Impact of Economic Hardship and Financial Threat on Suicide Ideation and Confusion

The mediating effect of institutional trust in the relationship between precarity and conspiracy beliefs: A conceptual replication of Adam-Troian et al. (2023)

The paper reports the results of registered conceptual replications of the indirect effect of institutional trust in the relationship between precarity and the endorsement of conspiracy beliefs (CB). The original study of Adam-Troian et al. (2023; British Journal of Social Psychology, 62(S1), 136-159) indicated that subjective appraisals of economic hardship are associated with lower trust in governments and institutions, which in turn is associated with stronger endorsement of CB. Our Studies 1 to 3 report a series of replications using Slovak panel data. Study 4 reports a replication of the mediation model using data from the European Social Survey Round 10 collected in 17 countries. To provide a quantitative synthesis of these and previous results, we conducted mini meta-analysis (N = 50,340). Although the strength of the observed relationships differed across the studies to some degree, the original patterns of relations remained robust, supporting the original model. The study corroborates the view that to curb the spread of CB, it is necessary to address structural issues, such as growing financial insecurity, socioeconomic inequalities, and the deficit of institutional trust. Finally, we discuss the role of cultural and political settings in conditioning the mechanisms through which precarity enhances the endorsement of CB.

Sociodemographic and environmental characteristics associated with thoughts of death and suicidal ideation in community-dwelling residents of a rural town in Japan: analyses from a perspective of accompanying problems

OBJECTIVE

Suicide prevention has been focused on primary prevention as a group rather than individuals. However, we aimed to identify sociodemographic and environmental characteristics of individuals with suicidal thoughts among rural residents in Japan.

METHODS

In 2015, a cross-sectional home visit survey was conducted in a rural town in Akita Prefecture. A total of 1,844 residents aged ≥ 20 years (response rate, 65%) answered a self-administered questionnaire about suicidal thoughts in the past one month. Multivariate logistic regression analyses were used to investigate sociodemographic and environmental characteristics associated with suicidal thoughts in models with accompanying problems for human relations problems (HRP), health problems (HP), and financial problems (FP), or with no accompanying problems.

RESULTS

In total, 218 (men 9.4%, women 13.8%) had suicidal thoughts with accompanying problems for HRP (n = 104), HP (n = 112), and FP (n = 72). The risk characteristics were Kessler Psychological Distress Scale scores ≥ 9 in models with HRP, HP, and FP or with no accompanying problems; being a woman and current smoking with no accompanying problems; absence of a person for help in a model of FP; and absence of family member for help in a model of HRP or with no accompanying problems. The mitigating factor were being optimistic (a domain of resilience skills identified by factor analysis) in models of HRP, HP, and FP or with no accompanying problems; being aged 70-79 and being aged ≥ 80 in a model of HRP.

CONCLUSIONS

Suicidal thoughts among rural residents in Japan were associated with multifactorial sociodemographic and environmental characteristics.

Psychosocial and financial well-being mediated the effects of COVID-19 distress on suicidality: a serial mediation model among Hong Kong young adults

PURPOSE

The COVID-19 pandemic has brought significant distress on not only the physical health but also mental health of individuals. The present study investigated the direct and indirect effects from COVID-19 distress to suicidality via psychosocial and financial well-being among young people.

METHODS

This cross-sectional survey recruited 1472 Hong Kong young people via random sampling in 2021. The respondents completed a phone survey on COVID-19 distress, the four-item Patient Health Questionnaire and items on social well-being, financial well-being, and suicidality. Structural equation modeling (SEM) was conducted to examine the direct and indirect effects of COVID-19 distress on suicidality via psychosocial and financial well-being.

RESULTS

The direct effect of COVID-19 distress on suicidality was not significant (β = 0.022, 95% CI  - 0.097-0.156). The total indirect effect from COVID-19 distress to suicidality was significant and positive (αβγ = 0.150, 95% CI = 0.085-0.245) and accounted for 87% of the total effect (B = 0.172, 95% CI = 0.043-0.341). There were significant specific indirect effects via social well-being and psychological distress, and financial well-being and psychological distress.

CONCLUSION

The present findings support different pathways from COVID-19 distress to suicidality via functioning in different domains among young people in Hong Kong. Measures are needed to ameliorate the impact on their social and financial well-being to reduce their psychological distress and suicidality.

