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Cañón Buitrago SC, Pérez Agudelo JM, Narváez Marín M, Montoya Hurtado OL, Bermúdez Jaimes GI. Predictive model of suicide risk in Colombian university students: quantitative analysis of associated factors. Front Psychiatry 2024; 15:1291299. [PMID: 38855643 PMCID: PMC11157033 DOI: 10.3389/fpsyt.2024.1291299] [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: 09/18/2023] [Accepted: 04/11/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction The risk of suicide and completed suicides among young university students presents critical challenges to mental and public health in Colombia and worldwide. Employing a quantifiable approach to comprehend the factors associated with these challenges can aid in visualizing the path towards anticipating and controlling this phenomenon. Objective Develop a predictive model for suicidal behavior in university students, utilizing predictive analytics. Method We conducted an observational, retrospective, cross-sectional, and analytical research study at the University of Manizales, with a focus on predictive applicability. Data from 2,436 undergraduate students were obtained from the research initiative "Building the Future: World Mental Health Surveys International College Students." Results The top ten predictor variables that generated the highest scores (ranking coefficients) for the sum of factors were as follows: history of sexual abuse (13.21), family history of suicide (11.68), medication (8.39), type of student (7.4), origin other than Manizales (5.86), exposure to cannabis (4.27), exposure to alcohol (4.42), history of physical abuse (3.53), religiosity (2.9), and having someone in the family who makes you feel important (3.09). Discussion Suicide involves complex factors within psychiatric, medical, and societal contexts. Integrated detection and intervention systems involving individuals, families, and governments are crucial for addressing these factors. Universities also play a role in promoting coping strategies and raising awareness of risks. The predictive accuracy of over 80% in identifying suicide risk underscores its significance. Conclusion The risk factors related to suicidal behavior align with the findings in specialized literature and research in the field. Identifying variables with higher predictive value enables us to take appropriate actions for detecting cases and designing and implementing prevention strategies.
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Affiliation(s)
- Sandra Constanza Cañón Buitrago
- Medical Research Group - Medicine Program - Faculty of Health Sciences, University of Manizales, Manizales, Caldas, Colombia
| | - Juan Manuel Pérez Agudelo
- Medical Research Group - Medicine Program - Faculty of Health Sciences, University of Manizales, Manizales, Caldas, Colombia
| | - Mariela Narváez Marín
- Clinical Psychology and Health Processes Group, Psychology Program, Faculty of Social and Human Sciences, Manizales University, Manizales, Caldas, Colombia
| | - Olga Lucia Montoya Hurtado
- Human Abilities, Health, and Inclusion Group - Physiotherapy - Research Department, Colombian School of Rehabilitation, Manizales, Caldas, Colombia
| | - Gloria Isabel Bermúdez Jaimes
- Human Abilities, Health, and Inclusion Group - Research Department, Colombian School of Rehabilitation, Manizales, Caldas, Colombia
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Stewart JG, Meddaoui B, Kaufman EA, Björgvinsson T, Beard C. Changes in suicide capability during short-term partial hospital treatment. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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3
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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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Tull MT, DeMoss ZT, Anestis MD, Lavender JM, McDermott MJ, Gratz KL. Examining associations between suicidal desire, implicit fearlessness about death, and lifetime frequency of suicide attempts. Suicide Life Threat Behav 2022; 52:1110-1120. [PMID: 35899809 PMCID: PMC10087538 DOI: 10.1111/sltb.12905] [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: 03/22/2022] [Revised: 06/01/2022] [Accepted: 07/11/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Suicide models propose that the capability for suicide, such as fearlessness about death (FAD), is necessary for the transition from suicidal desire to a suicide attempt. Most studies have relied on self-report methods to assess FAD. However, this research has produced equivocal results. As individuals may have limited awareness of learned or pre-existing associations between fearlessness and death, implicit measures of FAD hold promise. This study used a novel implicit association test (IAT), the IAT-FAD, to examine associations between suicidal desire, implicit FAD, and lifetime suicide attempt frequency. METHODS Patients in residential substance use treatment (N = 75), a population with increased suicide risk and exposure to painful and provocative events, completed the IAT-FAD and assessments of suicidal desire and past suicide attempts. RESULTS Implicit FAD moderated the association between suicidal desire and lifetime frequency of suicide attempts associated with an intent to die and requiring medical attention (although not ambivalent suicide attempts). Suicidal desire related to medically attended suicide attempts only at high implicit FAD levels, and to suicide attempts with a clear intent to die only at high or mean implicit FAD levels. CONCLUSION Results provide initial support for the relevance of implicit measures of FAD for understanding suicide risk.
