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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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Lawson SG, Lowder EM, Ray B. Correlates of suicide risk among Black and White adults with behavioral health disorders in criminal-legal systems. BMC Psychiatry 2022; 22:163. [PMID: 35246077 PMCID: PMC8895515 DOI: 10.1186/s12888-022-03803-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 02/19/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Adults with behavioral health disorders in criminal-legal systems are at heightened risk of suicide relative to the general population. Despite documented racial disparities in criminal processing and behavioral health treatment, few studies have examined racial differences in suicide risk in this already high-risk population. This study examined 1) the correlates of suicide risk in this population overall and by race and 2) the moderating role of race in these associations. METHODS We investigated correlates of clinician-rated suicide risk at baseline in a statewide sample of 2,827 Black and 14,022 White adults with criminal-legal involvement who engaged in community-based behavioral health treatment. Regression-based approaches were used to model suicide risk and test for evidence of interaction effects. RESULTS Findings showed the strongest correlates of suicide risk were greater behavioral health needs, evidence of self-harm, and a primary mental health diagnosis or co-occurring diagnosis. In race-specific analyses, correlates of suicide risk were mostly similar for both Black and White clients, with a couple exceptions. Interaction terms testing between-group effects on correlates of suicide risk were non-significant. CONCLUSIONS Adults with behavioral health disorders in criminal-legal systems experience similar risk factors for suicide as the general population. Similar to prior research, we found that Black adults, in particular, are at lower risk for suicide overall. Contrary to expectations, we found similarities in correlates of suicide risk across race in our sample of felony-level adults with behavioral health disorders in the criminal-legal system. Prior research shows that behavioral health professionals should be cognizant of cultural factors when developing a comprehensive approach to suicide care and treatment. Our findings show correlates of suicide risk are largely stable in Black and White adults involved in criminal-legal systems, suggesting culturally responsive treatment for suicide risk should target shared risk factors.
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Affiliation(s)
- Spencer G Lawson
- School of Criminal Justice, Michigan State University, East Lansing, MI, USA.
| | - Evan M Lowder
- Department of Criminology, Law and Society, George Mason University, Fairfax, VA, USA
| | - Bradley Ray
- Division for Applied Justice Research, RTI International, Research Triangle Park, NC, USA
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Ruchensky JR, Balsis S, Edens JF, Douglas KS. Suicidal ideation across race in a justice-involved sample: An item response theory approach. Suicide Life Threat Behav 2021; 51:385-393. [PMID: 33263936 DOI: 10.1111/sltb.12717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Compared to community samples, rates of suicide are much higher in forensic and correctional settings, yet limited research has focused on the development and improvement of suicide assessment methods used in such contexts. Moreover, despite evidence that suicide assessment varies across Caucasians and African Americans, to our knowledge this important issue has received little attention within higher risk correctional samples. We used Item Response Theory and Differential Item Functioning analyses to address this gap within the literature. METHOD Specifically, we examined the psychometric properties of the Suicidal Ideation scale of the Personality Assessment Inventory (Morey, 2007) in a large sample of justice-involved individuals. RESULTS Caucasians report greater suicidal ideation compared to African American participants on average. However, after controlling for mean differences, Caucasians and African Americans differentially endorsed symptoms of suicidal ideation. If the level of suicidal ideation is held constant across racial categories, Caucasians underreported suicidal ideation relative to African Americans. CONCLUSION Results suggest a nuanced picture of suicidal ideation across racial categories that can be informed by Item Response Theory approaches to scale construction and refinement.
