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Xu Z, Li N, Kong Y, Lin L, Liu Y, Zhang H, He Y, Zhao S. Nonsuicidal self-injury as the gateway and consequence of suicidal ideation among adolescents: a cross-lagged regression analysis. Front Psychiatry 2024; 15:1434191. [PMID: 39211538 PMCID: PMC11358082 DOI: 10.3389/fpsyt.2024.1434191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 07/23/2024] [Indexed: 09/04/2024] Open
Abstract
Background There is a consensus that both nonsuicidal self-injury (NSSI) and suicidal ideation as risk factors for suicidal behavior have a strong connection. However, a lack of longitudinal information has limited the clarification of the concrete relationship between them. Aims This study aimed to examine the specific mechanism between NSSI and suicidal ideation over time, during adolescence. Method A longitudinal study was conducted with 193 Chinese adolescents. NSSI and suicidal ideations were examined over the course of a 1year followed-up, and three waves of data were collected. Results The NSSI at time T1 significantly positively predicted suicidal ideation at time T2; Suicidal ideation at time T2 also significantly positively predicted NSSI at time T3. Limitations Given that the small number of participants with suicidal ideation and NSSI, the findings of the study should be interpreted with caution and a lager sample is needed in the future. Conclusion It was suggested that NSSI may occur before suicidal ideation, which in turn would strengthen NSSI, so interventions should be carried out from two aspects (behaviors and thoughts) to improve adolescents' mental health.
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Affiliation(s)
- Zhansheng Xu
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
- Center of Collaborative Innovation for Assessment and Promotion of Mental Health, Tianjin, China
| | - Nianqin Li
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
- Center of Collaborative Innovation for Assessment and Promotion of Mental Health, Tianjin, China
| | - Yaxin Kong
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
- Center of Collaborative Innovation for Assessment and Promotion of Mental Health, Tianjin, China
| | - Lin Lin
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
- Center of Collaborative Innovation for Assessment and Promotion of Mental Health, Tianjin, China
| | - Yu Liu
- Intelligent Laboratory of Child and Adolescent Mental Health and Crisis Intervention of Zhejiang Province, Zhejiang Normal University, Jinhua, Zhejiang, China
- Department of Psychology, Zhejiang Normal University, Jinhua, Zhejiang, China
| | - Huan Zhang
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
- Center of Collaborative Innovation for Assessment and Promotion of Mental Health, Tianjin, China
| | - Yunfeng He
- Liaoning Key Laboratory of Psychological Testing and Behavior Analysis, Liaoning University, Shenyang, China
| | - Song Zhao
- Liaoning Key Laboratory of Psychological Testing and Behavior Analysis, Liaoning University, Shenyang, China
- Liao Ning University Judicial Authentication Center, Liaoning University, Shenyang, China
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Butler W, Lewis KL, Benheim TS, Arauz Boudreau A, Brigham KS, Feldman M, Jellinek M, Murphy JM. Screening and Follow-Up Treatment Practices for Suicide Risk in Adolescent Primary Care: A Retrospective Chart Review. Clin Pediatr (Phila) 2024:99228241253158. [PMID: 38742439 DOI: 10.1177/00099228241253158] [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] [Indexed: 05/16/2024]
Abstract
Universal depression screening in adolescent primary care often encompasses questions about suicide risk. We conducted a retrospective chart review of well-child visits where adolescents (ages 13-17.9) had endorsed self-injurious thoughts and behaviors or suicidal ideation. The goal was to investigate primary care providers' follow-up actions, including documentation, further assessment, and referrals. Over 3-quarters of the progress notes showed evidence of further assessment, and two-thirds documented same-day actions, including mental health referrals, emergency department referrals, safety plans, medication changes, primary-care follow-up, and talking to parents. Actions varied by depression severity. Cases without interventions often had justifications. Owing to the variety of possible meanings and severity underlying positive screens, providers implemented an array of interventions, using clinical judgment to tailor actions to patients' individual needs and preferences. From these observations, we propose that standardized guidelines for suicide risk screening and follow-up should involve a clinical assessment and individualized treatment planning.