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Affiliation(s)
- Matthew T Tull
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
| | - Zachary T DeMoss
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
| | - Michael D Anestis
- New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA.,School of Public Health, Rutgers, the State University of New Jersey, Piscataway, New Jersey, USA
| | - Jason M Lavender
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Bethesda, Maryland, USA.,The Metis Foundation, San Antonio, Texas, USA
| | - Michael J McDermott
- Department of Psychology, University of Louisiana at Lafayette, Lafayette, Louisiana, USA
| | - Kim L Gratz
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
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Moseley RL, Gregory NJ, Smith P, Allison C, Cassidy S, Baron-Cohen S. Non-suicidal self-injury and its relation to suicide through acquired capability: investigating this causal mechanism in a mainly late-diagnosed autistic sample. Mol Autism 2022; 13:45. [PMID: 36371252 PMCID: PMC9655904 DOI: 10.1186/s13229-022-00522-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) has been linked with a higher risk of suicide attempts in autistic and non-autistic people. In the general population, NSSI may confer acquired capability for suicide by eroding one's fear and avoidance of pain and death. The present study aimed to explore acquired capability as the mediator of increased suicide risk conferred by NSSI in autistic and non-autistic adults. METHODS Autistic and non-autistic adults (n = 314, n = 312) completed an online survey exploring lifetime suicide attempts, experience with NSSI, and acquired capability for suicide. We explored relationships between lifetime incidence of NSSI and lifetime suicide attempts via three facets of acquired capability (pain tolerance, reduced fear of death, and mental rehearsal of suicide). In self-harming participants (224 autistic and 156 non-autistic), we explored whether particular types and features of NSSI might be especially associated with capability and through that with suicide: namely engagement in scratching, cutting, and self-hitting, and engaging in more numerous forms of NSSI. RESULTS While a higher frequency of NSSI was associated with all three facets of acquired capability, only reduced fear of death and mental rehearsal of suicide mediated an indirect relationship with lifetime suicide attempts. NSSI also directly predicted more numerous suicide attempts. Autistic people tended towards reduced fear of death and mental rehearsal regardless of NSSI status. Among self-harming autistic and non-autistic participants, cutting and an increased number of NSSI behaviours were associated with lifetime suicide attempts directly and indirectly via acquired capability. In both groups, self-hitting was associated with lifetime suicide attempts only via acquired capability. LIMITATIONS Our cross-sectional methodology negates inferences of directionality. While we controlled for age, our samples were poorly matched, with the autistic group two times older on average. The autistic sample, predominantly late-diagnosed, female and highly qualified, were unrepresentative of the whole autistic community. CONCLUSIONS Our data suggest that acquired capability, as measured herein, is an incomplete explanation for the association between NSSI and suicide risk. A broader construct with stable and transient facets may offer greater explanatory power, but it is probable that other variables explain or provide additional means through which this association arises.
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Affiliation(s)
- Rachel L. Moseley
- grid.17236.310000 0001 0728 4630Department of Psychology, Bournemouth University, Talbot Campus, Fern Barrow, Poole, Dorset, BH12 5BB UK
| | - Nicola J. Gregory
- grid.17236.310000 0001 0728 4630Department of Psychology, Bournemouth University, Talbot Campus, Fern Barrow, Poole, Dorset, BH12 5BB UK
| | - Paula Smith
- grid.5335.00000000121885934Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Carrie Allison
- grid.5335.00000000121885934Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Sarah Cassidy
- grid.4563.40000 0004 1936 8868School of Psychology, University of Nottingham, Nottingham, UK
| | - Simon Baron-Cohen
- grid.5335.00000000121885934Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
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Bayliss LT, Christensen S, Lamont-Mills A, du Plessis C. Suicide capability within the ideation-to-action framework: A systematic scoping review. PLoS One 2022; 17:e0276070. [PMID: 36301944 PMCID: PMC9612581 DOI: 10.1371/journal.pone.0276070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/28/2022] [Indexed: 11/19/2022] Open
Abstract
Suicide capability is theorised to facilitate the movement from suicidal ideation to suicide attempt. Three types of contributors are posited to comprise suicide capability: acquired, dispositional, and practical. Despite suicide capability being critical in the movement from ideation-to-attempt, there has been no systematic synthesis of empirical evidence relating to suicide capability that would enable further development and refinement of the concept. This study sought to address this synthesis gap. A scoping review was conducted on suicide capability studies published January 2005 to January 2022. Eleven electronic databases and grey literature sources were searched returning 5,212 potential studies. After exclusion criteria application, 90 studies were included for final analysis. Results synthesis followed a textual narrative approach allocating studies based on contributors of suicide capability. Most studies focused on investigating only one factor within contributors. Painful and provocative events appear to contribute to acquired capability more so than fearlessness about death. Whilst emerging evidence for dispositional and practical contributors is promising, the small number of studies prevents further conclusions from being drawn. An unexpected additional cognitive contributor was identified. The focus of a single factor from most studies and the limited number of studies on contributors other than acquired capability limits the theoretical development and practical application of suicide capability knowledge. Given that suicide is a complex and multifaceted behaviour, future research that incorporates a combination of contributors is more likely to advance our understandings of suicide capability.
