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Buerke M, Karnick A, Capron DW. Relations between worry, thought control, suicidal ideation and attempt history. ANXIETY, STRESS, AND COPING 2024:1-13. [PMID: 39257357 DOI: 10.1080/10615806.2024.2399083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 08/21/2024] [Accepted: 08/27/2024] [Indexed: 09/12/2024]
Abstract
BACKGROUND Thought processes such as worries are often described as difficult to control and predict suicidal thoughts and behaviors (STBs). Due to their uncontrollable nature, worries may lead to STBs as people attempt to escape their own internal thought processes. OBJECTIVE Examine the indirect role of perceived uncontrollability of one's thoughts in the relationship between worry and STBs. DESIGN AND METHOD We used stepwise mediation models to examine the proposed relationship in a sample of 145 undergraduates with lifetime suicidal ideation. STBs were categorized into (1) severity of lifetime suicidal ideation, (2) likelihood and (3) severity of recent suicidal ideation, and (4) lifetime suicide attempt. The likelihood and severity of recent ideation were separated due to the skewed nature of suicidal thoughts, with many people reporting zero ideation. RESULTS Worry was related to the severity of lifetime ideation, the likelihood of reporting recent ideation, and the severity of recent ideation through lower levels of perceived ability to control one's thoughts. Worry was not related to a lifetime suicide attempt. CONCLUSION The perception that one's thoughts are uncontrollable may be a core feature of worry for the development and worsening of suicidal thinking. Interventions targeting internal perceptions of uncontrollability may be beneficial for suicidal ideation management.
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Affiliation(s)
- Morgan Buerke
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Aleksandrs Karnick
- Department of Psychiatry and Human Behavior, Quantitative Sciences Program, Alpert Medical School of Brown University, Providence, RI, USA
| | - Daniel W Capron
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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2
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Peterson A, Chen J, Bozzay M, Bender A, Chu C. Suicide risk profiles among service members and veterans exposed to suicide. J Clin Psychol 2024; 80:65-85. [PMID: 37659101 DOI: 10.1002/jclp.23592] [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: 02/01/2023] [Revised: 08/10/2023] [Accepted: 08/24/2023] [Indexed: 09/04/2023]
Abstract
OBJECTIVES Rates of suicide exposure are high among service members and Veterans and are especially concerning given the link between suicide exposure and subsequent suicide risk. However, to date, it is unclear which individuals who are exposed to suicide are subsequently at high risk for suicide. Latent profile analysis (LPA) can provide information on unique risk profiles and subgroups of service members and Veterans who have higher suicide risk after suicide exposure, which has not yet been empirically studied. The purpose of this study was to utilize LPA to identify subgroups of service members and Veterans who are at the highest risk for suicidal thoughts and behaviors following suicide exposure. METHODS We analyzed data using LPA from 2570 service members and Veterans (82.1% male, 69.5% White, and 12.1% Latino/a/x) who completed the Military Suicide Research Consortium's Common Data Elements, a battery of self-report suicide-related measures. Psychopathology, substance use, mental health service utilization, interpersonal theory of suicide, and suicide exposure variables were used to validate classes. RESULTS Three latent classes emerged from analyses, one low-risk class and two-high risk classes with differing profile compositions (one primarily differentiated by anxiety symptoms and one differentiated by substance use). CONCLUSION Class-specific recommendations for suicide prevention efforts will be discussed.
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Affiliation(s)
- Amanda Peterson
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Jason Chen
- Portland VA Health Care System, Portland, Oregon, USA
| | - Melanie Bozzay
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island, USA
| | - Ansley Bender
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Carol Chu
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
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Jemcov A, Olthuis JV, Watt MC, Stewart SH. Do anxiety sensitivity cognitive concerns and/or depression symptoms independently explain sleep disturbances in a high anxiety sensitive treatment-seeking sample? J Anxiety Disord 2023; 97:102731. [PMID: 37236069 DOI: 10.1016/j.janxdis.2023.102731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 05/08/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023]
Abstract
Cognitive models of insomnia posit a role for anxiety sensitivity (AS) in sleep difficulties. While sleep disturbances have been linked to AS, particularly AS cognitive concerns, prior studies have rarely accounted for the correlated construct of depression. We used pre-treatment intervention trial data from 128 high AS, treatment-seeking adults with a DSM-5 diagnosis of an anxiety, depressive, or posttraumatic stress disorder to determine whether AS cognitive concerns and/or depression are independently associated with sleep impairment domains (e.g., sleep quality, latency, daytime dysfunction). Participants provided data on AS, depressive symptoms, and sleep impairments. AS cognitive concerns (but not other AS dimensions) were correlated with four of five sleep impairment domains; depression was correlated with all five. Multiple regressions revealed four of five sleep impairment domains were predicted by depression with no independent contribution of AS cognitive concerns. In contrast, AS cognitive concerns and depression were independently associated with daytime dysfunction. Results suggest previous findings linking AS cognitive concerns to sleep impairments may have been largely secondary to the overlap of cognitive concerns with depression. Findings demonstrate the importance of incorporating depression into the cognitive model of insomnia. Both AS cognitive concerns and depression may be useful targets for reducing daytime dysfunction.
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Affiliation(s)
- Anastasija Jemcov
- Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, 1355 Oxford St., Halifax, Nova Scotia B3H 4R2, Canada
| | - Janine V Olthuis
- Department of Psychology, Faculty of Arts, University of New Brunswick, 38 Dineen Drive, Fredericton, New Brunswick E3B 5A3, Canada
| | - Margo C Watt
- Department of Psychology, Faculty of Science, St. Francis Xavier University, 2323 Notre Dame Ave., Antigonish, Nova Scotia B2G 2W5, Canada
| | - Sherry H Stewart
- Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, 1355 Oxford St., Halifax, Nova Scotia B3H 4R2, Canada; Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veteran's Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada.
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Liu J, Zhao K, Zhou S, Hong L, Xu Y, Sun S, Tong S, Huang L, Liu J, Wang J, Li N, Lou M, Tang W, Cai Z. Suicidal ideation in Chinese adults with schizophrenia: associations with neurocognitive function and empathy. BMC Psychiatry 2023; 23:311. [PMID: 37138258 PMCID: PMC10155378 DOI: 10.1186/s12888-023-04739-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/31/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Suicidal ideation is common among people diagnosed with schizophrenia spectrum disorders and may be related to neurocognitive, social cognitive, and clinical variables. This study aimed to investigate the relationships between suicidal ideation and both neurocognitive function and empathy. METHODS The sample for this cross-sectional study comprised 301 schizophrenic patients aged 18-44 years. All participants were administered the Beck Scale for Suicide Ideation-Chinese Version (BSI-CV), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Interpersonal Reactivity Index (IRI), and the Positive and Negative Syndrome Scale (PANSS). The demographic and clinical data of the patients were also collected. RESULTS In total, 82 patients reported suicidal ideation. Compared to patients without suicidal ideation, patients with suicidal ideation showed significant differences in the IRI-Personal Distress subscale, PANSS-General Psychopathology symptom scores, and suicide attempts. Moreover, there were moderating effects of neurocognitive function and empathy on the relationship between suicide attempts and suicidal ideation. CONCLUSIONS These results indicate that the personal distress component of empathy, general psychopathology symptoms and suicide attempts are independent risk factors for suicidal ideation in Chinese adults with schizophrenia. Moreover, neurocognitive function may also be related to suicidal ideation through a moderating relationship. In order to reduce suicidal ideation among patients with schizophrenia, early screening of empathy and neurocognitive function is essential.
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Affiliation(s)
- Jie Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ke Zhao
- Lishui Second People's Hospital Affiliated to Wenzhou Medical University, Lishui, China
| | - Siyao Zhou
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lan Hong
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yao Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shiyu Sun
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Siyu Tong
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Liandan Huang
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325000, Wenzhou, China
| | - Jiahong Liu
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325000, Wenzhou, China
| | - Jieqiong Wang
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325000, Wenzhou, China
| | - Na Li
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mengbei Lou
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wei Tang
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325000, Wenzhou, China.
| | - Zhengmao Cai
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325000, Wenzhou, China.
