliation(s)
- Koen Demyttenaere
- University Psychiatric Center KU Leuven, Campus Gasthuisberg, Leuven, Belgium (Dr Demyttenaere); Eli Lilly and Company, Indianapolis, Indiana (Dr Desaiah); Eli Lilly and Company, Toronto, Canada (Dr Raskin); Boehringer Ingelheim GmbH (consultant statistician), Oxford, United Kingdom (Dr Cairns); and Boehringer Ingelheim GmbH, Ingelheim, Germany (Dr Brecht)
| | - Durisala Desaiah
- University Psychiatric Center KU Leuven, Campus Gasthuisberg, Leuven, Belgium (Dr Demyttenaere); Eli Lilly and Company, Indianapolis, Indiana (Dr Desaiah); Eli Lilly and Company, Toronto, Canada (Dr Raskin); Boehringer Ingelheim GmbH (consultant statistician), Oxford, United Kingdom (Dr Cairns); and Boehringer Ingelheim GmbH, Ingelheim, Germany (Dr Brecht)
| | - Joel Raskin
- University Psychiatric Center KU Leuven, Campus Gasthuisberg, Leuven, Belgium (Dr Demyttenaere); Eli Lilly and Company, Indianapolis, Indiana (Dr Desaiah); Eli Lilly and Company, Toronto, Canada (Dr Raskin); Boehringer Ingelheim GmbH (consultant statistician), Oxford, United Kingdom (Dr Cairns); and Boehringer Ingelheim GmbH, Ingelheim, Germany (Dr Brecht)
| | - Victoria Cairns
- University Psychiatric Center KU Leuven, Campus Gasthuisberg, Leuven, Belgium (Dr Demyttenaere); Eli Lilly and Company, Indianapolis, Indiana (Dr Desaiah); Eli Lilly and Company, Toronto, Canada (Dr Raskin); Boehringer Ingelheim GmbH (consultant statistician), Oxford, United Kingdom (Dr Cairns); and Boehringer Ingelheim GmbH, Ingelheim, Germany (Dr Brecht)
| | - Stephan Brecht
- University Psychiatric Center KU Leuven, Campus Gasthuisberg, Leuven, Belgium (Dr Demyttenaere); Eli Lilly and Company, Indianapolis, Indiana (Dr Desaiah); Eli Lilly and Company, Toronto, Canada (Dr Raskin); Boehringer Ingelheim GmbH (consultant statistician), Oxford, United Kingdom (Dr Cairns); and Boehringer Ingelheim GmbH, Ingelheim, Germany (Dr Brecht)
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Associations between reasons for living and diminished suicide intent among African-American female suicide attempters. J Nerv Ment Dis 2014; 202:569-75. [PMID: 25010106 DOI: 10.1097/nmd.0000000000000170] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
African-American women are at high risk for suicide ideation and suicide attempts and use emergency psychiatric services at disproportionately high rates relative to men and other ethnic groups. However, suicide death rates are low for this population. Cultural variables in the African-American community may promote resilience and prevent fatal suicidal behavior among African-American women. The present study evaluated self-reported reasons for living as a protective factor against suicidal intent and suicide attempt lethality in a sample of African-American female suicide attempters (n = 150). Regression analyses revealed that reasons for living were negatively associated with suicidal intent, even after controlling for spiritual well-being and symptoms of depression. These results indicate that the ability to generate and contemplate reasons for valuing life may serve as a protective characteristic against life-threatening suicidal behavior among African-American women. Implications for research and clinical practice are further discussed.
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Nkansah-Amankra S. Adolescent suicidal trajectories through young adulthood: prospective assessment of religiosity and psychosocial factors among a population-based sample in the United States. Suicide Life Threat Behav 2013; 43:439-59. [PMID: 23601148 PMCID: PMC4140945 DOI: 10.1111/sltb.12029] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Accepted: 02/22/2013] [Indexed: 01/17/2023]
Abstract
The main objective was to identify distinct patterns of suicidal behaviors over the life course from adolescence to young adulthood and to determine influences of religiosity and other contextual factors on subgroup membership. Semiparametric growth mixture models were used to identify distinct clusters of suicide ideation and suicide attempt trajectories, and generalized estimating equations were used to assess individual and contextual characteristics predicting suicidal behaviors in adolescence and in young adulthood. Distinct trajectories of suicide ideation and suicide attempt were identified for the total sample and for the gender groups. Results showed marked gender differences in the trajectory of suicide ideation and attempt patterns. Religiosity effects on suicidality were prominent in adolescence but not in young adulthood. Analysis showed that an important window of opportunity for preventing the escalation of suicidality exists during the early adolescent period, an opportunity that should be emphasized in interventions on adolescence suicide prevention.
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Ghafoori B, Barragan B, Tohidian N, Palinkas L. Racial and ethnic differences in symptom severity of PTSD, GAD, and depression in trauma-exposed, urban, treatment-seeking adults. J Trauma Stress 2012; 25:106-10. [PMID: 22354513 PMCID: PMC3599779 DOI: 10.1002/jts.21663] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Urban, socially disadvantaged individuals are at high risk for traumatic event exposure and its subsequent psychiatric symptomatology. This study examined the association between race/ethnicity and symptom severity of posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), and depression in an urban clinical sample of 170 trauma-exposed adults. In addition, this study investigated the role of socioeconomic position (SEP) and coping style in the relationship between race/ethnicity and posttrauma psychiatric symptom severity. Hierarchical regression analyses indicated that Blacks had lower depression symptom severity compared to Whites. No significant relationship was found between racial/ethnic group status and indices of SEP, PTSD, or GAD symptom severity. Adjustment for trauma exposure, gender, positive reframe coping, avoidance coping and negative coping accounted for 3%, 3%, 8%, 4%, and 3% of the variance in depression severity, respectively; however, Black race remained significantly associated with decreased depression symptom severity accounting for a statistically significant 5% of the variance in lower depression symptom severity. These preliminary findings and their clinical implications are discussed.
