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Huang X, Fan B, Jiang Y, Li Y, Chen Y, Zhao H, Jiang Y, Wang W, Guo L, Chen Y, Liu Y, Li Z, Wong S, McIntyre RS, Han X, Lu C. Associations of rumination with suicidal ideation and suicide attempts amongst individuals with major depressive disorder: A 12-month longitudinal study in China. Compr Psychiatry 2024; 132:152472. [PMID: 38513451 DOI: 10.1016/j.comppsych.2024.152472] [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: 12/04/2023] [Revised: 02/17/2024] [Accepted: 03/08/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND This study aimed to explore the longitudinal associations of rumination with suicidal ideation and suicide attempts in individuals with major depressive disorder (MDD). METHODS Participants were derived from the Depression Cohort in China study (DCC). Those who completed at least one follow-up visit during the 12 months were included in the analysis. Dimensions of rumination including brooding and reflection were each measured using five items of the Ruminative Responses Scale. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation. Suicide attempts were also assessed and all were analyzed with generalized estimating equations. RESULTS Our final sample included 532 participants aged 18 to 59 years (mean [SD], 26.91 [6.94] years) consisting of 148 (27.8%) males and 384 (72.2%) females. After adjusting for temporal trend and potential confounders, individuals with higher levels of reflection were more likely to report suicidal ideation (AOR =1.11, 95% CI:1.01-1.22). However, no statistically significant association was found between brooding and suicidal ideation (AOR =1.06, 95% CI:0.96-1.17). Conversely, individuals with higher levels of brooding were more likely to report suicide attempts (AOR =1.13, 95% CI:1.02-1.24), while no statistically significant association was observed between reflection and suicide attempts (AOR =0.91, 95% CI:0.82-1.01). CONCLUSION Rumination reflects a disturbance in cognitive emotional processing and manifests in different dimensions. Our findings suggest that high levels of reflection and brooding may be associated with a higher likelihood of having suicidal ideation and suicide attempts, respectively. However, it should be interpreted with caution, given that effect sizes are small.
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Affiliation(s)
- Xinyu Huang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Beifang Fan
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Yingcheng Jiang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yanzhi Li
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ya Chen
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Hao Zhao
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yunbin Jiang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Wanxin Wang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Lan Guo
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yan Chen
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Yifeng Liu
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Zehui Li
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Sabrina Wong
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Roger S McIntyre
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Xue Han
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China.
| | - Ciyong Lu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China.
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LaCroix JM, Baggett CMR, Lee-Tauler SY, Carter SP, Vileta S, Neff LC(RDR, Finton LB, Bottema MGSJ, Bowling SM(RE, Hosack TSME, Grammer J, Stivers M, Darmour CA, Ghahramanlou-Holloway M. Special Operations Cognitive Agility Training (SOCAT) for Special Operations Forces and spouses. MILITARY PSYCHOLOGY 2024; 36:266-273. [PMID: 38661465 PMCID: PMC11057656 DOI: 10.1080/08995605.2021.1981709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 09/08/2021] [Indexed: 10/19/2022]
Abstract
Increasingly complex and unpredictable personnel and operational demands require Special Operations Forces (SOF) members and their families to remain flexible, adaptive, and resilient within ever-changing circumstances. To mitigate the impact of these stressors on psychological health and fitness, researchers and educators at the Uniformed Services University of the Health Sciences (USUHS) developed Special Operations Cognitive Agility Training (SOCAT), a cognitive performance optimization program supported by the United States Special Operations Command (USSOCOM) Preservation of the Force and Family (POTFF). The goal of SOCAT is to enhance cognitive agility, defined as the ability to deliberately adapt cognitive processing strategies in accordance with dynamic shifts in situational and environmental demands, in order to facilitate decision making and adapt to change. Overall, SOCAT emphasizes optimal cognitive performance across different contexts - as well as across various stages of the military lifecycle - to serve as a buffer against biopsychosocial vulnerabilities, environmental and social stressors, military operational demands, and behavioral health problems, including suicide. This paper reviews foundational research behind SOCAT, mechanisms through which SOCAT is anticipated to build psychological resilience, and describes the process of developing and tailoring SOCAT for active duty SOF members and spouses. Limitations and future directions, including an ongoing, randomized controlled program evaluation, are discussed.
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Affiliation(s)
- Jessica M. LaCroix
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | | | - Su Yeon Lee-Tauler
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Sarah P. Carter
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Staci Vileta
- Headquarters United States Special Operations Command, Preservation of the Force and Family, MacDill Air Force Base, Tampa, Florida, USA
| | | | | | | | | | - Tech Sergeant Meagan E. Hosack
- Headquarters United States Special Operations Command, Preservation of the Force and Family, MacDill Air Force Base, Tampa, Florida, USA
| | - Joseph Grammer
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Max Stivers
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Charles A. Darmour
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Marjan Ghahramanlou-Holloway
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Haime Z, Kennedy L, Grace L, Cohen R, Derges J, Biddle L. The Journey of Engaging With Web-Based Self-Harm and Suicide Content: Longitudinal Qualitative Study. JMIR INFODEMIOLOGY 2024; 4:e47699. [PMID: 38546718 PMCID: PMC11009851 DOI: 10.2196/47699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/10/2023] [Accepted: 02/15/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Self-harm and suicide are major public health concerns worldwide, with attention focused on the web environment as a helpful or harmful influence. Longitudinal research on self-harm and suicide-related internet use is limited, highlighting a paucity of evidence on long-term patterns and effects of engaging with such content. OBJECTIVE This study explores the experiences of people engaging with self-harm or suicide content over a 6-month period. METHODS This study used qualitative and digital ethnographic methods longitudinally, including one-to-one interviews at 3 time points to explore individual narratives. A trajectory analysis approach involving 4 steps was used to interpret the data. RESULTS The findings from 14 participants established the web-based journey of people who engage with self-harm or suicide content. In total, 5 themes were identified: initial interactions with self-harm or suicide content, changes in what self-harm or suicide content people engage with and where, changes in experiences of self-harm or suicide behaviors associated with web-based self-harm or suicide content engagement, the disengagement-reengagement cycle, and future perspectives on web-based self-harm or suicide content engagement. Initial engagements were driven by participants seeking help, often when offline support had been unavailable. Some participants' exposure to self-harm and suicide content led to their own self-harm and suicide behaviors, with varying patterns of change over time. Notably, disengagement from web-based self-harm and suicide spaces served as a protective measure for all participants, but the pull of familiar content resulted in only brief periods of disconnection. Participants also expressed future intentions to continue returning to these self-harm and suicide web-based spaces, acknowledging the nonlinear nature of their own recovery journey and aiming to support others in the community. Within the themes identified in this study, narratives revealed that participants' behavior was shaped by cognitive flexibility and rigidity, metacognitive abilities, and digital expertise. Opportunities for behavior change arose during periods of cognitive flexibility prompted by life events, stressors, and shifts in mental health. Participants sought diverse and potentially harmful content during challenging times but moved toward recovery-oriented engagements in positive circumstances. Metacognitive and digital efficacy skills also played a pivotal role in participants' control of web-based interactions, enabling more effective management of content or platforms or sites that posed potential harms. CONCLUSIONS This study demonstrated the complexity of web-based interactions, with beneficial and harmful content intertwined. Participants who demonstrated metacognition and digital efficacy had better control over web-based engagements. Some attributed these skills to study processes, including taking part in reflective diaries, showing the potential of upskilling users. This study also highlighted how participants remained vulnerable by engaging with familiar web-based spaces, emphasizing the responsibility of web-based industry leaders to develop tools that empower users to enhance their web-based safety.
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Affiliation(s)
- Zoë Haime
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Laura Kennedy
- Centre for Society and Mental Health, Kings College, London, United Kingdom
- Samaritans, Surrey, United Kingdom
- Department of Health Service and Population Research, King's College London, London, United Kingdom
| | | | - Rachel Cohen
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Health and Social Services Group, Welsh Government, Cardiff, United Kingdom
| | - Jane Derges
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Lucy Biddle
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Lee HJ, Kang J, Yu H, Lim CE, Oh E, Choi JM, You S, Cho YS. Reactive control in suicide ideators and attempters: An examination of the congruency sequence effect in cognitive and emotional Simon tasks. PLoS One 2023; 18:e0295041. [PMID: 38032975 PMCID: PMC10688694 DOI: 10.1371/journal.pone.0295041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 11/13/2023] [Indexed: 12/02/2023] Open
Abstract
Reactive control is the cognitive ability to adjust thoughts and behaviors when encountering conflict. We investigated how this ability to manage conflict and stress distinguishes suicidal from nonsuicidal individuals. The hypothesis was that suicidal individuals would show poorer reactive control when faced with conflict generated by emotional than neutral stimuli. Hence, individuals with a lifetime history of suicide ideation or attempt and nonsuicidal controls were tested in cognitive and emotional Simon tasks. We examined the congruency sequence effect (CSE) in the Simon tasks as an indication of the efficiency of reactive control in resolving conflict. Whereas controls demonstrated significant CSEs in both tasks, suicide attempters showed a significant CSE in the cognitive task but not in the emotional task. Suicide ideators, on the other hand, displayed marginally significant CSEs in both tasks. Comparing groups with pairwise comparison demonstrated that the difference in CSE was significant only in the emotional task between attempters and controls. Our findings of attempters' inefficiency in adjusting reactive control during the emotional task reflect cognitive inflexibility in coping with conflicting situations during which suicidal individuals become vulnerable to suicide attempts in states of negative emotion.
