Family Dysfunction and Suicide Risk in a Community Corrections Sample

Family Factors Related to Suicidal Behavior in Adolescents

Objective: This research aims to investigate what type of family patterns (specifically attachment, bonding and family functioning) and stressful life events can trigger or protect adolescents from developing suicidal behavior. Methods: For these purposes, a case-control study (adolescents with suicidal behavior vs. paired adolescents with no suicidal behavior) was conducted with one hundred 12 to 17-year-old adolescents (50 controls, 50 cases, 74% females), assessed between 2018 and 2020. Results: Negligent (p < 0.001) or affection-less control bonding (p < 0.001), insecure attachment (p = 0.001) and stressful life events (p < 0.001) revealed to be significant risk factors for suicidal behavior. On the contrary, parents’ care (p < 0.001) and security (p < 0.001) were revealed as protective factors for suicidal behavior. Conclusions: Considering these results, family interventions and improving coping skills seem to be two essential targets for any suicide prevention intervention in adolescents.

Examining the association between the COVID-19 pandemic and self-harm death counts in four Canadian provinces

Governments implemented lockdowns and other physical distancing measures to stop the spread of SARS-CoV-2 (COVID-19). Resulting unemployment, income loss, poverty, and social isolation, coupled with daily reports of dire news about the COVID-19 pandemic, could serve as catalysts for increased self-harm deaths (SHD). This ecological study examined whether observed SHD counts were higher than predicted SHD counts during the pandemic period in the Canadian provinces of Alberta, British Columbia, Ontario, and Québec. The study also explored whether SHD counts during the pandemic were affected by lockdown severity (measured using the lockdown stringency index [LSI]) and COVID-19 case numbers. We utilized publicly available SHD data from January 2018 through November 2020, and employed AutoRegressive Integrated Moving Average (ARIMA) modelling, to predict SHD during the COVID-19 period (March 21 to November 28, 2020). We used Poisson and negative binomial regression to assess ecological associations between the LSI and COVID-19 case numbers, controlling for seasonality, and SHD counts during the COVID-19 period. On average, observed SHD counts were lower than predicted counts during this period (p < 0.05 [except Alberta]). Additionally, LSI and COVID-19 case numbers were not statistically significantly associated with SHD counts.

Correlates of suicide risk among Black and White adults with behavioral health disorders in criminal-legal systems

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.

National suicide management guidelines recommending family-based prevention, intervention and postvention and their association with suicide mortality rates: systematic review

BACKGROUND

Suicidal behaviour remains a major public health concern and countries have responded by authoring guidelines to help mitigate death by suicide. Guidelines can include family-based recommendations, but evidence for the level and category of family-based involvement that is needed to effectively prevent suicide is unclear.

AIMS

To explore the association between family-based recommendations in guidelines and countries' crude suicide rates. PROSPERO registration: CRD42019130195.

METHOD

MEDLINE, Embase, PsycInfo, Web of Science and WHO MiNDbank databases and grey literature were searched within the past 20 years (1 January 2000 to 22 June 2020) for national guidelines giving family-based recommendations in any of three categories (prevention, intervention and postvention).

RESULTS

We included 63 guidelines from 46 countries. All identified guidelines included at least one family-based recommendation. There were no statistically significant differences seen between mean World Health Organization crude suicide rates for countries that included only one, two or all three categories of family-based recommendations. However, a lower spread of crude suicide rates was seen when guideline recommendations included all three categories (mean crude suicide rates for one category: 11.09 (s.d. = 5.71); for two categories: 13.42 (s.d. = 7.76); for three categories: 10.68 (s.d. = 5.20); P = 0.478).

CONCLUSIONS

Countries should work towards a comprehensive national suicide guideline that includes all categories of family-based recommendations. Countries with previously established guidelines should work towards the inclusion of evidence-based recommendations that have clear implementation plans to potentially help lower suicide rates.

The Prevalence of Generalised Anxiety Disorder Among Prisoners of the Penitentiary Institution in North-Eastern Poland

