Purpose in life and reasons for living as mediators of the relationship between stress, coping, and suicidal behavior

Crisis of Faith and Sleep Quality in the United States: A Literal Dark Night of the Soul?

A crisis of faith is an intrapersonal struggle with ultimate meaning that occurs when one's supramundane reality is called in question. We propose a theoretical model which suggests that a crisis of faith will contribute to poorer sleep quality by undermining a general sense of meaning and purpose in life, especially among women. We use national survey data from the Wave 5 of the Baylor Religion Survey United States (N = 1395). Ordinary least squares regression models with robust standard errors are utilized. Sobel-Goodman mediation techniques are used to test the proposed mediating pathway. Our results suggest that a crisis of faith is associated with lower sleep quality, and that this pathway is partially mediated by a lower sense of meaning and purpose in life. Finally, we found that the relationship between a crisis of faith and lower sleep quality was weaker for women. We discuss the implications of our results and suggest how future research may explore the relevance of a crisis of faith for well-being as well as other aspects of the human condition.

Emotional regulation and suicidal ideation-Mediating roles of perceived social support and avoidant coping

Introduction

Recent research has uncovered a wide prevalence variation of suicidal ideation in university students ranging from 9.7% to 58.3%. India has witnessed a 4.5% increase in suicide rates in the year 2021. The interplay between cognitive reappraisal of a stressful situation, suppression of emotional expression, and coping strategies for suicidal ideation of Indian University students is yet to be explored. We aim to determine whether suicidal ideation would differ across different types of family units, and to predict the extent to which perceived social support and avoidant coping could mediate the relation between emotion regulation processes and suicidal ideation.

Methods

Two hundred randomly selected University students (Mean age = 19.9, SD = 1.43) participated. Kruskal-Wallis, Pearson's product-moment correlation, and GLM mediation model were computed.

Results and discussion

Lifetime suicidal ideation significantly differed between those who stay alone and those who live in a nuclear family (p < 0.01), and also those who stay in a joint family (p < 0.05). Cognitive reappraisal predicted a reduction in suicidal ideation mediated by perceived social support (B = -0.06, p < 0.05) and avoidant coping (B = -0.07, p < 0.05). Whereas, expressive suppression predicted induced levels of suicidal ideation through perceived social support (B = 0.05, p < 0.05), and avoidant coping (B = 0.06, p < 0.05) as mediators.

Conclusion

Though our sample size restricts the generalization, our findings implied the importance of regular psychological consultation regarding the efficacy of the said coping processes in dealing with suicidal ideation.

The relationship between purpose in life and depression and anxiety: A meta-analysis

Purpose in life consists of having a sense of meaning and purpose regarding one's activities as well as an overall sense that life is meaningful. This study reports a comprehensive assessment of the relationship of purpose in life with depression and anxiety. A meta-analysis (total n = 66,468, total k = 99) investigated the association of purpose in life with depression and anxiety. Across samples, greater purpose in life was significantly associated with lower levels of depression and anxiety. The mean weighted effect size between purpose in life and depression was r = -0.49, [95% confidence intervals, CIs: -0.52, -0.45], p < 0.001. For the purpose in life and anxiety the mean weighted effect size was r = -0.36, [95% CIs: -0.40, -0.32], p < 0.001. The association of purpose in life with mental health was stronger for clinical populations, especially with regard to the relationship with anxiety. Both approach deficits and avoidance motivation are argued to play a role in the relationship between purpose and psychopathology, with greater purpose potentially limiting avoidance tendencies and reducing the effects of depression and anxiety. Understanding the role that purpose in life may play in depression and anxiety could help to inform current conceptualizations of these disorders and improve treatment outcomes.

The Association Between Personal, Affective, and Cognitive Factors and Suicide Risk Among Muslims in Turkey

This study was conducted to examine the association of various personal, affective, and cognitive factors with suicide risk. The study group consisted of a total of 423 individuals, including 341 (74%) females and 82 (26%) males, who lived in Turkey and declared that they were Muslims. The data of the study, in which a cross-sectional design was employed, were collected between October and December 2022. The mean age of the participants was 26.84 years (SD = 9.88, min-max = 18-64). The data collection measures included the Psychological Distress Scale, the Perception of God Scale, the Two-Dimensional Self-Esteem Scale, the Suicide Probability Scale, and a personal information form. Pearson correlation analysis and Hierarchical Multiple Linear Regression analysis were employed in the analysis of the data obtained from the research. In the study, it was found that gender, age, suicide attempt, communication with the mother, communication with the father, psychological distress, self-esteem, and perception of God explained 58% of the variance in suicide risk. Psychological distress had the strongest positive association with suicide risk (β = 0.136, p < 0.001), while self-esteem had the strongest negative relation (β = - 0.454, p < 0.001). In conclusion, it was determined that the female gender, suicide attempt, and psychological distress increased the risk of suicide, but that age, positive communication with parents, self-esteem, and positive perception of God decreased it. The findings of the research were discussed in light of the literature.