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The Relationship Among Anxiety Sensitivity, Psychache, and Suicidality in Patients With Generalized Anxiety Disorder. J Nerv Ment Dis 2022; 210:760-766. [PMID: 35605224 DOI: 10.1097/nmd.0000000000001534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although generalized anxiety disorder (GAD) is associated with suicide, not all dimensions of this relationship have been addressed. This study aimed to investigate the relationship between psychache and anxiety sensitivity with suicidality in patients with GAD. We included 80 patients with GAD (17 of whom had previous suicide attempts). The Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Scale (HAM-D), Beck Scale for Suicidal Ideation (BSIS), Psychache Scale (PS), and Anxiety Sensitivity Index-3 (ASI) were applied to the participants. The patients with previous suicide attempts had significantly higher scores on ASI total, ASI-physical and cognitive subdimensions, HAM-A total and psychic subscale, PS, and BSIS than those without ( p < 0.05 for each). Mediation analyses revealed that psychache was a full mediator in the relationship between ASI-cognitive subdimension and suicidal ideation. Therapeutic interventions for anxiety sensitivity and psychache in patients with GAD will help reduce the risk of suicide.
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Toward an integrative model of transdiagnostic risk factors and suicide: A network comparison of psychiatric outpatients. J Psychiatr Res 2022; 154:252-260. [PMID: 35961181 DOI: 10.1016/j.jpsychires.2022.07.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/20/2022] [Accepted: 07/21/2022] [Indexed: 11/21/2022]
Abstract
Predictive models using traditional statistical methods have largely failed to describe suicide etiology. Network theory, which conceptualizes factors as mutually interacting, reinforcing elements of a complex outcome, can model relationships between transdiagnostic and neurocognitive vulnerability factors. The present study used a network approach to produce an atheoretical model of psychological factors and their interrelationships within a population of ideators and non-ideators. We developed two network models (i.e., suicidal ideators and psychiatric controls) describing the relationships between a diverse set of risk factors and symptom measures for a population of psychiatric outpatients. We compared networks using three measures of network structure (i.e., network structure invariance, global strength invariance, edge invariance) and described the differences. Network structures for ideators (N = 229) and non-ideators (N = 454) were stable and accurate. In non-ideators, cognitive-affective depression symptoms (Expected Influence [EI]: 2.06), trauma avoidance (EI: 1.08), and negative affect (EI: 0.81) were most influential to the psychological network. In ideators, cognitive-affective depression symptoms (EI: 1.77), intolerance of uncertainty-negative self-referent implications (EI: 1.29), and negative affect (EI: 1.19) were most influential. Invariance testing did not indicate significant differences in overall network structure between ideators and non-ideators (p = .111), but did indicate significant differences in node strength (p = .013). Significant differences in node EI were detected for intolerance of uncertainty-negative self-referent implications, anxiety sensitivity physical concerns, thwarted belongingness, worry, and negative affect. These findings indicated differences in network structures for suicidal psychiatric outpatients and provide crucial directions for future research on therapeutic targets for suicidal thoughts and behaviors.
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Jin Q, Ma W, Zhang Y, Wang H, Hao J, Geng Y, Zhong B, Li J, Hou W, Lu S. Risk Factors Associated With Increased Anxiety Sensitivity in Children and Adolescents in Northwest China During COVID-19 Pandemic Lockdown. Front Psychol 2022; 13:933207. [PMID: 35874358 PMCID: PMC9305390 DOI: 10.3389/fpsyg.2022.933207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 06/10/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose A large body of evidence has revealed that the sudden outbreak of public health emergencies induces dramatic effects on the mental health of the general public. We aimed to investigate the level of anxiety sensitivity and its risk factors in children and adolescents from northwest China during the COVID-19 pandemic lockdown in early 2020. Methods A cross-sectional survey was conducted through the Wenjuanxing platform using a convenience sampling method between 18 and 26 February 2020. The self-designed questionnaire contained sociodemographic characteristics, factors associated with the COVID-19 pandemic, and the Childhood Anxiety Sensitivity Index (CASI) scale. The data from 1,091 valid questionnaires from students aged 9–17 years were analyzed using ANOVA, multiple linear regression, and binary logistic regression. Results The average CASI scores were 11.47 ± 6.631, and 642 students (58.9%) had prominent anxiety sensitivity. Gender, education level, family members participating in anti-COVID-19 work, getting ill and needing medical help during the lockdown, feeling afraid or having heart palpitations on hearing things associated with COVID-19, believing that COVID-19 would have adverse impacts on themselves or their family in the future, and fear of infection were identified as significant factors for elevated levels of anxiety sensitivity (p < 0.05). We established a multiple linear regression model for the anxiety sensitivity score. Risk factors found for anxiety sensitivity in children and adolescents during the COVID-19 lockdown included studying in secondary or high school, becoming ill during the pandemic, feeling afraid or experiencing rapid heartbeat or palpitations on hearing about the COVID-19 pandemic, thinking that COVID-19 would have an adverse impact on themselves or their family in the future, and fear of infection. Conclusions During the COVID-19 pandemic and home quarantine, scores measuring the prevalence of anxiety sensitivity in children and adolescents from northwest China were elevated. We should develop measures that especially target possible risk factors to intervene against and prevent anxiety sensitivity in children and adolescents in both the current and future pandemics.
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Affiliation(s)
- Qiaoyan Jin
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Biochemistry and Molecular Biology, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Wenxian Ma
- Department of Biochemistry and Molecular Biology, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Yang Zhang
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Biochemistry and Molecular Biology, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Huiyuan Wang
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Juanjuan Hao
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yan Geng
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Bo Zhong
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jing Li
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wei Hou
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- *Correspondence: Wei Hou
| | - Shemin Lu
- Department of Biochemistry and Molecular Biology, Xi'an Jiaotong University Health Science Center, Xi'an, China
- Shemin Lu
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Caulfield NM, Martin RL, Smith NS, Karnick AT, Norr AM, Capron DW. A preliminary assessment of the link between anxiety sensitivity cognitive concerns and suicidal thoughts through dissociative symptoms. J Trauma Dissociation 2022; 23:97-109. [PMID: 34633910 DOI: 10.1080/15299732.2021.1989112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Anxiety sensitivity (AS) and AS subfactors (physical, cognitive, and social) have been found to have robust associations with suicide risk. While the direct association between AS subfactors and suicide risk have been explored, little is known about how specific mechanisms, such as dissociation, might explain this relationship. This study aimed to run three analyses to examine the direct and indirect effects of suicidal thoughts and AS via dissociative symptoms. We predicted that dissociation would be a pathway through which AS physical concerns (ASPC) and AS cognitive concerns (ASCC) predicts suicidal ideation. Participants included 84 undergraduate students from a Southeastern University who were elevated on ASCC. Participants completed measures examining dissociative experiences, anxiety sensitivity, and current suicidal ideation. Results revealed that dissociation had a significant indirect effect with ASPC but not ASCC. The current preliminary study showed that ASCC had direct associations with suicide risk; however, those with lower levels of ASPC and dissociation may also be more likely to develop suicide risk. Future research should explore the possibility that the dissociation/ASPC and ASCC pathways are separate, but related, paths to suicidality.
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Affiliation(s)
- Nicole M Caulfield
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Rachel L Martin
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Nicole S Smith
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Aleksandr T Karnick
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Aaron M Norr
- Mental Health Research Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, Washington, USA
| | - Daniel W Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
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9
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Smith NS, Bauer BW, Martin RL, Tucker RP, Capron DW. Anxiety Sensitivity Index-3 Suicidal Cognition Concerns: A New Measure Examining Negative Reactions to Suicidal Ideation. Arch Suicide Res 2022; 26:245-260. [PMID: 32749205 DOI: 10.1080/13811118.2020.1793042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Anxiety sensitivity cognitive concerns (ASCC), the fear of the consequences of mental dyscontrol, has been established as a risk factor for suicidal ideation (SI). Treatments targeted at reducing ASCC have been shown to reduce suicide risk. In this study, a new self-report measure, the Anxiety Sensitivity Index-3 Suicidal Cognition Concerns (ASI-3-SCC), was developed to assess sensitivity specifically to thoughts of suicide and wanting to die. METHOD Participants completed the new measure as well as measures of anxiety sensitivity, depressive symptoms, SI, and worst point SI. We hypothesized that the ASI-3-SCC would be associated with SI and worst point SI. Additionally, we hypothesized that the ASI-3-SCC would moderate the relationship between ASCC and SI. RESULTS As predicted, the ASI-3-SCC was significantly associated with SI in the past two weeks and lifetime worst point SI after accounting for ASCC and depression. The ASI-3-SCC also moderated the relationship between ASCC and SI such that ASCC was related to SI at high levels of ASI-3-SCC. CONCLUSIONS We suggest that the interpretation of SI and feelings of wanting to die as dangerous may lead to more attention to those thoughts when they occur and increased psychological distress associated with those thoughts. This measure will allow researchers to measure a novel construct in the literature and further examine the impact of catastrophic interpretations of suicidal thoughts.HighlightsCreated a new measure for sensitivity to thoughts of suicide and wanting to die.Suicidal cognition concerns associated with suicidal ideation in the past two weeks.Suicidal cognition concerns associated with lifetime worst point suicidal ideation.Suicidal cognition concerns moderated AS cognitive concerns and ideation relation.