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Affiliation(s)
- Jared R Ruchensky
- Department of Psychology & Philosophy, Sam Houston State University, Huntsville, TX, USA
| | - Steve Balsis
- University of Massachusetts Lowell, Lowell, MA, USA
| | | | - Kevin S Douglas
- Simon Fraser University, Burnaby, BC, Canada.,Centre for Research and Education in Forensic Psychiatry, Helse Bergen-HF, Bergen, Norway.,Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital-HF, Oslo, Norway
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McKetin R, Leung J, Stockings E, Huo Y, Foulds J, Lappin JM, Cumming C, Arunogiri S, Young JT, Sara G, Farrell M, Degenhardt L. Mental health outcomes associated with of the use of amphetamines: A systematic review and meta-analysis. EClinicalMedicine 2019; 16:81-97. [PMID: 31832623 PMCID: PMC6890973 DOI: 10.1016/j.eclinm.2019.09.014] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The use of amphetamines is a global public health concern. We summarise global data on use of amphetamines and mental health outcomes. METHODS A systematic review and meta-analysis (CRD 42017081893). We searched Medline, EMBASE, PsycInfo for methamphetamine or amphetamine combined with psychosis, violence, suicidality, depression or anxiety. Included studies were human empirical cross-sectional surveys, case-control studies, cohort studies and randomised controlled trials that assessed the association between methamphetamine and one of the mental health outcomes. Random effects meta-analysis was used to pool results for any use of amphetamines and amphetamine use disorders. FINDINGS 149 studies were eligible and 59 were included in meta-analyses. There was significant heterogeneity in effects. Evidence came mostly from cross-sectional studies. Any use of amphetamines was associated with higher odds of psychosis (odds ratio [OR] = 2.0, 95%CI 1.3-3.3), violence (OR = 2.2, 95%CI 1.2-4.1; adjusted OR [AOR] = 1.4, 95%CI 0.8-2.4), suicidality OR = 4.4, 95%CI 2.4-8.2; AOR = 1.7, 95%CI 1.0-2.9) and depression (OR = 1.6, 95%CI 1.1-2.2; AOR = 1.3, 95%CI 1.2-1.4). Having an amphetamine use disorder was associated with higher odds of psychosis (OR = 3.0, 95%CI 1.9-4.8; AOR = 2.4, 95%CI 1.6-3.5), violence (OR = 6.2, 95%CI 3.1-12.3), and suicidality (OR = 2.3, 95%CI 1.8-2.9; AOR = 1.5, 95%CI 1.3-1.8). INTERPRETATION Methamphetamine use is an important risk factor for poor mental health. High quality population-level studies are needed to more accurately quantify this risk. Clinical responses to methamphetamine use need to address mental health harms.
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Affiliation(s)
- Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Corresponding author.
| | - Janni Leung
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Faculty of Health and Behavioural Sciences, The University of Queensland, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Yan Huo
- Faculty of Health and Behavioural Sciences, The University of Queensland, Australia
| | - James Foulds
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Julia M. Lappin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- School of Psychiatry, University of NSW, Sydney, Australia
| | - Craig Cumming
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Shalini Arunogiri
- Turning Point, Eastern Health, Richmond, VIC, Australia
- Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Jesse T. Young
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Grant Sara
- Northern Clinical School, Sydney Medical School, University of Sydney, Australia
- InforMH, System Information and Analytics Branch, NSW Ministry of Health, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Ammerman BA, Fahlgren MK, Sorgi KM, McCloskey MS. Differences in Suicidal Thoughts and Behaviors Among Three Racial Groups. CRISIS 2019; 41:172-178. [PMID: 31512928 DOI: 10.1027/0227-5910/a000621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Despite being a major public health concern, it is unclear how suicidal thoughts and behaviors differentially impact separate racial groups. Aims: The aim of the current study was to examine the occurrence of nonlethal suicide events, in addition to suicide attempt characteristics and factors contributing to suicide attempts. Method: A final sample of 7,094 undergraduates from a large northeastern university, identifying as members of three racial groups (White [67.30%], Black [17.30%], and Asian [15.40%]), completed online questionnaires. Results: White participants reported increased likelihood of endorsing lifetime suicidal ideation and plan, whereas Black participants reported decreased likelihood of these events; no differences were found in rates of lifetime suicide attempts. Black participants' suicidal behavior may involve greater ambivalence of intent. A higher proportion of Asian participants endorsed interpersonal factors as contributing to their suicide attempts, whereas a greater percentage of White participants reported internal contributing factors. Limitations: Findings are limited by the sample size and assessment of lifetime suicidal thoughts and behaviors. Conclusion: The findings present a more nuanced look at attitudes and actions related to suicidal thoughts and behaviors that may inform future research and risk assessment procedures.
