CART analysis with unit-weighted regression to predict suicidal ideation from Big Five traits

Beck’s Depression Inventory II Suicidal Ideation in Medical Students – Prevalence and Associated Factors

Background: Suicide is the second leading cause of death in 15- to 29-year-olds in Germany. Studies have shown that compared to the general population students are more affected by suicidal ideation, as one major indicator of an attempted suicide. This effect is observed all over the world, interestingly, it is also true for physicians. Therefore, we investigated whether medical students are at an even higher risk than their peers to develop suicidal ideation. Methods: N=1,103 medical students at a German university completed a self-reporting survey investigating socio-demographic, potential risk, and protective factors. The Beck’s Depression Inventory (BDI)-II Item 9 “Suicidality“ served as the dependent variable. Results: N=130 students (11.8% of the total sample) reported suicidal ideation within the last two weeks. Stepwise computed logistic regression models including all potential risk factors resulted in 40% explained variance. The most significant independent risk factors were the BDI-score, usage of tranquilizers, feeling lonely, insufficient time for hobbies and prior personal mental health issues, whereas focus enhancing drugs showed to be the only independent protective predictor. The BDI-II score correlated positively with the number of students suffering from suicidal ideation. Conclusion: The prevalence of suicidal ideation in our sample medical student population exceeds that of the general population greatly, confirming existing data and emphasizing the need to raise awareness and establish prevention programs.

The role of clinical and Personological features in predicting high lethality suicide attempts: A study among mood disorder patients

Suicidal attempts (SA) represent heterogeneous behaviours ranging in their seriousness from fatal and near-fatal (high-lethality) cases to those that do not require medical attention (low lethality). These considerations stress the need to identify high-risk individuals for high lethality SA in order to target suicide preventive interventions. The present study aims at evaluating the role of sociodemographic and clinical variables and examining personality pathological features in predicting high lethality SA. The sample was composed by 94 patients who were consecutively admitted to the Mood Disorders Unit of the San Raffaele Turro Hospital in Milan. The results of binary logistic regression analyses showed that previous SA and current suicide ideation play a role in predicting serious SA. Considering the DSM-5 personality dysfunctional domains assessed by the Personality Inventory for DSM-5, our logistic regression analyses suggested that high lethality SA was associated with Detachment PID-5 domain. Finally, binary hierarchical regression analysis showed that Detachment domain remained a significant predictor of serious SA over and above the effect of previous SA and suicide ideation. As a whole, our results highlight the importance of a multidimensional approach to develop adequate assessment, effective treatments and prevention of high lethality SA risk.

The Synergistic Effects of Neuroticism and Extraversion on Suicidal Ideation, Single Attempts, and Multiple Attempts in an Inpatient Sample

The current study sought to investigate the differential risk/protective factors of neuroticism and extraversion among individuals with only suicide ideation, those with a single suicide attempt, and those with multiple attempts. We hypothesized that extraversion would moderate the relation between neuroticism and suicide attempts (single and multiple) but not ideation. Patients in a private facility (N = 3343) completed measures assessing suicide history and general personality traits. Four moderation analyses were conducted with extraversion moderating the relationship between neuroticism and suicide ideation, single attempt (compared to zero attempts), and multiple attempts (compared to zero attempts and to single attempts). Extraversion moderated neuroticism only when comparing individuals with multiple suicide attempts to those with no attempts. Individuals who were low in both neuroticism and extraversion had higher levels of attempts than individuals with low neuroticism and high extraversion, highlighting the importance of considering biological predispositions as risk factors for suicide.