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Hippocampal neuropathology in suicide: Gaps in our knowledge and opportunities for a breakthrough. Neurosci Biobehav Rev 2021; 132:542-552. [PMID: 34906612 DOI: 10.1016/j.neubiorev.2021.12.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 12/03/2021] [Accepted: 12/10/2021] [Indexed: 01/27/2023]
Abstract
Suicide is a major global hazard. There is a need for increasing suicide awareness and effective and evidence-based interventions, targeting both suicidal ideation and conduct. However, anti-suicide pharmacological effects are unsatisfactory. The human hippocampus is vulnerable to neuropsychiatric damages and subsequently releases psychobiological signals. Human hippocampal studies of suicide completers have shown mechanistic changes in neurobiology, which, however, could not reflect the neuropathological 'fingerprints' of fatal suicide ideations and suicide attempts. In this review, we provide several leading theories of suicide, including the serotoninergic system, Wnt pathway and brain-derived neurotrophic factor/tropomyosin receptor kinase B signalling, and discuss the evidence for their roles in suicide and treatment. Moreover, the cognitive dysfunctions associated with suicide risk are discussed, as well as the novel evidence on cognitive therapies that decrease suicidal ideation. We highlight the need to apply multi-omics techniques (including single-nucleus RNA sequencing and mass spectrometry histochemistry) on hippocampal samples from donors who died by suicide or legal euthanasia, to clarify the aetiology of suicide and propose novel therapeutic strategies.
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Yang H, Zhao X, Fang J, Elhai JD. Relations between anxiety sensitivity's cognitive concerns and anxiety severity: brooding and reflection as serial multiple mediators. CURRENT PSYCHOLOGY 2021; 42:9218-9224. [PMID: 34426723 PMCID: PMC8372224 DOI: 10.1007/s12144-021-02195-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2021] [Indexed: 11/29/2022]
Abstract
The outbreak of COVID-19 has caused a major impact on productivity and life functioning, and also led to adverse emotional reactions. In the face of this public health event, increased anxiety is one of the most common emotional reactions. Previous studies have shown that anxiety sensitivity, rumination and anxiety are closely related. Various dimensions of anxiety sensitivity have different effects on anxiety. Also, rumination can be divided into brooding and reflection. To explore the relationships among anxiety sensitivity’s cognitive concerns, anxiety and different types of rumination, we conducted an online survey during the outbreak of coronavirus (February 17–25, 2020), using the Anxiety Sensitivity Scale-3 (ASI-3), Ruminative Responses Scale (RSS), and Depression Anxiety Stress Scale-21 (DASS-21). The results showed significant positive correlations among anxiety sensitivity’s cognitive concerns, anxiety, brooding and reflection. Furthermore, brooding and reflection had a chain mediation effect between cognitive concerns and anxiety, and the mediation effect of reflection was even stronger. Results suggest that anxiety sensitivity’s cognitive concerns may not only affect anxiety directly, but also affect anxiety through rumination, especially reflection.
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Affiliation(s)
- Haibo Yang
- Academy of Psychology and Behavior of Tianjin Normal University, No. 393 Binshuixi Road, Tianjin, 300387 Xiqing District China.,Tianjin Social Science Laboratory of Students' Mental Development and Learning, No. 393 Binshuixi Road, Tianjin, 300387 Xiqing District China
| | - Xiaoyu Zhao
- Faculty of Psychology, Tianjin Normal University, No. 393 Binshuixi Road, Tianjin, 300387 Xiqing District China
| | - Jianwen Fang
- Faculty of Psychology, Tianjin Normal University, No. 393 Binshuixi Road, Tianjin, 300387 Xiqing District China
| | - Jon D Elhai
- Department of Psychology, University of Toledo, 2801 West Bancroft Street, Toledo, OH 43606 USA.,Department of Psychiatry, University of Toledo, 3000 Arlington Avenue, Toledo, OH 43614 USA
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Brooks JR, Lebeaut A, Zegel M, Walker RL, Vujanovic AA. Anxiety sensitivity and suicide risk: Mindfulness as a psychological buffer for Black adults. J Affect Disord 2021; 289:74-80. [PMID: 33945917 DOI: 10.1016/j.jad.2021.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/18/2021] [Accepted: 04/12/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Anxiety sensitivity (AS), defined as the fear of anxiety-related sensations, is associated with increased risk for suicide and related behavior. However, investigations of AS have centered on primarily non-Hispanic White men and women and with limited attention to clinically relevant underlying factors. METHODS The purpose of this preliminary study was to examine the indirect effect of AS on suicide ideation and elevated suicide risk through mindfulness in a sample of 307 Black adults (79.2% female; Mage = 22.4, SD = 5.6). Participants completed an online questionnaire battery that included measures of AS, mindfulness, suicide ideation, and elevated suicide risk. RESULTS After controlling for age and gender, results indicated that AS was directly and indirectly associated with suicide ideation and elevated suicide risk via lower levels of mindfulness. LIMITATIONS Limitations include using a cross-sectional methodological design and exclusive reliance on self-report measures. CONCLUSIONS These findings provide preliminary insight into novel risk and protective factors that influence suicide ideation and elevated suicide risk among Black Americans.
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Affiliation(s)
- Jasmin R Brooks
- Department of Psychology, University of Houston, Houston, TX
| | - Antoine Lebeaut
- Department of Psychology, University of Houston, Houston, TX
| | - Maya Zegel
- Department of Psychology, University of Houston, Houston, TX
| | - Rheeda L Walker
- Department of Psychology, University of Houston, Houston, TX
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Capron DW, Allan NP, Schmidt NB. The Depression Sensitivity Index: Initial Development and Tests of Convergent and Construct Validity. J Affect Disord 2021; 287:417-426. [PMID: 33839487 DOI: 10.1016/j.jad.2021.03.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Depression and suicide are prominent and increasing U.S. public health issues, which suggests novel assessment and treatment approaches are needed. Reiss' Expectancy Model of Fear, Anxiety, and Panic states that fear is based on two classes of variables, expectations and sensitivities, which has led to much research on anxiety sensitivity as a significant risk factor for later anxiety psychopathology. Major depressive disorder also includes biased expectations and sensitivities; however, a depression sensitivity rooted in Expectancy Theory has never been formalized. Uncovering depression-related sensitivities may lead to earlier risk detection and prevention before mood disorders develop. METHOD The goal of the paper was to create a Depression Sensitivity Index using exploratory factor analysis and item response theory and then conduct tests of convergent and construct validity using structural equation modeling using three independent samples. RESULTS indicated two lower order factors: 1) physical and cognitive concerns (DSPCC) and 2) social concerns (DSSC). Factors showed incremental associations with depression (DSPCC), social anxiety (both) and suicidal thoughts and behaviors (DSPCC), above and beyond anxiety sensitivity cognitive concerns. Both factors together predicted depressive disorder diagnoses LIMITATIONS: : Mostly self-report data, large percentage of non-Hispanic White participants in Study 1. CONCLUSIONS The results offer initial evidence that expectancy theory applies beyond "fear, anxiety, and panic" and that with further development depression sensitivity could be an important intervention target for prevention of major depressive disorder and suicidal thoughts and behaviors.
