1
|
Greydanus DE, Nazeer A, Qayyum Z, Patel DR, Rausch R, Hoang LN, Miller C, Chahin S, Apple RW, Saha G, Prasad Rao G, Javed A. Pediatric suicide: Review of a preventable tragedy. Dis Mon 2024; 70:101725. [PMID: 38480023 DOI: 10.1016/j.disamonth.2024.101725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
Concepts of suicide are explored in this issue with a focus on suicide in children and adolescents. The epidemiology of pediatric suicide in the United States is reviewed; also, risk and protective factors, as well as prevention strategies, are discussed. Suicide in the pediatric athlete and the potential protective effect of exercise are examined. In addition, this analysis addresses the beneficial role of psychological management as well as current research on pharmacologic treatment and brain stimulation procedures as part of comprehensive pediatric suicide prevention. Though death by suicide in pediatric persons has been and remains a tragic phenomenon, there is much that clinicians, other healthcare professionals, and society itself can accomplish in the prevention of pediatric suicide as well as the management of suicidality in our children and adolescents.
Collapse
Affiliation(s)
- Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States.
| | - Ahsan Nazeer
- Division of Child and Adolescent Psychiatry, Sidra Medicine/Weill Cornell Medicine, Doha, Qatar
| | - Zheala Qayyum
- Harvard Medical School, Boston, Massachusetts, United States
| | - Dilip R Patel
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Rebecca Rausch
- Division of Pediatric Psychology, Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Linh-Nhu Hoang
- Western Michigan University, Kalamazoo, MI, United States
| | - Caroline Miller
- Fielding Graduate University, Santa Barbara, CA, United States
| | - Summer Chahin
- Mott Children's Hospital, University of Michigan, Ann Arbor, MI, United States
| | - Roger W Apple
- Division of Pediatric Psychology, Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Gautam Saha
- Immediate Past President of the SAARC (South Asian Association for Regional Cooperation) Psychiatric Federation (SPF), India
| | - G Prasad Rao
- President, Asian Federation of Psychiatric Association (AFPA), India
| | - Afzal Javed
- Chairman Pakistan Psychiatric Research Centre, Immediate Past President of the World Psychiatric Association (WPA), Pakistan
| |
Collapse
|
2
|
Liu L, Wang W. Suicide attempts of friends and family during adolescence and long-term suicidal ideation and attempts: Findings from the 25-year Add Health study. J Affect Disord 2024; 358:377-382. [PMID: 38735584 DOI: 10.1016/j.jad.2024.05.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND Suicide is a significant global public health concern. However, previous studies have predominantly focused on individual-level risk factors. Against this backdrop, microsystem suicide propinquity, which encompasses suicidal thoughts and behaviors (STB) within families and peer groups, is significant in elucidating the development and perpetuation of STB in adolescents. METHODS This study utilized data from the National Longitudinal Study of Adolescent to Adult Health (Add Health, 1994-2018). Adolescents who reported instances of suicide attempts among their friends and family members during Wave 1 were selected (N = 4826). Generalized estimation equations (GEE) and structural equation models (SEM) were employed. RESULTS GEE analyses indicated that individuals with friends who had attempted suicide exhibited higher risks for suicidal ideation (OR [95 % CI] = 2.57 [2.13, 3.11]) and suicide attempts (OR [95 % CI] = 2.47 [1.78, 3.42]). Also, individuals with family members who had attempted suicide exhibited higher risks for suicidal ideation (OR [95 % CI] = 2.37 [1.62, 3.46]) and attempts (OR [95 % CI] = 2.27 [1.17, 4.41]). However, friends' and family members' suicide attempts failed to show significant interactive effect. Besides, SEM analyses indicated that friends' and family members' suicide attempts were associated with one's long-term suicidal ideation and attempts via depressive symptoms. CONCLUSION Suicide attempts of friends and family during adolescence were long-term risk factors for suicidal ideation and attempts from adolescence to young adulthood. Moreover, depressive symptoms served as long-term mechanisms in these associations.
Collapse
Affiliation(s)
- Luming Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Wenchao Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing 100875, China; Department of Psychology, Faculty of Arts and Sciences, Beijing Normal University, Zhuhai 519087, China.
| |
Collapse
|
3
|
Morrissey J, Higgins A, Buus N, Berring LL, Connolly T, Hybholt L. The gift of peer understanding and suicide bereavement support groups: A qualitative study. DEATH STUDIES 2024:1-12. [PMID: 39002111 DOI: 10.1080/07481187.2024.2378354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/15/2024]
Abstract
There is a growing recognition and need for more studies on groups practices and processes to develop greater insight into the helpful elements that may be distinctive to bereavement peer support groups for traumatic loss such as, suicide. Using a qualitative descriptive design, focus groups and individual interviews were conducted online and face-to-face with a purposive sample of 27 participants in Ireland and in Denmark, who were bereaved by suicided and were attending peer bereavement support groups. Data were analyzed through Thematic Analysis. The findings suggest that the group provided a safe place where people felt and nurtured a deep emotional connection, a place where people trusted themselves and others to speak the unspoken and to tell and re-tell their story without fear of consequence as well as a place where they learnt to process their loss. Findings are discussed and recommendations based on the findings are proposed.
Collapse
Affiliation(s)
- Jean Morrissey
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Agnes Higgins
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Niels Buus
- Monash Nursing & Midwifery, Monash University, Victoria, Australia
| | - Lene Lauge Berring
- Psychiatric Research Unit, Centre for Relation & De-escalation, Mental Health Services, Region Zealand
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | | | - Lisbeth Hybholt
- Psychiatric Research Unit, Psychiatry, Region Zealand
- Research Unit, Mental Health Services East, Psychiatry, Region Zealand
| |
Collapse
|
4
|
Hofmann L, Wagner B. Understanding the complexity of suicide loss: PTSD, complex PTSD and prolonged grief disorder following suicide bereavement. DEATH STUDIES 2024:1-10. [PMID: 38913771 DOI: 10.1080/07481187.2024.2369858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Suicide-bereaved individuals are often confronted with profound grief reactions and have an increased risk for mental health disorders. Little is known about the development of complex post-traumatic stress disorder (CPTSD) following a loss by suicide. This paper aims to assess the prevalence of CPTSD, PTSD, prolonged grief disorder (PGD), and depression as well as to identify sociodemographic and loss-related factors regarding their development. A total of 161 suicide loss survivors (91.3% female) completed a questionnaire, which collected symptoms of grief (TGI-SR+), PTSD, CPTSD (ITQ), and depression (PHQ-D). In total, 12.4% met the diagnosis for CPTSD, 5.0% for PTSD. A total of 22.0% fulfilled the diagnosis for PGD. 41.6% showed at least moderate symptoms of depression. Pearson's correlation showed that time since loss was negatively associated with PG and PTSD symptoms, kinship to the deceased was associated with PG severity. The sample scored high on all disturbances in self-organization (DSO) symptom clusters typical for CPTSD. A focus on symptoms of CPTSD may be a necessary component in the care of survivors of suicide loss.
Collapse
Affiliation(s)
- Laura Hofmann
- Department of Clinical Psychology, Medical School Berlin, Berlin, Germany
| | - Birgit Wagner
- Department of Clinical Psychology, Medical School Berlin, Berlin, Germany
| |
Collapse
|
5
|
Tucker BC, Gonzalez VM. Effect of enhanced informed consent on veteran hesitancy to disclose suicidal ideation and related risk factors. Suicide Life Threat Behav 2024; 54:405-415. [PMID: 38345128 DOI: 10.1111/sltb.13053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/17/2023] [Accepted: 01/04/2024] [Indexed: 06/11/2024]
Abstract
INTRODUCTION The concealment of suicidal ideation (SI) constitutes a significant barrier to reducing veteran deaths by suicide and is associated with fear of negative consequences (e.g., involuntary hospitalization). This study examined whether augmenting informed consent with psychoeducation aimed to help patients achieve a more realistic risk appraisal of consequences associated with disclosure of SI, decreased hesitancy to disclose SI, and related risk behaviors among U.S. veterans. METHOD Participants (N = 133) were recruited from combat veteran social media groups and were randomly assigned to a video simulated treatment-as-usual informed consent (control) or to one of two psychoeducation-enhanced informed consent conditions (psychoed, psychoed + trust). RESULTS Compared with the control group, participants in both psychoeducation and enhanced informed consent conditions reported lower hesitancy to disclose SI, firearm access, and problems with drugs/thoughts of harming others, as well as greater trust and respect for the simulated clinician. CONCLUSIONS These findings suggest that brief psychoeducation regarding common factors that affect hesitancy to disclose SI may be beneficial for increasing trust in providers during the informed consent process and decreasing concealment of SI and firearm access among veterans.
Collapse
Affiliation(s)
- Brock C Tucker
- Department of Psychology, University of Alaska Anchorage, Anchorage, Alaska, USA
| | - Vivian M Gonzalez
- Department of Psychology, University of Alaska Anchorage, Anchorage, Alaska, USA
| |
Collapse
|
6
|
Brown HL, Selbe SM, Flesaker M, Rosellini AJ, Maple M, Gradus JL, Cerel J. The impact of relationship type and closeness on mental health following suicide loss. Suicide Life Threat Behav 2024; 54:479-488. [PMID: 38375945 DOI: 10.1111/sltb.13063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Most research investigating the effect of suicide on loss survivors has been limited to first-degree family members. Few studies examine the impact of suicide on others outside the immediate family and the influence of relationship type and closeness on mental health. METHODS This study used data from a sample obtained through random digit dialing (n = 805) to assess exposure to suicide loss, relationship types, perceived closeness, and mental health symptoms (prolonged grief, depression, anxiety, and posttraumatic stress disorder). RESULTS Familial status, friend status, and higher perceived closeness were associated with prolonged grief, depression, and posttraumatic stress disorder, with the strongest adjusted associations observed for posttraumatic stress disorder and prolonged grief. In general, the magnitude of adjusted standardized associations for closeness and mental health symptoms was stronger than those observed for familial status and mental health symptoms and friend status and mental health symptoms. CONCLUSION Closeness, familial status, and friend status are associated with mental health symptoms experienced after suicide loss, but the magnitude of associations was strongest for closeness. Future studies should examine perceived closeness in addition to other factors related to relationship type and dynamics to assess the complexities of suicide bereavement reactions.