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Affiliation(s)
- William Butler
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kristina L Lewis
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Talia S Benheim
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Alexy Arauz Boudreau
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Kathryn S Brigham
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Mitchell Feldman
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Michael Jellinek
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - J Michael Murphy
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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McCool MW, Schwebel FJ, Pearson MR, Wong MM. Using recursive partitioning to predict presence and severity of suicidal ideation amongst college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-11. [PMID: 38728739 DOI: 10.1080/07448481.2024.2351419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 04/19/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE Predicting the presence and severity of suicidal ideation in college students is important, as deaths by suicide amongst young adults have increased in the past 20 years. PARTICIPANTS We recruited college students (N = 5494) from ten universities across eight states. METHOD Participants answered three questionnaires related to lifetime and past month suicidal ideation, and an indicator of suicidal ideation in a DSM-5 symptom measure. We used recursive partitioning to predict the presence, absence, and severity, of suicidal ideation. RESULTS Recursive partitioning models varied in their accuracy and performance. The best-performing model consisted of predictors and outcomes measured by the DSM-5 Level 1 Cross-Cutting Symptom Measure. Sexual orientation was also an important predictor in most models. CONCLUSIONS A single measure of DSM-5 symptom severity may help universities understand suicide severity to promote targeted interventions. Though further work is needed, as similar scaling amongst predictors could have influenced the model.
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Affiliation(s)
- Matison W McCool
- Center on Alcohol, Substance use, and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
| | - Frank J Schwebel
- Center on Alcohol, Substance use, and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
| | - Matthew R Pearson
- Center on Alcohol, Substance use, and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
| | - Maria M Wong
- Psychology Department, Idaho State University, Pocatello, Idaho, USA
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Kister K, Laskowski J, Makarewicz A, Tarkowski J. Application of artificial intelligence tools in diagnosis and treatmentof mental disorders. CURRENT PROBLEMS OF PSYCHIATRY 2023. [DOI: 10.12923/2353-8627/2023-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Introduction: Artificial intelligence research is increasing its application in mental health services. Machine learning, deep learning, semantic analysis in the form of transcriptions of patients' statements enable early diagnosis of psychotic disorders, ADHD, anorexia nervosa. Of great importance are the so-called digital therapists. This paper aims to show the use of AI tools in diagnosing, treating, the benefits and limitations associated with mental disorders.
Material and methodS: This literature review was conducted by searching scientific articles from 2015 to 2022. The basis were PubMED, OpenKnowledge, Web of Science, using the following keywords: artificial intelligence, digital therapy, psychiatry, machine learning.
Results: A review indicates the widespread use of AI tools in screening for mental disorders. These tools advance the clinical diagnosis medical specialists make up for several years. They impact solving medical staff shortages, lack of access to medical facilities and leveling patient resistance to treatment. The benefits are ultra-fast analysis of large sets of information, effective screening of people in need of specialized psychiatric care, reduction of doctors' duties and maximization of their work efficiency. During the current COVID 19 pandemic, robots in the form of digital psychotherapists are playing a special role.
Conclusions: The need for further research, testing and clarification of regulations related to the use of AI tools is indicated. Ethical and social problems need to be resolved. The tools should not form the basis of autonomous therapy without the supervision of highly trained professionals. Human beings should be at the center of analysis just as their health and well-being.
Keywords: artificial intelligence, digital therapy, psychiatry, machine learning
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Affiliation(s)
- Klaudia Kister
- I Departmentof Psychiatry, Psychoterapy and Early Intervention of Medical University in Lublin, Poland - Students Research Group
| | - Jakub Laskowski
- Department of Paediatrician Oncology, Transplantology and Haematology of Medical University in Lublin, Medical University in Lublin, Poland - Students Research Group
| | - Agata Makarewicz
- I Department of Psychiatry, Psychoterapy and Early Intervention of Medical University in Lublin, Poland
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Alabi AA. Management of self-harm, suicidal ideation and suicide attempts. S Afr Fam Pract (2004) 2022; 64:e1-e4. [PMID: 35532131 PMCID: PMC9082270 DOI: 10.4102/safp.v64i1.5496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/24/2022] Open
Abstract
The strategic location of primary care providers (PCPs) in clinics, private general practices and emergency departments is critical to the detection and appropriate management of patients with suicidal behaviour. Their position within the primary care setting and responsibility for preventive and promotive care require PCPs to possess good clinical skills and evidence-based knowledge to assist patients presenting with suicidal ideation and behaviour. The objective of this article is to provide guidelines for the management of suicidal behaviour within the primary care setting, with the goal of reducing deaths from suicide, and the frequency and intensity of suicide attempts. The priority in the management of patients presenting at health facilities following suicide attempts is medical resuscitation and stabilisation. As soon as the patient is medically stable, a thorough suicide risk assessment, which evaluates suicidal ideation/intent, preceding circumstances, predisposing and protective factors, should be conducted. An assessment of current and ongoing suicide risk will assist in determining the safest place to manage the patient. For those with a low level of suicide risk, outpatient management may be considered in the presence of a good social support system at home and a well-documented safety plan. Measures should be put in place to address the modifiable psychosocial risk factors for suicide, whilst appropriate pharmacotherapy is instituted for co-existing mental illness. Post-discharge care such as referral to psychologist, psychiatrist or social worker should be initiated by the primary care practitioner to ensure continuity of care. Support and psycho-education should also be extended to immediate family members of patients with suicidal behaviour for their own well-being and their ability to support the patient.