Worldviews and Individual Vulnerability to Suicide: The Role of Social Axioms

Research investigating the role of generalized beliefs about the world or worldviews is relatively scarce in the suicide literature. Two studies, using Hong Kong Chinese samples, examined how worldviews, as assessed by the Social Axioms Survey (SAS), were linked with individual vulnerability to suicide. In Study 1, we investigated the relationships of social axioms with various suicide indicators in cognitive, emotional and interpersonal domains, viz., suicidal ideation, negative self–esteem, psychache, burdensomeness and thwarted belongingness. Results from canonical correlation analysis showed that beliefs along the axiom dimensions of social cynicism, reward for application, and social complexity were linked to these suicide indicators. In Study 2, we tested the interplay of worldviews and personality traits in the prediction of suicidal thoughts. Hierarchical regression results demonstrated the predictive power of social axioms over and above that provided by the Big Five personality dimensions. Moreover, a significant interaction was observed between belief in reward for application and negative life events in predicting suicidal ideation, showing that reward for application buffered the effect of negative life events on suicidal ideation. Based on these results, we discussed the significance of worldviews as a consideration in suicide research and their implications for clinical assessment and intervention. Copyright © 2010 John Wiley & Sons, Ltd.

Lifetime and prospective associations among personality trait domains and suicide-related behaviors in patients with severe mental illness

BACKGROUND

Despite extensive research and clinical efforts, the suicide rate in the United States continues to rise, driving the need for more research to identify latent factors that increase risk for suicide and to guide treatment decision-making.

METHODS

The current study examined a large cohort (N = 1,219) of high-risk psychiatric inpatients to explore associations between personality traits and suicide-related variables measured retrospectively (lifetime history prior to hospital admission) and prospectively (at discharge and 12-month follow-up).

RESULTS

Lifetime suicide-related behavior (SRB: combination of ideational severity, aborted, interrupted, actual attempts, and non-suicidal self-injury) was associated with age (younger), gender (female), and elevated scores on the Personality Inventory for DSM-5 (PID-5) negative affectivity, borderline trait composite score, and five-factor model traits of conscientiousness and neuroticism. Patients who manifested persistent suicidal ideation throughout a 6-8 week inpatient treatment (n = 162; 16.9%) tended to be younger, female, and to have elevated PID-5 borderline trait composite scores. Twelve-month post-discharge SRB was predicted by elevated PID-5 borderline trait composite scores.

LIMITATIONS

Personality traits accounted for a small amount of variance in the overall model, thus limiting prediction based on individual traits.

CONCLUSIONS

This large sample of high-risk inpatients with longitudinal outcomes provides a rare assessment of proximal personality traits in predicting lifetime SRB, persistent suicidal ideation observed during the course of a 6-8-week intensive inpatient treatment, and SRB outcomes within 12 months after discharge from hospitalization. Personality traits should be included in future attempts to create predictive algorithms that include relevant biological data (neuroimaging, genetic, microbiome).

Predicting Suicidal Ideation in Adolescent Boys and Girls: The Role of Psychological Maturity, Personality Traits, Depression and Life Satisfaction

In recent years, suicide rates have increased in adolescents and the young population, so these age groups are considered as populations at risk. Considering that suicidal ideation is the first sign of possible future suicide behavior, the objective of this study is to determine the relative importance of psychological maturity, personality, depression and life satisfaction in predicting suicidal ideation in adolescents. Results show that depressive symptoms is the variable that best predicts suicidal ideation, but psychological maturity, life satisfaction and emotional stability are predictors as well (R2 = .51, p < .001). However, the Multigroup Structural Equation Models analyses carried out show that emotional stability has an indirect relationship with suicidal ideation, through its relationship with depressive symptoms, life satisfaction and identity. Two Multigroup Structural Equation Models were proposed to better understand the relationships between these variables for each sex. The results show that the fit of the model that includes the variable Self-reliance is better for boys than for girls (chi-square contributions of 8.175 for girls and 1.978 for boys) unlike the other model (chi-square contributions of 0.288 for girls and 1.650 for boys). These results suggest that the psychological maturity subscale Self-reliance play a role in suicidal ideation in males but not in females. Although there have been no previous studies on the role of psychological maturity as a predictor of suicidal phenomena, the current study suggests that it is a feature to be considered in the prediction of adolescent suicidal ideation.

