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Ross R, Prater LC, Cole A, Mustafa A, Pham K, Gallagher A, Rowhani-Rahbar A, Phelan EA. Provider Perspectives on Addressing Firearm Safety with Older Adults in Primary Care. Clin Gerontol 2024; 47:555-570. [PMID: 37791738 PMCID: PMC10991080 DOI: 10.1080/07317115.2023.2264291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
OBJECTIVES Chronic conditions, including mild cognitive impairment and depression, place older adults at high risk of firearm suicide. Approximately 40% of older adults have access to a firearm, and many do not store their firearms safely. However, firearm counseling occurs infrequently in clinical settings. Using by the Ottawa Decision Support Framework (ODSF) to conceptualize the decisional support needed by patients and their providers to facilitate firearm counseling, we explore provider perspectives on desired resources for addressing firearm safety with older adult patients. METHODS From March - August 2022, we conducted 21 semi-structured interviews with primary care providers caring for older adults. We report deductive concepts as well as emergent themes. RESULTS Major themes were identified from the three components of the ODSF; decisional needs, decision support and decisional outcomes. Themes included: provider self-efficacy to conduct firearm counseling, clinical workflow considerations, stories for change, patient diagnosis implications, and caregiver involvement. CONCLUSIONS There is a need for decision aids in the clinical setting that facilitate firearm counseling and promotes shared decision-making about firearm storage. CLINICAL IMPLICATIONS Implementing a decision aid in the clinical setting can improve provider self-efficacy to conduct firearm counseling and help reduce risk factors associated with firearm-related harm among older adults.
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Affiliation(s)
- Rachel Ross
- Department of Pediatrics, University of Washington, Seattle, WA, USA
- Firearm Injury & Policy Research Program, University of Washington, Seattle, WA, USA
| | - Laura C. Prater
- Firearm Injury & Policy Research Program, University of Washington, Seattle, WA, USA
- Department of Psychiatry & Behavorial Sciences, University of Washington, Seattle, WA, USA
| | - Allison Cole
- Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Ayah Mustafa
- Department of Pediatrics, University of Washington, Seattle, WA, USA
- Firearm Injury & Policy Research Program, University of Washington, Seattle, WA, USA
| | - Kiet Pham
- School of Psychology, University of Washington, Seattle, WA, USA
| | - Amy Gallagher
- Department of Pediatrics, University of Washington, Seattle, WA, USA
- Firearm Injury & Policy Research Program, University of Washington, Seattle, WA, USA
| | - Ali Rowhani-Rahbar
- Firearm Injury & Policy Research Program, University of Washington, Seattle, WA, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Elizabeth A. Phelan
- School of Medicine, Division of Gerontology and Geriatric Medicine, School of Public Health, Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
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Owsiany MT, Fiske A. Control in relation to suicidal ideation and nonfatal suicidal behavior among older adults: a systematic review. Aging Ment Health 2024:1-12. [PMID: 38884617 DOI: 10.1080/13607863.2024.2365885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/03/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVES This review aims to evaluate and synthesize quantitative and qualitative findings on perceived control and value placed on control within the context of suicidal ideation or nonfatal suicidal behaviors in older adults. METHOD A comprehensive literature search was completed in June 2022, October 2022, and November 2023. Included studies focused on perceived control or value placed on control and on suicidal ideation or nonfatal suicidal behavior. Studies were published in English and included older adults (≥ 60 years) in separate analyses. Studies focusing on self-efficacy were excluded. RESULTS Twelve studies with 10 unique samples of 1487 total participants from eight countries were assessed. Quantitative studies indicated that perceived control and value placed on control are significant correlates of suicidal ideation and nonfatal suicidal behaviors, while qualitative studies highlighted that individuals who survive suicide attempts often specify decreased perceived control as a reason for their attempts. CONCLUSION Results of this review indicate that perceived control and value placed on control are relevant variables when studying suicidal ideation and nonfatal suicidal behavior. This conclusion should be considered preliminary. Future research should examine heterogeneous samples, adopt gold standard assessments, and assess covariates in the associations.
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Affiliation(s)
| | - Amy Fiske
- Department of Psychology, West Virginia University, Morgantown, WV, USA
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Nieuwenhuijs B, Gorus E, Portzky G, De Witte N. Risk and protective factors of a wish to die and suicidal ideation in community-dwelling, older, Flemish adults: results of the Belgian ageing studies. Aging Ment Health 2024:1-8. [PMID: 38708865 DOI: 10.1080/13607863.2024.2345779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 04/15/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVES This study aims to increase the understanding of suicidality in older adults by investigating the prevalence, characteristics, risk and protective factors of suicidal phenomena in community-dwelling older adults (60+) in Flanders, specifically of a current wish to die (WTD) and lifetime suicidal ideation and behaviour (LSIB). METHOD Cross-sectional data from the Belgian Ageing Studies (BAS) is used (N = 3050). The BAS aims to monitor the needs and quality of life of community-dwelling older adults through a standardised survey. Statistical methods used are bivariate analyses and binary logistic regression. RESULTS Prevalence rates of 4.8% for WTD and 8.2% for LSIB are found. LSIB is the biggest predictor of a current WTD, followed by requiring support on three domains, elder abuse, depression and subjective cognitive complaints, and elder abuse were significant risk factors for both WTD and LSIB. Limited effects of protective factors were found. CONCLUSION Previous research regarding risk factors to be confirmed in this study, and new insights on the effect of elder abuse, subjective indicators of cognitive complaints and requiring support are added. Further research into protective factors and underlying mechanisms is required.
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Affiliation(s)
- Beau Nieuwenhuijs
- Gerontology and Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ellen Gorus
- Gerontology and Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel, Brussels, Belgium
- Geriatrics Department, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Gwendolyn Portzky
- Unit for Suicide Research, Department Head and Skin, Ghent University, Gent, Belgium
| | - Nico De Witte
- Gerontology and Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel, Brussels, Belgium
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- School of Healthcare, HOGENT University of Applied Sciences and Arts, Ghent, Belgium
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Lutzman M, Sommerfeld E. Mental pain as a mediator in the association between avoidant attachment and suicidal ideation among older men. Aging Ment Health 2024:1-8. [PMID: 38456825 DOI: 10.1080/13607863.2024.2323957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES In the present study, our aim was to deepen the understanding of suicidality in older men by adopting a biopsychosocial approach. The study focused on older men as they face an elevated risk of suicide, surpassing not only other age groups but also exhibiting higher rates compared to women. We examined the contribution of mental pain as a mediator in the association between attachment avoidance and suicidal ideation among older men, taking into consideration the severity of their physical illnesses. METHODS Participants were 200 men in Israel, aged ≥65 years, living in the community and without cognitive impairment. Data collection was based on self-report measures of suicidal ideation (Beck Scale for Suicidal Ideation, BSSI), attachment (Experience in Close Relationships, ECR-R), mental pain (Orbach and Mikulincer Mental Pain Scale, OMMP), and the severity of physical illnesses (Cumulative Illnesses Rating Scale, CIRS). RESULTS Mental pain was found to mediate the association between attachment avoidance and suicidal ideation, but only among participants with higher levels of physical illnesses. CONCLUSIONS Mental pain should be considered as a complication of an avoidant coping strategy, which increases the risk of suicide among older men, especially those suffering from significant physical illnesses. The theoretical and clinical implications of these findings are discussed.
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Affiliation(s)
- Mira Lutzman
- Department of Psychology, Ariel University, Ariel, Israel
- Sheba Medical Center, Tel Hashomer, Israel
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Chen X, Wang Z, Zhou J, Loke AY, Li Q. A scoping literature review of factors influencing cancer patients' self-perceived burden. Eur J Oncol Nurs 2024; 68:102462. [PMID: 37995428 DOI: 10.1016/j.ejon.2023.102462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 10/19/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE A cancer diagnosis disrupts the peaceful lives and plans of patients and even their caregivers, and patients can easily feel burdened when they are being cared for by others. However, the influencing factors of self-perceived burden (SPB) have not been summarized, and related research is still in its infancy. This review explores factors related to the SPB of cancer patients and identifies future research directions. METHOD A systematic search, including trolling through six electronic databases, was conducted to identity articles published in English and Chinese from January 2003 to April 2022, using key terms related to cancer patients' burden on others; a manual search was also performed on the articles' reference lists. RESULTS Thirty-three articles were identified. The content was described into three groups: patient-related factors, caregiver-related factors, and family-related (financial) factors. Despite the heterogeneity, patients' physical/disease factors, psychological factors, social factors, caregiver type, quality of care provided, caregiver physical and psychological status, and financial factors were all correlated with SPB. CONCLUSIONS This literature review shows that SPB imposes a huge burden on cancer patients, and that SPB in cancer patients is influenced by patient-related factors, caregiver-related factors, and family factors. These influencing factors directly or indirectly affect SPB. In addition, SPB is complex and studies related to its factors deserve a further detailed analysis based on the actual situation of the patients in order to make the results more accurate and relevant.
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Affiliation(s)
- Xuan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Zhiming Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Junrui Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon Hong Kong, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China; Affiliated Hospital of Jiangnan University, Wuxi, China.
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Guo L, Ye B, Li B, Liu X. Perceived COVID-19 Stress and Suicidal Ideation Among College Students: Meditation Roles of Family Cohesion and Unmet Interpersonal Needs. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228231225994. [PMID: 38174861 DOI: 10.1177/00302228231225994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Purpose: Few studies examined variables that might explain the link between perceived COVID-19 stress and suicidal ideation. The present study tested a multiple-sequence mediation model with family cohesion, thwarted belongingness, and perceived burdensomeness as mediators. Methods: The current study surveyed 1098 college students in China using questionnaires concerning perceived COVID-19 stress, family cohesion, unmet interpersonal needs, and suicide ideation. Results: Perceived COVID-19 stress was significantly associated with family cohesion, thwarted belongingness, perceived burdensomeness, and suicidal ideation. Family cohesion, thwarted belongingness, and perceived burdensomeness mediated the relationship between perceived COVID-19 stress and suicidal ideation separately. These factors also had multiple sequence-mediated effects between perceived COVID-19 stress and suicidal ideation. Conclusion: The study revealed pathways from perceived COVID-19 stress to suicidal ideation and suggested that interventions to increase family cohesion and reduce one's unmet interpersonal needs were beneficial in decreasing individuals' suicidal ideation.