The Association between Perceived Family Financial Stress and Adolescent Suicide Ideation: A Moderated Mediation Model

Nowadays, suicide (especially adolescents' suicide) has been an increasingly prominent social problem worldwide; suicide ideation, as an important predictor, has been the focus of relevant studies and practices. Against this background, the present study aimed to examine the association between perceived family financial stress and adolescents' suicidal ideation, as well as the potential roles of depression and parent-child attachment. A sample of 526 junior middle school students was recruited voluntarily to participate in this cross-sectional study, and the results indicated that the prevalence of suicidal ideation among junior high school students was 15.45%; perceived family financial stress was positively associated with suicidal ideation, and depression could significantly mediate this relation; parent-child attachment significantly moderated the mediating effect of depression (in particular, the relation between depression and suicidal ideation); specifically, this relation was stronger among adolescents with lower values of parent-child attachment. These findings could deepen our understanding of the influences of perceived family financial condition and the risky factors of adolescents' suicidal ideation, which could provide guidance for the prevention and intervention of adolescents' depression and suicidal ideation.

Social connectedness and mental health before and during the COVID-19 pandemic in a community sample in Korea

This study compared social connectedness patterns and examined the relationships between objective or subjective social connectedness and mental health before and during the COVID-19 pandemic among community dwelling adults in South Korea. An identical online survey was administered at two time points, in 2019 prior to the onset and again in 2021. Objective (network diversity and network size) and subjective (thwarted belongingness and perceived burdensomeness) social connectedness were measured along with positive and negative indices of mental health (depression, suicidal behavior, happiness, and life satisfaction). The results indicated that among social connectedness indices perceived burdensomeness were significantly higher during the COVID-19 pandemic compared to the prior period, while network size was smaller. Subjective social connectedness was associated with all aspects of mental health consequences, either positive or negative. Among objective social connectedness, only network diversity was significantly associated with increased happiness and life satisfaction, and objective social connectedness was not associated with depression and suicidal behavior. These associations did not differ across the two time periods. The findings, both before and during the pandemic, indicated that network diversity is an important factor for positive indices of mental health and that efforts to increase subjective social connectedness are needed to decrease the risk of depression and suicidal behavior.

Behavioral and psychosocial factors related to mental distress among medical students

Introduction

Physicians die by suicide at rates higher than the general population, with the increased risk beginning in medical school. To better understand why, this study examined the prevalence of mental distress (e.g., depressive symptoms and suicide risk) and behavioral and psychosocial risk factors for distress, as well as the associations between mental distress and risk factors among a sample of medical students in a pre-COVID-19-era.

Methods

Students enrolled in a large California medical school in 2018-2019 (N = 134; 52% female) completed questionnaires assessing sociodemographic characteristics, depression and suicide family history, health behaviors, and psychosocial wellbeing. Assessment scores indexing mental distress (e.g., depressive symptoms, thoughts of suicide in the past 12 months, suicide risk, and history of suicidality) and risk factors (e.g., stress, subjective sleep quality, alcohol use, impostor feelings, and bill payment difficulty) were compared across biological sex using chi-squared tests, and associations between mental distress and risk factors were determined through logistic regression.

Results

Elevated mental distress indicators were observed relative to the general public (e.g., 16% positive depression screen, 17% thought about suicide in previous 12 months, 10% positive suicide risk screen, and 34% history of suicidality), as well as elevated risk factors [e.g., 55% moderate or high stress, 95% at least moderate impostor feelings, 59% poor sleep quality, 50% screened positive for hazardous drinking (more likely in females), and 25% difficulty paying bills]. A positive depression screen was associated with higher stress, higher impostor feelings, poorer sleep quality, and difficulty paying bills. Suicidal ideation in the previous 12 months, suicide risk, and a history of suicidality were independently associated with higher levels of impostor feelings.

Discussion

Higher scores on assessments of depressive symptoms and suicidal thoughts and behaviors were related to several individual-level and potentially modifiable risk factors (e.g., stress, impostor feelings, sleep quality, and bill payment difficulties). Future research is needed to inform customized screening and resources for the wellbeing of the medical community. However, it is likely that the modification of individual-level risk factors is limited by the larger medical culture and systems, suggesting that successful interventions mitigate suicide risk for medical providers need to address multiple socio-ecological levels.