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Affiliation(s)
- Hyejin J. Lee
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Joohyang Kang
- Department of Psychology, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Hwajeong Yu
- Department of Psychology, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Chae Eun Lim
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - EunByeol Oh
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Jong Moon Choi
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Sungeun You
- Department of Psychology, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Yang Seok Cho
- School of Psychology, Korea University, Seoul, Republic of Korea
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Cheek SM, Kudinova AY, Kuzyk EG, Goldston DB, Liu RT. Cognitive inflexibility and suicidal ideation among adolescents following hospitalization: The moderating role of life stress. J Affect Disord 2023; 339:698-705. [PMID: 37463644 PMCID: PMC10878321 DOI: 10.1016/j.jad.2023.07.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/23/2023] [Accepted: 07/14/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Cognitive inflexibility has recently been investigated as potential vulnerability factor for suicidal ideation (SI), but the context in which it may convey risk is unclear. Life stress has also been reliably associated with SI among adolescents, and following a stress-diathesis model, may be a factor that moderates the relationship between cognitive inflexibility and SI. METHODS Psychiatrically hospitalized adolescents (N = 259) at high risk for future SI were followed for 18 months after discharge. Interviews assessing life stress and SI and a neurocognitive task assessing cognitive inflexibility were conducted at six- and 12-months. SI was also assessed at 18-month post-discharge. Linear mixed models were used to determine the moderating effect of stress on the relationship between cognitive inflexibility and SI, accounting for relevant clinical and demographic covariates. RESULTS Chronic stress moderated the association between cognitive inflexibility and SI, with a stronger association found among youth with greater levels compared to lower levels of chronic stress. This finding was maintained after statistically adjusting for depressive symptoms and relevant demographic covariates. No prospective associations between cognitive inflexibility, life stress, and SI were found. LIMITATIONS SI was measured at 6-month intervals, precluding evaluation of the relationship on a more proximal timescale. CONCLUSIONS Cognitively inflexible adolescents under conditions of high chronic stress are more likely to experience increased SI severity, supporting a cognitive inflexibility stress-diathesis model of SI in adolescents. The findings highlight the importance of assessing these modifiable factors among adolescents at a high risk for SI.
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Affiliation(s)
- Shayna M Cheek
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States of America.
| | - Anastacia Y Kudinova
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Eva G Kuzyk
- Massachusetts General Hospital, Boston, MA, United States of America
| | - David B Goldston
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States of America
| | - Richard T Liu
- Massachusetts General Hospital, Boston, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, United States of America
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Deng W, Acquah K, Joormann J, Cannon TD. Cognitive flexibility and emotion regulation: Dual layers of resilience against the emergence of paranoia. Behav Res Ther 2023; 167:104360. [PMID: 37413786 DOI: 10.1016/j.brat.2023.104360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/08/2023]
Abstract
Cognitive inflexibility has been linked to difficulties in revising paranoid beliefs, whereas cognitive flexibility may protect against the development and maintenance of paranoid beliefs by allowing for troubleshooting in light of available evidence. While less discussed in the context of paranoia research, better regulation of affective states may reduce the likelihood of biased beliefs developing in the first place, reducing the burden on belief updating mechanisms. The present study hypothesized that high cognitive flexibility and strong emotion regulation ability may act as a reciprocal protective shield against the risk associated with lower ability in the other domain. Participants were recruited from the general population (N = 221) to complete the Ambiguous Interpretation Inflexibility Task, as well as self-report measures for paranoia and emotion regulation ability. The results show an interaction between cognitive flexibility and emotion regulation ability as related to less severe paranoia. Better emotion regulation ability is associated with lower paranoia in individuals with lower cognitive flexibility, whereas higher cognitive flexibility is associated with less severe paranoia in individuals with greater emotion regulation difficulties. These findings highlight the importance of emotion regulation in early interventions of paranoia, especially how emotion regulation relates to known cognitive vulnerabilities such as inflexibility.
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Wolff B, Franco VR, Magiati I, Pestell CF, Glasson EJ. Psychosocial and neurocognitive correlates of suicidal thoughts and behaviours amongst siblings of persons with and without neurodevelopmental conditions. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 139:104566. [PMID: 37441861 DOI: 10.1016/j.ridd.2023.104566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/24/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE Siblings of individuals with neurodevelopmental conditions (NDCs) have greater incidence of neuropsychiatric diagnoses and neurocognitive difficulties compared to siblings of persons without NDCs. Despite suicidality being labelled a global health crisis (WHO, 2014) and NDC siblings experiencing risk factors implicated in suicidality, no previous studies examined suicidality amongst adolescent and young adult siblings of persons with NDCs. Our study aimed to bridge this gap. METHOD The present study used Bayesian analyses and risk classification models to examine individual and environmental risk factors associated with suicidal thoughts and behaviours amongst siblings of persons with and without NDCs (n = 267; 132 NDC, 135 control group, mean age 20.61, range 14-27, 76.40% female, 76.78% White Caucasian), as measured using self-report survey data and remote self-administered cognitive tests. RESULTS NDC siblings had higher rates of current nonsuicidal self-injury (NSSI; 18.94% versus 14.07%, δ = -0.32), suicidal ideation (25.76% versus 8.89%, δ = -0.40) and history of suicide attempts (18.18% versus 4.44%, δ = -0.43) compared to controls. Classification models using boosting and random forest demonstrated adequate performance: positive predictive value 0.86-0.91, negative predictive value 0.81-0.90, false negative rates 0.11-0.24. Cognitive inflexibility, alexithymia, inattention, bullying, depression, NSSI, and eating or psychotic disorder history had the highest relative importance in predicting lifetime suicidality. Poorer executive functioning (measured by the Wisconsin Card Sorting Task, Sustained Attention to Response Task, Stop Signal Task, and N-Back 2-back task) was strongly correlated with suicidality. CONCLUSIONS Screening for proximal and modifiable risk factors is critical to inform suicidal behaviour intervention and prevention programs for at-risk siblings.
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Affiliation(s)
- Brittany Wolff
- School of Psychological Science, The University of Western Australia, Perth, Australia; Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia.
| | | | - Iliana Magiati
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Carmela F Pestell
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Emma J Glasson
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia; Discipline of Psychiatry, Medical School, The University of Western Australia, Perth, WA, Australia
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Riera-Serra P, Gili M, Navarra-Ventura G, Riera-López Del Amo A, Montaño JJ, Coronado-Simsic V, Castro A, Roca M. Longitudinal associations between executive function impairments and suicide risk in patients with major depressive disorder: A 1-year follow-up study. Psychiatry Res 2023; 325:115235. [PMID: 37178501 DOI: 10.1016/j.psychres.2023.115235] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/16/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023]
Abstract
Impaired executive function (EF) is a key feature of patients with major depressive disorder (MDD) that several studies have linked to suicidal ideation and suicide attempts. This is the first longitudinal study to examine the association between impaired EF and suicide risk in adult patients with MDD. Longitudinal prospective study with 3 assessment points: baseline, 6 and 12 months. The Columbia-Suicide Severity Rating Scale (C-SSRS) was used to assess suicidality. The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess EF. The association between EF impairments and suicidality was analyzed using mixed-effects models. Out of 167 eligible outpatients, 104 were included in the study. Of these, 72 were re-evaluated at 6 months and 60 at 12 months, obtaining 225 complete observations of the EF. Impaired decision-making and risk-taking behavior were associated with suicidal ideation. Difficulty in impulse control was related to suicidal ideation and to greater severity of suicidal ideation. Impaired spatial planning and working memory was linked to suicide attempts. Our results add to previous literature that the association between EF impairments and suicidality is maintained over the long term, supporting it as a longitudinal risk factor and a possible neurocognitive marker of suicide in patients with MDD.
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Affiliation(s)
- Pau Riera-Serra
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Guillem Navarra-Ventura
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain.
| | - Antonio Riera-López Del Amo
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain
| | - Juan José Montaño
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Victoria Coronado-Simsic
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain
| | - Adoración Castro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain
| | - Miquel Roca
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain; Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
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Tam NWY, Kwok SYCL, Gu M. Individual, Peer, and Family Correlates of Depressive Symptoms among College Students in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4304. [PMID: 36901313 PMCID: PMC10001517 DOI: 10.3390/ijerph20054304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
In this study, an ecological model and developmental psychopathology theory focusing on an ontogenic system (hopelessness) and microsystems (peer alienation and childhood abuse and trauma) was adopted to examine the individual, peer, and family correlates of depressive symptoms among college Chinese students in Hong Kong, China. A cross-sectional survey research design with a convenience sampling procedure was used to examine a sample of college students (n = 786) aged 18 to 21 years old in Hong Kong. Among them, 352 respondents (44.8%) reported having depressive symptoms, with a Beck Depression Inventory-II (BDI-II) score of 14 or above. The results of this study indicated that childhood abuse and trauma, peer alienation, and hopelessness were positively related to depressive symptoms. The underlying arguments and implications were discussed. The study results provided further support for the ecological model and the developmental psychopathology theory on the predictive roles of individual, peer, and family correlates of adolescent depression.
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Affiliation(s)
- Nelson W. Y. Tam
- Department of Social and Behavioral Science, The City University of Hong Kong, Kowloon, Hong Kong 518057, China
| | - Sylvia Y. C. L. Kwok
- Department of Social and Behavioral Science, The City University of Hong Kong, Kowloon, Hong Kong 518057, China
| | - Minmin Gu
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu 610074, China
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Keum BT, Li X. Online Racism, Rumination, and Vigilance: Impact on Distress, Loneliness, and Alcohol Use. COUNSELING PSYCHOLOGIST 2022. [DOI: 10.1177/00110000221143521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We examined the potential anticipatory response (rumination, vigilance) associated with online racism and its impact on psychological distress, loneliness, and alcohol use severity. With a sample of 407 racial minority adults, we conducted a path analysis to examine the indirect relation of online racism on our outcome variables via online racism-related rumination and offline racism-related vigilance. Online racism was significantly linked to psychological distress, alcohol use severity, and loneliness. Rumination and vigilance explained significant indirect relations between online racism and psychological distress and loneliness. Only rumination explained the significant indirect relation between online racism and alcohol use severity. Posthoc multigroup analysis suggested that the path model estimates for the full sample applied equivalently to the African American/Black, Asian/Asian American, and Latinx/Hispanic American groups. Online racism is likely an unjust burden for racial minority individuals that may give rise to prolonged rumination and anticipation about facing racial discrimination in their offline world.