Sense of purpose interventions for depression and anxiety in youth: A scoping review and cross-cultural youth consultation

BACKGROUND/OBJECTIVES

To investigate the effectiveness, feasibility, and acceptability of sense of purpose (SOP) interventions in preventing or reducing anxiety or depression in youth aged 14-24 years.

METHODS

A systematic search was conducted of the academic (PubMed/MEDLINE, PsycINFO, EMBASE) and grey literature. We also consulted two SOP experts and an Australian and Indian youth advisory group with lived experience of anxiety and/or depression. Consultations focused on the feasibility and acceptability of reviewed interventions.

RESULTS

The search identified 25 studies reporting on 4408 participants from six countries (64.0 % of studies in the US). Multi-component interventions targeting several SOP components (i.e., value clarification, goal setting, gratitude enhancement) reported, on average, moderate reductions in depression and anxiety symptoms in youth. Interventions were generally more effective at reducing depression than anxiety symptoms. In terms of sub-populations or groups, there was some evidence for greater intervention effectiveness among youth with prior therapy experience, extraverted personalities, and those with already elevated anxiety/depression symptoms. Youth advisors and experts opined that group interventions were most acceptable to young people.

LIMITATIONS

This review was limited to a recent 10-year timeframe and publications in English, potentially excluding relevant studies published prior to 2011 or in other languages.

CONCLUSIONS

Fostering SOP can lead to better psychological wellbeing in youth. Potential harms resulting from interventions can occur without adequate consideration for a person's readiness for purpose discovery, environmental barriers, and familial and cultural settings. Further research in more diverse populations is required to determine who benefits and in what contexts.

Examining the role of life purpose in high school students' self-esteem through structural equation modelling

The aim of this study was to examine the extent to which high school students' sense of purpose explained variance their self-esteem. Life purpose is a multidimensional construct that encompasses long-term goals, commitments, and intentions to fulfill aspirations that are meaningful to self and have consequences for the world beyond-the-self. For this study, we explored the role of three distinct dimensions of awareness of purpose, awakening to purpose, and altruistic purpose in predicting students' self-esteem. High school students' (N = 234) between 14 and 18 years, completed surveys on self-esteem and sense of purpose. A structural model was tested, in which the three latent factors of awakening to purpose, awareness of purpose, and altruistic purpose were specified to predict a latent factor of self-esteem. Analyses were conducted using maximum likelihood estimation method. Findings showed that both awareness of purpose and altruistic purpose contributed positively to adolescents' self-esteem. Awakening to purpose, on the other hand, was not significantly related to adolescents' self-esteem once their awareness of purpose and altruistic purpose were taken into account. This study expanded the growing body of research on the role of purpose in contributing to school students' personal wellbeing and development. We have discussed the findings of this study and previous literature in the context of practical implications that could support school personnel, teachers, and counselors to engage in wellness-oriented approaches that could strengthen students' sense of purpose, and thereby their self-esteem.

Stress and suicidal ideation in Korean baby boomers: the mediating effect of mindfulness and meaning in life

Stress has been shown to enhance elderly suicidal ideation. However, the effect of mindfulness and meaning in life on the relationship between stress and suicidal ideation in Korean baby boomers are still unknown. This study investigated (a) a significant correlation between the stress, suicidal ideation, mindfulness, and meaning in life, (b) the mediating effect of mindfulness in the association between stress and suicidal ideation, and (c) the serial mediating effect of mindfulness and then meaning in life on the relationship between stress and suicidal ideation. Data were collected from 200 baby boomers (born between 1955-1963) concerning their stress, mindfulness, meaning in life, and suicidal ideation. These findings suggest that if interventions directed at baby boomers can successfully improve their mindfulness and by extension raise their meaning in life, suicidal ideation will decrease within their population.

A machine learning analysis of risk and protective factors of suicidal thoughts and behaviors in college students

OBJECTIVE

To identify robust and reproducible factors associated with suicidal thoughts and behaviors (STBs) in college students.

METHODS

356 first-year university students completed a large battery of demographic and clinically-relevant self-report measures during the first semester of college and end-of-year (n = 228). Suicide Behaviors Questionnaire-Revised (SBQ-R) assessed STBs. A machine learning (ML) pipeline using stacking and nested cross-validation examined correlates of SBQ-R scores.

RESULTS

9.6% of students were identified at significant STBs risk by the SBQ-R. The ML algorithm explained 28.3% of variance (95%CI: 28-28.5%) in baseline SBQ-R scores, with depression severity, social isolation, meaning and purpose in life, and positive affect among the most important factors. There was a significant reduction in STBs at end-of-year with only 1.8% of students identified at significant risk.

CONCLUSION

Analyses replicated known factors associated with STBs during the first semester of college and identified novel, potentially modifiable factors including positive affect and social connectedness.

Life-Satisfaction, Engagement, Mindfulness, Flourishing, and Social Support: Do they Predict Depression, Suicide Ideation, and History of Suicide Attempt in Late Life?