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Affiliation(s)
- Lingjing Guo
- Center of Mental Health Education and Research, Preschool Education Research Center, School of Psychology, School of Education, Jiangxi Normal University, Nanchang, China
- Mental Health Education Center, Chengdu University, Chengdu, China
| | - Baojuan Ye
- Center of Mental Health Education and Research, Preschool Education Research Center, School of Psychology, School of Education, Jiangxi Normal University, Nanchang, China
| | - Bingbing Li
- Center of Mental Health Education and Research, Preschool Education Research Center, School of Psychology, School of Education, Jiangxi Normal University, Nanchang, China
- Huai'an Third People's Hospital, Huai'an, China
| | - Xuezhi Liu
- Center of Mental Health Education and Research, Preschool Education Research Center, School of Psychology, School of Education, Jiangxi Normal University, Nanchang, China
- Jiangxi College of Foreign Studies, Nanchang, China
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Leonardi J, Gazzillo F, Gorman B, Bush M. Assessing Burdening Guilt and Its Correlates. Psychodyn Psychiatry 2023; 51:479-499. [PMID: 38047672 DOI: 10.1521/pdps.2023.51.4.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Burdening guilt refers to the belief that one's emotions, needs, and ways of being are a burden to others, and is one type of interpersonal guilt proposed by the control-mastery theory (CMT). The aim of this article is to validate two new measures of burdening guilt. In the two studies conducted, we examined the psychometric properties of these scales and the relationship between burdening guilt and self-perceived burden (burdensomeness), self-esteem, shame, anxiety, depression, mental health, attachment insecurity, adverse childhood experiences, social desirability, empathy, and suicidal ideation. In Study 1, we presented a newly developed Burdening Guilt Rating Scale (BGRS) and its correlation with measures of the abovementioned dimensions. In Study 2 we verified, through confirmatory factor analysis and correlation techniques, the possibility of expanding the Interpersonal Guilt Rating Scale-15 with a shorter, 5-item burdening guilt scale derived from the BGRS, and showed that this shorter scale correlates similarly to the longer one. Findings allowed us to validate these new scales providing empirical measures of burdening guilt-a theoretical concept with important clinical implications.
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Affiliation(s)
- Jessica Leonardi
- Department of Dynamic and Clinical Psychology and Health Studies, "Sapienza" University of Rome
| | - Francesco Gazzillo
- Department of Dynamic and Clinical Psychology and Health Studies, "Sapienza" University of Rome
| | - Bernard Gorman
- Derner School of Psychology, Adelphi University, Garden City, NY
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Pardue-Bourgeois S, Goldberg SB, Wyman MF, Abbas M, Flynn AWP, Domínguez S, Tucker RP. The Link between Deployment-Related Injuries and Suicidal Thinking in the Army National Guard: Examining the Role of Perceived Burdensomeness and Hopelessness. Arch Suicide Res 2023:1-12. [PMID: 37881842 PMCID: PMC11045658 DOI: 10.1080/13811118.2023.2270667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
OBJECTIVE In 2020, Army National Guard members demonstrated greater risk of suicide than their military and civilian counterparts. Though literature on deployment-related experiences and suicidal ideation (SI) is mixed, investigations of specific deployment-related experiences (e.g., injuries) may further elucidate the relationship between deployment and suicide risk. Deployment-related injuries, including pain severity and functional impairment, have been linked to increased risk of SI, and correlates like perceived burdensomeness (PB) and hopelessness. The current study sought to examine the cross-sectional relationship between deployment-related injuries, including pain severity and functional impairment, and severity of SI through PB and hopelessness. METHOD Immediately post-deployment, Army National Guard members (N = 2,261) completed validated self-report measures on past-week SI, PB, hopelessness, and single items regarding injury sustained during deployment and associated functional impairment and pain severity. RESULTS Indirect effect analyses revealed that experience of deployment-related injury was related to SI through PB and hopelessness (R2 = .1993), functional impairment was related to SI through PB, and pain severity was related to SI through PB. Contrary to hypotheses, hopelessness was not associated with SI when PB was simultaneously considered. CONCLUSIONS Army National Guard members who develop a sense of PB related to their injury and functional impairment of that injury may be at increased risk for suicidal ideation. Military suicide-prevention efforts may be potentiated through targeting distorted cognitions such as PB and hopelessness, especially in service members who have been injured.
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McLaren S, Adhikari P. Hope and Suicidal Ideation Among Older Adults Living in the Rural Mid-Hills of Nepal. Clin Gerontol 2023:1-15. [PMID: 37882778 DOI: 10.1080/07317115.2023.2274049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
OBJECTIVES The current study investigated whether hope and its two components (agency and pathways) weakened the relations between perceived burdensomeness, thwarted belongingness, and fearlessness about death and suicidal ideation among older adults living in rural Nepal. METHODS A community sample of 300 people aged from 60 to 90 years (Mage = 67.07, SDage = 6.23) who resided in the rural mid-hills of Nepal completed standardized measures. RESULTS Hope and agency moderated the relationship between perceived burdensomeness and suicidal ideation and pathways moderated the relationship between thwarted belongingness and suicidal ideation. CONCLUSIONS Hope, and particularly agency, may play a protective role in reducing suicidal ideation among older Nepali adults living in rural areas who experience perceived burdensomeness. In contrast, pathways may be an additional risk factor for older adults experiencing unmet belongingness needs. Research is required to understand fearlessness about death and suicidality among older Nepali adults. CLINICAL IMPLICATIONS Increasing hope and particularly agency may be associated with a reduction in suicidal ideation among older Nepali adults who experience feelings of being a burden. However, increasing pathways may be associated with an increase in suicidal ideation among those who experience unmet belongingness needs. Research is needed to understand how to accurately assess suicide risk among Nepali older adults.
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Affiliation(s)
- Suzanne McLaren
- School of Psychology, Charles Sturt University, Port Macquarie, Australia
| | - Pralhad Adhikari
- Department of Psychology and Philosophy, TriChandra Multiple College, Kathmandu, Nepal
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Hale W, Vacek S, Crabtree M, Grelle K, Bryan CJ, McGeary DD, Kanzler KE. The benefits of making peace with pain: chronic pain acceptance moderates the indirect effect of perceived burdensomeness between pain severity and suicidal cognitions. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:993-1000. [PMID: 37027224 PMCID: PMC10391590 DOI: 10.1093/pm/pnad042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/25/2023] [Accepted: 03/03/2023] [Indexed: 04/08/2023]
Abstract
OBJECTIVE The purpose of this study was (1) to examine the degree to which perceived burdensomeness mediates the relationship between pain severity and suicidal cognitions and (2) to determine whether this mediated relationship was moderated by pain acceptance. We predicted that high levels of pain acceptance would buffer relationships on both paths of the indirect effect. METHODS Two-hundred seven patients with chronic pain completed an anonymous self-report battery of measures, including the Chronic Pain Acceptance Questionnaire, the Interpersonal Needs Questionnaire, the Suicidal Cognitions Scale, and the pain severity subscale of the West Haven-Yale Multidimensional Pain Inventory. Conditional process models were examined with Mplus. RESULTS Chronic pain acceptance significantly moderated both paths of the mediation model. Results from the conditional indirect effect model indicated that the indirect effect was significant for those with low (b = 2.50, P = .004) and medium (b = 0.99, P = .01) but not high (b = 0.08, P = .68) levels of pain acceptance and became progressively stronger as pain acceptance scores decreased. The nonlinear indirect effect became nonsignificant at acceptance scores 0.38 standard deviation above the mean-a clinically attainable treatment target. CONCLUSIONS Higher acceptance mitigated the relationship between pain severity and perceived burdensomeness and the relationship between perceived burdensomeness and suicidal cognitions in this clinical sample of patients experiencing chronic pain. Findings indicate that any improvement in pain acceptance can be beneficial, and they provide clinicians with a clinical cut-point that might indicate lower vs higher suicide risk.
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Affiliation(s)
- Willie Hale
- Department of Psychology, University of Texas at San Antonio, San Antonio, TX, United States
| | - Sarah Vacek
- Department of Psychology, University of Texas at San Antonio, San Antonio, TX, United States
| | - Meghan Crabtree
- Tri-Ethnic Center for Prevention Research, Department of Psychology, Colorado State University, Ft. Collins, CO, United States
| | - Kaitlin Grelle
- Department of Psychology, University of Texas at San Antonio, San Antonio, TX, United States
| | - Craig J Bryan
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, Columbus, OH, United States
| | - Donald D McGeary
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Kathryn E Kanzler
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Houtson, TX, United States
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Shin H, Park C. Social network typologies moderate the association of loneliness with depressive symptomatology in middle-aged and older adults. Front Psychiatry 2023; 14:1141370. [PMID: 37215658 PMCID: PMC10198616 DOI: 10.3389/fpsyt.2023.1141370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/14/2023] [Indexed: 05/24/2023] Open
Abstract
Background Depression remains among the most prevalent mental disorders, and it severely affects daily functioning and quality of life. There has been extensive research reporting on the impact of social relationships on depression, but much of this research has only considered isolated aspects of relationships. This study derived social network types based on the multiple components of social relationships, and then investigated their effects on depressive symptoms. Methods Using samples of 620 adults (Mage = 53.52), Latent Profile Analysis (LPA) was conducted to uncover network types based on the structural (network size, contact frequency, marital status, and social engagement), functional (levels of support and conflict), and qualitative (satisfaction with relationships) aspects of social relationships. Multiple regressions were used to test if distinct network types directly impact on depressive symptoms and whether network types moderate the association of loneliness (perceived social isolation) with depressive symptoms. Results LPA identified four distinct network types (diverse, family-focused, friend-focused, and restricted) and there were significant differences in depressive symptoms among four network types. Analysis using the BCH method showed that individuals in the restricted network type had the highest depressive symptoms, followed in order by individuals in the friend-focused, family-focused, and diverse network types. Regression results further indicated that an individual's network network type membership was significantly associated with depressive symptoms, and being in the diverse and family-focused network types alleviated the negative effect of loneliness on depressive symptoms. Conclusion The results suggest that both quantitative and qualitative aspects of social relationships are important in buffering against the adverse effect of loneliness on depressive symptoms. These findings underscore the utility of taking a multi-dimensional approach to uncover heterogeneity in the social networks of adults and their implications on depression.
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Dargahi S, Pireinaladin S, Ahmadboukani S, Bashirgonbadi S, Molaei B, Fathi D. The Role of Perceived Burdensomeness, Thwarted Belongingness, and Giving Meaning to Life in Psychosocial Adjustment: The Mediating Role of Self-Care in the Elderly. IRANIAN JOURNAL OF PSYCHIATRY 2023; 18:145-152. [PMID: 37383964 PMCID: PMC10293687 DOI: 10.18502/ijps.v18i2.12365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 06/25/2022] [Accepted: 10/12/2022] [Indexed: 06/30/2023]
Abstract
Objective: In old age, people suffer from many mental and physical illnesses, which make it important for the elderly to pay attention to adapting to these diseases. So, the aim of this research was to study the role of perceived burdensomeness, thwarted belongingness, and giving meaning to life in psychosocial adjustment, as well as the mediating role of self-care in the elderly. Method : This research was descriptive and correlational, conducted through available sampling of 200 elderly people who lived in the city of Ardabil. After the necessary assessments in terms of mental disorders and inclusion criteria, they were chosen to conduct this investigation in 2020. The Meaning in Life Questionnaire, Psychosocial Adjustment Scale, Self-Care Questionnaire for the Elderly, and Interpersonal Needs scale were used to gather the data. The data were analyzed using SPSS25 and Amos24 software. Results: The findings showed that perceived burdensomeness and thwarted belongingness have a negative and direct effect on elderly self-care [β = -0.25, P < 0.01] [β = -0.20, P < 0.05] and psychosocial adjustment [β = -0.0, P < 0.05] [β = -0.12, P < 0.05]. Also, giving meaning to life has a positive and direct effect on elderly self-care [β = 0.32, P = 0.01] and psychosocial adjustment [β = 0.033, P < 0.01]. The variable of self-care can play a mediating role in the relationship between thwarted belongingness [β = -0.174, P < 0.05], perceived burdensomeness [β = -0.140, P < 0.05], and giving meaning to life [β = 0.223, P < 0.05] with psychosocial adjustment. Moreover, among the exogenous variables, thwarted belongingness and perceived burdensomeness by change in self-care have been able to reduce psychosocial adjustment. Giving meaning through self-care, however, has increased psychosocial adjustment. Conclusion: The findings revealed that thwarted belongingness, perceived burdensomeness, and giving meaning to life are important variables in health and adaptability of the elderly, which draws attention to family-centered interventions and individual therapies.