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Affiliation(s)
- Brian TaeHyuk Keum
- Department of Social Welfare, University of California Los Angeles, Los Angeles, CA, USA
| | - Xu Li
- Department of Educational Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Transgender Youth Executive Functioning: Relationships with Anxiety Symptoms, Autism Spectrum Disorder, and Gender-Affirming Medical Treatment Status. Child Psychiatry Hum Dev 2022; 53:1252-1265. [PMID: 34146208 DOI: 10.1007/s10578-021-01195-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 05/21/2021] [Indexed: 10/21/2022]
Abstract
Executive function (EF) underlies broad health and adaptive outcomes. For transgender youth, navigating gender discernment and gender affirmation demand EF. Yet, factors associated with transgender youth EF are unknown. We investigate hypothesized predictors of EF: over-represented conditions among transgender youth (anxiety and depression symptoms, autism spectrum disorder [ASD]) and gender-affirming care. One-hundred twenty-four transgender 11-21-year-olds participated. Parents/caregivers completed EF and mental health report measures. ASD diagnostics and gender-affirming medication histories were collected. 21 % of non-autistic and 69 % of autistic transgender youth had clinically elevated EF problems. Membership in the gender-affirming hormone treatment group was associated with better EF. ASD, anxiety symptoms, and membership in the long-duration pubertal suppression group were associated with poorer EF. Given the importance of EF skills for multiple outcomes, and the unique and additional EF demands specific to transgender youths' experiences, EF skill monitoring-and when appropriate, supports-should be considered for transgender youth.
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12
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Crocker LD, Jurick SM, Merritt VC, Keller AV, Hoffman SN, Davey DK, Jak AJ. Mechanisms through which executive dysfunction influences suicidal ideation in combat-exposed Iraq and Afghanistan veterans. Clin Neuropsychol 2022; 36:2073-2092. [PMID: 34524071 DOI: 10.1080/13854046.2021.1974566] [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] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Executive dysfunction has previously been associated with suicidality, but it remains unclear how deficits in executive functioning contribute to increased suicidal thoughts and behaviors. Although it has been proposed that poorer executive functioning leads to difficulty generating and implementing appropriate coping strategies to regulate distress and inhibit suicidal thoughts and behaviors, studies have not systematically examined these relationships. Therefore, the present study examined various hypotheses to elucidate the mechanisms through which executive dysfunction influences suicidal ideation (SI) in combat-exposed Iraq/Afghanistan veterans. METHOD Veterans who endorsed SI were compared to those who denied SI on demographic and diagnostic variables and measures of neuropsychological functioning, psychological symptoms, coping styles, and combat experiences. Serial mediation models were tested to examine mechanistic relationships among executive functioning, psychological distress, coping, and SI. RESULTS Those who endorsed SI had worse executive functioning, greater psychological distress, and greater avoidant coping relative to those who denied SI. Serial mediation model testing indicated a significant indirect path, such that executive dysfunction increased psychological distress, which in turn increased avoidant coping, leading to SI. CONCLUSIONS Findings support and extend previous hypotheses regarding how executive functioning contributes to increased risk of suicidality via increased distress and avoidant coping. Intervention efforts focused on reducing suicidality may benefit from techniques that enhance executive functioning (e.g. computerized training, cognitive rehabilitation) and in turn reduce distress prior to targeting coping strategies.
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Affiliation(s)
- Laura D Crocker
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - Sarah M Jurick
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Victoria C Merritt
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Amber V Keller
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Samantha N Hoffman
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Delaney K Davey
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Amy J Jak
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA.,Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
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13
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Esgalhado G, Pereira H, Silva P. Adaptation of an Emotional Stroop Test for Screening of Suicidal Ideation in Portugal. Behav Sci (Basel) 2022; 12:bs12080281. [PMID: 36004852 PMCID: PMC9404836 DOI: 10.3390/bs12080281] [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: 07/11/2022] [Revised: 08/07/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
Cognitive instruments, especially those with emotional components, may be useful to address the limitations of self-report scales commonly used to assess suicidal ideation. The aim of this study was to develop an emotional Stroop test for screening suicidal ideation in Portugal. The project was developed in five phases using different samples for each phase. The first two phases were focused on the formulation of the potential words that would compose the slides. For this purpose, five biology teachers (neutral slide) and five mental health professionals (positive and negative slides) were invited to help choose the words that were most representative for each slide. The third phase validated the words defined in the previous phase. In this phase, 300 university students participated (Mage = 21.66; SD = 3.67; 68% female). They rated the words on a Likert scale in terms of their frequency of use, familiarity, level of understanding, and degree of image evocation. In the fourth phase, the researchers developed the complete version of the test, which consists of three slides with neutral, positive, and negative emotional stimuli, consecutively. Finally, in the fifth phase, we validated the final version of the test through a comparative study between a clinical group and a non-clinical group, each one composed by 50 participants (Mage = 32; SD = 9.70; 55% female). Results indicated that the clinical group demonstrated significantly higher scores for depression and suicidal ideation and lower scores for the three Stroop tasks. Words related to negative emotions were strongly correlated with suicidal ideation. Finally, the three Stroop slides explained 74.1% of the variance in suicidal ideation. These findings suggest that this test can be a viable complementary measure in the psychological assessment of suicide ideation, and intervention in the field of suicide prevention in Portugal.
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Affiliation(s)
- Graça Esgalhado
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, Estrada do Sineiro, s/n, 6200-209 Covilhã, Portugal
- Institute of Cognitive Psychology, Human and Social Development (IPCDHS), 3000-115 Coimbra, Portugal
| | - Henrique Pereira
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, Estrada do Sineiro, s/n, 6200-209 Covilhã, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Correspondence:
| | - Patricia Silva
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, Estrada do Sineiro, s/n, 6200-209 Covilhã, Portugal
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14
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Muneeb NUA, Hassan SMU. Psychological strain and suicidal ideation in young university students during Covid-19 outbreak: the mediating roles of rumination and depression. CURRENT PSYCHOLOGY 2022; 42:1-12. [PMID: 35915773 PMCID: PMC9330948 DOI: 10.1007/s12144-022-03551-8] [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] [Accepted: 07/20/2022] [Indexed: 11/03/2022]
Abstract
The link between psychological strain and suicidal ideation is well embedded in literature, however, the underlying mechanism is rarely explored. Therefore, this study aimed to examine the relationship between psychological strain, suicidal ideation, rumination, and depression among Pakistani young adults during the Covid-19 outbreak. In addition, it will also try to determine the mediating role of ruminative subtypes and depression in the relationship between psychological strain and suicidal ideation. The sample consists of 400 university students (83 males and 289 females) with the age range from 18 to 30 years (M = 22.25, SD = 2.40). Psychological strain scale, Suicidal Ideation Scale, Beck Depression Inventory, and Ruminative Response Scale were administered to the participants. Results indicated a significant and positive association between the study variables. Psychological strain positively influenced suicidal ideation both directly, and indirectly via brooding and depression. Both variables were found to be serially mediated by the brooding subtype of rumination and depression and not with the reflective subtype. Strain theory of suicide and response style theory also postulated important insights regarding the association of these variables in young adults, among which, strain is serially related to first brooding and then depression, which is eventually related to suicidal ideation. The present study makes a significant contribution to the literature by providing a unique conceptual and theoretical framework to identify suicide at the ideation level before it proceeds to behavior during this unprecedented time of the pandemic outbreak.
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Affiliation(s)
- Noor Ul Ain Muneeb
- Department of Behavioral Sciences, S3H, National University of Science and Technology, Islamabad, H-12 Pakistan
| | - Sumara Masood Ul Hassan
- Department of Behavioral Sciences, S3H, National University of Science and Technology, Islamabad, H-12 Pakistan
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15
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Cha CB, Robinaugh DJ, Schacter DL, Altheimer G, Marx BP, Keane TM, Kearns JC, Nock MK. Examining multiple features of episodic future thinking and episodic memory among suicidal adults. Suicide Life Threat Behav 2022; 52:356-372. [PMID: 34978101 PMCID: PMC9233069 DOI: 10.1111/sltb.12826] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/29/2021] [Accepted: 10/15/2021] [Indexed: 11/30/2022]
Abstract
BCKGROUND Theories of suicide suggest that suicidal ideation (SI) results in part from difficulty imagining the future, which itself relies on the ability to remember the past. The present study examines multiple components of episodic future thinking and memory including event richness, which is commonly measured within the cognitive literature but has not previously been assessed with suicidal individuals. METHODS Here, we tested the associations between SI and episodic future thinking and episodic memory across two studies (Study 1, n = 25; Study 2, n = 141): the first with a healthy comparison group and the second with a psychiatric comparison group. RESULTS Future event richness yielded large but statistically non-significant deficits in the SI group relative to healthy controls in Study 1 after controling the false discovery rate. The most robust effects for future thinking emerged in the case of perceived duration of future events, such that the SI group (vs. psychiatric comparison) imagined future events as longer-lasting in Study 2. Across both studies, episodic memory was unrelated to SI, and neither episodic future thinking nor memory predicted future SI. CONCLUSION Episodic future thinking may better distinguish individuals with SI history from psychiatric controls when compared with episodic memory, but that this effect is limited to select components of future thinking.