OBJECTIVE

Suicide is an outcome arising from a combination of risk and protective factors. Examining psychological resilience traits associated with successful aging may help to better understand late-life suicide and depression. We examined self-reported protective factors including mindfulness, life satisfaction and engagement, flourishing, and subjective and objective social support in a high suicide-risk sample of depressed older adults.

METHODS

Participants were 297 individuals aged 55+ (mean age: 64.2): 92 depressed suicide attempters, 138 depressed individuals who never attempted suicide, and 67 non-psychiatric comparisons. Using linear and binomial logistic regression, we examined the effects of a combined Protective Factor value on presence and severity of depression and suicidal ideation, and history of suicide attempt.

RESULTS

Relative to the non-psychiatric comparison group, all depressed participants had significantly lower Protective Factor values. Higher Protective Factor value was associated with lower likelihood of depression, depression severity, and likelihood of ideation, but was not associated with ideation severity or history of suicide attempt. Participants with one standard deviation higher Protective Factor had lower odds of ideation incidence by a factor of OR=0.68 (95%CI=0.48-0.96).

CONCLUSION

Resiliency characteristics relevant to psychological wellbeing and successful aging may mitigate the emergence of depression and suicidal ideation, as well as the severity of depression in late-life. The Resilience Factor used in this study can help clinicians nuance their appraisal of depression and suicide risk.

Distinct trajectories of suicidal behaviors throughout the university stage and associated risk and protective factors: A large-scale prospective study

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.

Meaning of life as a resource for coping with psychological crisis: Comparisons of suicidal and non-suicidal patients

Introduction

Meaning is an important psychological resource both in situations of accomplishment and in situations of ongoing adversity and psychological crisis. Meaning in life underlies the reasons for staying alive both in everyday and in critical circumstances, fulfilling a buffering function with respect to life adversities.

Aim

The aim of the present study was to reveal the role of both meaningfulness, including specific sources of meaning and reasons for living, and meaninglessness (alienation) in patients suffering from profound crisis situations with or without suicidal intentions and behavior.

Methods

The sample included 148 patients (all Caucasian) who were referred to a crisis center in Moscow, Russia. Seventy-seven patients (54 females, mean age 32.00 ± 11.98 years) reported a current crisis situation in their life but denied suicidal thoughts or behavior. Twenty-nine patients (21 females, mean age 31.55 ± 13.76 years) reported suicidal ideations but denied suicidal attempts or self-harming behavior. Forty-two patients (31 females, mean age 30.64 ± 11.38 years) had episodes of suicidal attempts or self-harming behavior accompanied by suicidal intentions. There were no significant gender or age differences between groups.

Participants completed a number of measures of different aspects of meaning and meaninglessness, well-being, ill-being and psychological resources. For some patients (N = 74), a clinical checklist was completed by their doctors assessing 28 various characteristics associated with the patient’s clinical status.

Results and discussion

Meaningfulness and reasons for living were more helpful in distinguishing between reactions to profound crisis situations (suicidal intentions versus non-suicidal behavior) than were measures of well-being, ill-being, meaning crisis or personality resources. In both suicidal and non-suicidal crisis patients meaningfulness predicted more positive reasons for living. The relationship between meaningfulness and most reasons for living remained significant after controlling for clinically appraised suicidal “readiness,” acute stress and lack of social support. Self-transcendence was the major specific source of meaning predicting higher reasons for living after adjusting for general meaningfulness.

Conclusion

The data cast some light on the psychological meaning of suicide. It follows that prevention efforts are to be focused not on eliminating the factors “pushing” one to suicidal behavior, but rather on supporting inner strengths conducive of a positive decision, to be, through enhancing meaningfulness and reasons for living.

Sleep quality mediates the relationship between traumatic events, psychological distress, and suicidality in college undergraduates

Objectives: To determine whether sleep quality mediates the relationship between traumatic life events and psychological wellbeing in college students. Methods: 40,646 undergraduate responses from the Spring 2017 National College Health Assessment II were evaluated for relationships between two predictor variables: satisfactory sleep and traumatic life events, and two outcome variables: psychological distress (a composite of anxiety, exhaustion, feeling overwhelmed, depression, sadness, loneliness, hopelessness, and anger) and suicidality (composite of self-harm behaviors, suicidal ideation, suicide attempts). Linear mediation regression analysis via structural equation modeling was used to test these relationships. Results: Each additional traumatic life event students reported experiencing was associated with a 27.6% - 58.9% increase in the odds of reporting indicators of psychological distress or suicidality. Satisfactory sleep significantly mediated this negative relationship (proportional effects between 10.6 and 12.5%). Conclusions: Healthy sleep mediates the impact of traumatic life events on psychological distress and suicidality.

