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Nobile B, Jaussent I, Kahn JP, Leboyer M, Risch N, Olié E, Courtet P. Risk factors of suicide re-attempt: A two-year prospective study. J Affect Disord 2024; 356:535-544. [PMID: 38657762 DOI: 10.1016/j.jad.2024.04.058] [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: 02/08/2024] [Revised: 04/09/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND History of suicide attempt (SA) is the strongest predictor of a new SA and suicide. It is primordial to identify additional risk factors of suicide re-attempt. The aim of this study was to identify risk factors of suicide re-attempt in patients with recent SA followed for 2 years. METHODS In this multicentric cohort of adult inpatients, the median of the index SA before inclusion was 10 days. Clinicians assessed a large panel of psychological dimensions using validated tools. Occurrence of a new SA or death by suicide during the follow-up was recorded. A cluster analysis was used to identify the dimensions that best characterized the population and a variable "number of personality traits" was created that included the three most representative traits: anxiety, anger, and anxious lability. Risk factors of re-attempt were assessed with adjusted Cox regression models. RESULTS Among the 379 patients included, 100 (26.4 %) re-attempted suicide and 6 (1.6 %) died by suicide. The two major risk factors of suicide re-attempt were no history of violent SA and presenting two or three personality traits among trait anxiety, anger and anxious lability. LIMITATIONS It was impossible to know if treatment change during follow-up occur before or after the re-attempt. DISCUSSION One of the most important predictors of re-attempt in suicide attempters with mood disorders, was the presence of three personality traits (anger, anxiety, and anxious lability). Clinicians should provide close monitoring to patients presenting these traits and proposed treatments specifically targeting these dimensions, especially anxiety.
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Affiliation(s)
- B Nobile
- Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, France.
| | - I Jaussent
- Institute for Neurosciences of Montpellier INM, INSERM Montpellier, University of Montpellier, Montpellier, France
| | - J P Kahn
- Université de Lorraine, Nancy, France; Clinique Soins-Etudes de Vitry le François, Fondation Sant'e des Etudiants de France (FSEF), Paris, France
| | - M Leboyer
- FondaMental Foundation, France; Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory, Créteil, France; AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
| | - N Risch
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - E Olié
- Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, France
| | - Ph Courtet
- Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, France
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Azizy AH, Thontowi HB. Stigma, Support, and Ideation About Suicide in Indonesian Twitter: A Topic Modelling Study. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241253972. [PMID: 38739857 DOI: 10.1177/00302228241253972] [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: 05/16/2024]
Abstract
Stigma surrounding suicide is a massive problem in Indonesia. Thus, it is important to study how conversations about suicide take place. We take a machine learning approach and study tweets with suicide keywords to understand how people converse about suicide or express suicide ideation. Tweets with suicide-related keywords were extracted from May to June 2023. 20,057 tweets were subject to topic modelling with an 11-topic solution. While most topics contain negative messages, no purely stigmatizing topics emerge, despite prior research suggesting overwhelming stigma. Various kinds of existential, emotional, and social tweets about suicide take place among Indonesian users, indicating that Indonesian Twitter users utilize the platform to express their thoughts and emotions. Notably, religious-spiritual keywords are highly prevalent, suggesting that in a highly religious society, there is a need for policy makers and awareness campaigns to frame their positive messaging within the society's religious context.
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Affiliation(s)
- Afrizal Hasbi Azizy
- Center for Indigenous and Cultural Psychology, Universitas Gadjah Mada, Sleman, Indonesia
| | - Haidar Buldan Thontowi
- Center for Indigenous and Cultural Psychology, Universitas Gadjah Mada, Sleman, Indonesia
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Namgung E, Ha E, Yoon S, Song Y, Lee H, Kang HJ, Han JS, Kim JM, Lee W, Lyoo IK, Kim SJ. Identifying unique subgroups in suicide risks among psychiatric outpatients. Compr Psychiatry 2024; 131:152463. [PMID: 38394926 DOI: 10.1016/j.comppsych.2024.152463] [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: 09/05/2023] [Revised: 01/27/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The presence of psychiatric disorders is widely recognized as one of the primary risk factors for suicide. A significant proportion of individuals receiving outpatient psychiatric treatment exhibit varying degrees of suicidal behaviors, which may range from mild suicidal ideations to overt suicide attempts. This study aims to elucidate the transdiagnostic symptom dimensions and associated suicidal features among psychiatric outpatients. METHODS The study enrolled patients who attended the psychiatry outpatient clinic at a tertiary hospital in South Korea (n = 1, 849, age range = 18-81; 61% women). A data-driven classification methodology was employed, incorporating a broad spectrum of clinical symptoms, to delineate distinctive subgroups among psychiatric outpatients exhibiting suicidality (n = 1189). A reference group of patients without suicidality (n = 660) was included for comparative purposes to ascertain cluster-specific sociodemographic, suicide-related, and psychiatric characteristics. RESULTS Psychiatric outpatients with suicidality (n = 1189) were subdivided into three distinctive clusters: the low-suicide risk cluster (Cluster 1), the high-suicide risk externalizing cluster (Cluster 2), and the high-suicide risk internalizing cluster (Cluster 3). Relative to the reference group (n = 660), each cluster exhibited distinct attributes pertaining to suicide-related characteristics and clinical symptoms, covering domains such as anxiety, externalizing and internalizing behaviors, and feelings of hopelessness. Cluster 1, identified as the low-suicide risk group, exhibited less frequent suicidal ideation, planning, and multiple attempts. In the high-suicide risk groups, Cluster 2 displayed pronounced externalizing symptoms, whereas Cluster 3 was primarily defined by internalizing and hopelessness symptoms. Bipolar disorders were most common in Cluster 2, while depressive disorders were predominant in Cluster 3. DISCUSSION Our findings suggest the possibility of differentiating psychiatric outpatients into distinct, clinically relevant subgroups predicated on their suicide risk. This research potentially paves the way for personalizing interventions and preventive strategies that address cluster-specific characteristics, thereby mitigating suicide-related mortality among psychiatric outpatients.
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Affiliation(s)
- Eun Namgung
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, South Korea
| | - Eunji Ha
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Sujung Yoon
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Yumi Song
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Hyangwon Lee
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Jung-Soo Han
- Department of Biological Sciences, Konkuk University, Seoul, South Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Wonhye Lee
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, South Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea; Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea.
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, South Korea.
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Stiltner B, Fischer IC, Duek O, Polimanti R, Harpaz-Rotem I, Pietrzak RH. Functional correlates of a novel 8-factor model of PTSD in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. J Psychiatr Res 2024; 171:69-74. [PMID: 38244335 DOI: 10.1016/j.jpsychires.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/21/2023] [Accepted: 01/10/2024] [Indexed: 01/22/2024]
Abstract
Emerging evidence indicates that more nuanced models of posttraumatic stress disorder (PTSD) may better capture the condition's symptom structure. Recent theoretical and empirical work suggest that an 8-factor model of PTSD with separate internally- (e.g. flashbacks) and externally- (e.g. trauma-cue related physiological reactivity) generated intrusive symptom clusters may advance understanding of PTSD and its treatment and course. However, the model's functional and clinical significance still requires evaluation. To this end, we analyzed data from the National Health and Resilience in Veterans Study, a nationally representative sample of 3847 trauma-exposed U.S. military veterans. Multivariable regressions were performed to assess the relationship between the 8 PTSD symptom clusters, assessed using the PTSD Checklist for DSM-5, and clinical and functional measures. Results revealed that externally-generated intrusions were associated with higher odds of current depression and anxiety and worse mental, cognitive, and psychosocial functioning. Anhedonia (e.g., loss of interest in enjoyable activities) symptoms were associated with all the correlates tested, while negative affect (e.g., having strong negative feelings such as fear) symptoms were associated with all measures except depression. Avoidance symptoms were associated with lower odds of current anxiety while externalizing behavior symptoms were linked to higher odds of suicidal ideation. Anxious arousal symptoms were associated with lower odds of suicidal ideation but higher odds of PTSD-related impairment/distress, while dysphoric arousal symptoms were associated with higher odds of current depression, PTSD-related impairment/distress and worse mental and cognitive functioning. Results suggest that a more nuanced 8-factor model of PTSD symptoms may help inform understanding of the clinical and functional correlates of this multi-faceted disorder.
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Affiliation(s)
- Brendan Stiltner
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - Ian C Fischer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Or Duek
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Epidemiology, Biostatistics and Community Health Sciences, School of Public Health, Ben-Gurion University of the Negev, Israel
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - Ilan Harpaz-Rotem
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA.
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Gifuni AJ, Spodenkiewicz M, Laurent G, MacNeil S, Jollant F, Renaud J. Symptoms characteristics of personality disorders associated with suicidal ideation and behaviors in a clinical sample of adolescents with a depressive disorder. Front Psychiatry 2023; 14:1269744. [PMID: 38146283 PMCID: PMC10749562 DOI: 10.3389/fpsyt.2023.1269744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 11/16/2023] [Indexed: 12/27/2023] Open
Abstract
Introduction Pathological personality traits have repeatedly been identified as important risk factors for suicidal ideation and behaviors. Moreover, impulsive-aggressive traits, have shown a consistent association with suicidal behaviors across the lifespan. Adolescence represents a critical period for the emergence of different personality traits, mood disorders, and suicidal behaviors, but the relationship between these variables remain poorly understood. Methods These variables were examined in a cross-sectional case-control design involving three groups: 30 adolescents with a depressive disorder and past suicide attempt (Mean Age = 16.2, Females = 26), 38 adolescents with a depressive disorder but without past suicide attempt (Mean age = 16.0, Females = 29), and 34 healthy adolescent controls (Mean age = 15.2, Females = 22). Suicidal ideations were indexed using Suicidal Behavior Questionnaire (SBQ-R), psychiatric disorder assessed using a semi-structured questionnaire (K-SADS-PL), depressive symptoms with the Beck Depressive Inventory (BDI), symptoms characteristics of personality disorders with the Scheduled Clinical Interview for the DSM-IV (SCID-II) screening questionnaire, and impulsivity with the Barratt Impulsivesness Scale (BIS). Results Findings showed that impulsivity (F = 11.0, p < 0.0001) and antisocial symptoms characteristics of personality disorders (p < 0.001, d = 0.70) displayed the most robust association with adolescent suicide attempts. Borderline symptoms characteristics of personality disorders did not discriminate attempters from non-attempters but presented high correlations with suicidal ideation and depression severity. In an item-wise analysis, suicide attempt status was uniquely correlated with symptoms characteristics of an antisocial personality disorder. Suicide attempt status also correlated with non-suicidal self-injury and a chronic feeling of emptiness. Discussion The caveats of this cross-sectional study include the stability of symptoms characteristics of personality disorders in adolescence and the limited sample size. In sum, suicidal behaviors were characteristically correlated with increased impulsivity and antisocial symptoms characteristics of personality disorders, but other symptoms characteristics of personality disorders were relevant to adolescent depression and suicidal ideation. Understanding the emergence of symptoms characteristics of personality disorders and suicidal behaviors in a developmental context can ultimately inform not only the neurobiological origin of suicidal behaviors, but also provide new avenues for early detection and intervention.