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Affiliation(s)
- Daniel W Capron
- Department of Psychology, University of Southern Mississippi.
| | - Nicholas P Allan
- Department of Psychology, Ohio University; VA Center of Excellence for Suicide Prevention, VA Finger Lakes Health Care System
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Kremyar AJ, Lee TTC. MMPI-3 Predictors of Anxiety Sensitivity and Distress Intolerance. Assessment 2021; 29:1103-1116. [PMID: 33759600 DOI: 10.1177/10731911211001948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Documenting empirical correlates of the Minnesota Multiphasic Personality Inventory-3 (MMPI-3) scale scores is important for expanding the clinical utility of the instrument. To this end, the goals of the current study were to examine associations between scores on MMPI-3 scales and measures of anxiety sensitivity and distress intolerance, two constructs reflecting intolerance of negative emotional states that are implicated in many psychological conditions, and to identify the scales that most strongly predict each construct. Using a sample of 287 undergraduate students (71% women; Mage = 18.90, SD = 1.12; 85% White), zero-order correlational, regression, and dominance analyses were performed to address these goals. Results indicate that when MMPI-3 scale scores are considered conjointly by scale family, they predict meaningful variance in anxiety sensitivity and distress intolerance measure scores, with conceptually implicated scales offering the strongest prediction across scale families. Implications for both research and practice, limitations, and future research directions are discussed.
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15
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Rogers AH, Bogiaizian D, Salazar PL, Solari A, Garey L, Fogle BM, Schmidt NB, Zvolensky MJ. COVID-19 and Anxiety Sensitivity Across Two Studies in Argentina: Associations with COVID-19 Worry, Symptom Severity, Anxiety, and Functional Impairment. COGNITIVE THERAPY AND RESEARCH 2021; 45:697-707. [PMID: 33424059 PMCID: PMC7778696 DOI: 10.1007/s10608-020-10194-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 01/08/2023]
Abstract
Background The novel 2019 SARS2-Coronavirus (COVID-19) has had a devastating physical health, mental health, and economic impact, causing millions of infections and hundreds of thousands of deaths. While COVID-19 has impacted the entire world, COVID-19 has disproportionately impacted low-income countries, particularly in South America, causing not only increased mortality but also increased associated mental health complaints. Anxiety sensitivity (AS), reflecting fear of anxiety-related physical sensations, may be particularly important to understand COVID-19 mental health effects among Latinx individuals in South America (Argentina). Past work suggests that Latinx individuals report greater somatization of mental health symptoms, and AS has been specifically linked to greater mental health symptoms. Yet, to date, no work has examined AS as a vulnerability factor for the negative mental health effects of COVID-19. Method Therefore, the current manuscript examined the association of AS with COVID-19 worry, functional impairment, anxiety, and symptom severity across two samples of adults in Argentina: a community sample (n = 105, M age = 38.58, SD = 14.07, 69.5% female) and a clinical sample comprised of individuals with an anxiety disorder (n = 99, M age = 34.99, SD = 10.83, 66.7% female). Results Results from the current study provide support for AS as a potential vulnerability factor for COVID-19-related mental health problems across both samples, and these effects were evident over and above the variance accounted for by age, sex, pre-existing medical conditions, and COVID-19 exposure. Conclusions These data identify AS as a potential intervention target to reduce COVID-19 mental health burden among adults in Argentina.
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Affiliation(s)
- Andrew H Rogers
- Department of Psychology, University of Houston, Houston, TX USA
| | - Daniel Bogiaizian
- Department of Psychology, Universidad Argentina de la Empresa, Buenos Aires, Argentina
| | | | - Adrian Solari
- Department of Psychology, Universidad Argentina de la Empresa, Buenos Aires, Argentina
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX USA
| | - Brienna M Fogle
- Department of Psychology, University of Houston, Houston, TX USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX USA.,HEALTH Institute, University of Houston, Houston, TX USA
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16
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Paulus DJ, Capron DW, Zvolensky MJ. Understanding hazardous drinking and suicidal ideation and suicide risk among college students: anxiety sensitivity as an explanatory factor. Cogn Behav Ther 2020; 50:378-394. [DOI: 10.1080/16506073.2020.1840622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Daniel J. Paulus
- Department of Neuroscience, Medical University of South Carolina, Charlestion, SC, USA
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Daniel W. Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Health Institute, University of Houston, Houston, TX, USA
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17
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Martin RL, Smith NS, Caulfield NM, Capron DW. The Pathways of Aggression - Differential Indirect Associations Between Anxiety Sensitivity Cognitive Concerns and Suicidality. CRISIS 2020; 42:335-342. [PMID: 33151097 DOI: 10.1027/0227-5910/a000725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background: Suicide prevention efforts have focused on risk factors that help identify people with an increased risk for suicide. One risk factor related to suicide risk is anxiety sensitivity cognitive concerns (ASCC), which is the "fear of going crazy." The association between ASCC and suicidal ideation is hypothesized to result from the depression-distress amplification model, which postulates that ASCC exacerbates feelings of depression and concurrent distress. Furthermore, there is evidence for associations between ASCC/dysregulated anger and dysregulated anger/suicidal ideation. We hypothesized that aggression may provide pathways from ASCC to suicidality. The current study examined how facets of aggression (described as elevated agitation) meditated the association between ASCC and suicidality. Aims: The current study aimed to extend prior research by examining how different facets of aggression mediate the association between ASCC and suicidality. Method: Participants were 440 adults recruited online, 32.7% of whom endorsed experiencing lifetime suicidal ideation. Results: Our hypotheses were partially supported with two significant indirect effects. Results indicated that physical aggression and hostility provided significant indirect effects; however, verbal aggression and anger did not. Limitations: The study was cross-sectional in nature, limiting causal interpretations about the indirect effects. The sample included primarily White participants. Conclusion: Specific facets of aggression provide pathways through which ASCC is associated with suicidality. Aggression may be a catalyst for individuals to progress to suicidality. The current study provides foundational research for continued examination of physical aggression as a catalyst for suicide attempts.
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Affiliation(s)
- Rachel L Martin
- Department of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Nicole S Smith
- Department of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Nicole M Caulfield
- Department of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Daniel W Capron
- Department of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
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Caulfield NM, Martin RL, Norr AM, Capron DW. The Association Between Posttraumatic Stress Symptoms and Anxiety Sensitivity in a College Sample. Psychol Rep 2020; 124:1539-1558. [PMID: 32781893 DOI: 10.1177/0033294120948227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES One-half of all U.S. adults will experience at least one traumatic event, and of those, approximately 11% develop posttraumatic stress disorder (PTSD) symptoms. Despite efficacious treatments for PTSD, one-third of people diagnosed still express symptoms after treatment.Thus, it is important to identify underlying factors that may be associated with PTSD symptom clusters to improve treatment efficacy. One potential factor is anxiety sensitivity (AS), or "the fear of fear," and includes three different subfactors: physical, cognitive, and social concerns, yet few studies have examined this association using the Anxiety Sensitivity Index-3. METHOD Participants included 65 undergraduate students from a Southeastern University who were elevated on anxiety sensitivity cognitive concerns and experienced at least one traumatic event. Participants completed measures of trauma exposure, anxiety sensitivity, posttraumatic stress symptoms, and suicidal ideation. RESULTS Results revealed that AS physical symptoms had the most robust association with potential PTSD symptoms and individual PTSD symptom clusters with the exception of the avoidance and numbing cluster. CONCLUSIONS These findings may help clarify the nature of the relationship between PTSD symptoms and AS using the most updated measure of AS (ASI-3).
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Affiliation(s)
| | - Rachel L Martin
- 5104University of Southern Mississippi, Hattiesburg, MS, USA
| | - Aaron M Norr
- 20128VA Puget Sound Health Care System, Seattle, WA, USA
| | - Daniel W Capron
- 5104University of Southern Mississippi, Hattiesburg, MS, USA
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19
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Tang W, Kang Y, Xu J, Li T. Associations of Suicidality with Adverse Life Events, Psychological Distress and Somatic Complaints in a Chinese Medical Student Sample. Community Ment Health J 2020; 56:635-644. [PMID: 31919657 DOI: 10.1007/s10597-019-00523-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/09/2019] [Indexed: 02/05/2023]
Abstract
The present study aimed to examine the associations of suicidality with psychological distress, somatic symptoms, and stressors in medical school students. We conducted a cross-sectional survey of medical students at a large, top-ranked medical school. A total sample of 662 medical students (269 men) completed a battery of self-reported questionnaire. Of the respondents, 136 (20.5%) reported having suicidal ideation, 40 (6.0%) reported having planned suicide, and 10 (1.5%) reported having attempted suicide during the previous year. Students from rural areas and the 3rd year of study reported higher levels of suicidal ideation than their counterparts. General pain/fatigue was associated with suicidal ideation and planning, while interpersonal difficulties were associated only with suicidal ideation. This study provides evidence linking severe psychological distress, general pain/fatigue, interpersonal stress and psychosocial factors with suicide risk among Chinese medical students which provides targets for future psychological interventions.
