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Wang Y, Liu J, Chen S, Zheng C, Zou X, Zhou Y. Exploring risk factors and their differences on suicidal ideation and suicide attempts among depressed adolescents based on decision tree model. J Affect Disord 2024; 352:87-100. [PMID: 38360368 DOI: 10.1016/j.jad.2024.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/04/2024] [Accepted: 02/11/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Suicide has been recognized as a major global public health issue. Depressed adolescents are more prone to experiencing it. We explore risk factors and their differences on suicidal ideation and suicide attempts to further enhance our understanding of suicidal behavior. METHODS 2343 depressed adolescents aged 12-18 from 9 provinces/cities in China participated in this cross-sectional study. We utilized decision tree model, incorporating 32 factors encompassing participants' suicidal behavior. The feature importance of each factor was measured using Gini coefficients. RESULTS The decision tree model demonstrated a good fit with high accuracy (SI = 0.86, SA = 0.85 and F-Score (SI = 0.85, SA = 0.83). The predictive importance of each factor varied between groups with suicidal ideation and with suicide attempts. The most significant risk factor in both groups was depression (SI = 16.7 %, SA = 19.8 %). However, factors such as academic stress (SI = 7.2 %, SA = 1.6 %), hopelessness (SI = 9.1 %, SA = 5.0 %), and age (SI = 7.1 %, SA = 3.2 %) were more closely associated with suicidal ideation than suicide attempts. Factors related to the schooling status (SI = 3.5 %, SA = 10.1 %), total years of education (SI = 2.6 %, SA = 8.6 %), and loneliness (SI = 2.3 %, SA = 7.4 %) were relatively more important in the suicide attempt stage compared to suicidal ideation. LIMITATIONS The cross-sectional design limited the ability to capture changes in suicidal behavior among depressed adolescents over time. Possible bias may exist in the measurement of suicidal ideation. CONCLUSION The relative importance of each risk factor for suicidal ideation and attempted suicide varies. These findings provide further empirical evidence for understanding suicide behavior. Targeted treatment measures should be taken for different stages of suicide in clinical interventions.
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Affiliation(s)
- Yang Wang
- College of Management, Shenzhen University, Shenzhen, China
| | - Jiayao Liu
- College of Management, Shenzhen University, Shenzhen, China
| | - Siyu Chen
- College of Management, Shenzhen University, Shenzhen, China
| | - Chengyi Zheng
- College of Management, Shenzhen University, Shenzhen, China
| | - Xinwen Zou
- School of Business Informatics and Mathematics, University of Mannheim, Mannheim, Germany
| | - Yongjie Zhou
- Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, China.
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Xu W, Shen X, McDonnell D, Wang J. Childhood maltreatment and suicidal ideation among Chinese adolescents: Moderated mediation effect of perceived social support and maladaptive cognitive emotion regulation strategies. CHILD ABUSE & NEGLECT 2024; 151:106732. [PMID: 38503245 DOI: 10.1016/j.chiabu.2024.106732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 02/21/2024] [Accepted: 03/04/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Although previous studies have shown that childhood maltreatment is a risk factor for adolescent suicidal ideation, less is known about the mediating and moderating mechanisms underlying this association. OBJECTIVE The current study aimed to investigate the relationship between childhood maltreatment and suicidal ideation among adolescents, as well as the mediating role of maladaptive cognitive emotion regulation strategies (maladaptive CERSs) and the moderating role of perceived social support. METHODS In a cross-sectional design, 4005 adolescents (Mage = 14.24 years, SD = 1.53; 49.0 % males) completed self-report questionnaires regarding childhood maltreatment, maladaptive CERSs, perceived social support and suicidal ideation, along with their basic information. RESULTS After controlling for gender, family location, family structure, and depression, childhood maltreatment was positively related to adolescent suicidal ideation, and maladaptive CERSs were found to mediate this association. Moderated mediation analyses revealed that perceived social support buffered the associations between maladaptive CERSs and adolescent suicidal ideation. CONCLUSIONS The findings assist in understanding the mechanisms of maladaptive CERSs and perceived social support in the relationship between childhood maltreatment and suicidal ideation and can provide new perspectives for researchers designing interventions for suicidal ideation.
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Affiliation(s)
- Wei Xu
- Center for Mental Health Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Xi Shen
- Center for Mental Health Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Dean McDonnell
- Department of Humanities, South East Technological University, Carlow R93 V960, Ireland
| | - Jinliang Wang
- Center for Mental Health Education, Faculty of Psychology, Southwest University, Chongqing, China.
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Souza K, Sosu EM, Thomson S, Rasmussen S. A systematic review of the studies testing the integrated motivational-volitional model of suicidal behaviour. Health Psychol Rev 2024:1-25. [PMID: 38626312 DOI: 10.1080/17437199.2024.2336013] [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: 06/12/2023] [Accepted: 03/22/2024] [Indexed: 04/18/2024]
Abstract
Despite the influence of the integrated motivational-volitional (IMV)1 model on research and practice, the supporting literature has not been systematically synthesised. This systematic review aims to synthesise the literature testing the IMV model of suicidal behaviour. Using citation and database searching, PsycINFO, EMBASE, PubMed, Web of Science, and Google Scholar were searched for studies referencing the IMV model (last searched on 28th March 2023). Included studies empirically tested the hypotheses of the model. Quality assessment was conducted using the National Institute of Health tool. Findings from 98 records (100 studies, 138,365 participants) were narratively synthesised. Results from studies directly testing the hypothesised pathways of the model supported the defeat-entrapment-suicidal ideation pathway of the IMV model. Case-control studies comparing differences between control, ideation, and enactment groups were consistent with hypotheses in univariate and cross-sectional analyses. However, support for the model was mixed for case-control multivariate and prospective studies. Due to low overlap in variables studied, the role of specific pre-motivational phase variables and stage-specific moderators was inconclusive. The studies received overall good quality ratings. The IMV model presents a promising framework for understanding and preventing suicide. Defeat, entrapment, and key variables may be useful in informing suicide prevention measures.
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Affiliation(s)
- Kenvil Souza
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Edward M Sosu
- Strathclyde Institute of Education, University of Strathclyde, Glasgow, UK
| | - Scott Thomson
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Susan Rasmussen
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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Keefner T, Minton M, Antonen K. Embracing Emotional Pain: A Case Study of Adolescent Suicidality and Spirituality. J Am Psychiatr Nurses Assoc 2024; 30:397-408. [PMID: 36016492 DOI: 10.1177/10783903221118932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Suicidality continues to be the second leading cause of adolescent death. Nurses are in a prime position to address the emotional pain associated with adolescent suicidality but report skepticism and discomfort. Moreover, spirituality is identified as a protective factor against suicidality, yet a gap exists related to exploring spirituality within the context of the emotional pain associated with adolescent suicidality. Building awareness of adolescents' spirituality and emotional pain associated with suicidality is essential to address nurse skepticism and discomfort. AIMS The purpose of this study was to explore young adults' experiences of suicide attempt(s) during adolescence in the context of spirituality using a case study application of participant narratives to Minton and Antonen's B.L.E.S.S. acronym. METHOD A multiple-case study design was used to provide an alternative perspective for understanding adolescent suicidality from a spiritual context. Reed's theory of self-transcendence and the B.L.E.S.S. acronym guided the analysis and interpretation. Convenience online sampling resulted in six adult participants who provided email narratives of their adolescent experiences. Email data collection was guided by Fritz and Vandermause. Analysis of participant narratives followed the protocol of Baxter and Jack. RESULTS Participant's narratives revealed self-transcendence that paralleled the five truths about emotional pain and spirituality inherent in the B.L.E.S.S. acronym. CONCLUSION This case study provides nurses a guide for counteracting the barriers of skepticism and stigma to promote help-seeking behavior associated with adolescent suicidality. Further research is needed for the application of the B.L.E.S.S. acronym with other population samples.
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Affiliation(s)
- Tamara Keefner
- Tamara Keefner, PhD, RN, CNE, University of South Dakota, Vermillion, SD, USA
| | - Mary Minton
- Mary Minton, PhD, RN, CHPN, South Dakota State University, Brookings, SD, USA
| | - Kathy Antonen
- Kathy Antonen, PhD, South Dakota School of Mines and Technology, Rapid City, SD, USA
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Ahmadboukani S, Kivi HG, Kiani A, Rezaeisharif A. A structural test of the three-step theory (3ST) of suicide in the Iranian population: From ideation to action. Health Sci Rep 2023; 6:e1697. [PMID: 38028675 PMCID: PMC10654840 DOI: 10.1002/hsr2.1697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/05/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Aims Suicide is one of the leading causes of death, especially in adolescents and young adults. This study aimed to perform a structural test of the three-step theory (3ST) of suicide in the Iranian population. Methods The research population included Iranian people over 18 years of age. The participants were 600 persons selected through convenience sampling. The data in this study were collected using the Suicide Attempt Questionnaire, the Suicide Behaviors Questionnaire-Revised, the Interpersonal Needs Questionnaire, the Impulsiveness Scale, the Depressive Symptom-Suicidality Subscale, ACSSACSS-Fearlessness About Death, the Psychache Scale, the Beck Hopelessness Scale, and the Suicide Capacity Scale. Results Data analysis showed that pain and positive helplessness (β = 0.45; p < 0.05) positively interact with suicidal behavior. Moreover, pain and negative helplessness significantly interact with suicidal ideation (β = 0.65; p < 0.001). The data also showed that the absence of interpersonal needs plays a protective role. A comparison of the three suicidal capacity factors indicated that only the practical capacity differentiates the ideation and action subgroups. Conclusions The insights from this study provide a clear picture of the underlying causes of suicidal ideation and behavior and can help counselors and other human health professionals working with people with suicidal thoughts and behavior to prevent suicide attempts. Following functional models, they can also make serious efforts to perform therapeutic interventions to eliminate or reduce suicidal thoughts and feelings.