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Affiliation(s)
- Anthony Joseph Gifuni
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Michel Spodenkiewicz
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- INSERM UMR-1178, Moods Team, CESP, Le Kremlin-Bicêtre, France
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Geneviève Laurent
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Sasha MacNeil
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Fabrice Jollant
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Johanne Renaud
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- Division of Child Psychiatry, Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
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Zhang B, Dong L, Kong L, Liu M, Zhao Y, Hui M, Chu X. Prediction of Impulsive Aggression Based on Video Images. Bioengineering (Basel) 2023; 10:942. [PMID: 37627827 PMCID: PMC10451168 DOI: 10.3390/bioengineering10080942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
In response to the subjectivity, low accuracy, and high concealment of existing attack behavior prediction methods, a video-based impulsive aggression prediction method that integrates physiological parameters and facial expression information is proposed. This method uses imaging equipment to capture video and facial expression information containing the subject's face and uses imaging photoplethysmography (IPPG) technology to obtain the subject's heart rate variability parameters. Meanwhile, the ResNet-34 expression recognition model was constructed to obtain the subject's facial expression information. Based on the random forest classification model, the physiological parameters and facial expression information obtained are used to predict individual impulsive aggression. Finally, an impulsive aggression induction experiment was designed to verify the method. The experimental results show that the accuracy of this method for predicting the presence or absence of impulsive aggression was 89.39%. This method proves the feasibility of applying physiological parameters and facial expression information to predict impulsive aggression. This article has important theoretical and practical value for exploring new impulsive aggression prediction methods. It also has significance in safety monitoring in special and public places such as prisons and rehabilitation centers.
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Affiliation(s)
- Borui Zhang
- School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China
- Beijing Key Laboratory for Precision Optoelectronic Measurement Instrument and Technology, Beijing 100081, China
| | - Liquan Dong
- School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China
- Beijing Key Laboratory for Precision Optoelectronic Measurement Instrument and Technology, Beijing 100081, China
- Yangtze Delta Region Academy of Beijing Institute of Technology, Jiaxing 314019, China
| | - Lingqin Kong
- School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China
- Beijing Key Laboratory for Precision Optoelectronic Measurement Instrument and Technology, Beijing 100081, China
- Yangtze Delta Region Academy of Beijing Institute of Technology, Jiaxing 314019, China
| | - Ming Liu
- School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China
- Beijing Key Laboratory for Precision Optoelectronic Measurement Instrument and Technology, Beijing 100081, China
- Yangtze Delta Region Academy of Beijing Institute of Technology, Jiaxing 314019, China
| | - Yuejin Zhao
- School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China
- Beijing Key Laboratory for Precision Optoelectronic Measurement Instrument and Technology, Beijing 100081, China
- Yangtze Delta Region Academy of Beijing Institute of Technology, Jiaxing 314019, China
| | - Mei Hui
- School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China
- Beijing Key Laboratory for Precision Optoelectronic Measurement Instrument and Technology, Beijing 100081, China
| | - Xuhong Chu
- School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China
- Beijing Key Laboratory for Precision Optoelectronic Measurement Instrument and Technology, Beijing 100081, China
- Yangtze Delta Region Academy of Beijing Institute of Technology, Jiaxing 314019, China
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Hu CS, Zhang H, Short LA, Hu S. Individuals with higher suicide risk showed more anger and disgust during rest. DEATH STUDIES 2023; 48:9-15. [PMID: 36906516 DOI: 10.1080/07481187.2023.2186537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Previous research showed that suicide risk was associated with the anger trait and the facial expression of anger when advising on life dilemmas. We investigated if suicide risk was associated with the facial expression of anger during rest, a state when individuals often reflect upon their lives. Participants took a 1-min rest before being assessed for suicide risk. We measured 147 participants' frontal-view facial expressions during their rest 1475-3694 times using automated facial expression analysis technology. Participants' suicide risk was significantly positively correlated with their anger and disgust during the rest, which may be related to psychological pain and death-related thoughts among individuals with suicide risk. Therefore, rest for clinical patients should not be seen simply as a "rest" for the mind. Rather, for counselors, rest may open a window to look into patients' inner thoughts that may be important to their lives.
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Affiliation(s)
- Chao S Hu
- Department of Medical Humanities, School of Humanities, Southeast University, Nanjing, China
- Psychological Research & Education Center, School of Humanities, Southeast University, Nanjing, China
| | - Haotian Zhang
- Department of Psychology, School of Philosophy, Wuhan University, Wuhan, China
| | - Lindsey A Short
- Department of Psychology, Redeemer University, Ancaster, Canada
| | - Shuhua Hu
- Department of Psychology, Jinghengyi Education School, Hangzhou Normal University, Hangzhou, China
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Alberdi-Páramo Í, Díaz-Marsá M, Saiz González MD, Carrasco Perera JL. Antisocial traits and neuroticism as predictors of suicidal behaviour in borderline personality disorder: A retrospective study. REVISTA COLOMBIANA DE PSIQUIATRÍA (ENGLISH ED.) 2023; 52:11-19. [PMID: 36997367 DOI: 10.1016/j.rcpeng.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/02/2021] [Indexed: 03/30/2023]
Abstract
INTRODUCTION The spectrum of suicidal behaviour (SB) is nuclear in the clinic and management of borderline personality disorder (BPD). The pathological personality traits of BPD intervene as risk factors for SB in confluence with other clinical and sociodemographic variables associated with BPD. The objective of this work is to evaluate the specific personality traits of BPD that are related to SB. METHODS A cross-sectional, observational and retrospective study was carried out on a sample of 134 patients diagnosed with BPD according to DSM-5 criteria. The Millon-II, Zuckerman-Kuhlman and Barrat questionnaires were used to assess different personality parameters. Variable comparisons were made using the χ2 test and the Student's t-test. The association between variables was analysed using multivariate logistic regression. RESULTS Statistically significant differences were observed between SB and related factors and the neuroticism-anxiety dimension in the Zuckerman-Kuhlman test. It is also significantly related to the phobic and antisocial subscale of the Millon-II. Impulsivity measured with the Zuckerman-Kuhlman and Barrat tests does not appear to be related to SB. CONCLUSIONS The results presented raise the role of phobic, antisocial and neuroticism traits as possible personality traits of BPD related to SB, suggesting an even greater importance within the relationship between BPD and SB than that of impulsivity. Looking to the future, longitudinal studies would increase the scientific evidence for the specified findings.
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Yarar EZ, Bulut BP, Demirbaş H. Does Gender Really Matter: Childhood Trauma, Trait Anger, and Suicide Risk in Early Adulthood. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1222-NP1238. [PMID: 35435769 DOI: 10.1177/08862605221087704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background: Previous studies have reported mixed findings regarding gender differences in suicidal behavior. This discrepancy may be partly attributable to common predictors of suicide risk, such as childhood trauma and anger, and may also be independent of gender. Objectives: The present study investigated gender differences in the impact of childhood trauma and current trait anger on suicide risk, in a group of young Turkish adults. We hypothesized that trait anger would mediate the association between childhood trauma and suicide risk, independently of gender. Participants and Setting: Participants were 589 university students (84.3% women) aged 18-34 years (M = 21.43, SD = 1.82). Methods: Gender group differences in suicide risk, history of childhood trauma, and trait anger as well as possible covariates (i.e., self-rated socio-economic status and academic performance) were assessed. Possible predictors of suicide risk in gender groups were examined. The role of trait anger as a mediator of the relationship between childhood trauma and suicide risk was also examined. Results: Results showed that men reported a higher suicide risk, history of childhood trauma, and trait anger than women. Early childhood trauma and current trait anger scores were significant predictors of suicide risk in both gender groups. Trait anger significantly mediated the relationship between early trauma history and risk for suicide, independently of gender. Conclusions: Study findings support early reports of the effects of childhood trauma and trait anger on suicide risk. It was suggested that preventive interventions for suicidal behavior and monitoring risk groups with aggressive tendencies and childhood trauma history may be important.
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Affiliation(s)
- Esra Zıvralı Yarar
- Department of Psychology, 390121Social Sciences University of Ankara, Ankara, Turkey
| | - Burcu Pınar Bulut
- Department of Psychology, 523228Ankara Hacı Bayram Veli University, Ankara, Turkey
| | - Hatice Demirbaş
- Department of Psychology, 523228Ankara Hacı Bayram Veli University, Ankara, Turkey
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Clinical correlates and prognostic impact of binge-eating symptoms in major depressive disorder. Int Clin Psychopharmacol 2022; 37:247-254. [PMID: 35815954 PMCID: PMC9521583 DOI: 10.1097/yic.0000000000000422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Binge-eating (BE) symptoms are relatively common in major depressive disorder (MDD), but their prognostic role is not fully understood. This study compared two groups of patients with MDD experiencing or not BE symptoms to ascertain differences in terms of clinical manifestations, presence of bipolar features, and antidepressant treatment outcomes. The study involved 482 outpatients collected within the Combining Medications to Enhance Depression Outcomes (CO-MED) trial, who were assessed with scales for depressive and hypomanic symptomatology, suicidality, comorbid mental disorders, and childhood traumas. BE symptoms were reported in 95 patients (20%). Patients with MDD experiencing BE symptoms were characterized by higher scores of negative self-outlook ( P = 0.0018), negative outlook of future ( P = 0.0014), irritability ( P = 0.0043), comorbid anxiety disorders (generalized anxiety disorder: P = 0.0006; panic disorder: P < 0.0001; social phobia: P < 0.0001), obsessive-compulsive disorder ( P = 0.0053), hypomanic symptoms (increased talkativeness: P = 0.0029; reduced need for sleep: P = 0.0171), and suicidality (suicidal propensity: P = 0.0013; suicidal risk: P = 0.0148; lifetime suicidal behavior: P = 0.0052). BE symptoms (OR = 2.02; 95% CI = 1.06-3.84) and depression severity (OR = 1.04; 95% CI = 1.00-1.08) were independently associated with lifetime attempted suicide. The presence of BE symptoms might indicate higher severity of depressive disorder. Suicidal risk is a major issue in these patients, whereas the association between BE and bipolar features needs further research.
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Okuyama A, Yoo S, Managi S. Children mirror adults for the worse: evidence of suicide rates due to air pollution and unemployment. BMC Public Health 2022; 22:1614. [PMID: 36008764 PMCID: PMC9403225 DOI: 10.1186/s12889-022-14013-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Every year, more than 700,000 people die due to suicide, one of the most common reasons for youth death. While many studies have revealed two main factors for suicidal behavior: impulsive suicidal behavior due to mental illness and financial stress, it is not clear what happens if individuals face deterioration of mental health and economic recession. This paper attempts to answer this question and how suicide rates are correlated with these factors. Methods We empirically investigate whether economic recessions and air pollution trigger suicides by examining Japan, a country with one of the highest suicide rates, from 2014 to 2021. We take advantage of the characteristics of the COVID-19 pandemic and the periods before the pandemic, when both economic recessions and reductions in air pollution occurred simultaneously. Using monthly and municipal- level data, we construct a triple difference model that takes air pollution and unemployment as treatments. Results Our findings show that high (upper half of each period) levels of air pollution and unemployment have substantial impacts on the suicide rates of adults (22.9% in the short term) and children (42.7% in the short term, 36.0% in the long term), indicating that the increase in suicide rates among children is almost twice as high as that among adults. Our study finds that unemployment and air pollution alone are not associated with increased suicide rates but their simultaneous occurrence triggers suicides during the pandemic. Conclusions Our study urges suicide prevention, particularly among children, as an essential consideration for public health. Furthermore, our results indicate the need for the government to allocate resources to recover air quality and the economy simultaneously during a recession to reduce suicide mortality of both child and adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14013-y.