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Affiliation(s)
- Christine B. Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | | | | | | | - Brian P. Marx
- National Center for Posttraumatic Stress Disorder, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, and Boston University School of Medicine
| | - Terence M. Keane
- National Center for Posttraumatic Stress Disorder, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, and Boston University School of Medicine
| | - Jaclyn C. Kearns
- National Center for Posttraumatic Stress Disorder, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, and Boston University School of Medicine
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16
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Akdeniz S, Gültekin Ahçı Z. The role of cognitive flexibility and hope in the relationship between loneliness and psychological adjustment: a moderated mediation model. EDUCATIONAL AND DEVELOPMENTAL PSYCHOLOGIST 2022. [DOI: 10.1080/20590776.2022.2050460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Seher Akdeniz
- Faculty of Social and Humanity Science, Psychology Department, KTO Karatay University, Konya, Turkey
| | - Zeynep Gültekin Ahçı
- Faculty of Social and Humanity Science, Psychology Department, KTO Karatay University, Konya, Turkey
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17
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Relationship between cognitive flexibility and subsequent course of mood symptoms and suicidal ideation in young adults with childhood-onset bipolar disorder. Eur Child Adolesc Psychiatry 2022; 31:299-312. [PMID: 33392723 PMCID: PMC8253874 DOI: 10.1007/s00787-020-01688-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 11/18/2020] [Indexed: 02/03/2023]
Abstract
Neurocognitive deficits, such as cognitive flexibility impairments, are common in bipolar disorder (BD) and predict poor academic, occupational, and functional outcomes. However, the association between neurocognition and illness trajectory is not well understood, especially across developmental transitions. This study examined cognitive flexibility and subsequent mood symptom and suicidal ideation (SI) course in young adults with childhood-onset BD-I (with distinct mood episodes) vs. BD-not otherwise specified (BD-NOS) vs. typically-developing controls (TDCs). Sample included 93 young adults (ages 18-30) with prospectively verified childhood-onset DSM-IV BD-I (n = 34) or BD-NOS (n = 15) and TDCs (n = 44). Participants completed cross-sectional neuropsychological tasks and clinical measures. Then participants with BD completed longitudinal assessments of mood symptoms and SI at 6-month intervals (M = 39.18 ± 16.57 months of follow-up data). Analyses included ANOVAs, independent-samples t tests, chi-square analyses, and multiple linear regressions. Participants with BD-I had significant deficits in cognitive flexibility and executive functioning vs. BD-NOS and TDCs, and impaired spatial working memory vs. TDCs only. Two significant BD subtype-by-cognitive flexibility interactions revealed that cognitive flexibility deficits were associated with subsequent percentage of time depressed and with SI in BD-I but not BD-NOS, regardless of other neurocognitive factors (full-scale IQ, executive functioning, spatial working memory) and clinical factors (current and prior mood and SI symptoms, age of BD onset, global functioning, psychiatric medications, comorbidity). Thus, cognitive flexibility may be an important etiological brain/behavior mechanism, prognostic indicator, and intervention target for childhood-onset BD-I, as this deficit appears to endure into young adulthood and is associated with worse prognosis for subsequent depression and SI.
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18
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Rogers ML, Vespa A, Bloch-Elkouby S, Galynker I. Validity of the modular assessment of risk for imminent suicide in predicting short-term suicidality. Acta Psychiatr Scand 2021; 144:563-577. [PMID: 34333759 DOI: 10.1111/acps.13354] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/29/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The Modular Assessment of Risk for Imminent Suicide (MARIS) is a clinical assessment tool, consisting of four modules assessing (1) a pre-suicidal cognitive-affective state (Module 1); (2) patients' attitudes toward suicide (Module 2); (3) clinicians' assessment of suicide risk factors (Module 3); and (4) clinicians' emotional responses to patients (Module 4) that assesses short-term suicide risk. Initial evidence provided evidence for its reliability and concurrent validity. The present study extended these findings by examining the MARIS's predictive validity in relation to suicidal thoughts and behaviors at one-month follow-up. METHODS A sample of 1039 psychiatric patients (378 inpatients, 661 outpatients) and their clinicians (N = 144) completed a battery of measures at baseline; 670 patients completed the one-month follow-up assessment. RESULTS MARIS total scores predicted suicidal thoughts and behaviors at one-month follow-up, even after controlling for baseline suicidal thoughts and behaviors. Moreover, both Module 1 and the Distress subscale of Module 4 were uniquely associated with suicidal thoughts and behaviors at one-month follow-up, controlling for baseline suicidal thoughts and behaviors. Modules 2 and 3, on the other hand, exhibited poor internal consistency. CONCLUSION Overall, both patient- and clinician-rated indices are uniquely predictive of suicidal thoughts and behaviors at one-month follow-up, highlighting the need for integrating clinicians' emotional responses into suicide risk assessment. Pending replication and extension of these findings in external samples, a briefer, two-module version of MARIS (MARIS-2) may be such an integrative, psychometrically sound, and clinically useful instrument that can be utilized to assess short-term suicide risk.
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Affiliation(s)
- Megan L Rogers
- Icahn School of Medicine, Mount Sinai Beth Israel, New York, New York, USA
| | - Allison Vespa
- Icahn School of Medicine, Mount Sinai Beth Israel, New York, New York, USA
| | | | - Igor Galynker
- Icahn School of Medicine, Mount Sinai Beth Israel, New York, New York, USA
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19
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Rogers ML, Cao E, Sinclair C, Galynker I. Associations between goal orientation and suicidal thoughts and behaviors at one-month follow-up: Indirect effects through ruminative flooding. Behav Res Ther 2021; 145:103945. [PMID: 34399271 DOI: 10.1016/j.brat.2021.103945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/24/2021] [Accepted: 08/10/2021] [Indexed: 12/29/2022]
Abstract
Previous research has identified both goal orientation and ruminative flooding as potential risk factors for suicidal thoughts and behaviors, as well as positive associations between goal orientation and rumination. The present study examined whether the association between goal orientation and suicidal thoughts and behaviors, assessed one month later, was accounted for by ruminative flooding. A sample of 924 psychiatric outpatients (Mage = 39.09 years, SD = 14.82, range = 18 to 84; 61.7% female; 37.0% White) completed self-report and interview measures at baseline and provided information about suicide-related outcomes at one-month follow-up. Goal orientation was positively associated with ruminative flooding, and both goal orientation and ruminative flooding were associated with suicidal thoughts and behaviors at one-month follow-up. Controlling for lifetime suicidal thoughts and behaviors, as well as patient age and sexual orientation, ruminative flooding accounted for the relationship between goal orientation and suicidal thoughts and behaviors at one-month follow-up. These findings were especially relevant for individuals with a history of multiple suicide attempts. Overall, this study provided evidence that difficulties with goal orientation may relate to suicidal thoughts and behaviors through intense ruminations perceived as a loss of cognitive control. Interventions that address ruminative thinking and cognitive flexibility may, in turn, assist in reducing emotion dysregulation and managing suicidality among those who struggle with goal orientation.
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Affiliation(s)
| | - Erjia Cao
- Icahn School of Medicine, Mount Sinai Beth Israel, USA; Department of Counseling and Clinical Psychology, Teachers College, Columbia University, USA
| | - Courtney Sinclair
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, USA
| | - Igor Galynker
- Icahn School of Medicine, Mount Sinai Beth Israel, USA
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20
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Kato T. Moderation Effects of Coping Flexibility on the Association Between Depressive Symptoms and Suicidal Risk. CRISIS 2021; 43:398-403. [PMID: 34128687 DOI: 10.1027/0227-5910/a000800] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: This study focused on poor coping flexibility, which involves the perseveration of a failed coping strategy, as a moderator of the association between depression and suicidal risk; no study has previously examined the association between coping flexibility and suicidal risk. Aims: This study examined whether individuals with lower coping flexibility would have a stronger suicidal risk when experiencing depression above a certain level. Method: Participants, who were 682 college students, answered questionnaires regarding coping flexibility, depressive symptoms, and suicidal risk. Results: Hierarchical multiple regression analyses showed that in individuals with greater depressive symptoms, lower coping flexibility was associated with higher suicidal risk, but this was not the case in individuals without depressive symptoms. Our hypothesis was supported. Limitations: Our findings cannot indicate the causal direction of the association between coping flexibility and depressive symptoms and suicidal risk. Conclusion: Our findings may be useful in understanding the association between depression and suicidal risk through coping flexibility and contribute to reductions in suicidal risk, as coping flexibility can be improved through training.
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Affiliation(s)
- Tsukasa Kato
- Department of Social Psychology, Tokyo University, Japan
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21
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Stange JP, Jenkins LM, Pocius S, Kreutzer K, Bessette KL, DelDonno SR, Kling LR, Bhaumik R, Welsh RC, Keilp JG, Phan KL, Langenecker SA. Using resting-state intrinsic network connectivity to identify suicide risk in mood disorders. Psychol Med 2020; 50:2324-2334. [PMID: 31597581 PMCID: PMC7368462 DOI: 10.1017/s0033291719002356] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Little is known about the neural substrates of suicide risk in mood disorders. Improving the identification of biomarkers of suicide risk, as indicated by a history of suicide-related behavior (SB), could lead to more targeted treatments to reduce risk. METHODS Participants were 18 young adults with a mood disorder with a history of SB (as indicated by endorsing a past suicide attempt), 60 with a mood disorder with a history of suicidal ideation (SI) but not SB, 52 with a mood disorder with no history of SI or SB (MD), and 82 healthy comparison participants (HC). Resting-state functional connectivity within and between intrinsic neural networks, including cognitive control network (CCN), salience and emotion network (SEN), and default mode network (DMN), was compared between groups. RESULTS Several fronto-parietal regions (k > 57, p < 0.005) were identified in which individuals with SB demonstrated distinct patterns of connectivity within (in the CCN) and across networks (CCN-SEN and CCN-DMN). Connectivity with some of these same regions also distinguished the SB group when participants were re-scanned after 1-4 months. Extracted data defined SB group membership with good accuracy, sensitivity, and specificity (79-88%). CONCLUSIONS These results suggest that individuals with a history of SB in the context of mood disorders may show reliably distinct patterns of intrinsic network connectivity, even when compared to those with mood disorders without SB. Resting-state fMRI is a promising tool for identifying subtypes of patients with mood disorders who may be at risk for suicidal behavior.