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Guo T, Bai X, Tian X, Firmin S, Xia F. Educational Anomaly Analytics: Features, Methods, and Challenges. Front Big Data 2022; 4:811840. [PMID: 35098114 PMCID: PMC8795666 DOI: 10.3389/fdata.2021.811840] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
Anomalies in education affect the personal careers of students and universities' retention rates. Understanding the laws behind educational anomalies promotes the development of individual students and improves the overall quality of education. However, the inaccessibility of educational data hinders the development of the field. Previous research in this field used questionnaires, which are time- and cost-consuming and hardly applicable to large-scale student cohorts. With the popularity of educational management systems and the rise of online education during the prevalence of COVID-19, a large amount of educational data is available online and offline, providing an unprecedented opportunity to explore educational anomalies from a data-driven perspective. As an emerging field, educational anomaly analytics rapidly attracts scholars from a variety of fields, including education, psychology, sociology, and computer science. This paper intends to provide a comprehensive review of data-driven analytics of educational anomalies from a methodological standpoint. We focus on the following five types of research that received the most attention: course failure prediction, dropout prediction, mental health problems detection, prediction of difficulty in graduation, and prediction of difficulty in employment. Then, we discuss the challenges of current related research. This study aims to provide references for educational policymaking while promoting the development of educational anomaly analytics as a growing field.
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Affiliation(s)
- Teng Guo
- School of Software, Dalian University of Technology, Dalian, China
| | - Xiaomei Bai
- Computing Center, Anshan Normal University, Anshan, China
| | - Xue Tian
- School of Arts, Law and Education, University of Tasmania, Launceston, TAS, Australia
| | - Selena Firmin
- School of Engineering, IT and Physical Sciences, Federation University Australia, Ballarat, VIC, Australia
| | - Feng Xia
- School of Engineering, IT and Physical Sciences, Federation University Australia, Ballarat, VIC, Australia
- *Correspondence: Feng Xia
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Xu H, Jiang Z, Li S, Zhang X, Xu S, Wan Y, Tao F. Differences in Influencing Factors Between Non-suicidal Self-Injury and Suicide Attempts in Chinese Adolescents: The Role of Gender. Front Psychiatry 2022; 13:870864. [PMID: 35845460 PMCID: PMC9280144 DOI: 10.3389/fpsyt.2022.870864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/01/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Non-suicidal self-injury (NSSI) and suicide attempts (SA) are common in adolescents and are important risk factors for suicide deaths. They are related to various psychosocial, behavioral, and biological factors. We aimed to compare the differences on psychological behavior problem and family environment characteristics between NSSI and SA, and the role of gender. METHODS A multi-center population-based survey was conducted in 29 schools across 4 provinces in China. A total of 14,500 urban and rural adolescents in grades 7-12 completed a structured questionnaire to report their sociodemographic information, psychological and behavioral characteristics, childhood maltreatment, parent-child relationships, NSSI, and SA. Post-hoc tests, pairwise comparisons, and multinomial logistic regression analyses were conducted to explore the differences and similarities between subjects who had engaged in NSSI and SA. RESULTS The prevalence of NSSI and SA were 27.3 and 4.9%, respectively, and the co-occurrence of these two behaviors (NSSI + SA) was reported to 2.8%. The NSSI + SA group scored the highest on all study variables, followed by the SA-only group, the NSSI-only group, and the non-self-harm group (p < 0.001). Compared with the non-self-harm group, adolescents who reported either NSSI or SA scored significantly higher on all study variables (p< 0.0083). The comparison between other self-harm groups, this difference have varied in all research variables. CONCLUSION The current study indicate that psychological, behavioral, and family relationships profiles of Chinese adolescents with SA and NSSI are similar, but the measured problematic characteristics were more severe in suicide attempters. In the future, it's necessary to pay more attention to adolescents with more serious psychological and behavioral problems to prevent and early intervene in their self-harm, and actively explore gender differences.
