Suicide Risk in Veterinary Professionals in Portugal: Prevalence of Psychological Symptoms, Burnout, and Compassion Fatigue

Mental health problems and suicide risk among veterinarians and veterinary nurses are well documented in the literature. Data on veterinary assistants have been overlooked, however. In addition, information on Portuguese veterinary professionals is lacking. An online sample of 833 Portuguese veterinary professionals (443 veterinarians, 287 nurses, and 103 assistants) completed self-report questionnaires about suicide risk and mental health between December 2022 and March 2023. Descriptive analysis revealed that 3.5% of respondents attempted suicide during their lifetime; 17.2% experienced extremely severe depression and suicidal ideation; 17.8% and 27.0% experienced extremely severe stress and anxiety, respectively; and 27.4% and 27.7% reported burnout and compassion fatigue, respectively. Multiple linear regression analysis revealed that professionals with a history of mental illness history; with current clinical symptoms of depression, anxiety, and stress; and working more than 40 hours per week experienced greater levels of burnout, compassion fatigue, and suicide ideation. Other variables such as being a woman, being a veterinary assistant, and disagreeing with motives for euthanasia also predicted some mental health problems. Mental health problems in the Portuguese veterinary professionals are a major health concern. These professionals are at higher risk for suicide, and clinical implications and guidelines are discussed.

An Exploratory Study in the Portuguese Population on Writing a Suicide Note: Correlates in the Suicide Spectrum and Qualitative Analysis

Suicide notes are an important warning sign for suicidal behaviors. The aim of this exploratory research is (a) to contribute to understanding the place of suicide notes in the spectrum of suicidal behaviors in Portugal, and (b) to analyze the content remembered by individuals regarding a suicide note. Two complementary studies were carried out. In the first, a quantitative investigation, the statistical relationship of writing a suicide note: To the occurrence of lifetime suicide attempts, to lifetime self-harming behaviors, and to suicidal ideation in the two weeks prior to the assessment was evaluated. In the second study, a qualitative investigation, the content recalled by individuals regarding a suicide note was analyzed. In the quantitative study, 841 adults aged between 18 and 65 years, and 1,012 young adults participated. In the qualitative study, 18 young adults participated. Findings of the quantitative study reveal that writing a suicide note significantly related to the lifetime presence of a suicide attempt and to self-harming behaviors and to suicidal ideation in the two weeks prior to the assessment. Findings of the qualitative study suggest that individuals who have written suicide notes exhibit a significant self-oriented focus, yet they also demonstrate a strong sense of concern for the survivors.

The Impact of Adverse Childhood Experiences on Mental Health and Suicidal Behaviors: A Study from Portuguese Language Countries

Background: Research on adverse childhood experiences (ACEs) demonstrates that they can be associated with physical and mental health problems throughout the lifecourse. However, few studies have examined this topic in the Community of Portuguese Language Countries (CPLC). Objective: This study aims to assess the impact of ACEs on mental health and suicidal behaviors in a sample of participants from the CPLC. Participants and Setting: The sample consists of 1006 participants aged between 18 and 80 years (mean = 41.76; SD = 14.19). Methods: This study used an online survey that included a sociodemographic questionnaire, the Brief Symptom Inventory-18 (BSI-18) to assess somatization, depression, and anxiety symptoms, and overall mental functioning, the Suicidal Behaviors Questionnaire-Revised (SBQ-R) to assess suicidal behaviors, and the Family Adverse Childhood Experiences Questionnaire to assess ACEs. Results: Emotional abuse was the most reported ACE (32.7%). Participants from Brazil had higher levels of somatization, depression, anxiety, and suicide ideation and attempt, while participants from Portugal had a higher probability of suicide in the future. ACEs were strong and significant predictors of psychological symptoms and the likelihood of suicide in the future, with emotional abuse and emotional neglect being the domains with the greatest contribution, respectively. Conclusions: ACEs are a prevalent and general phenomenon across several countries. It is urgent to alert policymakers and mental health professionals of the need to intervene with children and families to ensure their harmonious and adjusted development, thus promoting quality of life and well-being of populations.

The impact of imprisonment on individuals' mental health and society reintegration: study protocol

BACKGROUND

Prison sentences are a particular type of penalty that aim to reintegrate individuals into society. Nonetheless, research suggests that prison sentences have a null or a criminogenic effect on recidivism and a critical impact on inmates' mental health, negatively interfering with their successful reintegration into society and recidivism. Prevalence rates of mental health disorders among individuals who commit crimes are high, but little is known about how incarceration perpetuates and/or worsens mental health symptoms. In the Portuguese context, no studies focused on understanding the impact of imprisonment on prisoners' mental health. Thus, this project aims to understand incarceration's mental health and well-being impact on male and female individuals convicted to prison, both while incarcerated and after release.

METHODS

The study will follow a quantitative cross-sectional design of male and female individuals in prison and parole, aiming to assess different samples at different moments of the prison sentence. It will also follow a longitudinal design in a subsample of male and female individuals sentenced to prison and on parole who will be followed for one year.