Collapse
Affiliation(s)
- Hannah L Brown
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Sophie M Selbe
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Michelle Flesaker
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Anthony J Rosellini
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Myfanwy Maple
- University of New England, Armidale, New South Wales, Australia
| | - Jaimie L Gradus
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Julie Cerel
- College of Social Work, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
7
|
Yu M, Li X, Lei T, He Y, Gan X, Wang W, Zhu D, Chen R, Zhou X. The familial transmission of suicide and non-suicidal self-injury in different income levels in town. Int J Soc Psychiatry 2024:207640241250312. [PMID: 38803229 DOI: 10.1177/00207640241250312] [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: 05/29/2024]
Abstract
BACKGROUND Prior researches have established that suicide and non-suicidal self-injury (NSSI) exhibit familial transmission patterns. However, the extent to which these patterns vary across different income levels remains unclear, as well as the specific factors that influence them. This study aimed to explore these questions. METHODS We analyzed data from 13,988 parent-child pairs in Chongqing, China, where the children were aged from 7 to 12 years old. Six income levels were considered, and the children's depression and anxiety symptoms were assessed using standardized scales (the Center for Epidemiological Studies Depression Scale for Children, [CES-DC], and the Screen for Child Anxiety Related Emotional Disorders [SCARED], respectively). Binary logistic regression analysis was employed to examine the transmission of suicide and NSSI across different income levels. RESULTS Familial transmission of suicide was significant difference in all income levels except the highest, while familial transmission of NSSI was significant difference in all income levels except the lowest. Notably, in both low- and high-income levels, suicide and NSSI transmissions primarily occurred among male children, mothers with higher education, and children who spent long time with their mothers. Additionally, the transmissions were mediated partially or entirely by children's depression and anxiety symptoms. LIMITATIONS Future studies should investigate the separate effects of fathers' and mothers' suicide and NSSI histories on familial transmission patterns. CONCLUSION The familial transmissions of suicide and NSSI exhibited distinct patterns across different income levels.
Collapse
Affiliation(s)
- Mei Yu
- Vanke School of Public Health, Tsinghua University, China
- Institute for Healthy China, Tsinghua University, China
| | - Xuemei Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, China
| | - Tingting Lei
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, China
| | - Yuqian He
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, China
| | - Xieyu Gan
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, China
| | - Wenjing Wang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, China
| | - Dan Zhu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, China
- Institute for Healthy China, Tsinghua University, China
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, China
| |
Collapse
|
8
|
Logan N, Krysinska K, Andriessen K. Impacts of suicide bereavement on men: a systematic review. Front Public Health 2024; 12:1372974. [PMID: 38655522 PMCID: PMC11035897 DOI: 10.3389/fpubh.2024.1372974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/26/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction This systematic review examines the impacts of suicide bereavement on men's psychosocial outcomes relating to suicidality, mental health, substance use, grief, and social functioning. Given the high global incidence of suicide and the substantial number of individuals affected by each suicide, understanding the specific experiences and outcomes for men is crucial, particularly in the context of observed gender differences in suicide rates, grief coping styles and mental health outcomes. Methods Adhering to PRISMA guidelines, this review included peer-reviewed, English-language studies that involved men bereaved by suicide using quantitative, qualitative and mixed-methods designs. Searches were conducted in MEDLINE, Embase, Emcare, PsycINFO, and Scopus. Analysis used narrative synthesis methods due to the heterogeneity of findings. These were categorised based on comparison groups: non-bereaved men, or women bereaved by suicide. Prospero registration: CRD42023437034. Results The review included 35 studies (25 quantitative, 8 qualitative, 2 mixed-methods) published between 1995 and 2023. Compared to non-bereaved men, suicide-bereaved men are more likely to experience adverse psychosocial outcomes included increased suicide mortality, heightened susceptibility to mental health problems such as depression and posttraumatic stress disorder, and challenges in interpersonal relationships and social functioning. The review also identified gender differences in grief responses and coping strategies, with men often exhibiting more pronounced grief reactions and facing unique challenges due to societal expectations and norms regarding masculinity. Discussion The findings of this review underscore the elevated risk of adverse suicide- and mental-health related outcomes for suicide-bereaved men and the need for tailored postvention supports for this cohort. Gender-specific factors, including cultural norms and coping strategies, significantly influence men's experiences of suicide bereavement. Further qualitative and longitudinal quantitative exploration is needed to enhance understanding and effective support for men bereaved by suicide. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023437034.
Collapse
Affiliation(s)
- Nina Logan
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | | |
Collapse
|
9
|
Zia B, Kouser T, Helal H, Awaad R. A Brief Overview of the Islamic Ethics of Suicide and Suicide-Related Contemporary Issues from a Sunnī Perspective: A Primer for Clinicians and Researchers. JOURNAL OF RELIGION AND HEALTH 2024; 63:968-984. [PMID: 38421564 DOI: 10.1007/s10943-024-02007-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 03/02/2024]
Abstract
Suicide is a growing global health concern with complex socioeconomic implications. Understanding psychosocial resiliency factors may facilitate suicide prevention. Religious moral objections to suicide, including those inspired by the Islamic faith, appear to promote resilience to suicide. However, few English-language resources provide an overview of Islam's moral and ethical position on suicide, potentially hindering treatment of, and research on, suicide risk among Muslims. In the current paper, Islam's unanimous prohibition of suicide is explored and contextualized within the religion's foundational principles regarding the sanctity of life, the role and necessity of hardships, and one's responsibility to care for their body and to maintain their rights to their community. The role of harsh deterrents to suicide are contrasted with the impetus to show compassion to the deceased and the bereaved. Given the increasing focus on suicide-related topics such as euthanasia/ medical assistance in dying (MAID) and suicide contagion, Islam's ethical and legal position on suicide is discussed in the context of these contemporary moral issues.
Collapse
Affiliation(s)
- Belal Zia
- Department of Psychology, University of Manitoba, Winnipeg, Canada
| | - Taimur Kouser
- Department of Psychiatry and Behavioural Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA, 94305, USA
| | - Hosam Helal
- Department for the Study of Religion, University of Toronto, Toronto, Canada
| | - Rania Awaad
- Department of Psychiatry and Behavioural Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA, 94305, USA.
| |
Collapse
|
10
|
Putri AK, Armstrong G, Setiyawati D, Andriessen K. Unveiling studies on self-healing practices for suicide loss survivors: A scoping review. DEATH STUDIES 2024; 48:1107-1120. [PMID: 38259251 DOI: 10.1080/07481187.2024.2304773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
This scoping review aimed to examine how self-healing practices had been addressed in the empirical literature on suicide bereavement. Adhering to PRISMA-ScR guidelines, we searched five databases for peer-reviewed studies that reported using self-healing practices, either as a primary or secondary finding and 32 studies were included. The results highlight a substantial research gap in understanding self-healing practices' definition, implementation, and effectiveness in suicide bereavement. Further studies are necessary to clarify the definition, identify facilitators and barriers to implementation, and explore the applicability of these strategies in diverse contexts, particularly in non-Western and Low-and Middle-income countries.
Collapse
Affiliation(s)
- Adelia Khrisna Putri
- Center for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
- Center for Public Mental Health, Faculty of Psychology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Diana Setiyawati
- Center for Public Mental Health, Faculty of Psychology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Karl Andriessen
- Center for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
11
|
Jamieson SK, Cerel J, Maple M. Impacts of exposure to suicide of a military colleague from the lived experience of veterans: Informing postvention responses from a military cultural perspective. DEATH STUDIES 2024; 48:688-697. [PMID: 38212987 DOI: 10.1080/07481187.2023.2261408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Although exposure to the suicide death of a military colleague has been shown quantitatively to increase suicide risk factors among veterans, there are very few studies where veterans have been asked about this experience. This article presents a qualitative analysis of 38 interviews with U.S. veterans with exposure to the suicide death of a military colleague in past war operations. Participants described the impact of exposure in relation to the military context and official response to the death, which had long-term ramifications. Our findings suggest suicide prevention and postvention responses for veterans should be informed by the lived experience of veterans, including those for whom this experience occurred significantly in the past, as the impacts of different military policies and practices in response to suicide deaths over time are relevant to the impact of exposure to death of a military colleague in the short and long term.
Collapse
Affiliation(s)
- Sacha Kendall Jamieson
- Sydney School of Education and Social Work, The University of Sydney, Sydney, Australia
- School of Health, University of New England, Armidale, Australia
| | - Julie Cerel
- Suicide Prevention & Exposure Lab (SPEL), College of Social Work, University of Kentucky, Lexington, KY, USA
| | - Myfanwy Maple
- School of Health, University of New England, Armidale, Australia
| |
Collapse
|
12
|
Shame, depression, and complicated grief among suicide loss-survivors: the moderating role of self-disclosure. Eur J Psychotraumatol 2023; 14:2182820. [PMID: 37052086 PMCID: PMC9987731 DOI: 10.1080/20008066.2023.2182820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
Background: Suicide-loss survivors (SLSs) are recognised as an at-risk population for several psychiatric complications, including complicated grief (CG) and depression (SI). However, whereas shame is known as one of the characteristics of this population, knowledge about possible psychological processes which may moderate the contribution of shame levels to CG and depression in the aftermath of suicide loss is sparse. This study examines the role of self-disclosure - the inclination to share personal information with others - as a possible moderator of the associations of shame with CG and shame with depression over time.Method: Participants were 152 suicide-loss survivors, aged 18-70, who completed questionnaires tapping CG and depression at three time points (T1- index measurement, T2-two years after T1. and T3-four years after T1) and questionnaires tapping shame and SD at T3.Results: Hierarchical regression analyses showed that shame significantly and positively contributed to CG at T3 and to depression at T3, beyond the CG/depression trajectories. Notably, two significant interactions were found: Self-disclosure moderated the contribution of shame to CG at T3 and to depression at T3. At lower self-disclosure levels, shame's contribution to CG and depression was higher.Conclusion: The study's findings highlight shame as a significant facilitator of CG and depression in the aftermath of suicide loss. Moreover, the role of interpersonal interaction on SLSs' distress levels and grieving process was underscored, as this interaction may serve as a buffer against the deleterious sequelae of the suicide of a loved one.