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Affiliation(s)
- Shahriar Dargahi
- Faculty of Psychology and Educational Sciences, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Saeed Pireinaladin
- Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran
| | - Soliman Ahmadboukani
- Faculty of Psychology and Educational Sciences, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Sepideh Bashirgonbadi
- Faculty of Psychology and Educational Sciences, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Behnam Molaei
- Department of Family Health, Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Davod Fathi
- Faculty of Psychology and Educational Sciences, University of Mohaghegh Ardabili, Ardabil, Iran
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Pedroso-Chaparro MDS, Cabrera I, Vara-García C, Márquez-González M, Losada-Baltar A. Physical limitations and loneliness: The role of guilt related to self-perception as a burden. J Am Geriatr Soc 2023; 71:903-908. [PMID: 36434819 DOI: 10.1111/jgs.18149] [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: 05/04/2022] [Revised: 10/20/2022] [Accepted: 11/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Limitations in performing physical activities have been associated with greater loneliness in older adults. This association could be moderated by maladaptive social cognition or feelings, such as guilt related to perceiving oneself as a burden. This study analyzes the effect of guilt related to self-perception as a burden on the relationship between physical limitations and loneliness in older adults. METHODS Participants were 190 community-dwelling people aged over 60 years who did not show cognitive or functional limitations in daily life activities. We used linear regression to test the influence of guilt related to self-perception as a burden on the association between physical limitations and loneliness. RESULTS The interaction between physical limitations and guilt related to self-perception as a burden was found to be significant in the explanation of loneliness, explaining 18.10% of the variance. Specifically, the relationship between physical limitations and loneliness was stronger when levels of guilt related to self-perception as a burden were high or medium than when these levels were low. CONCLUSIONS The findings suggest that feelings of loneliness are more frequent in people who report more physical limitations and, at the same time, report guilt for perceiving themselves as a burden. Guilt related to perceiving oneself as a burden seems to be a relevant modulator variable for understanding the effects of physical limitations on loneliness.
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Affiliation(s)
| | - Isabel Cabrera
- Departamento de Psicología Biológica y de la Salud, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - María Márquez-González
- Departamento de Psicología Biológica y de la Salud, Universidad Autónoma de Madrid, Madrid, Spain
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14
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Zhang X, Clarke C, Ding R. Living with dementia: Why I am thinking of 'death'. DEMENTIA 2023; 22:807-819. [PMID: 36809154 PMCID: PMC10088338 DOI: 10.1177/14713012231158859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
BACKGROUND AND AIMS Dementia is recognized globally as a massive burden on public health and wider society. It is a major cause of disability and mortality amongst older people. China has the largest population of people with dementia worldwide, accounting for approximately 25% of the entire global population of people with dementia. The study investigated the perceived experiences of care giving and care receiving in China, with one area identified in the data concerning the extent to which the participants discussed death. The research also explored the meaning of living with dementia in modern China, where the economy, demography and culture are rapidly changing. METHOD The qualitative approach of interpretative phenomenological analysis was used for this study. Semi-structured interviews were used for data collection. FINDING The paper reports on one specific finding concerning death as a way out of the situation that participants found themselves in. CONCLUSION The study described and interpreted one of the specific issues, 'death', in the participants' narratives. This finding reflects how psychological and social factors, such as stress, social support, healthcare cost, caring burden and medical practice have created the participants' thoughts of 'wishing to die' and the reasons why they believe 'death is a way to reduce burden'. It calls for an understanding, supportive social environment and a reconsideration of a culturally and economically appropriate family-based care system.
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Affiliation(s)
- Xiubin Zhang
- National Heart and Lung Institute, 4615Imperial College London, London, UK
| | | | - Rong Ding
- School of Heath in Social Science, The University of Edinburgh, Edinburgh, UK
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15
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Nan J, Salina N, Chong ST, Jiang HJ. Trajectory of suicidal ideation among medical students during the COVID-19 pandemic: the role of childhood trauma. BMC Psychiatry 2023; 23:90. [PMID: 36747156 PMCID: PMC9900550 DOI: 10.1186/s12888-023-04582-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The aim of this study was to understand the longitudinal trajectory of suicidal ideation (SI) among Chinese medical students and the role of childhood trauma (CT). METHODS Using a whole-group sampling method, we assessed SI in 2192 (male = 834, female = 1358) medical students on three occasions over a period of one year. The Suicidal Ideation Self-Assessment Scale (SISAS) and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess SI and CT. The growth mixture modeling (GMM) was used to classify the developmental trajectory of SI. RESULTS A greater number of medical students were experiencing suicidal ideation during the COVID-19 pandemic. The trajectory of SI among medical students was divided into two groups: a low risk, slowly rising group and a high risk, continuous group. The low risk, slowly rising group had a significant time effect (B = 1.57, p < 0.001) and showed a slowly increasing trend. Emotional neglect (EN), physical neglect (PN), emotional abuse (EA) and physical abuse (PA) all had significant positive predictive effects for the high risk, continuous group (B = 0.18-0.65, P < 0.01). CONCLUSION The trajectory of SI among medical students can be divided into a low risk, slowly rising group and a high risk, continuous group; the more EN, PN, EA and PA experienced during childhood, the more likely medical students are to develop a high risk, continuous state of SI.
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Affiliation(s)
- Jiang Nan
- grid.412113.40000 0004 1937 1557Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia ,grid.443397.e0000 0004 0368 7493Hainan Medical University, Haikou, 571199 China
| | - Nen Salina
- grid.412113.40000 0004 1937 1557Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia ,grid.412113.40000 0004 1937 1557Counselling Program, Postgraduate Secretariat, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Sheau Tsuey Chong
- Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600, Bangi, Malaysia. .,Counselling Program, Postgraduate Secretariat, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600, Bangi, Malaysia.
| | - Hong-juan Jiang
- grid.443397.e0000 0004 0368 7493Hainan Medical University, Haikou, 571199 China ,grid.443397.e0000 0004 0368 7493The First Affiliated Hospital of Hainan Medical University, Haikou, 571199 China
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16
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Kim J, Gwak D, Kim S, Gang M. Identifying the suicidal ideation risk group among older adults in rural areas: Developing a predictive model using machine learning methods. J Adv Nurs 2023; 79:641-651. [PMID: 36534434 DOI: 10.1111/jan.15549] [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: 01/11/2022] [Revised: 10/10/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
AIMS The aim of this study was to develop a predictive model that can identify the suicidal ideation risk group among older adults in rural areas using machine learning methods. DESIGN This study applied an exploratory, descriptive and cross-sectional design. METHODS The participants were older adults (N = 650) aged over 65 living in rural areas of South Korea. Self-report questionnaires were used to collect the demographics, suicidal ideation, depression, socioeconomic information and basic health information from September to October 2020. The collected data were analysed using machine learning methods with R statistical software 4.1.0. RESULTS The predictive models indicated that depression, pain, age and loneliness were significant factors of suicidal ideation. Good performance was observed based on the area under the receiver operating characteristic curve in the decision tree, random forest and logistic regression. Finally, the evaluation of model performance indicated moderate to high sensitivity and specificity. CONCLUSION The predictive models using machine learning methods may be useful to predict the risk of suicidal ideation. Furthermore, depression with pain, age and feelings of loneliness should be included in the initial screening to assess suicide risk among older adults in rural areas. IMPACT Identifying suicidal risk among older adults is challenging. Thus, employing predictive models that can assess depression, pain, age and loneliness can enable public healthcare providers to detect suicidal risk groups. Particularly, the presented models from this study can facilitate healthcare providers with initiating early interventions to prevent suicide among older adults in clinical and community nursing care settings. REPORTING METHOD The reporting of this study (Observational, cross-sectional study) conforms to the STROBE statement. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public. IMPLICATION FOR THE PROFESSION AND/OR PATIENTS CARE Applying this model may help to prevent geriatric suicide because the nursing staff will have a greater awareness regarding the suicide ideation risk of older adults, thereby reducing the possibility of their suicide.
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Affiliation(s)
- Junglyun Kim
- College of Nursing, Chungnam National University, Daejeon, South Korea.,Department of Biobehavioral Nursing Science, University of Florida, Gainesville, Florida, USA
| | - DongHyeon Gwak
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - Seonhee Kim
- Nursing Department, Songwon University, Gwangju, South Korea
| | - Moonhee Gang
- College of Nursing, Chungnam National University, Daejeon, South Korea
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17
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Wang X, Beltran S, Burns R, Hamel M, Gray S, Gryglewicz K. Suicide Risk Help-Seeking Among Middle- to Old-Age Adults: A Systematic Review. Innov Aging 2023; 7:igac079. [PMID: 36815014 PMCID: PMC9940623 DOI: 10.1093/geroni/igac079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Indexed: 01/28/2023] Open
Abstract
Background and Objectives Suicide has become a major public health concern worldwide and in the United States. Rates of suicide increase during the life course and are highest among middle- to old-age adults. Help-seeking represents a crucial coping mechanism that can mitigate suicide risk. Yet, less is known about suicide risk help-seeking, especially among these age groups. To address this knowledge gap, a systematic review of existing literature was performed to obtain a refined understanding of help-seeking for suicide risk among middle- to old-age adults. Research Design and Methods Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, electronic databases and key journals with suicide and/or gerontology focuses were searched to identify peer-reviewed publications in English between 2010 and 2020. A total of 4 732 unduplicated publications were screened for relevance based on titles and abstracts, of which 52 were reviewed in full text. Results Twenty-four articles met inclusion criteria and were included in the qualitative synthesis. These articles discussed a range of topics, including the prevalence of service utilization, service use prior to a suicide death, and correlates of help-seeking. In general, the prevalence of service utilization was low and varied by suicidal history (eg, higher prevalence among individuals with a history of suicide attempts than those with suicide ideation only). Key facilitators (eg, current or history of suicidal thoughts, plans, or attempts) and barriers (eg, stigma) for service use and help-seeking were also identified. Discussion and Implications Findings highlight the need for future studies and tailored services to improve age-appropriate and culturally responsive suicide prevention and intervention strategies for middle- to old-age adults.