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Affiliation(s)
- Akihiro Okuyama
- Urban Institute, School of Engineering, Kyushu University, Fukuoka, Japan
| | - Sunbin Yoo
- Urban Institute, School of Engineering, Kyushu University, Fukuoka, Japan.
| | - Shunsuke Managi
- Urban Institute, School of Engineering, Kyushu University, Fukuoka, Japan
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Patel TA, Dillon KH, Cassiello-Robbins C, Calhoun PS, Beckham JC, Kimbrel NA. Anger, impulsivity and wall/object punching in a sample of U.S. veterans with psychiatric disorders. J Psychiatr Res 2022; 147:269-273. [PMID: 35074743 PMCID: PMC8882153 DOI: 10.1016/j.jpsychires.2022.01.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 12/16/2021] [Accepted: 01/13/2022] [Indexed: 11/17/2022]
Abstract
Nonsuicidal self-injury (NSSI) has been identified as one of the strongest predictors of suicide attempts. Wall/object punching is a particularly prevalent form of NSSI among male veterans that has been linked to both impulsivity and anger. The objective of the present study was to examine the indirect effect of impulsivity on wall/object punching via anger. Participants included 124 veterans (32 identified as women, 92 identified as men) with at least one psychiatric disorder. A third of the sample met criteria for NSSI disorder (33.1%) with nearly a half of the remaining sample endorsing NSSI. Almost half (41.94%) of the sample endorsed wall/object punching. Consistent with our hypothesis, impulsivity was significantly associated with anger, which was, in turn, significantly associated with wall/object punching. Impulsivity was found to be indirectly related to wall/object punching via anger. These findings underscore the significance of assessing and treating anger among veterans engaging in wall/object punching. Improving our knowledge of anger and impulsivity and their relationship with this particularly prevalent form of NSSI among veterans may lead to a better understanding of suicide risk among veterans and inform future treatments.
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Affiliation(s)
- Tapan A Patel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Kirsten H Dillon
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.
| | - Clair Cassiello-Robbins
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Patrick S Calhoun
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Jean C Beckham
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Nathan A Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
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13
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Hu CS, Huang J, Huang C, Munroe M, Xie D, Li M. Expressions of anger during advising on life dilemmas predict suicide risk among college students. Psych J 2022; 11:370-375. [PMID: 35193167 DOI: 10.1002/pchj.529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/27/2021] [Accepted: 01/17/2022] [Indexed: 11/09/2022]
Abstract
Research has demonstrated a relationship between anger and suicidality, while real-time authentic emotions behind facial expressions could be detected during advising hypothetical protagonists in life dilemmas. This study aimed to investigate the predictive validity of anger expressions during advising for suicide risk. Besides advising on life dilemmas (a friend's betrayal, a friend's suicide attempt), 130 adults completed the suicidal scale of the Mini-International Neuropsychiatric Interview. Participants' anger during advice-giving was measured 29 times/s by artificial intelligence (AI)-based software FaceReader 7.1. The results showed that anger was a significant predictor of suicide risk. Increased anger during advising was associated with higher suicide risk. In contrast, there was no significant correlation between suicide risk and duration or length of advising. Therefore, measuring micro expressions of anger with AI-based software may help detect suicide risk among clinical patients in both traditional and online counseling contexts and help prevent suicide.
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Affiliation(s)
- Chao S Hu
- School of Humanities, Southeast University, Nanjing, China.,Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Art Therapy Psychological Research Centre, Hangzhou Normal University, Hangzhou, China
| | - Jinhao Huang
- Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Art Therapy Psychological Research Centre, Hangzhou Normal University, Hangzhou, China.,Department of Social Security, School of Public Affairs, Zhejiang University, Hangzhou, China
| | - Chengli Huang
- Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Art Therapy Psychological Research Centre, Hangzhou Normal University, Hangzhou, China.,School of Psychology, University of Southampton, Southampton, UK
| | - Melanie Munroe
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Dong Xie
- Department of Psychology and Counseling, University of Central Arkansas, Conway, Arkansas, USA
| | - Mei Li
- Mental Health Education and Counseling Center, Hangzhou Normal University, Hangzhou, China
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14
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Serretti A, De Ronchi D, Olgiati P. Irritable Mood and Subthreshold Hypomanic Episodes Correlate with More Severe Major Depression. Neuropsychobiology 2022; 80:425-436. [PMID: 33601366 DOI: 10.1159/000514127] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 12/29/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Irritable mood (IM) and subthreshold hypomanic symptoms are reported in half and two-fifths of major depressed subjects respectively, but their clinical and prognostic meanings remain unclear. The aim of this study was to test the clinical usefulness of 2 specifiers in DSM-IV major depressive disorder (MDD): IM occurring during an index episode (IM+) and lifetime episodes of elated mood or IM with at least 2 concurrent hypomanic symptoms (subthreshold hypomanic episodes [SHEs]). METHOD We included 482 outpatients with MDD participating in the Combining Medications to Enhance Depression Outcome study (mean age 43.14 ± 12.46 years, 144 males - 30%). The main aim of the original study was to test whether 2 different medications when given in combination as the first treatment step, compared to 1 medication, would improve antidepressant response. RESULTS IM + subjects (N = 349; 70%) were younger and more often females, with a more severe depression, a more marked social impairment, and more psychiatric comorbidities. The IM + group was also characterized by higher levels of suicidal ideation and more cases of emotional abuse. The combination of IM+ and SHEs was associated with an even more severe clinical picture. Limitations include the post hoc method, incomplete assessment of bipolar validators (e.g., family history of bipolar illness), personality disorders and suicide attempts. CONCLUSIONS The presence of IM and SHEs in MDD correlate with an overall more severe clinical condition.
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Affiliation(s)
- Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy,
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Paolo Olgiati
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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15
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Coci C, Invernizzi R, Capone L, Casini E, Orlandi M, Galli P, Rossi I, Martinelli O, Borgatti R, Mensi MM. Psychological and behavioral characterization of suicide ideators and suicide attempters in adolescence. Front Psychiatry 2022; 13:1009460. [PMID: 36299537 PMCID: PMC9589341 DOI: 10.3389/fpsyt.2022.1009460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Suicide is a global cause of death, a chronic disability, and a significant public health problem. Recent works emphasize the importance of differentiating people with suicide ideation (SI) and people with suicidal attempts (SA), so we conducted a clinical cross-sectional study to better characterize the features most associated with SA. We enrolled 88 adolescents (77 females) from 12 to 18 years of age (M = 15.21, SD = 1.63) admitted to Northern Italian Child Neurology and Psychiatry Service who presented SI and/or SA. We conducted an assessment using the Columbia-Suicide Severity Rating Scale, and divided participants into two groups: adolescents with SA, and adolescents with thoughts about killing themselves which may include a plan but no suicidal attempts (SI). We found that the SA group showed greater severity of SI [t (86) = -3.485, p < 0.001], higher levels of subjective depression [t (70) = -2.65, p = 0.01)], and a higher prevalence of personality disorders [ χ ( 3 ) 2 = 8.775, p = 0.032] than the SI group. Both groups presented a prevalence of internalizing problems compared to the externalizing ones in the Youth Self-Report (YSR). Higher scores on YSR internalizing problems correlate positively with the "Repulsion by Life" subscale of the Multi-Attitude Suicide Tendency (MAST) Scale in both SA and SI groups (p = 0.41 and p = 0.67, respectively), while low levels of the MAST "Attraction to Life" subscale appear more often in the SA one (p = -0.71). In conclusion, results showed that some features (e.g., prevalence of personality disorders, SI intensity, and subjective depression) might help clinicians distinguish between patients with SI and those with SA and support the importance of carefully pursuing this distinction in research.
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Affiliation(s)
- Chiara Coci
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Roberta Invernizzi
- Child Neurology and Psychiatry Unit, ASST Lecco, Lecco, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Luca Capone
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Erica Casini
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Marika Orlandi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Paola Galli
- Child Neurology and Psychiatry Unit, ASST Lecco, Lecco, Italy
| | - Ilaria Rossi
- Child Neurology and Psychiatry Unit, ASST Lecco, Lecco, Italy
| | | | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Martina Maria Mensi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
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16
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Okado I, Floyd FJ, Goebert D, Sugimoto-Matsuda J, Hayashi K. Applying ideation-to-action theories to predict suicidal behavior among adolescents. J Affect Disord 2021; 295:1292-1300. [PMID: 34706443 DOI: 10.1016/j.jad.2021.08.137] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/31/2021] [Accepted: 08/27/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although many risk factors for adolescent suicidal behavior have been identified, less is known about distinct risk factors associated with the progression from suicide ideation to attempts. Based on theories grounded in the ideation-to-action framework, we used structural equation modeling to examine risk and protective factors associated with the escalation from suicide ideation to attempts in adolescents. METHODS In this cross-sectional study, data from the 2013 and 2015 Hawaii High School Youth Risk Behavior Surveys (N = 8,113) were analyzed. The sample was 54.0% female and racially/ethnically diverse. Risk factors included depression, victimization, self-harm, violent behavior, disinhibition, and hard substance use, and protective factors included adult support, sports participation, academic achievement and school safety. RESULTS One in 6 adolescents (16.4%) reported suicide ideation, and nearly 1 in 10 (9.8%) adolescents had made a suicide attempt. Overall, disinhibition predicted the escalation to attempts among adolescents with suicide ideation, and higher academic performance was associated with lower suicide attempt risk. Depression and victimization were associated with suicide ideation. LIMITATIONS This study examined data from the Youth Risk Behavior Survey, and other known risk factors such as anxiety and family history of suicide were not available in these data. CONCLUSIONS Findings provide guidance for targets for clinical interventions focused on suicide prevention. Programs that incorporate behavioral disinhibition may have the greatest potential for reducing suicide attempt risk in adolescents with suicidal thoughts.
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Affiliation(s)
- Izumi Okado
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States.
| | - Frank J Floyd
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
| | - Deborah Goebert
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
| | - Jeanelle Sugimoto-Matsuda
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
| | - Kentaro Hayashi
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
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17
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Hong JS, Zhang S, Burlaka V, Yoshihama M, Yan Y, Voisin DR. From Exposure to Violence between Mother and Her Intimate Partner to Suicidality Experienced by Urban Adolescents in Chicago's Southside. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157870. [PMID: 34360163 PMCID: PMC8345526 DOI: 10.3390/ijerph18157870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/11/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022]
Abstract
Although the relationship between exposure to intimate partner violence and youths’ psychological and other wellbeing has been widely studied, there is limited research about how youths’ exposure to violence between mother and her intimate partner may be related to youth psychological wellbeing. The study used a sample of urban adolescents in Chicago Southbound to examine whether youths’ exposure to verbal conflict between mother and her intimate partner is related to their suicidality and whether youth depression and aggression may be in between such a linkage. Our findings indicated that one-third of the youth had suicidal thoughts or suicidal/self-hurting attempts. Youths’ exposure to verbal conflict between mother and her intimate partner was associated with their depressive and aggressive symptoms, and depressive symptoms subsequently were linked to suicidality. The findings also showed that youth depressive symptoms and aggressive symptoms were positively correlated, which may influence their associations with suicidality. We concluded that youth exposure to parental intimate partner violence, even comparatively mild forms such as a verbal conflict between mother and her intimate partner, may increase their risk of suicidality by worsening psychological wellbeing. The findings highlight the importance of tackling youth suicidality risks while accounting for their exposure to intimate partner violence including verbal conflicts between parents.