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Affiliation(s)
- Adeyinka A Alabi
- Department of Family Medicine, Faculty of Health Science, Walter Sisulu University, Uitenhage, South Africa; and, Department of Family Medicine, Dore Nginza Hospital, Uitenhage.
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Bresin K, Mekawi Y. Different Ways to Drown Out the Pain: A Meta-Analysis of the Association Between Nonsuicidal Self-Injury and Alcohol Use. Arch Suicide Res 2022; 26:348-369. [PMID: 32780651 DOI: 10.1080/13811118.2020.1802378] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE There is a significant overlap in the motivations for nonsuicidal self-injury (NSSI) and alcohol use. Moreover, several theories would predict that more frequent alcohol use is likely associated with more NSSI engagement. Still, the size and direction of this association has not been well documented in the literature. METHOD To address this gap, the goal of this article was to conduct a meta-analysis of the relation between alcohol use and NSSI. RESULTS Across 57 samples and 141,669 participants, we found that there was a significant positive association between NSSI and alcohol use, odds ratio = 1.78, 95% confidence interval [1.53, 2.07], k = 64, m = 52. Moderator analyses found that this effect was stronger for younger samples and samples with more severe alcohol use problems. CONCLUSIONS These results help establish a link between NSSI and alcohol use. Implications and future directions for NSSI research and intervention are discussed.HighlightsThere are several reasons to think that NSSI and alcohol use are linked.No reviews or meta-analyses have been conducted.We found a significant and small effect linking greater NSSI with greater alcohol use.
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7
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Wallace GT, Conner BT, Shillington AM. Classification trees identify shared and distinct correlates of nonsuicidal self-injury and suicidal ideation across gender identities in emerging adults. Clin Psychol Psychother 2020; 28:682-693. [PMID: 33169471 DOI: 10.1002/cpp.2530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 09/29/2020] [Accepted: 10/29/2020] [Indexed: 11/09/2022]
Abstract
College students have an elevated risk for self-injurious thoughts and behaviours (SITBs), and there are robust differences in prevalence rates for SITBs across gender identities. Although numerous constructs have been implicated as risk factors, researchers have not significantly improved at predicting SITBs, possibly owing to constraints of confirmatory analyses. Classification trees are exploratory, person-centred analyses that enable joint examination of numerous correlates and their interactions. Thus, classification trees may discern previously unstudied risk factors and identify distinct subpopulations with elevated risk for SITBs. We tested classification trees that evaluated 298 potential correlates of nonsuicidal self-injury and suicidal ideation across self-identified women and men. Data came from 5,131 college students who completed the National College Health Assessment, which assesses a wide range of health-related constructs. Models produced parsimonious decision trees that accounted for a substantial amount of outcome variability (38.3-51.5%). Psychopathology, poorer psychological well-being, and other SITBs emerged as important correlates for all participants. Trauma, disordered eating, and heavy alcohol use were salient among women, whereas alcohol use norms were important correlates among men. Importantly, models identified several constructs that may be amenable to intervention. Results support the use of exploratory analyses to explicate heterogeneity among individuals who engage in SITBs and suggest that gender identity is an important moderator for certain risk factors.
