Validation of the Suicide Resilience Inventory-25 with American and Chinese college students

The Relationship Between Social Support and Suicide Resilience in Chinese Cancer Patients: A Serial Multiple Mediation Model Through Self-care Self-efficacy and Meaning in Life

BACKGROUND

A growing body of literature has shown a higher risk of suicide in cancer patients compared with the general population. Early detection of factors related to suicide resilience in cancer patients could prevent loss of life.

OBJECTIVE

The study aimed to investigate the serial-multiple mediation of self-care self-efficacy and meaning in life in the relationship between social support and suicide resilience among Chinese cancer patients.

METHODS

A cross-sectional investigation of 287 cancer patients using a battery of self-reported questionnaires was performed. For preliminary analyses, descriptive, univariate, and Pearson correlation analyses were performed. Mediation analyses were tested using a serial-multiple mediation model (PROCESS model 6).

RESULTS

Mediation analysis indicated the indirect effects of social support on suicide resilience mediated solely by either self-care self-efficacy (point estimate = 0.20; 95% confidence interval [CI], 0.12-0.30), or by meaning in life (point estimate = 0.06; 95% CI, 0.01-0.12), or by the multiple mediation of self-care self-efficacy to meaning in life (point estimate = 0.03; 95% CI, 0.01-0.06).

CONCLUSIONS

The findings demonstrated the crucial direct or indirect effects of social support, self-care self-efficacy, and meaning in life on facilitating cancer patients' suicide resilience.

IMPLICATIONS FOR PRACTICE

Oncology nurses, as 24-hour care providers for cancer patients, may interact with and be important sources for the psychosocial care of cancer patients at risk of suicide. Prevention and intervention efforts must be directed at assisting cancer patients, improving self-care self-efficacy, and finding meaning in life after a cancer diagnosis.

Moderating effects of suicide resilience and meaning in life on the association between entrapment and suicidal ideation in Chinese patients with ovarian cancer: a cross-sectional study

BACKGROUND

Numerous studies have confirmed that patients with ovarian cancer have a relatively high risk of suicidality. Early identification of psychological factors related to suicidal ideation in patients with ovarian cancer may provide effective information for suicide prevention strategies. This study aimed to investigate whether and how suicide resilience and meaning in life moderate the relationship between entrapment and suicidal ideation in patients with ovarian cancer.

METHODS

This was a cross-sectional investigation was conducted in 505 Chinese patients with ovarian cancer. Patients completed a battery of self-reported questionnaires that included the General Information Questionnaire, and Chinese versions of the Entrapment Scale, Scale for Suicidal Ideation, Suicide Resilience Inventory-25, and Meaning in Life Scale. Descriptive statistics, Pearson' s chi-square, Pearson' s correlation, and hierarchical multiple linear regression analysis were performed.

RESULTS

In this study, the prevalence of suicidal ideation reported by patients with ovarian cancer was 32.07%. Patients' suicidal ideation could be explained by the following three predictors: entrapment × suicide resilience × meaning in life (β = -0.169, p < 0.001), entrapment × suicide resilience (β = -0.148, p < 0.001), and entrapment × meaning in life (β = -0.107, p = 0.005).

CONCLUSION

These findings suggest that ovarian cancer patients are prone to suicidal ideation when they feel a sense of entrapment. Enhancing patients' suicide resilience and meaning in life may be two targeted interventions to reduce suicidal ideation in ovarian cancer patients. In particular, considering both the protective effects of suicide resilience and meaning in life may yield better suicide prevention outcomes than considering only one of these factors.

Symptom distress and suicidal ideation among Chinese ovarian cancer patients: A moderated mediation model of depression and suicide resilience

Objective

The aim of this study was to examine whether depression mediates the relationship between symptom distress and suicidal ideation in Chinese patients with ovarian cancer, and whether this mediating effect was moderated by suicide resilience.

Methods

From March to October 2022, this cross-sectional study was performed in a three Grade 3A hospital and an oncology specialty hospital in Wuhan, Hubei Province, China. Ultimately, 213 ovarian cancer patients completed anonymous self-report. Bootstrapping method was used for regression analysis to test the mediating and moderating effects.