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Affiliation(s)
- Wanjie Tang
- Centre for Educational and Health Psychology, Sichuan University, Chengdu, China
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China
- Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Yukun Kang
- Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Jiuping Xu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China.
| | - Tao Li
- Centre for Educational and Health Psychology, Sichuan University, Chengdu, China.
- Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
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20
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Repeated Exposure to Perceptual Illusion Challenges Reduces Anxiety Sensitivity Cognitive Concerns: Evidence From a Randomized Clinical Trial. Behav Ther 2019; 50:1173-1184. [PMID: 31735251 PMCID: PMC6866663 DOI: 10.1016/j.beth.2019.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 04/11/2019] [Accepted: 04/16/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Anxiety sensitivity cognitive concerns (ASCC), or fear of cognitive dyscontrol sensations, confers risk for anxiety and mood psychopathology. Recent work demonstrated that novel perceptual challenges generated by a head mounted display can elicit fear among those with elevated ASCC. This suggests that interoceptive exposure to perceptual challenges may offer a means to mitigate ASCC. This study was designed to evaluate whether repeated exposure to novel perceptual challenges can reduce ASCC, and if these effects are stronger among those experiencing greater negative emotionality as a proxy for individuals likely to present for treatment. METHODS Participants with elevated ASCC (N = 57) were randomized to one of three experimental conditions utilizing a head-mounted display. In the rotations condition (n = 20), participants viewed themselves spinning in a circle. In the opposite directions condition (n = 20), participants turned their head while the camera moved in the opposite direction creating dissonance in their visual field. In the control condition (n = 17), participants completed a series of simple arithmetic problems. RESULTS Participants in the rotation condition, relative to control, reported significant reductions in ASCC from pre- to post-exposure and these effects were strongest for those with elevated negative affect. The main effect of the opposite directions exposure on post-treatment ASCC was non-significant, but follow-up analyses revealed that reductions in ASCC were observed among those with elevated negative affectivity. DISCUSSION Perceptual illusion challenges appear to have utility for reducing ASCC through repeated exposure. There was evidence for the perceptual illusion exercises, particularly the rotations condition, specifically reducing ASCC, making this challenge the first we are aware of that specifically targets ASCC-related concerns. LIMITATIONS As a proof-of-concept study, the present sample was not recruited for clinically-significant psychopathology, and only a brief follow-up was utilized. Future research should utilize a longer follow-up and test if these exposures mitigate ASCC-relevant psychopathology among clinical samples.
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21
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Hom MA, Duffy ME, Rogers ML, Hanson JE, Gutierrez PM, Joiner TE. Examining the link between prior suicidality and subsequent suicidal ideation among high-risk US military service members. Psychol Med 2019; 49:2237-2246. [PMID: 30355371 DOI: 10.1017/s0033291718003124] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Research is needed to identify the factors that explain the link between prior and future suicidality. This study evaluated possible mediators of the relationship between: (1) the severity of prior suicidality and (2) suicidal ideation severity at 3-month follow-up among a sample of high-risk military personnel. METHODS US military service members referred to or seeking care for suicide risk (N = 624) completed self-report psychiatric domain measures and a clinician interview assessing prior suicidality severity at baseline. Three months later, participants completed a self-report measure of suicidal ideation severity. Three separate percentile bootstrap mediation models were used to examine psychiatric factors (i.e. alcohol abuse, anxiety sensitivity, hopelessness, insomnia, posttraumatic stress symptoms, suicidal ideation, and thwarted belongingness) as parallel mediators of the relationship between prior suicidality severity (specifically, suicidal ideation, suicide attempt, and overall suicidality - i.e. ideation/attempt severity combined) at baseline and suicidal ideation severity at follow-up. RESULTS Hopelessness, specifically, and the total effect of all mediators, each significantly accounted for the relationship between prior suicidality severity and subsequent ideation severity across models. In the models with attempt severity and overall suicidality severity as predictors, thwarted belongingness was also a significant mediator. CONCLUSIONS Hopelessness, thwarted belongingness, and overall severity of psychiatric indices may explain the relationship between prior suicidality severity and future suicidal ideation severity among service members at elevated suicide risk. Research is needed to replicate these findings and examine other possible mediators.
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Affiliation(s)
- Melanie A Hom
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Megan L Rogers
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Jetta E Hanson
- Rocky Mountain Mental Illness Research, Education and Clinical Center, Aurora, CO, USA
| | - Peter M Gutierrez
- Rocky Mountain Mental Illness Research, Education and Clinical Center, Aurora, CO, USA
- Denver Veterans Affairs Medical Center, Aurora, CO, USA
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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22
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Bauer BW, Albanese BJ, Martin RL, Smith NS, Schmidt NB, Capron DW. Fear reactivity to head-mounted display perceptual illusion challenges is associated with suicidality. Psychiatry Res 2019; 276:262-268. [PMID: 31125903 DOI: 10.1016/j.psychres.2018.12.106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 12/19/2018] [Accepted: 12/19/2018] [Indexed: 10/27/2022]
Abstract
Suicide remains a public health concern with suicide rates showing a consistent increase over the last 20 years. Recent studies have found a relationship between anxiety sensitivity (i.e., the fear of anxiety related symptoms) and suicidality. Specifically, a relationship has been found between anxiety sensitivity cognitive concerns (ASCC) and suicidality. The knowledge around this relationship, however, has relied mostly on self-report measures. This study seeks to expand on the current literature by exploring the association between ASCC and suicidality, through the use of head-mounted display perceptual illusion challenges (e.g., using tactile sensations and mannequins to create illusions that the participant has switched bodies). A head-mounted display was used to elicit symptoms (e.g., depersonalization, derealization) related to ASCC in a sample of undergraduate students (N = 54). Suicidality and depression were measured by the Inventory of Depression and Anxiety Symptoms-2 (IDAS-II), anxiety sensitivity cognitive concerns by the Anxiety Sensitivity Index-3 (ASI-3), and distress by the Subjective Units of Distress Scale (SUDS). Findings indicated that suicidality was associated with self-reported ASCC as well as the fear generated from the challenges. Furthermore, our results found that challenge-induced fear predicted suicidality scores above and beyond the traditional self-report measures of ASCC. The small sample size and low suicide risk of the current sample limits generalizations to more severe populations.
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Affiliation(s)
- Brian W Bauer
- Department of Psychology, University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406, USA.
| | - Brian J Albanese
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Rachel L Martin
- Department of Psychology, University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406, USA
| | - Nicole S Smith
- Department of Psychology, University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Daniel W Capron
- Department of Psychology, University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406, USA
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Hudiburgh SE, Shaw AM, Arditte Hall KA, Timpano KR. Anxiety Sensitivity Differentially Predicts Factors of Interpersonal-Psychological Suicide Risk: A Consideration of Specificity. Suicide Life Threat Behav 2019; 49:264-277. [PMID: 29108113 DOI: 10.1111/sltb.12421] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 09/07/2017] [Indexed: 11/28/2022]
Abstract
Recent studies have identified anxiety sensitivity (AS) as a risk factor for suicidality; however, limited work has been performed to understand this risk within the context of the interpersonal-psychological theory of suicide (IPTS; Joiner, 2005). The current study examined the relationship between overall AS, each AS subfactor (cognitive, social, and physical), and the three IPTS domains (perceived burdensomeness, thwarted belongingness, and acquired capability). While each AS subfactor uniquely predicted one IPTS domain, greater overall AS only predicted greater acquired capability, suggesting that assessment of AS at the subfactor level may offer us more information about an individual's interpersonal suicide risk.
