Skala Suizidales Erleben und Verhalten (SSEV)

Suicide-specific rumination as a predictor of suicide planning and intent

BACKGROUND

Suicide-specific rumination (SSR), that is repetitive negative thinking about suicide, has been proposed as a risk factor for suicidal behavior. Yet, few studies have investigated associations between SSR and suicide intent and planning in a longitudinal study design. The purpose of the present study was to investigate the association between SSR, suicide intent, suicide planning and suicide attempts in a sample of adult outpatients undergoing psychotherapy.

METHOD

Data from N = 637 patients (58.4% female, 41.6% male; Mage = 35.81, SDage = 13.50, range: 18-79 years) who started therapy at an outpatient clinic were collected. A subsample of n = 335 patients (n = 335; 56,4% female, 43,6% male; Mage = 35.4, SDage = 13.1, range: 18-73 years) also took part in a post-treatment assessment after twelve therapy sessions.

RESULTS

SSR differentiated lifetime suicide attempters from suicide ideators. Furthermore, SSR was associated with lifetime suicide attempt status above age, sex, suicide ideation, depression, anxiety, and stress. Finally, SSR served as a prospective predictor of both suicide planning and suicide intent.

CONCLUSION

The results emphasize the key role of SSR in understanding the suicidal process.

Lifetime victimization experiences, depressiveness, suicidality, and feelings of loneliness in youth in care

BACKGROUND

Research has demonstrated the damaging effects of poly-victimization on the mental health of children and adolescents. However, few studies have been conducted in high-risk youth in care (Y-IC) samples.

OBJECTIVE

The study examines the frequency of lifetime victimization and the association of poly-victimization and victimization types on depressiveness, suicidality, and feelings of loneliness among Y-IC.

PARTICIPANTS AND SETTING

164 participants aged 14 and 21 years (M = 17.39, SD = 1.95), who live in family-based care or residential care.

METHODS

The Juvenile Victimization Questionnaire (JVQ) was used to assess lifetime victimization. The Patient Health Questionnaire (PHQ-9), and the Loneliness Scale-SOEP (LS-S) to measure depressiveness, suicidality, and loneliness. Hierarchical regression models were calculated.

RESULTS

Participants reported on average 12.66 (SD = 6.58) victimization experiences. The female and diverse gender groups reported higher rates of victimization, loneliness, depressiveness, and suicidality than the males. Participants in residential care reported more victimizations and stronger feelings of loneliness than those in family-based care. Poly-victimization was not associated with any of these internalizing symptoms but peer victimization was significantly associated with depressiveness (β = 0.23, p = .002) and loneliness (β = 0.22, p = .006), sexual victimization with depressiveness (β = 0.22, p = .004).

CONCLUSION

Y-IC show high levels of victimization and internalizing symptoms, with higher burden on girls and youth living in residential care. Findings underscore the relevance of social exclusion experiences among peers within Y-IC. Interventions should address multiple forms of victimization, with a special focus on sexual and peer victimization.

Prevalence of suicidal ideation in German psychotherapy outpatients: A large multicenter assessment

BACKGROUND

Suicidal ideation is a major concern in clinical practice. Yet, little is known about prevalence rates of suicidal ideation in patients undergoing outpatient psychotherapeutic treatment. Therefore, the aim of the current study is to assess the prevalence of suicidal ideation in a large sample of psychotherapy outpatients in Germany. The data analyzed in this study is taken from the KODAP-project on the coordination of data collection and analysis at German university-based research and training outpatient clinics for psychotherapy.

METHODS

A total of N = 10,357 adult outpatients (64.4 % female; age: M(SD) = 35.94 (13.54), range: 18-92 years of age) starting cognitive-behavioral therapy at one of 27 outpatient clinics in Germany were included in the current study. Prevalence of suicidal ideation was assessed with the Suicide Item (Item 9) of the Beck-Depression Inventory II.