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Affiliation(s)
- Xiaochuan Wang
- Address correspondence to: Xiaochuan Wang, PhD, School of Social Work, University of Central Florida, Orlando, FL 32816, USA. E-mail:
| | - Susanny Beltran
- School of Social Work, University of Central Florida, Orlando, Florida, USA
| | - Rachael Burns
- School of Social Work, University of Central Florida, Orlando, Florida, USA
| | - Marie Hamel
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida, USA
| | - Sydney Gray
- School of Social Work, University of Central Florida, Orlando, Florida, USA
| | - Kim Gryglewicz
- School of Social Work, University of Central Florida, Orlando, Florida, USA
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18
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Jang Y, Kim J, Yoon H, Park NS, Chiriboga DA, Rice E, Kim MT. Older Korean Americans' Perceived Burdensomeness to Their Healthcare Partners: An Egocentric Network Assessment. J Aging Health 2023; 35:62-70. [PMID: 35580996 DOI: 10.1177/08982643221103057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objectives: The objective is to examine how older Korean Americans' perceived burdensomeness to their healthcare partners is associated with the characteristics of older adult participants (egos) and their healthcare partners (alters). Methods:Surveys of 2150 participants in the Study of Older Korean Americans provided ego data. Participants were also asked to list up to three individuals whom they usually asked for help on health-related matters or healthcare use, which generated 3402 alters. Multilevel modeling was conducted to examine the role of the characteristics of egos and alters, as well as their cross-level interactions. Results: Perceived burdensomeness was negatively associated with English-speaking ability and residence in a low Korean density area. Perceived burden was also lowered when emotional support was received from the alters, and this pattern was pronounced among those with multi-comorbidity. Discussion: By identifying older immigrants prone to the sense of burdensomeness, the study suggests strategies to promote their health and healthcare use.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Los Angeles, CA, USA.,Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Jangmin Kim
- School of Social Work, 5116Texas State University, San Marcos, TX, USA
| | - Hyunwoo Yoon
- Department of Social Welfare, 65361Kongju National University, Gongju, South Korea
| | - Nan Sook Park
- School of Social Work, 7831University of South Florida, Tampa, FL, USA
| | - David A Chiriboga
- Department of Child and Family Studies, 7831University of South Florida, Tampa, FL, USA
| | - Eric Rice
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Miyong T Kim
- School of Nursing, 7174University of Texas at Austin, Austin, TX, USA
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19
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Alfaro AJ, Carlson C, Segal DL, Gould CE. Distinctions between depression and anxiety with fear of being a burden in late life. Aging Ment Health 2022; 26:2366-2371. [PMID: 34713761 DOI: 10.1080/13607863.2021.1993131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objectives: The perception of being a burden is a well-known risk factor for dying by suicide. Research on factors that precede the state of perceived burdensomeness, such as fearing being a burden, is necessary. We investigated the extent to which health status, elevated depressive symptoms, and elevated anxiety symptoms are associated with fear of being a burden in late life.Method: Older adult participants (N = 155) completed the Geriatric Anxiety Scale (GAS), Patient Health Questionnaire (PHQ-8), and demographic and health questions. Fear of being a burden, assessed with a supplemental item on the GAS, was categorically grouped as 'no fear' or 'some fear'. Using logistic regression, we examined predictors of fear of being a burden.Results: In the first step, elevated depression was associated with fear of being a burden (OR = 2.30, 95% CI: 1.09, 4.89, p = .03), but health status was not significant. In the second step, elevated anxiety was significant (OR = 2.63, 95% CI: 1.15, 5.99, p = .02); depression was no longer significant.Conclusion: Contrary to expectations, anxiety more strongly predicted fear of being a burden than depression. Future research should further investigate the role of anxiety in fear of being a burden and ways of intervening.
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Affiliation(s)
- Ana Jessica Alfaro
- GRECC, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Daniel L Segal
- Department of Psychology, University of Colorado, Colorado Springs, CO, USA
| | - Christine E Gould
- GRECC, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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20
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Pedroso-Chaparro MDS, Cabrera I, Márquez-González M, Vara-García C, Fernandes-Pires JA, Gallego-Alberto L, Losada-Baltar A. [Guilt for perceiving oneself as a burden: A relevant variable associated with the psychological distress of older adults]. Rev Esp Geriatr Gerontol 2022; 57:303-311. [PMID: 36243650 DOI: 10.1016/j.regg.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 08/09/2022] [Accepted: 09/13/2022] [Indexed: 12/05/2022]
Abstract
AIMS To analyze the relationship between guilt for perceiving oneself as a burden and negative self-perceptions of aging, perceived control and anxious and depressive symptomatology in older people without cognitive or functional limitations. METHODS Participants were 351 community-dwelling people over 60 years without explicit cognitive or functional limitation. Indirect effet analysis were conducted that examined the indirect effect of negative self-perceptions of aging through 1) perceived control and anxious symptomatology and 2) perceived control and depressive symptomatology in guilt for perceiving oneself as a burden. RESULTS Both models showed an indirect relationship between negative self-perceptions of aging and guilt for perceiving oneself as a burden through 1) perceived control and anxious symptomatology and 2) perceived control and depressive symptomatology, explaining 26.37% of anxious symptomatology, 48.51% of depressive symptomatology and 13.73% and 14.44% of guilt for perceiving oneself as a burden, respectively. DISCUSSION The results obtained suggest that higher negative self-perceptions of aging is associated with a lower perception of control and greater psychological distress (anxiety and depression), and this process increases the feeling of guilt for perceiving oneself as burden to family members in older people without functional or cognitive limitations.
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Affiliation(s)
| | - Isabel Cabrera
- Departamento de Psicología Biológica y de la Salud, Universidad Autónoma de Madrid, Madrid, España
| | - María Márquez-González
- Departamento de Psicología Biológica y de la Salud, Universidad Autónoma de Madrid, Madrid, España
| | | | | | - Laura Gallego-Alberto
- Departamento de Psicología Biológica y de la Salud, Universidad Autónoma de Madrid, Madrid, España
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21
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Okan C, Bilson L, Zhong D, Weidemann G, Bailey PE. Validating the interpersonal theory of suicide among older adultspre- and peri-COVID-19 pandemic. Aging Ment Health 2022:1-7. [PMID: 36052977 DOI: 10.1080/13607863.2022.2116402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Global suicide rates are highest among older adults, and especially older men, yet proximal predictors of suicidal ideation in older age remain poorly understood. This study tested the Interpersonal Theory of Suicide in older men and women by investigating whether perceived burdensomeness and thwarted belongingness and/or their interaction are proximal predictors of suicidal ideation before versus during the global COVID-19 pandemic. METHODS The sample (N = 208) included healthy community-dwelling older Australian persons surveyed face-to-face pre-pandemic (n = 102), or online peri-pandemic (n = 106). Depression, social interaction, social satisfaction, thwarted belongingness, and perceived burdensomeness were assessed as predictors of suicidal ideation. RESULTS Perceived burdensomeness was a more proximal predictor of suicidal ideation among older adults than depression or thwarted belongingness. Suicidal ideation and perceived burdensomeness were higher in men than women, but sex did not moderate the influence of perceived burdensomeness, thwarted belongingness or social satisfaction on suicidal desire. The interaction between perceived burdensomeness and thwarted belongingness predicted more additional variance in suicidal ideation in the older persons surveyed during the COVID-19 pandemic relative to those surveyed before the pandemic. CONCLUSION Suicidal ideation among older persons peri-pandemic is discussed, and recommendations are made for age-specific suicide prevention strategies.
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Affiliation(s)
- Ceylan Okan
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Lily Bilson
- School of Psychology, Western Sydney University, Sydney, Australia
| | - David Zhong
- School of Psychology, Western Sydney University, Sydney, Australia
| | | | - Phoebe E Bailey
- School of Psychology, Western Sydney University, Sydney, Australia.,Graduate School of Health, University of Technology Sydney, Sydney, Australia
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22
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Abbing J, Suanet B, Broese van Groenou M. How does long-term care impact the psychological wellbeing of older adults in different care policy contexts in the Netherlands?: A comparison of 1998, 2008 and 2018: A comparison of 1998, 2008 and 2018. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2750-e2760. [PMID: 35038204 PMCID: PMC9546213 DOI: 10.1111/hsc.13719] [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: 05/26/2021] [Revised: 11/03/2021] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
Receipt of long-term care (LTC) is generally associated with worse psychological wellbeing for community-dwelling older adults. In addition to objective features of care use (e.g. formal vs. informal care), the subjective evaluation of care provision in terms of perceived sufficiency might be particularly predictive of one's wellbeing but is seldomly considered in the literature. Substantial changes in the availability of long-term care in past decades raise the question to what extent these effects, if present, are consistent over historic time. The present study, therefore, aims at better understanding the associations between types of LTC use and perceived care sufficiency on psychological wellbeing in a changing LTC context in the Netherlands. Data from the Longitudinal Aging Study Amsterdam (LASA) were used from three points in time: 1998 (N = 582), 2008 (N = 459) and 2018 (N = 415). At each wave, participants were between 75 and 85 years of age and living independently. The results show that after adjusting for age, gender, education and health, using formal LTC had a negative effect on depressive symptoms only in 2018, but that this effect was not significantly worse compared to previous cohorts. Perceived care sufficiency was consistently negatively associated with depressive symptoms in all three points in time. This suggests that despite a less generous Dutch LTC system, psychological wellbeing among LTC users remains stable. Perceiving care provision as sufficient, however, can help older adults maintain psychological wellbeing and should be considered by researchers and policymakers that aim to improve care recipients' wellbeing.
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Affiliation(s)
- Jens Abbing
- Department of SociologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Bianca Suanet
- Department of SociologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
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23
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Chattun MR, Amdanee N, Zhang X, Yao Z. Suicidality in the geriatric population. Asian J Psychiatr 2022; 75:103213. [PMID: 35917739 DOI: 10.1016/j.ajp.2022.103213] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/01/2022] [Accepted: 07/14/2022] [Indexed: 11/28/2022]
Abstract
Suicide in older adults is a major global concern in both public and mental health. With an ageing population on the rise, a surge in suicidal deaths is predicted in the coming years. The objectives of this paper are to review the risk factors, protective factors, assessment rating scales and current prevention strategies in the geriatric population. The identification of modifiable risk factors and strengthening of protective factors as well as staging according to suicidal ideation, behaviors and/or attempt(s) are necessary to devise appropriate personalized interventions in vulnerable older adults. A history or current psychiatric illness particularly depression, physical illnesses, previous suicide attempt, substance abuse, loneliness, marital status, financial stress, a family history of psychiatric illnesses or suicide in 1st degree relatives and low social support most commonly increase suicidal susceptibility in older adults. Conversely, factors that increase resilience in older adults include a good physical health and cognitive function, religiousness, good quality of life and life satisfaction, ability to perform activities of daily living, marital status, having friends and social connectedness. While the risk factors associated with suicide in the geriatric population are complex and multidimensional in nature, the current preventive strategies have provided no substantial decline in suicidal risk. Therefore, a combination of strategies applied via a multilevel prevention program at a primary, mental healthcare, societal and community level could mitigate suicidal risk. Further research and better preventive measures are warranted to diminish suicidal risk in older adults.
