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Marks RB, Moreira N, O'Connell KL, Hearne A, Law KC. Suicide While Locked Up in Texas: Risk Factors for Death by Suicide in Custody. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241243366. [PMID: 38591139 DOI: 10.1177/08862605241243366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
In the United States, suicide is a leading cause of death in prisons and jails, with incarcerated individuals being nine times more likely to die by suicide than the general population. Identifying vulnerabilities at each stage of custody (prebooking, jail, prison) and factors that increase suicide risk can improve prevention efforts. A hierarchical binary logistic regression was conducted on data from the Texas Justice Initiative's Deaths in Custody Report. Variables included race/ethnicity, sex, age at death, days in custody, classification of crime as violent or nonviolent, and custody type of prebooking, jail, or prison. Among main effects, when compared to suicide rates in prison, jail suicide deaths were over three and a half times more likely (OR = 3.61), and the period of prebooking emerged as a period of staggering risk of suicide death, with suicides being over 5,000% more likely than at other stages of custody (OR = 50.86). When interactions were entered, Latinx individuals were at a particularly increased risk of suicide death (OR = 10.46), likelihood of suicide death decreased with each year of age (OR = .89), nonviolent offenders were just under three and a half times more likely to die by suicide when compared to violent offenders (OR = 3.45), and each stage of custody was shown to affect the relationship between age-related rates of suicide in different ways. Results call for further investigation into suicide among understudied populations in corrections, such as Latinx individuals, juveniles in the prison system, and nonviolent offenders, to identify the groups at the highest risk of premature death in correctional systems.
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Affiliation(s)
| | | | | | | | - Keyne C Law
- Seattle Pacific University, Seattle, WA, USA
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2
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Cramer RJ, Cacace S, Coffey A, Hazlett E, Kaniuka AR, Robertson R, Peiper LJ. Latent profiles and psychosocial correlates of persistent self-injury among incarcerated adults. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2024; 93:101967. [PMID: 38401176 DOI: 10.1016/j.ijlp.2024.101967] [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: 10/11/2023] [Revised: 01/07/2024] [Accepted: 02/17/2024] [Indexed: 02/26/2024]
Abstract
Self-directed violence (SDV), including both suicide and non-suicidal self-injury, represents a major challenge for carceral systems. Persistent self-injury (PSI) is an understudied SDV subtype, especially within the carceral context. The present study addressed three research questions: (a) do naturally occurring SDV subgroups occur within a carceral population (e.g., PSI versus other classes); (b) how SDV groups may be differentiated by verbal or behavioral SDV; and (c) whether demographic, mental health, and incarceration-related factors are associated with SDV subgroups. We conducted a secondary analysis of existing data from a statewide carceral electronic medical record (N = 3527). Latent class analysis supports two SDV subtypes: episodic and persistent self-injury. The PSI class was characterized by significantly greater verbal expressions and behavioral acts of SDV compared to the episodic group. Correlates of the PSI subtype included older age, male sex, prior SDV, and lower depressive symptoms. Findings are discussed with respect to the proposed Diagnostic and Statistical Manual self-injury focused disorder, influential factors on SDV in carceral settings, and recommendations for future research and practice.
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Affiliation(s)
- Robert J Cramer
- Department of Public Health Sciences, UNC Charlotte, 19201 University City Blvd., Charlotte, NC 28223, USA.