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Affiliation(s)
- Soliman Ahmadboukani
- Department of Counseling, Faculty of Educational Sciences and PsychologyUniversity of Mohaghegh ArdabiliArdabilIran
| | - Hosein Ghamari Kivi
- Department of Counseling, Faculty of Educational Sciences and PsychologyUniversity of Mohaghegh ArdabiliArdabilIran
| | - Ahmadreza Kiani
- Department of Counseling, Faculty of Educational Sciences and PsychologyShahid Beheshti UniversityTehranIran
| | - Ali Rezaeisharif
- Department of Counseling, Faculty of Educational Sciences and PsychologyUniversity of Mohaghegh ArdabiliArdabilIran
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Wang S, Wei T, Zhu R, Li S, Liu X, Cai Y, Gong R. Perceived entrapment predicts first-onset suicidal ideation: A longitudinal study among medical students in China. Front Public Health 2023; 10:1049975. [PMID: 36743178 PMCID: PMC9892625 DOI: 10.3389/fpubh.2022.1049975] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction The prevalence of suicidal ideation among medical students is high. Evidence indicates that feelings of entrapment are a predictor of suicidal ideation. In this study, we aimed to (1) investigate the prevalence of first-onset suicidal ideation among Chinese medical students and (2) explore the predictive effects of perceived entrapment on first-onset suicidal ideation. Methods This longitudinal study was conducted between 2018 and 2019 among 211 newly enrolled medical students in Shanghai. Using an anonymous questionnaire, we collected information on sociodemographic (sex, major, parents' income, and academic performance) and psychological (entrapment, depression, loneliness, defeat, social support, and interpersonal needs) variables as well as suicidal ideation. Participants were divided into four subgroups based on their exposure to entrapment (control, new-onset, reduced, and persistent). The primary outcome, first-onset suicidal ideation, was defined as suicidal ideation absent at baseline but present at follow-up. Results In total, 54.98% of participants (116/211) were women, and 76.78% (162/211) majored in clinical medicine. In the follow-up survey, 6.16% of participants (16/211) reported first-onset suicidal ideation, 17.54% (37/211) reported new-onset entrapment, and 12.80% (27/211) reported persistent entrapment during follow-up. Compared with the control group who reported no perceived entrapment at baseline and follow-up, participants who reported new-onset entrapment had the highest risk of new-onset suicidal ideation [odds ratio (OR) = 14.700, 95% confidence interval (CI) = 2.906-74.364; adjusted OR = 8.798; 95% CI = 1.588-48.757; multivariate OR = 8.238, 95% CI = 1.394-48.693). Conclusion New-onset entrapment can significantly predict suicidal ideation. Therefore, greater attention is needed for new-onset entrapment, such as intervention for suicidal ideation.
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Affiliation(s)
- Suping Wang
- Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ting Wei
- Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Rui Zhu
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Sicong Li
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xinyi Liu
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yong Cai
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Community Health Care, Hospital Development Institute Shanghai Jiao Tong University, Shanghai, China
| | - Ruijie Gong
- Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department Immunization Program, Xuhui Center for Disease Control and Prevention, Shanghai, China
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De Jaegere E, Stas P, van Heeringen K, Dumon E, van Landschoot R, Portzky G. Future-Oriented Group Training for suicidal individuals: A randomized controlled trial. Suicide Life Threat Behav 2023; 53:270-281. [PMID: 36650920 DOI: 10.1111/sltb.12944] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/23/2022] [Accepted: 01/03/2023] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Suicide is a serious public health concern worldwide. Current psychological interventions targeting suicidal ideation and behavior are, however, limited and often lack convincing empirical support. Future-Oriented Group Training (FOGT) targets crucial aspects of the suicidal process, thus possibly offering a promising intervention for suicidal ideation. This study aimed at investigating the short-term and long-term effects of FOGT on suicidal thoughts and related variables. METHODS A randomized controlled trial was conducted, comparing the intervention group (FOGT + treatment as usual (TAU)) to a control group (TAU) at pre and posttreatment and at a 12-week follow-up. Suicidal ideation was the primary outcome, while depressive symptoms, hopelessness, defeat, entrapment, worrying, and the ability for future-oriented thinking were secondary outcomes. RESULTS When compared to the control group, the intervention group showed significant decreases in worrying at posttreatment and significant increases in future-oriented thinking at follow-up. Pre-post analyses within the intervention group showed significant small-to-medium effects for primary as well as most secondary outcomes. Changes in suicidal ideation, depression, hopelessness, and future-oriented thinking remained significant at follow-up. CONCLUSION This study provides promising empirical evidence for the use of FOGT for individuals with suicidal ideation.
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Affiliation(s)
- Eva De Jaegere
- Flemish Centre of Expertise in Suicide Prevention, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Pauline Stas
- Flemish Centre of Expertise in Suicide Prevention, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Kees van Heeringen
- Flemish Centre of Expertise in Suicide Prevention, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Eva Dumon
- Flemish Centre of Expertise in Suicide Prevention, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Renate van Landschoot
- Flemish Centre of Expertise in Suicide Prevention, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Gwendolyn Portzky
- Flemish Centre of Expertise in Suicide Prevention, Department of Head and Skin, Ghent University, Ghent, Belgium
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Chen J, Zhang Y, Cheng F, Xie J, Zhang K, Hu D. Symptom distress and suicidal ideation among Chinese ovarian cancer patients: A moderated mediation model of depression and suicide resilience. Front Psychol 2023; 14:1073995. [PMID: 36895757 PMCID: PMC9989189 DOI: 10.3389/fpsyg.2023.1073995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/03/2023] [Indexed: 02/25/2023] Open
Abstract
Objective The aim of this study was to examine whether depression mediates the relationship between symptom distress and suicidal ideation in Chinese patients with ovarian cancer, and whether this mediating effect was moderated by suicide resilience. Methods From March to October 2022, this cross-sectional study was performed in a three Grade 3A hospital and an oncology specialty hospital in Wuhan, Hubei Province, China. Ultimately, 213 ovarian cancer patients completed anonymous self-report. Bootstrapping method was used for regression analysis to test the mediating and moderating effects. Results Among the 213 participants, 29.58% (n = 63) exhibited significant suicidal ideation. Symptom distress was positively associated with suicidal ideation, and depression partially mediated this relationship. Suicide resilience moderated the relationship between depression and suicidal ideation. In ovarian cancer patients with low suicide resilience, the effect of symptom distress on suicidal ideation through depression was greater, while in patients with high suicide resilience, this effect was attenuated. Conclusion Our study suggests that symptom distress could be more likely to lead to suicidal ideation as depression levels increase in ovarian cancer patients. Fortunately, suicide resilience could attenuate this negative effect.
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Affiliation(s)
- Jie Chen
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yinying Zhang
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Cheng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinzhi Xie
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Keke Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Deying Hu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Bayliss LT, Christensen S, Lamont-Mills A, du Plessis C. Suicide capability within the ideation-to-action framework: A systematic scoping review. PLoS One 2022; 17:e0276070. [PMID: 36301944 PMCID: PMC9612581 DOI: 10.1371/journal.pone.0276070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/28/2022] [Indexed: 11/19/2022] Open
Abstract
Suicide capability is theorised to facilitate the movement from suicidal ideation to suicide attempt. Three types of contributors are posited to comprise suicide capability: acquired, dispositional, and practical. Despite suicide capability being critical in the movement from ideation-to-attempt, there has been no systematic synthesis of empirical evidence relating to suicide capability that would enable further development and refinement of the concept. This study sought to address this synthesis gap. A scoping review was conducted on suicide capability studies published January 2005 to January 2022. Eleven electronic databases and grey literature sources were searched returning 5,212 potential studies. After exclusion criteria application, 90 studies were included for final analysis. Results synthesis followed a textual narrative approach allocating studies based on contributors of suicide capability. Most studies focused on investigating only one factor within contributors. Painful and provocative events appear to contribute to acquired capability more so than fearlessness about death. Whilst emerging evidence for dispositional and practical contributors is promising, the small number of studies prevents further conclusions from being drawn. An unexpected additional cognitive contributor was identified. The focus of a single factor from most studies and the limited number of studies on contributors other than acquired capability limits the theoretical development and practical application of suicide capability knowledge. Given that suicide is a complex and multifaceted behaviour, future research that incorporates a combination of contributors is more likely to advance our understandings of suicide capability.
