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Xu I, Millner AJ, Fortgang RG, Nock MK. Suicide decision-making: Differences in proximal considerations between individuals who aborted and attempted suicide. Suicide Life Threat Behav 2024. [PMID: 39221628 DOI: 10.1111/sltb.13127] [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: 12/19/2023] [Revised: 08/14/2024] [Accepted: 08/17/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION The transition from suicidal thoughts to behaviors often involves considering the consequences of suicide as part of the decision-making process. This study explored the relationship between this consideration process and the decision to either abort or carry out a suicide attempt. METHODS Among inpatients with a suicide-related event in the past 2 weeks (suicide attempt n = 30 or aborted attempt n = 16), we assessed the degree to which they considered six domains of consequences, the impact of these considerations on their inclination to attempt suicide, and the duration of their decision-making. RESULTS All the participants who aborted and 87% of those who attempted considered consequences of suicide. Participants who aborted took longer to progress through decision-making stages and considered more suicide-hindering factors, especially interpersonal ones, though these differences were no longer significant after correction. Group status moderated the relationship between the balance of suicide-facilitating and suicide-hindering considerations and decision-making duration. Considering the consequences of suicide more favorably was related to a shorter ideation-to-action period before a suicide attempt and a longer ideation period before aborting an attempt. CONCLUSION This study highlights the complexity of suicide decision-making and its role in better understanding the progression from ideation to action.
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Affiliation(s)
- Irene Xu
- Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Alexander J Millner
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Rebecca G Fortgang
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
- Mental Health Research, Franciscan Children's, Brighton, Massachusetts, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
- Mental Health Research, Franciscan Children's, Brighton, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
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Chen JI, Osman A, Freedenthal SL, Gutierrez PM. An Examination of the Psychometric Properties of the Reasons for Living Inventory within a Male Veteran Clinical Sample. Arch Suicide Res 2020; 24:204-230. [PMID: 30636520 DOI: 10.1080/13811118.2018.1563576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Elevated suicide risk among veteran populations remains a significant public health concern. However, few suicide assessment measures have been validated for veterans. The current study evaluated the reliability and validity of the Reasons for Living Inventory (RFL) scores among veteran populations. The participants included male veterans (N = 421) from a broad range of ages, combat exposures, and history of suicide attempts. Participants completed the RFL and a set of additional self-report measures of relevant constructs in a cross-sectional design. Estimates of internal consistency reliability were adequate for scores on all the original RFL subscale scores. Exploratory factor analysis (EFA) and exploratory bifactor (bi-factor EFA) analyses provided detailed information regarding the 6-factor solution from the original validation studies with the RFL. Additional analyses identified potential correlates for the RFL total and subscale scores. Secondary analyses showed support for evidence of known-groups validity for the RFL total scale score. Overall, this study provides initial support for the RFL as a reliable and valid measure of protective factors in veterans. Future studies may wish to consider further validation of the current findings.
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Affiliation(s)
- Jason I Chen
- VA Portland Health Care System, Portland, OR, USA
| | - Augustine Osman
- Department of Psychology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Stacey L Freedenthal
- Department of Psychology, University of Denver Graduate School of Social Work, Denver, CO, USA
| | - Peter M Gutierrez
- Rocky Mountain Mental Illness Research, Education and Clinical Center at the Denver VA Medical Center, Aurora, CO, USA.,Department of Psychology, University of Colorado School of Medicine, Aurora, CO, USA
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Din NC, Ibrahim N, Amit N, Kadir NBA, Halim MRTA. Reasons for Living and Coping with Suicidal Ideation among Adolescents in Malaysia. Malays J Med Sci 2019; 25:140-150. [PMID: 30914870 PMCID: PMC6419889 DOI: 10.21315/mjms2018.25.5.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 09/20/2018] [Indexed: 11/06/2022] Open
Abstract
Introduction The rate of suicide ideation everywhere continues to increase, and adolescents are therefore at risk of displaying suicidal behaviour. This study examined the protective role of the reasons for living and coping strategies in reducing suicidal ideation among young adolescents in Malaysia. Methods A cross-sectional survey was conducted among 176 adolescents aged between 13 and 19 years of age with the majority being Malay and Muslim. The Brief Reasons for Living for Adolescents (BRFL-A), Jalowiec Coping Scale and Suicide Ideation Scale were employed. Results The results showed that the reasons for living and palliative coping strategy correlated negatively with suicide ideation; although, further analysis using multiple regression revealed that family alliance and optimistic and palliative coping strategies were found to be significant reasons for living that protect adolescents from suicidal thoughts. Also, those adolescents who used emotive and evasive coping strategies had higher suicidal ideation. Conclusion Cultural and social values continue to play an important role in protecting adolescents in Malaysia from suicidal behaviour.
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Affiliation(s)
- Normah Che Din
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda A Aziz, 50300 Kuala Lumpur, Malaysia
| | - Norhayati Ibrahim
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda A Aziz, 50300 Kuala Lumpur, Malaysia
| | - Noh Amit
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda A Aziz, 50300 Kuala Lumpur, Malaysia
| | - Nor Ba'yah Abdul Kadir
- Centre of Human and Societal Well-being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 Bangi, Selangor, Malaysia
| | - Mohd Radzi Tarmizi A Halim
- Centre of Human and Societal Well-being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 Bangi, Selangor, Malaysia
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van den Brink B, Schaap H, Braam AW. Moral Objections and Fear of Hell: An Important Barrier to Suicidality. JOURNAL OF RELIGION AND HEALTH 2018; 57:2301-2312. [PMID: 29423644 DOI: 10.1007/s10943-018-0573-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This review explores the literature to test the hypothesis that 'moral objections to suicide (MOS), especially the conviction of going to hell after committing suicide, exert a restraining effect on suicide and suicidality.' Medline and PsycInfo were searched using all relevant search terms; all relevant articles were selected, rated and reviewed. Fifteen cross-sectional studies were available on this topic, and raise sufficient evidence to confirm a restraining effect of MOS, and sparse data on fear of hell. MOS seem to counteract especially the development of suicidal intent and attempts, and possibly the lethality of suicidal attempts. A differential pattern of influence of MOS on the suicidal continuum is suggested.
