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Haghish EF, Nes RB, Obaidi M, Qin P, Stänicke LI, Bekkhus M, Laeng B, Czajkowski N. Unveiling Adolescent Suicidality: Holistic Analysis of Protective and Risk Factors Using Multiple Machine Learning Algorithms. J Youth Adolesc 2024; 53:507-525. [PMID: 37982927 PMCID: PMC10838236 DOI: 10.1007/s10964-023-01892-6] [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: 07/17/2023] [Accepted: 10/17/2023] [Indexed: 11/21/2023]
Abstract
Adolescent suicide attempts are on the rise, presenting a significant public health concern. Recent research aimed at improving risk assessment for adolescent suicide attempts has turned to machine learning. But no studies to date have examined the performance of stacked ensemble algorithms, which are more suitable for low-prevalence conditions. The existing machine learning-based research also lacks population-representative samples, overlooks protective factors and their interplay with risk factors, and neglects established theories on suicidal behavior in favor of purely algorithmic risk estimation. The present study overcomes these shortcomings by comparing the performance of a stacked ensemble algorithm with a diverse set of algorithms, performing a holistic item analysis to identify both risk and protective factors on a comprehensive data, and addressing the compatibility of these factors with two competing theories of suicide, namely, The Interpersonal Theory of Suicide and The Strain Theory of Suicide. A population-representative dataset of 173,664 Norwegian adolescents aged 13 to 18 years (mean = 15.14, SD = 1.58, 50.5% female) with a 4.65% rate of reported suicide attempt during the past 12 months was analyzed. Five machine learning algorithms were trained for suicide attempt risk assessment. The stacked ensemble model significantly outperformed other algorithms, achieving equal sensitivity and a specificity of 90.1%, AUC of 96.4%, and AUCPR of 67.5%. All algorithms found recent self-harm to be the most important indicator of adolescent suicide attempt. Exploratory factor analysis suggested five additional risk domains, which we labeled internalizing problems, sleep disturbance, disordered eating, lack of optimism regarding future education and career, and victimization. The identified factors provided stronger support for The Interpersonal Theory of Suicide than for The Strain Theory of Suicide. An enhancement to The Interpersonal Theory based on the risk and protective factors identified by holistic item analysis is presented.
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Affiliation(s)
- E F Haghish
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Ragnhild Bang Nes
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Milan Obaidi
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychology, Copenhagen University, Copenhagen, Denmark
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Line Indrevoll Stänicke
- Department of Psychology, University of Oslo, Oslo, Norway
- Nic Waals Institute, Lovisenberg hospital, Oslo, Norway
| | - Mona Bekkhus
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Bruno Laeng
- Department of Psychology, University of Oslo, Oslo, Norway
- RITMO Centre for Interdisciplinary Studies in Rhythm, Time and Motion, University of Oslo, Oslo, Norway
| | - Nikolai Czajkowski
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
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Cunha AM, Carmo C, Bras M. Psychological Risk and Protective Factors for Suicidal Ideation: A Study in an Adolescent Sample in an Insular Context. Soa Chongsonyon Chongsin Uihak 2023; 34:250-257. [PMID: 37841492 PMCID: PMC10568188 DOI: 10.5765/jkacap.230031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/10/2023] [Accepted: 08/18/2023] [Indexed: 10/17/2023] Open
Abstract
Objectives Adolescents are at risk of suicide. As suicide is a multifactorial process, risk and protective factors are relevant constructs for suicide prediction. This study explored the effects of risk and protective factors on suicidal ideation in adolescents on the island of São Miguel (Azores). Methods A sample of 750 adolescents (male: n=358; 47.7%; mean age=14.67 years; standard deviation=1.85 years) from the island of São Miguel (Azores) completed several measures related to suicidal ideation and associated factors. Using a cross-sectional design, this study conducted descriptive, correlational, predictive, mediation, and moderation analyses. Results Adolescents generally displayed high levels of risk and protective factors; an indicative proportion exhibited significant suicidal ideation with females presenting the greatest vulnerability. Furthermore, the results highlight that depression is the best predictor of suicidal ideation, however, the association between these variables is mediated. Conclusion The data corroborate that the suicidal reality of adolescents in the Autonomous Region of the Azores is worrisome. Having substantiated the complexity of the suicidal context in young people in the present research, the need to continue studying risk/protective factors in this area is supported.