Collapse
|
13
|
Čepulienė AA, Skruibis P. What is spirituality for women bereaved by a partner’s suicide: A qualitative study. COGENT PSYCHOLOGY 2023. [DOI: 10.1080/23311908.2023.2183676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Affiliation(s)
- Austėja Agnietė Čepulienė
- Suicidology Research Centre, Institute of Psychology, Department of Philosophy, Vilnius University Vilnius Lithuania
| | - Paulius Skruibis
- Suicidology Research Centre, Institute of Psychology, Department of Philosophy, Vilnius University Vilnius Lithuania
| |
Collapse
|
14
|
Clayton MG, Pollak OH, Prinstein MJ. Why Suicide? Suicide Propinquity and Adolescent Risk for Suicidal Thoughts and Behaviors. Clin Child Fam Psychol Rev 2023; 26:904-918. [PMID: 37801188 DOI: 10.1007/s10567-023-00456-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 10/07/2023]
Abstract
Suicide represents an international public health concern, and for adolescents aged 14 to 18 in the United States, is the third leading cause of death (Centers for Disease Control and Prevention. 2021 Youth Risk Behavior Survey Data. Available at: www.cdc.gov/yrbs . Accessed on August 30, 2023.). In response to this alarming rate, as well as the relative lack of meaningful progress in the prediction and prevention of suicidal thoughts and behaviors (STB) over the past decades (see Franklin et al., 2017), recent reviews of the suicide literature have advocated for the adoption of novel frameworks and theoretical reexamination of the processes that confer risk for suicide. Currently, the majority of suicide theories emphasize distal factors associated with suicide risk, but these factors also generalize to other types of psychopathology and do not answer the fundamental question of "why suicide?" vs. other maladaptive outcomes. In an effort to address this gap and build off existing theoretical and empirical science from various disciplines, the current theoretical paper will explore the concept of suicide propinquity, the degree of closeness and identification with STB, as a potential moderator of the link between psychological distress and suicide. Specifically, this paper: (1) provides context within the existing theories of suicide, highlighting gaps that might otherwise be explained by propinquity; (2) discusses historical and scientific evidence of suicide phenomena that support the existence of propinquity; (3) explores potential processes of how propinquity may confer risk for STB in adolescence; and (4) suggests future directions for research to examine adolescent suicide from a propinquity perspective.
Collapse
Affiliation(s)
- Matthew G Clayton
- Department of Psychology and Neuroscience, University of North Carolina, Davie Hall, Campus, Box 3270, Chapel Hill, NC, USA.
| | - Olivia H Pollak
- Department of Psychology and Neuroscience, University of North Carolina, Davie Hall, Campus, Box 3270, Chapel Hill, NC, USA
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, University of North Carolina, Davie Hall, Campus, Box 3270, Chapel Hill, NC, USA
| |
Collapse
|
15
|
Levi-Belz Y, Blank C. The longitudinal contribution of prolonged grief to depression and suicide risk in the aftermath of suicide loss: The moderating role of self-criticism. J Affect Disord 2023; 340:658-666. [PMID: 37586648 DOI: 10.1016/j.jad.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/18/2023] [Accepted: 08/03/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Suicide-loss survivors (SLSs)-individuals who lost family member to suicide, have been recognized as at risk for several mental health complications, including depression and suicide. Recent studies have emphasized the contribution of prolonged grief (PG) symptoms and suicide-related shame as facilitators of depression and suicide risk in the aftermath of suicide loss. In this six-year longitudinal design study, we examined self-criticism as a moderator of the link between PG and depression and suicide risk, with suicide-related shame mediating these links. METHOD Participants were 152 SLSs (130 females) aged 18-70 who completed questionnaires assessing prolonged grief, depression, and suicide risk as well as trauma-related shame and self-criticism. RESULTS A moderated mediation model shows that high self-criticism intensified the relations between PG and shame and between shame and depression and suicide risk, above and beyond the contribution of the longitudinal PG trajectory. Importantly, the indirect effects of PG on both depression and suicide risk via shame levels were found only among SLSs with high levels of self-criticism. CONCLUSION The findings highlight the critical longitudinal role of self-criticism in facilitating depression and suicide risk among SLSs with higher levels of PG. Theoretical implications relating to healing processes and focused clinical recommendations are discussed, including interventions for addressing self-criticism and suicide-related shame in the aftermath of suicide loss.
Collapse
Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel; Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel.
| | - Carmel Blank
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
| |
Collapse
|
16
|
Sanford RL, Frey LM, Thind N, Butcher B, Maple M. Unpacking the Meaning of Closeness, Reconsidering the Concept of Impact in Suicide Exposure, and Expanding Beyond Bereavement: "Just, I Hope You Don't Forget About Us". OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231196616. [PMID: 37599374 DOI: 10.1177/00302228231196616] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Suicide exposure research has relied on samples of treatment-seeking kin, resulting in an attachment-based model centering bereavement as the most significant form of impact and obscuring other forms of significant and life-altering impact. From a community-based sample (N = 3010) exposed to suicide, we examine a subset (n = 104) with perceived high impact from the death yet low reported closeness to the person who died and analyze qualitative comments (n = 50). On average and out of 5.00, participants rated closeness as 1.56 but impact of death as 4.51. We illustrate dimensions of low closeness and identify themes on the meaning of impact: impact through society and systemic circumstances, impact through history and repeated exposure, impact through other people, impact as a motivator for reflection or change, and impact through shared resonance. Participants reported impact of death as significant or devastating, yet none of their comments reflected experiences typical of bereavement.
Collapse
Affiliation(s)
- Rebecca L Sanford
- School of Social Work and Human Service, Thompson Rivers University, Kamloops, BC, Canada
| | - Laura M Frey
- Couple & Family Therapy Program, Kent School of Social Work & Family Science, University of Louisville, Louisville, KY, USA
| | - Neetika Thind
- School of Social Work and Human Service, Thompson Rivers University, Kamloops, BC, Canada
| | - Brock Butcher
- School of Social Work and Human Service, Thompson Rivers University, Kamloops, BC, Canada
| | - Myfanwy Maple
- Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| |
Collapse
|
17
|
Kleinhendler-Lustig D, Hamdan S, Mendlovic J, Gvion Y. Burnout, depression, and suicidal ideation among physicians before and during COVID-19 and the contribution of perfectionism to physicians' suicidal risk. Front Psychiatry 2023; 14:1211180. [PMID: 37520224 PMCID: PMC10374214 DOI: 10.3389/fpsyt.2023.1211180] [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: 04/24/2023] [Accepted: 06/22/2023] [Indexed: 08/01/2023] Open
Abstract
Objectives There is limited data regarding the prevalence of suicidal risk among physicians during COVID-19, and the risk factors relating to it. Dominant risk factors for suicide among physicians are depression and burnout. Maladaptive perfectionism may also serve as a profound risk factor for suicidality among physicians and may aggravate symptoms of distress under the challenges of COVID-19. This study aims to evaluate current suicidal risk, suicidal ideation, depression, and burnout before and during COVID-19 among physicians in Israel, and to identify the best sets of correlates between perfectionism and burnout, depression and suicidal ideation, during these time periods. Methods A sample of 246 Israeli physicians (160 before COVID-19 and 86 during COVID-19) completed online surveys assessing lifetime suicidal risk, suicidal ideation during the last year and current suicidal ideation, depression, burnout symptoms and maladaptive perfectionism. Results More than one-fifth of the sample (21.9%) reported high suicidal risk (Lifetime suicidal behaviors). More than one-fourth (27.2%) reported suicidal ideation during the last 12 months; and 13.4% reported suicidal ideation during the last 3 months. In addition, more than one-third (34.6%) exhibited moderate-severe levels of depressive symptoms and more than a half of the sample reported burnout symptoms. Maladaptive perfectionism was positively correlated with current suicidal ideation, burnout, and depression. Moderated serial mediation analysis demonstrated indirect effect of perfectionism on suicidal ideation by its impact on burnout and depression only during COVID-19. Before COVID-19, physicians were more likely to experience depressive symptoms. Conclusion Physicians in Israel are at increased risk for depression and suicidal ideation, regardless of the COVID-19 pandemic. Maladaptive perfectionism was found to be a risk factor for burnout, depression, and suicidal ideation. During the first waves of the pandemic, physicians were less likely to experience depressive symptoms. However, among physicians who were characterized with high maladaptive perfectionism, depression served as a significant risk factor for suicidal ideation during the pandemic, which places these individuals at increased risk for suicidality. These results highlight the importance of implementing intervention programs among physicians to reduce suicidal risk and to better identify rigid perfectionism and depressive symptoms.
Collapse
Affiliation(s)
| | - Sami Hamdan
- School of Behavioral Sciences, The Academic College of Tel-Jaffa (MTA), Tel-Jaffa, Israel
| | - Joseph Mendlovic
- Shaare Zedek Medical Center, Hadassah-Hebrew University School of Medicine, Jerusalem, Israel
- Ministry of Health, Jerusalem, Israel
| | - Yari Gvion
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| |
Collapse
|
18
|
Visser V, Tretheway R. A Longitudinal Study of the Impact of a Suicide Bereavement Service on People Bereaved by Suicide. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231188751. [PMID: 37423761 DOI: 10.1177/00302228231188751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Whilst the body of research on the impacts of suicide bereavement interventions continues to grow, there is little understanding of the impact over time. This study measured changes in suicidality, levels of loneliness and grief reactions over time between those receiving support from a community-based suicide bereavement service (StandBy) compared with those that did not receive this support. Data were collected through an online survey with participation at baseline being varying times post loss, and three-months post-baseline (StandBy n = 174, Comparison n = 322). Statistical analysis included linear mixed-effects modelling for repeated measures. Results were consistent with earlier studies showing the positive impact of StandBy on participants' grief responses, loneliness and suicidality, specifically within the first 12 months after their loss. However, these outcomes were not retained over time, with the exception of suicidality. Further longitudinal studies consisting of more than two time-points and a greater period between time-points is warranted.
Collapse
|
19
|
Michel CA, Galfalvy HC, Mann JJ, Schneck N. Attentional bias during acute grief predicts clinical outcome in suicide-related bereavement. J Affect Disord 2023; 328:6-12. [PMID: 36750161 PMCID: PMC10316461 DOI: 10.1016/j.jad.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND Individuals who have lost a loved one to suicide are at increased risk for developing complicated grief (CG). It is unclear why only a subgroup of bereaved develops pathological forms of grief. Vulnerability may be related to the ability to regulate attention toward reminders of the deceased during the acute phase of grief. Using a longitudinal design, we determined whether loss-related attentional bias during acute grief predicts grief severity one year later. METHODS Thirty-seven participants grieving a first-degree relative or partner to suicide in the prior 6 months performed an emotional Stroop task using words related to the deceased, a living attachment figure, living non-attachment figure, and color congruent Stroop to quantify related attentional bias during the acute grief period. Clinical interviews were conducted at baseline (N = 37) and one year later (N = 35). RESULTS Participants showed greater attentional bias to deceased-related word trials compared with living attachment, non-attachment, and congruent trials, controlling for age, time since loss, depression, and psychiatric medication. A greater reduction in grief severity over time was associated with more deceased-related attentional bias at baseline. Self-reported grief avoidance was related to deceased-related attentional bias, with lower avoidance scores associated with greater bias. LIMITATIONS Lack of non-suicide grief control and small sample size. CONCLUSIONS Less deceased-related bias following the loss may hinder the transition from acute to integrated grief and result in poorer grief trajectories.