Factors associated with remission of suicidal thoughts and behaviors in U.S. military veterans with a history of suicide attempt

Suicide is a major public health problem in U.S. military veterans, but little is known about factors associated with remission from suicide attempts in this population. We aimed to identify risk and protective correlates of remission from suicidal thoughts and behavior (STB) in U.S. veterans with a prior suicide attempt. Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study survey. A broad range of sociodemographic, military, physical and mental health, and psychosocial variable were assessed. Purpose in life, dispositional gratitude, and conscientiousness emerged as independent correlates of STB remission (24.3%-40.3% of explained variance), even after accounting for other relevant risk and protective factors. While the cross-sectional nature of the study precludes the ability to determine whether the identified protective factors are causally related to STB remission, results suggest three potentially modifiable targets for suicide prevention efforts in veterans. Longitudinal studies are needed to better understand the role of purpose in life, dispositional gratitude, and conscientiousness in promoting remission from STBs in veterans and other populations at risk for suicide.

Black Youth Suicide Crisis: Prevalence Rates, Review of Risk and Protective Factors, and Current Evidence-Based Practices

Suicide is the second leading cause of death among adolescents and young adults. Historically, Black youths have experienced lower rates of suicide; however, recent data point to significant racial disparities. In this article, the authors review current suicide rates, including alarming new data suggesting that suicide rates are two times higher among Black children ages 5-12 compared with White children in that age range. A clinically focused summary of socioecological risk and protective factors associated with suicide among Black youths, with particular attention on structural drivers and culturally relevant factors, is provided. Current evidence-based reviews suggest that dialectical behavior therapy is the only well-established treatment against self-harm and suicide among youths. However, it is unknown whether current established treatments work for Black youths, because Black youths are rarely included in randomized controlled trials. The authors conclude by reviewing emerging treatments developed and tested specifically for Black youths.

How spousal physical abuse impacts suicidal ideation among community-dwelling older adults: the effects of protective factors

PURPOSE

The purpose of this study is to examine the impact on suicidal ideation (SI) of having experienced spousal physical abuse and the possible effects of protective factors on the relationship between depressive symptoms and SI among community-dwelling older adults.

METHODS

Using Wisconsin Longitudinal Study data (N = 6,125), a path analysis was conducted to examine the impact of spousal physical abuse on SI and test the possible effects of protective factors.

RESULTS

First, the experience of spousal physical abuse had a significant impact on both depressive symptoms and SI. Second, problem-focused coping, social support, and having a family confidant reduced depressive symptoms directly and mitigated SI indirectly. Third, emotional-focused coping had both direct and indirect effects on depressive symptoms and SI, leading to increases in both. Fourth, although the practical significance may be small, emotional-focused coping worked as a moderator between depressive symptoms and SI.

CONCLUSIONS

Interventions are necessary to increase protective factors and decrease risk factors of depressive symptoms and SI among older adults. In addition, regular screening tests of Intimate Partner Violence, depressive symptoms and SI are recommended.

Meaning in Life Among Patients With Chronic Pain and Suicidal Ideation: Mixed Methods Study

BACKGROUND

Patients with chronic pain have elevated risk of suicidal ideation and behavior, including suicide attempts and completed suicides. In most studies, associations between chronic pain and suicidal ideation/suicidal behavior are robust even after adjusting for the effect of sociodemographics and psychiatric comorbidity. However, to refine the risk profile of these patients, further exploration of other possible risk and protective factors is necessary.

OBJECTIVE

There is a common clinical observation that experiencing chronic pain often requires a revision of life goals and expectations, and hence, it impacts the existential domain including one's perception of the meaning in life (MiL). This study aimed to characterize the main domains that constitute the personal MiL, including the "presence of" and "search for" constructs, in a group of patients with chronic pain and suicidal ideation.

METHODS

Seventy participants were enlisted by ongoing recruitment through a larger project anchored in daily clinical practice at the Multidisciplinary Pain Center of the Geneva University Hospitals. It was an observational mixed method study. Data were recorded through both validated quantitative questionnaires and qualitative open-ended questions.

RESULTS

The total sample consisted of 70 patients. Responses to questionnaires showed a depressive episode in 68 (97%) patients and anxious disorders in 25 (36%) patients. With a score threshold for positive MiL of 24, the mean score for the "presence of" construct was 20.13 (SD 8.23), and 63% (44/70) of respondents had a score <24. The mean score for the "search for" construct was lower at 18.14 (SD 8.64), and 70% (49/70) of respondents had a score <24. The "presence of" and "search for" constructs were significantly positively correlated (R=0.402; P=.001). An open question addressed the "presence of" construct by inviting the respondents to cite domains they consider as providing meaning in their life at the present time. All patients responded to this question, citing one or more domains. The three main dimensions that emerged from content analysis of this qualitative section were as follows: the domain of relationships, the domain of personal activities, and pain and its consequences on MiL.

CONCLUSIONS

The study results provide insights into patients with chronic pain and suicidal ideation, including the domains that provide them with meaning in their lives and the impact of pain on these domains with regard to suicidal ideation. The main clinical implications concern both prevention and supportive/psychotherapeutic interventions. They are based on a narrative approach aiming to explore with the patients the content of their suffering and the MiL domains that they could identify to mitigate it, in order to restructure/reinforce these domains and thus possibly reduce suicidal ideation. Specifically, a focus on maintaining the domains of interpersonal relationships and personal activities can allow patients to ultimately escape the biopsychosocial vicious cycle of chronic pain-induced deep moral suffering.