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Affiliation(s)
| | | | - Kristen M Sorgi
- Department of Psychology, Temple University, Philadelphia, PA, USA
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DeCou CR, Lynch SM, Cole TT. Physical and Sexual Victimization Predicts Suicidality among Women in Prison: Understanding Ethnic and Trauma-Specific Domains of Risk. CURRENT PSYCHOLOGY 2017. [DOI: 10.1007/s12144-016-9465-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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The Connection Between Thwarted Belongingness, Alcohol Consumption, Suicidal, and Homicidal Ideation in a Criminal Justice Sample. J Addict Med 2016; 10:437-442. [PMID: 27608194 DOI: 10.1097/adm.0000000000000257] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND To determine if thwarted belongingness in combination with frequent alcohol use increased suicidal and homicidal ideation when known predictors were controlled for (eg, depressive disorders, anxiety disorders, drug use, race, sex, age, and employment status). METHOD This study utilized an archival database. Participants were 574 individuals at an outpatient substance abuse treatment facility who were under community corrections supervision. The average age was 34.5 (SD = 10.9) years; there were 371 (64.6%) men and 287 (50.0%) Black participants. Data were originally gathered from face-to-face interviews with the participants by their case manager or an intake specialist when they entered treatment. Self-reported suicidal and homicidal ideation was used as a dependent variable in unadjusted and adjusted binary logistic regressions to determine the influence of thwarted belongingness and frequent alcohol use. RESULTS Thwarted belongingness alone (ie, without frequent alcohol use) was associated with risk for suicidal ideation, and was approaching significance for homicidal ideation. The combination of thwarted belongingness and frequent alcohol use was associated with the greatest risk for suicidal and homicidal ideation. Cocaine use and employment status were also identified as significant predictors for suicidal and homicidal ideation in the fully adjusted models. CONCLUSIONS Thwarted belongingness in combination with frequent alcohol use seems to have a large and meaningful relationship with both suicidal and homicidal ideation. Additional research is needed to better understand the relationship between alcohol, thwarted belongingness, and outcomes such as suicide and homicide.
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Clark CB, Li Y, Cropsey KL. Family Dysfunction and Suicide Risk in a Community Corrections Sample. CRISIS 2016; 37:454-460. [PMID: 27445017 DOI: 10.1027/0227-5910/a000406] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND When comparted with the general population, the suicide rate in correctional populations is elevated. While predictors of suicide are well researched in jail and prison populations, much less work has been done to examine predictors of suicide in community corrections samples where 80% of the US correctional population is currently supervised. AIMS The goal of this study was to determine factors associated with suicide risk in a community corrections sample. METHOD Self-reported current ideation was examined in a sample of 512 individuals under supervision. RESULTS When univariate associations between current suicidal ideation and predictor variables were examined, current suicidal ideation was associated with being female, being White, reporting an increased level of stress, reporting an increased level of depression, meeting criteria for an anxiety disorder, an increased number of physical health complaints, and self-report of family dysfunction. In a multivariate analysis predicting suicide risk, only meeting criteria for an anxiety disorder, an increased number of physical health complaints, and self-report of family dysfunction were significant. CONCLUSION Mental and physical health complaints as well as self-report of family dysfunction are salient predictors of suicide risk in the community corrections population.
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Affiliation(s)
- C Brendan Clark
- 1 Wichita State University, Department of Psychology, Wichita, KS, USA
| | - Ye Li
- 2 University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, Birmingham, AL, USA
| | - Karen L Cropsey
- 2 University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, Birmingham, AL, USA
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May AM, Klonsky ED. What Distinguishes Suicide Attempters From Suicide Ideators? A Meta-Analysis of Potential Factors. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2016. [DOI: 10.1111/cpsp.12136] [Citation(s) in RCA: 185] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Alexis M. May
- Department of Psychology; University of British Columbia; Vancouver BC Canada
| | - E. David Klonsky
- Department of Psychology; University of British Columbia; Vancouver BC Canada
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Cavanaugh CE, Messing JT, Eyzerovich E, Campbell JC. Ethnic Differences in Correlates of Suicidal Behavior Among Women Seeking Help for Intimate Partner Violence. CRISIS 2015; 36:257-66. [DOI: 10.1027/0227-5910/a000321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Women abused by an intimate partner are at risk of engaging in nonfatal suicidal behavior and suicidal communication (NSBSC). No studies have examined ethnic differences in correlates of NSBSC among abused women. Aims: This secondary data analytic study examined whether correlates of NSBSC previously reported among a mixed ethnic sample of women seeking help for abuse by a male intimate partner differed for those who self-identified as Latina (N = 340), African American (N = 184), or European American (N = 67). Method: Logistic regression was used to examine correlates of NSBSC separately among Latina, African American, and European American women. Results: More severe violence by a male intimate partner, having a chronic or disabling illness, being younger, and being unemployed were positively associated with NSBSC in bivariate analyses among Latina women, but unemployment did not remain significantly associated with NSBSC in the multiple logistic regression. There were no significant correlates of NSBSC for African American women. Having a chronic illness was significantly associated with NSBSC among European American women. Conclusion: Findings suggest the need for culturally tailored suicide prevention interventions and studies that examine risk and protective factors for NSBSC among a diversity of women abused by male intimate partners
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Affiliation(s)
| | - Jill T. Messing
- School of Social Work, Arizona State University, Phoenix, AZ, USA
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Yu SSV, Sung HE. Suicidal Ideation of Probationers. Gender Differences. CRISIS 2015; 36:424-32. [PMID: 26648230 PMCID: PMC4673689 DOI: 10.1027/0227-5910/a000336] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 03/25/2015] [Accepted: 03/30/2015] [Indexed: 01/27/2023]
Abstract
BACKGROUND Gender is often related to different life stressors and mental health disorders, but a limited amount of research examines risks of suicidal ideation of probationers by gender. AIMS The aim of this study was to examine gender differences in suicidal ideation of probationers. METHOD Using a national sample of 3,014 male and 1,306 female probationers with data from the National Survey on Drug Use and Health (2009-2011), multivariate regression analysis was conducted. RESULTS Male and female probationers display similar demographic characteristics although their life circumstances and experiences seem different. Female probationers in the study were more likely to experience financial, psychological, and residential stressors than male probationers were. Female probationers were also more likely to have received medical and/or psychiatric treatments. Female probationers were exposed to more suicidal ideation risks than male probationers were. Additionally, no protective factors to suicidal ideation were found for female probationers. CONCLUSION The findings suggest that a gender-specific approach to suicidal ideation of probationers may lessen the prevalence of suicidal ideation of this largely neglected population.