Collapse
Affiliation(s)
- Christina A Michel
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University, New York, NY, USA.
| | - Hanga C Galfalvy
- Department of Psychiatry, Columbia University, New York, NY, USA; Department of Biostatistics, New York State Psychiatric Institute, New York, NY, USA
| | - J John Mann
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University, New York, NY, USA; Department of Radiology, Columbia University, New York, NY, USA
| | - Noam Schneck
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University, New York, NY, USA
| |
Collapse
|
20
|
Levi-Belz Y, Krysinska K, Andriessen K. What Do We Know about Suicide Bereavement, and What We Can Do to Help Suicide-Loss Survivors? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085577. [PMID: 37107858 PMCID: PMC10138333 DOI: 10.3390/ijerph20085577] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/18/2023] [Indexed: 05/11/2023]
Abstract
"Suicide is not only the end of life for the deceased but also the beginning of a highly challenging life for those left behind" [...].
Collapse
Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer 40250, Israel
- Correspondence:
| | - Karolina Krysinska
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia
| |
Collapse
|
21
|
Mitchell KJ, Banyard V, Ybarra M. Overlap Between Exposure to Suicidal Behavior and Indirect Interpersonal Violence: Evidence for a More Integrated Approach to Violence Research. JOURNAL OF INTERPERSONAL VIOLENCE 2023:8862605231163238. [PMID: 37070812 DOI: 10.1177/08862605231163238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
This study examines the overlap between indirect exposure to forms of interpersonal violence and suicidal behavior, and the impact of the co-occurrence of these exposures on indicators of depressed mood and substance use among adolescents. Participants were a national sample of 3,917 youth aged 14-15 years, recruited online between June 2018 and March 2020, including an oversample of sexual and gender minority youth. Eight in ten (81.3%) youth reported exposure to indirect interpersonal violence and/or suicidal behavior in their lifetimes: 39.5% reported only interpersonal violence exposure, 5.9% only suicidal behavior exposure, and 35.9% reported both. Youth who reported exposure to interpersonal violence were almost three times more likely (adjusted odds ratio [OR] = 2.78, p < .001) to also report suicidal behavior exposure. Compared with youth having no indirect violence exposure, those with only interpersonal violence exposure were 2.25 times more likely (p < .001), those with only exposure to suicidal behavior 2.93 times more likely (p < .001), and those with both were 5.63 times more likely to report recent depressed mood. The unadjusted odds of any substance use was significantly elevated for each type of indirect violence exposure, with the highest odds seen among youth with dual interpersonal violence and suicide exposure (OR = 4.87, p < .001). For both outcomes, significant findings remained but were attenuated after adjusting for demographic characteristics, non-victimization adversity exposure, and cumulative direct victimization. Findings suggest that the combination of exposure to interpersonal violence and suicidal behavior appears to be particularly impactful. Results highlight that assessment of trauma exposure among adolescents needs to be more comprehensive and include not only direct and indirect interpersonal violence, but also knowledge of other people's suicidal thoughts and behaviors.
Collapse
Affiliation(s)
| | | | - Michele Ybarra
- Center for Innovative Public Health Research, San Clemente, CA, USA
| |
Collapse
|
22
|
ROCHE JESSICAS, CARTER PATRICKM, ZEOLI APRILM, CUNNINGHAM REBECCAM, ZIMMERMAN MARCA. Challenges, Successes, and the Future of Firearm Injury Prevention. Milbank Q 2023; 101:579-612. [PMID: 37096629 PMCID: PMC10126989 DOI: 10.1111/1468-0009.12621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/21/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points Firearm injury is a leading cause of death in the United States, with fatality rates increasing 34.9% over the past decade (2010-2020). Firearm injury is preventable through multifaceted evidence-based approaches. Reviewing past challenges and successes in the field of firearm injury prevention can highlight the future directions needed in the field. Adequate funding, rigorous and comprehensive data availability and access, larger pools of diverse and scientifically trained researchers and practitioners, robust evidence-based programming and policy implementation, and a reduction in stigma, polarization, and politicization of the science are all needed to move the field forward.
Collapse
Affiliation(s)
| | - PATRICK M. CARTER
- University of Michigan Institute for Firearm Prevention
- University of Michigan Injury Prevention Center
- University of Michigan School of Medicine
- University of Michigan School of Public Health
- Michigan Youth Violence Prevention CenterUniversity of Michigan School of Public Health
| | - APRIL M. ZEOLI
- University of Michigan Institute for Firearm Prevention
- University of Michigan School of Public Health
| | - REBECCA M. CUNNINGHAM
- University of Michigan Institute for Firearm Prevention
- University of Michigan Injury Prevention Center
- University of Michigan School of Medicine
- University of Michigan School of Public Health
| | - MARC A. ZIMMERMAN
- University of Michigan Institute for Firearm Prevention
- University of Michigan Injury Prevention Center
- University of Michigan School of Public Health
- Michigan Youth Violence Prevention CenterUniversity of Michigan School of Public Health
| |
Collapse
|
23
|
Risk and Protective Factors in Ecuadorian Adolescent Survivors of Suicide. CHILDREN 2023; 10:children10030549. [PMID: 36980107 PMCID: PMC10047342 DOI: 10.3390/children10030549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/17/2023]
Abstract
Suicide is one of the main causes of death among the adolescent population, which is why it is considered an important mental-health problem. In addition to this situation, for each suicide, the group of people who survive it (known as suicide survivors) can present serious emotional affectations, becoming a population at risk for this problem. The purpose of this study was to analyze the effect of suicide-survivor status on risk factors and protective factors for suicide. A total of 440 adolescents with a mean age of 15.78 (SD = 1.74) participated, who were divided according to survivor status, identified as the SV group (79 cases), and non-survivors, identified as the NSV group—adolescents that did not have experience or contact with a suicide attempt (361 cases). A questionnaire of sociodemographic characterization and risk conditions, the Alexian Brother Urge to Self-Injure (ABUSI), the Plutchik Suicide Risk Scale, the Multidimensional Scale of Perceived Social Support, and the Cognitive and Affective Empathy Test (TECA) were applied. Descriptive statistics, mean difference for independent samples, contingency tables, X2 statistic, Fisher’s exact statistic, and Cohen’s d coefficient were used. The results show significant differences between SV and NSV participants in risk and protective factors regarding the presence of a greater adoption of perspective and emotional understanding. On the other hand, NSV adolescents presented higher scores of perceived social supports regarding risk factors, and there was a higher proportion of a history of suicide attempt, severity/hospitalization, impulse to self-harm, and level of suicidal risk in the SV group. The need to incorporate forms of suicide prevention with the survivor population is discussed, increasing the possibilities of postvention.
Collapse
|
24
|
Park Y, Ammerman BA. For Better or Worse?: The role of cognitive flexibility in the association between nonsuicidal self-injury and suicide attempt. J Psychiatr Res 2023; 158:157-164. [PMID: 36586214 DOI: 10.1016/j.jpsychires.2022.12.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/25/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
Nonsuicidal self-injury (NSSI) has been repeatedly associated with increased suicide risk. However, the transition from NSSI to suicidal thoughts and behaviors still remains as an enigma. One possible construct that may influence this relationship is cognitive flexibility, which refers to the ability to adapt responses/strategies based on environmental feedback. It may be that greater cognitive flexibility increases one's cognitive accessibility to suicide, making it a more viable option upon distress especially for those with a prior history of NSSI. Conversely, it may be that less cognitive flexibility creates a negative bias that exacerbates the effects of NSSI on suicide. Thus, in this study, we examined how NSSI characteristics (i.e., frequency and methods) interact with cognitive flexibility to predict lifetime suicide attempt (SA) history. Participants were 505 individuals with a lifetime history of NSSI who completed a survey assessing for their NSSI experiences, cognitive flexibility, and SA history. Moderation analyses were conducted while controlling for sexual orientation, which significantly predicted SA history. Results indicated a significant interaction between number of NSSI methods endorsed and cognitive flexibility. In particular, individuals were more likely to have had a history of SA if they scored higher on the alternative subscale of cognitive flexibility. The results suggest that the adaptive value of cognitive flexibility may be context dependent, and highlight the importance of personalized care among those who engage in self-harm.
Collapse
Affiliation(s)
- Yeonsoo Park
- University of Notre Dame, Department of Psychology, USA.
| | | |
Collapse
|
25
|
Maple M, Wayland S, Sanford RL, Bhullar N. Predictors of Caregiver Burden Among Carers of Suicide Attempt Survivors. CRISIS 2023; 44:41-48. [PMID: 34915733 PMCID: PMC9909369 DOI: 10.1027/0227-5910/a000836] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Family members often provide informal care following a suicide attempt. Carers may be vulnerable to caregiver burden. Yet, little is known about what contributes to this. Aims: To determine the predictors of caregiver burden in those carers who support people who have attempted suicide. Method: An online survey of 435 participants assessed exposure to suicide, caring behaviors, and psychological variables and caregiver burden. Results: A multivariate model explained 52% of variance in caregiver burden. Being female, closeness to the person, impact of suicide attempt, frequency of contact pre-attempt, and psychological distress were positively associated with caregiver burden. Confidence in supporting the person after suicide attempt, perceived adequacy of healthcare the person received and the support the carer received, and suicidal ideation of the carer were negatively associated with caregiver burden. Moderation analysis suggested that carers with high levels of distress reported negative association between suicidal ideation and caregiver burden. Limitations: The cross-sectional online survey design of self-identified carers is a limitation of the study. Conclusion: Carers are highly distressed, and if unsupported report increased suicide ideation. In their caring roles they may have contact with support services, thus attending to their needs may ameliorate caregiver burden and associated negative outcomes.