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Yasdiman MB, Townsend E, Blackie LER. Examining the protective influence of posttraumatic growth on interpersonal suicide risk factors in a 6-week longitudinal study. Front Psychol 2022; 13:998836. [PMID: 36337476 PMCID: PMC9630643 DOI: 10.3389/fpsyg.2022.998836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
Research has found an inverse relationship between posttraumatic growth (PTG) and suicidal ideation in military and community samples that holds when controlling for other suicide risk factors. However, further research is needed into the underlying mechanisms to clarify how PTG protects against the formation of suicidal ideation. The current two-wave longitudinal study examined whether perceiving PTG from recent adverse circumstances while in a national lockdown during the COVID-19 pandemic attenuated the positive relationship of two interpersonal suicide risk factors – perceived burdensomeness (PB) and thwarted belonginess (TB)–over 6 weeks. Participants (n = 170) were recruited online from Prolific from income-deprived areas in the United Kingdom (mean age = 37.65; SD = 12.50; 53.5% female). Post-hoc power analyses indicated we had insufficient power to examine the hypothesised mediation for TB. We examined whether PTG mediated the relationship between PB at wave 1 and wave 2 while controlling for depression and anxiety in a sample of individuals at-risk for suicidal ideation. PTG did significantly and partially mediate the positive relationship between PB at wave 1 and 2. We discuss the theoretical and clinical implications that could result if future research successfully replicates these initial exploratory findings.
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Affiliation(s)
- Meryem Betul Yasdiman
- Personality, Social Psychology and Health Research Group, University of Nottingham, Nottingham, United Kingdom
- Self-Harm Research Group, University of Nottingham, Nottingham, United Kingdom
- *Correspondence: Meryem Betul Yasdiman,
| | - Ellen Townsend
- Personality, Social Psychology and Health Research Group, University of Nottingham, Nottingham, United Kingdom
- Self-Harm Research Group, University of Nottingham, Nottingham, United Kingdom
| | - Laura E. R. Blackie
- Personality, Social Psychology and Health Research Group, University of Nottingham, Nottingham, United Kingdom
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Wetherall K, Cleare S, Eschle S, Ferguson E, O'Connor DB, O'Carroll RE, O'Connor RC. Predicting suicidal ideation in a nationally representative sample of young adults: a 12-month prospective study. Psychol Med 2022; 52:3168-3175. [PMID: 33634764 DOI: 10.1017/s0033291720005255] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Evidence-based theoretical models outlining the pathways to the development of suicidal ideation may inform treatment. The current research draws from the Interpersonal Theory of Suicide (IPT) and the Integrated Motivational-Volitional (IMV) Model of suicidal behaviour and aims to test the interaction between perceived burdensomeness and thwarted belongingness as proposed by the IPT model, and the defeat-entrapment pathway as proposed by the IMV model, in the prediction of suicidal ideation at 12-month follow-up. METHODS The Scottish Wellbeing Study is a nationally representative prospective study of young people aged 18-34 years (n = 3508) from across Scotland, who completed a baseline interview and a 12-month follow-up (n = 2420). The core factors from both the IPT (perceived burdensomeness and thwarted belongingness) and the IMV model (defeat, internal and external entrapment) were measured alongside demographics, depressive symptoms and suicidal ideation at baseline. At 12-month follow-up, suicidal ideation was assessed again. RESULTS In multiple regression analysis perceived burdensomeness and internal entrapment, with baseline suicidal ideation, predicted 12-month suicidal ideation. No support for the interaction between perceived burdensomeness and thwarted belongingness in predicting 12-month suicidal ideation was found. However, there was evidence that internal, but not external, entrapment mediated the relationship between defeat and 12-month suicidal ideation, but no support was found for the moderation of burdensomeness and belongingness on the entrapment to suicidal ideation pathway. CONCLUSIONS The current findings highlight the importance of targeting perceived burdensomeness and internal entrapment to reduce the likelihood that suicidal ideation emerges in at risk individuals.
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Affiliation(s)
- Karen Wetherall
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, G12 0XH, UK
| | - Seonaid Cleare
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, G12 0XH, UK
| | - Sarah Eschle
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, G12 0XH, UK
| | | | | | - Ronan E O'Carroll
- Division of Psychology, School of Natural Sciences, University of Stirling, UK
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, G12 0XH, UK
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12
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Yasdiman MB, Townsend E, Blackie LER. Examining the protective function of perceptions of post-traumatic growth against entrapment and suicidal ideation. J Affect Disord 2022; 300:474-480. [PMID: 34979187 DOI: 10.1016/j.jad.2021.12.118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 12/30/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Recent evidence has found that reporting post-traumatic growth (PTG) from a past stressful life event is associated with lower reports of suicidal ideation. Perceptions of PTG measure the extent to which an individual reports positive changes in their identity, relationships, and worldviews after a stressful event. However, little is known about how perceptions of PTG interact with feelings of defeat and entrapment to influence suicidal ideation. The current study examined this question through the Integrated Motivational-Volitional (IMV) Model of Suicidal Behavior. METHODS 521 adult participants (315 females with age range of 18-82, M = 30.4 years, SD = 13.6) completed an online cross-sectional questionnaire with defeat, entrapment, suicidal ideation, PTG, depression and anxiety measures. Hypotheses and data analysis plans were pre-registered prior to data collection. RESULTS PTG negatively correlated with defeat, entrapment and suicidal ideation. PTG predicted lower suicidal ideation when controlling for entrapment, depression and anxiety. PTG did not moderate the relationship between defeat on entrapment or the relationship between entrapment on suicidal ideation. LIMITATIONS The findings were based on cross-sectional data where participants recalled experiences of defeat, entrapment and suicidal ideation from the past year. The sample was a large community (non-clinical) sample, and most of the participants identified as white (85%). CONCLUSION Although PTG did not function as a moderator within the IMV model of suicidality, it predicted lower suicidal ideation while controlling for other known predictors of suicidal ideation. Future research could explore the function of PTG in appraisal-based models of suicidality.
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Affiliation(s)
- Meryem Betul Yasdiman
- Personality, Social Psychology and Health Research Group, School of Psychology, University Park, University of Nottingham, Nottingham NG7 2RD, United Kingdom; Self-harm Research Group, School of Psychology, University Park, University of Nottingham, Nottingham NG7 2RD, United Kingdom.
| | - Ellen Townsend
- Personality, Social Psychology and Health Research Group, School of Psychology, University Park, University of Nottingham, Nottingham NG7 2RD, United Kingdom; Self-harm Research Group, School of Psychology, University Park, University of Nottingham, Nottingham NG7 2RD, United Kingdom
| | - Laura E R Blackie
- Personality, Social Psychology and Health Research Group, School of Psychology, University Park, University of Nottingham, Nottingham NG7 2RD, United Kingdom
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Roland L, Höller I, Forkmann T, Glaesmer H, Paashaus L, Schönfelder A, Teismann T, Juckel G, Rath D. Suicidal behavior in the social environment: Does exposure moderate the relationship between an individual's own suicidal ideation and behavior? Clin Psychol Psychother 2022; 29:1309-1320. [PMID: 35005811 DOI: 10.1002/cpp.2709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/13/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Suicidal behavior still cannot be sufficiently predicted. Exposure to suicidal behavior in the personal social environment is assumed to moderate the individual's transition from suicidal ideation to suicidal behavior within the Integrated Motivational-Volitional Model of Suicidal Behavior (IMV-model). This study aimed to investigate this moderating effect in a German high-risk sample. METHODS We interviewed 308 psychiatric inpatients (53% female) aged 18 to 81 years (M = 36.9, SD = 14.30) admitted after attempted suicide (53%) or due to an acute suicidal crisis (47%) regarding exposure events in their social environment. Four types of exposure events were analyzed using moderation analyses: familial suicides/suicide attempts, non-familial suicides/suicide attempts. Additionally, the numbers of reported exposure events were compared between patients with and without a recent suicide attempt as well as between patients with lifetime suicide attempts and lifetime suicidal ideation. RESULTS Neither moderating effects of exposure events on the relationship between lifetime suicidal ideation and recent suicidal behavior nor group differences between suicidal ideators and suicide attempters regarding the exposure events were found. CONCLUSIONS Exposure events might have differential and possibly protective effects on suicidal behavior - depending on type and quality (intensity, personal relevance, and recency) of event - and on the outcome (suicide vs. suicide attempt).