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Affiliation(s)
- Mohammad Ridwan Chattun
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Nousayhah Amdanee
- Department of Geriatric Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xiangrong Zhang
- Department of Geriatric Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China.
| | - Zhijian Yao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Medical School of Nanjing University, Nanjing Brain Hospital, 22 Hankou Road, Nanjing 210093, China.
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A scoping review exploring the ‘grey area’ of suicide-related expression in later life: Developing a conceptual framework for professional engagement. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22000642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
As the body of research on suicide in later life has developed, so has its vocabulary. This has generated a high level of overlap in concepts and terminology used to articulate suicide and how it might present, as well as ‘grey area’ behavioural terms that are both specific to older adults and less well-defined (e.g. ‘hastening of death’ or ‘completed life’). A better understanding of individual experiences and pathways to suicide can help to inform assessment and interventions, and increase the potential to relate any theoretical concepts to the implementation of such. Here, we adopted a scoping review to search systematically literature on specific presentation, features, circumstances and outcomes of these grey areas of suicide in later life. Fifty-three articles (quantitative, qualitative and theoretical) were reviewed. A narrative approach was used to merge and translate this body of knowledge into a new conceptual framework based on four key themes: (a) a sense of completed life or existential loneliness; (b) death thoughts, wishes and ideation; (c) death-hastening behaviour and advanced directives; and (d) self-destructive or self-injurious behaviour. We discuss the importance of integrating this understanding into current knowledge and suicide prevention strategies for older adults. Recommendations are made for unifying research with policy themes on healthy ageing, person-centredness within service provision and citizen participation.
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Park J, Lee O, McKee M. Association between hearing loss and suicidal ideation among middle-aged and older adults. Aging Ment Health 2022; 26:1287-1294. [PMID: 33979563 DOI: 10.1080/13607863.2021.1919991] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Hearing loss (HL) is regarded as a major risk factor for late-life depression. This study aims to further examine the association between HL and suicidal ideation (SI) among middle-aged and older adults using a nationally representative sample. METHOD The study sample comprised 34,142 adults (aged 50+) drawn from the 2015 to 2018 National Survey on Drug Use and Health. SI was measured by response to the question, 'At any time in the past year, did you seriously think about trying to kill yourself?' HL was assessed by asking respondents whether they were deaf or had serious difficulty hearing. Multivariate logistic regression analyses were conducted to examine the association between HL and SI after adjusting for a comprehensive list of covariates. RESULTS Compared to those without HL, middle-aged and older adults with HL experienced significant health disparities regarding history of hospitalization, poor perceived health, higher prevalence of chronic diseases, depression, substance use, and SI. HL was positively associated with SI in the past year in both middle-aged (aOR = 1.59, 95% CI [1.14, 2.21], p < .001) and older adult groups (aOR = 1.58, 95% CI [1.07, 2.33], p < .001), controlling for depression, substance use, health status, and sociodemographic variables. CONCLUSION Given the high prevalence of hearing loss (HL) in aging populations, this study aimed to expand our knowledge of the relative strength of association between HL and SI. Findings implied that healthcare providers should consider screening for SI in those with HL.
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Affiliation(s)
- Junghyun Park
- Silver School of Social Work, New York University, New York, NY, USA
| | - Othelia Lee
- School of Social Work, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Michael McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
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26
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Abstract
OBJECTIVES Rates of suicide in older adults may be higher than reported due to poor understandings of presentation of suicide ideation in this group. The objectives of this paper were to (i) review current measurement tools designed for older adults to detect suicide ideation and (ii) assess their psychometric properties. DESIGN We used a systematic review approach to identify measurement tools developed specifically for older adults without cognitive decline or impairment. RESULTS Ten articles that reported on a total of seven different measurement tools were identified. These included tools that focused on resiliency to suicide and those that measured risk of suicide behavior. There was wide variation across the articles: some were adaptations of existing scales to suit older populations, others were developed by authors; they varied in length from four to 69 items; a range of settings was used, and there was a mix of self-report and clinician-administered measures. Most displayed good psychometric properties, with both approaches showing similar quality. Limitations in terms of samples, settings, and measurement design are discussed. CONCLUSION The case for specific measures for older adults is clear from this review. There appear to be unique factors that should be considered in understanding suicide ideation and behavior among older adults that may not be directly assessed in non-specific measurements. However, there is a need to expand the diversity of individuals included in measurement development to ensure they are appropriate across gender, culture and minority status, and for the views of professionals to be considered.
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27
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Shim SH, Kwon YJ, Lee D, Lee HS, Jin MJ, Kim JS. Impact of Interpersonal Relationships and Acquired Capability for Suicide on Suicide Attempts: A Cross-Sectional Study. Psychiatry Investig 2022; 19:362-370. [PMID: 35620821 PMCID: PMC9136520 DOI: 10.30773/pi.2021.0379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/30/2022] [Accepted: 03/07/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study examined the path model predicting suicide attempts (SA) by interpersonal need for suicide desire, acquired capability for suicide, the emotion dysregulation, and depression symptoms in people admitted to hospitals for medical treatment. METHODS A total of 344 participants (200 depressed patients with attempted suicide, 144 depressed patients with suicidal ideation) were enrolled for this study. Depression, anxiety, emotion regulation, interpersonal needs, and acquired capability for suicide were evaluated. A model with pathways from emotion regulation difficulties and interpersonal needs to SA was proposed. Participants were divided into two groups according to the presence of SA or suicidal ideation. RESULTS Acquired capability for suicide mediated the path from depression to SA. In the path model, difficulties in emotion regulation and interpersonal needs predicted depression significantly. Although depression itself was not significantly related to acquired capability for suicide, depression was significantly related to acquired capability for suicide in suicide attempter group. CONCLUSION Interventions with two factors affecting SA will clarify the suicide risk and contribute to finding risk factors.
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Affiliation(s)
- Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Young Joon Kwon
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Dongwook Lee
- Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Ho Sung Lee
- Department of Pulmonology and Allergy, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Min Jin Jin
- Division of Liberal Arts, Kongju National University, Gongju, Republic of Korea
| | - Ji Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
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Vasiliadis HM, D'Aiuto C, Lamoureux-Lamarche C, Pitrou I, Gontijo Guerra S, Berbiche D. Pain, functional disability and mental disorders as potential mediators of the association between chronic physical conditions and suicidal ideation in community living older adults. Aging Ment Health 2022; 26:791-802. [PMID: 33890523 DOI: 10.1080/13607863.2021.1913478] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To examine the associations between chronic physical conditions and suicidal ideation and to assess whether associations are mediated by pain, anxiety, depression, post-traumatic stress syndrome (PTSS), and functional disability. METHODS The study sample includes 1533 older adults aged 65+ recruited in primary care clinics between 2011-2013 and participating in Quebec's Health Survey on Services "Étude sur la Santé des Aînés-Services" (ESA-S) study. Path analysis was used to assess the associations. The presence of suicidal behaviour was ascertained using 4 questions. PTSS was based on a validated scale for primary care older adults. Anxiety and depression were assessed according to DSM-IV criteria. Pain was self-reported on an ordinal scale and functional disability was based on the presence of disability in 8 dimensions of activities of daily living. The main predictors included a list of 13 physical disorders identified by diagnostic codes. Suicidal ideation was also controlled by a number of socio-demographic and psychosocial factors. RESULTS PTSS, depression, and functional disability mediate the association between various chronic conditions and suicidal ideation. Although pain and anxiety are associated with many physical disorders, they did not mediate the association with suicidal ideation. CONCLUSIONS Chronic physical disorders are associated with suicidal ideation, either directly or indirectly through PTSS, depression, and functional disability. The findings underscore the importance of early identification and management of older patients with specific chronic disorders in primary care as they may be most at risk for suicidal ideation.
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Affiliation(s)
- H-M Vasiliadis
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Longueuil, QC, Canada.,Centre de Recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Longueuil, QC, Canada
| | - C D'Aiuto
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Longueuil, QC, Canada.,Centre de Recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Longueuil, QC, Canada
| | - C Lamoureux-Lamarche
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Longueuil, QC, Canada.,Centre de Recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Longueuil, QC, Canada
| | - I Pitrou
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Longueuil, QC, Canada.,Centre de Recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Longueuil, QC, Canada
| | - S Gontijo Guerra
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Longueuil, QC, Canada.,Centre de Recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Longueuil, QC, Canada
| | - D Berbiche
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Longueuil, QC, Canada.,Centre de Recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Longueuil, QC, Canada
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Cosh SM, Pinto R, Denson L, Tully PJ. Understandings and experiences of adherence to secondary prevention for patients with cardiovascular disease and comorbid depression or anxiety. PSYCHOL HEALTH MED 2022:1-8. [PMID: 35356823 DOI: 10.1080/13548506.2022.2060515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Over 20% of cardiovascular disease (CVD) patients have a comorbid mental health disorder, resulting in an increased risk of recurring major adverse cardiac events (MACE) and mortality. Despite the higher risk, patients with comorbid depression or anxiety disorders are twice as likely to be non-adherent to secondary prevention. Therefore, better understanding of the adherence experiences of this subgroup is needed to inform service delivery and enhance adherence for this higher risk group. This study aims to explore the perceptions, understandings, and experiences of adherence to secondary prevention amongst 33 cardiac patients with diagnosed depression and/or anxiety disorder. Participants were recruited as part of the Cardiovascular Health in Anxiety or Mood Problems Study. Semi-structured interviews were conducted and data were analysed via inductive thematic analysis. Patient understandings of adherence to secondary prevention were limited, with medication compliance considered the marker of adherence. Further, participants did not perceive unintentional non-adherence to constitute non-adherence, rather an intent to engage was viewed as defining adherence. Participants also reported that a lack of practitioner understanding and management around their mental health negatively impacted the practitioner-patient relationship and their engagement with secondary prevention. Results highlight that unique barriers, especially around management of comorbid mental health exist for this subgroup. Additionally, adherence to secondary prevention might be limited by patients' narrow understandings of adherence as the intent to engage and as medication compliance.