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Affiliation(s)
- Gemma T Wallace
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Bradley T Conner
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Audrey M Shillington
- College of Health and Human Sciences, San José State University, San José, California, 95192, USA
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8
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Fonseka TM, Bhat V, Kennedy SH. The utility of artificial intelligence in suicide risk prediction and the management of suicidal behaviors. Aust N Z J Psychiatry 2019; 53:954-964. [PMID: 31347389 DOI: 10.1177/0004867419864428] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Suicide is a growing public health concern with a global prevalence of approximately 800,000 deaths per year. The current process of evaluating suicide risk is highly subjective, which can limit the efficacy and accuracy of prediction efforts. Consequently, suicide detection strategies are shifting toward artificial intelligence platforms that can identify patterns within 'big data' to generate risk algorithms that can determine the effects of risk (and protective) factors on suicide outcomes, predict suicide outbreaks and identify at-risk individuals or populations. In this review, we summarize the role of artificial intelligence in optimizing suicide risk prediction and behavior management. METHODS This paper provides a general review of the literature. A literature search was conducted in OVID Medline, EMBASE and PsycINFO databases with coverage from January 1990 to June 2019. Results were restricted to peer-reviewed, English-language articles. Conference and dissertation proceedings, case reports, protocol papers and opinion pieces were excluded. Reference lists were also examined for additional articles of relevance. RESULTS At the individual level, prediction analytics help to identify individuals in crisis to intervene with emotional support, crisis and psychoeducational resources, and alerts for emergency assistance. At the population level, algorithms can identify at-risk groups or suicide hotspots, which help inform resource mobilization, policy reform and advocacy efforts. Artificial intelligence has also been used to support the clinical management of suicide across diagnostics and evaluation, medication management and behavioral therapy delivery. There could be several advantages of incorporating artificial intelligence into suicide care, which includes a time- and resource-effective alternative to clinician-based strategies, adaptability to various settings and demographics, and suitability for use in remote locations with limited access to mental healthcare supports. CONCLUSION Based on the observed benefits to date, artificial intelligence has a demonstrated utility within suicide prediction and clinical management efforts and will continue to advance mental healthcare forward.
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Affiliation(s)
- Trehani M Fonseka
- Centre for Mental Health and Krembil Research Centre, University Health Network, Toronto, ON, Canada.,Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto, ON, Canada.,School of Social Work, King's University College, Western University, London, ON, Canada
| | - Venkat Bhat
- Centre for Mental Health and Krembil Research Centre, University Health Network, Toronto, ON, Canada.,Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sidney H Kennedy
- Centre for Mental Health and Krembil Research Centre, University Health Network, Toronto, ON, Canada.,Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
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9
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Ammmerman BA, Hong M, Sorgi K, Park Y, Jacobucci R, McCloskey MS. An examination of individual forms of nonsuicidal self-injury. Psychiatry Res 2019; 278:268-274. [PMID: 31238297 DOI: 10.1016/j.psychres.2019.06.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 11/18/2022]
Abstract
Nonsuicidal self-injury (NSSI) is a growing public health concern, and there is an increasing need to better characterize and identify severe NSSI behavior. One readily accessible, yet understudied, avenue for improving the assessment of NSSI severity is through the examination of individual forms, or methods, of the behavior. The present study aimed to address this gap in the literature by investigating the relationship between 12 different NSSI methods with three NSSI severity indicators and three distinct suicidal thoughts and behaviors among 1,436 undergraduate students with a history of NSSI (70.90% female, M age = 20.69, SD = 3.32). Results across six decision tree analyses highlighted the use self-hitting / punching, in addition to cutting oneself, as the most informative NSSI methods for differentiating outcome severity. Gender differences were only found for the outcome of suicidal ideation. The present study provides preliminary evidence that the examination of individual NSSI methods may be useful in identifying individuals at risk for negative correlates of NSSI, including NSSI-related hospital visits, unintended serious injury, and suicidal behavior. Upon replication in longitudinal work, findings have important clinical utility by providing a potential marker of prognosis and the need for higher levels of care.
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Affiliation(s)
- Brooke A Ammmerman
- University of Notre Dame, Department of Psychology, 390 Corbett Family Hall, Notre Dame, IN, 46556, United States.
| | - Max Hong
- University of Notre Dame, Department of Psychology, 390 Corbett Family Hall, Notre Dame, IN, 46556, United States
| | - Kristen Sorgi
- Temple University, Department of Psychology, 1701N. Broad Street, Philadelphia, PA, 19122, United States
| | - Yeonsoo Park
- University of Notre Dame, Department of Psychology, 390 Corbett Family Hall, Notre Dame, IN, 46556, United States
| | - Ross Jacobucci
- University of Notre Dame, Department of Psychology, 390 Corbett Family Hall, Notre Dame, IN, 46556, United States
| | - Michael S McCloskey
- Temple University, Department of Psychology, 1701N. Broad Street, Philadelphia, PA, 19122, United States
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10
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Klassen JA, Hamza CA, Stewart SL. An Examination of Correlates for Adolescent Engagement in Nonsuicidal Self-Injury, Suicidal Self-Injury, and Substance Use. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2018; 28:342-353. [PMID: 28758354 DOI: 10.1111/jora.12333] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Little research has examined potential risk factors for direct versus indirect self-injury among adolescents. To address this limitation, 541 clinically referred adolescents were assessed using the interRAI Child and Youth Mental Health Assessment. Logistic regression analyses revealed that older females who experienced heightened depressive symptoms and neighborhood violence were at increased risk for direct self-injury, specifically nonsuicidal and suicidal self-injury. Additionally, adolescents who experienced higher levels of caregiver distress were at greater risk of suicidal self-injury. In contrast, older adolescents who experienced heightened aggressive behavior were at increased risk for one form of indirect self-injury, substance use. Findings suggest that nonsuicidal self-injury, suicidal self-injury, and substance use are associated with differential risk factors. Implications for targeted prevention strategies are discussed.