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Affiliation(s)
| | | | | | | | | | | | | | - Runa Bhaumik
- University of Illinois at Chicago, Chicago, IL, USA
| | | | | | - K. Luan Phan
- University of Illinois at Chicago, Chicago, IL, USA
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22
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Marchiol F, Lionetti F, Luxardi GL, Cavallero C, Roberts M, Penolazzi B. Cognitive inflexibility and over‐attention to detail: The Italian validation of the
DFlex
Questionnaire in patients with eating disorders. EUROPEAN EATING DISORDERS REVIEW 2020; 28:671-686. [DOI: 10.1002/erv.2781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/22/2020] [Accepted: 07/28/2020] [Indexed: 12/19/2022]
Affiliation(s)
| | - Francesca Lionetti
- Department of Neurosciences Imaging and Clinical Sciences University "G. D'Annunzio", Chieti‐Pescara, IT; Department of Biological and Experimental Psychology, Queen Mary University of London London UK
| | - Gian Luigi Luxardi
- Center for Eating Disorders, AAS n5 'Friuli Occidentale’ – Pordenone Pordenone Italy
| | | | - Marion Roberts
- Department of General Practice & Primary Health Care, Faculty of Medical & Health Sciences University of Auckland Auckland New Zealand
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Maternal depressive symptoms, rumination, and child emotion regulation. Eur Child Adolesc Psychiatry 2020; 29:1125-1134. [PMID: 31679099 DOI: 10.1007/s00787-019-01430-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 10/24/2019] [Indexed: 10/25/2022]
Abstract
Children of depressed mothers are at risk for maladaptive emotion regulation. This study examined a model of maternal rumination that links maternal depressive symptoms to child emotion regulation. A sample of 126 mother-child dyads (65 girls) participated in the current study, at three assessment points when children were age three, four, and five. At all assessment points, mothers reported their depressive symptoms and ruminative response style. Child emotion regulation was assessed observationally from two laboratory tasks, which were designed to elicit anger and sadness. Elevated maternal depressive symptoms were associated with higher concurrent rumination. Maternal rumination at child age four predicted that more child focus on distress during sadness-eliciting tasks and less child active distraction during anger-eliciting tasks 1 year later. Additionally, maternal rumination at child age three and four predicted less child passive behaviors in anger-eliciting tasks prospectively. Findings suggest that maternal rumination is predictive of using maladaptive regulatory strategies among children of depressed mothers. This study has significant implications for intervention programs targeting depressed mothers and their children.
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24
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A Test of the Habit-Goal Framework of Depressive Rumination and Its Relevance to Cognitive Reactivity. Behav Ther 2020; 51:474-487. [PMID: 32402262 DOI: 10.1016/j.beth.2019.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 07/31/2019] [Accepted: 08/08/2019] [Indexed: 12/15/2022]
Abstract
The aim of the present study was to test predictions derived from the habit-goal framework of depressive rumination and investigate its relevance to cognitive reactivity-another well-known vulnerability factor to depression. Formerly depressed (FD; n=20) and never depressed (ND; n=22) participants completed self-report measures of rumination, cognitive reactivity, and habitual characteristics of rumination (e.g., lack of awareness, control, intent). A standard mood-induction task was also used to measure cognitive reactivity and an outcome-devaluation task to measure general habit vs. goal-directed behavior control. Habitual characteristics of ruminative thoughts were greater in the FD group and were related to depressive brooding and cognitive reactivity, but not reflective pondering. Reliance on habit on the outcome-devaluation task was strongly correlated with number of depression episodes, although group differences were not observed in general habit vs. goal-directed control. Habitual characteristics of rumination (e.g., greater automaticity) may explain reactivity and persistence of negative thoughts in depression. Habitual behavior control may contribute to inflexible responding and vulnerability for depression episodes.
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25
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Schmaal L, van Harmelen AL, Chatzi V, Lippard ETC, Toenders YJ, Averill LA, Mazure CM, Blumberg HP. Imaging suicidal thoughts and behaviors: a comprehensive review of 2 decades of neuroimaging studies. Mol Psychiatry 2020; 25:408-427. [PMID: 31787757 PMCID: PMC6974434 DOI: 10.1038/s41380-019-0587-x] [Citation(s) in RCA: 177] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 10/21/2019] [Accepted: 10/29/2019] [Indexed: 01/06/2023]
Abstract
Identifying brain alterations that contribute to suicidal thoughts and behaviors (STBs) are important to develop more targeted and effective strategies to prevent suicide. In the last decade, and especially in the last 5 years, there has been exponential growth in the number of neuroimaging studies reporting structural and functional brain circuitry correlates of STBs. Within this narrative review, we conducted a comprehensive review of neuroimaging studies of STBs published to date and summarize the progress achieved on elucidating neurobiological substrates of STBs, with a focus on converging findings across studies. We review neuroimaging evidence across differing mental disorders for structural, functional, and molecular alterations in association with STBs, which converges particularly in regions of brain systems that subserve emotion and impulse regulation including the ventral prefrontal cortex (VPFC) and dorsal PFC (DPFC), insula and their mesial temporal, striatal and posterior connection sites, as well as in the connections between these brain areas. The reviewed literature suggests that impairments in medial and lateral VPFC regions and their connections may be important in the excessive negative and blunted positive internal states that can stimulate suicidal ideation, and that impairments in a DPFC and inferior frontal gyrus (IFG) system may be important in suicide attempt behaviors. A combination of VPFC and DPFC system disturbances may lead to very high risk circumstances in which suicidal ideation is converted to lethal actions via decreased top-down inhibition of behavior and/or maladaptive, inflexible decision-making and planning. The dorsal anterior cingulate cortex and insula may play important roles in switching between these VPFC and DPFC systems, which may contribute to the transition from suicide thoughts to behaviors. Future neuroimaging research of larger sample sizes, including global efforts, longitudinal designs, and careful consideration of developmental stages, and sex and gender, will facilitate more effectively targeted preventions and interventions to reduce loss of life to suicide.
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Affiliation(s)
- Lianne Schmaal
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | | | - Vasiliki Chatzi
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Yara J Toenders
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Lynnette A Averill
- Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Veterans Affairs National Center for PTSD, Clinical Neurosciences Division, West Haven, CT, USA
| | - Carolyn M Mazure
- Psychiatry and Women's Health Research at Yale, Yale School of Medicine, New Haven, CT, USA
| | - Hilary P Blumberg
- Psychiatry, Radiology and Biomedical Imaging, Child Study Center, Yale School of Medicine, New Haven, CT, USA.
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Sousa GSD, Perrelli JGA, Mangueira SDO, Sougey EB. Validation by experts of Risk of suicide Nursing Diagnosis in the elderly. Rev Bras Enferm 2019; 72:111-118. [PMID: 31826199 DOI: 10.1590/0034-7167-2018-0252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/10/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to validate the conceptual and operational definitions content of factors for Risk of suicide Nursing Diagnosis in the elderly. METHOD this is validation of the conceptual and operational definitions content of factors for Risk of suicide in the elderly, performed by 15 experts, from November 2015 to March 2016. Risk factors were classified into three hierarchical chuncks. The data were analyzed by descriptive statistics and binomial test. RESULTS of the 54 validated risk factors, only eight presented problems regarding clarity, simplicity and accuracy: chronic pain, vision problems, retirement, frustration, medication neglect and depression. Only rigidity was not validated as relevant for the study diagnosis. CONCLUSION content validation of the risk factors for Nursing Diagnosis can guide the clinical practice of the nurse in the early detection of risk of suicide in the elderly.
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Huber RS, Hodgson R, Yurgelun-Todd DA. A qualitative systematic review of suicide behavior using the cognitive systems domain of the research domain criteria (RDoC) framework. Psychiatry Res 2019; 282:112589. [PMID: 31703982 DOI: 10.1016/j.psychres.2019.112589] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/23/2019] [Accepted: 09/26/2019] [Indexed: 12/24/2022]
Abstract
Neurocognitive deficits are associated with both suicide behavior (SB) and psychiatric disorders. Application of a transdiagnostic framework to identify neurocognitive commonalities of SB may clarify important risk factors of SB across psychiatric disorders. The aim of this study was to conduct a qualitative systematic literature review of SB using the Research Domain Criteria (RDoC) Cognitive Systems framework to determine if cognitive deficits exist independently of psychiatric disorders in SB. The following six constructs that encompass the Cognitive Systems domain were assessed: 1) Attention, 2) Cognitive Control, 3) Declarative Memory, 4) Language, 5) Perception, and 6) Working Memory. A total of 1386 abstracts were identified and 74 studies met the inclusion criteria for this review. The majority of studies reviewed (65%) had significant differences in cognition between individuals with and without SB. Seventy-nine percent of studies with a patient control group showed significant cognitive deficits in SB groups. Deficits in cognitive control were associated with SB and had the greatest percentage of studies with significant main findings. Use of the RDoC cognitive systems framework to evaluate SB revealed that cognitive deficits may be a transdiagnostic risk factor for SB, especially alterations in cognitive control.
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Affiliation(s)
- Rebekah S Huber
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States; Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, United States.
| | - Riley Hodgson
- Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, United States
| | - Deborah A Yurgelun-Todd
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States; Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, United States; U.S. Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, UT, United States
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Bomyea J, Stout DM, Simmons AN. Attenuated prefrontal and temporal neural activity during working memory as a potential biomarker of suicidal ideation in veterans with PTSD. J Affect Disord 2019; 257:607-614. [PMID: 31349177 DOI: 10.1016/j.jad.2019.07.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 04/05/2019] [Accepted: 07/04/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Suicide is a significant health concern among veterans, and suicidal ideation is a common and functionally debilitating condition that frequently precedes suicidal behavior. Characterizing neurobiological substrates associated with suicidal ideation in veterans may inform evaluation of risk for this population. Associations between suicidal ideation and functional abnormalities in prefrontal, temporal, and striatal regions supporting cognitive task performance have been documented in individuals with mood and psychotic disorders, suggesting a potential role for neurocognitive vulnerabilities in this condition. To date, however, relatively little research has explored neural correlates of suicidal ideation, particularly among individuals with posttraumatic stress disorder (PTSD). METHODS Twenty three combat veterans diagnosed with PTSD completed an adapted Reading Span (Rspan) working memory task during functional magnetic resonance imaging (fMRI). Participants were classified based on presence of current SI. We evaluated differences between these groups on neural activation in response to interference-based working memory demands within the task. Primary analyses were conducted using a voxel-wise between-group t-test. RESULTS Task-based activations were observed in regions including the cingulate, middle frontal, parietal, and occipital cortex, striatum, and cerebellum. Relative to individuals without SI, individuals with SI demonstrated less activation in a large region spanning the lateral prefrontal cortex and cingulate cortex, as well as the inferior temporal cortex, in response to interference demands. CONCLUSIONS Results are consistent with models proposing that prefrontal neural substrates involved in cognitive regulation are implicated in suicidal ideation. Involvement of temporal functioning may also exist based on current findings. Future research is needed to understand whether disturbances in prefrontal regulatory control reflect a specific profile subtype with distinct neural correlates, and how such neural patterns may be used to improve detection and treatment personalization.