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Affiliation(s)
- Ana Margarida Cunha
- Department of Psychology and Educational Sciences, Universidade do Algarve, Faro, Portugal
| | - Claudia Carmo
- Department of Psychology and Educational Sciences, Universidade do Algarve, Faro, Portugal
- Psychology Research Centre (CIP-UAL), Universidade Autónoma de Lisboa, Lisbon, Portugal
| | - Marta Bras
- Department of Psychology and Educational Sciences, Universidade do Algarve, Faro, Portugal
- Psychology Research Centre (CIP-UAL), Universidade Autónoma de Lisboa, Lisbon, Portugal
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Shi X, Jiang L, Chen X, Zhu Y. Distinct trajectories of suicidal behaviors throughout the university stage and associated risk and protective factors: A large-scale prospective study. J Affect Disord 2022; 319:407-415. [PMID: 36162687 DOI: 10.1016/j.jad.2022.09.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 09/05/2022] [Accepted: 09/20/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Suicide is a major public health concern, especially among adolescents and young adults. Although research has begun to explore the developmental trajectories of suicide-related outcomes, most have thus far focused on children and adolescents. The current study extends existing literature by identifying subgroup trajectories and related factors of college students over a two-year period. METHODS The data used in this study was obtained from an ongoing longitudinal study in Guangdong, China. A total of 3871 students participated in assessments performed at three time points at one-year assessment intervals. Growth mixture modeling (GMM) was used to estimate trajectory classes for suicidal behaviors, followed by multivariable logistic regression to explore the association between predictive factors and classes. RESULTS GMM analyses extracted two distinct trajectories of suicidal behaviors: a low-decreasing group (n = 3669, 94.8 %) and a high-increasing group (n = 202, 5.2 %). Multivariate logistic regression analyses revealed that depressive symptoms, non-suicidal self-injury, hopelessness, and childhood emotional abuse served as risk factors for the high-increasing group, while reasons for living served as protective factors. CONCLUSIONS Psychological interventions aimed at reducing the influence of risk factors and bolstering reasons to live may help to decrease the risk of suicide behaviors in college students.
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Affiliation(s)
- Xuliang Shi
- College of Education, Hebei University, Baoding, China.
| | - Lin Jiang
- College of Education, Hebei University, Baoding, China
| | - Xiaoyan Chen
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Ya Zhu
- Center for Mental Health Education and Counseling, Guangdong University of Science and Technology, Dongguan, China
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Hogge I, Kim J, Kim E. The Burden of Keeping Things to Yourself: Self-Concealment and Suicidality. COUNSELLING PSYCHOLOGY QUARTERLY 2022. [DOI: 10.1080/09515070.2022.2150144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- Ingrid Hogge
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Jisu Kim
- Department of Counseling, Administration, Supervision, and Adult Learning, Cleveland State University, Cleveland, OH, USA
| | - Eunha Kim
- Department of Psychology, Ajou University, Suwon, South Korea
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Kausar N, Manaf A, Shoaib M. Suicidal Ideation among Adolescents: A Case of Bullying Victimization and Emotional Intelligence. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221120123. [PMID: 35960955 DOI: 10.1177/00302228221120123] [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: 11/17/2022]
Abstract
This paper attempted to examine suicidal ideation among adolescents in terms of bullying victimization and emotional intelligence. It had been observed that adolescents have to face the challenge of suicidal ideation through bullying and reduce it through emotional intelligence. A sample of 1017 adolescents was sampled from public sector primary schools in the district of Gujrat, Punjab, Pakistan to conduct the cross-sectional survey. For this study, the scale of bullying victimization (Illinois Bullying Scale by Espelage & Holt, 2001), emotional intelligence (Emotional Intelligence Scale for Children & Adolescents by Batool & Hayat, 2018) and suicidal ideation (Suicidal Ideation Attribution Scale by Van Spijker, 2014) had been used to measure the responses of the students. The study findings pointed out that emotional intelligence was a significant negative predictor of suicidal ideation. Similarly, the analysis showed that bullying victimization was a significant predictor of suicidal ideation among adolescents.