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11
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Stephen AH, Karlin DR, Luppens CL, Adams CA. Self-inflicted penetrating injury: A review. TRAUMA-ENGLAND 2018. [DOI: 10.1177/1460408617694404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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12
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Herres J, Kodish T, Fein J, Diamond G. Screening to Identify Groups of Pediatric Emergency Department Patients Using Latent Class Analysis of Reported Suicidal Ideation and Behavior and Non-Suicidal Self-Injury. Arch Suicide Res 2018; 22:20-31. [PMID: 28121237 DOI: 10.1080/13811118.2017.1283264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Latent class analysis of medical records data from 3,523 emergency department (ED) patients (ages 14-24; 31% Caucasian; 67% female) distinguished 6 groups with varying histories of suicidal ideation and behavior based on items endorsed on the Behavioral Health Screen, a web based, nurse-initiated screening tool. As expected, the more severe suicidality groups reported higher levels of depressive symptoms, traumatic distress, and substance abuse symptoms. Findings support the validity of the BHS and its utility as a medical decision tool to help ED staff evaluate the severity of patients' suicidality.
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13
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Weber AN, Michail M, Thompson A, Fiedorowicz JG. Psychiatric Emergencies: Assessing and Managing Suicidal Ideation. Med Clin North Am 2017; 101:553-571. [PMID: 28372713 PMCID: PMC5777328 DOI: 10.1016/j.mcna.2016.12.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The assessment of suicide risk is a daunting, but increasingly frequent task for outpatient practitioners. Guidelines for depression screening identify more individuals at risk for treatment and mental health resources are not always easily accessible. For those patients identified as in need of a formal suicide risk assessment, this article reviews established risk and protective factors for suicide and provides a framework for the assessment and management of individuals at risk of suicide. The assessment should be explicitly documented with a summary of the most relevant risk/protective factors for that individual with a focus on interventions that may mitigate risk.
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Affiliation(s)
- Andrea N Weber
- Department of Internal Medicine, The University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA; Department of Psychiatry, Carver College of Medicine, The University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - Maria Michail
- School of Health Sciences, University of Nottingham, D17 Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
| | - Alex Thompson
- Department of Psychiatry, Carver College of Medicine, The University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - Jess G Fiedorowicz
- Department of Internal Medicine, The University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA; Department of Psychiatry, Carver College of Medicine, The University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA; Department of Epidemiology, College of Public Health, The University of Iowa, 145 North Riverside Drive, 100 CPH, Iowa City, IA 52242, USA; Abboud Cardiovascular Research Center, Carver College of Medicine, The University of Iowa, 2269 Carver Biomedical Research Building, Iowa City, IA 52242, USA.
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14
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Shearer A, Russon J, Herres J, Atte T, Kodish T, Diamond G. The relationship between disordered eating and sexuality amongst adolescents and young adults. Eat Behav 2015; 19:115-9. [PMID: 26332989 DOI: 10.1016/j.eatbeh.2015.08.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 05/29/2015] [Accepted: 08/12/2015] [Indexed: 11/18/2022]
Abstract
Research shows that gay and bisexual males are at increased risk for disordered eating symptoms (DES); however, studies examining DES amongst lesbians and bisexual women have produced mixed findings. Furthermore, few studies have included questioning or "unsure" individuals. This study examined DES symptoms in adolescents and young adults across self-reported sexual attraction and behavior. Participants were recruited from ten primary care sites in Pennsylvania and administered the Behavioral Health Screen (BHS) - a web-based screening tool that assesses psychiatric symptoms and risk behaviors - during a routine visit. As expected, males who were attracted to other males exhibited significantly higher disordered eating scores than those only attracted to members of the opposite sex. Males who engaged in sexual activities with other males also exhibited significantly higher scores than those who only engaged in sexual activities with females. Amongst females, there were no significant differences in DES scores between females who were only attracted to females and those only attracted to males. Those who reported being attracted to both sexes, however, had significantly higher scores, on average, than those only attracted to one sex. More surprisingly, females who were unsure of who they were attracted to reported the highest DES scores of all. These findings are contrary to previous assumptions that same-sex attraction plays a protective role against eating pathology in females. Females who are unsure or attracted to both sexes may actually be at increased risk for developing DES.
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