Health, Suicidal Thoughts, and the Life Course: How Worsening Health Emerges as a Determinant of Suicide Ideation in Early Adulthood

Poor physical health places adults at greater risk for suicide ideation. However, the linkage between health and suicidal thoughts may emerge and become established during early adulthood, concomitant with other social processes underlying suicidality. Using nationally representative survey data from Waves III through V of the National Longitudinal Study of Adolescent to Adult Health (n = 8,331), we examine the emergence of health as a predictor of suicide ideation across the early adult life course (ages 18-43). We find that worsening health does not significantly predict suicide ideation until young adults approach the transition into midlife. Our findings suggest this may be due to the increasing severity of health problems, reduced social network engagement, and disruption of social responsibilities later in early adulthood. Our findings underscore the need for social science research to examine the relationship between mental and physical health from a life course perspective.

Personal well-being and financial threats in Peruvian adults: The mediating role of financial well-being

Crises negatively affect the economy of a country, increasing financial risk, as they affect work activities and the well-being of the population. This study aimed to examine the mediating role of financial well-being in the relationship between personal well-being and financial threats. A predictive cross-sectional study was conducted. The variables analyzed were personal well-being, financial threats, and financial well-being. A total of 416 Peruvian adults from the three regions of Peru participated. The mean age was M = 35.36, SD = 8.84, with a range of 19-62 years. To represent the statistical mediation model, a structural equation model (SEM) was used. The analysis showed that the variables were significantly related (p < 0.001). The theoretical model indicated a perfect mediation, also obtaining a good fit, χ ²(168) = 394.3, CFI = 0.931, RMSEA = 0.057, SRMR = 0.062. The study showed that personal well-being serves as a basis for promoting financial well-being and this contributes to the reduction of financial threats.

Three leading suicide methods in the United States, 2017-2019: Associations with decedents' demographic and clinical characteristics

Background and aims

The U.S. suicide data show that use of lethal methods, specifically firearms and hanging/suffocation, has been increasing among young and middle-aged adults of both sexes over the past decades. In this study, we examined demographic and clinical correlates of use of firearms, hanging/suffocation, and poisoning as suicide methods among suicide decedents age 18+.

Methods

Data came from the 2017-2019 National Violent Death Reporting System (NVDRS; N = 94,454, age ≥ 18 at the time of suicide; 74,042 men and 20,412 women). We fit generalized linear models (GLMs) for a Poisson distribution with a log link to examine (1) changes in four suicide methods (firearms, hanging/suffocation, poisoning, and other) during the study period, controlling for sex and age group; and (2) correlates of firearms, hanging/suffocation, and poisoning use.

Results

In all age groups, 55% of men and 30% of women used firearms; 28% of men and 29% of women hanging/suffocation; 9% of men and 32% of women poisoning, and 8% of men and 9% of women "other" methods. Men age < 45 had higher likelihood of firearm and/or hanging/suffocation use than those age 45-64. Women age<45 also had higher likelihood of hanging/suffocation than those age 45-64. Prior suicide attempt history was associated with higher likelihood of poisoning in both sexes and hanging/suffocation in men; mental disorders/SUD were associated with higher likelihood of hanging/suffocation and poisoning in both sexes; physical health problems were associated with higher likelihood poisoning in both sexes and firearm use in men; relationship problems were associated with higher likelihood of firearm use; legal problems and job/financial/housing problems were associated with higher likelihood of hanging/suffocation in both sexes; and more crises were associated with higher likelihood of firearm use in both sexes.

Implications

The findings call for the following suicide prevention strategies: (1) restricted access to firearms; (2) improved access to mental health/substance use treatment; (3) improved long-term and palliative care services for those (mostly older adults) with physical health problems; (4) financial/housing support policies to mitigate economic hardship; and (5) more research to identify effective strategies to curtail the increasing use of firearm and hanging/suffocation among young and middle-aged adults.