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Affiliation(s)
- Jun Sung Hong
- School of Social Work, Wayne State University, Detroit, MI 48202, USA;
- Correspondence: ; Tel.: +1-313-577-9367
| | - Saijun Zhang
- Department of Social Work, University of Mississippi, Oxford, MS 38677, USA;
| | - Viktor Burlaka
- School of Social Work, Wayne State University, Detroit, MI 48202, USA;
| | - Mieko Yoshihama
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Yueqi Yan
- Biostatistics and Data Support, University of California Merced, Merced, CA 95344, USA;
| | - Dexter R. Voisin
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada;
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18
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Martin RL, Smith NS, McGrew SJ, Capron DW. Aggressive Worriers: How Aggression Moderates the Association between Intolerance of Uncertainty and Suicidal Desire Constructs. Arch Suicide Res 2021; 25:353-372. [PMID: 31749417 DOI: 10.1080/13811118.2019.1689877] [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: 01/27/2023]
Abstract
Suicide is a public health concern and has been the tenth leading cause of death in the United States since 2008. The Interpersonal-Psychological Theory of Suicidal Behavior is an empirically supported model of suicide. The theory posits that thwarted belongingness and perceived burdensomeness examine the individual's perceived connectedness to others around them and together create suicidal desire. Anxiety is another widespread public health concern, associated with suicidal ideation and suicide attempts above and beyond the effects of socio-demographic factors and other mental disorders. A key factor in anxiety disorders is intolerance of uncertainty, or the individual's tendency to perceive ambiguous situations and events as being aversive to emotional and behavioral well-being. Additionally, different facets of aggression have been associated with both intolerance of uncertainty and suicidal desire. The current study sought to examine how facets of aggression moderated the associations between intolerance of uncertainty (both prospective and inhibitory) and thwarted belongingness/perceived burdensomeness. Participants were 440 adults recruited online. The hypotheses of aggression facets moderating the association between intolerance of uncertainty and perceived burdensomeness were largely supported with statistical significance for six out of eight models. Similarly, the hypotheses of aggression facets moderating thwarted belongingness were largely supported with significant moderations for seven out of eight models. The results were upheld when using Benjamini-Hochberg test of significance to account for Type I error. Overall, results indicate that aggressive facets can amplify the associations between intolerance of uncertainty and thwarted belongingness/perceived burdensomeness; however, results differed based on the intolerance of uncertainty dimensions.
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19
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Uğur K, Demirkol ME, Tamam L. The Mediating Roles of Psychological Pain and Dream Anxiety in the Relationship between Sleep Disturbance and Suicide. Arch Suicide Res 2021; 25:512-528. [PMID: 32191162 DOI: 10.1080/13811118.2020.1740124] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
ABSRTACTSuicide is a significant public health problem worldwide, and sleep disturbances have negative effects on mental health and suicidality. Several psychological concepts may mediate the relationship between sleep disturbances and suicide. We aimed to investigate the mediating roles of psychological pain and dream anxiety in this relationship. This cross-sectional study included 150 depressive patients with or without recent suicide attempts and 91 healthy controls. The Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Psychache Scale (PS), and Van Dream Anxiety Scale (VDAS) were used to assess sleep quality, depression severity, psychological pain, and dream anxiety, respectively. Depression group's mean depression, dream anxiety, psychache, and median sleep quality scores were higher than those of the control group. The ROC analyses indicated no relationship between the violence status of the suicides and the mean dream anxiety, sleep quality or psychache scores. Multivariate regression analysis demonstrated that only the depression score predicted suicide attempts. Mediation analyses revealed that both psychache and dream anxiety have full mediator roles in the relationship between sleep disturbance and suicide attempts. Psychotherapeutic approaches to relieve dream anxiety and psychache may help prevent suicide attempts of at-risk individuals.
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20
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Denollet J, Trompetter HR, Kupper N. A review and conceptual model of the association of Type D personality with suicide risk. J Psychiatr Res 2021; 138:291-300. [PMID: 33882425 DOI: 10.1016/j.jpsychires.2021.03.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 12/31/2022]
Abstract
The role of personality as distal risk factor for suicidal thoughts and behavior is still unclear. This review aims to propose two conceptual models that explain the psychological plausibility of Type D personality as distal risk factor and contributor to the transition from general to suicide distress. To support this aim, we performed a systematic review of existing studies on the association between Type D personality and suicidal distress. A systematic search yielded eight studies that reported on Type D personality and suicidal distress. Type D personality was robustly associated with suicidal thoughts and behaviors, across populations and countries. Type D was related to the level/frequency of suicidal ideation in seven studies, and suicide attempt in two studies. Our first theoretical model identifies intra-psychic (depression, alcohol misuse, posttraumatic stress) and interpersonal (low belonging, social isolation, lack of support) vulnerabilities of individuals with Type D that may fuel the development of suicidal thoughts and behaviors. Type D by itself will not account for why people become suicidal, but our second theoretical model suggests that the avoidant-passive tendencies of Type D individuals may result in persistent problem-solving deficits, and, eventually, feelings of entrapment that may contribute to the desire to escape from pain. We conclude that empirical evidence supports the hypothesized link between Type D personality, and suicidal thoughts and behaviors. Our conceptual models - albeit often supported by indirect evidence - further substantiate the plausibility of this link, and offer concrete guidance for future studies. Primarily, more longitudinal research is necessary.
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Affiliation(s)
- Johan Denollet
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, the Netherlands
| | - Hester R Trompetter
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, the Netherlands.
| | - Nina Kupper
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, the Netherlands
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21
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De Rozario MR, Van Velzen LS, Davies P, Rice SM, Davey CG, Robinson J, Alvarez-Jimenez M, Allott K, McKechnie B, Felmingham KL, Schmaal L. Mental images of suicide: Theoretical framework and preliminary findings in depressed youth attending outpatient care. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 4:100114. [PMID: 36567757 PMCID: PMC9785063 DOI: 10.1016/j.jadr.2021.100114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- MR De Rozario
- Orygen, Parkville, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia,Corresponding author at: Centre for Youth Mental Health, University of Melbourne, 35 Poplar Rd, Parkville, Melbourne, VIC 3052, Australia. (M. De Rozario)
| | - LS Van Velzen
- Orygen, Parkville, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - P Davies
- Orygen, Parkville, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - SM Rice
- Orygen, Parkville, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - CG Davey
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - J Robinson
- Orygen, Parkville, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - M Alvarez-Jimenez
- Orygen, Parkville, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - K Allott
- Orygen, Parkville, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | | | - KL Felmingham
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - L Schmaal
- Orygen, Parkville, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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22
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Pan CH, Lee MB, Wu CY, Liao SC, Chan CT, Chen CY. Suicidal ideation, psychopathology, and help-seeking in 15 to 19-year-old adolescents in Taiwan: A population-based study 2015-2019. J Affect Disord 2021; 282:846-851. [PMID: 33601727 DOI: 10.1016/j.jad.2020.12.139] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/29/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Suicide in the young population has been an urgent issue worldwide. The study aimed to assess the overall prevalence of suicide ideation and the associations between adolescent suicide and psychiatric distress/ psychiatric morbidity, as well as the myths and help-seeking behavior of adolescents with suicide ideation. METHOD The nationwide community-based telephone interviews were conducted with adolescents aged between 15 to 19 for five consecutive years (2015-2019). The measurements included demographic variables, the five-item Brief Symptom Rating Scale (BSRS-5), and help-seeking experiences of formal medical services or psychological consultations. Stepwise multiple regression analysis was performed to examine which of the five symptoms and demographic variables had discriminative validity for suicidal ideation. RESULTS Among 727 participants, the prevalence of lifetime and one-week suicidal ideation was 11.4% and 2.8%, respectively. Adolescents with lifetime/ one-week suicidal ideation and with psychiatric morbidity (BSRS-5≥6) sought psychiatric service more than their counterparts (p<0.001). Female, depression, hostility, and anxiety were significantly associated with suicidal ideation in adolescents. LIMITATIONS Telephone interview and structured questionnaire. CONCLUSION Adolescents with psychiatric morbidity who have sought help should be carefully monitored for suicidal ideation by parents, teachers, mental health workers, and psychiatric specialists altogether.
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Affiliation(s)
- Chia-Ho Pan
- Department of Psychiatry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Ming-Been Lee
- Department of Psychiatry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Taiwan Suicide Prevention Center, Department of Welfare and Health, Executive Yuan, Taipei, Taiwan
| | - Chia-Yi Wu
- Taiwan Suicide Prevention Center, Department of Welfare and Health, Executive Yuan, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan; School of Nursing, National Taiwan University College of Medicine, Taiwan.
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Taiwan Suicide Prevention Center, Department of Welfare and Health, Executive Yuan, Taipei, Taiwan
| | - Chia-Ta Chan
- Department of Psychiatry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Taiwan Suicide Prevention Center, Department of Welfare and Health, Executive Yuan, Taipei, Taiwan
| | - Chun-Yin Chen
- Taiwan Suicide Prevention Center, Department of Welfare and Health, Executive Yuan, Taipei, Taiwan
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23
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Lübbert M, Bahlmann L, Josfeld S, Bürger J, Schulz A, Bär KJ, Polzer U, Walter M, Kastner UW, Sobanski T, Wagner G. Identifying Distinguishable Clinical Profiles Between Single Suicide Attempters and Re-Attempters. Front Psychiatry 2021; 12:754402. [PMID: 34646179 PMCID: PMC8503539 DOI: 10.3389/fpsyt.2021.754402] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 08/31/2021] [Indexed: 11/26/2022] Open
Abstract
More than 800,000 individuals die from suicide each year in the world, which has a devastating impact on families and society. Ten to twenty times more attempt suicide. Previous studies showed that suicide attempters represent a heterogeneous group regarding demographic characteristics, individual characteristics of a suicidal attempt, and the assumed clinical factors, e.g., hopelessness or impulsivity, thus differently contributing to the likelihood of suicidal behavior. Therefore, in the present study, we aim to give a comprehensive clinical description of patients with repeated suicide attempts compared to single attempters. We explored putative differences between groups in clinical variables and personality traits, sociodemographic information, and specific suicide attempt-related information. A sample of patients with a recent suicide attempt (n = 252), defined according to DSM-5 criteria for a suicidal behavior disorder (SBD), was recruited in four psychiatric hospitals in Thuringia, Germany. We used a structured clinical interview to assess the psychiatric diagnosis, sociodemographic data, and to collect information regarding the characteristics of the suicide attempt. Several clinical questionnaires were used to measure the suicide intent and suicidal ideations, depression severity, hopelessness, impulsivity, aggression, anger expression, and the presence of childhood trauma. Univariate and multivariate statistical methods were applied to evaluate the postulated risk factors and, to distinguish groups based on these measures. The performed statistical analyses indicated that suicide attempters represent a relatively heterogeneous group, nevertheless associated with specific clinical profiles. We demonstrated that the re-attempters had more severe psychopathology with significantly higher levels of self-reported depression, suicidal ideation as well as hopelessness. Furthermore, re-attempters had more often first-degree relatives with suicidal behavior and emotional abuse during childhood. They also exhibited a higher degree of specific personality traits, i.e., more "urgency" as a reaction to negative emotions, higher excitability, higher self-aggressiveness, and trait anger. The multivariate discriminant analysis significantly discriminated the re-attempters from single attempters by higher levels of self-aggressiveness and suicidal ideation. The findings might contribute to a better understanding of the complex mechanisms leading to suicidal behavior, which might improve the early identification and specific treatment of subjects at risk for repeated suicidal behavior.
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Affiliation(s)
- Marlehn Lübbert
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Lydia Bahlmann
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Sebastian Josfeld
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Jessica Bürger
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Alexandra Schulz
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Thüringen-Kliniken Georgius Agricola GmbH, Saalfeld, Germany
| | - Karl-Jürgen Bär
- Department of Gerontopsychiatry and Psychosomatics, Jena University Hospital, Jena, Germany
| | - Udo Polzer
- Clinics for Psychiatry, Psychotherapy and Addition Disorders, Asklepios Fachklinikum Stadtroda, Stadtroda, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Ulrich W Kastner
- Department of Psychiatry and Psychotherapy, Helios Fachkliniken Hildburghausen, Hildburghausen, Germany
| | - Thomas Sobanski
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Thüringen-Kliniken Georgius Agricola GmbH, Saalfeld, Germany
| | - Gerd Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
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Martin RL, Bauer BW, Smith NS, Daruwala SE, Green BA, Anestis MD, Capron DW. Internal Battles: Examining How Anger/Hostility Moderate the Association Between Negative Urgency and Suicidal Desire Variables in Military and Civilian Samples. Suicide Life Threat Behav 2020; 50:805-822. [PMID: 32026518 DOI: 10.1111/sltb.12616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 01/07/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Suicide is consistently within the top ten leading causes of death in the United States. The suicide rate of National Guard personnel is elevated relative to the general population; however, research suggests that many of the suicide risk factors for military personnel are similar to the suicide risk factors for civilians. We examined whether negative urgency moderated the relationships between anger/hostility and perceived burdensomeness/thwarted belongingness in both a military and civilian samples. METHOD There were two samples in the current study: (1) military personnel (majority national guard) and (2) community members oversampled for suicide attempt history. RESULTS Our hypotheses were partially supported with the interaction of hostility and negative urgency predicting perceived burdensomeness in the military sample. Within civilians, anger interacted with negative urgency to predict perceived burdensomeness. There were nonsignificant findings for analyses predicting thwarted belongingness. Exploratory analyses indicated that in both samples, anger and hostility interacted with negative urgency to predict suicidal ideation. CONCLUSIONS Results suggest that aggressive attributes may contribute to individuals feeling as though they are a burden on others when moderate to high levels of negative urgency are present. Additionally, this study provides foundational support for the differences between suicidal desire and ideation.