| | - Sam Cacace
- Department of Public Health Sciences, UNC Charlotte, 19201 University City Blvd., Charlotte, NC 28223, USA
| | - Abby Coffey
- NC Division of Public Health, 5605 Six Forks Rd., Raleigh, NC 27609, USA
| | - Emily Hazlett
- Office of Scientific Integrity, Duke University, Durham, NC 27708, USA
| | - Andréa R Kaniuka
- Department of Public Health Sciences, UNC Charlotte, 19201 University City Blvd., Charlotte, NC 28223, USA
| | - Ryan Robertson
- Department of Public Health Sciences, UNC Charlotte, 19201 University City Blvd., Charlotte, NC 28223, USA
| | - Lewis J Peiper
- NC Department of Adult Correction, 831 W. Morgan Street, Raleigh, NC 27699, USA
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Vorstenbosch E, Rodríguez-Liron A, Vicens-Pons E, Félez-Nóbrega M, Escuder-Romeva G. Suicide risk in male incarcerated individuals in Spain: clinical, criminological and prison-related correlates. BMC Psychol 2023; 11:282. [PMID: 37735464 PMCID: PMC10514969 DOI: 10.1186/s40359-023-01315-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 09/06/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Prison suicide is a complex phenomenon that may be influenced by individual, clinical, social and environmental factors. In Spain, few studies have explored the relationship with institutional, prison-related variables. The aim of this study is to examine correlates of suicide in a sample of male incarcerated individuals from 5 Spanish penitentiary centers. METHODS This present study entails a secondary data analysis, using data from the Prevalence of mental disorders in prisons study. This is a cross-sectional multicenter study conducted in 2007-2008 across 5 penitentiary centers in Spain. The Spanish version of the Plutchik suicide risk scale was used to assess the risk of suicide (those scoring ≥ 6 were considered to be at risk of suicide). Sociodemographic, clinical, criminological and prison-related data were collected via face-to face interviews and criminological data were confirmed using penitentiary records. RESULTS The final sample included 707 male incarcerated individuals (mean age 36.79 years ± 9.90 years). Several significant correlates associated with higher risk of suicide were identified including criminological factors (having committed a violent offense, being a recidivist), clinical factors (family history of mental disorders, the presence of mental disorders, having physical conditions, contact with a mental health specialist, medication treatment in the last 12 months), and prison-related determinants (workshop/training course participation) was significantly associated with lower suicide risk. CONCLUSIONS Several correlates within a comprehensive range of sociodemographic, criminological, clinical and prison-related variables were identified. This information is primordial for preventing suicide and reducing the existing risk. The findings may contribute to developing effective suicide prevention programs within Spanish prison services. Importantly, future research must continue to investigate the nature of suicidal outcomes among incarcerated individuals.
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Affiliation(s)
- Ellen Vorstenbosch
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain.
- Instituto de Salud Carlos III, Centre for Biomedical Research On Mental Health (CIBERSAM), C/ Monforte de Lemos 3-5, 28029, Madrid, Spain.
| | - Ariadna Rodríguez-Liron
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
| | - Enric Vicens-Pons
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
| | - Mireia Félez-Nóbrega
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centre for Biomedical Research On Mental Health (CIBERSAM), C/ Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Gemma Escuder-Romeva
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Parc Sanitari Sant Joan de Déu, Penitentiary Psychiatric Hospitalization Unit of Catalonia, Carretera de Martorell a Capellades, Km 23, 08635, Sant Esteve Sesrovires, Spain
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4
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Stoliker BE, Wangler H, Abderhalden FP, Jewell LM. Lifetime and Jail-Specific Suicidal Ideation: Prevalence and Correlates in a Sample of People in Jail in the United States. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023:306624X231170112. [PMID: 37098823 DOI: 10.1177/0306624x231170112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Despite high suicide mortality in U.S. jails, there is limited research into precursors for suicide in this population, such as suicidal ideation. The current study examined the prevalence and correlates of lifetime and jail-specific suicidal ideation among a sample of 196 individuals (137 men) in custody in a U.S. jail. Nearly half the sample had reported lifetime suicidal ideation (45%), whereas 30% had reported jail-specific suicidal ideation. Adjusted correlates of lifetime suicidal ideation included a history of mental illness (OR = 2.79) and drug use (OR = 2.70). Adjusted correlates of jail-specific suicidal ideation included a history of mental illness (OR = 2.74), drug use (OR = 3.16), and a dehumanizing custodial environment (OR = 3.74). Some theoretically and empirically relevant factors were not significantly associated with suicidal ideation. Both expected and unexpected findings are discussed within the context of suicide theory and research, and practical implications are explored.