Mining voices from self-expressed messages on social-media: Diagnostics of mental distress during COVID-19

The COVID-19 pandemic has had a severe impact on mankind, causing physical suffering and deaths across the globe. Even those who have not contracted the virus have experienced its far-reaching impacts, particularly on their mental health. The increased incidences of psychological problems, anxiety associated with the infection, social restrictions, economic downturn, etc., are likely to aggravate with the virus spread and leave a longer impact on humankind. These reasons in aggregation have raised concerns on mental health and created a need to identify novel precursors of depression and suicidal tendencies during COVID-19. Identifying factors affecting mental health and causing suicidal ideation is of paramount importance for timely intervention and suicide prevention. This study, thus, bridges this gap by utilizing computational intelligence and Natural Language Processing (NLP) to unveil the factors underlying mental health issues. We observed that the pandemic and subsequent lockdown anxiety emerged as significant factors leading to poor mental health outcomes after the onset of COVID-19. Consistent with previous works, we found that psychological disorders have remained pre-eminent. Interestingly, financial burden was found to cause suicidal ideation before the pandemic, while it led to higher odds of depressive (non-suicidal) thoughts for individuals who lost their jobs. This study offers significant implications for health policy makers, governments, psychiatric practitioners, and psychologists.

Parental Phubbing, Self-Esteem, and Suicidal Ideation among Chinese Adolescents: A Longitudinal Mediational Analysis

Parental phubbing refers to a phenomenon in which parents are distracted by their smartphones when they interact with their children. It has become a common concern and linked to adolescents' internalizing and externalizing behavior problems. However, much remains unclear about reciprocal associations among parental phubbing, self-esteem, and suicidal ideation and the potential mechanisms underlying these associations. To address these gaps, the current study tested bidirectional relationships among parental phubbing, self-esteem, and suicidal ideation, as well as the mediating role of self-esteem. In addition, the present study examined whether these relationships varied by extraversion, gender, and perceived economic stress across three time points using a cross-lagged design. A total of 2407 Chinese adolescents (50.23% girls, M_age = 12.75, SD = 0.58 at baseline) participated in the study. The results showed that parental phubbing was associated with self-esteem as well as with suicidal ideation, and there were bidirectional relationships between self-esteem and suicidal ideation. Self-esteem significantly mediated the association between parental phubbing and suicidal ideation. Extraversion moderated the link between parental phubbing and suicidal ideation as well as self-esteem and suicidal ideation during the first year. Gender and perceived economic stress did not play a moderating role. The results indicate that parental phubbing is a new risk factor for adolescents' suicidal ideation. Parents concerned about adolescents' self-esteem and suicidal ideation should focus on minimizing the frequency of smartphone use and teach adolescents some social skills to seek more sources of social support.

The prevalence of suicide ideation and predictive factors among pregnant women in the third trimester

BACKGROUND

Pregnancy is a period for women undergo major physical and psychological changes. Suicide is a cause of maternal death and suicidal ideation is a key factor in suicidal behavior. The purpose of this study was to investigate the prevalence of suicidal ideation in the third trimester and associated predictors including psychological factors such as attachment.

METHODS

A cross-sectional study included 432 pregnant women in the third trimester of pregnancy was conducted in a tertiary hospital. The Edinburgh Postpartum Depression Scale (EPDS) was used to assess prenatal depression and suicidal ideation. The Zung Self-Rating Anxiety Scale (SAS) and Experience of Close Relationship (ECR) scale were used to assess anxiety and attachment respectively.

RESULTS

The results showed that the EPDS scale screened 6.71% of pregnant women with suicidal ideation. Compared with those without suicidal ideation, pregnant women with suicidal ideation had a higher prevalence of insecure attachment, higher scores on the two dimensions of attachment (attachment avoidance and attachment anxiety), and higher prevalence of prenatal depression and anxiety. Binary logistic regression showed that marital satisfaction was a protective factor for suicidal ideation, while prenatal depression, prenatal anxiety and attachment anxiety were risk factors for suicidal ideation.

CONCLUSIONS

The suicidal ideation among pregnant women was high, which should be given more attention. In the process of preventing and intervening suicidal ideation, in addition to the emotional state of pregnant women, their psychological factors such as attachment anxiety should also be considered.

Does Belief in a Just World Moderate the Relationship Between Financial Stress and Suicide Risk in University Students?