The Function of Personality in Suicidal Ideation from the Perspective of the Interpersonal-Psychological Theory of Suicide

The Interpersonal-Psychological Theory of Suicide (IPTS) has been increasingly studied over the last years, responding to the demand for a valid framework addressing suicidality. Yet, only a few studies have explored the function of personality in the IPTS and none with clinical patients. We aimed to contribute to fill this gap in investigating the relationship between personality as conceptualized by the Five-Factor Model, the IPTS constructs, and a dimensional measure of current suicidal ideation. We conducted correlation, multiple linear regression, and path analyses based on a trait-interpersonal framework in a sample of 201 individuals visiting the psychiatric emergency room of a general hospital with current suicidal ideation. Neuroticism (positively) and openness (negatively) predicted perceived burdensomeness, while neuroticism (positively) and extraversion (negatively) predicted thwarted belongingness. Higher conscientiousness and lower extraversion were both predictors of the acquired capability for suicide. However, none of the models involving path analyses with IPTS variables as mediators of the relationship between personality traits and suicidal ideation was adequately adjusted to the data. Thus, it appears that personality plays a significant albeit modest role in suicidality when considered from an IPTS perspective. As personality is frequently assessed in the clinical routine, health professionals should consider it as complementary to detect individuals at risk of or presenting suicidal ideation.

Interpersonal trauma moderates the relationship between personality factors and suicidality of individuals with posttraumatic stress disorder

Individuals with posttraumatic stress disorder (PTSD) are more prone to suicidal ideation and behavior. While those who have experienced interpersonal trauma exhibit more suicidality than those who have experienced non-interpersonal trauma, it is unclear how the traumatic effects are related to an individual’s personality characteristics. This study examined the association between interpersonal trauma and personality factors with suicidality, and elucidated the moderating role of interpersonal trauma in individuals with PTSD. The study included 6,022 participants from the Korean Epidemiologic Catchment Area Study 2011. The Korean Version of Composite International Diagnostic Interview was used for the survey, including the participants’ history of suicidality, the traumas they have experienced, and their PTSD symptoms. The 11-item version of the Big Five Inventory (BFI-11) was used to assess the participants’ personality factors. 76 individuals were diagnosed with PTSD, while 810 had been exposed to trauma but were not diagnosed with any DSM-IV mental disorder. Among the individuals with PTSD, those who had experienced interpersonal trauma were more likely to have suicidal ideation than those who had experienced non-interpersonal trauma (p = .020; odds ratio [OR] = 3.643; 95% confidence interval of OR = [1.226, 10.825]). High agreeableness and conscientiousness predicted less suicidality in those exposed to non-interpersonal trauma, while predicting more suicidality in those exposed to interpersonal trauma. Clinicians examining individuals with PTSD should pay closer attention to the trauma that they have experienced, as well as their personality factors, to provide appropriate treatment.

Temperament and character profile of college students who have suicidal ideas or have attempted suicide

OBJECTIVE

Suicide is a major cause of death in university students. Personality traits have been suggested as possible risk factors for suicidal behaviors. This study looked at the relationship between the personality dimensions of the Temperament and Character Inventory (TCI) and suicidal behaviors.

METHOD

A total of 5644 college students took the TCI test and the suicidality module of the M.I.N.I. The students were divided into the suicidal ideation group (n = 302; 5.4%) and the suicide attempt group (n = 301; 5.3%). Each group's TCI dimension and sub-dimension scores were compared with one another. To find out which TCI dimension affects suicide risk when depressed, regression analysis and mediation analysis were conducted.

RESULTS

First, we adjusted for age, sex and depressive mood and compared the TCI scores of the participants based on their suicide risk. After the adjustment, self-directedness decreased in the suicidal ideation group while novelty seeking and persistence increased in the suicide attempt group. It turned out that self-directedness has a partial mediating effect between depressive symptom and suicide risk (β = -0.068 P < 0.001).

CONCLUSION

We adjusted for depressive mood and it turned out that the suicidal ideation group is affected by character whereas the suicide attempt group is affected by temperament. Among the character dimensions, self-directedness was found to reduce the effect of depressive mood on suicide risk. Therefore, when evaluating suicide risk, assessing character dimensions, especially self-directedness along with depressive mood, a risk factor, will be helpful.