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Affiliation(s)
- Noreena Kausar
- Department of Psychology, University of Gujrat, Gujrat, Pakistan
| | - Afsheen Manaf
- Department of Psychology, University of Gujrat, Gujrat, Pakistan
| | - Muhammad Shoaib
- Department of Sociology, University of Gujrat, Gujrat, Pakistan
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Kustov GV, Zinchuk MS, Gersamija AG, Voinova NI, Yakovlev AA, Avedisova AS, Guekht AB. [Psychometric properties of the Russian version of the brief «Reasons for Living Inventory»]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:87-94. [PMID: 34874661 DOI: 10.17116/jnevro202112110187] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate psychometric properties of the Russian version of the brief Reasons for Living Inventory (bRFL) in patients with non-psychotic mental disorders (NPMD) and to define its association with current suicide ideation. MATERIAL AND METHODS Six hundred and 15 consecutive patients with NPMD were included. The median age was 27 (19) years; 403 (65.5%) were female. Cronbach's alpha, Cronbach's alpha coefficient if an item is deleted and corrected item-total correlation were used for the internal consistency evaluation. The internal structure assessment was based on the exploratory and confirmatory factor analysis. To identify an association of bRFL with current suicidal ideation, MANCOVA was used. RESULTS An internal consistency of bRFL was good (Cronbach's Alpha-0.856). The exploratory factor analysis revealed a 6-factor model, explaining 80.22% of variance. These factors were: «survival and coping beliefs», «responsibility to family», «child related concerns», «fear of suicide», «fear of social disapproval» and «moral objections». The confirmatory factor analysis indicated a good agreement of the 6-factor model with an empirical data (CMIN/DF - 2.98, CFI - 0.956, SRMR - 0.05, RMSEA - 0.057, PNFI - 0.497). Regardless of gender and age, the total scores of bRFL and its subscales were significantly lower in patients with suicide ideation (p<0.01). CONCLUSION The Russian version of bRFL is a reliable and valid tool for the assessment of the adaptive beliefs and expectations that form an anti-suicidal barrier.
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Affiliation(s)
- G V Kustov
- Solovyov Scientific and Practical Psychoneurological Center DZM, Moscow, Russia
| | - M S Zinchuk
- Solovyov Scientific and Practical Psychoneurological Center DZM, Moscow, Russia
| | - A G Gersamija
- Solovyov Scientific and Practical Psychoneurological Center DZM, Moscow, Russia
| | - N I Voinova
- Solovyov Scientific and Practical Psychoneurological Center DZM, Moscow, Russia
| | - A A Yakovlev
- Solovyov Scientific and Practical Psychoneurological Center DZM, Moscow, Russia.,Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia
| | - A S Avedisova
- Solovyov Scientific and Practical Psychoneurological Center DZM, Moscow, Russia.,Serbsky National Medical Research Center of Psychiatry and Narcology Ministry of Health of Russia, Moscow, Russia
| | - A B Guekht
- Solovyov Scientific and Practical Psychoneurological Center DZM, Moscow, Russia.,Pirogov Russian National Research Medical University, Moscow, Russia
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Resilience among students at risk of dropout: Expanding perspectives on youth suicidality in a non-clinical setting. SCHOOL MENTAL HEALTH 2020; 12:567-579. [PMID: 33343759 DOI: 10.1007/s12310-020-09366-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
While research supports a strong association between risk of school dropout and suicidality, this youth population remains understudied. This qualitative study addresses this gap by examining self-reported risk and protective factors among 44 alternative high school students who endorsed varying levels of suicidal ideation. Criterion sampling of Suicidal Ideation Questionnaire-JR scores informed student selection for semi-structured interviews. Students were grouped by low, moderate, or high suicidal ideation scores. Transcribed interviews were analyzed using thematic analysis. The findings demonstrate subgroup differences of suicide risk and resiliency among students at risk of dropout and offer points for prevention and intervention. School practitioners can advocate for school-based suicide preventive interventions that are tailored for students who are both at risk of suicide and academic failure.
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Carter T, Walker GM, Aubeeluck A, Manning JC. Assessment tools of immediate risk of self-harm and suicide in children and young people: A scoping review. J Child Health Care 2019; 23:178-199. [PMID: 30058359 DOI: 10.1177/1367493518787925] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
There are increasing numbers of children presenting to paediatric hospital settings in mental health crisis. Typically, non-mental health professionals are responsible for the initial assessment of these children and are required to identify immediate physical and emotional health needs. To ensure the safety of these children, immediate risk of suicide and self-harm should be assessed. However, no standardized assessment tool is used in clinical practice, and for those tools that are used, their validity and reliability is unclear. A scoping review was conducted to identify the existing assessment tools of immediate self-harm and suicide risk. Searches of electronic databases and relevant reference lists were undertaken. Twenty-two tools were identified and most assessed acute risk of suicide with only four tools incorporating a self-harm assessment. The tools varied in number of items (4-146), subscales (0-11) and total scores (16-192). Half incorporated Likert-type scales, and most were completed via self-report. Many tools were subject to limited psychometric testing, and no single tool was valid or reliable for use with children presenting in mental health crisis to non-mental health settings. As such, a clinically appropriate, valid and reliable tool that assesses immediate risk of self-harm and suicide in paediatric settings should be developed.