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Affiliation(s)
| | | | - Kimberly A Arditte Hall
- National Center for PTSD/VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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24
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Stanley IH, Boffa JW, Rogers ML, Hom MA, Albanese BJ, Chu C, Capron DW, Schmidt NB, Joiner TE. Anxiety sensitivity and suicidal ideation/suicide risk: A meta-analysis. J Consult Clin Psychol 2018; 86:946-960. [PMID: 30335426 PMCID: PMC6469498 DOI: 10.1037/ccp0000342] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Suicide is a global public health concern. To inform the prevention and treatment of suicidality, it is crucial to identify transdiagnostic vulnerability factors for suicide and suicide-related conditions. One candidate factor is anxiety sensitivity (AS)-the fear of anxiety-related sensations-which has been implicated in the pathogenesis of a host of mental health outcomes, including suicidal thoughts and behaviors. Importantly, AS is distinct from trait anxiety and negative affectivity, highlighting its potential incremental utility in the understanding of psychopathology. Despite a burgeoning body of literature demonstrating that AS is linked to suicidal thoughts and behaviors, this research has yet to be synthesized. METHOD This meta-analysis includes 33 articles representing 34 nonredundant samples (N = 14,002) that examined at least one relationship between AS global or subfactor (i.e., cognitive, physical, social) scores and suicidal ideation and/or suicide risk. RESULTS Findings revealed small-to-moderate and moderate associations between global AS and suicidal ideation (r = .24, 95% confidence interval (CI): [.21, .26], p < .001) and suicide risk (r = .35, 95% CI [.31, .38], p < .001), respectively. All AS subfactors evinced significant associations with suicidal ideation (rs = .13-.24) and suicide risk (rs = .22-.32). CONCLUSIONS AS is related to suicidal ideation and global suicide risk. Research is needed to disentangle AS from other indices of distress in the prediction of suicidal thoughts and behaviors. Theoretical and clinical implications of these findings are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | | | - Daniel W Capron
- Department of Psychology, University of Southern Mississippi
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25
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Stanley IH, Smith LJ, Boffa JW, Tran JK, Schmidt NB, Joiner TE, Vujanovic AA. Anxiety sensitivity and suicide risk among firefighters: A test of the depression-distress amplification model. Compr Psychiatry 2018; 84:39-46. [PMID: 29684659 PMCID: PMC6402324 DOI: 10.1016/j.comppsych.2018.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 02/18/2018] [Accepted: 03/28/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Firefighters represent an occupational group at increased suicide risk. How suicidality develops among firefighters is poorly understood. The depression-distress amplification model posits that the effects of depression symptoms on suicide risk will be intensified in the context of anxiety sensitivity (AS) cognitive concerns. The current study tested this model among firefighters. METHODS Overall, 831 firefighters participated (mean [SD] age = 38.37 y [8.53 y]; 94.5% male; 75.2% White). The Center for Epidemiologic Studies Depression Scale (CES-D), Anxiety Sensitivity Index-3 (ASI-3), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to assess for depression symptoms, AS concerns (cognitive, physical, social), and suicide risk, respectively. Linear regression interaction models were tested. RESULTS The effects of elevated depression symptoms on increased suicide risk were augmented when AS cognitive concerns were also elevated. Unexpectedly, depression symptoms also interacted with AS social concerns; however, consistent with expectations, depression symptoms did not interact with AS physical concerns in the prediction of suicide risk. CONCLUSIONS In the context of elevated depression symptoms, suicide risk is potentiated among firefighters reporting elevated AS cognitive and AS social concerns. Findings support and extend the depression-distress amplification model of suicide risk within a sample of firefighters. Interventions that successfully impact AS concerns may, in turn, mitigate suicide risk among this at-risk population.
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Affiliation(s)
- Ian H. Stanley
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - Lia J. Smith
- Department of Psychology, University of Houston, 3695 Cullen Boulevard, Houston, TX 77204, USA
| | - Joseph W. Boffa
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - Jana K. Tran
- Houston Fire Department, 1801 Smith Street, Suite 626, Houston, TX 77002, USA
| | - N. Brad Schmidt
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - Thomas E. Joiner
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - Anka A. Vujanovic
- Department of Psychology, University of Houston, 3695 Cullen Boulevard, Houston, TX 77204, USA, Corresponding author at: Trauma and Stress Studies Center, University of Houston, Department of Psychology, 3695 Cullen Boulevard, 126 Heyne Building, Houston, TX 77204, USA. (A.A. Vujanovic)
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26
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Stanley IH, Buchman-Schmitt JM, Chu C, Rogers ML, Gai AR, Wagner RK, Gutierrez PM, Joiner TE. The Military Suicide Research Consortium Common Data Elements: An Examination of Measurement Invariance Across Current Service Members and Veterans. Assessment 2018; 26:963-975. [DOI: 10.1177/1073191118777635] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Suicide rates within the U.S. military are elevated, necessitating greater efforts to identify those at increased risk. This study utilized a multigroup confirmatory factor analysis to examine measurement invariance of the Military Suicide Research Consortium Common Data Elements (CDEs) across current service members ( n = 2,015), younger veterans (<35 years; n = 377), and older veterans (≥35 years; n = 1,001). Strong factorial invariance was supported with adequate model fit observed for current service members, younger veterans, and older veterans. The structures of all models were generally comparable with few exceptions. The Military Suicide Research Consortium CDEs demonstrate at least adequate model fit for current military service members and veterans, regardless of age. Thus, the CDEs can be validly used across military and veteran populations. Given similar latent structures, research findings in one group may inform clinical and policy decision making for the other.
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Affiliation(s)
| | | | - Carol Chu
- Florida State University, Tallahassee, FL, USA
| | | | - Anna R. Gai
- Florida State University, Tallahassee, FL, USA
| | | | - Peter M. Gutierrez
- University of Colorado School of Medicine, Denver, CO, USA
- Denver Veterans Affairs Medical Center, Denver, CO, USA
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27
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Boffa JW, Stanley IH, Smith LJ, Mathes BM, Tran JK, Buser SJ, Schmidt NB, Vujanovic AA. Posttraumatic Stress Disorder Symptoms and Suicide Risk in Male Firefighters: The Mediating Role of Anxiety Sensitivity. J Nerv Ment Dis 2018; 206:179-186. [PMID: 29309295 PMCID: PMC5825264 DOI: 10.1097/nmd.0000000000000779] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Posttraumatic stress disorder (PTSD) symptoms are positively related to suicide risk among firefighters. One mechanism that may account for this relationship is anxiety sensitivity (AS) cognitive concerns-the fear that cognitive symptoms of anxiety will have catastrophic consequences. We sought to replicate the mediating effect of AS cognitive concerns on the relationship between PTSD symptoms and suicide risk among 214 trauma-exposed male firefighters with non-zero suicide risk. Bootstrap mediation analyses tested AS cognitive concerns as a statistical mediator of PTSD symptoms (total and symptoms clusters scores) and suicide risk, controlling for depression symptoms and relevant demographic variables. AS cognitive concerns statistically mediated the relationship between PTSD symptoms (total score, as well as intrusion, avoidance, and arousal-reactivity symptoms clusters) and suicide risk; however, the reverse was also true. AS cognitive concerns may confer risk for suicide among trauma-exposed firefighters. Firefighters may benefit from AS-specific interventions, which are shown to reduce PTSD symptoms and suicidality.