Despite an established relationship between financial stress and suicide risk, factors that may influence this relationship are unclear. This study examined whether the belief that the world is fair and people generally get what they deserve (i.e., belief in a just world: BJW) moderates the financial stress-suicide risk relationship in university students. A total of 365 university students completed an online survey three times between May 2019 and April 2020. Multilevel model analyses indicated that financial stress increased suicide risk, after controlling for demographic factors and depression. The level of BJW-self and BJW-others moderated the relationship between financial stress and suicide risk. Specifically, the negative impact of financial stress on suicide risk was significant in students with a low or mean level of BJW-self, but not in those with a high level of BJW-self. Financial stress had a significant negative impact at all levels of BJW-others, with a stronger impact on students with lower levels of BJW others. These results suggest a need to address lower BJW, as it may worsen the financial stress-suicide risk relationship.

The Mental Health of Employees with Job Loss and Income Loss during the COVID-19 Pandemic: The Mediating Role of Perceived Financial Stress

The COVID-19 outbreak, which was followed by home confinement, is expected to have had profound negative impact on the mental health of people. Associated factors, such as losing jobs and income, can be expected to lead to an increased risk of suffering from psychopathological problems. Therefore, this study was aimed at researching the associations of job and income loss with mental health, as well as the possible mediating role of perceived financial stress during the COVID-19 outbreak. The sample included 2381 Spanish workers who were interviewed right after the first COVID-19 lockdown. Measures were taken for generalized anxiety disorder, panic attacks, depression, post-traumatic stress disorder, substance abuse, suicidal thoughts and behaviors, working conditions, sociodemographic variables, and perceived financial stress. Logistic regression models were calculated with psychological variables as outcomes, and with job loss and income loss as predictors. Mediation analyses were performed by adding the financial threat as a mediator. Nineteen point six percent and 33.9% of participants reported having lost their jobs and incomes due to the pandemic, respectively. Only income loss was related to a higher risk of suffering from depression and panic attacks. When adding financial stress as a mediator, the indirect effects of job and income loss on the mental health measures were found to be significant, therefore indicating mediation. These findings pinpoint the vulnerability of this population, and highlight the need for interventional and preventive programs targeting mental health in economic crisis scenarios, such as the current one. They also highlight the importance of implementing social and income policies during the COVID-19 pandemic to prevent mental health problems.

Financial distress and suicidal behaviour during COVID-19: Family identification attenuates the negative relationship between COVID-related financial distress and mental Ill-health

COVID-19 provides a 'perfect storm' of social and economic suicide risk-factors. Recent research has evidenced an initial impact of the pandemic upon suicide rates, but has yet to understand how elevated financial threat and social isolation may predict suicide ideation/behaviour, or which social factors promote resilience. This study addressed these shortcomings. An online longitudinal survey study (N = 370) which took place from May to September 2020 showed COVID-related financial distress predicts suicidal thoughts and behaviour via increased depression and loneliness. Family identification attenuates these relationships. Our findings reaffirm the importance of social factors in reducing mental ill-health outcomes of economic crises.

Financial hardship and suicide ideation: Age and gender difference in a Korean panel study

BACKGROUNDS

Socioeconomic factors influence suicide risk but a systematic understanding of the role of financial hardship is unclear. We examined whether financial hardship had cumulative or contemporaneous impacts on suicide ideation and any gender and age differences in a large Korean sample.

METHODS

Data of 67,728 observations from 14,321 individuals were extracted from seven waves of Korean Welfare Panel Study. The association of financial hardship at baseline and its change over two years with suicide ideation was investigated using generalized estimation equation to account for repeated measurements within an individual, adjusting for other socioeconomic factors.

RESULTS

Financial hardship was associated with suicide ideation but the magnitude of association varied across age and gender groups. Specifically, the impact of financial hardship was persistent over two years presenting a cumulative effect among men aged 50-64 years and ≥65 years; e.g., adjusted OR (adjusted odds ratio) = 3.87, 95 % CI = 2.71-5.54 for emergent hardship group vs adjusted OR = 4.22, 95 %CI = 3.00-5.93 for persistent group in those aged ≥65 years. Financial hardship increased the risk of suicide ideation incrementally with age, although the pattern was less clear among women.

LIMITATIONS

Financial hardship was identified as having changing nature, though it was assumed to occur over two years.