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Affiliation(s)
- Bryce E Stoliker
- Centre for Forensic Behavioural Science and Justice Studies, University of Saskatchewan, SK, Canada
| | - Haile Wangler
- Centre for Forensic Behavioural Science and Justice Studies, University of Saskatchewan, SK, Canada
| | - Frances P Abderhalden
- School of Criminal Justice and Criminalistics, California State University, Los Angeles, United States
| | - Lisa M Jewell
- Centre for Forensic Behavioural Science and Justice Studies, University of Saskatchewan, SK, Canada
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Favril L. Drug use before and during imprisonment: Drivers of continuation. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 115:104027. [PMID: 37060886 DOI: 10.1016/j.drugpo.2023.104027] [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: 12/01/2022] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Many people who enter prison have recently used drugs in the community, a substantial portion of whom will continue to do so while incarcerated. To date, little is known about what factors may contribute to the continuation of drug use during imprisonment. METHODS Self-reported data were collected from a random sample of 1326 adults (123 women) incarcerated across 15 prisons in Belgium. Multivariate regression was used to investigate associations between in-prison drug use and sociodemographic background, criminological profile, drug-related history, and mental health among participants who reported pre-prison drug use. RESULTS Of all 1326 participants, 719 (54%) used drugs in the 12 months prior to their incarceration and 462 (35%) did so while in prison. There was a strong association between drug use before and during imprisonment (OR = 6.77, 95% CI 5.16-8.89). Of those who recently used drugs in the community, half (52%) continued to do so while incarcerated. Factors independently associated with continuation (versus cessation) were young age, treatment history, polydrug use, and poor mental health. In a secondary analysis, initiation of drug use while in prison was further related to incarceration history and low education. CONCLUSION Persistence of drug use following prison entry is common. People who continue to use drugs inside prison can be differentiated from those who discontinue in terms of drug-related history and mental health. Routine screening for drug use and psychiatric morbidity on admission to prison would allow for identifying unmet needs and initiating appropriate treatment.
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Affiliation(s)
- Louis Favril
- Faculty of Law and Criminology, Ghent University, Belgium.
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Stijelja S, Mishara BL. Preventing suicidal and self-Injurious behavior in correctional facilities: A systematic literature review and meta-analysis. EClinicalMedicine 2022; 51:101560. [PMID: 35898320 PMCID: PMC9309412 DOI: 10.1016/j.eclinm.2022.101560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Rates of suicide and self-harm are elevated in carceral institutions. Inmates are a vulnerable group since they are exposed to multiple risk factors. This paper critically reviews empirical research on programs to prevent suicidal and self-harmful behaviors in correctional facilities and summarizes effect sizes across studies. METHODS We searched PsychINFO, PubMed, IEEEXPLORE and the CRISE Documentation Centre Database to identify relevant articles published before June 2022. Inclusion criteria were: peer-reviewed and with outcome data on effectiveness of prevention activities. Two reviewers independently assessed 905 articles to determine inclusion eligibility. Quality was assessed by two independent reviewers using the Quality Assessment Tool for Quantitative Studies. Meta-analyses using random-effect models were used to pool effect sizes for each outcome. This review was conducted in accordance with PRISMA guidelines. FINDINGS Twenty-four of the 905 articles, published between 1980 and 2022, were included. Studies were frequently conducted in the United States (n=13; 54%) and used varying study designs; most frequently pre-post with no control group (n=9; 38%). Sample sizes and interventions varied considerably. Most were of moderate quality (n=21; 88%). On average, prevention programs in correctional facilities were effective in decreasing suicide deaths (pooled rate ratio of 0·35 [95% CI 0·23 to 0·55; p<0·001]; I2=68·01%), incidents of self-harm (pooled Hedges'g of -0·54 (95% CI: -1·03 to -0·05; p=0·031]; I2=81·34%), and suicidal ideation (pooled Hedges'g of -0·39 [95% CI: -0·65 to -0·14; p=0·003]; I2=47·09%). INTERPRETATION Prevention activities are effective in reducing suicide death, self-harm and suicidal ideation in correctional settings. Multicomponent programs, which include several preventive activities, seem to be most effective in reducing suicide deaths. Future evaluation studies should control for confounding variables by including control groups, having larger samples and limiting attrition. Standards for suicide prevention in jails and prisons should be included in National suicide prevention strategies. FUNDING None.
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Affiliation(s)
- Stefan Stijelja
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Brian L. Mishara
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
- Corresponding author at: CRISE-UQAM, C.P. 8888, Succ. Centre-ville, Montréal, Québec H3C 3P8, Canada.