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Affiliation(s)
- Huiqiong Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Zhicheng Jiang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Shuqin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Xinyu Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Shaojun Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
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Zhou Y, Yu R, Ai M, Cao J, Li X, Hong S, Huang Q, Dai L, Wang L, Zhao L, Zhang Q, Shi L, Kuang L. A Resting State Functional Magnetic Resonance Imaging Study of Unmedicated Adolescents With Non-suicidal Self-Injury Behaviors: Evidence From the Amplitude of Low-Frequency Fluctuation and Regional Homogeneity Indicator. Front Psychiatry 2022; 13:925672. [PMID: 35782416 PMCID: PMC9247173 DOI: 10.3389/fpsyt.2022.925672] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) behaviors are common in adolescents with major depressive disorder (MDD). Brain studies specifically targeting adolescents with MDD and NSSI may provide new insights into suicide warnings in adolescents with MDD. METHODS This study examined the whole-brain neural activity in adolescents aged between 12-17 years, 50 unmedicated MDD patients with (nsMDDs) or without NSSI (nnsMDDs), and 25 healthy controls (HCs) participated in this study, and analyzed the correlation between the values of amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuation (fALFF) and regional homogeneity (ReHo) in significantly different brain regions and the scores of the relevant clinical psychological scale. RESULTS Compared with nnsMDDs, nsMDDs had enhanced ALFF values in left middle occipital gyrus and left median cingulate and paracingulate gyri; the fALFF values of the right caudate nucleus was weakened in the nsMDDs; the ReHo values of right middle occipital gyrus and right middle temporal gyrus weakened and the ReHo values of right medial cingulate gyrus enhanced in nsMDDs. And all of differences were statistically significant. In nsMDDs, the value of ALFF in the left calcarine fissure and surrounding cortex was negatively correlated with the score of Children's depression Inventory (CDI); the value of fALFF in the right caudate nucleus was positively correlated with the score of Beck Scale for Suicidal Ideations (BSSI); the value of ReHo in the right middle temporal gyrus was positively correlated with the score of Multidimensional Anxiety Scale for Children (MASC); and the value of ReHo in the right median cingulate and paracingulate gyri was negatively correlated with the score of BSSI. CONCLUSIONS We found that in ALFF, fALFF and ReHo, the significant differences between nsMDDs and nnsMDDs are mainly located in default mode network (DMN) and visual network (VN), and there may be brain regions related to NSSI in DMN and VN. The significant differences brain regions in ALFF, fALFF and ReHo between nsMDDs and nnsMDDs were related to the total score of the relevant clinical psychological scale, and may be related to NSSI.
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Affiliation(s)
- Yi Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Renqiang Yu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ming Ai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Cao
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Su Hong
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Huang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Linqi Dai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - LiXia Wang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lin Zhao
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qi Zhang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lei Shi
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Gratz KL, Spitzen TL, Tull MT. Expanding our understanding of the relationship between nonsuicidal self-injury and suicide attempts: The roles of emotion regulation self-efficacy and the acquired capability for suicide. J Clin Psychol 2020; 76:1653-1667. [PMID: 32227691 PMCID: PMC7723229 DOI: 10.1002/jclp.22950] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Although past literature has emphasized the role of acquired capability in the relationship between nonsuicidal self-injury (NSSI) and suicide attempts, support for the indirect relationship of NSSI to suicide attempts through acquired capability is limited. Thus, research examining other factors that may underlie this relationship is needed. Across two studies, this research examined the indirect relationships of NSSI frequency to suicide attempts through both acquired capability and emotion regulation self-efficacy (ERSE). METHOD Two large samples of adults (one nationwide community sample and one clinical sample of patients with substance use disorders) completed questionnaires and/or interviews. RESULTS Results revealed significant indirect relationships of NSSI frequency to lifetime suicide attempts through ERSE, but not acquired capability, within both samples. CONCLUSIONS Results highlight the relevance of ERSE to both suicide attempts and the NSSI-suicide attempt relationship, and suggest the potential utility of interventions aimed at increasing ERSE among individuals with repeated NSSI.
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Mento C, Silvestri MC, Muscatello MRA, Rizzo A, Celebre L, Bruno A, Zoccali AR. Psychological pain and risk of suicide in adolescence. Int J Adolesc Med Health 2020; 34:/j/ijamh.ahead-of-print/ijamh-2019-0270/ijamh-2019-0270.xml. [PMID: 32304305 DOI: 10.1515/ijamh-2019-0270] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 01/30/2020] [Indexed: 11/15/2022]
Abstract
Psychological pain or psychache is intolerable and unacceptable mental pain. This construct plays a key role in the risk of suicide in adolescence. This is a frequent condition in adolescents with depression; a variety of studies propose a bidirectional relationship between these two circumstances. Adolescents with psychological pain are exposed to the risk of suicidal ideation, and behavior. This review aimed to explore psychological pain in adolescents, and the correlation to the risk of suicide. We have conducted, following PRISMA guidelines, a systematic review for the literature on PubMed. Search terms were "Suicide risk in adolescents" AND "Mental Pain in adolescence" OR "Psychological Pain in adolescence". An initial search identified publications 1189. A total of 15 studies met the predefined inclusion criteria and were analyzed. Mental pain is a stronger factor of vulnerability of suicidal ideation and behavior. Intense negative emotions, such as guilt, shame, hopelessness, may become a psychological pain in adolescence, and many studies showed a relation between psychological pain and capability for suicide.