Results

Among the 213 participants, 29.58% (n = 63) exhibited significant suicidal ideation. Symptom distress was positively associated with suicidal ideation, and depression partially mediated this relationship. Suicide resilience moderated the relationship between depression and suicidal ideation. In ovarian cancer patients with low suicide resilience, the effect of symptom distress on suicidal ideation through depression was greater, while in patients with high suicide resilience, this effect was attenuated.

Conclusion

Our study suggests that symptom distress could be more likely to lead to suicidal ideation as depression levels increase in ovarian cancer patients. Fortunately, suicide resilience could attenuate this negative effect.

Adolescent mobile phone addiction during the COVID-19 pandemic predicts subsequent suicide risk: a two-wave longitudinal study

Both the rate of mobile phone addiction and suicidality among adolescents have increased during the pandemic lockdown. However, the relationship between mobile phone addiction and suicide risk and the underlying psychological mechanisms remains unknown. This study examined the associations between mobile phone addiction in adolescents during the first month of lockdown and the suicide risk in the subsequent five months. A two-wave short-term longitudinal web-based survey was conducted on 1609 senior high school students (mean age = 16.53 years, SD = 0.97 years; 63.5% female). At Time 1 (T1), the severity of mobile phone addiction and basic demographic information was collected from Feb 24 to 28, 2020 in Sichuan Province, China (at the pandemic's peak). Five months later, between July 11 and July 23 (Time 2, T2), mobile phone addiction, daytime sleepiness, depression, and suicidality were measured within the past five months. The regression analysis revealed that mobile phone addiction during quarantine directly predicted suicidality within the next five months, even after controlling for the effect of depression and daytime sleepiness. Meanwhile, mobile phone addiction at T1 also indirectly predicted suicidality at T2, with depression and daytime sleepiness mediating this association. Programs targeting improvement of daytime sleepiness and depressive symptoms may be particularly effective in reducing suicide risk among adolescents with mobile phone addiction.

Psychometric properties and diagnostic capacity of the scale of resilience to suicide attempts-18

OBJECTIVE

Early detection of suicide attempts remains a handicap for suicide prevention. Most studies have focused on risk factors, but few have assessed protective factors that promote resilient outcomes, especially in subpopulations vulnerable to suicide re-attempts. This study aims to create and adapt a new Scale of Resilience to Suicide Attempts (SRSA), and to analyse its predictive validity and diagnostic capacity for the detection of suicide re-attempts at six months in people who have made a previous attempt.Design and main outcome measures: The psychometric properties and diagnostic capacity of the resulting SRSA-18 scale were assessed in 229 persons (where 133-58.1% were women, aged 18- to 76-year old) who had made a previous suicide attempt.

RESULTS

Factor analyses (AFE and AFC) yielded a three-dimensional structure with excellent goodness-of-fit indices RMSEA, high levels of reliability and adequate convergent validity with the Suicide Resilience Inventory-25 (SRI-25) scale. Additionally, the SRSA-18 has significant diagnostic power on suicide re-attempts across months of follow-up.

CONCLUSION

Reliable and valid protective factor-based instruments for the detection of future suicide re-attempts may help in the prevention of suicide-associated mortality in specific clinical subpopulations.

The relationship between the frequency of suicidal ideation and sleep disturbance factors among adolescent earthquake victims in China

OBJECTIVE

This study aimed to examine the frequency of suicidal ideation (SI) and identify exposure variables, mental health, and sleep-related risk factors of SI among adolescents following the 2013 Ya'an earthquake.

METHODS

Participants consisted of 5563 adolescent students selected through random sampling from 11 primary and high schools in the counties most severely affected by the earthquake. They were asked to complete the Pittsburgh Sleep Quality Index, Children's Revised Impact of Event Scale-13, Short Mood and Feelings Questionnaire, and Screen for Child Anxiety-Related Emotional Disorders. Multinomial logistic analysis was used to identify possible relationships between SI and psychopathology, sleep problems, earthquake exposures or demographic characteristics. The mediation analysis was used to identify direct and indirect effects among sleep problems, psychopathology, earthquake exposures and SI.