RESULTS

Suicidal ideation was reported by 36.7 % (n = 3795) of the participants. Borderline Personality Disorder, Posttraumatic Stress Disorder, and recurrent Major Depression were the diagnoses most strongly associated with the presence and severity of suicidal ideation.

LIMITATION

Suicide ideation was assessed only with the respective item of the Beck Depression Inventory II.

CONCLUSION

Suicidal ideation is very common among adult patients who start psychotherapy in Germany. A well-founded knowledge of risk assessment in suicidal patients and suicide-specific treatment options is therefore highly relevant.

Anxious and depressive symptoms mediate the influence of sleep quality on suicidality in young adults

This study investigated how sleep quality affects the global severity of psychiatric symptoms, including suicidality, in young adults. Poor sleep quality has a significant impact on mental health and should therefore be given special attention in suicidal treatment. 1,214 participants (914 females; age: M = 25.81, SD = 6.35) completed the Brief Symptom Inventory (BSI-18), the Scale for Suicidal Experience and Behavior (SSEV), and the Pittsburgh Sleep Quality Index (PSQI) via an online survey. Correlation statistics and path analysis were conducted for data evaluation. Thereby, anxiety and depression but not somatization mediated the relationship between sleep quality and suicidality. Our findings confirm the putative link between diminished sleep quality and increased suicidality and may lead to an early detection of suicidal behavior.

Study protocol for a feasibility study of microinterventions in smartphone-based assessments to reduce depressive rumination

INTRODUCTION

Depression as well as suicidal ideation and behaviours share several precipitating and maintaining factors and are subject to the influence of overlapping constructs. One of these transdiagnostic constructs is rumination. For the treatment of rumination, a variety of interventions are already available. However, not everyone with a need receives psychotherapeutic treatment. And even if they do: implementing learnt strategies alone at home can be challenging for patients. Therefore, this study aims to test the feasibility of delivering microinterventions for the reduction of rumination in a smartphone-based setting with the goal to make these interventions accessible to a larger number of people and support their use in everyday life.

METHODS AND ANALYSIS

The study's design is an uncontrolled-within-group design. Participants with at least mild depressive symptoms and reported rumination will be included and recruited via outpatient clinics as well as in the general population. The aim is to recruit at least N=70 participants. Participants first undergo a short telephone screening, a baseline assessment, a 7-day smartphone-based assessment including microinterventions in case participants report rumination and a postassessment. For feasibility purposes, primary outcomes relate to participants' compliance, their evaluation of the smartphone-based assessment as well as the microinterventions delivered during the assessment. As a secondary goal, clinical utility will be examined. Clinical outcomes (eg, depressive symptoms, rumination) will be measured at baseline and postassessment.

ETHICS AND DISSEMINATION

The ethics committee of the institute of psychology of the university of Duisburg-Essen and University of Leipzig has approved the study. Study results will be disseminated to healthcare communities, in peer-reviewed science journals and at conferences.

TRIAL REGISTRATION NUMBER

DRKS00031743.

Understanding suicidal ideation-a network analysis of the Interpersonal Needs Questionnaire

INTRODUCTION

Identifying various interacting risk factors for suicidality is important to develop preventive measures. The Interpersonal-Psychological Theory of Suicidal Behavior (IPTS) postulates suicidal ideation resulting from the occurrence of Perceived Burdensomeness (PB) and Thwarted Belongingness (TB). Suicidal behavior ultimately occurs if people have a Capability for Suicide. In past studies, the validity of TB was often not empirically confirmed, questioning which of the aspects of TB are central and related to suicidal ideation and whether applied measurement methods adequately capture the construct.

METHOD

Using a sample of 3,404 individuals from different clinical and nonclinical settings, 30% (1,023) of whom reported suicidal ideation, two network analyses were conducted on the Interpersonal Needs Questionnaire (INQ) and a variable mapping suicidal ideation.

RESULTS

Analyses revealed that some items of the INQ were not related to suicidal ideation and the most central items did not have the strongest associations to suicidal ideation.

