Self-Injurious Thoughts and Behaviors Among College Students: A Latent Class Analysis

Adolescent Nonsuicidal Self-Injury and Suicidality: A Latent Class Analysis and Associations with Clinical Characteristics in an At-Risk Cohort

Nonsuicidal self-injury (NSSI) is frequently encountered in adolescents, but its predictive value for suicidality or other clinical characteristics is challenging due to its heterogeneous nature. This study used latent class analysis to identify subgroups of NSSI and compared these on sociodemographic characteristics, adverse outcomes and protective factors. The study included 966 high-risk adolescents, Mage 14.9 y, SD 0.9 y, 51.8% female. Four classes emerged: (1) "Low NSSI-Low suicidality", (2) "Moderate NSSI-Low suicidality", (3) "Moderate NSSI-High suicidality", and (4) "High NSSI-High suicidality". Girls predominated in the high suicidality classes. Generally, Class 4 had the poorest outcomes: more internalizing and externalizing problems, less social support from friends and families and worst self-esteem. These findings emphasize the need for interventions tailored to specific phenotypes of adolescents engaging in NSSI.

Navigating college campuses: The impact of stress on mental health and substance use in the post COVID-19 era

The college years are one of excitement and often thought of as a dream like setting of growth, creativity, and independence. This exciting time can be marred by the onset or exacerbation of mental health conditions, alcohol, and/or drug dependence. This writing looks to explore the world of college mental health and the changes the provisions of this type of care has undergone during and after the COVID-19 pandemic. We look at the staggering rates of diagnosed mental health diagnoses and mental health related symptoms that may undermine a student's ability to meet their full growth and academic potential. We look to explore different health settings where college age students are accessing care and how that care is being delivered (e.g. community vs on-campus, telehealth vs in-person). We also aim to highlight specific mental health conditions (e.g. anxiety, depression, suicidality, PTSD) and specific student stressors (e.g. participating in athletics, socioeconomic pressures) to underscore the message that the mental health of college age students is an area that needs continued study and engagement of all parties involved in student development and well-being.

Depression, anxiety, and suicidal behaviors in a large-scale national survey of student athletes versus non-athlete college students: risk and protective factors

OBJECTIVE

This study investigates the prevalence and risk factors of internalizing disorders and suicidal behaviors in student-athletes and their non-athlete peers.

PARTICIPANTS

The sample consisted of 223,226 college students (69,404 student-athletes [31.09%]) who participated in the NCHA-ACHA II survey (Fall 2015-2018).

METHODS

Items from the NCHA-ACHA II were used to assess severity of depression, anxiety, and suicidal behaviors. Chi-squared Test of Independence and multinomial logistic regressions were used to examine self-reported internalizing symptoms, previous diagnosis, previous use of mental health resources, and suicidal behaviors within student-athletes and non-athletes.

RESULTS

Findings indicated high rates of internalizing symptoms. Student-athletes, both varsity and intramural/club, displayed decreased odds of internalizing symptoms, self-reported mental health diagnosis, and suicidal behaviors.

CONCLUSIONS

This study with a national sample expands previous studies showing concerning rates of mental health difficulties, student-athletes demonstrated lower odds. These findings highlight the importance of further research and need for targeted intervention within this population.

Nonsuicidal self-injury methods among U.S. Veterans: Latent class analysis and associations with psychosocial outcomes

Nonsuicidal self-injury (NSSI) is a debilitating concern among U.S. veterans, with wall/object-punching commonly endorsed as an NSSI method. We examined how this behavior relates to other NSSI methods and psychosocial outcomes. We conducted a latent class analysis (LCA) of NSSI methods among 1,138 Gulf War Era veterans, (77.9% male), 21.7% of whom endorsed lifetime NSSI. We categorized classes based on their associations with age, sex, combat and military sexual assault exposure, then examined the association of class membership with psychosocial indicators. LCA results supported four classes: 1) High punching/banging NSSI (2.5%); 2) Multimethod NSSI methods (6.3%); 3) High-risk, multimethod NSSI (3.1%); and 4) Low-risk NSSI (88.1%). Psychosocial indicators (suicide attempt, ideation, possible depressive or posttraumatic stress disorders, poor psychosocial functioning) were worse for members of the NSSI classes versus those in the low-risk group. A subset of U.S. veterans may engage in NSSI primarily via punching/banging methods. All patterns of NSSI engagement were associated with negative psychosocial outcomes relative to those in the low-risk class of the behavior.