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Affiliation(s)
- Rachel L Martin
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Brian W Bauer
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Nicole S Smith
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Samantha E Daruwala
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Bradley A Green
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Michael D Anestis
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Daniel W Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
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Hausman C, Meffert BN, Mosich MK, Heinz AJ. Impulsivity and Cognitive Flexibility as Neuropsychological Markers for Suicidality: A Multi-Modal Investigation Among Military Veterans with Alcohol Use Disorder and PTSD. Arch Suicide Res 2020; 24:313-326. [PMID: 31248349 PMCID: PMC6954988 DOI: 10.1080/13811118.2019.1635930] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
To examine relations between self-report and behavioral measures of impulsivity and cognitive flexibility with suicidal ideation and self-harm and suicide attempt history. Methods: Eighty-seven military veterans who met DSM-5 diagnostic criteria for alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) were evaluated for current suicidal ideation and self-harm, suicide attempt history, impulsivity, and cognitive flexibility. Results: Higher levels of self-reported impulsivity were associated with greater suicidal ideation and self-harm and lower behavioral inhibition was associated with greater likelihood of endorsing a suicide attempt. Conclusion: Use of multi-modal assessment of impulsivity and cognitive flexibility may aid in suicide screening and intervention among vulnerable and high-risk populations.
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Subramanian K, Menon V, Sarkar S, Chandrasekaran V, Selvakumar N. Study of Risk Factors Associated with Suicide Attempt in Patients with Bipolar Disorder Type I. J Neurosci Rural Pract 2020; 11:291-298. [PMID: 32367986 PMCID: PMC7195972 DOI: 10.1055/s-0040-1709347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background
Suicide is the leading contributor to mortality in bipolar disorder (BD). A history of suicidal attempt is a robust predictive marker for future suicide attempts. Personality profiles and coping strategies are the areas of contemporary research in bipolar suicides apart from clinical and demographic risk factors. However, similar research in developing countries is rarer.
Objectives
The present study aimed to identify the risk factors associated with suicidal attempts in BD type I (BD-I).
Materials and Methods
Patients with BD-I currently in clinical remission (
N
= 102) were recruited. Sociodemographic details and the clinical data were collected using a semistructured pro forma. The psychiatric diagnoses were confirmed using the Mini-International Neuropsychiatric Interview 5.0. The National Institute of Mental Health–Life Chart Methodology Clinician Retrospective Chart was used to chart the illness course. Presumptive Stressful Life Events Scale, Coping Strategies Inventory Short Form, Buss–Perry aggression questionnaire, Past Feelings and Acts of Violence, and Barratt Impulsivity scale were used to assess the patient’s stress scores, coping skills, aggression, violence, and impulsivity, respectively.
Statistical Analysis
Descriptive statistics were used for demographic details and characteristics of the illness course. Binary logistic regression analyses were performed to identify the predictors for lifetime suicide attempt in BD-I.
Results
A total of 102 patients (males = 49 and females = 53) with BD-I were included. Thirty-seven subjects (36.3%) had a history of suicide attempt. The illness course in suicide attempters more frequently had an index episode of depression, was encumbered with frequent mood episodes, especially in depression, and had a higher propensity for psychiatric comorbidities. On binary logistic regression analysis, the odds ratios (ORs) for predicting a suicide attempt were highest for positive family history of suicide (OR: 13.65, 95% confidence interval [CI]: 1.28–145.38,
p
= 0.030), followed by the presence of an index depressive episode (OR: 6.88, 95% CI: 1.70–27.91,
p
= 0.007), and lower scores on problem-focused disengagement (OR: 0.72, 95% CI: 0.56–0.92,
p
= 0.009).
Conclusion
BD-I patients with lifetime suicide attempt differ from non-attempters on various course-related and temperamental factors. However, an index episode depression, family history of suicide, and lower problem-focused engagement can predict lifetime suicide attempt in patients with BD-I.
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Affiliation(s)
- Karthick Subramanian
- Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed-to-be University), Puducherry, India
| | - Vikas Menon
- Department of Psychiatry, JIPMER, Puducherry, India
| | - Siddharth Sarkar
- Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India
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Dir AL, Allebach CL, Hummer TA, Adams ZW, Aalsma MC, Finn PR, Nurnberger JI, Hulvershorn LA. Atypical Cortical Activation During Risky Decision Making in Disruptive Behavior Disordered Youths With Histories of Suicidal Ideation. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:510-519. [PMID: 32007432 PMCID: PMC10568982 DOI: 10.1016/j.bpsc.2019.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/31/2019] [Accepted: 10/31/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Suicidality is a leading cause of death among adolescents. In addition to other psychiatric conditions, youths with attention-deficit/hyperactivity disorder (ADHD) and disruptive behavior disorders (DBDs) are at heightened risk for suicide. Decision-making deficits are a hallmark symptom of ADHD and DBDs and are also implicated in suicidal behavior. We examined behavioral and neural differences in decision making among youths with ADHD and DBDs with (SI+) and without (SI-) histories of suicidal ideation. METHODS The Balloon Analog Risk Task, a risky decision-making task, was completed by 57 youths with ADHD and DBDs (38% SI+) during functional magnetic resonance imaging. Mean stop wager (mean wager at which youths bank money) was the primary measure of risk taking. We conducted whole-brain and region-of-interest analyses in the anterior cingulate cortex and orbitofrontal cortex (OFC) during choice (win vs. inflate) and outcome (inflate vs. explode) contrasts using parametric modulators accounting for probability of balloon explosion. RESULTS There were no differences between SI+ and SI- youths in Balloon Analog Risk Task performance. SI+ youths showed decreasing activation in the right medial frontal gyrus when choosing inflate as explosion probability increased compared with SI- youths. During explosions, SI- youths showed increasing activation in the left OFC as explosions became more likely. SI+ showed increasing left medial OFC activity in response to inflations as explosion probability increased. CONCLUSIONS SI+ youths may show heightened sensitivity to immediate reward and decreased sensitivity to potential loss as evidenced by medial frontal gyrus activity. OFC findings suggest that SI+ youths may be drawn to reward even when there is high probability of loss.
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Affiliation(s)
- Allyson L Dir
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana; Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, Indiana
| | - Christian L Allebach
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
| | - Tom A Hummer
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
| | - Zachary W Adams
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana; Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, Indiana
| | - Matthew C Aalsma
- Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, Indiana; Department of Pediatrics, Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Peter R Finn
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana
| | - John I Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
| | - Leslie A Hulvershorn
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana.
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Hirvikoski T, Jokinen J. Personality traits in attempted and completed suicide. Eur Psychiatry 2020; 27:536-41. [PMID: 21696924 DOI: 10.1016/j.eurpsy.2011.04.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 02/08/2011] [Accepted: 04/08/2011] [Indexed: 10/18/2022] Open
Abstract
AbstractObjectiveThough widely used in clinical and biological studies, no investigation of the factor structure of the Karolinska Scales of Personality (KSP) has been performed in suicide attempters. There are very few studies of personality traits in suicide completers. The aim of the present study was to assess the factor structure of KSP in suicide attempters. A secondary aim was to examine whether the factor structure of the KSP was related to gender and/or to violent method of the suicide attempt or to suicide completion.MethodThe factor structure of the KSP was analysed in data from 165 suicide attempters from the Suicide Prevention Clinic at the Karolinska University Hospital using principal component analysis and orthogonal varimax rotation for the factor extraction. The effect of gender and (1) used method in the suicide attempt (violent versus nonviolent), and (2) later completed suicide on the factors was assessed in two separate series of the two-way ANOVAs.ResultA four-factor solution appeared: (1) Neuroticism, (2) Nonconformity, (3) Psychoticism and (4) Extraversion. Men who later completed suicide reported more Extroversion than male survivors.ConclusionThe obtained factor structure is comparable to a previous factor structure in a group of twins from the population-based Swedish Twin Registry indicating that no specific personality structure characterized the current sample. Differences in personality traits between suicide completers and survivors indicate that these groups may have some distinct characteristics.
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29
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Kim SI, Kong KA. The Relationship between Performance of Attention Task and Suicidal Ideation in Korean Patients with Mood Disorders. Psychiatry Investig 2020; 17:374-381. [PMID: 32252509 PMCID: PMC7176557 DOI: 10.30773/pi.2020.0020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 02/19/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE We examined the performance of attention tests related to suicidal ideation in mood disorder patients and to explain the difference of attention test performance in relation to suicidal ideation after controlling clinical and psychological variables of mood disorder patients. METHODS Seventy-three in- and outpatients with major depressive disorder (n=41) or bipolar disorder (n=32) completed a self-rating questionnaire assessing socio-demographic characteristics, and clinical and psychological variables. Comprehensive Attention Test (CAT) also was conducted. RESULTS Thirty-three patients were the high-suicidal ideation (SI) group, and forty patients were the low-SI group. The errors of commission (CEs) of visual sustained attention in the high-SI group was 6.3 times higher on average than that of the low-SI group. After controlling for sex, age, and diagnosis, a higher number of CEs on visual sustained attention tasks predicted higher SI score. However, after controlling for sex, age, diagnosis, and depressive mood, this predictive ability was no longer observed. CONCLUSION This study showed that CE on the visual sustained attention task seems to influence suicidal ideation as a result of interaction with depressive symptoms.
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Affiliation(s)
- Soo In Kim
- Department of Psychiatry, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Kyoung Ae Kong
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
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30
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Impulsivity and Impulsivity-Related Endophenotypes in Suicidal Patients with Substance Use Disorders: an Exploratory Study. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00259-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AbstractSuicidal behavior (SB) is a major problem in patients with substance use disorders (SUDs). However, little is known about specific SB risk factors in this population, and pathogenetic hypotheses are difficult to disentangle. This study investigated some SB and SUD-related endophenotypes, such as impulsivity, aggression, trait anger, and risk-taking behaviors (RTBs), in forty-eight patients with SUDs in relation to lifetime history of suicide attempts (SAs). Disorders related to alcohol, cannabis, cocaine, opiates, and hallucinogenic drugs were included. Lifetime SAs was significantly associated with both higher impulsivity and higher aggression, but not with trait anger. A higher number of RTBs were associated with lifetime SAs and higher impulsivity, but not with aggression and trait anger. Assessing these endophenotypes could refine clinical SB risk evaluation in SUDs patients by detecting higher-risk subgroups. An important limitation of this study is exiguity of its sample size. Its primary contribution is inclusion of all SUD types.