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Affiliation(s)
- Tim Carter
- 1 School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Gemma M Walker
- 2 Nottingham Children's Hospital and Neonatal Services, Family Health Division, Nottingham University Hospitals, Nottingham, UK
| | - Aimee Aubeeluck
- 1 School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Joseph C Manning
- 1 School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.,2 Nottingham Children's Hospital and Neonatal Services, Family Health Division, Nottingham University Hospitals, Nottingham, UK.,3 Children and Families Research, Centre for Technology Enabled Health Research, Coventry University, Coventry, UK
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Ventosa Brás MS, Guerreiro Carmo CI, de Jesus SN. Reasons for Living Inventory for Adolescents: Psychometric Properties Among Portuguese Adolescents. OMEGA-JOURNAL OF DEATH AND DYING 2018; 82:527-547. [PMID: 30577719 DOI: 10.1177/0030222818819340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Reasons for living are protective factors against suicidal behavior in adolescents. One of the most useful measures to assess them is the Reasons for Living Inventory for Adolescents (RFL-A) developed by Osman et al. The goal of this study was to examine the psychometric properties of its Portuguese version of the RFL-A. To this end, we recruited 512 high school adolescents (mean age = 16.7 years), who completed the RFL-A, a Suicidal Ideation Questionnaire, and a hopelessness scale. Exploratory factor analysis replicated the original five-factor model and confirmatory factor analysis obtained satisfactory adjustment values. The RFL-A shows good reliability (internal consistency and temporal stability) as well as good convergent, discriminant, and concurrent validities. These results indicate that the RFL-A is a valid and reliable measure to study protective factors against suicidal behaviors in Portuguese adolescents.
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Affiliation(s)
- Marta Sofia Ventosa Brás
- Psychology and Educational Department, Faculty of Human and Social Sciences, University of the Algarve, Faro, Portugal
| | | | - Saul Neves de Jesus
- Psychology and Educational Department, Faculty of Human and Social Sciences, University of the Algarve, Faro, Portugal
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10
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Ren Y, You J, Lin M, Xu S. Low self‐esteem, entrapment, and reason for living: A moderated mediation model of suicidal ideation. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2018; 54:807-815. [DOI: 10.1002/ijop.12532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 08/17/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Yaxuan Ren
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, & School of PsychologySouth China Normal University Guangzhou P. R. China
| | - Jianing You
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, & School of PsychologySouth China Normal University Guangzhou P. R. China
| | - Min‐Pei Lin
- Department of Educational Psychology and CounselingNational Taiwan Normal University Taipei City Taiwan (R.O.C)
| | - Sian Xu
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, & School of PsychologySouth China Normal University Guangzhou P. R. China
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11
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Gallagher ML, Miller AB. Suicidal Thoughts and Behavior in Children and Adolescents: An Ecological Model of Resilience. ADOLESCENT RESEARCH REVIEW 2018; 3:123-154. [PMID: 29904718 PMCID: PMC5995470 DOI: 10.1007/s40894-017-0066-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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12
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Erford BT, Jackson J, Bardhoshi G, Duncan K, Atalay Z. Selecting Suicide Ideation Assessment Instruments: A Meta-Analytic Review. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2017. [DOI: 10.1080/07481756.2017.1358062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Bradley T. Erford
- Peabody College at Vanderbilt University, Human and Organizational Development, Nashville, TN, USA
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Eskiyurt R, Ozkan B. The investigation of the relationship between probability of suicide and reasons for living in psychiatric inpatients. Indian J Psychiatry 2017; 59:435-441. [PMID: 29497185 PMCID: PMC5806322 DOI: 10.4103/psychiatry.indianjpsychiatry_31_17] [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] [Indexed: 11/08/2022] Open
Abstract
AIM This study was carried out to determine the reasons of the suicide probability and reasons for living of the inpatients hospitalized at the psychiatry clinic and to analyze the relationship between them. MATERIALS AND METHODS The sample of the study consisted of 192 patients who were hospitalized in psychiatric clinics between February and May 2016 and who agreed to participate in the study. In collecting data, personal information form, suicide probability scale (SPS), reasons for living inventory (RFL), and Beck's depression inventory (BDI) were used. Stepwise regression method was used to determine the factors that predict suicide probability. RESULTS In the study, as a result of analyses made, the median score on the SPS was found 76.0, the median score on the RFL was found 137.0, the median score on the BDI of the patients was found 13.5, and it was found that patients with a high probability of suicide had less reasons for living and that their depression levels were very high. As a result of stepwise regression analysis, it was determined that suicidal ideation, reasons for living, maltreatment, education level, age, and income status were the predictors of suicide probability (F = 61.125; P < 0.001). DISCUSSION It was found that the patients who hospitalized in the psychiatric clinic have high suicide probability and the reasons of living are strong predictors of suicide probability in accordance with the literature.