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Favril L, Shaw J, Fazel S. Prevalence and risk factors for suicide attempts in prison. Clin Psychol Rev 2022; 97:102190. [PMID: 36029609 DOI: 10.1016/j.cpr.2022.102190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/28/2022] [Accepted: 08/03/2022] [Indexed: 11/18/2022]
Abstract
Suicidal behaviour represents a substantial burden of morbidity and mortality in prisons worldwide. We aimed to synthesise the evidence on prevalence and risk factors for suicide attempts during incarceration. In this systematic review and meta-analysis, we searched four bibliographic databases for studies (published up to May 31, 2022) reporting on adults sampled from the general prison population who attempted suicide while incarcerated and an unselected comparison group. A total of 20 studies comprising 19,882 individuals (6.5% women) in 20 countries were eligible for inclusion. The pooled prevalence of suicide attempts during incarceration was 8.6% (95% CI 6.1-11.2) in men and 12.2% (95% CI 7.1-17.2) in women. Across all 36 risk factors studied, the strongest associations were found for suicidal ideation, previous self-harm, and markers of psychiatric morbidity. Prison-related risk factors included solitary confinement, victimisation, and poor social support while incarcerated. Sensitivity analyses indicate that risk factors for near-lethal suicide attempts are similar to those for suicide attempts more generally. In addition to providing a synthesis of previous work, our systematic review highlights several key limitations of the extant literature, which provide directions for future research.
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Affiliation(s)
- Louis Favril
- Faculty of Law and Criminology, Ghent University, Ghent, Belgium.
| | - Jenny Shaw
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
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8
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Favril L. Epidemiology, Risk Factors, and Prevention of Suicidal Thoughts and Behaviour in Prisons: A Literature Review. Psychol Belg 2021; 61:341-355. [PMID: 34900324 PMCID: PMC8622377 DOI: 10.5334/pb.1072] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 10/19/2021] [Indexed: 12/21/2022] Open
Abstract
Suicide is a global public health concern that affects all echelons of society, albeit not equally so. Compared with adults in the general population, incarcerated offenders are at increased risk to consider, attempt, and die by suicide, which represents a substantial burden of morbidity and mortality in prisons worldwide. This review synthesises recent literature pertaining to the epidemiology, risk factors, and prevention of suicidal thoughts and behaviour among prisoners, and outlines a framework which emphasises the interplay between individuals (importation) and their surroundings (deprivation). The available evidence suggests that prison-specific stressors may exacerbate risk of suicide in an already vulnerable population characterised by complex health and social care needs. Emerging data point to differential mechanisms through which prisoners come to think about suicide and subsequently progress to suicidal behaviour. As risk of suicide is determined by a complex web of synergistically interacting factors, its management and prevention demands a cross-sectoral policy and service response that includes targeted interventions aimed at high-risk prisoners in combination with population strategies that promote the health and wellbeing of all people in prison.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, BE
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9
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Hidayati NO, Suryani S, Rahayuwati L, Dewi NS. Scoping Review of Mental Health Problems among Female Prisoners. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Detention can cause problems and stressors for prisoners, one of which is mental health problems. Female prisoners have a high rate of mental health needs in prisons. Awareness and the ability to recognize prisoners’ health problems are important. Therefore, the mental welfare of female prisoners is the responsibility of each prison.
AIM: This review aimed to identify mental health problems among female prisoners.
METHODS: The method used was a scoping review. A systematic searched of the literature between 2000 and August 2021 on several databases and search engines, namely, PubMed, CINAHL, SAGE Journals, and Google Scholar using keywords in English, namely, mental health, female prisoners, and prison.
RESULTS: Of the 112 articles found, nine were eligible for inclusion. It was found that the mental health problems of female prisoners were anxiety, depression, substance abuse, stress, loss and grief, trauma, and suicide attempts that put them at risk of psychological distress. There was still limited study on female prisoners, especially to explore mental health problems in prison, and there were few studies discussing adjustment to female prisoners in prison, as well as mental health services which are still rarely carried out in prisons.