Collapse
Affiliation(s)
- Myfanwy Maple
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia,Myfanwy Maple, School of Health, Faculty of Medicine and Health, University of New England, Armidale 2351 NSW, Australia,
| | - Sarah Wayland
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Rebecca L. Sanford
- School of Social Work and Human Service, Thompson Rivers University, Kamloops, BC, Canada
| | - Navjot Bhullar
- School of Psychology, Faculty of Medicine and Health, University of New England, NSW, Armidale, Australia
| |
Collapse
|
26
|
Hill NTM, Walker R, Andriessen K, Bouras H, Tan SR, Amaratia P, Woolard A, Strauss P, Perry Y, Lin A. Reach and perceived effectiveness of a community-led active outreach postvention intervention for people bereaved by suicide. Front Public Health 2022; 10:1040323. [PMID: 36620290 PMCID: PMC9815599 DOI: 10.3389/fpubh.2022.1040323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Postvention is a core component of suicide prevention strategies, internationally. However, the types of supports provided to people impacted by suicide vary widely. This study examines the perceived effectiveness of the Primary Care Navigator (PCN) model for people bereaved by suicide. The PCN model was implemented in response to a suicide cluster. It is an active outreach postvention intervention, initiated by police in response to a suspected suicide and links individuals to support in the immediate aftermath of their loss. Methods A retrospective cross-sectional mixed methods approach was used to (1) identify the reach of the PCN model, (2) describe the type of support provided to people bereaved by a suspected suicide and (3) identify the perceived effectiveness of the PCN model from the perspective of WA police, postvention stakeholders and individuals bereaved by suicide. Quantitative data was used to examine the characteristics of suicide in the region, the characteristics of people who received bereavement support, and the types of support that were provided. Interviews with police, postvention stakeholders, and people bereaved by a suspected suicide were conducted to identify the perceived effectiveness of the intervention. Results Between 1 January 2019 and 31 March 2021 there were 80 suspected suicides. Active outreach was provided to 347 bereaved individuals via the PCN model. Just under half of those who were offered outreach accepted further support (N = 164) in the form of suicide bereavement information (98%), mental health or clinical support (49.6%), specialized postvention counseling (38.4%), financial assistance (16%) and assistance with meals (16%), followed by housing assistance (14%) and referral to community services (11%). Police, stakeholders, and people with lived experience of a suspected suicide perceived the PCN model to be effective at connecting them to the community, linking people to support, and preventing suicide. Conclusion The results provide evidence supporting the perceived effectiveness of an active outreach approach to postvention that provides acute support to people bereaved by suicide. Findings highlight important practical areas of support such as providing referral pathways and information on grief and suicide loss in the immediate aftermath of a suicide loss.
Collapse
Affiliation(s)
- Nicole T. M. Hill
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia,School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia,*Correspondence: Nicole T. M. Hill
| | - Roz Walker
- School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia,Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, Australia,School of Indigenous Studies, University of Western Australia, Perth, WA, Australia
| | - Karl Andriessen
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Hamza Bouras
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Shawn R. Tan
- Telethon Kids Institute, Nedlands, WA, Australia
| | | | - Alix Woolard
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia
| | - Penelope Strauss
- Telethon Kids Institute, Nedlands, WA, Australia,School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia
| | - Yael Perry
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia
| |
Collapse
|
27
|
Levi-Belz Y, Birnbaum S. Depression and Suicide Ideation among Suicide-Loss Survivors: A Six-Year Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416561. [PMID: 36554459 PMCID: PMC9778882 DOI: 10.3390/ijerph192416561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/27/2022] [Accepted: 12/07/2022] [Indexed: 05/13/2023]
Abstract
Suicide is not only a tragic end of life but also may be the beginning of a very challenging life for those left behind. Suicide-loss survivors (SLSs) are individuals who were exposed to the suicide of a close family member or a friend and endure highly emotional distress. The psychological stance and reactions of SLS are deeply colored by painful, intense emotions that are expressed through different psychiatric symptoms, including depression and suicide ideation (SI). The present study investigated the long-term effects of interpersonal factors such as social support, self-disclosure, thwarted belongingness, and perceived burdensomeness on depression and suicidal ideation among SLS. One hundred fifty-two Israeli SLS, aged 20-72, participated in this longitudinal study, during which their suicide ideation and depression levels were assessed at four points over six years (T1-baseline, and two (T2), four (T3), and six (T4) years after baseline). At the last time point, interpersonal factors were also assessed. SLSs' interpersonal variables significantly predicted depression and SI levels beyond their usual trajectories over the years. Significant correlations were found between both perceived burdensomeness and thwarted belongingness and depression levels at all measurement points. Moreover, thwarted belongingness was found to be a significant moderator of the relationship between former and current depression levels, as the contribution of depression-T3 to depression-T4 was lower among SLSs with low thwarted belongingness (b = 0.14, CI = 0.05-0.34) compared with SLSs with high thwarted belongingness (b = 0.25, CI = 0.22-0.45). These findings emphasize the vital healing role of interpersonal factors such as belongingness, as they may attenuate depression and SI symptoms over time. Hence, clinicians should focus on therapies that boost interpersonal interactions and belongingness, as they seem to be crucial stepping stones on the way to recovery. Moreover, national programs should be implemented to offer SLSs targeted interventions to reduce distress and depression in the aftermath of suicide loss.
Collapse
Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer 4025000, Israel
- Correspondence:
| | - Shai Birnbaum
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer 4025000, Israel
- Clinical Psychology M.A. Program, Ruppin Academic Center, Emek Hefer 4025000, Israel
| |
Collapse
|
28
|
Mary McDaniel B, Daly P, Pacheco CL, Crist JD. Experiences With Suicide Loss: A Qualitative Study. Clin Nurs Res 2022; 31:1491-1499. [PMID: 36082419 DOI: 10.1177/10547738221119344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
To better understand suicide loss survivors' experiences and barriers to accessing support and mental health care, 28 (21 women and 7 men) suicide loss survivors were interviewed. Using qualitative analysis of 28 in-depth, semi-structured phone interviews data, three categories emerged: Life before Suicide, Life after Suicide, and Meaning of Life. This deeper understanding of suicide loss survivors along with inclusion of experiences of male and rural participants' suicide loss, fill previously identified research gaps. Our findings suggest importance in providing emotional support and mental health resources to those with suicide intent or experiences with suicide loss. Most importantly, the recognition of suicide loss survivors extends beyond the immediate family and includes cousins, friends, and work associates. Recognition of extended suicide loss survivors' bereavement will provide additional opportunities for healthcare providers to effectively intervene with this vulnerable population.
Collapse
|
29
|
Maple M, Cerel J, Sanford R, Shand F, Batterham PJ, Bhullar N. Suicide exposure experience screener for use in therapeutic settings: A validation report. Suicide Life Threat Behav 2022; 52:975-982. [PMID: 35713122 PMCID: PMC9796633 DOI: 10.1111/sltb.12894] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/20/2022] [Accepted: 06/02/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION A brief screener assessing experience of exposure to suicide for use in therapeutic settings is warranted. To examine the concurrent validity of such a screening tool, labeled as the Suicide Exposure Experience Screener (SEES), the associations of the two SEES items: (i) reported closeness with the person who died by suicide and (ii) perceived impact of suicide death with psychological distress are presented. METHODS Five separate datasets comprising surveys from Australia, Canada, and the United States (Ncombined = 7782) were used to provide evidence of concurrent validity of closeness and impact of suicide exposure. RESULTS Overall, closeness and impact were significantly correlated with measures of global distress across five different datasets, showing small to medium effect sizes. Closeness and impact were also intercorrelated demonstrating a large effect size across all surveys. This report used cross-sectional data and comprised varied sample sizes across different datasets that influenced statistical significance of obtained effects and did not tease apart the roles of cumulative exposure of suicide and prolonged bereavement in experiencing global distress. CONCLUSION The SEES has clinical utility in determining psychological distress in bereaved individuals and is recommended for use in therapeutic settings.
Collapse
Affiliation(s)
- Myfanwy Maple
- School of HealthUniversity of New EnglandArmidaleNew South WalesAustralia
| | - Julie Cerel
- College of Social WorkUniversity of KentuckyLexingtonKentuckyUSA
| | - Rebecca Sanford
- School of Social Work and Human ServiceThompson Rivers UniversityKamloopsBritish ColumbiaCanada
| | - Fiona Shand
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Philip J. Batterham
- Centre for Mental Health ResearchThe Australian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Navjot Bhullar
- Discipline of PsychologyEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| |
Collapse
|
30
|
McGill K, Bhullar N, Batterham PJ, Carrandi A, Wayland S, Maple M. Key issues, challenges, and preferred supports for those bereaved by suicide: Insights from postvention experts. DEATH STUDIES 2022; 47:624-629. [PMID: 35984768 DOI: 10.1080/07481187.2022.2112318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
For many, suicide bereavement is challenging. Postvention responses are few and evidence to inform them is lacking. Eighteen postvention experts completed an online survey regarding the key issues, challenges, and supports available to people bereaved by suicide. Participants were asked to identify the issues, then rank them in terms of importance at key times during the first 2 years after death, with navigating grief, managing relationships, and dealing with practical challenges identified. Access to information, practical assistance and non-judgmental support were most important early in the bereavement period. These findings provide a foundation for recommendations for postvention interventions.
Collapse
Affiliation(s)
- Katie McGill
- Faculty of Medicine and Health, University of New England, Armidale, Australia
- MH-READ, Hunter New England Local Health District, Newcastle, Australia
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, Australia
| | - Navjot Bhullar
- Faculty of Medicine and Health, University of New England, Armidale, Australia
- Discipline of Psychology, Edith Cowan University, Perth, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Alayna Carrandi
- Faculty of Medicine and Health, University of New England, Armidale, Australia
| | - Sarah Wayland
- Faculty of Medicine and Health, University of New England, Armidale, Australia
| | - Myfanwy Maple
- Faculty of Medicine and Health, University of New England, Armidale, Australia
| |
Collapse
|
31
|
Hybholt L, Higgins A, Buus N, Berring LL, Connolly T, Erlangsen A, Morrissey J. The Spaces of Peer-Led Support Groups for Suicide Bereaved in Denmark and the Republic of Ireland: A Focus Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19169898. [PMID: 36011534 PMCID: PMC9407788 DOI: 10.3390/ijerph19169898] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 05/13/2023]
Abstract
Research has shown that people bereaved by suicide have an increased risk of mental health problems, suicidality and associated stigma, as well as higher rates of sick leave and increased rates of receiving disability pensions. Peer-led suicide bereavement support groups are perceived to enhance people's recovery by enabling shared experiences with others who are bereaved in similar circumstances. The aim of the research was to explore the viewpoints of participants living in Denmark and the Republic of Ireland on these peer-led support groups. This study focused on how the participants experienced being part of the peer-led support and how the participation affected them. We conducted four focus groups, two in Denmark and two in the Republic of Ireland, and two individual interviews, involving a total of 27 people bereaved by suicide. Data were analyzed thematically. The participants' experiences in the peer-led support groups were in contrast to what they had experienced in their daily lives. They felt alienated in daily living, as they believed that people could not comprehend their situation, which in turn led participants to search for people with similar experiences and join the peer-led support groups. While peer-led support groups may not be helpful for everyone, they created 'supportive spaces' that potentially affected the participants' recovery processes, from which we generated three key themes: (i) 'A transformative space', describing how the peer-led support group created a place to embrace change, learning and knowledge about suicide and suicide bereavement and the making of new connections; (ii) 'An alternative space for belonging and grieving', describing how the participants felt allowed to and could give themselves permission to grieve; and (iii) 'A conflicted space' describing how it was troublesome to belong to and participate in the peer-led support groups. In conclusion, despite the two cultural settings and different organizational approaches, the experiences were comparable. Peer-led support groups can, despite being a conflicted space for some, provide supportive spaces aiding the participants' recovery process.