Beyond psychopathology: A case-control psychological autopsy study of young adult males

BACKGROUND

As young Australian males are at a high risk of suicide, the identification of risk factors other than psychopathology is vital for the development of comprehensive suicide prevention measures.

AIMS

The study investigated whether there were differences in risk factors and pathways to suicide in young adult males from Queensland, Australia, with and without a diagnosable psychiatric disorder.

METHODS

A case-control, psychological autopsy method was applied using a control group of young males who had died suddenly from causes other than suicide.

RESULTS

Suicide cases without a psychiatric diagnosis more frequently displayed behaviours indicative of their suicidality (such as previous attempts, disposing of possessions and making statements of hopelessness) than controls without a diagnosis. Suicides without a diagnosis also displayed more 'difficult' personality traits, such as higher levels of neuroticism and aggression. They also experienced poorer quality of life and were significantly more likely than their controls to have experienced a recent separation from a spouse or partner.

CONCLUSION

The results of this study confirmed the existence of several distinct characteristics of young males who die by suicide in the absence of any diagnosable psychiatric disorder.

Value-added predictors of expressive and receptive language growth in initially nonverbal preschoolers with autism spectrum disorders

Eighty-seven preschoolers with autism spectrum disorders who were initially nonverbal (under 6 words in language sample and under 21 parent-reported words said) were assessed at five time points over 16 months. Statistical models that accounted for the intercorrelation among nine theoretically- and empirically-motivated predictors, as well as two background variables (i.e., cognitive impairment level, autism severity), were applied to identify value-added predictors of expressive and receptive spoken language growth and outcome. The results indicate that responding to joint attention, intentional communication, and parent linguistic responses were value-added predictors of both expressive and receptive spoken language growth. In addition, consonant inventory was a value-added predictor of expressive growth; early receptive vocabulary and autism severity were value-added predictors of receptive growth.

Predicting suicide ideation through intrapersonal and interpersonal factors: The interplay of Big-Five personality traits and social support

While a specific personality trait may escalate suicide ideation, contextual factors such as social support, when provided effectively, may alleviate the effects of such personality traits. This study examined the moderating role of social support in the relationship between the Big-Five personality traits and suicide ideation. Significant interactions were found between social support and extraversion and emotional stability. Specifically, the relationship between emotional stability and extraversion to suicide ideation was exacerbated when social support was low. Slope analysis showed openness also interacted with low social support. Results were computed for frequency, duration and attitude dimensions of suicide ideation. Extraversion interacted with social support to predict all three dimensions. Social support moderated emotional stability to predict frequency and duration, moderated conscientiousness towards frequency and attitude, and moderated openness towards attitude. The results imply that whereas personality traits may be difficult to alter, social support may play a significant role in saving a life. Psychologists should include family and friends when treating a suicidal youth, guiding them to awareness of one's personality and being more supportive.

Five factor model traits as a predictor of suicide ideation and interpersonal suicide risk in a college sample

Research has demonstrated an inconsistent relationship between suicide ideation and personality traits. This is the first study to empirically examine the relationship of the Five Factor Model of personality with current, past and no suicide ideation, and with the two interpersonal risk factors of suicide: thwarted belongingness and perceived burdensomeness (Joiner, T., 2005. Why people die by suicide. Cambridge, MA, US: Harvard University Press). Results indicate that high neuroticism was associated with both current ideation and a history of suicide ideation and extraversion was associated with current ideation. Neuroticism was positively related to thwarted belongingness and perceived burdensomeness, while extraversion was negatively related to these interpersonal predictors of suicide. Agreeableness was negatively related to thwarted belongingness but not perceived burdensomeness, indicating differentiated patterns of relationships between this personality domain and the two suicide constructs. Furthermore, these personality domains predicted 23.82% of variance for thwarted belongingness and 15.07% of the variance for perceived burdensomeness, above and beyond demographic variables associated with suicide ideation. This study, which was conducted with a college sample, demonstrates the potential benefit of identifying predispositional risk factors for suicide ideation and interpersonal predictors of suicide. This may have implications for the development of upstream preventative measures against suicide.