DISCUSSION

This study intends to have a meaningful impact on the understanding of imprisonment effects, giving important clues for developing and implementing evidence-based prevention and intervention strategies to address prisoners' and ex-prisoners' mental health and improve their ability to successfully reintegrate into society and reduce recidivism.

Burnout and Suicidal Behaviours in Health Professionals in Portugal: The Moderating Effect of Self-Esteem

The main objective of this study was to investigate the effect of burnout on suicidal behaviours and the mediating effect of self-esteem in this relationship. A total of 1172 healthcare professionals working in Portugal's private and public sector organisations participated in this study. The results indicate a high level of burnout among these professionals and that exhaustion (β = 0.16; p < 0.001) and disengagement (β = 0.24; p < 0.001) positively and significantly affect suicidal behaviours. In turn, self-esteem has a significant and negative effect (β = -0.51; p < 0.001) on suicidal behaviours. Self-esteem moderates the relationship between disengagement and suicidal behaviours (B = -0.12; p < 0.001) and the relationship between exhaustion and suicidal behaviours (B = -0.11; p < 0.001), representing an essential variable for future lines of research, namely on the role of self-esteem in preventing burnout and suicidal behaviours in professionals from other professional areas.

The Impact of Life Trauma on Mental Health and Suicidal Behavior: A Study from Portuguese Language Countries

Several studies report the incidence of traumatic experiences in community and clinical samples, and substantial research demonstrates the impact of traumatic events on mental health and suicidal behavior, but this area remains unexplored in the Community of Portuguese Language Countries (CPLC). Thus, this study aims to (1) describe traumatic experiences, mental health levels and suicidal behavior among individuals from Portugal, Brazil and African Countries with Portuguese as an Official Language (ACPOL); (2) assess correlations between traumatic experiences and mental health and suicidal behavior; and (3) assess the impact of exposure to a traumatic event on mental health and suicidal behavior. The measurement instruments included a sociodemographic questionnaire, Brief Trauma Questionnaire, Brief Symptoms Inventory-18, and the Portuguese version of the Suicidal Behaviors Questionnaire-Revised. ACPOL participants reported greater impact of war, Portuguese participants reported greater impact of disasters, and Brazilian participants reported greater impact of psychological and sexual abuse, assault, and death of a family member. Brazilian participants showed the worst levels of mental health and suicidal thoughts. Strong correlations were found between traumatic experiences and mental health levels and suicidal behavior. Traumatic experiences contributed to the explanation of mental health levels and probability of committing suicide.

Validating the Suicide Behavior Questionnaire-Revised among Filipino adults during the COVID-19 pandemic

The study aimed to examine the validity of the Suicide Behavior Questionnaire-Revised (SBQ-R) among adult Filipinos experiencing severe depression symptoms during the COVID-19-related lockdowns in 2020. Results support SBQ-R's internal reliability. Confirmatory factor analyses supported SBQ-R's one-factor structure and its measurement invariance across gender and age. The SBQ-R's positive relationship with negative affect and its negative relationships with positive affect and family support demonstrate the questionnaire's criterion-related validity. The SBQ-R's cutoff of ≥8 shows that 78% of the sample were at-risk for suicide. The SBQ-R is valid in assessing suicide risk among severely depressed adults during the COVID-19 pandemic.

The roles of weight stigma, emotion dysregulation, and eating pathology in suicide risk

Using an interpersonal theory of suicide and affect regulation framework, we investigated the relationships between perceived burdensomeness, thwarted belongingness, weight stigmatization, emotion dysregulation, eating pathology, and suicide risk. Three main hypotheses were investigated. First, we predicted a positive linear relationship between weight stigmatization and risk. Second, an indirect effect of weight stigmatization on risk via perceived burdensomeness and thwarted belongingness was posited. Third, we hypothesized that weight stigmatization would indirectly affect suicide risk via emotion dysregulation and eating pathology. Undergraduates (N = 156) completed online surveys. Linear regressions and indirect effect analyses were performed. Weight stigmatization was directly, positively associated with increased suicide risk. Weight stigmatization indirectly affected suicide risk via perceived burdensomeness but not thwarted belongingness. Higher stigmatization was associated with higher levels of perceived burdensomeness, which was associated with higher risk. An indirect effect of weight stigmatization on suicide risk through emotional dysregulation emerged. Higher weight stigmatization was associated with higher emotional dysregulation, which was associated with higher suicide risk. When all models were combined, only an indirect effect via perceived burdensomeness remained. Our findings may have clinical and public health implications for suicide prevention among people with weight stigma-related risk factors.

Measurement and correlates of irritability in clinically referred youth: Further examination of the Affective Reactivity Index

BACKGROUND

Research on youth irritability has proliferated in recent years, largely facilitated by items from existing measures and by key new instruments like the Affective Reactivity Index (ARI). The present study extends this literature by investigating the psychometric properties of the parent- and youth-report ARI and the correlates of irritability in an independent, clinically referred sample.