RESULTS

Our findings suggest that 29.5% of the sample experienced SI during the past year (12.9% once, 11.9% twice, 2.6% on 3-4 occasions and 2.1% on at least 5 occasions). Multiple sleeping problems, including trouble falling asleep, shorter sleep duration, and daytime dysfunction, showed independent associations with SI. The mediation analysis suggested that depression and anxiety mainly mediated the association of sleep with SI.

LIMITATIONS

This study was cross-sectional and did not include controls. No baseline data were collected prior to the earthquake.

CONCLUSION

SI can be a serious problem among adolescents following a major earthquake, especially those who are older, who live in one-child households, or who are female. Years after a disaster, we found that exposure severity, psychopathology and sleep impairment all contributed to SI, and that earthquake exposure may have disrupted sleep and worsened mood, which in turn may have impacted SI. By enhancing teenagers' sleep management and shaping their activities, post-disaster intervention programs may help prevent SI among Chinese adolescents.

Suicidality, posttraumatic stress, and depressive reactions after earthquake and maltreatment: A cross-sectional survey of a random sample of 6132 chinese children and adolescents

BACKGROUND

Surviving an earthquake can greatly increase the risk of suicidality among children and adolescents, especially if they experience physical and emotional neglect or abuse within the family after the earthquake. How various types of childhood adversity affect the vulnerability of adolescents to suicidality after exposure to a natural disaster is not well understood. This study examined the relationships among different types of earthquake exposure, childhood trauma, psychopathology and suicidality.

METHODS

Suicidality, the level of earthquake exposure, post-traumatic stress disorder (PTSD), depression, and maltreatment, including physical and emotional abuse and neglect, were assessed in 6132 child and adolescent survivors randomly selected from three primary schools, five junior high schools, two senior high schools and one six-year high school in Baoxing, Lushan and Tianquan counties, which were the areas most severely affected by the 2013 Ya'an earthquake.

RESULTS

The Suicidal Behaviors Questionnaire-Revised (SBQ-R) scores were high, with 27.8% of the participants scoring at or above the cut-off score of 7. Multivariate regression showed that emotional abuse and depression experienced after the earthquake contributed to the suicide risk, whereas emotional neglect and PTSD made somewhat smaller contributions. The mediation analysis suggested that PTSD and depression symptoms partially mediated the association of suicidality with emotional neglect or abuse. The PTSD, depression and suicidality scores were generally higher for females than for males, whereas the depression and suicidality scores were higher for older than younger respondents.

CONCLUSIONS

Our results highlight the need for the implementation of school-based, adolescent-centered suicide prevention programs in the long-term aftermath of exposure to traumatic events. Interventions may also need to be tailored to gender and developmental stage. Suicidality is independently associated with emotional abuse, neglect, depression and PTSD symptoms in this disaster-exposed young population. Longitudinal studies should explore whether depression and PTSD symptoms mediate the relationship between past emotional abuse or neglect and the current suicide risk.

Child Abuse - Suicide Resilience Link in African American Women: Interpersonal Psychological Mediators

The interpersonal-psychological theory of suicidal behavior (IPTS) is an exemplary model for understanding the desire for suicidal behavior. As such, it is important to explore its applicability in ethnoracial minority groups at increasing risk for suicidal behavior, such as low-income African American women. Guided by the IPTS, the current study used five parallel mediation models to examine if there are links between individual types of childhood abuse (physical, sexual, emotional) and suicide resilience and between cumulative abuse (higher levels of abuse inclusive of all three types, more types of severe levels of abuse) and suicide resilience, and whether the three components of the model (thwarted belongingness, perceived burdensomeness, acquired capability for suicide) mediate these associations. In a sample of low-income, African American women (n = 179), higher levels of each of the three types of childhood abuse and cumulative abuse correlated with lower levels of suicide resilience. Parallel mediation analyses using bootstrapping techniques revealed that increased acquired capability for suicide mediated all five associations and perceived burdensomeness mediated three of the links (emotional abuse, cumulative abuse, and cumulative abuse-severe with suicide resilience). Attention is paid to the clinical implications of the findings in terms of attending to the acquired capability for suicide and suicide resilience in the assessment and treatment of low-income, suicidal, African American women.