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Affiliation(s)
- Carmela Mento
- Department of Biomedical and Dental Sciences, Morphofunctional Imaging, University of Messina, Consolare Valeria 1, 98125 Messina, Italy, Phone: +390903489.,University of Messina, BIOMORF, via Consolare Valeria 1 Messina, Italy.,Policlinico Hospital, Psychiatric Unit, Messina, Italy
| | | | - Maria Rosaria Anna Muscatello
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, BIOMORF, Messina, Italy.,Department of Biomedical and Dental Sciences, Morphofunctional Imaging, University of Messina, Consolare Valeria 1, 98125 Messina, Italy
| | - Amelia Rizzo
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, Messina, Italy
| | - Laura Celebre
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, Messina, Italy
| | - Antonio Bruno
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, BIOMORF, Messina, Italy.,Department of Biomedical and Dental Sciences, Morphofunctional Imaging, University of Messina, Consolare Valeria 1, 98125 Messina, Italy
| | - Antonio Rocco Zoccali
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, BIOMORF, Messina, Italy.,Department of Biomedical and Dental Sciences, Morphofunctional Imaging, University of Messina, Consolare Valeria 1, 98125 Messina, Italy
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La Guardia AC, Cramer RJ, Bryson CN, Emelianchik‐Key K. Analysis of Personality, Suicide, and Self‐Injury in Emerging Adulthood. JOURNAL OF COLLEGE COUNSELING 2020. [DOI: 10.1002/jocc.12149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - Robert J. Cramer
- School of Community and Environmental HealthOld Dominion University
- Now at Department of Public Health SciencesUniversity of North Carolina at Charlotte
| | - Claire N. Bryson
- Department of Psychology and PhilosophySam Houston State University
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13
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Xu H, Song X, Wang S, Zhang S, Xu S, Wan Y. Mediating Effect of Social Support in the Relationship Between Childhood Abuse and Non-Suicidal Self-Injury Among Chinese Undergraduates: The Role of Only-Child Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16204023. [PMID: 31640165 PMCID: PMC6843968 DOI: 10.3390/ijerph16204023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 01/08/2023]
Abstract
Previous research has found a relationship between child abuse and non-suicidal self-injury (NSSI). However, few studies have examined the role of social support underlying this association. Moreover, the influence of the only child status on the mediating effect of social support has not been studied yet. The aim of this study was to investigate the mediating role of social support on the association between specific forms of child abuse and NSSI as well as the role of the only child status on the mediated pathways, among undergraduates. A total of 4799 participants were selected from two medical colleges in the Anhui province using stratified cluster sampling. Pearson's correlation analysis was used in analyzing the relationship. Bootstrapping procedures were applied to examine the mediating effects. After adjusting for confounders, the results showed that the mediating effect of social support on the association between childhood abuse and NSSI was not significant in the total sample. However, among only children, the mediating effects of social support between overall childhood abuse, physical abuse, emotional abuse, and NSSI were 9.65%, 14.82%, and 8.12%, respectively. Moreover, the mediating effect of social support from family and relatives was relatively higher than that from other sources. Social support had a mediating effect on the relationship between childhood abuse and NSSI among only-children. The enhancing of social support may contribute to the prevention and control of NSSI for those who were only-children in undergraduates, especially those who have experienced childhood abuse.
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Affiliation(s)
- Huiqiong Xu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Xianbing Song
- Department of Basic Course, Anhui medical College, 632 Furong Road, Hefei 230601, Anhui, China.
| | - Shanshan Wang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Shichen Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health &Aristogenics, 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Shaojun Xu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health &Aristogenics, 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Yuhui Wan
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health &Aristogenics, 81 Meishan Road, Hefei 230032, Anhui, China.
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Funkhouser CJ, Correa KA, Carrillo VL, Klemballa DM, Shankman SA. The time course of responding to aversiveness in females with a history of non-suicidal self-injury. Int J Psychophysiol 2019; 141:1-8. [PMID: 31028756 DOI: 10.1016/j.ijpsycho.2019.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/27/2019] [Accepted: 04/24/2019] [Indexed: 01/26/2023]
Abstract
Non-suicidal self-injury is a risk factor for suicidal behavior, particularly in females. Two prominent theories of suicide suggest that habituation to the psychophysiological aversiveness of NSSI is a mechanism by which NSSI exposure may lead to increased risk for suicide. Several laboratory studies examining the relationship between physiological habituation and suicide attempt history have yielded mixed results, potentially due to their use of broad measures of physiological arousal and/or focus on specific psychopathologies. However, no studies have examined the association between the time course (e.g., habituation, initial reactivity) of responding to aversiveness and NSSI, which may help to elucidate psychophysiological mechanisms of NSSI. Therefore, we examined habituation and initial reactivity to aversiveness (indexed by the time course of acoustic startle reflex, a well-validated measure of defensive responding) in three groups of young adult females - those with a history of NSSI, psychiatric controls matched on potential confounds (e.g., psychopathology, trauma history, demographics), and healthy controls. Results indicated that individuals with a history of NSSI exhibited blunted initial reactivity and marginally slower habituation to aversiveness relative to the two control groups. The NSSI group's insensitivity to aversiveness may reflect prior psychophysiological habituation, and may be a mechanism through which prior NSSI exposure leads to increased risk for suicidal behavior.