CONCLUSION

Based on these results, a shortened version of the INQ with the four items that showed the strongest associations with suicidal ideation in the network analyses was suggested.

Trust in higher guidance and suicidality in Afghan students under the Taliban regime{fr}(Confianza en la orientación superior y suicidalidad en estudiantes afganos bajo el régimen Talibán)

Background/Objective

After years of war, political instability and natural catastrophes high rates of PTSD and depression have been found in the Afghan population. On this background, it was investigated whether religious beliefs (trust in higher guidance; TIHG) moderated the association between PTSD symptoms and/or depression and suicidal ideation.

Method

A total of 279 Afghan university students (61.6% women; aged 18 to 30 years) took part in this cross-sectional study between July and November 2022. Self-report measures of PTSD, depression, suicidal ideation, trust in higher guidance were used.

Results

Severe PTSD symptoms were reported by 58.4%, clinically relevant depression symptoms were reported by 55.2% and current suicidal ideation was reported by 44.4% of the sample. TIHG moderated the impact of PTSD symptoms, on suicidal ideation. TIHG and depression were unrelated.

Conclusion

PTSD symptoms, depression and suicidal ideation show an alarmingly high prevalence in this specific sample of Afghan students. TIHG seems to be a resilience factor of special importance.

Validation of the Farsi version of the Suicide Ideation and Behavior Scale

Objective

Suicide ideation and suicide attempts are prevalent in Farsi speaking populations. The present study aimed at validating the Farsi version of the Suicide Ideation and Behavior Scale (SIBS).

Methods

Reliability and validity of the Farsi version of the SIBS were established in a highly burdened Afghan student sample (N = 279). Internal consistency, convergent and discriminant validity were investigated, and confirmatory factor analysis was conducted.

Results

The Farsi version of the SIBS was shown to have a unidimensional structure with excellent internal consistency, as well as good convergent and divergent validity.

Discussion

The results suggest that the SIBS is a brief, reliable, and valid measure of current suicidal ideation and behavior that can be used in Farsi speaking populations.

Social media use, mental health, and suicide-related outcomes in Russian women: A cross-sectional comparison between two age groups

BACKGROUND

Women who belong to the age group "emerging adulthood" (18 to 29 years) are vulnerable to mental health issues and suicide-related outcomes.

OBJECTIVES

This study investigated potential predictors of suicide-related outcomes in females emerging adulthood and compared them to older women.

DESIGN AND METHODS

Data of 2537 women from Russia (group "18 to 29 years": n = 1123; group "> 29 years": n = 1414) on lifetime suicide-related outcomes, (problematic) social media use, daily stress, depression and anxiety symptoms, and positive mental health were assessed via online cross-sectional surveys.

RESULTS

The younger group spent significantly more time on social media use than the older group. It had significantly higher levels of daily stress, problematic social media use, depression and anxiety symptoms, and suicide-related outcomes. The older group showed significantly higher levels of positive mental health. Only in the younger group, problematic social media use significantly mediated the relationship between daily stress and suicide-related outcomes in a moderated mediation analysis. Positive mental health significantly moderated the association between problematic social media use and suicide-related outcomes. Specifically, the higher the positive mental health level, the less close the link between both variables.

CONCLUSION

The current results reveal that young women in Russia could be at enhanced risk for daily stress, problematic social media use, and low levels of mental health. The interaction between these variables could foster suicide-related outcomes. Public governmental communication in Russia should call attention to potential negative impact of intensive social media use.

Suicidal behavior in the social environment: Does exposure moderate the relationship between an individual's own suicidal ideation and behavior?

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).

Ambivalent heroism? - Psychological burden and suicidal ideation among nurses during the Covid-19 pandemic

AIM

During the Covid-19 pandemic, the risk for nurses' mental health has rapidly increased. The two main goals of this study were the examination of (1) the psychological burden and (2) of suicidal ideation and its associated risk factors one year after the Covid-19 pandemic begun.

DESIGN

This was a cross-sectional online survey.