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Affiliation(s)
- Bart van den Brink
- Psychiatric Acute Care Unit, Eleos, Christian Institution for Mental Health Care, Printerweg 21, 3821 AP, Amersfoort, The Netherlands.
- Kennisinstituut christelijke ggz, Center for Christian Mental Health Care, Amersfoort, The Netherlands.
| | - Hanneke Schaap
- Kennisinstituut christelijke ggz, Center for Christian Mental Health Care, Amersfoort, The Netherlands
| | - Arjan W Braam
- University of Humanistic Studies, Utrecht, The Netherlands
- Department of Emergency Psychiatry, Altrecht Mental Health Care, Utrecht, The Netherlands
- Department of Residency Training, Altrecht Mental Health Care, Utrecht, The Netherlands
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Comparing characteristics of suicide attempters with suicidal ideation and those without suicidal ideation treated in the emergency departments of general hospitals in China. Psychiatry Res 2018; 262:78-83. [PMID: 29427911 DOI: 10.1016/j.psychres.2018.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 01/26/2018] [Accepted: 02/02/2018] [Indexed: 11/23/2022]
Abstract
Suicide attempts are more frequent than suicides, and suicidal ideation has been identified as an important precursor of both attempted and completed suicide. In this study, we compare the characteristics of suicide attempters with suicidal ideation and suicide attempters without suicidal ideation who were treated in the emergency departments of general hospitals in China. We identified 166 people as having suicidal ideation and 73 people who did not have suicidal ideation. The suicide attempters with suicidal ideation were more likely to be more depressed, older, have a lower score on life quality, female, divorced and unemployed, report having religious beliefs, have a suicide attempt history and a psychiatric diagnosis, and intend to reduce pain as motives. However, the suicide attempters without suicidal ideation were more likely to have a more self-rescue ideation and were more impulsive, and to threaten or intend revenge on others as motives. Multivariate logistic regression analysis identified the following independent predictors of suicidal ideation in the suicide attempters: a higher score on Hamilton Depression Rating Scale, religious beliefs, non-impulsive suicide attempts, and a psychiatric diagnosis. The results indicate the importance of developing different interventions for the two groups to prevent future suicide in China.
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Cwik JC, Siegmann P, Willutzki U, Nyhuis P, Wolter M, Forkmann T, Glaesmer H, Teismann T. Brief reasons for living inventory: a psychometric investigation. BMC Psychiatry 2017; 17:358. [PMID: 29110653 PMCID: PMC5674870 DOI: 10.1186/s12888-017-1521-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 10/26/2017] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- Jan Christopher Cwik
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Massenbergstrasse 11, 44787, Bochum, Germany.
| | - Paula Siegmann
- 0000 0004 0490 981Xgrid.5570.7Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Massenbergstrasse 11, 44787 Bochum, Germany
| | - Ulrike Willutzki
- 0000 0000 9024 6397grid.412581.bDepartment for Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
| | - Peter Nyhuis
- grid.440217.4St. Marien-Hospital Eickel, Herne, Germany
| | - Marcus Wolter
- grid.440217.4St. Marien-Hospital Eickel, Herne, Germany
| | - Thomas Forkmann
- 0000 0000 8653 1507grid.412301.5Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany
| | - Heide Glaesmer
- 0000 0001 2230 9752grid.9647.cDepartment of Medical Psychology and Medical Sociology, University Leipzig, Leipzig, Germany
| | - Tobias Teismann
- 0000 0004 0490 981Xgrid.5570.7Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Massenbergstrasse 11, 44787 Bochum, Germany
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Salami TK, Brooks BA, Lamis DA. Impulsivity and reasons for living among African American youth: a risk-protection framework of suicidal ideation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:5196-214. [PMID: 25988310 PMCID: PMC4454962 DOI: 10.3390/ijerph120505196] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 05/06/2015] [Accepted: 05/08/2015] [Indexed: 11/17/2022]
Abstract
This study aims to explore the impact of specific facets of impulsivity as measured by the UPPS Impulsive Behavior Scale (UPPS), as well as reasons for living in predicting suicidal ideation among African American college-aged students. The incremental validity of each facet of the UPPS interacting with reasons for living, a construct meant to buffer against risk for suicide, was explored in a sample of African American students (N = 130; ages 18-24). Results revealed significant interactions between reasons for living and two factors of impulsivity, (lack of) premeditation and sensation seeking. Higher levels of sensation seeking and lack of premeditation in conjunction with lower reasons for living was associated with increased suicidal ideation. Neither urgency nor (lack of) perseverance significantly interacted with reasons for living in association with suicidal ideation. These results suggest including elements of impulsivity, specifically sensation seeking and (lack of) premeditation, when screening for suicidal ideation among African American youth. Future investigations should continue to integrate factors of both risk and protection when determining risk for suicide.
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Affiliation(s)
- Temilola K Salami
- Department of Clinical Psychology, University of Georgia, 125 Baldwin St., Athens, GA 30602, USA.
| | - Bianca A Brooks
- Department of Clinical Psychology, Georgia State University, 140 Decatur St., Atlanta, GA 30303, USA.
| | - Dorian A Lamis
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, 80 Jesse Hill Jr. Drive, Atlanta, GA 30303, USA.
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