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Affiliation(s)
- Joseph W. Boffa
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, Florida, USA
| | - Ian H. Stanley
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, Florida, USA
| | - Lia J. Smith
- Department of Psychology, University of Houston, 126 Heyne Building, 3695 Cullen Boulevard, Houston, Texas, USA
| | - Brittany M. Mathes
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, Florida, USA
| | - Jana K. Tran
- Houston Fire Department, 1801 Smith Street, Suite 626, Houston, Texas, USA
| | - Sam J. Buser
- Houston Fire Department, 1801 Smith Street, Suite 626, Houston, Texas, USA
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, Florida, USA
| | - Anka A. Vujanovic
- Department of Psychology, University of Houston, 126 Heyne Building, 3695 Cullen Boulevard, Houston, Texas, USA
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Chu C, Buchman-Schmitt JM, Stanley IH, Hom MA, Tucker RP, Hagan CR, Rogers ML, Podlogar MC, Chiurliza B, Ringer-Moberg FB, Michaels MS, Patros C, Joiner TE. The interpersonal theory of suicide: A systematic review and meta-analysis of a decade of cross-national research. Psychol Bull 2017; 143:1313-1345. [PMID: 29072480 PMCID: PMC5730496 DOI: 10.1037/bul0000123] [Citation(s) in RCA: 570] [Impact Index Per Article: 81.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Over the past decade, the interpersonal theory of suicide has contributed to substantial advances in the scientific and clinical understanding of suicide and related conditions. The interpersonal theory of suicide posits that suicidal desire emerges when individuals experience intractable feelings of perceived burdensomeness and thwarted belongingness and near-lethal or lethal suicidal behavior occurs in the presence of suicidal desire and capability for suicide. A growing number of studies have tested these posited pathways in various samples; however, these findings have yet to be evaluated meta-analytically. This paper aimed to (a) conduct a systematic review of the unpublished and published, peer-reviewed literature examining the relationship between interpersonal theory constructs and suicidal thoughts and behaviors, (b) conduct meta-analyses testing the interpersonal theory hypotheses, and (c) evaluate the influence of various moderators on these relationships. Four electronic bibliographic databases were searched through the end of March, 2016: PubMed, Medline, PsycINFO, and Web of Science. Hypothesis-driven meta-analyses using random effects models were conducted using 122 distinct unpublished and published samples. Findings supported the interpersonal theory: the interaction between thwarted belongingness and perceived burdensomeness was significantly associated with suicidal ideation; and the interaction between thwarted belongingness, perceived burdensomeness, and capability for suicide was significantly related to a greater number of prior suicide attempts. However, effect sizes for these interactions were modest. Alternative configurations of theory variables were similarly useful for predicting suicide risk as theory-consistent pathways. We conclude with limitations and recommendations for the interpersonal theory as a framework for understanding the suicidal spectrum. (PsycINFO Database Record
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Affiliation(s)
- Carol Chu
- Florida State University, Department of Psychology, Tallahassee, FL
- McLean Hospital, Belmont, MA
- Harvard Medical School, Department of Psychiatry, Cambridge, MA
| | | | - Ian H. Stanley
- Florida State University, Department of Psychology, Tallahassee, FL
| | - Melanie A. Hom
- Florida State University, Department of Psychology, Tallahassee, FL
| | - Raymond P. Tucker
- Louisiana State University, Department of Psychology, Baton Rouge, LA
| | | | - Megan L. Rogers
- Florida State University, Department of Psychology, Tallahassee, FL
| | | | - Bruno Chiurliza
- Florida State University, Department of Psychology, Tallahassee, FL
| | | | | | - Connor Patros
- Temple University, Department of Psychology, Philadelphia, PA
| | - Thomas E. Joiner
- Florida State University, Department of Psychology, Tallahassee, FL
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Ringer FB, Soberay KA, Rogers ML, Hagan CR, Chu C, Schneider M, Podlogar MC, Witte T, Holm-Denoma J, Plant EA, Gutierrez PM, Joiner TE. Initial validation of brief measures of suicide risk factors: Common data elements used by the Military Suicide Research Consortium. Psychol Assess 2017; 30:767-778. [PMID: 29130694 DOI: 10.1037/pas0000519] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The Military Suicide Research Consortium (MSRC) developed a 57-item questionnaire assessing suicide risk factors, referred to as the Common Data Elements (CDEs), in order to facilitate data sharing and improve collaboration across independent studies. All studies funded by MSRC are required to include the CDEs in their assessment protocol. The CDEs include shortened measures of the following: current and past suicide risk, lethality and intent of past suicide attempts, hopelessness, thwarted belongingness, anxiety sensitivity, posttraumatic stress disorder symptoms, traumatic brain injury, insomnia, and alcohol abuse. This study aimed to evaluate the psychometric properties of the CDE items drawn from empirically validated measures. Exploratory factor analysis was used to examine the overall structure of the CDE items, and confirmatory factor analyses were used to evaluate the distinct properties of each scale. Internal consistencies of the CDE scales and correlations with full measures were also examined. Merged data from 3,140 participants (81.0% military service members, 75.6% male) across 19 MSRC-funded studies were used in analyses. Results indicated that all measures exhibited adequate internal consistency, and all CDE shortened measures were significantly correlated with the corresponding full measures with moderate to strong effect sizes. Factor analyses indicated that the shortened CDE measures performed well in comparison with the full measures. Overall, our findings suggest that the CDEs are not only brief but also provide psychometrically valid scores when assessing suicide risk and related factors that may be used in future research. (PsycINFO Database Record
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Affiliation(s)
| | - Kelly A Soberay
- Rocky Mountain Mental Illness Research, Education and Clinical Center, Denver Veterans Affairs Medical Center
| | | | | | - Carol Chu
- Department of Psychology, Florida State University
| | | | | | - Tracy Witte
- Department of Psychology, Florida State University
| | | | | | - Peter M Gutierrez
- Rocky Mountain Mental Illness Research, Education and Clinical Center, Denver Veterans Affairs Medical Center
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Raines AM, Capron DW, Stentz LA, Walton JL, Allan NP, McManus ES, Uddo M, True G, Franklin CL. Posttraumatic stress disorder and suicidal ideation, plans, and impulses: The mediating role of anxiety sensitivity cognitive concerns among veterans. J Affect Disord 2017; 222:57-62. [PMID: 28672180 DOI: 10.1016/j.jad.2017.06.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/10/2017] [Accepted: 06/17/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Although the relationship between posttraumatic stress disorder (PTSD) and suicide has been firmly established, research on underlying mechanisms has been disproportionately low. The cognitive concerns subscale of anxiety sensitivity (AS), which reflects fears of cognitive dyscontrol, has been linked to both PTSD and suicide and thus may serve as an explanatory mechanism between these constructs. METHODS The sample consisted of 60 male veterans presenting to an outpatient Veteran Affairs (VA) clinic for psychological services. Upon intake, veterans completed a diagnostic interview and brief battery of self-report questionnaires to assist with differential diagnosis and treatment planning. RESULTS Results revealed a significant association between PTSD symptom severity and higher suicidality (i.e., ideation, plans, and impulses), even after accounting for relevant demographic and psychological constructs. Moreover, AS cognitive concerns mediated this association. LIMITATIONS Limitations include the small sample size and cross-sectional nature of the current study. CONCLUSIONS These findings add considerably to a growing body of literature examining underlying mechanisms that may help to explain the robust associations between PTSD and suicide. Considering the malleable nature of AS cognitive concerns, research is needed to determine the extent to which reductions in this cognitive risk factor are associated with reductions in suicide among at risk samples, such as those included in the present investigation.
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Affiliation(s)
- Amanda M Raines
- Southeast Louisiana Veterans Health Care System, 3500 Canal St., New Orleans, LA 70119, USA; South Central VA Healthcare Network Mental Illness Research, Education, and Clinical Center (MIRECC), 1601 Perdido St., New Orleans, LA 70112, USA
| | - Daniel W Capron
- Department of Psychology, University of Southern Mississippi, 118 College Dr., Hattiesburg, MS 32406, USA
| | - Lauren A Stentz
- Department of Psychology, Florida State University, 1107W. Call St., Tallahassee, FL 32306, USA
| | - Jessica L Walton
- Southeast Louisiana Veterans Health Care System, 3500 Canal St., New Orleans, LA 70119, USA; South Central VA Healthcare Network Mental Illness Research, Education, and Clinical Center (MIRECC), 1601 Perdido St., New Orleans, LA 70112, USA
| | - Nicholas P Allan
- Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA
| | - Eliza S McManus
- Southeast Louisiana Veterans Health Care System, 3500 Canal St., New Orleans, LA 70119, USA
| | - Madeline Uddo
- Southeast Louisiana Veterans Health Care System, 3500 Canal St., New Orleans, LA 70119, USA; South Central VA Healthcare Network Mental Illness Research, Education, and Clinical Center (MIRECC), 1601 Perdido St., New Orleans, LA 70112, USA; Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1430 Tulane Ave, New Orleans, LA 70112, USA
| | - Gala True
- Southeast Louisiana Veterans Health Care System, 3500 Canal St., New Orleans, LA 70119, USA; South Central VA Healthcare Network Mental Illness Research, Education, and Clinical Center (MIRECC), 1601 Perdido St., New Orleans, LA 70112, USA; Division of General Internal Medicine and Geriatrics, Department of Medicine, Tulane University School of Medicine, 1430 Tulane Ave, New Orleans, LA 70112, USA
| | - C Laurel Franklin
- Southeast Louisiana Veterans Health Care System, 3500 Canal St., New Orleans, LA 70119, USA; South Central VA Healthcare Network Mental Illness Research, Education, and Clinical Center (MIRECC), 1601 Perdido St., New Orleans, LA 70112, USA; Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1430 Tulane Ave, New Orleans, LA 70112, USA.