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Affiliation(s)
- Carter J Funkhouser
- Department of Psychology, University of Illinois at Chicago, United States of America
| | - Kelly A Correa
- Department of Psychology, University of Illinois at Chicago, United States of America
| | - Vivian L Carrillo
- Department of Psychology, University of Illinois at Chicago, United States of America
| | - David M Klemballa
- Department of Psychology, University of Illinois at Chicago, United States of America
| | - Stewart A Shankman
- Department of Psychology, University of Illinois at Chicago, United States of America; Department of Psychiatry, University of Illinois at Chicago, United States of America; Department of Psychiatry and Behavioral Sciences, Northwestern University, United States of America.
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15
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Lewis SP, Heath NL, Hasking PA, Whitlock JL, Wilson MS, Plener PL. Addressing Self‐Injury on College Campuses: Institutional Recommendations. JOURNAL OF COLLEGE COUNSELING 2019. [DOI: 10.1002/jocc.12115] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Stephen P. Lewis
- Department of PsychologyUniversity of Guelph Guelph Ontario Canada
| | - Nancy L. Heath
- Department of Educational and Counselling PsychologyMcGill University Montreal Quebec Canada
| | | | | | - Mark S. Wilson
- School of PsychologyVictoria University Wellington New Zealand
| | - Paul L. Plener
- Department of Child and Adolescent PsychiatryMedical University of Vienna Vienna Austria
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16
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Knorr AC, Ammerman BA, Hamilton AJ, McCloskey MS. Predicting status along the continuum of suicidal thoughts and behavior among those with a history of nonsuicidal self-injury. Psychiatry Res 2019; 273:514-522. [PMID: 30708203 DOI: 10.1016/j.psychres.2019.01.067] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 01/23/2019] [Accepted: 01/23/2019] [Indexed: 12/01/2022]
Abstract
Nonsuicidal self-injury (NSSI) and suicidal thoughts and behavior often co-occur, representing a growing public health concern. Despite extensive research examining suicidal thoughts and behavior among those who engage in NSSI, there is a lack of research investigating factors that, when considered together, can differentiate individuals along the continuum of suicidal thoughts and behavior (no history, suicidal ideation, suicide plan, suicide attempt). This study sought to address this question using a sample of 1178 college students with NSSI history (68.70% female). Discriminant function analysis was conducted including the following predictors: NSSI characteristics, negative affect difficulties, and behavioral and demographic risk factors for suicidal thoughts and behavior. Results suggest that self-disclosure of suicidal ideation, number of lifetime NSSI methods, NSSI frequency, depressive symptoms, and age most parsimoniously differentiate study groups. Those who use a greater number of NSSI methods and acts, paired with higher depressive symptoms and repeated self-disclosure of suicidal ideation are most likely to have a suicide attempt history; decreases in these variables suggest membership within less severe groups. Furthermore, older age may be related to greater suicidality. Findings suggest that the evaluation and co-occurrence of these variables may contribute to a more accurate suicide risk assessment.
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Affiliation(s)
- Anne C Knorr
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA 19122, USA.
| | - Brooke A Ammerman
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA 19122, USA
| | - Alexander J Hamilton
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA 19122, USA
| | - Michael S McCloskey
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA 19122, USA
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Number and violence of suicide attempt methods: A preliminary investigation of the associations with fearlessness of suicide and fearlessness about death. Psychiatry Res 2018; 265:183-189. [PMID: 29727762 DOI: 10.1016/j.psychres.2018.04.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 03/01/2018] [Accepted: 04/17/2018] [Indexed: 11/24/2022]
Abstract
The Interpersonal Psychological Theory of Suicide (IPTS) proposes that to attempt suicide one must not only desire death, but must also have acquired the capability to act on that desire. The IPTS states capability for suicide can be acquired through exposure to painful and provocative events, with events most closely related to suicide (e.g., non-fatal attempt) having the strongest effects on capability. We tested the effects of two aspects of suicide attempt history-number and violence of methods-on acquired capability, operationalized as both fearlessness about death and fearlessness of suicide, in a sample of psychiatric inpatients with a history of multiple suicide attempts. Results from three separate models suggest that number of methods and number of violent methods, but not history of ever using a violent method, are associated with increased fearlessness of suicide, even after accounting for hopelessness, general painful and provocative events, NSSI, and number of attempts. Few variables were associated with fearlessness about death. Our results raise the possibility that fearlessness of death and suicide may not be synonymous constructs. They also indicate that number of methods, and/or number of violent methods, may be important markers of fearlessness of suicide among those at high risk.