Coping and Suicide in College Students

Background: Transitioning to college life in young adulthood can represent a challenging developmental period and college students are at heightened risk for engaging in suicidality. Aims: We aimed to investigate the roles dispositional optimism and coping strategies play in suicide risk (viz., suicidality) and suicide protection (viz., reasons for living) in college students. Method: A sample of 252 American college students were surveyed using anonymous questionnaires and hierarchical regression analyses were conducted to analyze the data. Results: Coping strategies, as a set, played an important role in both suicidality and reasons for living, after controlling for demographic factors (age and sex). When dispositional optimism was entered into the model, it was found to account for a significant amount of additional unique variance in both suicidality and reasons for living, even after accounting for coping. Limitations: It is unknown whether optimism remains meaningful in its association with suicide risk and protection beyond coping in other populations. Conclusion: Effective coping and optimism are associated with decreased suicide risk and increased suicide protection. Our findings point to the consistent role of dispositional optimism, over coping, in both suicide risk and protection.

Coping Strategies and Suicidality: A Cross-Sectional Study From China

Background and Objective: Suicide is a leading cause of death in young people. Suicidal thoughts and behaviors can be triggered by life and study stresses; therefore, it is important to understand the role of coping strategies. The current study analyzed the link between different coping strategies and suicidality in university students in China. Methods: A cross-sectional study of 2,074 undergraduate students from China used a stratified-clustered-random sampling method (response rate 94.4%). The Suicidal Behaviors Questionnaire-Revised Scale was used to identify suicidal risks, while the Brief COPE scale was used to measure different coping strategies. Univariate and multivariate logistic regression analyses were utilized to examine coping strategies and suicidality. Results: A negative association of some coping skills (active coping and positive reframing) with suicidality and a positive association of some other coping skills (self-distraction, substance abuse, behavioral disengagement, venting, and self-blame) with suicidality were observed after adjusting for sociodemographic and mental health variables. Conclusions: Training and supporting young people to identify and apply adaptive coping strategies to deal with life stress could help to reduce suicidal ideation and behavior.

The Brief COPE: Factor Structure and Associations With Self- and Other-Directed Aggression Among Emerging Adults

The Brief COPE has seen frequent use across populations despite lack of confirmatory factor-analytic examination. We further examine Brief COPE validity with respect to self- and other-directed aggression because emerging adulthood represents a distinct developmental time period in which stress, poor coping, and aggression intersect. Drawing on archival data (n = 576) from a larger investigation of college student health, this cross-sectional survey study tested (1) four competing Brief COPE factor structures, (2) Brief COPE factor associations with aggression, and (3) stress by coping interactions predicting aggression outcomes. Prominent findings included (1) poor-to-marginal confirmatory factor-analytic support for a four-factor structure; (2) positive bivariate associations of avoidant coping with elevated stress, depression, suicide, self-injury, and aggression; (3) positive bivariate associations between adaptive coping strategies with stress and aggression; and (4) an interaction where avoidant coping has a stronger association with other-directed aggression for those low in stress. The interaction findings were significant for males only and applied specifically to hostility. Findings are contextualized within future Brief COPE research as well as emerging adulthood theory.

The Meaning in Life in Suicidal Patients: The Presence and the Search for Constructs. A Systematic Review

Background and Objectives: Research on suicidal behavior (SB) has frequently focused more on risk factors than protective factors. Since the historic works of Viktor E. Frankl, who inquired how some Nazi concentration camps prisoners maintained their will to live though confronted with pervasive absurdity, Meaning in Life (MiL) has been interpreted as a potent resiliency factor. MiL then declined along a multitude of theoretical perspectives and was associated with various functioning domains of the individual. Surprising, few studies investigated the role of MiL on SB. We aimed to review and synthetize current literature on possible associations between MiL and SB, which included suicidal ideation (SI), suicidal attempts (SA), and completed suicide, focusing on two MiL constructs (the presence of MiL and search for MiL) from the Michael F. Steger’s recent conceptualization. Material andMethods: A systematic strategy following PRISMA guidelines was used to search for relevant articles in Pubmed/MEDLINE, Scopus, PsycINFO, and ScienceDirect (January 1980–February 2019) and yielded 172 articles, 37 of which met our inclusion criteria. Results: MiL emerged as a protective factor against SI, SA, and completed suicides, directly or through mediation/moderation models with other SB-related variables. When distinguishing the presence of MiL and the search for MiL, a consensual protective impact was described for the former. Data for the latter were less consistent but rather oriented towards a non-protective impact Conclusions: These findings could have clinical repercussions for SB prevention, in both suicide risk assessment refinement and psychotherapeutic interventions. Further research is needed to examine the dynamic interplay of the two constructs.