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31
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Perry KM, Stacy SE, Pepper CM. Masculine gender-related personality traits and acquired capability for suicide. DEATH STUDIES 2019; 46:329-336. [PMID: 31809654 DOI: 10.1080/07481187.2019.1699206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In most countries, substantially more men than women die by suicide, implicating masculine gender-related personality (MGP) traits as a risk factor for suicide. The Interpersonal Theory of Suicide posits that acquired capability for suicide (ACS) is needed to end one's life. To investigate MGP traits and ACS, college students (N = 149) completed measures of stoicism, sensation seeking, physical aggression, and ACS. For both genders, most MGP traits were associated with increased ACS. Physical aggression mediated relations between both stoicism and sensation seeking and ACS, but gender did not moderate these associations, suggesting similar patterns for men and women.
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Affiliation(s)
- Kandice M Perry
- Department of Psychology, University of Wyoming, Laramie, WY, USA
| | | | - Carolyn M Pepper
- Department of Psychology, University of Wyoming, Laramie, WY, USA
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32
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Scocco P, Macis A, Ferrari C, Bava M, Bianconi G, Bulgari V, Candini V, Carrà G, Cavalera C, Clerici M, Conte G, Cricelli M, Teresa Ferla M, Iozzino L, Stefana A, de Girolamo G. Self-harm behaviour and externally-directed aggression In psychiatric outpatients: a multicentre, prospective study (viormed-2 study). Sci Rep 2019; 9:17857. [PMID: 31780679 PMCID: PMC6882905 DOI: 10.1038/s41598-019-53993-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/26/2019] [Indexed: 12/03/2022] Open
Abstract
The aim of the project was to investigate differences between outpatients with Severe Mental Disorders (SMDs) with and without a history of Self-Harm behaviour (SHb) and/or Violent behaviour against other people (Vb) in relation to: (a) socio-demographic and clinical characteristics, (b) violent behaviour during a 1-year FU, (c) predictors of SHb and Vb during the FU. Outpatients with SMDs, with and without a history of Vb were enrolled. They were divided in four groups: patients with lifetime Vb (V), patients with both Vb and SHb (V-SH), patients with only SHb (SH) and patients with no history of SHb and Vb (control group, CONT). The frequency and severity of SHb and Vb during the FU were assessed every two weeks by the MOAS. Overall 246 patients were enrolled. BPRS-E Depression item, the SLOF Social acceptability, the BDHI Indirect Aggression, the BIS Motor Impulsiveness and the STAXI-2 Control-Out showed significant correlations with all the four groups (p < 0.030). V and V-SH patient groups reached higher scores in all MOAS sub-scales. Age among the SH group and BPRS-E affect-anxiety subscale among the V group significantly predicted aggression against people. In people with SMDs a history of SHb or Vb is associated with different medium-term outcomes.
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Affiliation(s)
- Paolo Scocco
- Department of Mental Health, ULSS 6 Euganea, Padova, Italy
| | - Ambra Macis
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Mattia Bava
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | | | - Viola Bulgari
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Valentina Candini
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,Division of Psychiatry, University College London, London, UK
| | - Cesare Cavalera
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Psychology, Catholic University of the Sacred Heart, Milano, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,Department of Mental Health, ASST of Monza, Monza, Italy
| | - Giovanni Conte
- Department of Mental Health, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Marta Cricelli
- Department of Mental Health, Asst-Rhodense G.Salvini of Garbagnate, Milano, Italy
| | - Maria Teresa Ferla
- Department of Mental Health, Asst-Rhodense G.Salvini of Garbagnate, Milano, Italy
| | - Laura Iozzino
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Alberto Stefana
- Department of Mental Health, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
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Takegata M, Takeda S, Sakanashi K, Tanaka T, Kitamura T. Perinatal self-report of thoughts of self-harm, depressive symptoms, and personality traits: Prospective study of Japanese community women. Psychiatry Clin Neurosci 2019; 73:707-712. [PMID: 31347220 DOI: 10.1111/pcn.12917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/29/2019] [Accepted: 07/21/2019] [Indexed: 12/22/2022]
Abstract
AIM The aim of this study was to identify women with thoughts of self-harm preceded by suicidal ideation, during the perinatal period, on cluster analysis and to clarify their psychological correlates. METHODS A secondary analysis was conducted using the data from a longitudinal study involving 18 obstetric clinics between 2011 and 2012 in Kumamoto Prefecture (Japan). Self-administered questionnaires including demographic data, Edinburgh Postnatal Depression Scale, Temperament and Character Inventory, and the Postnatal Bonding Questionnaire were distributed during the third trimester of pregnancy (wave 1), at 5 days (wave 2), and 1 month postpartum (wave 3). RESULTS On cluster analysis using the data of participants who answered all observational points, the participants were divided into two groups: cluster 1, normal (n = 201); and cluster 2, thoughts of self-harm (n = 42). Low self-directedness, low cooperativeness, higher anxiety, depression, and lack of affection and anger and rejection towards the baby were associated with cluster 2. CONCLUSIONS The finding that low self-directedness and low cooperativeness were related to the cluster 2 group suggests that immature personality traits may work as a predisposing factor mediating between anxiety, depression and thoughts of self-harm.
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Affiliation(s)
- Mizuki Takegata
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Satoru Takeda
- Department of Obstetrics and Gynaecology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Kyoko Sakanashi
- Department of Women's Health/Mother-Child Nursing, Faculty of Life Science, Kumamoto University, Kumamoto, Japan
| | | | - Toshinori Kitamura
- Kitamura Institute of Mental Health Tokyo, Tokyo, Japan.,Department of Psychiatry, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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Kim J, Kim J, Park S. Military hazing and suicidal ideation among active duty military personnel: Serial mediation effects of anger and depressive symptoms. J Affect Disord 2019; 256:79-85. [PMID: 31158719 DOI: 10.1016/j.jad.2019.05.060] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 04/09/2019] [Accepted: 05/27/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Military hazing is one of most serious problems affecting suicidal ideation (SI) among active duty personnel, but has received limited research attention. Studies on hazing and SI indicate anger and depressive symptoms as mediators for SI. METHODS A sample of active duty military personnel (N = 944) completed an offline survey, consisting of the revised Conflict Tactics Scale-2, Composite International Diagnostic Interview Screening Scale, and revised Columbia Suicide Severity Rating Scale. Frequency, bivariate correlation, and serial mediation analyses were conducted to assess the serial effects of military hazing on SI, mediated via anger and depressive symptoms. RESULTS Military hazing, anger, depressive symptoms, and SI were positively related to each other in bivariate analyses. In serial mediation analyses, hazing was found to be a significant predictor of higher levels of anger, consequently triggering depressive symptoms, which, in turn, were associated with greater SI. LIMITATIONS Study limitations included the use of cross-sectional data with the use of retrospective self-report. CONCLUSION Hazing in the military is prevalent (17.6%), and SI is associated with serial effects of hazing, anger, and depressive symptoms with full mediation path. Findings suggest that policies that address reducing hazing and implementing clinical interventions specifically focused on symptoms of anger and depression may be important for decreasing SI in military personnel.
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Affiliation(s)
- JaeYop Kim
- School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - JoonBeom Kim
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - SooKyung Park
- School of Social Welfare, Yonsei University, Seoul, Republic of Korea
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35
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Huang Y, Kuang L, Wang W, Cao J, Xu L. Association between personality traits and risk of suicidal ideation in Chinese university students: Analysis of the correlation among five personalities. Psychiatry Res 2019; 272:93-99. [PMID: 30579188 DOI: 10.1016/j.psychres.2018.12.076] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 10/27/2022]
Abstract
The purpose of our study was to determine the incidence of suicidal ideation among Chinese college students and to explore the risk factors for suicidal ideation. A large-sample epidemiological survey was conducted in 13 colleges in Chongqing, China (n = 69,790). Suicidal ideation was reported by 13.03% of the college students who were surveyed. The participants with suicidal ideation were more likely to be female, to come from rural areas, and to have poor life quality and psychological disorder compared to those without suicidal ideation. Moreover, this study revealed that neuroticism, psychoticism, impulsivity, and aggression are risk factors for suicidal ideation, while extroversion has a protective effect on suicidal ideation. We found that four personality traits of students with suicidal ideation, including impulsivity, aggression, psychoticism, and neuroticism, are positively correlated. However, there is a negative correlation between extroversion and the other four traits. These findings highlight the need for further exploration of personality traits in the risk of suicidal ideation.
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Affiliation(s)
- Yan Huang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China; GCP Office, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing 400016, China.
| | - Wo Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Cao
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing 400016, China
| | - Lu Xu
- Chongqing Medical and Pharmaceutical College, Chongqing, China
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The role of substance use, smoking, and inflammation in risk for suicidal behavior. J Affect Disord 2019; 243:33-41. [PMID: 30223137 PMCID: PMC6241516 DOI: 10.1016/j.jad.2018.09.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/09/2018] [Accepted: 09/06/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Alcohol and substance use disorders are important predictors for suicidal behavior. However, the role of individual substances as proximal risk factors for suicidal behavior and the mechanisms through which substance use affect risk are not entirely clear. We examine whether the frequency of substance use and whether biological markers in the HPA axis and inflammatory pathways are associated with clinical risk factors of suicidal behavior of aggression, impulsivity, hopelessness, and poor sleep. METHODS The sample consisted of psychiatric inpatients, aged 15-30 years, admitted for suicide attempt (n = 38), suicidal ideation (n = 40); and healthy controls (n = 37). We measured hair cortisol concentrations, glucocorticoid receptor (GR) sensitivity, stimulated production of interleukin- or IL-6, C-reactive protein, and mRNA expression of GR, SKA2, FKBP5, TNF-α, and IL-1β. RESULTS Smoking was associated with increased aggression [β = 2.9, 95% CI (-0.03, 6), p = 0.05], impulsivity [β = 3.1, 95% CI (1.6, 4.6), p < 0.001], and poor sleep [β = 0.5, 95% CI (0.03, 0.95), p = 0.04] even after controlling for demographics and group. Similarly, TNF-α mRNA was associated with impulsivity [β = 0.07, 95% CI (0.01, 0.1), p = 0.02] and hopelessness [β = 0.03, 95% CI (0.004, 0.05), p = 0.03]. Smoking tobacco (r = 0.32, p < 0.001) was positively associated with TNF-α mRNA. LIMITATIONS Study limitations include the cross-sectional design, retrospective assessment, and relatively small sample size. CONCLUSIONS Future longitudinal studies are needed to test whether inflammatory markers mediate the relationships between smoking, clinical risk factors, and suicidal behavior; and to examine whether smoking cessation could reduce the risk for suicidal behavior in at-risk patients.
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Beckman K, Lindh AU, Waern M, Stromsten L, Renberg ES, Runeson B, Dahlin M. Impulsive suicide attempts among young people-A prospective multicentre cohort study in Sweden. J Affect Disord 2019; 243:421-426. [PMID: 30268958 DOI: 10.1016/j.jad.2018.09.070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/12/2018] [Accepted: 09/16/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND We aimed to compare the prevalence of impulsive suicide attempts (ISA) among young adults and those over 25 who present at hospital in connection with attempted suicide. We also aimed to identify factors associated with ISA in young adults and to assess medical severity as well as the probability of repeated suicide attempts in this age group. METHOD A prospective multicentre cohort study included hospital known cases of suicide attempt (N = 666). The prevalence of ISA was compared between young adults (18-25) and adults aged > 26. We used logistic regression models to identify factors associated with ISA, associations of ISA with high medical severity and prediction of new fatal or non-fatal suicide attempts within 6 months. RESULTS 43.7% of the young patients had made an ISA, and 30.2% among those aged > 26 (p = 0.001). Among the young, substance use disorder was associated with ISA; crude odds ratio (OR) 2.0 (1.0-4.2), and adjusted OR 2.1 (0.99-4.4). Affective disorder and unemployment/ sickness absence implied lower odds of ISA. ISA resulted in injuries of high medical severity as often as more planned attempts and non-fatal or fatal repetition within 6 months was equally common (30%) in both groups. LIMITATIONS The study was set in psychiatric emergency services, which limits the generalizability. CONCLUSIONS Clinicians should acknowledge that suicide attempts among youth often occur without previous planning and may result in medically severe injuries. The probability of new fatal or non-fatal suicide attempts should be kept in mind also after an impulsive suicide attempt.