CONCLUSION: Based on the findings, it is recommended for future research to focus more on how female prisoners can access mental health services in prisons to overcome their mental health problems, conduct a deeper exploration of the extent to which mental health services in prisons have been carried out so far.
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Stoliker BE, Abderhalden FP. People in Custody With a Suicidal History: An Ideation-to-Action Perspective Involving Individuals Incarcerated in Two U.S. Jails. Arch Suicide Res 2021; 27:231-245. [PMID: 34582321 DOI: 10.1080/13811118.2021.1982095] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Despite high suicide mortality in U.S. jails, little is known about the cognitive (ideation) and behavioral (attempt) spectrum of suicide risk in this population. Identifying factors associated with the development of suicidal ideation, as well as the translation of thoughts to acts of suicide, is important for suicide prevention. METHOD Using data from a cross-sectional study conducted in 2018-2019, we investigated suicidal ideation and attempt among 548 individuals incarcerated in jail in the United States. Specifically, we compared those with suicidal ideation (n = 212) to those without suicidal ideation (n = 336), as well as compared those who had experienced suicidal ideation and attempted suicide (n = 114) to those who thought about suicide without making an attempt (n = 98), on a range of sociodemographic and clinical factors. RESULTS Over one-third (38.7%) of participants had a history of suicidal ideation, whereas 23.3% had attempted suicide. In the adjusted analyses, a family history of suicide (OR = 2.09), drug use (OR = 2.26), social support (OR = 0.61), and self-harm (OR = 24.93) were linked to suicidal ideation. No wish to live (OR = 5.26) and interpersonal violence while intoxicated (OR = 2.41) were associated with the progression from suicidal ideation to a suicide attempt. CONCLUSIONS Consistent with extant theoretical and empirical work, findings suggest that factors linked to the development of suicidal cognitions differ from those underlying the progression from suicidal ideation to a (non-lethal) suicide attempt.HIGHLIGHTSSuicidal risk is particularly high among individuals who are incarcerated in jail.Factors linked to suicidal ideation differ from those underlying acts of suicide.Ideators and attempters possess a different set of targets for intervention.
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Mai Y, Yang R, Wu X, Xie Z, Zhang X, Yang X, Liu H, Zhao J. Impulsiveness and suicide in male offenders: Examining the buffer roles of regulatory emotional self-efficacy and flourishing. Psychol Psychother 2021; 94:289-306. [PMID: 33765339 DOI: 10.1111/papt.12312] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/10/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Although impulsiveness has been recognized as a risk factor for suicide, few studies have explored how to protect offenders with impulsiveness from the risk of suicide. This study aims to examine the relationships among impulsiveness, suicide risk, regulatory emotional self-efficacy (RESE), and flourishing, focusing on the moderating effects of RESE and flourishing in the relationship between impulsiveness and suicide risk. DESIGN AND METHODS This is a cross-sectional study of 941 male offenders. All participants were requested to provide some items of demographic information and to complete a package of self-reported questionnaires measuring impulsiveness, suicide risk, RESE, and flourishing. RESULTS The results indicate that impulsiveness is positively correlated with suicide risk, while RESE and flourishing are negatively correlated with impulsiveness and suicide risk. Most importantly, both RESE and its dimension managing negative affect (NEG) negatively moderate the relationship between impulsiveness and suicide risk. Flourishing and the RESE dimension expressing positive affect (POS) show no significant moderating effect on impulsiveness-suicide risk link. CONCLUSIONS Regulatory emotional self-efficacy, especially its NEG dimension, can buffer the impact of impulsiveness on suicide risk in male offenders, indicating that these factors might be useful supplements in suicide prevention. PRACTITIONER POINTS Offender with higher level of RESE and flourishing show lower level of impulsiveness and suicide risk. High level of RESE and its NEG dimension can buffer the effect of impulsiveness on suicide risk. RESE, especially its NEG dimension might be a useful supplement for suicide prevention in offenders with high impulsiveness.