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Affiliation(s)
- Sung-Suk Violet Yu
- Department of Criminal Justice, John Jay College of Criminal Justice, New York, NY, USA
| | - Hung-En Sung
- Department of Criminal Justice, John Jay College of Criminal Justice, New York, NY, USA
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Cropsey KL, Leventhal AM, Stevens EN, Trent LR, Clark CB, Lahti AC, Hendricks PS. Expectancies for the effectiveness of different tobacco interventions account for racial and gender differences in motivation to quit and abstinence self-efficacy. Nicotine Tob Res 2014; 16:1174-82. [PMID: 24719492 PMCID: PMC4184395 DOI: 10.1093/ntr/ntu048] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 03/02/2014] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Racial and gender disparities for smoking cessation might be accounted for by differences in expectancies for tobacco interventions, but few studies have investigated such differences or their relationships with motivation to quit and abstinence self-efficacy. METHODS In this cross-sectional study, 673 smokers (African American: n = 443, 65.8%; women: n = 222, 33.0%) under criminal justice supervision who enrolled in a clinical smoking cessation trial in which all received bupropion and half received counseling. All participants completed pretreatment measures of expectancies for different tobacco interventions, motivation to quit, and abstinence self-efficacy. The indirect effects of race and gender on motivation to quit and abstinence self-efficacy through expectancies for different tobacco interventions were evaluated. RESULTS African Americans' stronger expectancies that behavioral interventions would be effective accounted for their greater motivation to quit and abstinence self-efficacy. Women's stronger expectancies for the effectiveness of pharmacotherapy accounted for their greater motivation to quit, whereas their stronger expectancies for the effectiveness of behavioral treatments accounted for their greater abstinence self-efficacy. CONCLUSIONS Findings point to the mediating role of expectancies for treatment effectiveness and suggest the importance of exploring expectancies among African Americans and women as a way to augment motivation and self-efficacy.
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Affiliation(s)
- Karen L Cropsey
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL;
| | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Erin N Stevens
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL
| | - Lindsay R Trent
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL
| | - C Brendan Clark
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL
| | - Adrienne C Lahti
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL
| | - Peter S Hendricks
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL
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Clark CB, Waesche MC, Hendricks PS, McCullumsmith CB, Redmond N, Katiyar N, Lawler RM, Cropsey KL. The relationship between prior suicidal behavior and mortality among individuals in community corrections. CRISIS 2013; 34:428-33. [PMID: 23685337 DOI: 10.1027/0227-5910/a000207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Individuals under community corrections have multiple risk factors for mortality including exposure to a criminal environment, drug use, social stress, and a lack of medical care that predispose them to accidents, homicides, medical morbidities, and suicide. The literature suggests that prior suicidal behavior may be a particularly potent risk factor for mortality among individuals in the criminal justice system. AIMS This study looked to extend the link between history of a suicide attempt and future mortality in a community corrections population. METHOD Using an archival dataset (N = 18,260) collected from 2002 to 2007 of individuals being monitored under community corrections supervision for an average of 217 days (SD = 268), we examined the association between past history of a suicide attempt and mortality. RESULTS A Cox Proportional Hazard Model controlling for age, race, gender, and substance dependence indicated that past history of a suicide attempt was independently associated with time to mortality, and demonstrated the second greatest effect after gender. CONCLUSION These data suggest the need for a greater focus on screening and preventive services, particularly for individuals with a history of suicidal behavior, so as to reduce the risk of mortality in community corrections populations.
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Affiliation(s)
- C Brendan Clark
- Department of Psychiatry and Behavioral Neurobiology, Substance Abuse Center, University of Alabama at Birmingham, AL, USA
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