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Affiliation(s)
- K Beckman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm City Council, St. Goran, SE-112 61, Stockholm.
| | - A U Lindh
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm City Council, St. Goran, SE-112 61, Stockholm
| | - M Waern
- Department of Psychiatry and Neurochemistry, University of Göteborg, Sweden
| | - L Stromsten
- Department of Clinical Sciences, University of Umeå, Sweden
| | - E S Renberg
- Department of Clinical Sciences, University of Umeå, Sweden
| | - B Runeson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm City Council, St. Goran, SE-112 61, Stockholm
| | - M Dahlin
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm City Council, St. Goran, SE-112 61, Stockholm
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Fanelli G, Serretti A. The influence of the serotonin transporter gene 5-HTTLPR polymorphism on suicidal behaviors: a meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2019; 88:375-387. [PMID: 30125622 DOI: 10.1016/j.pnpbp.2018.08.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 07/31/2018] [Accepted: 08/13/2018] [Indexed: 12/16/2022]
Abstract
Suicidal Behavior (SB) is the second leading cause of death among youths worldwide and the tenth among all age groups. Inherited genetic differences have a role in suicidality with heritability ranging from 30 to 55%. The SLC6A4 5-HTTLPR gene variant has been largely investigated for association with SB, with controversial results. In this work, we sought to determine whether the results of previous meta-analyses were confirmed or modified subsequent to the inclusion of more recent literature data. An electronic literature search was performed to identify relevant studies published until July 2018. Data were analysed through RevMan v5.3. Subgroup and sensitivity meta-analyses were performed considering different SB sub-phenotypes, ethnicity, gender and psychiatric diagnostic categories. Our literature search yielded 1186 articles; among these, we identified 45 pertinent case-control studies (15,341 subjects). No association was found between low-expressing alleles or genotypes (S + LG alleles or S' carrier genotypes) and SB in the primary analyses. However, low-expressing alleles (S + LG) were associated with an increased risk of Violent Suicide Attempt (OR = 1.44, C.I. 1.17-1.78, p = .0007). An effect of the same alleles on SB was found in a subpopulation of substance abusers, but this result was not confirmed after the exclusion of healthy subjects from the control group. The other sensitivity meta-analyses did not show any significant effect. Our findings contribute to clarify the conflicting previous evidence by suggesting an association between the 5-HTTLPR and Violent SB. Nonetheless, many other modulators, including environmental factors and epigenetic mechanisms may act to further increase the level of complexity.
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Affiliation(s)
- Giuseppe Fanelli
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
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Lewitzka U, Bauer M, Ripke B, Bronisch T, Günther L. Impulsivity and Saliva Cortisol in Patients with Suicide Attempt and Controls. Neuropsychobiology 2018; 75:162-168. [PMID: 29346785 DOI: 10.1159/000484664] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 10/24/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The objective of this study was to prove concepts in the characterization of suicidal patients and the possible usefulness of those markers to potentially identify patients with a higher risk for suicidality. METHODS Patients with a recent suicide attempt were compared with patients suffering from depression, adjustment disorder, anxiety, or eating disorders without suicidality, healthy controls and remitted patients with a history of at least 1 suicide attempt (≥1 year). We analyzed impulsivity (Barratt Impulsivity Scale, BIS) and saliva cortisol concentrations. RESULTS Independently of suicidality and disease state patients display higher BIS scores than healthy controls. Saliva cortisol levels tend to be higher in patients in the acute disease state than in remitted patients and healthy controls. CONCLUSIONS Saliva cortisol may be a useful marker that reveals alterations in nonsuicidal patients suffering from depression, adjustment disorder, anxiety, or eating disorders who might be at risk.
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Affiliation(s)
- Ute Lewitzka
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | | | - Lydia Günther
- Division of Medical Biology, Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Keefe KM, Sizemore S, Hammersley J, Sunami N. Recent Sexual Assault and Suicidal Behaviors in College Students: The Moderating Role of Anger. JOURNAL OF COLLEGE COUNSELING 2018. [DOI: 10.1002/jocc.12090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Fradkin Y, Khadka S, Bessette KL, Stevens MC. The relationship of impulsivity and cortical thickness in depressed and non-depressed adolescents. Brain Imaging Behav 2018; 11:1515-1525. [PMID: 27738995 DOI: 10.1007/s11682-016-9612-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Major Depressive Disorder (MDD) is recognized to be heterogeneous in terms of brain structure abnormality findings across studies, which might reflect previously unstudied traits that confer variability to neuroimaging measurements. The purpose of this study was to examine the relationships between different types of trait impulsivity and MDD diagnosis on adolescent brain structure. We predicted that adolescents with depression who were high on trait impulsivity would have more abnormal cortical structure than depressed patients or non-MDD who were low on impulsivity. We recruited 58 subjects, including 29 adolescents (ages 12-19) with a primary DSM-IV diagnosis of MDD and a history of suicide attempt and 29 demographically-matched healthy control participants. Our GLM-based analyses sought to describe differences in the linear relationships between cortical thickness and impulsivity trait levels. As hypothesized, we found significant moderation effects in rostral middle frontal gyrus and right paracentral lobule cortical thickness for different subscales of the Barratt Impulsiveness Scale. However, although these brain-behavior relationships differed between diagnostic study groups, they were not simple additive effects as we had predicted. For the middle frontal gyrus, non-MDD participants showed a strong positive association between cortical thickness and BIS-11 Motor scores, while MDD-diagnosed participants showed a negative association. For Non-Planning Impulsiveness, paracentral lobule cortical thickness was observed with greater impulsivity in MDD, but no association was found for controls. In conclusion, the findings confirm that dimensions of impulsivity have discrete neural correlates, and show that relationships between impulsivity and brain structure are expressed differently in adolescents with MDD compared to non-MDD.
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Affiliation(s)
- Yuli Fradkin
- Department of Psychiatry, Rutgers University Robert Wood Johnson Medical School, 675 Hoes Ln W, Piscataway, NJ, 08854, USA
| | - Sabin Khadka
- Olin Neuropsychiatry Research Center, Hartford Hospital / The Institute of Living, 200 Retreat Avenue, Whitehall Building, Hartford, CT, 06106, USA
| | - Katie L Bessette
- Olin Neuropsychiatry Research Center, Hartford Hospital / The Institute of Living, 200 Retreat Avenue, Whitehall Building, Hartford, CT, 06106, USA
| | - Michael C Stevens
- Olin Neuropsychiatry Research Center, Hartford Hospital / The Institute of Living, 200 Retreat Avenue, Whitehall Building, Hartford, CT, 06106, USA. .,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
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Björkenstam E, Hjern A, Björkenstam C, Kosidou K. Association of Cumulative Childhood Adversity and Adolescent Violent Offending With Suicide in Early Adulthood. JAMA Psychiatry 2018; 75:185-193. [PMID: 29238825 PMCID: PMC5838591 DOI: 10.1001/jamapsychiatry.2017.3788] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Childhood adversity (CA) is associated with an increased risk of suicide in young adulthood that might be explained by maladaptive trajectories during adolescence. Although adolescent violent offending is linked with suicide, little is known about its role in the association between CA and suicide. OBJECTIVE To examine whether adolescent violent offending mediates the association between CA and suicide in early adulthood. DESIGN, SETTING, AND PARTICIPANTS This population-based, longitudinal cohort study with a follow-up time spanning 5 to 9 years included 476 103 individuals born in Sweden between 1984 and 1988. The study population was prospectively followed up from 20 years of age until December 31, 2013, with respect to suicide. Data analysis was performed from January 1, 1984, to December 31, 2013. EXPOSURES Register-based CAs included parental death, parental substance abuse and psychiatric disorder, parental criminal offending, parental separation, public assistance recipiency, child welfare intervention, and residential instability. Adolescent violent offending was defined as being convicted of a violent crime between the ages of 15 and 19 years. MAIN OUTCOMES AND MEASURES Estimates of risk of suicide after 20 years of age (from 2004 if born in 1984 and from 2008 if born in 1988) until the end of 2013 were calculated as incidence rate ratios (IRRs) with 95% CIs using Poisson regression analysis. Adjustments were made for demographics and psychiatric disorder. In addition, binary mediation analysis with logistic regression was used. RESULTS A total of 476 103 individuals (231 699 [48.7%] female) were included in the study. Those with a conviction for violent offending had been exposed to all CAs to a greater extent than those with no violent offending. Cumulative CA was associated with risk of suicide in nonconvicted (adjusted IRR, 2.4; 95% CI, 1.5-3.9) and convicted youths, who had a higher risk of suicide (adjusted IRR, 8.5; 95% CI, 4.6-15.7). Adolescent violent offending partly mediated the association between CA and suicide. CONCLUSIONS AND RELEVANCE Individuals with a history of CA who also engage in violent offending in adolescence have a high risk of suicide. Interventions to prevent externalizing behavior during childhood and increased support to youths with delinquent behavior may have the potential to prevent suicide related to CA.
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Affiliation(s)
- Emma Björkenstam
- Division of Social Medicine, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden,Department of Neuroscience, Psychiatry Uppsala University, Uppsala, Sweden
| | - Anders Hjern
- Centre for Health Equity Studies, Stockholm University and Karolinska Institutet, Stockholm, Sweden,Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Kyriaki Kosidou
- Division Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden,Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
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Ludwig B, Dwivedi Y. The concept of violent suicide, its underlying trait and neurobiology: A critical perspective. Eur Neuropsychopharmacol 2018; 28:243-251. [PMID: 29254658 PMCID: PMC5809305 DOI: 10.1016/j.euroneuro.2017.12.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/14/2017] [Accepted: 12/02/2017] [Indexed: 12/21/2022]
Abstract
Suicide is one of the leading causes of death and represents a significant public health problem world-wide. Individuals who attempt or die by suicide represent a highly heterogeneous population. Recently, efforts have been made to identify sub-populations and variables to categorize them. A popular dichotomy in suicide research of the past years is violent versus non-violent suicide - based on the method. This dichotomy is important given that there is an association between method of attempted suicide and risk of subsequent death by suicide. The differentiation concerning suicide methods is also critical regarding preventive efforts. In this review, we have tried to approach the concept of violent suicide from different perspectives, including a discussion about its definition and overlapping categories. In addition, we have critically discussed aggression as underlying trait, the question of intent to die, and sociodemographic, environmental, neuropsychological, and neurobiological factors potentially associated with violent suicide.
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Affiliation(s)
- Birgit Ludwig
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yogesh Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA.
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Husky M, Swendsen J, Ionita A, Jaussent I, Genty C, Courtet P. Predictors of daily life suicidal ideation in adults recently discharged after a serious suicide attempt: A pilot study. Psychiatry Res 2017. [PMID: 28624676 DOI: 10.1016/j.psychres.2017.06.035] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aims of the study are to examine the predictive role of fluctuations in daily life mood, social contexts, and behavior on subsequent suicidal ideation (SI); and to identify clinical and psychological factors associated with the general frequency of SI in a high-risk sample. The sample comprised 42 adults (73.8% female) hospitalized for a suicide attempt. Immediately following hospital discharge, they used Ecological Momentary Assessment for seven consecutive days, providing repeated measures of SI, environmental, contextual, and behavioral factors. Controlling for prior SI, a number of contextual variables were associated with subsequent SI. Being at home or at work were both associated with an increased probability of SI, while being in the home of close others, or in a festive or leisure environment decreased SI probability. Working, passive leisure and inactivity all increased the likelihood of SI. Being alone increased SI while being with close others significantly reduced this risk. Finally, no overall effect for stressful events was found but negative family events specifically were associated with increased likelihood of SI (γ = 0.448, t = 2.255, df = 29, p < 0.05). The findings provide preliminary results regarding proximal environmental and behavioral factors associated with the occurrence of suicidal ideation in a high-risk sample.