A trait-interpersonal analysis of suicide proneness among lesbian, gay, and bisexual community members

Suicide remains a concerning issue for lesbian, gay, and bisexual (LGB) persons. The integrated effects of five-factor model personality traits and interpersonal-psychological theory of suicide (IPTS) constructs on suicide proneness in a community sample of 336 LGB adults were examined. Results supported a model inclusive of all five-factor model domains predicting IPTS constructs leading to suicide proneness. Effects of neuroticism and extraversion were both mediated by perceived burdensomeness and thwarted belongingness. Thwarted belongingness mediated the effect of agreeableness on suicide proneness. Identified mediation pathways build on existing trait-interpersonal theory and may inform clinical services for sexual minority persons.

Personality factors and suicide risk in a representative sample of the German general population

Objective

Previous research has shown an association between certain personality characteristics and suicidality. Methodological differences including small sample sizes and missing adjustment for possible confounding factors could explain the varying results. The aim of this study was to assess the impact of the Big Five personality dimensions on suicidality in a representative population based sample of adults.

Method

Interviews were conducted in a representative German population-based sample (n=2555) in 2011. Personality characteristics were assessed using the Big Five Inventory-10 (BFI-10) and suicide risk was assessed with the Suicidal Behaviors Questionnaire-Revised (SBQ-R). Multivariate logistic regression models were calculated adjusting for depression, anxiety, and various sociodemographic variables.

Results

Neuroticism and openness were significantly associated with suicide risk, while extraversion and conscientiousness were found to be protective. Significant sex differences were observed. For males, extraversion and conscientiousness were protective factors. Neuroticism and openness were found to be associated with suicide risk only in females. These associations remained significant after adjusting for covariates.

Conclusion

The results highlight the role of personality dimensions as risk factors for suicide-related behaviors. Different personality dimensions are significantly associated with suicide-related behaviors even when adjusting for other known risk factors of suicidality.

Risk assessment profile and strategies for success instrument: determining prelicensure nursing students' risk for academic success

The ultimate outcomes for succeeding in a collegiate prelicensure nursing program are earning a Bachelor of Science in Nursing degree and passing the NCLEX-RN®. The Risk Assessment Profile, Strategies for Success (RAPSS) is a criterion-based instrument that incorporates demographic and academic risk indicators. A convenience sample (N = 255) obtained retrospectively from student files was used to determine whether the RAPSS could be used to predict whether completers of a baccalaureate, prelicensure program will pass or fail the NCLEX-RN. Results indicate that the scale does discriminate between candidates who fail and pass, even with as few as three of the 13 items.

[Suicidality and musical preferences: a possible link?]

Music is an important part of young people's lives. In this article, we attempt to answer two questions on the links between music et suicide. First, we examine if certain types of music favor suicidal process (ideation and acting out); and, secondly, we examine if music can constitute a tool to reduce the risk of suicide. Several factors possibly involved in links between musical preferences and the suicidal process are developed: the Velten effect and the musical mood induction procedure, the identification and the learning by imitation, the media influence as well as the individual characteristics. A multifactor approach is necessary to understand the complex and birectional links that unite musical preferences and suicide risk.

Factors associated with caregiver stability in permanent placements: a classification tree approach

OBJECTIVE

Identify individual and environmental variables associated with caregiver stability and instability for children in diverse permanent placement types (i.e., reunification, adoption, and long-term foster care/guardianship with relatives or non-relatives), following 5 or more months in out-of-home care prior to age 4 due to substantiated maltreatment.

METHODS

Participants were 285 children from the Southwestern site of Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Caregiver instability was defined as a change in primary caregiver between ages 6 and 8 years. Classification and regression tree (CART) analysis was used to identify the strongest predictors of instability from multiple variables assessed at age 6 with caregiver and child reports within the domains of neighborhood/community characteristics, caregiving environment, caregiver characteristics, and child characteristics.

RESULTS

One out of 7, or 14% of the 285 children experienced caregiver instability in their permanent placement between ages 6 and 8. The strongest predictor of stability was whether the child had been placed in adoptive care. However, for children who were not adopted, a number of contextual factors (e.g., father involvement, expressiveness within the family) and child characteristics (e.g., intellectual functioning, externalizing problem behaviors) predicted stability and instability of permanent placements.