Collapse
Affiliation(s)
- Lisbeth Hybholt
- Psychiatric Research Unit, Psychiatry Region Zealand, 4200 Slagelse, Denmark
- Mental Health Services East, Psychiatry Region Zealand, 4000 Roskilde, Denmark
- Correspondence:
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Niels Buus
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3800, Australia
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Lene Lauge Berring
- Psychiatric Research Unit, Psychiatry Region Zealand, 4200 Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Terry Connolly
- Friends of Suicide Loss (FOSL), D06 T685 Dublin, Ireland
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, 2900 Hellerup, Denmark
- Copenhagen Research Centre for Mental Health, 2900 Hellerup, Denmark
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Center of Mental Health Research, Australian National University, Canberra, ACT 0200, Australia
| | - Jean Morrissey
- School of Nursing and Midwifery, Trinity College Dublin, D02 PN40 Dublin, Ireland
| |
Collapse
|
32
|
Soberay KA, Cerel J, Brown MM, Maple M. An Examination of Suicide Exposure and Fearlessness about Death on Suicide Risk among Active Duty Service Members, Veterans, and Civilians. Arch Suicide Res 2022; 26:1198-1218. [PMID: 33465319 DOI: 10.1080/13811118.2020.1868365] [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: 10/22/2022]
Abstract
Suicide exposure is associated with an increased risk for suicide. There is limited research on the mechanisms that increase this risk. This study aims to: (1) compare suicide exposure and associated variables in veteran, active duty, and civilian participants, (2) examine the extent to which fearlessness about death and suicide risk factors differ as a function of group membership and suicide exposure, and (3) determine the degree to which relationship to the decedent, perceived closeness, and reported impact of the death are associated with fearlessness about death and suicide-related outcomes. 1,533 participants were included, of whom 48% of active duty service members, 65% of veterans, and 58% of civilians reported knowing someone who died by suicide. A series of regressions were conducted. There were group differences by military service on the suicide exposure variables. Furthermore, there were significant main effects for military service group and suicide exposure on the outcome variables. In general, civilians reported greater suicide risk and active duty service members reported greater fearlessness about death. Fearlessness about death mediated the associations between perceived closeness and a history of suicide attempts. The loss of a military colleague to suicide was found to be unique and distinguishable from other important relationships. Results suggest the need to consider suicide exposure and closeness as salient variables associated with fearlessness about death and suicide risk factors. Inquiring about suicide exposure, closeness to the decedent, fearlessness about death, and beyond familial losses to suicide may indicate important avenues of intervention.
Collapse
|
33
|
Knipe D, Padmanathan P, Newton-Howes G, Chan LF, Kapur N. Suicide and self-harm. Lancet 2022; 399:1903-1916. [PMID: 35512727 DOI: 10.1016/s0140-6736(22)00173-8] [Citation(s) in RCA: 84] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/23/2021] [Accepted: 12/20/2021] [Indexed: 12/21/2022]
Abstract
Suicide and self-harm are major health and societal issues worldwide, but the greatest burden of both behaviours occurs in low-income and middle-income countries. Although rates of suicide are higher in male than in female individuals, self-harm is more common in female individuals. Rather than having a single cause, suicide and self-harm are the result of a complex interplay of several factors that occur throughout the life course, and vary by gender, age, ethnicity, and geography. Several clinical and public health interventions show promise, although our understanding of their effectiveness has largely originated from high-income countries. Attempting to predict suicide is unlikely to be helpful. Intervention and prevention must include both a clinical and community focus, and every health professional has a crucial part to play.
Collapse
Affiliation(s)
- Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka.
| | - Prianka Padmanathan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Lai Fong Chan
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Nav Kapur
- Centre for Mental Health and Safety, University of Manchester, Academic Health Science Centre, Manchester, UK; National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Academic Health Science Centre, Manchester, UK; Greater Manchester Mental Health National Health Service Foundation Trust, Manchester, UK
| |
Collapse
|
34
|
Levi-Belz Y. Growing together: interpersonal predictors of posttraumatic growth trajectory among suicide-loss survivors. ANXIETY, STRESS, AND COPING 2022; 35:284-297. [PMID: 34314267 DOI: 10.1080/10615806.2021.1958791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Recent studies have indicated that grieving after suicide loss can be particularly complex and traumatic. However, studies have recognized the opportunity for personal growth among suicide-loss survivors. This study signifies an effort to develop a comprehensive understanding of the underlying interpersonal facilitators of posttraumatic growth (PTG) among suicide-loss survivors in a longitudinal design. METHOD Participants included 189 suicide-loss survivors (155 females), aged 21-73, who completed questionnaires of thwarted belongingness (TB), perceived burdensomeness (PB), and self-disclosure at T1. Moreover, participants were assessed on PTG levels at T1, 18 months (T2), and 42 months (T3). RESULTS The integrated mediation model indicated that both TB and PB contributed to the PTG trajectory. PB and self-disclosure contributed to PTG at T3 beyond the PTG trajectory across time. We also found self-disclosure to mediate the association of TB and PTG at T2 and T3. CONCLUSIONS These findings suggest that interpersonal factors play critical roles in contributing to PTG over time among suicide-loss survivors. Basic psychoeducational interventions designed to foster interpersonal behaviors may facilitate achieving PTG among survivors in the aftermath of suicide loss.
Collapse
Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel.,Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
| |
Collapse
|
35
|
Recent exposure to others’ confided suicidal thoughts and risk of self-harm and suicidality among adolescents. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03123-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
36
|
Levi-Belz Y. Longitudinal Intercorrelations between Complicated Grief and Posttraumatic Growth among Suicide Survivors. Arch Suicide Res 2022; 26:677-691. [PMID: 32956611 DOI: 10.1080/13811118.2020.1820412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Suicide survivors are prone to elevated risk for several psychiatric and somatic complications, including complicated grief (CG) and depression. Recent studies have highlighted the possibility of posttraumatic growth (PTG) among suicide survivors. However, to date, no longitudinal study has focused on the relationships between CG and PTG among suicide survivors. AIMS In this 18-month longitudinal design study, our goal was to investigate the longitudinal bidirectional associations between PTG and CG, as well as between PTG and depression among suicide survivors. METHOD Participants were156 suicide-loss survivors, aged 18-70, who completed questionnaires tapping the CG and PTG at T1 and again after 18 months (T2). Depression was measured only at T2. RESULTS The integrated model showed that CG-T1 predicts a reduction in PTG-T2 levels, beyond the trajectory of PTG. Whereas PTG-T1 was negatively correlated with CG-T2 and with depression at T2, this path was only marginally significant in the model. LIMITATIONS Voluntary nature of the participants; self-report measures; lack of pre-suicide-loss assessment. CONCLUSION The study's findings suggest that CG levels play an important role in facilitating PTG among suicide survivors, with high CG levels impeding the possibility of growth. PTG did not act as a coping strategy to reduce CG. Clinical and research implications are discussed.
Collapse
|
37
|
Griffin E, O’Connell S, Ruane-McAteer E, Corcoran P, Arensman E. Psychosocial Outcomes of Individuals Attending a Suicide Bereavement Peer Support Group: A Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074076. [PMID: 35409760 PMCID: PMC8998629 DOI: 10.3390/ijerph19074076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/25/2022] [Accepted: 03/27/2022] [Indexed: 11/17/2022]
Abstract
Individuals bereaved by suicide represent an important group in terms of postvention. While peer support groups are often accessed by those bereaved, few studies have examined their impact in terms of physical and mental health wellbeing. The aim of this study was to examine psychosocial outcomes of individuals attending suicide bereavement peer support groups in Ireland. Between August 2020 and June 2021, all members were invited to complete a survey, with new members also surveyed at three- and six-month follow-up, to examine changes in wellbeing, depressive symptoms and grief reactions. Results were analyzed using descriptive statistics and mixed linear regression models. The 75 participants were mostly female, with lower levels of overall wellbeing and a higher prevalence of depressive symptoms and suicidal ideation than the general population. Participants also reported high levels of social adjustment difficulties and grief reactions, which were more pronounced for those more recently bereaved. At follow-up (n = 28), a significant improvement in wellbeing and a reduction in grief reactions were found, adjusting for time since bereavement. Participants identified the groups as creating a safe space and providing a sense of belonging and hope. Notwithstanding the small number of participants at follow-up, these findings underline the enduring mental health challenges for those bereaved by suicide and provide further evidence for the role of peer support in postvention.
Collapse
Affiliation(s)
- Eve Griffin
- School of Public Health, University College Cork, T12 XF62 Cork, Ireland; (S.O.); (E.R.-M.); (E.A.)
- National Suicide Research Foundation, T12 XF62 Cork, Ireland;
- Correspondence:
| | - Selena O’Connell
- School of Public Health, University College Cork, T12 XF62 Cork, Ireland; (S.O.); (E.R.-M.); (E.A.)
- National Suicide Research Foundation, T12 XF62 Cork, Ireland;
| | - Eimear Ruane-McAteer
- School of Public Health, University College Cork, T12 XF62 Cork, Ireland; (S.O.); (E.R.-M.); (E.A.)
| | - Paul Corcoran
- National Suicide Research Foundation, T12 XF62 Cork, Ireland;
| | - Ella Arensman
- School of Public Health, University College Cork, T12 XF62 Cork, Ireland; (S.O.); (E.R.-M.); (E.A.)
- National Suicide Research Foundation, T12 XF62 Cork, Ireland;
| |
Collapse
|
38
|
Lee H, Kim MJ, Hong M, Rhee SJ, Shin D, Park JI, Lee HJ, Jung HY, Ahn YM. Effect of suicidal loss on bereaved individuals' suicidal ideation: Structural equation model using attitudes towards suicide scale and moderation effect of interest in news media. J Affect Disord 2022; 298:51-57. [PMID: 34728297 DOI: 10.1016/j.jad.2021.10.085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/15/2021] [Accepted: 10/23/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Exposure to suicidal death may cause trauma and change the bereaved family/friends' attitudes towards suicide and increase their suicide-related behavior. We aimed to examine the life-time prevalence of loss experience among the general population of South Korea, the relationship between attitudes towards suicide and suicidal intensity, and the moderation effect of interest in news media. METHODS After analyzing 2973 structured interviews, we hypothesized structural equation model and conducted a moderation analysis. RESULTS A total of 10.1% (n = 301) respondents had experienced the suicide of acquaintances. Acceptive attitudes such as "suicide as right" and "suicide as normal-common" were higher in the "experienced" group. All fit indices of the hypothesized model were satisfied, and experience of suicidal loss was positively associated with both acceptive attitudes and suicidal intensity. "Suicide as normal-common" positively affected suicidal intensity, but "suicide as right" was not significant. "Interest in news media" significantly moderated the relationship between loss experience and suicidal intensity. LIMITATIONS Since our study was cross-sectional design, further longitudinal studies are needed to draw casual inferences between factors. We used the at home interview method, which might have resulted underestimated experience of suicidal loss. CONCLUSION Our findings showed that experiencing suicide death of any acquaintances could increase individual's acceptance of suicide and also increase the risk of suicide. Frequent exposure to suicide-related news amplified their risk of suicide. To reduce the suicide risk behavior, targeted intervention with those bereaved by suicide and restriction of media reports on suicide news will be needed as prevention strategies.