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Affiliation(s)
- Mathilde Husky
- University of Bordeaux, Laboratoire de Psychologie EA4139, Institut Universitaire de France, Bordeaux, France.
| | - Joel Swendsen
- University of Bordeaux, PSL Research University, EPHE, CNRS, UMR 5287 INCIA, F-33076 Bordeaux, France
| | - Adela Ionita
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier F-34093, France; University of Montpellier, Montpellier F-34000, France
| | - Isabelle Jaussent
- University of Montpellier, Montpellier F-34000, France; Inserm, U1061, Montpellier F-34093, France
| | - Catherine Genty
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier F-34093, France; University of Montpellier, Montpellier F-34000, France; Inserm, U1061, Montpellier F-34093, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier F-34093, France; University of Montpellier, Montpellier F-34000, France; Inserm, U1061, Montpellier F-34093, France; Fondamental Foundation, Créteil, France
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[Suicide risk in somatoform disorders]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT ÖSTERREICHISCHER NERVENÄRZTE UND PSYCHIATER 2017; 32:9-17. [PMID: 28940150 DOI: 10.1007/s40211-017-0248-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 08/14/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND The somatoform disorders include a group of complex disorders consist of somatic symptoms for which there are no identifiable organic cause or pathogenetic mechanisms. Given the importance of these disorders and the need to clarify the diagnosis of somatoform disorder affecting the suicide risk, we took into consideration the scientific literature to investigate the correlation between the two conditions. METHODS We performed a bibliographic search through Medline, Embase, PsycINFO, Scopus, SciELO, ORCID, Google Scholar, DOAJ using the following terms: somatoform, somatization disorder, pain disorder AND psychological factor, suicide, parasuicide, suicidality. RESULTS In all studies reported in our review, the suicidal behavior risk is high. But in the majority, the data are relatively unreliable because it takes into account the category nosographic "Neurotic, stress-related and somatoform disorders", too wide to be able to identify the clinical characteristics of patients at risk of only somatoform disorder. CONCLUSIONS Several studies conclude that psychiatric comorbidity increases the suicide risk: patients with two or more psychiatric disorders are more likely to commit a suicide attempt; in particular if there is a axis I diagnosis, the risk reduplicate. The somatization disorder seems to have a significant psychiatric comorbidity in particular with anxious and affective disorders spectrum.
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Bi B, Liu W, Zhou D, Fu X, Qin X, Wu J. Personality traits and suicide attempts with and without psychiatric disorders: analysis of impulsivity and neuroticism. BMC Psychiatry 2017; 17:294. [PMID: 28810846 PMCID: PMC5558700 DOI: 10.1186/s12888-017-1453-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 08/01/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a critical need for empirical data concerning the association of personality traits and attempted suicide with and without psychiatric disorders in mainland China. The objective of the present study is to provide such data by determining the prevalence of psychiatric disorders and analyzing the levels of impulsivity and neuroticism among people who have attempted suicide, and to examine the association between these personality traits and suicide attempt in people with or without psychiatric disorders. METHODS We administered self-reported tests and clinical interviews to 196 people who have attempted suicide who were admitted to a hospital emergency room or our psychiatric settings after a suicide attempt. RESULTS One hundred and fifty-six subjects (79.6%) met the criteria for Axis I disorders and eleven (6.6%) met the criteria Axis II personality disorders. Those who have attempted suicide who did not have psychiatric disorders exhibited a greater degree of background characteristics (e.g., high lethality, more interpersonal conflicts and more alcohol use), lower levels of suicidality (suicide risk, depressive symptoms) and differences of personality traits (e.g., more impulsive and less neuroticism) as compared to those who do have psychiatric disorders. Profile differences existed even after control for the stressful life event. CONCLUSION Our findings suggest that some personality traits differ between people who have attempted suicide depending on whether or not they have psychiatric disorders. Based on these findings, investigating the impact of personality traits on suicidal behavior in therapeutic settings would provide critical data to improve patient treatment and outcomes.
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Affiliation(s)
- Bo Bi
- The First Affiliated Hospital, China Medical University, 155 North Nanjing Street, Shenyang, 110001, Liaoning, China.
| | - Wei Liu
- 0000 0000 9678 1884grid.412449.eThe First Affiliated Hospital, China Medical University, 155 North Nanjing Street, Shenyang, 110001 Liaoning, China
| | - Die Zhou
- 0000 0000 9678 1884grid.412449.eThe First Affiliated Hospital, China Medical University, 155 North Nanjing Street, Shenyang, 110001 Liaoning, China
| | - Xu Fu
- 0000 0000 9678 1884grid.412449.eThe First Affiliated Hospital, China Medical University, 155 North Nanjing Street, Shenyang, 110001 Liaoning, China
| | - Xiaoxia Qin
- 0000 0000 9678 1884grid.412449.eThe First Affiliated Hospital, China Medical University, 155 North Nanjing Street, Shenyang, 110001 Liaoning, China
| | - Jiali Wu
- 0000 0000 9678 1884grid.412449.eThe First Affiliated Hospital, China Medical University, 155 North Nanjing Street, Shenyang, 110001 Liaoning, China
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Treatment of Intrusive Suicidal Imagery Using Eye Movements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070714. [PMID: 28665329 PMCID: PMC5551152 DOI: 10.3390/ijerph14070714] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/19/2017] [Accepted: 06/26/2017] [Indexed: 12/18/2022]
Abstract
Suicide and suicidal behavior are major public health concerns, and affect 3–9% of the population worldwide. Despite increased efforts for national suicide prevention strategies, there are still few effective interventions available for reducing suicide risk. In this article, we describe various theoretical approaches for suicide ideation and behavior, and propose to examine the possible effectiveness of a new and innovative preventive strategy. A model of suicidal intrusion (mental imagery related to suicide, also referred to as suicidal flash-forwards) is presented describing one of the assumed mechanisms in the etiology of suicide and the mechanism of therapeutic change. We provide a brief rationale for an Eye Movement Dual Task (EMDT) treatment for suicidal intrusions, describing techniques that can be used to target these suicidal mental images and thoughts to reduce overall behavior. Based on the available empirical evidence for the mechanisms of suicidal intrusions, this approach appears to be a promising new treatment to prevent suicidal behavior as it potentially targets one of the linking pins between suicidal ideation and suicidal actions.
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Suicidal Ideation vs. Suicide Attempts: Clinical and Psychosocial Profile Differences Among Depressed Patients: A Study on Personality Traits, Psychopathological Variables, and Sociodemographic Factors in 228 Patients. J Nerv Ment Dis 2017; 205:361-371. [PMID: 28225508 DOI: 10.1097/nmd.0000000000000667] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study investigated whether personality traits, psychopathological characteristics, and sociodemographic factors in depressed patients differentiate patients with only suicidal thoughts from those who have attempted suicide. We investigated two groups of patients with an affective disorder: 198 patients with a suicide attempt within the last 3 months (sex ratio male to female, 1:1.3; mean age male to female, 44.8/44.7 years) and 30 patients without a suicide attempt but with suicidal thoughts (sex ratio male to female, 1:2; mean age male to female, 39.4/42.6 years) using a comprehensive measurement (Mini-International Neuropsychiatric Interview, Structured Clinical Interview for DSM-4 Axis II disorders, Hamilton Depression Scale, Beck Depression Inventory, State-Trait Anxiety Inventory, Hamilton Anxiety Scale, Brief Psychiatric Rating Scale, Clinical Global Impression Scale, Beck-Hopelessness Scale, Scale for Suicide Ideation, Impulsivity Rating Scale, Barratt Impulsivity Scale, Inventory for the Assessment of Aggression Factors, State-Trait Anger Expression Inventory, Ways of Coping Checklist). Several differences distinguished the two groups, namely, in personality traits such as anxiety or coping strategies and sociodemographics (e.g., education level). Personality traits, psychopathological characteristics, and sociodemographic factors are useful tools for assessing suicidal risk. Our findings encourage us to suggest that clinicians pay particular attention to sociodemographic variables such as separation/divorce and a lower education level when conducting risk assessments on suicidal patients.
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Séguin M, Robert M, Beauchamp G. Temperament and Character Profiles of Group-Based Suicide Cases. CRISIS 2017; 38:177-185. [DOI: 10.1027/0227-5910/a000430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Personality and character traits may be a key predisposing factor to consider in the life course of people who are vulnerable to suicide. Aims: The aim of this study is first to explore the possible presence of different subgroups of suicide decedents based on developmental profiles of adversity, and secondly to examine the association of personality and character dimensions (covariates) with the trajectory outcome. Method: A total of 90 cases of suicide decedents were analyzed using growth mixture modeling (GMM). Results: Results generated two different life trajectories and identified specific temperament profiles. Subjects assigned to the trajectory of high burden of adversity demonstrated a greater predisposition for harm avoidance and those in the trajectory characterized by low burden of adversity displayed greater predisposition for self-directedness. Conclusion: Our results add to the literature by suggesting that different subgroups of suicide completers show a predisposition for either harm avoidance or self-directedness.
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Affiliation(s)
- Monique Séguin
- Département de psychoeducation et psychologie, Université du Québec en Outaouais, Gatineau, Canada
- McGill Group for Suicide Studies, Montréal, Canada
| | - Marie Robert
- Département de psychoeducation et psychologie, Université du Québec en Outaouais, Gatineau, Canada
| | - Guy Beauchamp
- Département de psychoeducation et psychologie, Université du Québec en Outaouais, Gatineau, Canada
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McKinney JM, Hirsch JK, Britton PC. PTSD symptoms and suicide risk in veterans: Serial indirect effects via depression and anger. J Affect Disord 2017; 214:100-107. [PMID: 28288403 DOI: 10.1016/j.jad.2017.03.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/22/2017] [Accepted: 03/05/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Suicide rates are higher in veterans compared to the general population, perhaps due to trauma exposure. Previous literature highlights depressive symptoms and anger as contributors to suicide risk. PTSD symptoms may indirectly affect suicide risk by increasing the severity of such cognitive-emotional factors. METHOD A sample of community dwelling veterans (N=545) completed online surveys, including the PTSD Checklist-Military Version, Suicidal Behaviors Questionnaire-Revised, Multidimensional Health Profile-Psychosocial Functioning, and Differential Emotions Scale -IV. Bivariate and serial mediation analyses were conducted to test for direct and indirect effects of PTSD symptoms on suicide risk. RESULTS In bivariate analyses, PTSD symptoms, depression, anger, and internal hostility were positively related to suicide risk. In serial mediation analyses, there was a significant total effect of PTSD symptoms on suicide risk in both models. PTSD symptoms were also indirectly related to suicidal behavior via depression and internal hostility, and via internal hostility alone. Anger was not a significant mediator. LIMITATION Our cross-sectional sample was predominantly White and male; prospective studies with diverse veterans are needed. DISCUSSION Our findings may have implications for veteran suicide prevention. The effects of PTSD and depression on anger, particularly internal hostility, are related to suicide risk, suggesting a potential mechanism of action for the PTSD-suicide linkage. A multi-faceted therapeutic approach, targeting depression and internal hostility, via cognitive-behavioral techniques such as behavioral activation and cognitive restructuring, may reduce suicide risk in veterans who have experienced trauma.
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Affiliation(s)
- Jessica M McKinney
- Department of Psychology, East Tennessee State University, United States
| | - Jameson K Hirsch
- Department of Psychology, East Tennessee State University, United States.
| | - Peter C Britton
- Center of Excellence, Canandaigua Veterans Administration Medical Center, United States
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