CONCLUSION

In general, financial hardship plays a role in amplifying suicide ideation in a contemporaneous way but also in a cumulative way, predominantly among late-middle-aged and elderly men. Monitoring and intervention for financial hardship would be a promising strategy for suicide prevention.

Job Insecurity, Work-Related Flow, and Financial Anxiety in the Midst of COVID-19 Pandemic and Economic Downturn

During the COVID-19 pandemic, every domain of industry has experienced a severe economic downturn with concomitant stress throughout the economy. Employees working in government and private sectors are experiencing different psychological problems. The current study was conducted to investigate the role of work-related flow in the relationship of job insecurity with financial anxiety in the employees working in private and government sectors of Saudi Arabia. The sample comprised 1,195 employees, 886 females, and 309 males. The participants' ages ranged from 25 to 60 years. The Financial Anxiety Scale, Work-Related Flow Inventory, and Qualitative Job Insecurity Measures were found valid and reliable. Structural equation modeling was applied to test the associations. As hypothesized, the results indicated that job insecurity was positively related to financial anxiety, work-related flow was negatively associated with financial anxiety, and work-related flow mediated the relationship between job insecurity and financial anxiety. All these associations were significant regardless of gender, age, marital status, sector of employment, income, self-rated health, and COVID-19 infection status. Further research is needed to understand the impact of job insecurity on financial anxiety in-depth through the paths of work-related flow, especially in the midst of COVID-19.

Investigation of the interpersonal theory of suicide in the context of attention-deficit/hyperactivity disorder symptomatology and suicide ideation

OBJECTIVE

The current study examines components of the Interpersonal Theory of Suicide as mediators of the association between attention-deficit/hyperactivity disorder (ADHD) symptoms and suicide ideation in college students with elevated depressive symptoms. Specifically, indirect effects of perceived burdensomeness and thwarted belongingness were simultaneously evaluated on the association between self-reported ADHD symptoms and suicide ideation, controlling for gender and levels of depression.

METHOD

Participants were 217 college students with elevated depressive symptoms (M_age  = 20.72 years old; SD = 3.74) who participated in a larger study on mood and well-being. The sample was predominantly female (77.9% female) and Hispanic (72.7%).

RESULTS

In a multivariate mediation model controlling for gender and depressive symptoms, there were significant indirect effects of perceived burdensomeness and thwarted belongingness on the association between self-reported ADHD symptoms and suicide ideation.

CONCLUSION

Perceived burdensomeness and thwarted belongingness may represent promising targets for preventing suicide ideation in individuals with elevated ADHD symptoms.

Job Insecurity and Financial Concern During the COVID-19 Pandemic Are Associated With Worse Mental Health

OBJECTIVE

To determine whether job insecurity due to COVID-19 and financial concern were associated with worse mental health during the COVID-19 pandemic.

METHOD

Participants (N = 474 employed U.S. individuals) completed an online survey from April 6 to 12, 2020. Linear regressions were used to examine factors associated with mental health.

RESULTS

After accounting for demographic characteristics, health status, other COVID-19 experiences, and anxiety symptoms, greater job insecurity due to COVID-19 was related to greater depressive symptoms. Conversely, after accounting for covariates and depressive symptoms, greater financial concern was related to greater anxiety symptoms. Further, greater job insecurity was indirectly related to greater anxiety symptoms due to greater financial concern.

CONCLUSIONS

Findings suggest that employers should aim to reduce job insecurity and financial concern among employees during the COVID-19 pandemic to address the associated mental health consequences.

COVID-19-Related Economic Anxiety Is As High as Health Anxiety: Findings from the USA, the UK, and Israel

As the COVID-19 outbreak peaks, millions of individuals are losing their income, and economic anxiety is felt worldwide. In three different countries (the USA, the UK, and Israel: N = 1200), the present study addresses four different sources of anxiety: health-related anxiety, economic-related anxiety, daily routine-change anxiety, and anxiety generated by social isolation. We hypothesized that, economic anxiety would have a similar or greater effect, compared to health anxiety. Results show that in all three countries, the levels of economic and health anxiety were essentially equal, and both surpassed routine-change and isolation anxiety. Although the COVID-19 crisis originated in the health field, this study emphasizes the need to move from a generalized concept of anxiety to specific types of distress, most notably economic anxiety. Economic anxiety results in serious mental and physical health problems and should be attended to by clinical professionals and by policy makers.