METHODS

N = 1311 nurses (96.9% female) aged 18-63 years (M = 30.96, SD = 8.48) were assessed for various symptoms of psychological burden, suicidal ideation and behaviour and its risk factors.

RESULTS

Almost half of participants (41.5%) reported heightened levels of depressive symptoms, 691 (52.7%) reported a medium to high risk for burnout. One fifth of participants (21.7%) reported suicidal ideation in the past 4 weeks. The direct contact to people with Covid-19 was not related to the extent of the psychological burden. Depression, agitation, perceived burdensomeness and previous suicide attempt were associated with suicidal ideation.

Perseverative Thinking about Suicide Questionnaire (PTSQ): Validation of a new measure to assess suicide-specific rumination

BACKGROUND

Suicide-specific rumination has been shown to be associated with lifetime suicide attempts as well as suicide intent and might be an important risk factor for the transition from suicidal ideation to suicidal behavior. Based on this background, the wording of the items of an often-used self-report measure assessing core characteristics of rumination was adapted to assess specifically suicide-specific rumination.

METHODS

The entire study sample comprised N = 1689 participants from the German healthcare sector. A total of 721 participants with a history of suicidal ideation (68% female; M_age = 30.63, SD_age = 8.41, range: 18-81 years) who had completed five measures assessing suicide-specific rumination, suicidal ideation, depression, hopelessness, and resilience were included for the present examination. Factorial validity (Exploratory [EFA] to determine the appropriate number of factors and confirmatory factor analyses [CFA] after randomly splitting of the sample to validate the EFA solution), construct validity, and reliability were evaluated.

RESULTS

The EFA revealed a one-factor solution consisting of four items, which could be confirmed within a CFA (RMSR = 0.006; RMSEA = 0.039; CFI = 0.999; TLI = 0.998). Internal consistency was excellent with Cronbachs α = 0.93. Construct validity was given with moderate to high positive correlations with suicidal ideation (0.76), depression (0.55), and hopelessness (0.38) and negative correlation with resilience (-0.31). Participants with recent suicidal ideation and/or lifetime suicide attempt reported significantly more suicide-specific rumination than those with only lifetime suicidal ideation.

CONCLUSION

A new 4-item measure for suicide-specific rumination was developed and could be shown to be a reliable and valid instrument in a large German sample. Results emphasize the potential importance of suicide-specific rumination for the understanding of trajectories of suicidal ideation and suicide risk assessments.

Repetitive negative thinking about suicide: Associations with lifetime suicide attempts

Background

Repetitive negative thinking has been identified as an important predictor of suicide ideation and suicidal behavior. Yet, only few studies have investigated the effect of suicide-specific rumination, i.e., repetitive thinking about death and/or suicide on suicide attempt history. On this background, the present study investigated, whether suicide-specific rumination differentiates between suicide attempters and suicide ideators, is predictive of suicide attempt history and mediates the association between suicide ideation and suicide attempts.

Method

A total of 257 participants with a history of suicide ideation (55.6% female; Age M = 30.56, Age SD = 11.23, range: 18–73 years) completed online measures on suicidality, general and suicide-specific rumination.

Results

Suicide-specific rumination differentiated suicide attempters from suicide ideators, predicted suicide attempt status (above age, gender, suicide ideation, general rumination) and fully mediated the association between suicide ideation and lifetime suicide attempts.

Conclusion

Overall, though limited by the use of a non-clinical sample and a cross-sectional study design, the present results suggest that suicide-specific rumination might be a factor of central relevance in understanding transitions to suicidal behavior.

Suicide-specific rumination was investigated in participants with a history of suicide ideation.

Suicide-specific rumination differentiated suicide attempters from suicide ideators.

Suicide-specific rumination predicted suicide attempt status.

Suicide-specific rumination mediated the association between suicide ideation and lifetime suicide attempts.

Suicide-specific rumination might be a factor of central relevance in understanding transitions to suicidal behavior.