CONCLUSIONS

Current findings suggest that a number of factors should be considered, in addition to placement type, if we are to understand what predicts caregiver stability and find stable permanent placements for children who have entered foster care. These factors include involvement of a father figure, family functioning, and child functioning.

PRACTICE IMPLICATIONS

Adoption was supported as a desired permanent placement in terms of stability, but results suggest that other placement types can also lead to stability. In fact, with attention to providing biological parents, relative, and non-relative caregivers with support and resources (e.g., emotional, financial, and optimizing father involvement or providing a stable adult figure) the likelihood that a child will have a stable caregiver may be increased.

Suicide, big five personality factors, and depression at the American state level

The research determined the relation of the 2004-2005 American state suicide rates to state means on neuroticism, agreeableness, extraversion, openness, and conscientiousness as assessed by Rentfrow, Gosling, and Potter (2008). Multiple regression strategies were used to analyze relations between state suicide rates and state personality means with state socioeconomic status, White population percent, urban population percent, and depression rates controlled. Multiple regression analysis showed that neuroticism accounted for 32.0% and agreeableness another 16.3% of the variance in suicide rates when demographics and depression were controlled. Lower neuroticism and lower agreeableness were associated with higher suicide rates. Lower neuroticism and lower agreeableness may be important risk factors for completed suicide but not suicidal ideation or attempted suicide.

The impact of suicidal rock music lyrics on youth: an investigation of individual differences

This study attempted to predict reactions after listening to music with lyrics about suicide. One hundred and twenty-six volunteers completed self-reports of personality and mood, and then listened to the music. Afterwards, they completed projective stories, self-reports of moods and reactions, and a memory test for the lyrics. Low openness to experience, and to a lesser extent, high neuroticism and low self-esteem predicted higher levels of suicide-related content in projective story-writing, as did knowing a suicide victim. Both the personality measures and post-listening mood predicted remembering too many nihilistic lyrics. Surprisingly, 68% of participants wrote at least one projective story with altruistic content. Individual differences were modestly associated with suicidal thoughts after listening to the music.

Factors linked to outcomes in sexually abused girls: a regression tree analysis

Children who report sexual abuse (SA) have been found to display a range of internalizing and externalizing behavior problems. In the present study, a tree-based analysis was used to derive models predicting the variability of internalizing and externalizing behavior problems as well as dissociation symptoms in SA girls. Participants were 150 girls aged 4 to 12 years referred to a specialized pediatric clinic after disclosure of SA. The potential predictors taken into account included sociodemographic and abuse-related variables as well as maternal and family characteristics. The models obtained point to prior abuse as a salient variable in predicting outcomes of SA girls. Implications for the treatment for children disclosing SA are discussed.

Determination of risk factors for hypertension through the classification tree method

Most current statistical strategies for determining risk factors for hypertension (HT) among certain populations have proved inconclusive. In this study, the classification tree method, which is more practical and easy to understand than other statistical methods, was used to determine the risk for HT among outpatients in a clinic in Denizli province, western Turkey, between January 2002 and July 2004. The effects of 14 risk factors (body mass index, waist-to-hip ratio, age, serum total cholesterol, serum triglycerides, sex, HT in first-degree relatives, diabetes mellitus, smoking, stress factors, alcohol consumption, dyslipidemia in first-degree relatives, dyslipidemia [previously diagnosed], and saturated fat consumption) on HT were evaluated in this population. In all, 1761 adults at the outpatient clinic were recruited for lipid and HT measurements. The classification tree method revealed 7 main risk factors (body mass index, waist-to-hip ratio, sex, serum triglycerides, serum total cholesterol, HT in first-degree relatives, and saturated fat consumption) for HT. The findings of the present study suggest that the classification tree is a valuable statistical method for evaluating multiple risk factors for HT.

Trends in suicidology: personality as an endophenotype for molecular genetic investigations

In studying the genetics of suicide, should personality be used as an endophenotype (an intermediate trait lying somewhere on the developmental pathway from genes to phenotype)?