Collapse
Affiliation(s)
- Hyunju Lee
- Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Clinical Medical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Min Ji Kim
- Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Minseok Hong
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sang Jin Rhee
- Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Daun Shin
- Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jong-Ik Park
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.
| | - Hyun Jeong Lee
- Division of Cancer Control and Policy, National Cancer Center, Goyang, Republic of Korea; Department of Psychiatry and Behavioral Science, National Cancer Center, Goyang, Republic of Korea.
| | - Hee Yeon Jung
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea; Seoul National University Medical Research Center, Institute of Human Behavioral Medicine, Seoul, Republic of Korea.
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Seoul National University Medical Research Center, Institute of Human Behavioral Medicine, Seoul, Republic of Korea.
| |
Collapse
|
39
|
Eskin M, Köskün T, Harlak H. Beliefs about suicide prevention by excluding the phenomenon versus the person: The role of cultural orientation, attitudes towards suicide, and social reactions to suicidal persons in Turkish university students. Scand J Psychol 2022; 63:83-90. [PMID: 35028943 DOI: 10.1111/sjop.12792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 10/02/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Mehmet Eskin
- Department of Psychology, College of Social Sciences and Humanities, Koc University, Istanbul, Turkey
| | - Tolga Köskün
- Department of Psychology, Faculty of Arts and Sciences, Aydin Adnan Menderes University, Aydin, Turkey
| | - Hacer Harlak
- Department of Psychology, Faculty of Arts and Sciences, Aydin Adnan Menderes University, Aydin, Turkey
| |
Collapse
|
40
|
Roland L, Höller I, Forkmann T, Glaesmer H, Paashaus L, Schönfelder A, Teismann T, Juckel G, Rath D. Suicidal behavior in the social environment: Does exposure moderate the relationship between an individual's own suicidal ideation and behavior? Clin Psychol Psychother 2022; 29:1309-1320. [PMID: 35005811 DOI: 10.1002/cpp.2709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/13/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Suicidal behavior still cannot be sufficiently predicted. Exposure to suicidal behavior in the personal social environment is assumed to moderate the individual's transition from suicidal ideation to suicidal behavior within the Integrated Motivational-Volitional Model of Suicidal Behavior (IMV-model). This study aimed to investigate this moderating effect in a German high-risk sample. METHODS We interviewed 308 psychiatric inpatients (53% female) aged 18 to 81 years (M = 36.9, SD = 14.30) admitted after attempted suicide (53%) or due to an acute suicidal crisis (47%) regarding exposure events in their social environment. Four types of exposure events were analyzed using moderation analyses: familial suicides/suicide attempts, non-familial suicides/suicide attempts. Additionally, the numbers of reported exposure events were compared between patients with and without a recent suicide attempt as well as between patients with lifetime suicide attempts and lifetime suicidal ideation. RESULTS Neither moderating effects of exposure events on the relationship between lifetime suicidal ideation and recent suicidal behavior nor group differences between suicidal ideators and suicide attempters regarding the exposure events were found. CONCLUSIONS Exposure events might have differential and possibly protective effects on suicidal behavior - depending on type and quality (intensity, personal relevance, and recency) of event - and on the outcome (suicide vs. suicide attempt).
Collapse
Affiliation(s)
- Lea Roland
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Inken Höller
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Thomas Forkmann
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Laura Paashaus
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Antje Schönfelder
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Georg Juckel
- Department of Psychiatry, LWL-University Hospital, Ruhr-Universität Bochum, Bochum, Germany
| | - Dajana Rath
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
41
|
Vachon M, Nicolas C, Notredame CE, Séguin M. [Investigating postvention best practices : The Delphi method]. Rev Epidemiol Sante Publique 2021; 69:367-379. [PMID: 34642047 DOI: 10.1016/j.respe.2021.05.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 04/23/2021] [Accepted: 05/28/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Postvention aims to implement services adapted to the needs of a population that may be vulnerable after suicide. While a plethora of postvention programs exist, they are generally based less on solid evidence than on the judgment of health professionals. Using the Delphi method, an Australian study obtained a consensus among experts as to which postvention actions are to be engineered in a postvention program. Since no similar study has been carried out for programs in French-speaking countries, it seemed important to reproduce the same type of study and to compare the respective results. The present study is aimed at establishing a French inventory of postvention actions and at achieving a consensus among experts as to the actions to be included in a postvention program. METHODS A systematic review of the scientific literature (PRISMA method) and the gray literature (documentation on the WEB) made it possible to identify the different actions that have been included in various postvention programs. Using the DELPHI method, experts endeavored to assess their relevance. RESULTS An inventory of 190 postvention actions was established and they were classified according to a sequential axis (pre-event, at the time of the event, and post-event), according to type of action (environment-centered or people-centered). The experts identified 128 actions to be included in a postvention program. CONCLUSION Convergence was observed among the experts, as they identified the practices to be encouraged following a suicide. When comparing the results in French-speaking countries to the 548 actions selected in the Australian study, we observe similarities between the two studies regarding types of postvention actions. This study provides an update for health professionals on the most relevant practices to be included in a postvention program.
Collapse
Affiliation(s)
- M Vachon
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Québec, Canada.
| | | | - C-E Notredame
- Service de psychiatrie de l'enfant et de l'adolescent, CHU de Lille, 59000Lille, France; Centre neurosciences et cognition de Lille, Subjectivité et plasticité, Inserm U1172, Université de Lille, 59000Lille, France
| | - M Séguin
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Québec, Canada; Groupe McGill d'études sur le suicide,; Réseau québécois de recherche sur le suicide, les troubles de l'humeur et les troubles associés,; Institut universitaire en santé mentale de l'Hôpital Douglas, Montréal, Canada
| |
Collapse
|
42
|
Spirituality and Religiosity during Suicide Bereavement: A Qualitative Systematic Review. RELIGIONS 2021. [DOI: 10.3390/rel12090766] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A loved one’s loss to suicide can be a traumatic experience and trigger a difficult grief process, identity changes, a loss of the sense of meaning and a spiritual crisis. Spirituality and/or religiosity (S/R) can be both an important resource and a source of stigmatisation during suicide bereavement. This study aims to synthesise the extant findings about S/R during suicide bereavement in qualitative studies. After an exhaustive selection of articles, the current review utilised a total of 484 citations and seven studies. A thematic synthesis yielded five major themes related to S/R during suicide bereavement: the need to be helped by the religious community without being judged; S/R-related experience of the deceased as a figure who continues to exist; S/R experienced without a conscious choice; conscious reach towards S/R themes; not relating to S/R during suicide bereavement. These findings indicate that the role of S/R during suicide bereavement is complex and varies from providing help to serving as a source of suffering. Hence, practitioners and religious communities should be mindful of the S/R themes during suicide bereavement.
Collapse
|
43
|
Pereira AM, Campos RC. Exposure to suicide in the family and suicidal ideation in Portugal during the Covid-19 pandemic: The mediating role of unbearable psychache. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:598-612. [PMID: 34370323 PMCID: PMC8420317 DOI: 10.1111/bjc.12325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/19/2021] [Indexed: 12/05/2022]
Abstract
Objectives This study tested the mediation effects of two facets of psychache – bearable and unbearable – in the relationship between exposure to suicide in the family and suicidal ideation in Portugal during the Covid‐19 pandemic. Methods Two hundred and forty‐four adults aged between 19 and 64 participated. Two groups were defined: one exposed to suicide in the family (n = 42) and a control group (n = 192). Results Path analysis using structural equation modelling tested a mediation model. Results demonstrated that unbearable psychache fully mediated the relationship between exposure to suicide and suicidal ideation, even when controlling for the mediation effects of depressive symptoms, the presence of a psychiatric diagnosis, and years of education. Conclusions These results suggest that rather than considering just the global experience of psychache in individuals exposed to suicide, researchers and clinicians should look to the presence of unbearable psychache given its contribution to suicidal ideation. Practitioner points Unbearable psychache fully mediated the relationship between exposure to suicide in the family and suicidal ideation It is not the global experience of psychache that contributes to suicide ideation in individuals exposed to suicide in the family rather the presence of unbearable psychache
Collapse
Affiliation(s)
| | - Rui C Campos
- Department of Psychology, School of Social Sciences, University of Évora, Portugal.,Department of Psychology, School of Social Sciences and CIEP-UE, University of Évora, Portugal
| |
Collapse
|
44
|
Geoffroy MC, Orri M, Girard A, Perret LC, Turecki G. Trajectories of suicide attempts from early adolescence to emerging adulthood: prospective 11-year follow-up of a Canadian cohort. Psychol Med 2021; 51:1933-1943. [PMID: 32290876 DOI: 10.1017/s0033291720000732] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Suicide is a leading cause of mortality in youth, yet the course of suicide attempts is poorly documented. We explored the vulnerable transition from adolescence to emerging adulthood to identify group trajectories and risk factors. METHODS The National Longitudinal Survey of Children and Youth is a prospective representative cohort of Canadian children. We followed participants aged 7-11 years in 1994-95 to age 23 (2008-09). We modelled self-reported past-year suicide attempts (ages 12 to 23 years) using growth mixture models. We analysed risk factors from self- and parent-report questionnaires at pre-adolescence (ages 10-11) and early adolescence (ages 12-13) using multinomial logistic regressions. Analyses were adjusted for sample non-response and attrition. RESULTS In 2233 participants answering questions on teen and adult suicide attempts, we identified three trajectories: never attempted (96.0%), adolescence-limited (2.0%) and persisting into adulthood (2.0%). Adolescent girls aged 12-13 with depression/anxiety symptoms, and with mothers experiencing depression had higher risks of adolescence-limited than never-attempted [relative risk RR 9.27 (95% confidence interval: 1.73-49.82); 2.03 (1.02-3.32), for each standard deviation increase; 1.07 (1.00-1.15); respectively]. Preteen ADHD symptoms increased the risk of attempts persisting into adulthood as compared to never-attempted [RR 2.05 (1.29-3.28) for each standard deviation increase]. Suicide death of schoolmate/acquaintance increased risks of an adulthood trajectory as compared to never-attempted and adolescence-limited [RR 8.41 (3.04-23.27) and 6.63 (1.29-34.06), respectively]. CONCLUSION In half the participants attempting suicide, attempts continued into adulthood. We stress the need for preventive strategies in early adolescence and differential clinical/educational interventions as identified for each trajectory.