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Affiliation(s)
- Suzanne M Cosh
- School of Psychology, University of New England, Armidale, NSW, Australia
| | - Ronette Pinto
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Linley Denson
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Phillip J Tully
- Freemason's Centre for Men's Health, School of Medicine, The University of Adelaide, Adelaide, SA, Australia
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McLaren S, Castillo P, Tindle R, Corboy D, Klein B, Burmeister O. Suicide Risk among Older Adults: The Moderating Role of Hope. Clin Gerontol 2022:1-15. [PMID: 35196962 DOI: 10.1080/07317115.2022.2039827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The current study investigated whether hope and its two components (agency and pathways) acted as protective factors by weakening the relations between perceived burdensomeness, thwarted belongingness, and acquired capability for suicide and suicide risk among older adults. METHODS A community sample of 594 older Australians aged from 60 to 95 years (Mage = 68.72, SDage = 6.67) completed the Suicidal Behaviors Questionnaire-Revised, Interpersonal Needs Questionnaire-Revised, Acquired Capability for Suicide Scale-Fearlessness about Death Scale, Adult Hope Scale, and Geriatric Depression Scale-short form. RESULTS After controlling for depressive symptoms and sociodemographic variables, hope and agency moderated the thwarted belongingness-suicide risk relation, and hope, agency, and pathways moderated the acquired capability for suicide-risk relation. CONCLUSIONS Hope may play an important role in reducing suicide risk among older adults experiencing thwarted belongingness and who have acquired the capability for suicide. Research is required to identify ways of reducing suicide risk among older adults who experience perceived burdensomeness. CLINICAL IMPLICATIONS Increasing hope may reduce suicide risk among older adults experiencing thwarted belongingness and who have acquired the capability for suicide.
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Affiliation(s)
- Suzanne McLaren
- School of Psychology, Charles Sturt University, Port Macquarie, Australia
| | - Paola Castillo
- School of Psychology, Charles Sturt University, Port Macquarie, Australia
| | - Richard Tindle
- School of Psychology, Charles Sturt University, Port Macquarie, Australia
| | - Denise Corboy
- School of Psychology, Charles Sturt University, Port Macquarie, Australia
| | - Britt Klein
- Biopsychosocial & eHealth Research & Innovation (Beri); Health Innovation and Transformation Centre; DVC-RI Portfolio, Federation University, Australia
| | - Oliver Burmeister
- School of Information Technology, Charles Sturt University, Bathurst, Australia
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Cultural attributes of suicidal ideation among older immigrants: a qualitative study. BMC Geriatr 2022; 22:678. [PMID: 35172754 PMCID: PMC8851697 DOI: 10.1186/s12877-021-02628-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 09/24/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Suicide is a large and growing public health problem. Little is known about the attributes of suicidal ideation (SI) in the contexts of immigration. This qualitative study aims to explore immigration- and acculturation-related attributes of SI among older immigrants. METHODS A qualitative semi-structured interview design. Interview were conducted with 57 older Chinese immigrants in Chicago with self-reported SI in the past month. RESULTS In addition to attributes of SI which have been well documented in the literature, we identified immigration- and acculturation-related attributes, including linguistic and cultural barriers of being integrated to the receiving communities, acculturation gaps in intergenerational support, and uselessness. CONCLUSIONS Findings of the study highlight the intersectionality of race, culture, and aging regarding SI, which are essential to improve recognition and understanding of SI among immigrant populations.
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32
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Heisel MJ, Flett GL. Screening for suicide risk among older adults: assessing preliminary psychometric properties of the Brief Geriatric Suicide Ideation Scale (BGSIS) and the GSIS-Screen. Aging Ment Health 2022; 26:392-406. [PMID: 33327729 DOI: 10.1080/13607863.2020.1857690] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To initially assess psychometric properties of two abbreviated versions of the Geriatric Suicide Ideation Scale (GSIS): a 10-item Brief Geriatric Suicide Ideation Scale (BGSIS), and a 5-item Geriatric Suicide Ideation Scale-Screen (GSIS-Screen). METHODS A series of psychometric analyses was conducted, assessing the internal consistency, test-retest reliability, construct and predictive validity of the abbreviated GSIS scales. This was done by selecting-out GSIS items from a combined dataset of studies on suicide ideation in older adults: 1) The GSIS scale development study (n = 107); 2) A clinical trial of Interpersonal Psychotherapy (IPT) modified for suicidal older adults(n = 25); 3) A longitudinal study of risk and resiliency to suicide ideation in community-residing older adults (n = 173). RESULTS Overall findings demonstrated strong internal consistency, test-retest reliability, concurrent and predictive validity for the BGSIS and GSIS-Screen with older adults across community, clinical, and residential settings. CONCLUSION Study findings support the use of the abbreviated GSIS scales when conducting research on suicide risk identification among older adults. Future research is recommended testing these scales prospectively in public health, residential, and clinical settings, in research and healthcare delivery contexts.
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Affiliation(s)
- Marnin J Heisel
- Departments of Psychiatry and of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Center for the Study and Prevention of Suicide, University of Rochester Medical Center, Rochester, USA
| | - Gordon L Flett
- Department of Psychology, York University, Toronto, Ontario, Canada
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33
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Widdershoven G, Beekman A, Evans N, van Veen S. The Role of Suffering in the "Tired of Life" Debate. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:68-70. [PMID: 35089841 DOI: 10.1080/15265161.2021.2013981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
| | | | | | - Sisco van Veen
- Amsterdam University Medical Centre, VUMC site
- GGZ inGeest
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34
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Lohman MC, Ko TM, Rapp A, Bennion E, Mezuk B. State Variation in Long-Term Care Availability, Regulation, and Cost and Suicide Mortality Among Older Adults in the United States: 2010-2015. J Am Med Dir Assoc 2021; 22:2337-2343.e3. [PMID: 33722567 PMCID: PMC8483567 DOI: 10.1016/j.jamda.2021.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/01/2021] [Accepted: 02/05/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Residential long-term care (LTC) facilities may be key settings for the prevention of suicide among older adults; however, little is known about the relationship between statewide policies determining characteristics of LTC facilities and suicide mortality. The primary goal of this study was to evaluate the association between state policies regarding availability, regulation, and cost of LTC and suicide mortality among adults aged 55 and older in the United States over a 5-year period. DESIGN Longitudinal ecological study. SETTING AND PARTICIPANTS LTC residents from 16 states reporting mortality data to the National Violent Death Reporting System (NVDRS) from 2010 to 2015. METHODS We linked suicide data from the NVDRS and data sources on LTC services and regulations for 16 states. We applied a natural language-processing algorithm to identify suicide deaths related to LTC. We used fixed effect regression models to assess whether state variation in LTC characteristics is related to variation in the rate of suicide (both overall and related to LTC) among older adults. RESULTS There were 25,040 suicides among those aged 55 and older reported to the NVDRS during the study period; 382 suicides were determined to be associated with LTC in some manner. After adjusting for state-level characteristics, greater average nursing home capacity was significantly associated with increase in the cumulative incidence of suicide related to LTC (β = 0.087, SE = 0.026, P < .01), but not overall suicide incidence. Neither cost nor regulation measures were significantly associated with state-level LTC-related suicide incidence. CONCLUSIONS AND IMPLICATIONS State-level variations in LTC facility capacity are related to variation in LTC-related suicide incidence among older adults. Given the challenges of preventing suicide among older adults through facility- or individual-level interventions, policies governing the features and provision of LTC services may therefore serve as a means for public health suicide prevention.
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Affiliation(s)
- Matthew C Lohman
- Department of Epidemiology and Biostatistics, University of South Carolina, Arnold School of Public Health, Columbia, SC, USA.
| | - Tomohiro M Ko
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA; Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - Ashley Rapp
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Erica Bennion
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Briana Mezuk
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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35
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Lutzman M, Sommerfeld E. The role of meaning in life as a protective factor in suicidal ideation among elderly men with physical illnesses. CURRENT PSYCHOLOGY 2021; 42:10603-10612. [PMID: 34629829 PMCID: PMC8486633 DOI: 10.1007/s12144-021-02332-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2021] [Indexed: 10/25/2022]
Abstract
The highest suicide rates are among elderly men. The aim of the present study is to extend previous findings by focusing on meaning in life as a protective factor for suicidal ideation among elderly men. Self-report measures were administered to 170 elderly men aged 65 and over in community. Meaning in life and physical illness predicted suicidal ideation among elderly men. Physical illness moderated the association between meaning in life and suicidal ideation. In the young-old group (ages 65-74), meaning in life predicted suicidal ideation among those who reported higher rates of physical illness. This moderation effect was not found among the older group (aged 75 years and older). The findings of this study highlight the importance of age-differences in studying suicidal ideation among elderly men. Our findings emphasize the importance of cultivating and maintaining meaning in life when coping with chronic illnesses and point at meaning in life as a goal in therapeutic interventions designed to reduce suicidal ideation among elderly.
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Affiliation(s)
- Mira Lutzman
- Department of Psychology, Ariel University, Ariel, Israel
- Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
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36
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Passive Suicidal Ideation in Older Adults from 12 European Countries. JOURNAL OF POPULATION AGEING 2021. [DOI: 10.1007/s12062-021-09350-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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37
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Beach VL, Brown SL, Cukrowicz KC. Examining the relations between hopelessness, thwarted interpersonal needs, and passive suicide ideation among older adults: does meaning in life matter? Aging Ment Health 2021; 25:1759-1767. [PMID: 33317336 DOI: 10.1080/13607863.2020.1855102] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Older adults are at an elevated risk for passive suicide ideation. The interpersonal theory of suicide and the 3-step theory may provide a framework to better understand factors that contribute to passive suicide ideation among older adults. Specifically, this study aimed to test components of prominent suicide theories and examine the role of meaning in life in the associations between hopelessness, thwarted belongingness, perceived burdensomeness and passive suicide ideation among older adults. Participants were 243 adults aged 60 and older recruited from primary care settings in the southwest United States. We hypothesized that high meaning in life would weaken the associations between hopelessness, thwarted belongingness, perceived burdensomeness and passive suicide ideation. Results from moderation analyses indicate that meaning in life was a significant moderator of the associations between hopelessness and passive suicide ideation, thwarted belongingness and passive suicide ideation, and perceived burdensomeness and passive suicide ideation. These findings suggest that when meaning in life is low there are significant negative associations between hopelessness, thwarted belongingness, perceived burdensomeness and passive suicide ideation among older adults. Implications, limitations, and future directions are discussed.
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Affiliation(s)
- Victoria L Beach
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Sarah L Brown
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA.,Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kelly C Cukrowicz
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
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38
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Gregg JJ, Cui R, Edelstein BA, Fiske A. Development and initial validation of the Hopelessness Inventory for Later Life (HILL). Aging Ment Health 2021; 25:1740-1749. [PMID: 32426988 DOI: 10.1080/13607863.2020.1768213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Hopelessness is associated with depression, physical illness, and mortality. It is a key risk factor for suicidality in later life. Limitations have been identified in available hopelessness assessment measures regarding their use with older adults. The current study describes the development and initial psychometric evaluation of a content-valid, self-report scale for late-life hopelessness (i.e. the Hopelessness Inventory for Later Life; HILL). METHODS A sample of 265 older adults (ages 60-99, M = 71.1, SD = 6.7) was recruited through a combination of in-person, online, and mailed solicitations. Participants completed a survey battery containing the preliminary HILL and measures of related constructs (e.g. depression, anxiety, suicide risk, social support) to examine its psychometric properties. RESULTS Multiple analytic item selection strategies resulted in two viable versions of the scale: the HILL and the HILL-Shortened (HILL-S). Both exhibited strong item response characteristics and preliminary evidence of unidimensionality (via factor analysis), internal consistency (α = .96 and α = .89, respectively), and construct validity (via correlations with related constructs). CONCLUSION Findings provide preliminary psychometric support for both the HILL and HILL-S. Advantages for use of the HILL and the HILL-S over existing measures of hopelessness are discussed.