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Affiliation(s)
- Lea Roland
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Inken Höller
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Thomas Forkmann
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Laura Paashaus
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Antje Schönfelder
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Georg Juckel
- Department of Psychiatry, LWL-University Hospital, Ruhr-Universität Bochum, Bochum, Germany
| | - Dajana Rath
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
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14
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Anderson AM, Ford J. Transgender adolescent and young adult suicide: A bioecological perspective. Nurs Inq 2021; 29:e12476. [PMID: 34796570 DOI: 10.1111/nin.12476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 11/01/2021] [Accepted: 11/04/2021] [Indexed: 11/27/2022]
Abstract
Suicide is a public health crisis disproportionately affecting transgender adolescents and young adults. There are gaps in research evaluating this phenomenon using a multilevel, life-course approach. The following paper will provide an overview of the current models of suicide, critique their applicability to understanding suicide among transgender youth, and discuss how using a bioecological systems approach will help to advance our understanding of suicide among transgender youth. Transgender adolescents and young adults often face unique combinations of interpersonal and intrapersonal challenges that require managing a stark misalignment of social characters, expectations, and roles. These factors are imposed by the complex interactions and influences of the bioecological systems in which transgender adolescents and young adults are situated. Future research is needed to elucidate the characteristics of bioecological adversity faced by this vulnerable population. Identification of these relationships are likely to highlight effective targets for multilevel interventions aimed at preventing suicide.
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Affiliation(s)
- Avery M Anderson
- Martha S. Pitzer Center for Women, Children and Youth, College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Jodi Ford
- Martha S. Pitzer Center for Women, Children and Youth, College of Nursing, The Ohio State University, Columbus, Ohio, USA
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15
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Robinson WL, Whipple CR, Keenan K, Flack CE, Wingate L. Suicide in African American Adolescents: Understanding Risk by Studying Resilience. Annu Rev Clin Psychol 2021; 18:359-385. [PMID: 34762495 DOI: 10.1146/annurev-clinpsy-072220-021819] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Historically, suicide rates for African American adolescents have been low,relative to rates for youth of other racial-ethnic backgrounds. Since 2001, however, suicide rates among African American adolescents have escalated: Suicide is now the third leading cause of death for African American adolescents. This disturbing trend warrants focused research on suicide etiology and manifestation in African American adolescents, along with culturally sensitive and effective prevention efforts. First, we revisit leading suicide theories and their relevance for African American adolescents. Next, we discuss health promotive and protective factors within the context of African American youth development. We also critique the current status of suicide risk assessment and prevention for African American adolescents. Then, we present a heuristic model of suicide risk and resilience for African American adolescents that considers their development within a hegemonic society. Finally, we recommend future directions for African American adolescent suicidology. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- W LaVome Robinson
- Department of Psychology, DePaul University, Chicago, Illinois, USA;
| | - Christopher R Whipple
- School of Behavioral Sciences and Education, Pennsylvania State University-Harrisburg, Harrisburg, Pennsylvania, USA
| | - Kate Keenan
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Caleb E Flack
- Department of Educational Psychology, University ofWisconsin-Madison, Madison, Wisconsin, USA
| | - LaRicka Wingate
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
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16
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Keefner TP, Stenvig T. Rethinking Suicide Risk With a New Generation of Suicide Theories. Res Theory Nurs Pract 2021; 34:389-408. [PMID: 33199410 DOI: 10.1891/rtnp-d-19-00128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Suicide is a global concern to nurses and other health-care providers. However, deaths by suicide are only part of the spectrum of suicide, as suicidal thinking and behaviors may precede a suicide attempt. Theoretical models are used infrequently in research to explain how the individual progresses from suicidal ideation to a suicide attempt. Thus, there is a critical need to advance the study of suicide with useful theoretical models to describe and explain processes whereby suicidal thoughts transition to attempts and to suicide. PURPOSE This article provides a conceptual discussion and scoping review comparing historical and contemporary ideation-to-action theories of suicide. METHOD Systematic reviews and meta-analyses from three databases (CINAHL, JSTOR, and PsychINFO) were reviewed to find literature describing suicide theories. RESULTS Historically, theory applications have limited capacity to differentiate between those individuals with suicidal ideations and those who attempt suicide. Newer theories, grounded in the ideation-to-action framework, propose distinct processes explaining what moves an individual from suicidal ideations toward suicidal behaviors. IMPLICATIONS FOR PRACTICE The ideation-to-action theories can guide health-care providers' assessment of at-risk individuals beyond merely asking about suicidal thinking. CONCLUSION The new generation of suicide theories suggest that suicidal ideations are only one component of risk. The common factor in ideation-to-action theories that distinguishes ideators from attempters is the acquired capability for suicide.
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Affiliation(s)
- Tamara P Keefner
- College of Nursing, South Dakota State University, Brookings, South Dakota
| | - Thomas Stenvig
- College of Nursing, South Dakota State University, Brookings, South Dakota
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17
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Rogers ML, Cao E, Sinclair C, Galynker I. Associations between goal orientation and suicidal thoughts and behaviors at one-month follow-up: Indirect effects through ruminative flooding. Behav Res Ther 2021; 145:103945. [PMID: 34399271 DOI: 10.1016/j.brat.2021.103945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/24/2021] [Accepted: 08/10/2021] [Indexed: 12/29/2022]
Abstract
Previous research has identified both goal orientation and ruminative flooding as potential risk factors for suicidal thoughts and behaviors, as well as positive associations between goal orientation and rumination. The present study examined whether the association between goal orientation and suicidal thoughts and behaviors, assessed one month later, was accounted for by ruminative flooding. A sample of 924 psychiatric outpatients (Mage = 39.09 years, SD = 14.82, range = 18 to 84; 61.7% female; 37.0% White) completed self-report and interview measures at baseline and provided information about suicide-related outcomes at one-month follow-up. Goal orientation was positively associated with ruminative flooding, and both goal orientation and ruminative flooding were associated with suicidal thoughts and behaviors at one-month follow-up. Controlling for lifetime suicidal thoughts and behaviors, as well as patient age and sexual orientation, ruminative flooding accounted for the relationship between goal orientation and suicidal thoughts and behaviors at one-month follow-up. These findings were especially relevant for individuals with a history of multiple suicide attempts. Overall, this study provided evidence that difficulties with goal orientation may relate to suicidal thoughts and behaviors through intense ruminations perceived as a loss of cognitive control. Interventions that address ruminative thinking and cognitive flexibility may, in turn, assist in reducing emotion dysregulation and managing suicidality among those who struggle with goal orientation.
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Affiliation(s)
| | - Erjia Cao
- Icahn School of Medicine, Mount Sinai Beth Israel, USA; Department of Counseling and Clinical Psychology, Teachers College, Columbia University, USA
| | - Courtney Sinclair
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, USA
| | - Igor Galynker
- Icahn School of Medicine, Mount Sinai Beth Israel, USA
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18
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Li X, Ren Y, Zhang X, Zhou J, Su B, Liu S, Cai H, Liu J, You J. Testing the Integrated Motivational-Volitional Model of Suicidal Behavior in Chinese Adolescents. Arch Suicide Res 2021; 25:373-389. [PMID: 32013796 DOI: 10.1080/13811118.2019.1690607] [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: 10/25/2022]
Abstract
The integrated motivational-volitional model of suicidal behavior (IMV; O'Connor & Kirtley, 2018) integrates some key factors of suicidal behavior (e.g., defeat and entrapment) to explain the development of suicidal ideation and suicidal attempts. This study aimed to empirically test this model in a sample of Chinese adolescents. A number of 1,239 Chinese adolescents (679 girls; Mage = 14.07, SD = 1.54) completed self-report questionnaires. Results showed that defeat was associated with entrapment, which, in turn, was related to suicidal ideation and suicidal attempts. In addition, the relationship between entrapment and suicidal ideation was significant at high levels of thwarted belongingness and perceived burdensomeness, and low levels of resilience. These findings support the application of the IMV model in Chinese adolescents, and might help mental health organizations and educational agencies formulate effective suicidal prevention programs geared toward Chinese adolescents.
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19
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Ideation-to-action framework variables involved in the development of suicidal ideation: A network analysis. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01765-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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20
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Tae H, Chae JH. Factors Related to Suicide Attempts: The Roles of Childhood Abuse and Spirituality. Front Psychiatry 2021; 12:565358. [PMID: 33868033 PMCID: PMC8044867 DOI: 10.3389/fpsyt.2021.565358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 02/25/2021] [Indexed: 02/05/2023] Open
Abstract
Objectives: The purpose of this article was to identify independent factors associated with suicide attempts in patients with depression and/or anxiety. Background and Aims: This study was conducted in order to examine whether risk and protective psychological factors influence the risk of suicide attempts among outpatients with anxiety and/or depressive disorders. In this regard, explanatory models have been reported to detect high-risk groups for suicide attempt. We also examined whether identified factors serve as mediators on suicide attempts. Materials and Methods: Patients from 18 to 65 years old from an outpatient clinic at Seoul St. Mary's Hospital were invited to join clinical studies. From September 2010 to November 2017, a total of 737 participants were included in the final sample. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Childhood Trauma Questionnaire (CTQ), Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp-12), and Functional Social Support Questionnaire (FSSQ) were used to assess psychiatric symptoms. An independent samples t-test, a chi-square test, hierarchical multiple regression analyses, and the Baron and Kenny's procedures were performed in order to analyze data. Results: Young age, childhood history of emotional and sexual abuse, depression, and a low level of spirituality were significant independent factors for increased suicide attempts. Depression was reported to mediate the relationship between childhood emotional and sexual abuse, spirituality, and suicide attempts. Conclusions: Identifying the factors that significantly affect suicidality may be important for establishing effective plans of suicide prevention. Strategic assessments and interventions aimed at decreasing depression and supporting spirituality may be valuable for suicide prevention.