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Affiliation(s)
- Bita Ghafoori
- Department of Advanced Studies in Education and Counseling, California State University, Long Beach, California 90840-2201, USA.
| | - Belen Barragan
- Department of Advanced Studies in Education and Counseling, California State University, Long Beach, Long Beach, California, USA
| | - Niloufar Tohidian
- Department of Advanced Studies in Education and Counseling, California State University, Long Beach, Long Beach, California, USA
| | - Lawrence Palinkas
- School of Social Work, University of Southern California, Los Angeles, California, USA
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Dervic K, Carballo JJ, Baca-Garcia E, Galfalvy HC, Mann JJ, Brent DA, Oquendo MA. Moral or religious objections to suicide may protect against suicidal behavior in bipolar disorder. J Clin Psychiatry 2011; 72:1390-6. [PMID: 21367349 PMCID: PMC3785100 DOI: 10.4088/jcp.09m05910gre] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 03/25/2010] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Patients with bipolar disorder are prone to suicidal behavior, yet possible protective mechanisms are rarely studied. We investigated a possible protective role for moral or religious objections to suicide against suicidal ideation and attempts in depressed bipolar patients. METHOD A retrospective case control study of 149 depressed bipolar patients (DSM-III-R criteria) in a tertiary care university research clinic was conducted. Patients who reported religious affiliation were compared with 51 patients without religious affiliation in terms of sociodemographic and clinical characteristics and history of suicidal behavior. The primary outcome measure was the moral or religious objections to suicide subscale of the Reasons for Living Inventory (RFLI). RESULTS Religiously affiliated patients had more children and more family-oriented social networks than nonaffiliated patients. As for clinical variables, religiously affiliated patients had fewer past suicide attempts, had fewer suicides in first-degree relatives, and were older at the time of first suicide attempt than unaffiliated patients. Furthermore, patients with religious affiliation had comparatively higher scores on the moral or religious objections to suicide subscale of the RFLI, lower lifetime aggression, and less comorbid alcohol and substance abuse and childhood abuse experience. After controlling for confounders, higher aggression scores (P = .001) and lower score on the moral or religious objections to suicide subscale of the RFLI (P < .001) were significantly associated with suicidal behavior in depressed bipolar patients. Moral or religious objections to suicide mediated the effects of religious affiliation on suicidal behavior in this sample. CONCLUSIONS Higher score on the moral or religious objections to suicide subscale of the RFLI is associated with fewer suicidal acts in depressed bipolar patients. The strength of this association was comparable to that of aggression scores and suicidal behavior, and had an independent effect. A possible protective role of moral or religious objections to suicide deserves consideration in the assessment and treatment of suicidality in bipolar disorder.
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A Guide for the Assessment and Treatment of Suicidal Patients With Traumatic Brain Injuries. J Head Trauma Rehabil 2011; 26:244-56. [DOI: 10.1097/htr.0b013e3182225528] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Garza MJ, Cramer RJ. The Spanish Reasons for Living Inventory (SRFL-I): factor structure and association with suicide risk among Spanish speaking Hispanics. Arch Suicide Res 2011; 15:354-71. [PMID: 22023643 DOI: 10.1080/13811118.2011.615704] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The present study examined the factor structure of a Spanish-translated version of the Reasons for Living Inventory (SRFL-I; Oquendo, Baca-Garcia, Graver et al., 2000). Participants (N = 168) were from a combined sample of bilingual undergraduate students and monolingual Spanish speaking outpatients at a community health center. Factor analytic results yielded a seven factor structure: Survival Beliefs, Suicide Appraisal, Problem Solving Beliefs, Family Related Concerns, Suicide Self-Efficacy, Moral Objections, and Fear of Suicide. The SRFL-I subscales displayed high internal consistencies, as well as appropriate convergent and divergent associations with depression and suicide indicators. As expected, subscales (Problem Solving Beliefs, Moral Objections, Survival Beliefs, and Suicide Self-Efficacy) from the SRFL-I displayed direct and moderating effects on suicide risk indicators. Results are discussed with respect to how culturally specific beliefs among Hispanics are reflected using the SRFL-I.
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이기원, 이수진, HyunMyoungHo. A Study on the Validation of The Reasons for Living Inventory. ACTA ACUST UNITED AC 2010. [DOI: 10.17315/kjhp.2010.15.2.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Bryant-Davis T, Ullman SE, Tsong Y, Tillman S, Smith K. Struggling to survive: sexual assault, poverty, and mental health outcomes of African American women. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2010; 80:61-70. [PMID: 20397989 DOI: 10.1111/j.1939-0025.2010.01007.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A substantial body of research documents the mental health consequences of sexual assault including, but not limited to, depression, posttraumatic stress disorder, substance use, and suicidality. Far less attention has been given to the mental health effects of sexual assault for ethnic minority women or women living in poverty. Given African American women's increased risk for sexual assault and increased risk for persistent poverty, the current study explores the relationship between income and mental health effects within a sample of 413 African American sexual assault survivors. Hierarchical regression analyses revealed that after controlling for childhood sexual abuse there were positive relationships between poverty and mental health outcomes of depression, posttraumatic stress disorder, and illicit drug use. There was no significant relationship between poverty and suicidal ideation. Counseling and research implications are discussed.
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Affiliation(s)
- Thema Bryant-Davis
- Graduate School of Education and Psychology, Pepperdine University, Encino, CA 91436, USA.
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