Collapse
Affiliation(s)
- Marie-Claude Geoffroy
- Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Massimiliano Orri
- Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
- Bordeaux Population Health Research Center, University of Bordeaux, INSERM U1219, France
| | - Alain Girard
- Research Unit on Children's Psychosocial Maladjustment, University of Montrea
| | - Lea C Perret
- Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Gustavo Turecki
- Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
45
|
Copeland M, Alqahtani RT, Moody J, Curdy B, Alghamdi M, Alqurashi F. When Friends Bring You Down: Peer Stress Proliferation and Suicidality. Arch Suicide Res 2021; 25:672-689. [PMID: 32264764 DOI: 10.1080/13811118.2020.1746939] [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: 10/24/2022]
Abstract
Peers play a significant role in adolescent mental well-being and suicidality. While social integration among peers is often assumed to benefit mental health, a growing literature recognizes that peer relationships can increase suicidality. Conceptualizing friends' disclosure of mental distress as a stressor on teens' own mental health clarifies how distressed peers relate to suicidal ideation given integration in key social contexts, such as school. This study applies the stress process to examine peer depression and self-harm disclosure as stressors predicting teens' suicidal ideation. Using cross-sectional data from an understudied context, youth in Saudi Arabia (n = 545, 50% female, mean age = 16.8), models find friends' disclosure of depression and self-harm are associated with adolescents' higher suicidal ideation net of their own depression. Teens who are more attached to school see higher risk of suicidality from friends' depression, while friends' self-harm predicts higher suicidality overall. Results challenge assumptions of uniformly beneficial social integration by indicating that friends' mental distress, particularly self-harm, can act as a stressor increasing youth suicidality.
Collapse
|
46
|
Feigelman W, Cerel J, Sheehan L, Oexle N. Using Multiple Regression Analyses to Uncover Patterns of Correlates of Grief Problems, Depression and Suicidal Ideation Among Suicide Bereaved Individuals. OMEGA-JOURNAL OF DEATH AND DYING 2021; 87:554-571. [PMID: 34148402 DOI: 10.1177/00302228211024812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This analysis of a convenience sample survey of 195 suicide bereaved adults focuses on predictors of three important highly interrelated experiences among the suicide bereaved: grief problems, depression and suicidal thinking. Although each of these three experiences can be explained by a unique set of predictors, they share many commonalities. Several predictors stood out especially in either aggravating or alleviating these experiences: personal (or post-traumatic) growth, perceived social support, feelings of blameworthiness, perceived suicide stigma, years since loss and a respondent's mental health difficulties experienced prior to their suicide loss. We also review the clinical implications of these results.
Collapse
Affiliation(s)
- William Feigelman
- Department of Sociology, Nassau Community College, Garden City, New York, United States
| | - Julie Cerel
- School of Social Work, College of Social Work, University of Kentucky, Lexington, Kentucky, United States
| | - Lindsay Sheehan
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, United States
| | - Nathalie Oexle
- Department of Psychiatry, Ulm University and BKH Gunzburg, Ulm, Germany
| |
Collapse
|
47
|
Wayland S, Coker S, Maple M. The human approach to supportive interventions: The lived experience of people who care for others who suicide attempt. Int J Ment Health Nurs 2021; 30:667-682. [PMID: 33355984 DOI: 10.1111/inm.12829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 01/29/2023]
Abstract
There is currently limited information about the impact and experiences of a suicide attempt on the well-being of a person providing care before, during, or after the attempt. Scant evidence available suggests that providing care has a profound impact on the support person or carers' own physical and psychological health; they may experience adverse health, financial, and functional outcomes, collectively described as 'caregiver burden'. This project sought to understand insights into the experience of providing care for someone who has previously attempted suicide. The larger study was designed in three phases consisting of an online survey, semi-structured interviews, and a follow-up survey. This paper reports the qualitative findings of the interviews which were thematically analysed. Two symbiotic themes emerged: the lived experience of caring and the impact of engagement and support from the healthcare system. The authors concluded that that the carer position is a multidimensional role involving informal agreements and situational or time-based support. Further, awareness of this shifting relationship needs to be embedded in the provision of care by health professionals following a suicide attempt. Recommendations for enhanced health system response are proposed.
Collapse
Affiliation(s)
- Sarah Wayland
- School of Social Work, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Sarah Coker
- SANE Australia, South Melbourne, Vic., Australia
| | - Myfanwy Maple
- School of Social Work, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| |
Collapse
|
48
|
Causer H, Bradley E, Muse K, Smith J. Bearing witness: A grounded theory of the experiences of staff at two United Kingdom Higher Education Institutions following a student death by suicide. PLoS One 2021; 16:e0251369. [PMID: 33979333 PMCID: PMC8115842 DOI: 10.1371/journal.pone.0251369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/24/2021] [Indexed: 11/21/2022] Open
Abstract
Wider networks of people are affected by a suicide death than originally thought, including those whose job-role brings them into contact with a death by suicide of another person. The impact of student suicide within United Kingdom (UK) Higher Education Institutions (HEIs) is unexplored and the experiences of staff members remain unknown. It is not known whether staff members have specific postvention needs following a student death by suicide. Any postvention support currently offered to staff members within UK HEIs lacks a context-specific evidence base. This study asked 'How is a student suicide experienced by staff members within a UK HEI and what are the features of that experience?' Staff members from diverse job-roles in two UK HEIs responded to a qualitative survey (n = 19) and participated in semi-structured interviews (n = 10). Data were transcribed and subjected to a constructivist grounded theory analysis. Participants' experiences informed the development of a core category: 'Bearing witness', which encompassed six further categories: 'Responding to a student suicide'; 'Experiencing a student suicide'; 'Needs and fears'; 'Experiences of support'; 'Human stories'; and 'Cultural stories'. The resulting grounded theory demonstrates how participants' perceptions of impact are informed by their experiences of undertaking tasks following a student suicide within the community of their HEI. Processes of constructing perceptions of closeness to the student who died are evident amongst participants who did not know the student prior to their death. Tailored postvention support is required to respond to the range and complexity of HEI staff needs following a student death by suicide.
Collapse
Affiliation(s)
- Hilary Causer
- School of Allied Health and Community, University of Worcester, Worcestershire, United Kingdom
| | - Eleanor Bradley
- College of Life, Health and Environmental Sciences, University of Worcester, Worcestershire, United Kingdom
| | - Kate Muse
- School of Psychology, University of Worcester, Worcestershire, United Kingdom
| | - Jo Smith
- School of Allied Health and Community, University of Worcester, Worcestershire, United Kingdom
| |
Collapse
|
49
|
Tucker RP, Drapeau CW, Schwab N, Campbell FR. Evaluation of a suicide loss support training program for organ procurement personnel. Suicide Life Threat Behav 2021; 51:308-315. [PMID: 33876484 DOI: 10.1111/sltb.12706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 04/23/2020] [Accepted: 05/29/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the impact of a 6-h traumatic loss training program on organ procurement personnel attitudes, confidence, and knowledge about suicide loss and best practices in supporting survivors. Organ procurement personnel may be uniquely positioned to deliver supportive programming as they have early access to suicide loss survivors (i.e., within hours or days of a loss) and are trained in a variety of backgrounds that include skills in supportive service delivery (i.e., nursing and social work). METHOD Sixty-four personnel participated in the 6-h Traumatic Loss Support Program (TLSP) training and completed measures of attitudes, confidence, and knowledge about supporting suicide loss survivors prior to and following the training. RESULTS Ratings of the usefulness of the training were high and mean scores on all measures of attitudes, confidence, and knowledge increased with moderate to large effect sizes. CONCLUSIONS Results of the current study demonstrate that the TLSP training may be an effective way of increasing suicide loss supportive services provided by organ procurement personnel; however, further research is needed to determine the extent to which these interactions influence the bereavement of those who have lost loved ones to suicide and the fidelity in which the TLSP is implemented.
Collapse
Affiliation(s)
- Raymond P Tucker
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | | | - Nila Schwab
- Louisiana Organ Procurement Agency, Baton Rouge, LA, USA
| | - Frank R Campbell
- Baton Rouge Crisis Intervention Center and National Suicidology Training Center, Baton Rouge, LA, USA
| |
Collapse
|
50
|
Mitchell KJ, Banyard V, Goodman KL, Strøm IF, Ybarra ML. Exposure to Suicidal Behavior and Social Support Among Sexual- and Gender-Minority Youth. Pediatrics 2021; 147:e2020033134. [PMID: 33722989 PMCID: PMC8015153 DOI: 10.1542/peds.2020-033134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES In this study, we examine reports of exposure to suicidal behavior by youth sexual and gender identity. We explore how exposure is related to depressed mood in the context of high social support while accounting for cumulative adversity. METHODS Data from a large national sample of youth aged 14 to 15 years in the United States (N = 3979) were collected online in 2018-2019. RESULTS Sexual- and gender-minority youth were more likely to know someone close to them who attempted suicide, relative to cisgender heterosexual youth. Cisgender heterosexual youth were buffered from recent depressed mood when they endorsed having high social support in the context of exposure to suicidal behavior; less social support did not provide such a buffer. For cisgender sexual-minority male and female youth, exposure to suicidal behavior was related to recent depressed mood regardless of the level of social support. For gender-minority youth assigned female at birth, the combination of exposure and high social support was significantly associated with elevated depressed mood. Cumulative adversity accounted for some but not all of these relationships, indicating the influential role of exposure to suicidal behavior on depressed mood for some youth. CONCLUSIONS These findings illustrate the complexities of social support and raise questions about its potential to magnify stress rather than serve as a buffer for some youth. Although findings need to be replicated, suicide prevention efforts should carefully consider how to promote resilience among these suicide-exposed sexual- and gender-minority youth who may themselves be at risk for suicidal ideation and behavior.
Collapse
Affiliation(s)
- Kimberly J Mitchell
- Crimes Against Children Research Center, University of New Hampshire, Durham, New Hampshire;
| | - Victoria Banyard
- School of Social Work, Rutgers University, New Brunswick, New Jersey
| | - Kimberly L Goodman
- Rape, Abuse & Incest National Network, Washington, District of Columbia; and
| | - Ida F Strøm
- Center for Innovative Public Health Research, San Clemente, California
| | - Michele L Ybarra
- Center for Innovative Public Health Research, San Clemente, California
| |
Collapse
|