Identifying suicide risk among college students: A systematic review

Mental health research highlights the need to focus on suicide risk in college students. However, evidence for associated risk and protective factors in this cohort is mixed. This review synthesizes data from 29 independent studies (N = 11,557 participants). Self-reported depression, cumulative stressful life events, sleep difficulties, a disconnection from others, and a sense of hopelessness demonstrated significant associations with heightened suicide risk. Reasons to live and hope provided significant protective effects. The findings highlight key intervention targets, pointing to the importance of cognitive-behavioral interventions to ameliorate suicidal thoughts but also build dispositional hope and goal-directed thinking.

Brief reasons for living inventory: a psychometric investigation

BACKGROUND

The present study aimed at validating the German version of the Brief Reasons for Living inventory (BRFL).

METHODS

Validity and reliability were established in a community (n = 339) and a clinical sample (n = 272). Convergent and discriminant validity were investigated, and confirmatory factor analyses were conducted for the complete BRFL as well as for a 10-item version excluding conditional items on child-related concerns. Furthermore, it was assessed how BRFL scores moderate the association between depression and suicide ideation.

RESULTS

Results indicated an adequate fit of the data to the original factor structure. The total scale and the subscales of the German version of the BRFL had sufficient internal consistency, as well as good convergent and divergent validity. The BRFL demonstrated clinical utility by differentiating between participants with vs. without suicide ideation. Reasons for living proved to moderate the association between depression and suicide ideation.

CONCLUSIONS

Results provide preliminary evidence that the BRFL may be a reliable and valid measure of adaptive reasons for living that can be used in clinic and research settings.

Suicide Risk in the Hospitalized Elderly in Turkey and Affecting Factors

OBJECTIVE

This study aimed to investigate the suicide risk among the elderly hospitalized and treated because of physical illnesses, and the factors affecting the risk.

METHODS

The study has a cross-sectional design. It was conducted with 459 elderly people hospitalized and treated in a public hospital between May 25, 2015 and December 4, 2015. Data were collected with the Personal Information Form, Suicide Probability Scale and Hospital Anxiety and Depression Scale. For the analysis, descriptive statistics, the chi-square test, Fisher's exact test and logistic regression analysis were used.

RESULTS

In the study, 24.0% of the elderly were at high risk for suicide. Suicide risk was even higher among the elderly in the 60-74 age group, living alone, drinking alcohol, perceiving his/her religious beliefs as weak, being treated for cancer, having the diagnosis 11 years or over, having a history of admission to a psychiatry clinic, and being at risk for anxiety and depression.

CONCLUSION

In the study, approximately one out of every four elderly people was at high risk for suicide. Therefore, older people should be assessed for suicide risk and programs targeting to prevent the elderly from committing suicide should be organized.

Suicidality Protective Factors for African American Adolescents: A Systematic Review of the Research Literature

Overall rates of African American adolescent suicide have been increasing for the past 50 years; however, the research literature examining factors related to suicide for these vulnerable youth is sparse. The shortage of research literature on suicidality protective factors is particularly significant. Little is known about the impact of protective factors on African American youth, especially within subgroups (e.g., gender and socioeconomic status). Approximately 40% of African American youth live in poverty, exposing them to contextual stressors that place them at increased risk for suicidality. Females are significantly more likely to have suicidal ideation and make attempts, whereas males surpass females in their rates of completions. To better understand suicidality protective factors, we conducted a systematic review of the research literature on protective factors for African American adolescents, with a focus on gender differences and urban, low-income youth. This review yielded 26 articles that met inclusion criteria and identified protective factors in the following categories: familial, religiosity-based, relational/social, personal, and socioecological. Gender differences and protective factors for urban, low-income youth are discussed, regarding their role in the prevention of suicidality. This review highlights a need for further research to identify and clarify suicidality protective factors for African American adolescents.

Understanding the Association Between Negative Life Events and Suicidal Risk in College Students: Examining Self-Compassion as a Potential Mediator

OBJECTIVE

We tested a hypothesized model consistent with the notion that self-compassion mediates the association between negative life events and suicidal risk (viz., depressive symptoms and suicidal behaviors) in college students METHOD: The sample was comprised of 331 college students. Self-compassion facets (viz., self-kindness, self-judgment, common humanity, isolation, mindfulness, and overidentification) were used in testing for multiple mediation, controlling for sex.

RESULTS

Common humanity, mindfulness, and overidentification were found to mediate the association between negative life events (NLE) and depressive symptoms. However, common humanity was found to be the only mediator of the association between NLE and suicidal behaviors.

CONCLUSION

These findings suggest that there are specific facets of self-compassion that account for the association between NLE and suicidal risk in college students and that (loss of) common humanity plays a central role in this process.

Types of childhood trauma and spirituality in adult patients with depressive disorders

OBJECTIVE

The aim of this study was to investigate the differences in spirituality among adult patients with depressive disorders, who had suffered various types of abuse or neglect in childhood.

METHODS

A total of 305 outpatients diagnosed with depressive disorders completed questionnaires on socio-demographic variables, childhood trauma history, and spirituality. We used the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to measure five different types of childhood trauma (emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp-12) to assess spirituality.