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Affiliation(s)
- J Bomyea
- VA San Diego Healthcare System Center of Excellence for Stress and Mental Health, University of California, San Diego, United States.
| | - D M Stout
- VA San Diego Healthcare System Center of Excellence for Stress and Mental Health, University of California, San Diego, United States
| | - A N Simmons
- VA San Diego Healthcare System Center of Excellence for Stress and Mental Health, University of California, San Diego, United States
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Attentional bias and the Suicide Status Form: Behavioral perseveration of written responses. Behav Res Ther 2019; 120:103403. [DOI: 10.1016/j.brat.2019.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 04/04/2019] [Accepted: 04/11/2019] [Indexed: 10/26/2022]
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Associations between depression, anxiety, stress, hopelessness, subjective well-being, coping styles and suicide in Chinese university students. PLoS One 2019; 14:e0217372. [PMID: 31260454 PMCID: PMC6602174 DOI: 10.1371/journal.pone.0217372] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/09/2019] [Indexed: 12/13/2022] Open
Abstract
Suicide is a major public health concern worldwide. This study aimed to predict the suicidal behavior of Chinese university students by studying psychological measures such as hopelessness, orientation to happiness, meaning in life, depression, anxiety, stress, and coping styles. In November 2016, a stratified-clustered-random sampling approach was utilized to select subjects from two large public medical-related universities in Shandong province, China. This sample consisted of 2,074 undergraduate students (706 males, 1,368 females; mean age = 19.79±1.39 years). The students’ major risk factors for suicide were depression, anxiety, stress, and hopelessness, and the students’ minor risk factors included orientation to happiness and coping styles (including self-distraction, self-blame and substance use). Notably, the presence of meaning in life had a positive effect on preventing suicide and acted as a protective factor, which suggests that it is important to identify risk factors as well as protective factors relevant to the target population group in order to increase the effectiveness of counseling and suicide prevention programs.
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Ram D, Chandran S, Sadar A, Gowdappa B. Correlation of Cognitive Resilience, Cognitive Flexibility and Impulsivity in Attempted Suicide. Indian J Psychol Med 2019; 41:362-367. [PMID: 31391670 PMCID: PMC6657482 DOI: 10.4103/ijpsym.ijpsym_189_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
CONTEXT Impaired cognitive flexibility and resilience and increased impulsivity are presumed to underlie an attempt of suicide. There is, however, a paucity of research examining their relationship in those who attempted suicide. AIMS To know the correlation of cognitive flexibility and resilience and impulsivity in attempted suicide. MATERIALS AND METHODS Two hundred seventy subjects with suicide attempt (s) were assessed with sociodemographic and clinical proforma, cognitive flexibility scale (CFS), cognitive resilience scale (CRS), and Barratt impulsiveness scale (BIS-15). STATISTICAL ANALYSIS USED Descriptive statistics, linear regression model. RESULTS Mean scores on CFS, CRS, and BIS-15 were 44.93 (SD ± 2.50), 4.49 (SD ± 0.25), and 36.13(SD ± 2.13), respectively. On linear regression analysis, BIS-15 nonplanning had statistically significant negative correlation with CFS and CRS scores, and BIS-15 attention had a positive correlation with CFS and CRS scores. CFS and CRS scores were positively correlated. CONCLUSIONS In attempted suicide, cognitive flexibility and resilience are interrelated positively and inversely associated with impulsivity (nonplanning and inattention).
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Affiliation(s)
- Dushad Ram
- Department of Psychiatry, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Suhas Chandran
- Department of Psychiatry, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Aarsha Sadar
- Department of Psychiatry, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Basavana Gowdappa
- Department of Medicine, JSS Medical College and Hospital, Mysore, Karnataka, India
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Brick LA, Marraccini ME, Micalizzi L, Benca-Bachman CE, Knopik VS, Palmer RHC. Overlapping genetic effects between suicidal ideation and neurocognitive functioning. J Affect Disord 2019; 249:104-111. [PMID: 30769295 PMCID: PMC6937431 DOI: 10.1016/j.jad.2019.02.003] [Citation(s) in RCA: 10] [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: 09/29/2018] [Revised: 01/18/2019] [Accepted: 02/05/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Suicide is the second leading cause of death among adolescents and young adults. Several studies have indicated significant genetic influences on suicide-related phenotypes and mounting evidence from neurobiological research has linked deficits in neurocognitive abilities to suicide phenotypes. The goal of the present study was to estimate the heritability of suicidal ideation (SI) in a large sample of adolescents and determine if SI is genetically correlated with neurocognitive functioning. METHODS Genome-wide data (N = 3564 unrelated individuals of European Ancestry) were drawn from the Philadelphia Neurodevelopment Cohort. Adolescents completed a psychiatric assessment, as well as a computerized neurocognitive battery to assess performance across four domains: memory, executive function, social cognition, and complex cognition. Genomic-relatedness-matrix restricted maximum likelihood (GREML) estimation was used to determine SNP-heritability (h2SNP) of SI and the genetic correlation (rG) between SI and neurocognitive domains. RESULTS Nearly 17% of adolescents reported SI. The SNP-heritability estimate for SI was marginally significant (h2SNP = 11%, SE = 8%, p = 0.086). Bivariate analyses indicated a significant rG between SI and emotion identification (rG = 0.79, SE = 0.45, p = 0.006; phenotypic correlation r = 0.04, p = 0.017). LIMITATIONS It is possible that SI may represent a related, but differentially heritable construct from suicide attempts/completion and other comorbid psychopathology. Additionally, though genetic correlations point to shared genetic factors across traits, direct causal mechanisms cannot be deduced. CONCLUSIONS Common heritable factors contribute to variation in SI and neurocognitive functioning. Genetic factors influencing emotion identification have significant genetic overlap with SI.
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Affiliation(s)
- Leslie A Brick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
| | - Marisa E Marraccini
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lauren Micalizzi
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA
| | - Chelsie E Benca-Bachman
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, Atlanta, GA, USA
| | - Valerie S Knopik
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, USA
| | - Rohan H C Palmer
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, Atlanta, GA, USA
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Hasking P, Boyes ME, Finlay-Jones A, McEvoy PM, Rees CS. Common Pathways to NSSI and Suicide Ideation: The Roles of Rumination and Self-Compassion. Arch Suicide Res 2019; 23:247-260. [PMID: 29791304 DOI: 10.1080/13811118.2018.1468836] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
We investigated whether rumination and self-compassion moderate and/or mediate the relationships between negative affect and both non-suicidal self-injury (NSSI) and suicide ideation. Undergraduate university students (n = 415) completed well-validated measures of negative affect, rumination, self-compassion, NSSI, and suicide ideation. Neither rumination nor self-compassion moderated associations between negative affect and NSSI and suicide ideation. However, both rumination and self-compassion mediated associations between negative affect and lifetime history of NSSI and suicide ideation. Self-compassion additionally mediated the association between negative affect and both 12-month NSSI and suicide ideation. The salience of self-compassion, particularly in predicting recent NSSI and suicide ideation, offers promise for early intervention initiatives focusing on less judgmental or self-critical means of self-relation.
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Affiliation(s)
- Penelope Hasking
- a School of Psychology and Speech Pathology , Curtin University , Perth , Western Australia
| | - Mark E Boyes
- a School of Psychology and Speech Pathology , Curtin University , Perth , Western Australia
| | - Amy Finlay-Jones
- a School of Psychology and Speech Pathology , Curtin University , Perth , Western Australia.,b Telethon Kids Institute , Perth , Western Australia
| | - Peter M McEvoy
- a School of Psychology and Speech Pathology , Curtin University , Perth , Western Australia.,c Centre for Clinical Interventions , Perth , Western Australia
| | - Clare S Rees
- a School of Psychology and Speech Pathology , Curtin University , Perth , Western Australia
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Cognition and self-injurious thoughts and behaviors: A systematic review of longitudinal studies. Clin Psychol Rev 2019; 69:97-111. [DOI: 10.1016/j.cpr.2018.07.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 07/08/2018] [Accepted: 07/12/2018] [Indexed: 12/11/2022]
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Abstract
Suicide morbidity and mortality are serious public health problems, accounting for over 40,000 deaths annually and over $10 billion in combined medical and work loss costs. Suicidal behavior is the outcome of a complex causal web of distal and proximal risk processes that includes a range of interacting environmental and biological determinants. We review current understanding of risk and protective factors, including recent findings on inflammatory processes, discuss recent research on environmental risks for suicidal behaviors with a focus on economic stress, and examine potential mechanisms by which external factors and internal processes such as inflammation might contribute to pathways leading to suicidal behavior. We propose a model that links changes in the default network or resting state of brain activity with corresponding changes in brain structure and function, which in turn may be influenced by diverse inflammatory mediators, and suggest a potential framework that highlights multidisciplinary opportunities for further research.