Introduction: Generalised anxiety disorder (GAD) is one of the most common mental disorders. The psychosocial factors that may lead to generalised anxiety disorders include stress, traumatic events, conscious and unconscious internal conflicts, and low social and economic status. Imprisonment and forced isolation may favour the development of depression or anxiety disorders in inmates. Thus, this study aimed to analyse the prevalence of generalised anxiety disorder (GAD) in the population of inmates detained in one of the largest penitentiary units in north-eastern Poland. Materials and Methods: The data comes from 2017 and includes information on 635 male inmates incarcerated at the Czerwony Bór Prison. The information comes from the health records of individual inmates, kept by the prison outpatient clinician, and documented consultations with doctors of units outside the prison. The classification of generalised anxiety disorders (F41.1) was made in accordance with the 10th Revision of the International Statistical Classification of Diseases and Health Problems and the clinical diagnosis made by a psychiatrist. The Mann-Whitney test was used to compare quantitative data without normal distribution, chi-squared test or Fisher exact test for comparing qualitative data. A one-dimensional and multi-dimensional logistic regression model was used to examine the impact of the prison type on the prevalence of generalised anxiety disorder. Results: Generalised anxiety disorder was observed among 44 prisoners (6.9%), most often in the age range 30-39 years and among men younger than 30 years, respectively 40.9 and 31.8% of all diagnosed. The average age of patients was 34.6 years. The least number of prisoners with GAD was in the age group 50-59 (2.3%). Nearly 66% of patients were prisoners detained in a closed type prison; the chance of generalised anxiety disorder was three times higher than among the prisoners in a half-open and open type facility. Generalised anxiety disorder was diagnosed significantly more often with those currently serving a prison sentence than those before incarceration. Conclusions: In Polish conditions, the importance of the problem associated with GAD is evidenced by a significant increase in its prevalence in the prison environment and a three times higher chance of developing generalised anxiety disorder among prisoners in a closed type institution, which calls for highly organised psychiatric care and increased availability of psychological assistance for prisoners.

Relationship between life skills, repetitive negative thinking, family function, and life satisfaction in attempted suicide

BACKGROUND

Impaired life skills, family dysfunction, negative thinking and low life satisfaction may predispose to suicidal behavior. There is paucity of study that examined these variables in suicide attempt.

AIMS

This study was conducted to know the levels and the relationships of these variables in attempted suicide.

SETTINGS AND DESIGN

Hospital-based cross-sectional.

MATERIALS AND METHODS

In this hospital-based cross-sectional study, 328 participants with a history of attempted suicide were assessed using socio-demographic and clinical pro forma, life skills profile (LSP), perseverative thinking questionnaire (PTQ), satisfaction with life scale (SLS), and family assessment device (FAD) after obtaining informed consent.

STATISTICAL ANALYSIS

Descriptive statistics, Mann-Whitney U and Kruskal-Wallis-H test and regression analysis.

RESULTS

Results revealed a mean scores on PTQ, LSP, SLS, and FAD to be 29.93 (standard deviation [SD] =13.5), 21.32 (SD = 13.5), 15.71 (SD = 6.8), and 26.46 (SD = 4.57), respectively. In linear regression analysis (R ² = 0.815, df = 3, F = 475.715, P = 0.001), LSP score had a statistically significant positive association with PTQ score (beta = 0.861, t = 32.76, P = 0.001) and FAD score (beta = 0.068, t = 2.79, P = 0.0046); while negative association with SLS score (beta = -0.078, t = -2.92, P = 0.004).

CONCLUSIONS

The study findings suggest of impaired life skills, life dissatisfaction, impaired family function, and elevated repetitive negative thinking pattern in attempted suicide. Better life skills have a positive association with higher life satisfaction, family function, and low repetitive thinking and thus seem to have a protective effect against suicidal behavior in the population.

The Role of Interpersonal Problems and Family Environment in the Association Between Impulsivity and Suicidal Ideation: A Moderate Mediation Model

Impulsivity, interpersonal problems, and family environment are important factors in the development of suicidal ideation, but the pathway of these factors on suicidal ideation is not clear. This study constructed a moderated mediation model to examine whether interpersonal problems mediated the relationship between impulsivity and suicidal ideation and whether this mediating process was moderated by family environment. For this purpose, 902 college students from Tianjin Normal University located in the north of China were recruited to participate in this study with Barratt Impulsiveness Scale, Adolescent Self-Rating Life Events Check List, Family Environment Scale, and Beck Scale for Suicidal Ideation. Impulsivity could significantly predict suicidal ideation, and the relationship between impulsivity and suicidal ideation was significantly mediated by interpersonal problems; furthermore, the mediating effect and the directing effect were significantly moderated by family environment. These findings contribute to our understanding of a comprehensive interpretation of both environmental and individual factors' impacts on suicidal ideation.

Gaging the impact of multiple substance use on community corrections involvement

Historically, research has demonstrated that multiple substance use, compared to single substance use, poses additional challenges for treatment throughout the continuum of care including referrals, interventions, and relapse prevention. However, it appears that this pattern cannot be easily generalized to all criminal justice settings as evidenced by mixed findings across criminal justice samples. The purpose of the current study is to investigate possible differences in legal and substance-related outcomes between multiple substance users and single substance users within a community corrections sample. Structured clinical interviews were conducted to divide 531 individuals under community corrections supervision into three groups including multiple substance users, single substance users, and non-substance users. Results indicated that while multiple substance users were arrested more frequently and had more problems with family members, there were no differences compared to their single substance using counterparts in terms of depressive disorders, anxiety disorders, or types of offense. These findings contrast with previous research on samples outside of community corrections suggesting that multiple substance use requires tailored interventions with consideration to context of their use. Discussion includes limitations to generalizability and assessment of substance use as well as implications for treatment and future research.