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31
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Stanley IH, Hom MA, Spencer-Thomas S, Joiner TE. Examining anxiety sensitivity as a mediator of the association between PTSD symptoms and suicide risk among women firefighters. J Anxiety Disord 2017. [PMID: 28645017 DOI: 10.1016/j.janxdis.2017.06.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) symptoms are associated with increased suicide risk. Anxiety sensitivity (AS)-the fear of anxiety-related sensations-is both a vulnerability factor for and consequence of PTSD symptoms. AS also predicts suicide risk. To our knowledge, no study has examined whether AS concerns account for the association between PTSD symptoms and suicide risk. METHOD A total of 254 women firefighters completed a web-based mental health survey. The Life Events Checklist for DSM-5 (LEC-5) was administered as a prelude to the PTSD Checklist for DSM-5 (PCL-5) to assess for exposure to a Criterion A event. The PCL-5, Anxiety Sensitivity Index-3 (ASI-3), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to assess PTSD symptoms, AS concerns, and suicide risk, respectively. Bootstrap mediation analyses were conducted, controlling for depression symptoms as measured by the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R). RESULTS Global and cognitive AS concerns, but neither physical nor social AS concerns, were statistically significant mediators of the relationship between PTSD symptoms (total score, re-experiencing and numbing clusters) and suicide risk. Alternate mediation models testing PTSD symptoms as a mediator of the relationship between AS concerns and suicide risk were not statistically significant, supporting the specificity of our proposed model. CONCLUSIONS Anxiety sensitivity concerns-specifically, cognitive AS concerns-account for the link between PTSD symptoms and suicide risk among women firefighters. Among firefighters with elevated PTSD symptoms, interventions that address cognitive AS concerns may thwart the trajectory to suicidal thoughts and behaviors.
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Affiliation(s)
- Ian H Stanley
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA.
| | - Melanie A Hom
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
| | | | - Thomas E Joiner
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
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32
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Capron DW, Norr AM, Albanese BJ, Schmidt NB. Fear reactivity to cognitive dyscontrol via novel head-mounted display perceptual illusion exercises. J Affect Disord 2017; 217:138-143. [PMID: 28410476 DOI: 10.1016/j.jad.2017.03.068] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 02/03/2017] [Accepted: 03/28/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Anxiety sensitivity cognitive concerns (ASCC), refer to fears of mental catastrophe or losing control over mental processes. Recent findings show that ASCC are related to suicide risk, mood disorders and trauma-related disorders. Using controlled experimental psychopathology paradigms could be one heretofore unutilized method of increasing understanding of ASCC. Our goal was to test fear reactivity to four head-mounted display perceptual illusion challenges designed to bring on feelings of cognitive dyscontrol (i.e., derealization, depersonalization) in a group of high and low anxiety sensitivity cognitive concerns participants. METHODS Participants (N=49) with Anxiety Sensitivity Index-3 cognitive scores at least 1.5 SD above or below the mean completed four cognitive dyscontrol challenges utilizing head-mounted display technology. RESULTS Results showed all four challenges successfully elicited high cognitive anxiety symptoms. Consistent with other laboratory challenge studies; high versus low ASCC participants reported comparable cognitive symptoms but reported significantly greater fear. LIMITATIONS This was an initial proof of concept study designed to examine fear reactivity to cognitive dyscontrol challenges. Therefore, no control exercises were evaluated. CONCLUSIONS The finding that fear reactivity to the laboratory challenges can potentially serve as a viable behavioral correlate of ASCC provides a potentially useful exposure exercise for clients experiencing high levels of ASCC. Given the association between ASCC and severe psychopathology, with further investigation and refinement, such exposure exercises could be integrated into cognitive-behavioral treatments.
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Affiliation(s)
- Daniel W Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA; Department of Psychology, Florida State University, Tallahassee, FL, USA.
| | - Aaron M Norr
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Brian J Albanese
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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Tucker RP, Lengel GJ, Smith CE, Capron DW, Mullins-Sweatt SN, Wingate LR. Maladaptive Five Factor Model personality traits associated with Borderline Personality Disorder indirectly affect susceptibility to suicide ideation through increased anxiety sensitivity cognitive concerns. Psychiatry Res 2016; 246:432-437. [PMID: 27788465 DOI: 10.1016/j.psychres.2016.08.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 08/17/2016] [Indexed: 11/18/2022]
Abstract
The current study investigated the relationship between maladaptive Five-Factor Model (FFM) personality traits, anxiety sensitivity cognitive concerns, and suicide ideation in a sample of 131 undergraduate students who were selected based on their scores on a screening questionnaire regarding Borderline Personality Disorder (BPD) symptoms. Those who endorsed elevated BPD symptoms in a pre-screen analyses completed at the beginning of each semester were oversampled in comparison to those with low or moderate symptoms. Indirect effect (mediation) results indicated that the maladaptive personality traits of anxious/uncertainty, dysregulated anger, self-disturbance, behavioral dysregulation, dissociative tendencies, distrust, manipulativeness, oppositional, and rashness had indirect effects on suicide ideation through anxiety sensitivity cognitive concerns. All of these personality traits correlated to suicide ideation as well. The maladaptive personality traits of despondence, affective dysregulation, and fragility were positive correlates of suicide ideation and predicted suicide ideation when all traits were entered in one linear regression model, but were not indirectly related through anxiety sensitivity cognitive concerns. The implication for targeting anxiety sensitivity cognitive concerns in evidence-based practices for reducing suicide risk in those with BPD is discussed.
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Affiliation(s)
- Raymond P Tucker
- Oklahoma State University, 116 North Murray, Stillwater, OK 74078, USA
| | - Greg J Lengel
- Oklahoma State University, 116 North Murray, Stillwater, OK 74078, USA
| | - Caitlin E Smith
- Oklahoma State University, 116 North Murray, Stillwater, OK 74078, USA
| | - Dan W Capron
- University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406-5025, USA
| | | | - LaRicka R Wingate
- Oklahoma State University, 116 North Murray, Stillwater, OK 74078, USA.
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Anxiety and Shame as Risk Factors for Depression, Suicidality, and Functional Impairment in Body Dysmorphic Disorder and Obsessive Compulsive Disorder. J Nerv Ment Dis 2016; 204:832-839. [PMID: 26998694 PMCID: PMC5026856 DOI: 10.1097/nmd.0000000000000498] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Body dysmorphic disorder (BDD) and obsessive compulsive disorder (OCD) are associated with elevated depression, suicidality, functional impairment, and days housebound, yet little research has identified risk factors for these outcomes. Using path analysis, the present study examined anxiety and shame as risk factors for these outcomes across Internet-recruited self-report groups (BDD [n = 114], OCD [n = 114], and healthy control [HC; n = 133]). Paths from anxiety and shame to outcomes were similar and mostly significant across BDD and OCD, compared to non-significant paths for HCs, with one exception: the path from shame to depression was significant in the BDD group (b = 0.32) but non-significant in the OCD group (b = 0.07). Findings underscore similarities in BDD and OCD, supporting their reclassification into the same Obsessive Compulsive Related Disorders category. Results emphasize the importance of targeting shame, in addition to anxiety, in treatments for BDD and OCD.
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35
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Nowakowski ME, Rowa K, Antony MM, McCabe R. Changes in Anxiety Sensitivity Following Group Cognitive-Behavior Therapy for Social Anxiety Disorder and Panic Disorder. COGNITIVE THERAPY AND RESEARCH 2016. [DOI: 10.1007/s10608-015-9750-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Examining the unique relations between anxiety sensitivity factors and suicidal ideation and past suicide attempts. Psychiatry Res 2015; 228:441-7. [PMID: 26154817 DOI: 10.1016/j.psychres.2015.05.066] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 05/12/2015] [Accepted: 05/29/2015] [Indexed: 11/24/2022]
Abstract
Anxiety sensitivity (AS) has recently been linked to suicidality. Specifically, AS cognitive concerns has been implicated as a risk factor, and AS physical concerns as a protective factor, for suicidal ideation and suicide attempts. However, no studies have used structural equation modeling (SEM) to address issues of skewed suicide variables and bifactor modeling of AS to address the high degree of overlap between the lower-order dimensions of AS that limit interpretation of these past findings. AS, suicidal ideation, past suicide attempts, and depression were assessed in a clinical sample of 267 individuals (M age=35.45 years, SD=16.53; 52.1% female). The global AS and AS cognitive concerns factors were positively, significantly associated with suicidal ideation, though these effects were nonsignificant controlling for depression. The global AS factor was positively, significantly associated with suicide attempts, controlling for depression. The current study demonstrated that the relations between AS and suicidal ideation are not maintained when accounting for depression, suggesting that the relation between AS and suicidal ideation may be mediated by depression. The positive relation between global AS and suicide attempts is consistent with theories positing suicide attempts as a consequence of an inability to cope with intolerable distress.
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