RESULTS

Depressive symptoms and total CTQ-SF scores showed a negative correlation with spirituality. In the regression model, being older and belonging to a religion significantly predicted greater spirituality. Depressive symptoms significantly predicted lower spirituality. From among the five types of childhood trauma assessed by the CTQ-SF, only emotional neglect significantly predicted lower spirituality.

CONCLUSION

A history of childhood emotional neglect was significantly related to lower spirituality, especially in the case of the Meaning aspect of spirituality. This finding suggests the potential harmful influence of childhood emotional neglect on the development of spirituality in psychiatric patients. Investigating different aspects of childhood trauma might be important in order to develop a more comprehensive psychiatric intervention that aids in the development of spirituality.

Do reasons for living protect against suicidal thoughts and behaviors? A systematic review of the literature

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.

'Give Me a Reason to Live!' Examining Reasons for Living Across Levels of Suicidality

Scholarly research focusing on social psychological factors (e.g. mental health) and social environmental factors (e.g. childhood trauma) has found these measures to be correlated with suicidality. However, such literature has tended to overlook what may impact one's reasons for living. Using a sample of over 1,200 students from a Canadian university, the goal of the current study is to empirically test, by employing multivariate nested regression models (by levels of suicidal behaviour), known and relative unknown correlates with reasons for living, with a particular focus on strength of religious faith, which is a well-known predictor for suicidality, but less studied as a reason for living. Results show that, among students with serious suicidal ideation and/or a previous suicide attempt, the strongest predictor for student's reasons for living was strength of religious faith. Strength of religious faith has seldom been acknowledged or identified as an important measure in assessing one's reasons to live. These findings have implications for the role of religiosity among suicidality research, especially studies that focus on reasons for living.

A Theory of Human Needs Should Be Human-Centered, Not Animal-Centered: Commentary on Kenrick et al. (2010)

Kenrick et al. (2010, this issue) make an important contribution by presenting a theory of human needs within an evolutionary framework. In our opinion, however, this framework bypasses the human uniqueness that Maslow intended to capture in his theory. We comment on the unique power of culture in shaping human motivation at the phylogenetic, ontogenetic, and proximate levels. We note that culture-gene coevolution may be a more promising lead to a theory of human motivation than a mammalcentric evolutionary perspective.

Sense of purpose in life and escape from self as the predictors of quality of life in clinical samples

Depression is a leading mental disorder from which suffer Europeans and especially women. In clinical groups with elevated risk of suicidal tendencies, both the negative factors and psychological variables that can protect a person should be analyzed. The aims of the current study were analysis of purpose in life function in perceived quality of life-self-efficacy and life satisfaction among people suffering from depression in comparison with control group and analysis of escape from self (EfS)-function as an indicator of suicidal thoughts occurrence, for suicide attempt and perceived quality of life (life satisfaction). Two studies were conducted on two clinical groups. The first study consists of females, 20 of them with depression and 40 without depression disorder as a control group. Measures used in this study are Purpose in Life Scale, General Self-Efficacy Scale, and Satisfaction with Life Scale (SWLS). The second study consists of 60 participants, including 20 who attempted suicide. Measures used in this study are SWLS Scale and an EfS measure. There is a significant meaning of the sense of purpose of life for well-being and self-efficacy. The ability to maintain the feeling of sense of one's existence seems to be a significant factor that protects from a decrease in life quality and keeps the feeling of being able to deal in difficult situations, as well as helps to accept depression symptoms.

Suicidal Asian American College Students' Perceptions of Protective Factors: A Qualitative Study

This study addresses the paucity of knowledge on protective factors associated with Asian American college students' suicidal behavior. Participants were 58 Asian American college students who seriously considered suicide within the past 12 months and responded to open-ended online survey questions about what was helpful during their suicide crisis. A phenomenological analysis of participants' narratives revealed the following protective factors: (a) a desire not to hurt or burden others, (b) social support, (c) fear, (d) self-reliance, and (e) insight. These findings can guide culturally informed clinical interventions by mental health professionals.

Associations between reasons for living and diminished suicide intent among African-American female suicide attempters

African-American women are at high risk for suicide ideation and suicide attempts and use emergency psychiatric services at disproportionately high rates relative to men and other ethnic groups. However, suicide death rates are low for this population. Cultural variables in the African-American community may promote resilience and prevent fatal suicidal behavior among African-American women. The present study evaluated self-reported reasons for living as a protective factor against suicidal intent and suicide attempt lethality in a sample of African-American female suicide attempters (n = 150). Regression analyses revealed that reasons for living were negatively associated with suicidal intent, even after controlling for spiritual well-being and symptoms of depression. These results indicate that the ability to generate and contemplate reasons for valuing life may serve as a protective characteristic against life-threatening suicidal behavior among African-American women. Implications for research and clinical practice are further discussed.