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The Relationship Between Negative Cognitive Styles and Lifetime Suicide Attempts is Indirect Through Lifetime Acute Suicidal Affective Disturbance Symptoms. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9968-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Crandall A, Allsop Y, Hanson CL. The longitudinal association between cognitive control capacities, suicidality, and depression during late adolescence and young adulthood. J Adolesc 2018; 65:167-176. [PMID: 29602159 DOI: 10.1016/j.adolescence.2018.03.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 03/15/2018] [Accepted: 03/17/2018] [Indexed: 12/28/2022]
Abstract
This study examined the association between cognitive control capacities, suicidal thoughts and attempts, and depressive symptoms during late adolescence and young adulthood. The sample included 4192 participants (55.5% female) from the United States who participated in Waves III (2001-2002; respondent age 18-26 years) and IV (2007-2008; respondent age 24-33 years) of the National Longitudinal Study of Adolescent to Adult Health. Data were analyzed using structural equation modeling. Suicidality in late adolescence predicted depressive symptoms in young adulthood. Depressive symptoms were not predictive of later suicide ideation nor attempts. Working memory was associated with lower depressive symptoms. Higher verbal ability was associated with more suicidal thoughts but not attempts. Internal locus of control was associated with decreased depressive symptoms and suicidal thoughts/attempts in young adulthood. Findings suggest that cognitive control capacities developed in adolescence differentially predict depressive symptoms, suicidal thoughts, and suicide attempts in young adulthood.
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Affiliation(s)
- AliceAnn Crandall
- Brigham Young University, Department of Public Health, 4103 Life Sciences Building, Provo, UT 84602, USA.
| | - Yvonne Allsop
- Brigham Young University, Department of Public Health, 4103 Life Sciences Building, Provo, UT 84602, USA.
| | - Carl L Hanson
- Brigham Young University, Department of Public Health, 4103 Life Sciences Building, Provo, UT 84602, USA.
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Li S, Yaseen ZS, Kim HJ, Briggs J, Duffy M, Frechette-Hagan A, Cohen LJ, Galynker II. Entrapment as a mediator of suicide crises. BMC Psychiatry 2018; 18:4. [PMID: 29310622 PMCID: PMC5759206 DOI: 10.1186/s12888-018-1587-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 01/01/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Prior research has validated the construct of a suicide crisis syndrome (SCS), a specific psychological state that precedes and may precipitate suicidal behavior. The feeling of entrapment is a central concept of the SCS as well as of several other recent models of suicide. However, its exact relationship with suicidality is not fully understood. In efforts to clarify the exact role of entrapment in the suicidal process, we have examined if entrapment mediates the relationship of other components of the SCS, including ruminative flooding, panic-dissociation, fear of dying and emotional pain, with suicidal ideation (SI) in recently hospitalized psychiatric inpatients. METHODS The Suicide Crisis Inventory (SCI) and Beck Scale for Suicidal Ideation (BSS) were administered to 200 high-risk adult psychiatric inpatients hospitalized following SI or suicide attempt, assessing SCS and SI levels at admission, respectively. The possible mediation effects of entrapment on the relationship between the other components of the SCS and SI at admission were evaluated. RESULTS Entrapment significantly and fully mediated the relationship of ruminative flooding, panic-dissociation, and fear of dying with SI, with no direct relationships between these variables and SI reaching statistical significance. Further, no reverse mediation relationships between these variables and SI were found, indicating that the mediation effects of entrapment were unidirectional. While entrapment did mediate the association between emotional pain and SI, the direct relationship between emotional pain and SI was also significant. Moreover, in reverse mediational analysis, emotional pain was a partial mediator of the relationship between entrapment and SI. CONCLUSION Entrapment and emotional pain may have a more direct association with SI than the other components of the SCS, including ruminative flooding, panic-dissociation, and fear of dying, the effects of which are mediated by the former. This suggests entrapment and emotional pain may represent key symptomatic targets for intervention in acutely suicidal individuals. Further research is needed to determine the relationship of these constructs to suicidal behavior.
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Affiliation(s)
- Shuang Li
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
| | - Zimri S. Yaseen
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
| | - Hae-Joon Kim
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
| | - Jessica Briggs
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
| | - Molly Duffy
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
| | - Anna Frechette-Hagan
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
| | - Lisa J. Cohen
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
| | - Igor I. Galynker
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
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Senra C, Merino H, Ferreiro F. Exploring the link between perfectionism and depressive symptoms: Contribution of rumination and defense styles. J Clin Psychol 2017; 74:1053-1066. [DOI: 10.1002/jclp.22571] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 10/23/2017] [Accepted: 11/13/2017] [Indexed: 11/09/2022]
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Hashemi R, Moustafa AA, Rahmati Kankat L, Valikhani A. Mindfulness and Suicide Ideation in Iranian Cardiovascular Patients: Testing the Mediating Role of Patience. Psychol Rep 2017; 121:1037-1052. [DOI: 10.1177/0033294117746990] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of the present study was to explore the mediating role of patience on the relationship between mindfulness and suicide ideation. To do so, 110 patients with cardiovascular diseases were recruited from the outpatient Clinic of Imam Reza in the city of Shiraz in Iran. These patients completed The Five Facets Mindfulness Questionnaire, Patience Scale, and Suicide Ideation Questionnaire. Data were analyzed using structural equation modeling. Results indicated a significant positive relationship between mindfulness and patience ( r = .32, p < .001). There was a significant negative relationship between patience and suicide ideation ( r = −.36, p < .001). The results of mediating model showed that patience functioned as a mediator in the relationship between mindfulness and suicide ideation among patients with cardiovascular diseases ( β = −.33, p = .005). According to these findings, it can be claimed that mindfulness affects patients’ suicidal thoughts negatively through patience.
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Affiliation(s)
- Razieh Hashemi
- Department of Clinical Psychology, School of Education and Psychology, Shiraz University, Shiraz, Iran
| | - Ahmed A. Moustafa
- School of Social Sciences and Psychology, Marcs Institute of Brain, Behaviour, and Development, Western Sydney University, Sydney, Australia
| | - Leila Rahmati Kankat
- Department of Clinical Psychology, Faculty of Humanities, Islamic Azad University of Arak, Arak, Iran
| | - Ahmad Valikhani
- Department of Clinical Psychology, School of Education and Psychology, Shiraz University, Shiraz, Iran
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Valderrama J, Miranda R. Early life stress predicts negative urgency through brooding, depending on 5-HTTLPR genotype: A pilot study with 6-month follow-up examining suicide ideation. Psychiatry Res 2017; 258:481-487. [PMID: 28890225 PMCID: PMC5681408 DOI: 10.1016/j.psychres.2017.08.092] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 08/29/2017] [Accepted: 08/30/2017] [Indexed: 12/26/2022]
Abstract
The present study examined the interaction between early life stress and 5-HTT genotypes in predicting two risk factors for suicidal behavior - the brooding subtype of rumination and impulsivity, in the form of negative urgency - over time. Furthermore, we examined early life stress, brooding, and impulsivity as predictors of suicidal ideation over time. Participants with and without a history of early life stress were genotyped for the 5-HTTLPR polymorphism and completed assessments assessing brooding and negative urgency at baseline and 6-month follow up. Early life emotional abuse was associated with negative urgency at follow-up. We found an indirect effect of early life emotional abuse on negative urgency through brooding among individuals with 5-HTT low expressing genotypes but not among individuals with 5-HTT high expressing genotypes. Further, a logistic regression analysis revealed that negative urgency was associated with higher odds (O.R. = 16.2) of reporting suicide ideation (versus no ideation) at follow-up. Our findings suggest that brooding and negative urgency may result from the interaction between early life emotional abuse and 5-HTT low expressing genotypes. Further research is necessary to understand how early life stress interacts with 5-HTT genotypes to confer risk for suicidal behavior through psychological mechanisms.
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Affiliation(s)
- Jorge Valderrama
- Department of Psychology, Hunter College, City University of New York, NY, USA; Department of Psychology, The Graduate Center, City University of New York, NY, USA.
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Abdollahi A, Hosseinian S, Nooripour R, Najafi M. Clarifying the Roles of Hardiness and Hopelessness in Relation to Suicidal Ideation Among Malaysian Undergraduate Students. PRACTICE IN CLINICAL PSYCHOLOGY 2017. [DOI: 10.29252/nirp.jpcp.5.4.243] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Repetitive negative thinking and suicide: a burgeoning literature with need for further exploration. Curr Opin Psychol 2017; 22:68-72. [PMID: 28888174 DOI: 10.1016/j.copsyc.2017.08.027] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 08/11/2017] [Accepted: 08/18/2017] [Indexed: 11/27/2022]
Abstract
Extant research has found a significant overlap between various repetitive negative thinking (RNT) patterns, such as rumination and worry, across different affective disorders implicating that the process of repetitive negative thinking is likely trans-diagnostic. Furthermore, RNT patterns at the core of psychiatric disorders associated with suicide (e.g., rumination and worry) have been found to be associated with suicide even after accounting for the disorder. A synthesis of existing literature on repetitive negative thoughts suggest that following negative emotional experiences, RNTs may lead to a sense of entrapment and hopelessness that may contribute to the onset of suicidal ideation and then facilitate the transition from thinking about suicide to making a suicide attempt by increasing an individual's capability for suicide through repetitive exposure to violent thoughts and imagery associated with suicide.
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Chung Y, Jeglic EL. Detecting Suicide Risk Among College Students: A Test of the Predictive Validity of the Modified Emotional Stroop Task. Suicide Life Threat Behav 2017; 47:398-409. [PMID: 27658610 DOI: 10.1111/sltb.12287] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 05/17/2016] [Indexed: 11/30/2022]
Abstract
Detecting suicide risk among nonclinical populations is challenging due to low base rates and the help-negation tendency of at-risk individuals. The current longitudinal study investigated the predictive validity of the modified emotional Stroop task (EST) by conducting a follow-up study of 197 students who participated in a study by Chung and Jeglic (2016). The EST latencies for suicide-related cues and past suicidal behaviors were the only significant predictors of suicide risk. The findings of this study provide preliminary support for the use of the EST as part of a suicide risk screening battery that could add to the detection of suicide risk.