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Affiliation(s)
- Hyejin Tae
- Stress Clinic, Health Promotion Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Jeong-Ho Chae
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
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21
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Bayliss LT, Lamont-Mills A, du Plessis C, Morgan T. Suicide capacity within the ideation-to-action framework: a scoping review protocol. BMJ Open 2021; 11:e043649. [PMID: 33589461 PMCID: PMC7887362 DOI: 10.1136/bmjopen-2020-043649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION A core facilitator of the transition from suicidal thoughts to suicide attempt is the individual's capacity for suicide. Suicide capacity is a theoretically universal concept adaptable for specific groups that is hypothesised to comprise three contributing factors: acquired capability, for example, previous self-harm; dispositional, such as genetic influences and practical, knowledge of and access to lethal means. Given that suicide capacity as a concept is continuing to develop, a review and synthesis of the current literature is timely to ensure future research and development of suicide prevention strategies are based on evidential knowledge. The aim of this review is to map the available evidence to provide an overview of factors that contribute to an adult's capacity for suicide. METHODS AND ANALYSIS This review will encompass five stages. Studies will be identified through broad search strings applied to 11 academic databases: Academic Search Ultimate, APA PsycArticles, APA PsycINFO, CINAHL, Psychology & Behavioural Sciences, & Sociology Source Ultimate via EBSCOHost Megafile Ultimate; PubMed; Science Direct; Wiley Online; Taylor & Francis and ProQuest dissertations and theses. Grey literature databases and key suicide organisations will also be searched for relevant literature. Two reviewers will independently screen titles and abstracts then review full texts to identify articles meeting inclusion criteria. Articles will be assessed for eligibility based on suicide attempt history, primary research study design, language and publication date. Data from eligible full texts will be extracted using a predesigned template for analysis. The synthesisation method will be textual narrative synthesis with an incorporated quality appraisal checklist tool. ETHICS AND DISSEMINATION Ethics approval is not required for this scoping review as no human participants are involved. Study findings will be shared with key suicide organisations, through peer-reviewed publications, and conference presentations.
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Affiliation(s)
- Luke T Bayliss
- Faculty of Health Engineering and Sciences, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Andrea Lamont-Mills
- School of Psychology and Counselling, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Carol du Plessis
- School of Psychology and Counselling, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Talia Morgan
- Faculty of Health Engineering and Sciences, University of Southern Queensland, Ipswich, Queensland, Australia
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22
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Pengpid S, Peltzer K. Associations of number of victimizations with mental health indicators and health-risk behaviours among a nationally representative sample of in-school adolescents in Curaçao. CHILD ABUSE & NEGLECT 2021; 111:104831. [PMID: 33278732 DOI: 10.1016/j.chiabu.2020.104831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 10/01/2020] [Accepted: 11/22/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE The study aimed to estimate the association of experiencing a higher number of victimizations with mental health and health-risk behaviours among adolescents in the 2015 Curaçao Global School-Based Student Health Survey (GSHS). METHODS In all, 2,765 in-school adolescents with a median age of 15 years from Curaçao responded to the cross-sectional GSHS. RESULTS Results indicate that from six forms of victimization (bullied, parental physical victimization, physically attacked, physical intimate partner violence victimization, forced sex and violent injury) assessed, 29.6 % reported one type of victimization, 11.3 % two types and 4.9 % three or more types of victimization. In adjusted logistic regression analyses, PV was associated with four poor mental health indicators (worry-induced sleep disturbance, suicidal ideation, loneliness, and suicide attempt) and eleven health-risk behaviours (current tobacco use, current alcohol use, current cannabis use, early sexual debut, sex among students who were drunk, multiple sexual partners, non-condom use at last sex, school truancy, carrying a weapon, short sleep and skipping breakfast). CONCLUSION Almost one in six students reported poly-victimization (≥2 types). Higher frequency of victimization was positively associated with four poor mental health indicators and eleven health-risk behaviours.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand; Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa
| | - Karl Peltzer
- Department for Management of Science and Technology Development, Ton Duc Thang University, Ho Chi Minh City, Viet Nam; Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City, Viet Nam.
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23
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Ordóñez-Carrasco JL, Sánchez-Castelló M, Calandre EP, Cuadrado-Guirado I, Rojas-Tejada AJ. Suicidal Ideation Profiles in Patients with Fibromyalgia Using Transdiagnostic Psychological and Fibromyalgia-Associated Variables. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010209. [PMID: 33396651 PMCID: PMC7795109 DOI: 10.3390/ijerph18010209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/23/2020] [Accepted: 12/25/2020] [Indexed: 12/13/2022]
Abstract
Several studies have emphasized the heterogeneity of fibromyalgia patients. Furthermore, fibromyalgia patients are considered a high-risk suicide group. The ideation-to-action framework proposes a set of transdiagnostic psychological factors involved in the development of suicidal ideation. The present study aims to explore the existence of different subgroups according to their vulnerability to suicidal ideation through these transdiagnostic psychological variables and a set of variables typically associated with fibromyalgia. In this cross-sectional study, 151 fibromyalgia patients were assessed through the Revised Fibromyalgia Impact Questionnaire, Beck Depression Inventory-II, Plutchik Suicide Risk Scale, Interpersonal Needs Questionnaire, Defeat Scale, Entrapment Scale, Psychache Scale, and Beck Hopelessness Scale. A K-means cluster analysis identified two clusters, one (45.70%) according to a low vulnerability, and a second (54.30%) with a high vulnerability to suicidal ideation. These clusters showed statistically significant differences in suicidal ideation and suicide risk. However, no differences were observed in most socio-demographic variables. In conclusion, fibromyalgia patients who present a clinical condition characterized by a moderate-high degree of physical dysfunction, overall disease impact and intensity of fibromyalgia-associated symptoms, along with a high degree of perceived burdensomeness, thwarted belongingness, defeat, entrapment, psychological pain and hopelessness, form a homogeneous group at high risk for suicidal ideation.
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Affiliation(s)
- Jorge L. Ordóñez-Carrasco
- Department of Psychology, University of Almería, 04120 Almería, Spain; (M.S.-C.); (I.C.-G.); (A.J.R.-T.)
- Correspondence:
| | - María Sánchez-Castelló
- Department of Psychology, University of Almería, 04120 Almería, Spain; (M.S.-C.); (I.C.-G.); (A.J.R.-T.)
| | - Elena P. Calandre
- Instituto de Neurociencias “F. Oloriz”, University of Granada, 18013 Granada, Spain;
| | - Isabel Cuadrado-Guirado
- Department of Psychology, University of Almería, 04120 Almería, Spain; (M.S.-C.); (I.C.-G.); (A.J.R.-T.)
| | - Antonio J. Rojas-Tejada
- Department of Psychology, University of Almería, 04120 Almería, Spain; (M.S.-C.); (I.C.-G.); (A.J.R.-T.)
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24
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Ordóñez-Carrasco JL, Cuadrado-Guirado I, Rojas-Tejada AJ. Experiential Avoidance in the Context of the Integrated Motivational-Volitional Model of Suicidal Behavior. CRISIS 2020; 42:284-291. [PMID: 33034517 DOI: 10.1027/0227-5910/a000721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: According to the integrated motivational-volitional model of suicide, the perception of defeat and entrapment are the variables involved in the development of suicidal ideation. However, entrapment is not an inevitable consequence of feeling defeated. This transition is moderated by a set of variables relating to the ability to resolve the state of defeat. Aim: We aimed to study the potential moderating role of experiential avoidance in the relationship between defeat and entrapment in young adults. Method: A sample of 644 participants residing in Spain (51.2% female; Mage = 25.91, SDage = 5.14; range = 18-35 years old), selected by sex, age, and education level quotas, completed an online questionnaire consisting of: Defeat Scale; Entrapment Scale; and Acceptance and Action Questionnaire-II; and other sociodemographic variables. Results: Defeat and experiential avoidance had a statistically significant effect on entrapment. The interaction variable (defeat × experiential avoidance) was also statistically significant according to a moderating effect. Limitations: Due to the cross-sectional design, we could not establish causal associations between the variables. Conclusion: People who experience a high degree of defeat and experiential avoidance are more likely to progress to a state of entrapment, being more vulnerable to having suicidal ideation.