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Affiliation(s)
- Jeffrey J Gregg
- Department of Psychology, West Virginia University, Morgantown, WV, USA.,Durham VA Health Care System, Durham, NC, USA.,Department of Medicine - Geriatrics, Duke University, Durham, NC, USA
| | - Ruifeng Cui
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Barry A Edelstein
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Amy Fiske
- Department of Psychology, West Virginia University, Morgantown, WV, USA
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Fullen MC, Shannonhouse LR, Mize MC, Miskis C. Mental health distress in homebound older adults: Importance of the aging network. Aging Ment Health 2021; 25:1580-1584. [PMID: 32347109 DOI: 10.1080/13607863.2020.1758920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Homebound older adults may be at risk of suicide due to elevated loneliness, social isolation, and depression. The Interpersonal Theory of Suicide posits that thwarted belongingness, perceived burdensomeness, and reduced fear of death are key components of suicide risk. To better understand suicide risk among culturally diverse, homebound older adults, we collected baseline data on the prevalence of psychological distress, thwarted belongingness, perceived burdensomeness, and past/present suicidality. Standardized measures were completed by 493 adults (ages 60-103) during in-home interviews, and results were compared to existing cutoffs to assess current risk. In total, 15.62% scored above the suicide risk cutoff, 23.73% of homebound older adults reported a history of suicidal ideation or behavior, 65 adults in this sample (13.18%) indicated the possibility of attempting suicide in the future, and 2.43% described a future attempt as "likely" or "very likely." There were no differences in suicide risk, thwarted belongingness, or perceived burdensomeness based on sex and race. However, there was a significant difference in psychological distress (F(3,428) = 2.624, p = .05), with White females (M = 7.90, SD = 5.63; N = 78) scoring higher than Black males (M = 5.43, SD = 5.04; N = 81). Using Aging Network services such as nutrition services (e.g.home-delivered meal programs) to intervene with at-risk older adults represents a strategy to prevent suicide. Implications for suicide intervention, including the potential to deliver services by linking them to nutrition services programs, are discussed.
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Affiliation(s)
- Matthew C Fullen
- Virginia Tech, School of Education, College of Liberal Arts and Human Sciences, Blacksburg, Virginia, USA
| | - Laura R Shannonhouse
- Department of Counseling and Psychological Services, College of Education and Human Development, Georgia State University, Atlanta, Georgia, USA
| | - Mary Chase Mize
- Department of Counseling and Psychological Services, College of Education and Human Development, Georgia State University, Atlanta, Georgia, USA
| | - Constantinos Miskis
- US Department of Health and Human Services, Administration for Community Living, Atlanta, Georgia, USA
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40
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Shim Y, Choe K, Kim KS, Kim JS, Ha J. The applicability of the interpersonal-psychological theory of suicide among community-dwelling older persons. Suicide Life Threat Behav 2021; 51:816-823. [PMID: 33870547 DOI: 10.1111/sltb.12757] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 07/03/2020] [Accepted: 03/05/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study examined the application of the interpersonal-psychological theory of suicide to community-dwelling older persons in South Korea. METHODS A cross-sectional study design was used. The data were collected by surveying 200 older persons (117 female, 83 male) aged over 65 years at welfare centers for older persons. The Interpersonal Needs Questionnaire, the Suicidal Ideation Scale, and the Acquired Capability for Suicide Scale were used to assess participants' thwarted belongingness, perceived burdensomeness, suicidal ideation, attempts, and the capability for suicide. Structural equation modeling was used to examine the fitness of a model based on the interpersonal-psychological theory of suicide. This theory described that perceived burdensomeness and thwarted belongingness lead to suicidal ideation, which is transformed into suicide attempts through an acquired capability for suicide. RESULTS Perceived burdensomeness was significantly associated with suicidal ideation among older persons, whereas thwarted belongingness was not. Furthermore, suicidal ideation influenced suicide attempts. The acquired capability for suicide moderated the relationship between suicidal ideation and suicide attempts. CONCLUSIONS To prevent suicidal ideation and suicide attempts among older persons, it is important to prevent them from feeling that they are a burden.
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Affiliation(s)
- Yuhwa Shim
- Department of Nursing, Chung-Ang University, Seoul, Korea
| | - Kwisoon Choe
- Department of Nursing, Chung-Ang University, Seoul, Korea
| | - Ki-Sook Kim
- Department of Nursing, Chung-Ang University, Seoul, Korea
| | - Ji-Su Kim
- Department of Nursing, Chung-Ang University, Seoul, Korea
| | - Jeongmin Ha
- Department of Nursing, Chung-Ang University, Seoul, Korea
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41
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Van Orden KA, Areán PA, Conwell Y. A Pilot Randomized Trial of Engage Psychotherapy to Increase Social Connection and Reduce Suicide Risk in Later Life. Am J Geriatr Psychiatry 2021; 29:789-800. [PMID: 33952416 PMCID: PMC8286301 DOI: 10.1016/j.jagp.2021.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/09/2021] [Accepted: 03/29/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Targeting social connection to prevent suicide in later life shows promise but requires additional study to identify the most effective and acceptable interventions. This study examines acceptability, feasibility, and efficacy of Engage Psychotherapy to improve subjective disconnection (target mechanisms: low belonging and perceived burden), and improve clinical and functional outcomes (depression, suicide ideation, quality of life). METHODS Pilot randomized trial with adults age 60 and older who reported feeling lonely and/or like a burden. Participants were randomly assigned to 10 sessions of 'Social Engage' (S-ENG; n = 32) or care-as-usual (CAU; n = 30), with follow-up assessments at 3 weeks, 6 weeks, and 10 weeks. RESULTS S-ENG is feasible to deliver over 10 sessions and acceptable to older adults who report social disconnection-a population at risk for suicide. Participants were willing and able to focus each session on social engagement and demonstrated high levels of compliance. Social Engage did not show preliminary evidence of impact on belonging or perceived burden but was effective in reducing depressive symptoms and improving social-emotional quality of life. DISCUSSION S-ENG holds promise for improving social-emotional quality of life and depressive symptoms. Future research is needed to identify and measure target mechanisms that account for clinical and functional improvement.
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Affiliation(s)
- Kimberly A Van Orden
- Department of Psychiatry (KAO, YC), University of Rochester Medical Center, Rochester, NY.
| | - Patricia A Areán
- Department of Psychiatry & Behavioral Sciences (PAA), University of Washington, WA
| | - Yeates Conwell
- Department of Psychiatry (KAO, YC), University of Rochester Medical Center, Rochester, NY
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Jiang B, Shen K, Sullivan WC, Yang Y, Liu X, Lu Y. A natural experiment reveals impacts of built environment on suicide rate: Developing an environmental theory of suicide. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 776:145750. [PMID: 33647665 DOI: 10.1016/j.scitotenv.2021.145750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/22/2021] [Accepted: 02/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Suicide is a global challenge. Although it is clear that socioeconomic and demographic factors influence suicide rates, we know little about the impacts of the built environment on suicide rates. METHODS We investigated the relationship between characteristics of the built environment and suicide death rates over a 13-year period in 151 rent-only public housing communities in Hong Kong. The regulations of the public housing authority in Hong Kong constituted a natural experiment with minimal self-selection bias. We conducted hierarchical regression analyses and found that characteristics of the built environment were significantly associated with suicide rates after controlling for SES and demographic factors at the community level. RESULTS Three significant environmental factors were identified distance to the nearest urban center, distance to the nearest Mass Transit Railway station, and gross flat area per person. CONCLUSION These findings demonstrate a significant association between features of the built environment and suicide rates. They also suggest possible interventions that might reduce suicide through design, or redesign, of the built environment. Lastly, we propose an environmental theory of suicide based on the Interpersonal Theory of Suicide.
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Affiliation(s)
- Bin Jiang
- Virtual Reality Lab of Urban Environments and Human Health, HKUrbanLabs, The University of Hong Kong, Hong Kong; Division of Landscape Architecture, Department of Architecture, The University of Hong Kong, Hong Kong.
| | - Ke Shen
- Virtual Reality Lab of Urban Environments and Human Health, HKUrbanLabs, The University of Hong Kong, Hong Kong; Division of Landscape Architecture, Department of Architecture, The University of Hong Kong, Hong Kong
| | - William C Sullivan
- Department of Landscape Architecture, University of Illinois at Urbana-Champaign, USA
| | - Yiyang Yang
- Department of Architecture and Civil Engineering, College of Engineering, City University of Hong Kong, Hong Kong
| | - Xueming Liu
- Virtual Reality Lab of Urban Environments and Human Health, HKUrbanLabs, The University of Hong Kong, Hong Kong
| | - Yi Lu
- Department of Architecture and Civil Engineering, College of Engineering, City University of Hong Kong, Hong Kong.
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Erlangsen A, Banks E, Joshy G, Calear AL, Welsh J, Batterham PJ, Conwell Y, Salvador-Carulla L. Physical, mental, and social wellbeing and their association with death by suicide and self-harm in older adults: a community-based cohort study. Int J Geriatr Psychiatry 2021; 36:647-656. [PMID: 33166417 DOI: 10.1002/gps.5463] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/01/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To assess associations between physical, mental, and social well-being and suicide and self-harm in a community-based sample of older adults. METHODS Using a cohort design, questionnaire data from 102,880 individuals aged 65 years or older living in New South Wales, Australia during 2006-2009 were linked to hospital and cause-of-death databases until 2017. Poisson regressions obtained adjusted incidence rate ratios (IRRs). RESULTS One hundred nine suicides and 191 deliberate self-harm (DSH) events occurred. Compared to those reporting excellent/good overall health, older adults reporting fair overall health had higher suicide rates (IRR = 2.8, 95% confidence interval: 1.8-4.4). Also, suffering from physical limitations was associated with higher rates of suicide. A fair versus excellent/good memory was associated with higher rates of suicide (IRR = 2.0, 1.3-3.3). Male erectile dysfunction was linked to self-harm (IRR = 2.8, 1.0-7.7). Suicide rates were elevated with baseline Kessler-10 scores of 20-50 versus 10-15 (IRR = 5.0, 2.9-8.9); the corresponding IRR for DSH was 2.9 (1.8-4.8). Elevated rates were observed for both self-reported depression and anxiety. Poor versus excellent/good quality of life was associated with suicide (IRR = 4.3, 1.7-10.7) and achieving less than desired to due to emotional problems was linked to self-harm (IRR = 1.8 1.3-2.4). Rates of suicide ande DSH were lower in those with ≥5 people to depend on versus one (suicide: IRR = 0.5, 0.3-0.9; DSH: IRR = 0.5, 0.3-0.7). CONCLUSIONS Older adults experiencing health problems, including those relating to overall health or memory, and those with psychological distress had elevated rates of suicidal behavior. Rates of subsequent self-harm and/or death by suicide were elevated in participants with small social networks.