Suicides of Male Portuguese Police Officers - 10 years of National Data

Background: Police officers, as first responders to difficult situations with ready access to firearms, are frequently considered to be at increased suicide risk. Aims: We aimed to calculate the suicide rate for male officers of the Portuguese National Police (PSP) and compare it with the Portuguese general population. Method: Retrospective review of the PSP male officers' suicides between 2005 and 2014 and comparison with the suicide rate for the general Portuguese population, adjusted for sex and age. Results: A total of 39 suicides were identified, with 34 using a firearm - mostly the service one (30 cases). The average truncated (20-59 years) suicide rate for male officers was 20.6 per 100,000 person-years (95% CI =14.2-27.1). Over the same period, the rate for the general Portuguese population was 13.9 per 100,000 person-years (95% CI = 13.5-14.3). The standardized rate ratio was 1.5 (95% CI = 0.9-2.4). Limitations: Despite the 10-year period of observation, this is a small sample and there are issues with missing data, such as lack of information for retired or dismissed police officers. Denominators were converted to estimates of person-years observations and we should be mindful of the limitations in the validity of the reported rates. Conclusion: Portuguese male police officers mostly die by suicide using service firearms. The suicide rates among them were not statistically different from those of the sex- and age-adjusted general population. However, given that police officers are healthy workers, we would expect lower rates - thus, similar rates could suggest an increased risk in the study sample.

Suicidality among gambling helpline callers: A consideration of the role of financial stress and conflict

BACKGROUND AND OBJECTIVES

High rates of suicidal ideation and attempts secondary to gambling are well established among those with gambling disorders. The present study explores potential risk factors for suicidal ideation and/attempt among a sample of help-line callers.

METHODS

Participants (N = 202) completed measures assessing demographics; gambling behavior; and financial, family/social, employment, substance use, and legal difficulties related to gambling. Bivariate analyses, logistic regression, and mediation analyses were used to explore relationship between predictors and risk of suicidal ideation and attempt.

RESULTS

Female gender, gambling severity (including engagement in illegal behaviors), a history of mental health problems, financial problems, and conflict related to gambling were associated with current suicidality in this sample. Mediation analyses revealed that financial problems were associated with increased familial conflict, which was in turn associated with increased suicidality.

CONCLUSIONS

Family and social conflict may be one important way in which financial problems confer risk for suicidality among problem gamblers. These results align with findings from the substance use disorder (SUD) literature and highlight one potential factor that may merit further assessment and/or intervention.

SCIENTIFIC SIGNIFICANCE

Researchers and clinicians may want to consider the overall level of conflict a patient is experiencing when assessing suicide risk among individuals with gambling problems. Professionals may also want to consider the suitability of interventions to address conflict within the context of gambling treatment. (Am J Addict 2018;27:531-537).

Sex and age modify the relationship between life circumstances and use of a firearm in suicide deaths across 17 U.S. states

BACKGROUND

Suicides are of growing public health concern in the United States. Although the demographics of firearm suicides are well established, the sex and age differences in the role that life circumstances play in the risk for firearm suicide are not known.

METHODS

We used suicide deaths from the National Violent Death Reporting System from 2003 to 2011 in 17 U.S. states to assess the difference in the relation between six life circumstances and risk of firearm versus non-firearm suicides across sex and age groups. Mixed effect logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI).

RESULTS

The risk of using a firearm as compared to other means for suicide were greater among white, male, non-Hispanic, older (>50 years of age), and currently married U.S. residents. Among all age and sex groups, the odds of firearm use were 21-29% greater in the presence of a recent crisis. Having a financial problem was significantly associated with firearm use among younger men (OR = 1.14, 95% CI = 1.07-1.21), younger women (OR = 1.19, 95% CI = 1.02-1.39), and older women (OR = 1.21, 95% CI = 1.05-1.39), while physical health issues were associated with risk of firearm suicide among older men (OR = 1.78, 95% CI = 1.65-1.92).

LIMITATIONS

Misclassification due to multiple data sources.

CONCLUSION

The life circumstances associated with a preference of using firearm for suicide differ by sex and by age.