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Affiliation(s)
- Yiling Mai
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ruilai Yang
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaohua Wu
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zhaoming Xie
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xin Zhang
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xueling Yang
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Huanhuan Liu
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiubo Zhao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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12
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Favril L, O’Connor RC, Hawton K, Vander Laenen F. Factors associated with the transition from suicidal ideation to suicide attempt in prison. Eur Psychiatry 2020; 63:e101. [PMID: 33183374 PMCID: PMC7737175 DOI: 10.1192/j.eurpsy.2020.101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Although research has identified a wide range of risk factors for suicidal behavior in prisoners, it does not establish who is most likely to act on their suicidal thoughts while incarcerated. METHODS Self-report data were collected from a random sample of 1,203 adult men incarcerated across 15 prisons in Belgium, who represent 12% of all male prisoners nationwide. RESULTS One-third (33%) of participants reported having suicidal thoughts during their incarceration, of whom 26% attempted suicide in prison (9% of all prisoners). Factors independently associated with suicide attempt among prisoners with suicidal ideation were violent offending (adjusted odds ratio [aOR] = 2.64, 95% confidence interval [CI] 1.33-5.23), in-prison drug use (aOR = 2.30, 95% CI 1.25-4.22), exposure to suicidal behavior (aOR = 1.96, 95% CI 1.04-3.68), and a lifetime history of nonsuicidal self-injury (aOR = 1.90, 95% CI 1.08-3.36). While related to suicidal thoughts, markers of psychiatric morbidity and aspects of the prison regime were not associated with the progression to suicide attempt. CONCLUSIONS Many prisoners who think about suicide do not attempt suicide while incarcerated. Factors associated with suicidal ideation are distinct from those that govern the transition to suicidal behavior. Our findings lend support to the hypothesis that behavioral disinhibition might act as a catalyst in the translation of suicidal thoughts into action.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Rory C. O’Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Freya Vander Laenen
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
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13
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Favril L, Stoliker B, Vander Laenen F. What Differentiates Prisoners Who Attempt Suicide from Those Who Experience Suicidal Ideation? A Nationally Representative Study. Suicide Life Threat Behav 2020; 50:975-989. [PMID: 32364639 DOI: 10.1111/sltb.12638] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 01/23/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Many people who think about suicide do not engage in suicidal behavior. Identifying risk factors implicated in the process of behavioral enaction is crucial for suicide prevention, particularly in high-risk groups such as prisoners. METHOD Cross-sectional data were drawn from a nationally representative sample of 17,891 prisoners (79% men) in the United States. We compared prisoners who attempted suicide (attempters; n = 2,496) with those who thought about suicide but never made an attempt (ideators; n = 1,716) on a range of established risk factors. RESULTS More than half (59%) of participants who experienced suicidal ideation had also attempted suicide. Violent offending, trauma, brain injury, alcohol abuse, and certain mental disorders distinguished attempters from ideators. CONCLUSION Our results fit within recent ideation-to-action theories that emphasize the role of a capability for suicide in the transition from thoughts to acts of suicide.
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Affiliation(s)
- Louis Favril
- Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Bryce Stoliker
- School of Criminology, Simon Fraser University, Burnaby, BC, Canada
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Favril L, Indig D, Gear C, Wilhelm K. Mental disorders and risk of suicide attempt in prisoners. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1145-1155. [PMID: 32144468 DOI: 10.1007/s00127-020-01851-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 02/28/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Mental disorders are overrepresented in prisoners, placing them at an increased risk of suicide. Advancing our understanding of how different mental disorders relate to distinct stages of the suicidal process-the transition from ideation to action-would provide valuable information for clinical risk assessment in this high-risk population. METHODS Data were drawn from a representative sample of 1212 adults (1093 men) incarcerated across 13 New Zealand prisons, accounting for 14% of the national prison population. Guided by an ideation-to-action framework, three mutually exclusive groups of participants were compared on the presence of mental disorders assessed by validated DSM-IV diagnostic criteria: prisoners without any suicidal history (controls; n = 778), prisoners who thought about suicide but never made a suicide attempt (ideators; n = 187), and prisoners who experienced suicidal ideation and acted on such thoughts (attempters; n = 247). RESULTS One-third (34.6%) of participants reported a lifetime history of suicidal ideation, of whom 55.6% attempted suicide at some point (19.2% of all prisoners). Suicidal outcomes in the absence of mental disorders were rare. Whilst each disorder increased the odds of suicidal ideation (OR range 1.73-4.13) and suicide attempt (OR range 1.82-4.05) in the total sample (n = 1212), only a select subset of disorders was associated with suicide attempt among those with suicidal ideation (n = 434). Drug dependence (OR 1.65, 95% CI 1.10-2.48), alcohol dependence (OR 1.89, 95% CI 1.26-2.85), and posttraumatic stress disorder (OR 2.09, 95% CI 1.37-3.17) distinguished attempters from ideators. CONCLUSION Consistent with many epidemiological studies in the general population, our data suggest that most mental disorders are best conceptualized as risk factors for suicidal ideation rather than for suicide attempt. Once prisoners consider suicide, other biopsychosocial factors beyond the mere presence of mental disorders may account for the progression from thoughts to acts of suicide.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Gent, Belgium.