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25
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Zortea TC, Gray CM, O'Connor RC. Perceptions of Past Parenting and Adult Attachment as Vulnerability Factors for Suicidal Ideation in the Context of the Integrated Motivational-Volitional Model of Suicidal Behavior. Suicide Life Threat Behav 2020; 50:515-533. [PMID: 31763711 DOI: 10.1111/sltb.12606] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 09/20/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE We aimed to investigate whether perceptions of past parenting and current attachment orientations are associated with key components of the Integrated Motivational-Volitional (IMV) Model of Suicidal Behavior. We investigated the relationship between perceptions of past parenting, attachment, suicide ideation, defeat, entrapment, coping, and resilience. METHOD A total of 730 adult participants responded to an online questionnaire comprised of psychological measures. An initial regression analysis indicated that memories of past parenting and attachment were associated with suicide ideation. Four mediation models were tested based on the IMV model, all controlling for depressive symptoms. RESULTS In the first model, attachment orientations mediated the relationships between perceptions of past parenting dimensions and defeat. In the second, defeat mediated the relationships between attachment orientations and entrapment. In the third, entrapment mediated the relationship between defeat and suicidal ideation, but coping did not moderate the defeat-entrapment relationship. In the final model, entrapment mediated the relationship between defeat and suicide ideation, with resilience moderating this relationship. CONCLUSIONS The findings are novel and congruent with the core principles of the IMV model. Clinical implications suggest the protective effect of resilience and strengthening of self-compassion attitudes to reduce the effect of insecure attachment strategies.
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Affiliation(s)
- Tiago C Zortea
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Cindy M Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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26
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Wang S, Li C, Jia X, Lyu J, Wang Y, Sun H. From depressive symptoms to suicide risk: Roles of sense of belongingness and acquired capability for suicide in patients with mental disorders. Psych J 2020; 9:185-198. [PMID: 31945807 DOI: 10.1002/pchj.334] [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] [Received: 09/04/2019] [Revised: 10/31/2019] [Accepted: 11/14/2019] [Indexed: 11/12/2022]
Abstract
In order to prevent suicides in patients with mental disorders, it was critical to recognize the risk factors and explore the mechanism. Based on depressive symptoms, which were common in patients with mental disorders in consolidation period in China, we constructed a moderated mediating model under the framework of Integrated Motivational-Volitional Model of suicidal behaviour, and examined the mechanism of how depressive symptoms, thwarted belongingness, and acquired capability for suicide influenced suicide risk. In this study, data were collected from 164 patients through four questionnaires, and analyzed with PROCESS macro for SPSS (Hayes, 2008). The result showed that in the predictive effects of depressive symptoms on suicide risk, thwarted belongingness was a partial mediating variable, while acquired capability for suicide played a moderating role in the partial mediating model. Specifically, the predictive effects of depressive symptoms and thwarted belongingness, both as motivation variables, on suicide risk both occurred in the case of the high acquired capability of suicide, which was a volition variable. The research pointed out the interdependence of depressive symptoms and a sense of belongingness, and clarified the critical role of acquired capability for suicide. The integrated perspective could enhance the interpretation of reality, and enlightened those carrying out the practice of suicide intervention to patients with mental disorders.
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Affiliation(s)
- Shengnan Wang
- Department of Psychology, Weifang Medical University, Weifang, China.,School of Public Health and Management, Weifang Medical University, Weifang, China
| | - Congcong Li
- Department of Psychology, Weifang Medical University, Weifang, China.,Weifang New Epoch School, Weifang, China
| | - Xuji Jia
- Institute of Psychology and Behavior, Tianjin Normal University, Tianjin, China
| | - Juncheng Lyu
- School of Public Health and Management, Weifang Medical University, Weifang, China
| | - Yanyu Wang
- Department of Psychology, Weifang Medical University, Weifang, China
| | - Hongwei Sun
- Department of Psychology, Weifang Medical University, Weifang, China
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27
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Spangenberg L, Glaesmer H, Hallensleben N, Rath D, Forkmann T. (In)stability of Capability for Suicide in Psychiatric Inpatients: Longitudinal Assessment Using Ecological Momentary Assessments. Suicide Life Threat Behav 2019; 49:1560-1572. [PMID: 30834576 DOI: 10.1111/sltb.12547] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 11/28/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The study examines the temporal stability of capability for suicide (i.e., its state-like component), because it has been recently discussed that capability for suicide may be subject to shift over time. METHOD Seventy-four psychiatric inpatients with an unipolar depressive disorder were included in the study (mean age 37.9 years, 71.6% female, 32.4% with a history of suicide attempt). After a baseline assessment with several self-report questionnaires, ecological momentary assessments were applied over six consecutive days using smartphones. Capability for suicide was rated with three items once a day. For daily capability for suicide, descriptive and variability statistics and associations with baseline clinical characteristics (depression, suicidal ideation, childhood maltreatment, and history of suicide attempt) were analyzed. The prospective association of daily level of active suicidal ideation and daily capability was investigated by multilevel analysis. RESULTS Indicators of within-person variability and temporal instability supported considerable fluctuation in daily capability for suicide. Yet the degree of temporal instability showed individual differences. Baseline and daily suicidal ideation were positively associated with daily fearlessness about death and perceived capability. CONCLUSION The results provide first evidence that capability for suicide includes a dynamic short-term component that is linked to clinical variables such as suicidal ideation.
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Affiliation(s)
- Lena Spangenberg
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Nina Hallensleben
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Dajana Rath
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany
| | - Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany.,Department of Clinical Psychology, Institute of Psychology, University Duisburg-Essen, Duisburg-Essen, Germany
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Forkmann T, Volz-Sidiropoulou E, Helbing T, Drüke B, Mainz V, Rath D, Gauggel S, Teismann T. Sense it and use it: interoceptive accuracy and sensibility in suicide ideators. BMC Psychiatry 2019; 19:334. [PMID: 31675999 PMCID: PMC6825340 DOI: 10.1186/s12888-019-2322-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 10/14/2019] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Interoceptive deficits have been found to be associated with suicidal ideation and behavior. However, an objective measure of interoceptive accuracy has not been investigated in participants with suicide ideation, by now. This study aimed at investigating interoceptive accuracy and sensibility in persons with and without suicide ideation (SI) while controlling for severity of depressive symptoms. METHOD Ninety-five participants (age: M = 34.8, SD = 11.6, n = 56 female [58.9%]; n = 51 patients with a Major Depressive Disorder and n = 44 healthy participants) were assessed for interoceptive accuracy and sensibility, depression and SI. RESULTS Twenty-five participants (26%) reported SI. They showed interoceptive accuracy comparable to persons without SI (t = -.81, p = .422), but significantly lower interoceptive sensibility. After controlling for severity of depressive symptoms in a hierarchical linear regression analysis, most associations between interoceptive sensibility and SI disappeared. CONCLUSION Results suggest that suicide ideators do not lack the ability to perceive their own bodily signals but they feel less able to use them in a way that is advantageous for them. Differences between suicide ideators and non-ideators appear to be largely driven by depressive symptoms (depression bias).
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Affiliation(s)
- Thomas Forkmann
- 0000 0001 2187 5445grid.5718.bDepartment of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Eftychia Volz-Sidiropoulou
- 0000 0000 8653 1507grid.412301.5Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany
| | - Trientje Helbing
- 0000 0000 8653 1507grid.412301.5Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany
| | - Barbara Drüke
- 0000 0000 8653 1507grid.412301.5Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany
| | - Verena Mainz
- 0000 0000 8653 1507grid.412301.5Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany
| | - Dajana Rath
- 0000 0001 2187 5445grid.5718.bDepartment of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Siegfried Gauggel
- 0000 0000 8653 1507grid.412301.5Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany.
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Yang L, Liu X, Chen W, Li L. A Test of the Three-Step Theory of Suicide among Chinese People: A Study Based on the Ideation-to-Action Framework. Arch Suicide Res 2019; 23:648-661. [PMID: 30024342 DOI: 10.1080/13811118.2018.1497563] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The aim of this study was to test the Three-Step Theory (3ST) of suicide in a sample of college students in China (N = 1,097). All participants completed a battery of questionnaires indexing psychological pain, hopelessness, connectedness, suicide capacity, suicide ideation, and suicide attempt. The prevalence of suicide ideation and suicide attempt among the sample were 21.42% and 3.83%, respectively. The hierarchical regression analysis showed that psychological pain and hopelessness interacted to predict suicide ideation, and that connectedness was the most protective against ideation in those high on both pain and hopelessness. Suicide capacity differentiated attempters from ideators above and beyond current suicide ideation. These findings provide preliminary evidence for the validity of 3ST of suicide within Chinese contexts. Implications for suicide prevention and intervention and future research directions are also discussed.