A latent profile analysis of at-risk first-year undergraduate students

Objective: We examined whether meaningful subgroups of self-injurious behaviors (SIBs) would emerge within a pool of first-year college students already deemed at elevated risk. Participants: First-year undergraduates (N = 1,068) recruited in 2015-2018 Fall terms. Methods: Past-year nonsuicidal self-injury (NSSI) frequency, past-year number of NSSI methods used, lifetime suicide attempt (SA) history, and recency of SA were included in a latent profile analysis. Results: Four subgroups emerged: low SIB (n = 558, 52%), high NSSI only (n = 182, 17%), high SIB (n = 141, 13%), and high SA only (n = 187, 18%). Students in the high SIB group reported higher levels of suicidal ideation at baseline and follow-up in comparison to all groups. Those in the high NSSI only or high SIB groups had relatively higher levels of NSSI at baseline and follow-up. Conclusions: Findings highlight the amount of heterogeneity within a high-risk group, along with the importance of considering distal and proximal SIBs in university screening efforts.

Profiles of patients using emergency departments or hospitalized for suicidal behaviors

OBJECTIVES

This study identified profiles of patients with suicidal behaviors, their sociodemographic and clinical correlates, and assessed the risk of death within a 12-month follow-up period.

METHODS

Based on administrative databases, this 5-year study analyzed data on 5064 patients in Quebec who used emergency departments (ED) or were hospitalized for suicidal behaviors over a 2-year period. Latent class analysis was used for patient profiles, bivariate analysis for patient correlates over 2 years, and survival analysis for risk of death within a 12-month follow-up.

RESULTS

Four profiles were identified: high suicidal behaviors and high service use (Profile 1: 23%); low suicidal behaviors and moderate service use (Profile 2: 46%); low suicidal behaviors and low service use (Profile 3: 25%); and high suicidal behaviors and high acute care, but low outpatient care (Profile 4: 6%). Profiles 1 and 4 patients had more serious conditions, with a higher risk of death in Profile 1 versus Profiles 2 and 3. Profile 2 patients had relatively more common mental disorders, and Profile 3 patients had less severe conditions. Profiles 3 and 4 included more men and younger patients.

CONCLUSION

Programs better adapted to patient profiles should be deployed after ED use and hospitalization in coordination with outpatient services.

Nonmedical Social Determinants, Syndemic Conditions, and Suicidal Thoughts and Behaviors in a Treatment-seeking Community Sample: A Latent Class Analysis

OBJECTIVE

Knowledge gaps remain regarding whether syndemic conditions identify treatment-seeking individuals most at risk for suicidal thoughts and behaviors (STB). We employed latent class analysis to: (1) model treatment-seeking individuals' syndemic conditions, (2) examine latent classes across nonmedical social determinants, and (3) assess associations between class membership and STB.

METHOD

Participants were 982 individuals presenting at a community mental health clinic between October 2014 and February 2020. The three-step latent class analytic approach was used. Regression analyses were employed to examine nonmedical social determinants and STB outcomes associated with class membership.

RESULTS

Participants were aged 18 to >72 (75.8% White; 76.7% heterosexual; 53.7% cisgender woman; 73.8% earned ≥$20,000 annually). Latent class analysis resulted in a three-class solution. Participants in Class 1 were characterized by low probabilities across syndemic conditions. Class 2 was characterized by high probabilities of anxiety and depression. Class 3 was characterized by high probabilities of eating disorders, anxiety, and depression. Participants of color, sexual minority participants, cisgender women, and those experiencing financial distress were more likely to be in classes characterized by syndemic conditions. Classes characterized by syndemic conditions, relative to no syndemic conditions, were associated with greater risk of STB.

CONCLUSION

Findings confirm the concentrated clustering of co-occurring syndemic conditions among marginalized groups and highlight differing risks for those considering suicide or who have attempted suicide vs. those engaging in self-harm. Results underscore the need for resource allocation and multilevel interventions targeting syndemic conditions and suicidality for minority populations and those experiencing financial distress.

The Common Factors of Grit, Hope, and Optimism Differentially Influence Suicide Resilience

No study to date has simultaneously examined the commonalities and unique aspects of positive psychological factors and whether these factors uniquely account for a reduction in suicide risk. Using a factor analytic approach, the current study examined the relationships between grit, hope, optimism, and their unique and overlapping relationships in predicting suicide ideation. Results of principle axis factor analysis demonstrated close relationships between these variables at both the construct and item level. Item-level analyses supported a five-factor solution (Stick-to-Itiveness, Poor Future, Consistency of Interest, Positive Future, and Poor Pathways). Four of the five factors (excluding Stick-to-Itiveness) were associated with suicide ideation. Additionally, results of a multiple regression analysis indicated that two of the five factors (Consistency of Interest and Positive Future) negatively predicted suicide ideation while Poor Future positively predicted suicide ideation. Implications regarding the interrelationships between grit, hope, and optimism with suicide ideation are discussed.