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Affiliation(s)
- Reyhan Eskiyurt
- Department of Nursing, Mental Health Nursing, Faculty of Health Sciences, University of Ankara Yildirim Beyazit, Ankara, Turkey
| | - Birgul Ozkan
- Department of Nursing, Mental Health Nursing, Faculty of Health Sciences, University of Ankara Yildirim Beyazit, Ankara, Turkey
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Gender differences and stage-specific influence of parent-adolescent conflicts on adolescent suicidal ideation. Psychiatry Res 2017; 255:424-431. [PMID: 28668758 DOI: 10.1016/j.psychres.2017.06.077] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 05/13/2017] [Accepted: 06/24/2017] [Indexed: 01/19/2023]
Abstract
This study examined familial and peer related factors as predictors of suicidal ideation in school students. Total 2896 participants were included from Taiwan Youth Project released data, a longitudinal survey of adolescent suicidal ideation at ages 15, 18, and 20. Logistic regression analysis risk factors associated with adolescent suicidal ideation reveled differences during the developmental stages. After adjusted for psychological symptoms, effect of quarrels with parents on suicidal ideation lasts in early and middle stages; in the late adolescent stage, only cigarette or alcohol use remained significant. Girls who reported quarrels with parents had the highest level of suicidal ideation before age 18. Stage- and gender-specific differences may provide appropriate intervention strategies for parents and teachers preventing adolescent suicidal ideation.
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Sheftall AH, Schoppe-Sullivan SJ, Bridge JA. Insecure attachment and suicidal behavior in adolescents. CRISIS 2016; 35:426-30. [PMID: 25231855 DOI: 10.1027/0227-5910/a000273] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Suicide among adolescents is an important public health problem. One risk factor for youth suicidal behavior that has been underexplored is insecure attachment. AIMS To investigate the association between attachment avoidance/anxiety and suicidal behavior in an adolescent sample. METHOD This study examined attachment insecurity in 40 adolescents who had attempted suicide and 40 never-suicidal demographically matched youths. Adolescents completed self-report measures of attachment style, family alliance, and depressive symptoms. RESULTS Suicide attempters reported significantly higher attachment avoidance and anxiety. Attachment avoidance, but not anxiety, predicted suicide attempt status in a conditional logistic regression analysis that controlled for depressive symptoms and family alliance. CONCLUSION Future research should determine the relative utility of attachment insecurity in prospectively predicting suicide attempts and investigate potential mediators and moderators of this association. Implications for clinicians working with suicidal youth with insecure attachment styles are discussed.
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Affiliation(s)
- Arielle H Sheftall
- The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Jeffrey A Bridge
- The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
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Luo X, Wang Q, Wang X, Cai T. Reasons for living and hope as the protective factors against suicidality in Chinese patients with depression: a cross sectional study. BMC Psychiatry 2016; 16:252. [PMID: 27439525 PMCID: PMC4955123 DOI: 10.1186/s12888-016-0960-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 07/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The risk factors of suicidal ideation and attempts have been discussed in many researches. Few studies have examined reasons for living and hope as protective factors against suicide in a clinical population. It is unclear if these factors help to reduce suicide rates in patients with depression. The study aimed to assess the role of reasons for living and hope in the identification and reduction of suicidality and explore the influence of reasons for living or hope in the transition from suicidal ideation to suicide attempts. METHODS Patients with depression (N = 115) completed the Beck Depression Inventory, Reasons for Living Inventory, and Adult Suicidal Ideation Questionnaire. RESULTS There were significant correlations among depression, hope, total reasons for living, and suicidal ideation and attempts. Further, after controlling for depression, reasons for living and hope had significant main effects on suicidal ideation. Hope also had a significant predictive effect in the transition of suicidal ideation to suicide attempt. CONCLUSIONS We concluded that reasons for living and hope may protect against suicidal ideation and attempts in patients with depression. Especially hope could reduce the possibility of suicide attempt.