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Affiliation(s)
| | | | - Wei Chen
- Tianjin Academy of Fine Arts , China
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30
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Distinguishing suicide ideation from suicide attempts: Further test of the Integrated Motivational-Volitional Model of Suicidal Behaviour. J Psychiatr Res 2019; 117:100-107. [PMID: 31376620 DOI: 10.1016/j.jpsychires.2019.07.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/22/2019] [Accepted: 07/26/2019] [Indexed: 11/21/2022]
Abstract
Suicidal behaviour poses a significant public health concern. Research into the factors that distinguish between the emergence of suicide ideation and the enactment of a suicide attempt is crucial. This study tests central tenets of the Integrated Motivational-Volitional Model of suicidal behaviour (IMV, O'Connor and Kirtley, 2018) which posits that volitional phase factors govern the transition from thinking to attempting suicide. 299 adults completed a face-to-face interview and were allocated to groups based on their suicidal history: Suicide attempt group (N = 100), suicide ideation group (N = 105), and a control group (N = 94). Measures were taken at baseline, at 1-month and 6-months follow-up. As predicted, the attempt group differed from the ideation group on all volitional phase factors. Those who had attempted suicide reported higher capability for suicide, were more likely to have a family member or friend who had self-injured or attempted suicide, and were more impulsive. In keeping with the IMV model, the ideation and attempt groups had similar scores on the motivational factors. Defeat and entrapment were significant predictors of ideation at baseline, and mediation analyses indicated that defeat had an indirect effect on ideation through entrapment at baseline and at 1-month follow-up. The results support the IMV model and suggest that entrapment should be routinely included in suicide risk assessments. Further research to test predictors of the transition from suicide ideation to suicide attempts is crucial to inform future intervention development and health care delivery.
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Rooney EE, Hill RM, Oosterhoff B, Kaplow JB. Violent victimization and perpetration as distinct risk factors for adolescent suicide attempts. CHILDRENS HEALTH CARE 2019. [DOI: 10.1080/02739615.2019.1630280] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Evan E. Rooney
- Department of Pediatrics, Baylor College of Medicine/Texas Children’s Hospital, Houston, TX, USA
| | - Ryan M. Hill
- Department of Pediatrics, Baylor College of Medicine/Texas Children’s Hospital, Houston, TX, USA
| | | | - Julie B. Kaplow
- Department of Pediatrics, Baylor College of Medicine/Texas Children’s Hospital, Houston, TX, USA
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32
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Barlow MA, Wrosch C, McGrath JJ. Goal adjustment capacities and quality of life: A meta‐analytic review. J Pers 2019; 88:307-323. [DOI: 10.1111/jopy.12492] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 04/30/2019] [Accepted: 05/17/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Meaghan A. Barlow
- Department of Psychology Concordia University Montreal Quebec Canada
| | - Carsten Wrosch
- Department of Psychology Concordia University Montreal Quebec Canada
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33
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Cohen LJ, Gorman B, Briggs J, Jeon ME, Ginsburg T, Galynker I. The Suicidal Narrative and Its Relationship to the Suicide Crisis Syndrome and Recent Suicidal Behavior. Suicide Life Threat Behav 2019; 49:413-422. [PMID: 29397571 DOI: 10.1111/sltb.12439] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 10/30/2017] [Indexed: 11/28/2022]
Abstract
In this study, we introduce the construct of the suicidal narrative, a hypothetical personal narrative linked to imminent suicide, and explore its relationship to near-term suicidal risk and the suicide crisis syndrome (SCS). Psychiatric outpatients (N = 289) were administered the Columbia Suicide-Severity Rating Scale (C-SSRS), Suicide Crisis Inventory (SCI), and Suicide Narrative Inventory (SNI), a novel instrument combining the documented risk factors of Thwarted Belongingness, Perceived Burdensomeness, Humiliation, Social Defeat, Goal Disengagement, and Goal Reengagement. Dimensional measures of past month, lifetime, and past suicidal phenomena, incorporating ideation and behavior, were calculated from the C-SSRS. Structural equation modeling was used to explore the interaction among variables. Factor analysis of the SNI yielded two orthogonal factors, termed Interpersonal and Goal Orientation. The former factor was comprised of Perceived Burdensomeness, Social Defeat, Humiliation, and Thwarted Belongingness, the latter of Goal Disengagement and Goal Reengagement. The Interpersonal factor correlated with both SCS severity and suicidal phenomena in each time frame and the Goal Orientation factor with no other variable. As hypothesized, the proposed model was significant for the past month only. Our findings support the construct of the suicidal narrative and its function as a near-term suicidal risk factor.
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Affiliation(s)
- Lisa Janet Cohen
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
| | - Bernard Gorman
- Department of Psychology, Adelphi University, Garden City, NY, USA
| | - Jessica Briggs
- Touro College of Osteopathic Medicine, New York, NY, USA
| | - Min Eun Jeon
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
| | - Tal Ginsburg
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
| | - Igor Galynker
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
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Wetherall K, Robb KA, O'Connor RC. An Examination of Social Comparison and Suicide Ideation Through the Lens of the Integrated Motivational-Volitional Model of Suicidal Behavior. Suicide Life Threat Behav 2019; 49:167-182. [PMID: 29315750 DOI: 10.1111/sltb.12434] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 08/28/2017] [Indexed: 12/30/2022]
Abstract
We aimed to investigate whether negative social comparisons are associated with key components of the integrated motivational-volitional (IMV) model of suicidal behavior. Specifically, we investigated the relationship between negative social comparisons, suicide ideation, defeat, entrapment, socially prescribed perfectionism, and resilience. Adult participants (N = 422) completed an online survey comprised of a range of psychological measures. An initial regression analysis indicated that negative social comparisons were associated with suicide ideation. Three mediation models were tested based on the IMV model, all controlling for depressive symptoms. In the first, social comparison partially mediated the relationship between socially prescribed perfectionism and defeat. In the second, defeat mediated the relationship between negative social comparisons and entrapment, and resilience moderated the relationship when defeat was high. In the final model, entrapment mediated the relationship between defeat and suicide ideation, with resilience moderating this relationship when entrapment was high. These findings are novel and lend support to the IMV model. The clinical implications include highlighting the importance of targeting resilience given its potential association with defeat and entrapment.
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Affiliation(s)
- Karen Wetherall
- Suicidal Behavior Research Laboratory, Academic Centre, Gartnavel Royal Hospital, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Kathryn A Robb
- Institute of Health and Wellbeing, General Practice and Primary Care, University of Glasgow, Glasgow, UK
| | - Rory C O'Connor
- Suicidal Behavior Research Laboratory, Academic Centre, Gartnavel Royal Hospital, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Wetherall K, Cleare S, Eschle S, Ferguson E, O'Connor DB, O'Carroll RE, O'Connor RC. From ideation to action: Differentiating between those who think about suicide and those who attempt suicide in a national study of young adults. J Affect Disord 2018; 241:475-483. [PMID: 30149335 DOI: 10.1016/j.jad.2018.07.074] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 07/23/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Although many suicide risk factors have been identified, there is still relatively little known about the factors that differentiate those who think about suicide from those who make a suicide attempt. AIMS Using the integrated motivational-volitional model (IMV) of suicidal behaviour as a framework, this study hypothesised that (i) motivational and volitional phase factors would differentiate non-suicidal controls from those who had a history of suicidal ideation or suicide attempts, and (ii) within a multivariable model only volitional phase factors would differentiate between those who had a history of suicidal ideation and those who had attempted suicide. METHOD The Scottish Wellbeing Study (n = 3508) is a nationally representative study of young people (18-34 years) recruited throughout Scotland. Using multinomial regression analysis, three groups (non-suicidal control (n = 2534), lifetime suicide ideation (n = 498) and lifetime suicide attempt (n = 403) groups) were compared on motivational and volitional phase variables. RESULTS Consistent with the IMV model, motivational and volitional phase variables differentiated the control group from both the ideation and attempt groups. Only volitional phase variables differentiated between the suicide attempt group and the suicidal ideation group in the multivariable model; with those reporting a suicide attempt being higher on acquired capability, mental imagery about death, impulsivity, and being more likely to know a friend who had made a suicide attempt. Having a family member or friend die by suicide or a family member attempt suicide did not differentiate between the groups. LIMITATIONS The findings were based on cross-sectional data derived from self-report measures. CONCLUSIONS These findings provide further support for the IMV model, and highlight potential targets for clinical intervention.
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Affiliation(s)
- Karen Wetherall
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow G12 0XH, UK.
| | - Seonaid Cleare
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow G12 0XH, UK
| | - Sarah Eschle
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow G12 0XH, UK
| | | | | | - Ronan E O'Carroll
- Division of Psychology, School of Natural Sciences, University of Stirling, UK
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow G12 0XH, UK.