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Baer MM, LaCroix JM, Browne JC, Hassen HO, Perera KU, Weaver J, Soumoff A, Ghahramanlou-Holloway M. Non-Suicidal Self-Injury Elevates Suicide Risk among United States Military Personnel with Lifetime Attempted Suicide. Arch Suicide Res 2018; 22:453-464. [PMID: 28885089 DOI: 10.1080/13811118.2017.1358225] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Military psychiatric inpatients with and without a lifetime history of non-suicidal self-injury (NSSI), combined with a history of at least one suicide attempt, were compared on suicide ideation severity, number of suicide attempts, and Interpersonal-Psychological Theory of Suicide variables. Data were derived from baseline assessments performed in a psychotherapy randomized controlled trial. Lifetime history of NSSI and lifetime number of suicide attempts were assessed using the Columbia Suicide Severity Rating Scale (C-SSRS; Posner et al., 2011 ). Individuals with versus without a combined lifetime history of attempted suicide and NSSI showed significant elevations on thwarted belongingness and acquired capability for suicide. No significant between-group differences were found on perceived burdensomeness, frequency, duration, and controllability of suicide ideation, or number of lifetime suicide attempts. A history of NSSI, above and beyond attempted suicide, appears to increase service members' social alienation and acquired capability for suicide.
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Matney J, Westers NJ, Horton SE, King JD, Eaddy M, Emslie GJ, Kennard BD, Stewart SM. Frequency and Methods of Nonsuicidal Self-Injury in Relation to Acquired Capability for Suicide Among Adolescents. Arch Suicide Res 2018; 22:91-105. [PMID: 28121238 DOI: 10.1080/13811118.2017.1283266] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The objective of this study was to test the Interpersonal Psychological Theory of Suicide (IPTS) proposal that the association of nonsuicidal self-injury (NSSI) with suicide attempt is mediated by acquired capability. Inpatient adolescents (n = 134) reported on suicide ideation and attempts, NSSI frequency and methods, depressive symptoms, and acquired capability for suicide. Consistent with the IPTS, both measures of NSSI were positively associated with acquired capability after accounting for depressive symptoms and past history of attempts. However, both NSSI measures explained independent variance in number of suicide attempts after controlling for suicide ideation and acquired capability. These findings contradict the IPTS and suggest that the role of NSSI in suicide attempt is mediated by variables external to the IPTS.
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20
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Chu C, Buchman-Schmitt JM, Stanley IH, Hom MA, Tucker RP, Hagan CR, Rogers ML, Podlogar MC, Chiurliza B, Ringer-Moberg FB, Michaels MS, Patros C, Joiner TE. The interpersonal theory of suicide: A systematic review and meta-analysis of a decade of cross-national research. Psychol Bull 2017; 143:1313-1345. [PMID: 29072480 PMCID: PMC5730496 DOI: 10.1037/bul0000123] [Citation(s) in RCA: 550] [Impact Index Per Article: 78.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Over the past decade, the interpersonal theory of suicide has contributed to substantial advances in the scientific and clinical understanding of suicide and related conditions. The interpersonal theory of suicide posits that suicidal desire emerges when individuals experience intractable feelings of perceived burdensomeness and thwarted belongingness and near-lethal or lethal suicidal behavior occurs in the presence of suicidal desire and capability for suicide. A growing number of studies have tested these posited pathways in various samples; however, these findings have yet to be evaluated meta-analytically. This paper aimed to (a) conduct a systematic review of the unpublished and published, peer-reviewed literature examining the relationship between interpersonal theory constructs and suicidal thoughts and behaviors, (b) conduct meta-analyses testing the interpersonal theory hypotheses, and (c) evaluate the influence of various moderators on these relationships. Four electronic bibliographic databases were searched through the end of March, 2016: PubMed, Medline, PsycINFO, and Web of Science. Hypothesis-driven meta-analyses using random effects models were conducted using 122 distinct unpublished and published samples. Findings supported the interpersonal theory: the interaction between thwarted belongingness and perceived burdensomeness was significantly associated with suicidal ideation; and the interaction between thwarted belongingness, perceived burdensomeness, and capability for suicide was significantly related to a greater number of prior suicide attempts. However, effect sizes for these interactions were modest. Alternative configurations of theory variables were similarly useful for predicting suicide risk as theory-consistent pathways. We conclude with limitations and recommendations for the interpersonal theory as a framework for understanding the suicidal spectrum. (PsycINFO Database Record