METHOD

Baseline assessment data were collected from 237 youths (ages 3-18; 36% female) and their parents, seen for outpatient therapy and/or assessment. We examined the ARI in terms of (1) its item, scale, and factor properties; (2) convergent/discriminant validity with internalizing, externalizing, and emotion regulation problems; (3) specificity of associations with reactive aggression, anger, dysregulation, and coping; and (4) robustness of associations after controlling for demographic variables (e.g., age, gender).

RESULTS

The ARI's internal consistency and unidimensional factor structure were acceptable or better, with some variation across items and informants. Irritability, as measured by parent- and youth-report, was associated with variables in the externalizing (inattention, hyperactivity, executive dysfunction, aggression), internalizing (anxiety, depression, suicidality), and emotion regulation domains. Associations with reactive aggression, anger, dysregulation, and coping problems were especially pronounced. Irritability's links with internalizing and externalizing problems remained robust after controlling for demographic covariates.

LIMITATIONS

The sample was limited in diversity and moderate in size.

CONCLUSIONS

Findings support the reliability and validity of the ARI for assessing parent- and youth-rated irritability among clinically referred youth. Future research is needed to understand variations in irritability's manifestations, measurement, and correlates across demographic groups.

Validation and psychometric properties of Suicide Behaviors Questionnaire-Revised (SBQ-R) in Iran

BACKGROUND

Suicide is increasing in young Iranian population, which necessitates the employing of valid, yet abridged instruments assessing the constellation of suicide-related behaviors. The study aimed at validating Suicide Behavior Questionnaire-Revised (SBQ-R) among Iranian undergraduates.

METHODS

A total of 487 undergraduates were surveyed in 2018. Construct validity of SBQ-R was examined via confirmatory factor analysis (CFA), and Spearman's correlation with two single-item indices of suicide acceptability (SA) and lifetime suicidal ideation (LSI) was determined. Logistic regression and Kruskal-Wallis tests were used to examine the cut-off points (≥ 7 and ≥ 8) and categorizations as per item 1.

RESULTS

The mean SBQ-R score was 5.79 ± 3.55. Cut-off points ≥ 7 and ≥ 8 categorized 150 (30.8%) and 123 (25.2%) samples with suicide risk, respectively. Women obtained significantly higher scores on all indices, except items 1 and 4. CFA confirmed the model with sound goodness-of-fit, with factor loadings of 0.70 to 0.83. Composite reliability and average variance extracted were 0.87 and 0.63, respectively. The SBQ-R's correlation with SA and LSI confirmed its concurrent validity. Regression analysis confirmed the ability of both cut-off points to distinguish the participants with high SA and LSI; however, the cut-off point ≥ 8 produced better results regarding high LSI. Based on item 1, normal versus low- and high-risk samples were significantly different in terms of SA, LSI, and adjusted total score of SBQ-R (P < 0.0001).

CONCLUSION

SBQ-R is an economic and psychometrically sound tool, which can be utilized to identify suicide-related behaviors and risks in young Iranian population.

Dimensionality of Suicide Behaviors: Results within Two Samples from Two Different Countries

Across two countries and two languages, this research examined the multidimensional associations of suicide behaviors (i.e., life-time attempts, life-time communication of intent to others, life-time self-harming, life-time suicide notes, and current suicide ideation) and empirically relevant psychological risk factors (i.e., different facets of mental pain, perceived burdensomeness, thwarted belongingness, and acquired capability), controlling for depressive symptoms. For the Portuguese sample, two underlying dimensions emerged: an ideation dimension and a behavioral dimension, and for the Canadian sample, three dimensions emerged: an ideation dimension and two behavioral dimensions that can be viewed as a splitting of the Portuguese second dimension. Results highlight possible cultural differences between the two countries and that suicide behaviors should be viewed as a multidimensional phenomenon not as a one-dimensional continuum.

Psychological pain and suicidal ideation in undergraduates: The role of pain avoidance

In the present study, the first with a Western sample, we tested the relationship between three dimensions of psychological pain and suicidal ideation in a sample of 331 Portuguese college students. When controlling for the effect of depressive symptoms, the avoidance dimension, but not the cognitive and affective dimensions of psychological pain, made a significant contribution in predicting the three indicators of suicidal ideation. According to these results, psychotherapeutic action may focus either on enabling clients to tolerate mental pain or on providing more effective and adaptive strategies to cope with this pain.

Assessing psychache as a suicide risk variable: Data with the Portuguese version of the psychache scale

Several studies have consistently related psychological pain to suicide risk. Psychache, according to Shneidman's perspective and measured by the Psychache Scale has been confirmed as an important variable in risk prediction. In the present study, we evaluated psychache as a construct related to suicide risk using data obtained with the Portuguese version of the Psychache Scale translated from the original English version. A community sample of 628 individuals responded to the Portuguese version of the Psychache Scale, the Suicidal Behavior Questionnaire-Revised, the CES-D Scale, the Beck Hopelessness Scale, and the Suicide Ideation Questionnaire. Results supported the unidimensional scoring of the Psychache scale, its ability to differentiate between individuals at-risk for suicide from individuals not at-risk, its relationship with different, but related, constructs and its ability to predict suicide ideation.