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Affiliation(s)
- Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Copenhagen Research Centre For Mental Health, Capital Region of Denmark, Denmark.,Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Grace Joshy
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Jennifer Welsh
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Yeates Conwell
- Center for the Study and Prevention of Suicide, University of Rochester Medical Center, Rochester, New York, USA
| | - Luis Salvador-Carulla
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
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Bryan CJ, May AM, Thomsen CJ, Allen MH, Cunningham CA, Wine MD, Taylor KB, Baker JC, Bryan AO, Harris JA, Russell WA. Psychometric evaluation of the suicide cognitions scale-revised (SCS-R). MILITARY PSYCHOLOGY 2021. [DOI: 10.1080/08995605.2021.1897498] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Craig J. Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Alexis M. May
- Department of Psychology, Wesleyan University, Middletown, Connecticut
| | - Cynthia J. Thomsen
- Department of Psychiatry, Naval Health Research Center, San Diego, California
| | | | | | | | | | - Justin C. Baker
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - AnnaBelle O. Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Julia A. Harris
- Department of Psychology, The University of Utah, Salt Lake City, Utah
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Factors Influencing Suicidal Ideation and Attempts among Older Korean Adults: Focusing on Age Discrimination and Neglect. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041852. [PMID: 33672881 PMCID: PMC7917585 DOI: 10.3390/ijerph18041852] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/06/2021] [Accepted: 02/11/2021] [Indexed: 11/28/2022]
Abstract
This study was conducted to identify factors influencing the development of suicidal ideation and the transition from suicidal ideation to attempts by focusing on experiences of age discrimination and neglect among older Korean adults. This study analyzed data from 10,042 older adults from the 2017 National Survey of Older Koreans using national representative samples. Multiple logistic analyses were used to identify factors influencing the development of suicidal ideation and transition from suicidal ideation to attempts. While younger age, higher educational attainment, living alone, number of chronic diseases, depressive symptoms, social isolation, social support, experience of neglect, and age discrimination influenced the development of suicidal ideation, all of these did not influence the transition from ideation to attempts. Factors influencing this transition included male gender, less educational attainment, and experience of age discrimination. Thus, social efforts to reduce age discrimination are necessary to prevent suicide attempts among Korean older adults.
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Sheffler JL, Joiner TE, Sachs-Ericsson NJ. The Interpersonal and Psychological Impacts of COVID-19 on Risk for Late-Life Suicide. THE GERONTOLOGIST 2021; 61:23-29. [PMID: 32959869 PMCID: PMC7454594 DOI: 10.1093/geront/gnaa103] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Indexed: 11/13/2022] Open
Abstract
Older adults experience increased risk for suicide compared to the general population, and the circumstances surrounding the Coronavirus Disease 2019 (COVID-19) may potentiate this risk. We discuss how current COVID-19 pandemic-related policies are likely to harm older adults disproportionately. COVID-19 pandemic social distancing policies and ethical guidelines for COVID-19 treatment may exacerbate experiences of social isolation, perceived expendability, and exposure to suffering, which are related to the three main components of the Interpersonal Theory of Suicide (i.e., thwarted belongingness, perceived burdensomeness to society, and capability for suicide). The COVID-19 pandemic poses a drain on services and has drawn ethical debates about policies around treating younger adults first. These experiences may lead older adults to have reduced access to needed medical and psychiatric services and may convey damaging messages of expendability. Further, the potential prolonged stress associated with the COVID-19 pandemic may impact neurological, immunological, and health functioning – exacerbating suicide risk. Potential venues to increase treatment options and decrease social isolation are discussed. We acknowledge optimistic effects as well, such as ‘pulling together’ as a society and the many valuable ways older adults may contribute during this crisis.
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Affiliation(s)
- Julia L Sheffler
- Center for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee
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Pennington ML, Ylitalo KR, Lanning BA, Dolan SL, Gulliver SB. An epidemiologic study of suicide among firefighters: Findings from the National Violent Death Reporting System, 2003 - 2017. Psychiatry Res 2021; 295:113594. [PMID: 33290941 DOI: 10.1016/j.psychres.2020.113594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022]
Abstract
Suicide is a significant concern among fire service due to high rates of suicide behaviors. The aim of this study was to describe suicides among firefighters using national suicide death data. Data from the National Violent Death Reporting System for 722 firefighters and 192,430 non-firefighters were analyzed to compare sociodemographics and risk factors between firefighter and non-firefighter decedents; and among firefighters based on suicide means. A greater proportion of firefighter decedents died by firearm compared to non-firefighters. Firefighter decedents were less likely to have been diagnosed with depression, but more likely to have been diagnosed with post-traumatic stress disorder compared to non-firefighters. A greater percentage of firefighter decedents had a relationship or physical health problem prior to death, but a lower percentage had a history of suicide thoughts/attempts. Among firefighter decedents, multivariate analysis showed physical health problems and disclosing suicide intent predicted death by firearm. Greater awareness of risk factors, reduced access to lethal means, and ensuring access to behavioral health services may aide in decreasing suicide mortality in this population. These findings should be interpreted with caution due to limitations concerning report accuracy, generalizability, small female sample size, and inclusion of data only for lethal suicide attempts.
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Affiliation(s)
- Michelle L Pennington
- Baylor University, 1311 S 5th St., Waco, TX 76708, United States; Baylor Scott & White Research Institute, 2201 MacArthur Dr., Suite 2200, Waco, TX 76708, United States.
| | - Kelly R Ylitalo
- Baylor University, 1311 S 5th St., Waco, TX 76708, United States.
| | - Beth A Lanning
- Baylor University, 1311 S 5th St., Waco, TX 76708, United States.
| | - Sara L Dolan
- Baylor University, 1311 S 5th St., Waco, TX 76708, United States.
| | - Suzy B Gulliver
- Baylor Scott & White Research Institute, 2201 MacArthur Dr., Suite 2200, Waco, TX 76708, United States; Texas A&M University Health Science Center, 2401 South 31st Street, Temple, TX 76508, United States.
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Laher N, Bocchinfuso S, Chidiac M, Doherty C, Persson A, Warren E. The Biopsychosocial Impact of COVID-19 on Older Adults. Gerontol Geriatr Med 2021; 7:23337214211034274. [PMID: 34414252 PMCID: PMC8369852 DOI: 10.1177/23337214211034274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
COVID-19 has spread rapidly around the world and taken over 2.6 million lives. Older adults experience disproportionate morbidity and mortality from the disease because increasing age and the presence of comorbidities are important predictors of negative outcomes. Lasting effects of COVID-19 have been described after recovery from the acute illness despite eradication of the virus from the body. The impact of COVID-19 on a person's biological health post-infection is observed in multiple systems including respiratory, cardiac, renal, haematological, and neurological. Psychological dysfunction following recovery is also prevalent. Social factors such as distancing and stay at home measures leave older adults isolated and food insecure; they also face intertwined financial and health risks due to the resulting economic shutdown. This study examines the effects of COVID-19 on older adults using the biopsychosocial model framework.
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Affiliation(s)
- Nazeefah Laher
- Trinity College Dublin School of Medicine, Dublin, Ireland
| | | | | | - Claire Doherty
- Trinity College Dublin School of Medicine, Dublin, Ireland
| | | | - Emma Warren
- Trinity College Dublin School of Medicine, Dublin, Ireland
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Iliceto P, D’Antuono L, Fino E, Carcione A, Candilera G, Silva C, Joiner TE. Psychometric properties of the Italian version of the Interpersonal Needs Questionnaire-15 (INQ-15-I). J Clin Psychol 2021; 77:268-285. [PMID: 32662083 PMCID: PMC8944175 DOI: 10.1002/jclp.23026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 04/13/2020] [Accepted: 06/24/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The Interpersonal Needs Questionnaire (INQ-15) is a self-report measure of thwarted belongingness and perceived burdensomeness, two constructs associated with suicidal ideation. The objective of the current study was to translate the INQ-15 from English to Italian (INQ-15-I) and to test its factor structure, reliability, and validity in Italian samples. METHOD We examined (a) whether the components of the hypothesized two-factor measurement model are invariant across a community sample (N = 510) and a clinical sample (N = 259); (b) the relations between the INQ-15-I factors and measures of depression (Beck Depression Inventory-II), hopelessness (Beck Hopelessness Scale), and suicidal ideation (Beck Scale for Suicide Ideation); (c) the reliability and psychometric properties of the INQ-15-I. RESULTS Results from multigroup confirmatory factor analyses supported the adequacy of the two-factor model to represent thwarted belongingness and perceived burdensomeness. The model is invariant across community and clinical groups, showing excellent fit. The two INQ-15-I scales measure highly intercorrelated constructs. Both significantly correlate with depression, hopelessness, and suicidal ideation, and correlations are high in the clinical sample. CONCLUSION The INQ-15-I is a valid and reliable measure of thwarted belongingness and perceived burdensomeness. Implications for research, assessment, and intervention in suicidal ideation are discussed.
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Affiliation(s)
| | | | - Emanuele Fino
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | | | | | - Caroline Silva
- Department of Psychiatry, University of Rochester School of Medicine & Dentistry, Rochester, New York, USA
| | - Thomas E. Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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Gratz KL, Tull MT, Richmond JR, Edmonds KA, Scamaldo KM, Rose JP. Thwarted belongingness and perceived burdensomeness explain the associations of COVID-19 social and economic consequences to suicide risk. Suicide Life Threat Behav 2020; 50:1140-1148. [PMID: 32589811 PMCID: PMC7361587 DOI: 10.1111/sltb.12654] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The social and economic consequences of COVID-19 and related public health interventions aimed at slowing the spread of the virus have been proposed to increase suicide risk. However, no research has examined these relations. This study examined the relations of two COVID-19 consequences (i.e., stay-at-home orders and job loss) to suicide risk through thwarted belongingness, perceived burdensomeness, and loneliness. METHOD Online data from a nationwide community sample of 500 adults (mean age = 40) from 45 states were collected between March 27 and April 5, 2020. Participants completed measures assessing thwarted belongingness, perceived burdensomeness, loneliness, and suicide risk, as well as whether they (a) were currently under a stay-at-home order and (b) had experienced a recent job loss due to the pandemic. RESULTS Results revealed a significant indirect relation of stay-at-home order status to suicide risk through thwarted belongingness. Further, whereas recent job loss was significantly correlated with suicide risk, neither the direct relation of job loss to suicide risk (when accounting for their shared relations to perceived burdensomeness) nor the indirect relation through perceived burdensomeness was significant. CONCLUSIONS Results highlight the potential benefits of interventions targeting thwarted belongingness and perceived burdensomeness to offset suicide risk during this pandemic.
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Affiliation(s)
- Kim L. Gratz
- Department of PsychologyUniversity of ToledoToledoOHUSA
| | | | | | | | | | - Jason P. Rose
- Department of PsychologyUniversity of ToledoToledoOHUSA
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