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Affiliation(s)
- Carol Chu
- Florida State University, Department of Psychology, Tallahassee, FL
- McLean Hospital, Belmont, MA
- Harvard Medical School, Department of Psychiatry, Cambridge, MA
| | | | - Ian H. Stanley
- Florida State University, Department of Psychology, Tallahassee, FL
| | - Melanie A. Hom
- Florida State University, Department of Psychology, Tallahassee, FL
| | - Raymond P. Tucker
- Louisiana State University, Department of Psychology, Baton Rouge, LA
| | | | - Megan L. Rogers
- Florida State University, Department of Psychology, Tallahassee, FL
| | | | - Bruno Chiurliza
- Florida State University, Department of Psychology, Tallahassee, FL
| | | | | | - Connor Patros
- Temple University, Department of Psychology, Philadelphia, PA
| | - Thomas E. Joiner
- Florida State University, Department of Psychology, Tallahassee, FL
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21
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May AM, Victor SE. From ideation to action: recent advances in understanding suicide capability. Curr Opin Psychol 2017; 22:1-6. [PMID: 30122270 DOI: 10.1016/j.copsyc.2017.07.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 07/10/2017] [Indexed: 10/19/2022]
Abstract
Suicide capability is one of few risk factors associated with suicide attempts among ideators. In the decade since the Interpersonal Psychological Theory of Suicide introduced the concept of acquired capability (i.e. the ability to face the fear and pain associated with death), understanding of the capability to attempt suicide has grown. Acquired (e.g. NSSI), dispositional (e.g. genetic), and practical contributors (e.g. access to firearms) appear to influence suicide capability via mechanisms such as the fear of death, persistence through pain, and familiarity with suicide methods. Self-report methods have shown mixed results, highlighting the importance of developing behavioral measures of suicide capability.
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Affiliation(s)
- Alexis M May
- University of Utah, Department of Psychology, 380 S 1530 E, Beh S 502, Salt Lake City, UT 84112, USA.
| | - Sarah E Victor
- University of Pittsburgh School of Medicine, Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
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22
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Madjar N, Ben Shabat S, Elia R, Fellner N, Rehavi M, Rubin SE, Segal N, Shoval G. Non-suicidal self-injury within the school context: Multilevel analysis of teachers' support and peer climate. Eur Psychiatry 2017; 41:95-101. [PMID: 28142107 DOI: 10.1016/j.eurpsy.2016.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/02/2016] [Accepted: 11/02/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Recent studies regarding non-suicidal self-injury (NSSI) among adolescents have focused primarily on individual characteristics (e.g., depressive symptoms) and background factors (e.g., parental relationship), whereas less emphasis has been given to the role of school-related factors in NSSI. Therefore, the purpose of the current study was to explore the relationships between teachers' support, peer climate, and NSSI within the school context. METHODS The sample consisted of 594 high school students nested within 27 regular classes (54.4% boys; mean age 14.96, SD=1.33 years). The students were evaluated for NSSI behaviors, perception of teacher support, peer climate, relationships with mothers, and depressive symptoms using validated scales. RESULTS The primary analysis used hierarchical linear modeling (HLM), controlling for gender and age. The main findings indicated that teacher support was positively associated with NSSI at the classroom-level (OR=6.15, 95% CI=2.05-18.5) but negatively associated at the student-level (OR=0.66, 95% CI=0.49-0.89). There was a trend toward an association between positive peer climate and NSSI at the classroom-level (OR=0.43, 95% CI=0.18-1.05), while negative peer climate was associated with NSSI at the student-level (OR=1.37, 95% CI=1.00-1.87). CONCLUSIONS School-related factors are associated with NSSI behaviors among students. Teachers and educators should focus on both individual-level and classroom-level perceptions of school context. Students who feel supported by their teachers and who are exposed to a positive peer climate are less likely to engage in NSSI.
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Affiliation(s)
- N Madjar
- School of Education, Bar-Ilan University, 5290002 Ramat-Gan, Israel.
| | - S Ben Shabat
- School of Education, Bar-Ilan University, 5290002 Ramat-Gan, Israel
| | - R Elia
- School of Education, Bar-Ilan University, 5290002 Ramat-Gan, Israel
| | - N Fellner
- School of Education, Bar-Ilan University, 5290002 Ramat-Gan, Israel
| | - M Rehavi
- School of Education, Bar-Ilan University, 5290002 Ramat-Gan, Israel
| | - S E Rubin
- School of Education, Bar-Ilan University, 5290002 Ramat-Gan, Israel
| | - N Segal
- School of Education, Bar-Ilan University, 5290002 Ramat-Gan, Israel
| | - G Shoval
- Child and Adolescents' Psychiatry Division, Geha Mental Health Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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