Suicide protective factors among trans adults

A recent study indicated a suicide attempt rate of 41 % among trans (e.g., trans, transgender, transexual/transsexual, genderqueer, two-spirit) individuals. Although this rate is alarming, there is a dearth of literature regarding suicide prevention for trans individuals. A vital step in developing suicide prevention models is the identification of protective factors. It was hypothesized that social support from friends, social support from family, optimism, reasons for living, and suicide resilience, which are known to protect cis (non-trans) individuals, also protect trans individuals. A sample of self-identified trans Canadian adults (N = 133) was recruited from LGBT and trans LISTSERVs. Data were collected online using a secure survey platform. A three block hierarchical multiple regression model was used to predict suicidal behavior from protective factors. Social support from friends, social support from family, and optimism significantly and negatively predicted 33 % of variance in participants' suicidal behavior after controlling for age. Reasons for living and suicide resilience accounted for an additional 19 % of the variance in participants' suicidal behavior after controlling for age, social support from friends, social support from family, and optimism. Of the factors mentioned above, perceived social support from family, one of three suicide resilience factors (emotional stability), and one of six reasons for living (child-related concerns) significantly and negatively predicted participants' suicidal behavior. Overall, these findings can be used to inform the practices of mental health workers, medical doctors, and suicide prevention workers working with trans clients.

Relations between hopelessness, depressive symptoms and suicidality: mediation by reasons for living

OBJECTIVE

The present study examined whether reasons for living (RFL) would partially account for the associations between traditional risk factors (depressive symptoms, hopelessness) and suicidal ideation and attempts.

METHOD

Data were collected from 1,075 undergraduate college students who completed a battery of online assessments.

RESULTS

Results from a series of simultaneous mediational models indicated that the relations between risk factors and current suicidal ideation were partially mediated by total RFL (and Coping Beliefs and Self-Evaluation subscales). Further, total RFL (and the Coping Beliefs subscale) fully mediated the relation between hopelessness and past-year suicide attempt, and partially mediated the depressive symptoms-suicide attempt relation.

CONCLUSIONS

This study demonstrates the importance of assessing for the presence of these suicide risk and protective factors. Implications for the improved identification and treatment of young adults at risk for suicide are discussed.

Examining suicide protective factors among black college students

The purpose of this study was to contribute to the nascent literature on resilience and suicidality among Black Americans by examining factors that may predict less suicidal behavior among this population. The authors hypothesized that reasons for living, life satisfaction, and religious awareness would account for unique variance in suicidal thoughts and behavior among Black Americans, above the variance accounted for by depressive symptoms. They also hypothesized that reasons for living and religious awareness would be stronger inverse predictors among Black women than Black men. Results indicated that both depression and life satisfaction were stronger predictors of suicidal behavior among Black men. Among women, only reasons for living was a significant inverse predictor of suicidal thoughts and behavior. More frequent reasons for living moderated the relationship between depression and suicidal thoughts and behavior among Black women.

Reasons for living, social support, and Afrocentric worldview: assessing buffering factors related to Black Americans' suicidal behavior

This study utilized an ecological framework to explore the role of 4 culturally relevant protective factors-reasons for living, Afrocentric worldview, family support, and friend support-in protecting Black American college students from suicidal behavior. Participants were 289 Black American college students. We hypothesized that these 4 culturally relevant factors would exert indirect protective effects on suicidal behavior through their association with reduced depressive symptoms. Results indicated that reasons for living, perceived supportive behaviors from family, and Afrocentric worldview exerted indirect protective effects on suicidal behaviors through their negative associations with depressive symptoms. The mediation effect from friend support to depression and suicidal behavior was not significant.

"Let me count the ways:" fostering reasons for living among low-income, suicidal, African American women

Protective factors for fostering reasons for living were examined among low-income, suicidal, African American women. Bivariate logistic regressions revealed that higher levels of optimism, spiritual well-being, and family social support predicted reasons for living. Multivariate logistic regressions indicated that spiritual well-being showed unique predictive value for reasons for living. Further, the multivariate model accurately predicted reasons for living 72% of the time. Partial support was found for a cumulative protective model hypothesizing a linear relationship between the number of protective factors endorsed and increased reasons for living. Implications for community-based preventive and recovery-oriented intervention efforts and future research are discussed.

Relationships among dispositional coping strategies, suicidal ideation, and protective factors against suicide in older adults

Older adults have a disproportionally high rate of completed suicide as compared to the general population. Whereas a large literature has focused on risk factors related to elder suicide, limited research exists on relationships between coping strategies with protective factors against suicide and suicidal ideation in this population. Community-dwelling older adults (N = 108, mean age = 71.5 years, age range = 60-95 years) completed the Coping Orientations to Problems Experienced scale, Reasons for Living inventory, and Geriatric Suicide Ideation Scale (GSIS). Problem- and emotion-focused coping were associated positively with reasons for living and negatively with suicide ideation. Dysfunctional coping was associated positively with suicide ideation, but results did not support the hypothesized negative relationship with reasons for living. Thus, problem- and emotion-focused coping appear to be adaptive, whereas dysfunctional coping appears to be somewhat less related to resilience to suicidal ideation among community-dwelling older adults. Implications of the study are that some coping strategies may serve as protective factors against suicide and that coping strategies should be evaluated as part of a thorough assessment of suicidal risk among older adults. The results also provide some evidence of convergent validity for the recently developed GSIS.