| | - Devon Indig
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | | | - Kay Wilhelm
- Discipline of Psychiatry, University of Notre Dame, Notre Dame, Australia
- School of Psychiatry, University of New South Wales, Sydney, Australia
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Favril L, Yu R, Hawton K, Fazel S. Risk factors for self-harm in prison: a systematic review and meta-analysis. Lancet Psychiatry 2020; 7:682-691. [PMID: 32711709 PMCID: PMC7606912 DOI: 10.1016/s2215-0366(20)30190-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/30/2020] [Accepted: 04/20/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Self-harm is a leading cause of morbidity in prisoners. Although a wide range of risk factors for self-harm in prisoners has been identified, the strength and consistency of effect sizes is uncertain. We aimed to synthesise evidence and assess the risk factors associated with self-harm inside prison. METHODS In this systematic review and meta-analysis, we searched four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) for observational studies on risk factors for self-harm in prisoners published from database inception to Oct 31, 2019, supplemented through correspondence with authors of studies. We included primary studies involving adults sampled from general prison populations who self-harmed in prison and a comparison group without self-harm in prison. We excluded studies with qualitative or ecological designs, those that reported on lifetime measures of self-harm or on selected samples of prisoners, and those with a comparison group that was not appropriate or not based on general prison populations. Data were extracted from the articles and requested from study authors. Our primary outcome was the risk of self-harm for risk factors in prisoners. We pooled effect sizes as odds ratios (OR) using random effects models for each risk factor examined in at least three distinct samples. We assessed study quality on the basis of the Newcastle-Ottawa Scale and examined between-study heterogeneity. The study protocol was registered with PROSPERO, CRD42018087915. FINDINGS We identified 35 independent studies from 20 countries comprising a total of 663 735 prisoners, of whom 24 978 (3·8%) had self-harmed in prison. Across the 40 risk factors examined, the strongest associations with self-harm in prison were found for suicide-related antecedents, including current or recent suicidal ideation (OR 13·8, 95% CI 8·6-22·1; I2=49%), lifetime history of suicidal ideation (8·9, 6·1-13·0; I2=56%), and previous self-harm (6·6, 5·3-8·3; I2=55%). Any current psychiatric diagnosis was also strongly associated with self-harm (8·1, 7·0-9·4; I2=0%), particularly major depression (9·3, 2·9-29·5; I2=91%) and borderline personality disorder (9·2, 3·7-22·5; I2=81%). Prison-specific environmental risk factors for self-harm included solitary confinement (5·6, 2·7-11·6; I2=98%), disciplinary infractions (3·5, 1·2-9·7; I2=99%), and experiencing sexual or physical victimisation while in prison (3·2, 2·1-4·8; I2=44%). Sociodemographic (OR range 1·5-2·5) and criminological (1·8-2·3) factors were only modestly associated with self-harm in prison. We did not find clear evidence of publication bias. INTERPRETATION The wide range of risk factors across clinical and custody-related domains underscores the need for a comprehensive, prison-wide approach towards preventing self-harm in prison. This approach should incorporate both population and targeted strategies, with multiagency collaboration between the services for mental health, social care, and criminal justice having a key role. FUNDING Wellcome Trust.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Rongqin Yu
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Keith Hawton
- Centre for Suicide Research, Warneford Hospital, University of Oxford, Oxford, UK
| | - Seena Fazel
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.
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