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Ren Y, You J, Lin M, Xu S. Low self‐esteem, entrapment, and reason for living: A moderated mediation model of suicidal ideation. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2018; 54:807-815. [DOI: 10.1002/ijop.12532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 08/17/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Yaxuan Ren
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, & School of PsychologySouth China Normal University Guangzhou P. R. China
| | - Jianing You
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, & School of PsychologySouth China Normal University Guangzhou P. R. China
| | - Min‐Pei Lin
- Department of Educational Psychology and CounselingNational Taiwan Normal University Taipei City Taiwan (R.O.C)
| | - Sian Xu
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, & School of PsychologySouth China Normal University Guangzhou P. R. China
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Cohen LJ, Ardalan F, Yaseen Z, Galynker I. Suicide Crisis Syndrome Mediates the Relationship Between Long-term Risk Factors and Lifetime Suicidal Phenomena. Suicide Life Threat Behav 2018; 48:613-623. [PMID: 28833408 DOI: 10.1111/sltb.12387] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 05/19/2017] [Indexed: 11/27/2022]
Abstract
In recent years, there has been growing attention to the distinction between acute and long-term suicidal risk factors. We have previously characterized an acute, negative affect state, termed the suicide crisis syndrome (SCS), as a marker of near-term suicidal risk. Here, we test whether documented long-term risk factors (i.e., trait vulnerabilities), including perfectionism, impulsivity, chronic substance abuse, insecure attachment, poor social support, and childhood trauma, associate to suicidal phenomena through a pathway of the SCS. A sample of 207 psychiatric inpatients were administered a battery of eight scales, including the Suicide Trigger Scale (STS-3) as a measure of the SCS. While both STS-3 and all trait vulnerabilities were associated with lifetime suicidal ideation and attempts, only STS-3 was related to pre-admission suicide attempts. The STS-3 significantly mediated the effect of each trait vulnerability on lifetime suicidal phenomena (combining ideation and behavior), with the proportion of mediating effect ranging from .29 to .56. Reverse mediation analyses were only significant for insecure attachment, supporting a largely unidirectional mediation effect. The SCS appears to serve as an acute risk factor for suicidal behavior in psychiatric inpatients and may act as a mechanism by which long-term risk factors increase suicidal risk.
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Affiliation(s)
| | | | - Zimri Yaseen
- Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
| | - Igor Galynker
- Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
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Klonsky ED, Saffer BY, Bryan CJ. Ideation-to-action theories of suicide: a conceptual and empirical update. Curr Opin Psychol 2018; 22:38-43. [DOI: 10.1016/j.copsyc.2017.07.020] [Citation(s) in RCA: 171] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 07/11/2017] [Accepted: 07/17/2017] [Indexed: 12/20/2022]
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Forkmann T, Teismann T, Stenzel JS, Glaesmer H, de Beurs D. Defeat and entrapment: more than meets the eye? Applying network analysis to estimate dimensions of highly correlated constructs. BMC Med Res Methodol 2018; 18:16. [PMID: 29370770 PMCID: PMC5785844 DOI: 10.1186/s12874-018-0470-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 01/02/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Defeat and entrapment have been shown to be of central relevance to the development of different disorders. However, it remains unclear whether they represent two distinct constructs or one overall latent variable. One reason for the unclarity is that traditional factor analytic techniques have trouble estimating the right number of clusters in highly correlated data. In this study, we applied a novel approach based on network analysis that can deal with correlated data to establish whether defeat and entrapment are best thought of as one or multiple constructs. METHODS Explanatory graph analysis was used to estimate the number of dimensions within the 32 items that make up the defeat and entrapment scales in two samples: an online community sample of 480 participants, and a clinical sample of 147 inpatients admitted to a psychiatric hospital after a suicidal attempt or severe suicidal crisis. Confirmatory Factor analysis (CFA) was used to test whether the proposed structure fits the data. RESULTS In both samples, bootstrapped exploratory graph analysis suggested that the defeat and entrapment items belonged to different dimensions. Within the entrapment items, two separate dimensions were detected, labelled internal and external entrapment. Defeat appeared to be multifaceted only in the online sample. When comparing the CFA outcomes of the one, two, three and four factor models, the one factor model was preferred. CONCLUSIONS Defeat and entrapment can be viewed as distinct, yet, highly associated constructs. Thus, although replication is needed, results are in line with theories differentiating between these two constructs.
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Affiliation(s)
- Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Pauwelsstraße 19, 52074, Aachen, Germany.
| | - Tobias Teismann
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany
| | - Jana-Sophie Stenzel
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Pauwelsstraße 19, 52074, Aachen, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Derek de Beurs
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
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Forkmann T, Teismann T. Entrapment, perceived burdensomeness and thwarted belongingness as predictors of suicide ideation. Psychiatry Res 2017; 257:84-86. [PMID: 28734241 DOI: 10.1016/j.psychres.2017.07.031] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/11/2017] [Accepted: 07/15/2017] [Indexed: 11/15/2022]
Abstract
The Integrated Motivational-Volitional (IMV) Model of suicide posits that perceived burdensomeness and thwarted belongingness moderate the association between perceptions of entrapment and suicide ideation. However, the proposed moderation is yet to be tested. Possible moderator effects were investigated in an online sample (N = 480; 74% female; Mage = 28.5, SDage = 11.1). Entrapment and perceived burdensomeness predicted suicide ideation. However, neither perceived burdensomeness nor thwarted belongingness moderated the association between entrapment and suicide ideation. The present results do not support a key assumption of the IMV-Model. Nonetheless, they underscore the importance of perceived burdensomeness and entrapment in the prediction of suicide ideation.
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Affiliation(s)
- Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany.
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Chase HW, Segreti AM, Keller TA, Cherkassky VL, Just MA, Pan LA, Brent DA. Alterations of functional connectivity and intrinsic activity within the cingulate cortex of suicidal ideators. J Affect Disord 2017; 212:78-85. [PMID: 28157550 PMCID: PMC5358995 DOI: 10.1016/j.jad.2017.01.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 11/27/2016] [Accepted: 01/14/2017] [Indexed: 01/21/2023]
Abstract
The 'default mode network' (DMN), a collection of brain regions including the posterior cingulate cortex (PCC), shows reliable inter-regional functional connectivity at rest. It has been implicated in rumination and other negative affective states, but its role in suicidal ideation is not well understood. We employed seed based functional connectivity methods to analyze resting state fMRI data in 34 suicidal ideators and 40 healthy control participants. Whole-brain connectivity with dorsal PCC or ventral PCC was broadly intact between the two groups, but while the control participants showed greater coupling between the dorsal anterior cingulate cortex (dACC) and dorsal PCC, compared to the dACC and ventral PCC, this difference was reversed in the ideators. Furthermore, ongoing low frequency BOLD signal in these three regions (dorsal, ventral PCC, dACC) was reduced in the ideators. The structural integrity of the cingulum bundle, as measured using diffusion tensor imaging (DTI), also explained variation in the functional connectivity measures but did not abolish the group differences. Together, these findings provide evidence of abnormalities in the DMN underlying the tendency towards suicidal ideation.
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Affiliation(s)
- Henry W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
| | - Anna Maria Segreti
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Timothy A Keller
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, United States
| | | | - Marcel A Just
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Lisa A Pan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - David A Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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Examining the role of psychological factors in the relationship between sleep problems and suicide. Clin Psychol Rev 2017; 54:1-16. [PMID: 28371648 PMCID: PMC5434037 DOI: 10.1016/j.cpr.2017.03.009] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 11/29/2016] [Accepted: 03/27/2017] [Indexed: 01/08/2023]
Abstract
We sought to conduct the first systematic review of empirical evidence investigating the role of psychological factors in the relationship between sleep problems and suicidal thoughts and behaviours. Twelve studies were identified which examined psychological factors grouped into four categories of cognitive appraisals, psychosocial factors, emotion regulation strategies, and risk behaviours. Although there was substantial heterogeneity across studies with respect to measurement, sampling, and analysis, preliminary evidence indicated that negative cognitive appraisals, perceived social isolation, and unhelpful emotion regulation strategies may contribute to the association between sleep problems and suicidal thoughts and behaviours. Given that findings in this area are currently restricted to studies with cross-sectional designs, the directionality of the interrelationships between these psychological factors, sleep problems and suicidality, remains unclear. We integrate the findings of our review with contemporary psychological models of suicidal behaviour to develop a clear research agenda. Identified pathways should now be tested with longitudinal and experimental designs. In addition, a more thorough investigation of the complexities of sleep, psychological factors, and suicidal thoughts and behaviours is crucial for the development of targeted psychological interventions. Systematic review of the role of psychological factors in sleep/suicide relationships Review findings integrated with suicide theory to define a clear research agenda. Reliance on cross-sectional designs limits interpretation of directionality of pathways. Identified pathways should be investigated with longitudinal and experimental designs.
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Network Analysis: A Novel Approach to Understand Suicidal Behaviour. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017. [PMCID: PMC5369055 DOI: 10.3390/ijerph14030219] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Although suicide is a major public health issue worldwide, we understand little of the onset and development of suicidal behaviour. Suicidal behaviour is argued to be the end result of the complex interaction between psychological, social and biological factors. Epidemiological studies resulted in a range of risk factors for suicidal behaviour, but we do not yet understand how their interaction increases the risk for suicidal behaviour. A new approach called network analysis can help us better understand this process as it allows us to visualize and quantify the complex association between many different symptoms or risk factors. A network analysis of data containing information on suicidal patients can help us understand how risk factors interact and how their interaction is related to suicidal thoughts and behaviour. A network perspective has been successfully applied to the field of depression and psychosis, but not yet to the field of suicidology. In this theoretical article, I will introduce the concept of network analysis to the field of suicide prevention, and offer directions for future applications and studies.
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