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Affiliation(s)
- Xingwei Luo
- Medical Psychology Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China ,Medical Psychology Institute of Central South University, Changsha, Hunan 410011 China
| | - Qin Wang
- The Third Experimental Primary School, Rizhao, Shandong 276800 China
| | - Xiang Wang
- Medical Psychology Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China ,Medical Psychology Institute of Central South University, Changsha, Hunan 410011 China
| | - Taisheng Cai
- Medical Psychology Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China. .,Medical Psychology Institute of Central South University, Changsha, Hunan, 410011, China. .,Medical Institute of Psychology, Secong Xiangya Hospital of Central South University, 139 Renmin Road, Furong District, Changsha, 410011, China.
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Bakhiyi CL, Calati R, Guillaume S, Courtet P. Do reasons for living protect against suicidal thoughts and behaviors? A systematic review of the literature. J Psychiatr Res 2016; 77:92-108. [PMID: 27014850 DOI: 10.1016/j.jpsychires.2016.02.019] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/22/2016] [Accepted: 02/26/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Few studies have investigated protective factors against suicide. OBJECTIVES To identify whether reasons for living (RFL), measured with the Reasons for Living Inventory (RFLI), protect against suicidal ideation (SI), attempts (SA) and suicide death. METHOD This systematic review followed the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) statement guidelines. PubMed database was searched for studies published until October 2015. Studies were eligible if they used RFLI or one of its versions. All eligible studies were included, regardless of study design, quality indicators, and target populations. No publication year limit was imposed. We included 39 studies. RESULTS RFL may protect against SI and SA and yield a predictive value. The role of two specific reasons for living (Moral Objections to Suicide and Survival and Coping Beliefs) was particularly emphasized. No study investigating suicide death was found. CONCLUSION RFL may moderate suicide risk factors and correlate with resilience factors. Moreover, RFL may depend on and interact with numerous factors such as DSM-IV Axis I disorders, personality disorders and features, coping abilities and social support. Clinicians could develop therapeutic strategies aimed at enhancing RFL, like Dialectical Behavior Therapy and Cognitive Behavioral Therapies, to prevent suicidal thoughts and behaviors and improve the care management of suicidal patients.
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Affiliation(s)
- Camélia Laglaoui Bakhiyi
- Department of Emergency Psychiatry & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; Psychiatric Unit, CHU Casablanca, Hassan II University, Casablanca, Morocco; INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France.
| | - Raffaella Calati
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; FondaMental Foundation, France
| | - Sébastien Guillaume
- Department of Emergency Psychiatry & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; FondaMental Foundation, France
| | - Philippe Courtet
- Department of Emergency Psychiatry & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; FondaMental Foundation, France
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Choi JH, Yu M, Kim KE. Suicidal ideation in adolescents: A structural equation modeling approach. Nurs Health Sci 2014; 17:119-125. [PMID: 24943997 DOI: 10.1111/nhs.12142] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 02/15/2014] [Accepted: 03/06/2014] [Indexed: 11/29/2022]
Abstract
The purpose of this study is to test a model linking adolescents' experience of violence and peer support to their happiness and suicidal ideation. The participants were high school students in Seoul, and in Kyungi, and Chungnam Provinces in Korea. The Conflict Tactics Scale, School Violence Scale, Oxford Happiness Inventory, and Suicidal Ideation Questionnaire were administered to just over 1000 adolescents. The model was tested using a path analysis technique within structural equation modeling. The model fit indices suggest that the revised model is a better fit for the data than the original hypothesized model. The experience of violence had a significant negative direct effect and peer support had a significant positive direct effect on their happiness. Happiness had a significant negative effect and the experience of violence had a significant positive effect on suicidal ideation. These findings demonstrate the fundamental importance of reducing exposure of violence to adolescents, and that increasing peer support and their happiness may be the key to adolescent suicidal ideation prevention.
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Affiliation(s)
- Jung-Hyun Choi
- Department of Nursing, Namseoul University, Cheonan, Republic of Korea
| | - Mi Yu
- Department of Nursing, Namseoul University, Cheonan, Republic of Korea
| | - Kyoung-Eun Kim
- Department of Child Welfare, Namseoul University, Cheonan, Republic of Korea
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