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Affiliation(s)
- Yeunjoo Chung
- The Graduate Center, City University of New York, New York, NY, USA
| | - Elizabeth L Jeglic
- John Jay College of Criminal Justice, City University of New York, New York, NY, USA
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Rumination, Suicidal Ideation, and Suicide Attempts: A Meta-Analytic Review. REVIEW OF GENERAL PSYCHOLOGY 2017. [DOI: 10.1037/gpr0000101] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Rumination has been implicated as a risk factor for suicidal ideation and attempts, yet the literature to date has not been synthesized. We conducted a meta-analysis of the association between rumination and both suicidal ideation and attempts to consolidate the existing literature ( k = 29). Results indicated that the relationships between global rumination ( k = 13; Hedge's g = .74, p < .001, 95% CI [.45, 1.04]), brooding ( k = 12; Hedge's g = .63, p < .001, 95% CI [.35, .90]), and reflection ( k = 12; Hedge's g = .38, p = .002, 95% CI [.10, .65]) with suicidal ideation were significant. Associations between global rumination ( k = 3; Hedge's g = .26, p < .001, 95% CI [.08, .44]) and brooding ( k = 4; Hedge's g = .47, p = .004, 95% CI [.02, .91]) and suicide attempts were significant, but reflection ( k = 4; Hedge's g = .09, p = .646, 95% CI [−.54, .72]) was unrelated. However, given the limited studies included in suicide attempt analyses—and the exclusive use of cross-sectional designs and heterogeneity with regard to samples and measures—these parameters should be taken with caution. Generally, age, gender, race/ethnicity, and year of publication were not moderators, and there was little evidence for publication bias across effects, with the exception of the effect of global rumination on suicidal ideation. Several future research directions are discussed.
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Chase HW, Segreti AM, Keller TA, Cherkassky VL, Just MA, Pan LA, Brent DA. Alterations of functional connectivity and intrinsic activity within the cingulate cortex of suicidal ideators. J Affect Disord 2017; 212:78-85. [PMID: 28157550 PMCID: PMC5358995 DOI: 10.1016/j.jad.2017.01.013] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 11/27/2016] [Accepted: 01/14/2017] [Indexed: 01/21/2023]
Abstract
The 'default mode network' (DMN), a collection of brain regions including the posterior cingulate cortex (PCC), shows reliable inter-regional functional connectivity at rest. It has been implicated in rumination and other negative affective states, but its role in suicidal ideation is not well understood. We employed seed based functional connectivity methods to analyze resting state fMRI data in 34 suicidal ideators and 40 healthy control participants. Whole-brain connectivity with dorsal PCC or ventral PCC was broadly intact between the two groups, but while the control participants showed greater coupling between the dorsal anterior cingulate cortex (dACC) and dorsal PCC, compared to the dACC and ventral PCC, this difference was reversed in the ideators. Furthermore, ongoing low frequency BOLD signal in these three regions (dorsal, ventral PCC, dACC) was reduced in the ideators. The structural integrity of the cingulum bundle, as measured using diffusion tensor imaging (DTI), also explained variation in the functional connectivity measures but did not abolish the group differences. Together, these findings provide evidence of abnormalities in the DMN underlying the tendency towards suicidal ideation.
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Affiliation(s)
- Henry W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
| | - Anna Maria Segreti
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Timothy A Keller
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, United States
| | | | - Marcel A Just
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Lisa A Pan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - David A Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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Cognitive Risk and Protective Factors for Suicidal Ideation: A Two Year Longitudinal Study in Adolescence. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 44:1145-60. [PMID: 26597963 DOI: 10.1007/s10802-015-0104-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Adolescence is a developmental period associated with heightened risk for both the onset and escalation of suicidal ideation (SI). Given that SI is a potent predictor of suicidal behavior, it is important to develop models of vulnerability for and protection against SI, particularly among young adolescents. This study examined the relative impact of several cognitive vulnerabilities, as well as protective factors, for SI among young adolescents over a 2-year interval encompassing their transition to mid-adolescence. At baseline, 324 adolescents (M = 12.39 years; SD = 0.63; 52.5 % female) completed measures of depressive symptoms, self-referent information processing biases, negative inferential style, and responses to negative affect. Further, the adolescents and their mothers were administered a diagnostic interview to assess current and past depressive disorders and SI. Over follow-up, adolescents and their mothers were administered the diagnostic interview every 12 months and adolescents completed a self-report measure inquiring about SI every 6 months to assess interviewer-rated and self-reported SI. Logistic regressions indicated that preferential endorsement of negative adjectives as self-referent (only among girls), rumination in response to negative affect, and a negative inferential style prospectively predicted SI. Additionally, young adolescents' tendency to respond to negative affect with distraction and problem-solving buffered against their risk for exhibiting SI. When these factors were entered simultaneously, preferential endorsement of negative adjectives as self-referent and the use of distraction and problem-solving skills remained the only significant prospective predictors of SI. No previous studies have examined these variables as predictors of SI, thereby highlighting their potential utility in improving the predictive validity of extant models of suicide risk and resilience.
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Kreuze E, Lamis DA. A Review of Psychometrically Tested Instruments Assessing Suicide Risk in Adults. OMEGA-JOURNAL OF DEATH AND DYING 2017; 77:36-90. [PMID: 28056621 DOI: 10.1177/0030222816688151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Identify suicidal ideation and behavior screening instruments with the strongest psychometric properties, using the Interpersonal-Psychological Theory of Suicidal Behavior. METHODS Information databases PsycINFO and PubMed were systematically searched, and articles evaluating the psychometric properties of instruments assessing suicidal ideation and behavior ( n = 2,238) were reviewed. International populations and articles with diverse methodologies were integrated. RESULTS Review of records resulted in the inclusion of 51 articles that assessed 16 instruments. The majority of studies used the English language version (68.6%) and included U.S. populations (65.7%). However, global populations and non-English language versions were also represented. CONCLUSION More diverse population representation, and non-English versions of instruments, is required to improve generalizability of assessment measures. Including underrepresented groups and non-English instruments will promote culturally and linguistically sensitive instruments that may better assess suicide risk in diverse populations.
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Affiliation(s)
- Elizabeth Kreuze
- 1 Medical University of South Carolina, College of Nursing, Charleston, SC, USA
| | - Dorian A Lamis
- 2 Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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50
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Parola N, Zendjidjian XY, Alessandrini M, Baumstarck K, Loundou A, Fond G, Berna F, Lançon C, Auquier P, Boyer L. Psychometric properties of the Ruminative Response Scale-short form in a clinical sample of patients with major depressive disorder. Patient Prefer Adherence 2017; 11:929-937. [PMID: 28553085 PMCID: PMC5440078 DOI: 10.2147/ppa.s125730] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The Ruminative Response Scale (RRS)-short form is one of the most widely used measures of rumination, comprising ten items and two components: reflection and brooding. The aim of this study was to investigate RRS validity and reliability in a clinical sample of French patients with major depressive disorder (MDD). SUBJECTS AND METHODS Outpatients with a DSM-IV-TR diagnosis of MDD were recruited from a public academic hospital in France. Depressive symptoms were evaluated by the Beck Depression Inventory, anxiety by the State-Trait Anxiety Inventory - state scale, and quality of life by the 36-Item Short Form Health Survey (SF-36) questionnaire. Confirmatory factor analyses, item-dimension correlations, Cronbach's α-coefficients, Rasch statistics, and external validity were tested. Differential item functioning analyses were performed for sex. RESULTS A total of 109 patients participated. The final reflection-brooding two-factor model of the RRS showed a good fit (root-mean-square error of approximation 0.041, comparative fit index 0.987, standardized root-mean-square residual 0.048) after removing one item (daily diary writing). Internal item consistency and reliability were satisfactory for the two dimensions. External validity testing confirmed that RRS scores were correlated with Beck Depression Inventory, State-Trait Anxiety Inventory, and SF-36 scores. There was no differential item functioning across sexes. CONCLUSION These results demonstrated good scale reliability and validity for assessing rumination in patients with MDD.
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Affiliation(s)
- Nathalie Parola
- Public Health, Chronic Diseases and Quality of Life – Research Unit EA 3279, Aix-Marseille University, Marseille
- Department of Psychiatry, Sainte-Marguerite University Hospital, Marseille
| | - Xavier Yves Zendjidjian
- Public Health, Chronic Diseases and Quality of Life – Research Unit EA 3279, Aix-Marseille University, Marseille
- Department of Psychiatry, La Conception University Hospital, Marseille
| | - Marine Alessandrini
- Public Health, Chronic Diseases and Quality of Life – Research Unit EA 3279, Aix-Marseille University, Marseille
- Correspondence: Marine Alessandrini, Public Health, Chronic Diseases, and Quality of Life Research Unit, Aix-Marseille University – EA 3279, 58 Boulevard Charles Livon, Marseille 13284, France, Tel +33 4 9172 4520, Email
| | - Karine Baumstarck
- Public Health, Chronic Diseases and Quality of Life – Research Unit EA 3279, Aix-Marseille University, Marseille
| | - Anderson Loundou
- Public Health, Chronic Diseases and Quality of Life – Research Unit EA 3279, Aix-Marseille University, Marseille
| | - Guillaume Fond
- Fondation FondaMental, Créteil
- Department of Psychiatry and Addictology, Henri Mondor University Hospital, INSERM U955, Eq 15 Genetic Psychiatry and Psychopathology, Paris Est-Créteil University, Créteil
| | - Fabrice Berna
- Fondation FondaMental, Créteil
- Department of Psychiatry, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg University Hospital, Strasbourg, France
| | - Christophe Lançon
- Public Health, Chronic Diseases and Quality of Life – Research Unit EA 3279, Aix-Marseille University, Marseille
- Department of Psychiatry, Sainte-Marguerite University Hospital, Marseille
- Department of Psychiatry, La Conception University Hospital, Marseille
| | - Pascal Auquier
- Public Health, Chronic Diseases and Quality of Life – Research Unit EA 3279, Aix-Marseille University, Marseille
| | - Laurent Boyer
- Public Health, Chronic Diseases and Quality of Life – Research Unit EA 3279, Aix-Marseille University, Marseille
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