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Clary KL, Murley WD, Ortiz RS, Rogers ML. A step forward in conceptualizing psychological closeness/distance to suicide methods: A qualitative approach. Suicide Life Threat Behav 2024; 54:649-662. [PMID: 38634715 DOI: 10.1111/sltb.13075] [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: 01/03/2024] [Revised: 03/04/2024] [Accepted: 03/13/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION Suicide is a leading cause of death, making suicide prevention a major public health priority. Increasing understanding of factors influencing suicidal behavior is paramount. Previous research has implicated psychological closeness, characterized by perceptions of how close/distant or attached/detached one feels to a particular object, as a cognitive factor that influences suicidal behavior. However, a better understanding of how psychological closeness to suicide methods is conceptualized by relevant populations is needed to improve its assessment and understand how it may confer risk for suicide. METHODS The goal was to refine the conceptualization of psychological closeness to suicide methods by incorporating feedback from relevant populations. We conducted 30 interviews with those primarily identifying as having lived experience of suicide (n = 10), clinicians who work with suicidal patients (n = 11), and suicide researchers (n = 9). A rigorous thematic approach using NVivo software was used to uncover common themes. RESULTS Primary themes included familiarity, comfort, and attachment, with one emerging theme of symbolism. We define these themes, provide context to their meaning, and share exemplary quotes across diverse participants. CONCLUSION We consider clinical, research, and policy implications from an interdisciplinary lens and discuss the strengths and limitations of this study.
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Affiliation(s)
- Kelly L Clary
- School of Social Work, Texas State University, San Marcos, Texas, USA
| | - William D Murley
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Rachel S Ortiz
- School of Social Work, Texas State University, San Marcos, Texas, USA
| | - Megan L Rogers
- Department of Psychology, Texas State University, San Marcos, Texas, USA
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Keefner T, Minton M. Acquired Capability for Suicide: An Evolutionary Concept Analysis. Issues Ment Health Nurs 2024; 45:734-745. [PMID: 38718381 DOI: 10.1080/01612840.2024.2346594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
While virtually all suicide attempters experience ideations, not all who think about suicide will attempt or die by suicide. The ideation-to-action framework has led to new theories distinguishing suicide ideators from suicide attempters. The framework suggests that suicide progresses on a spectrum of thoughts and behaviors with different identifiers and explanations. The concept of acquired capability for suicide (ACS), conceptualized by the Interpersonal Psychological Theory of Suicide, is the first to explain the movement from ideation to action. This concept analysis of ACS is timely and relevant for greater clarification of the role ACS has in the movement from ideation to action. Rodgers' evolutionary concept analysis method is used. The six-step evolutionary method highlights the concept's attributes, antecedents, and consequences and provides a basis for further inquiry and development rather than a final definition.
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Affiliation(s)
- Tamara Keefner
- Department of Nursing, University of South Dakota, Vermillion, South Dakota, USA
| | - Mary Minton
- South Dakota State University, Brookings, South Dakota, USA
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Choi NG, Marti CN. Depression in older women who died by suicide: associations with other suicide contributors and suicide methods. J Women Aging 2024; 36:210-224. [PMID: 38090746 PMCID: PMC11062817 DOI: 10.1080/08952841.2023.2292164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/02/2023] [Indexed: 05/02/2024]
Abstract
Suicides among older women have received little research attention. In this study based on the 2017-2019 National Violent Death Reporting System data, we examined the prevalence of depression in older female suicide decedents (N = 3,061), associations between depression and other suicide precipitants, and the associations between suicide methods and depression. Descriptive statistics and generalized linear models (GLM) for a Poisson distribution with a log link were used to examine the research questions. Of the decedents, 15.0% had depressed mood without a reported diagnosis and 41.8% had a depression diagnosis. Nearly one-half of the decedents with reported depression were receiving mental health/substance use treatment at the time of injury. The likelihood of depression was lower among those who were age 85 and older compared to those were age 65-74, but higher among those who had anxiety disorder (IRR = 1.50, 95% CI = 1.33-1.69), history of suicidal ideation (IRR = 1.22, 95% CI = 1.10-1.35), history of suicide attempt (IRR = 1.27, 95% CI = 1.14-1.41), and bereavement problems (IRR = 1.45, 95% CI = 1.27-1.65). Those who had depression were less likely to have used firearms (IRR = 0.85, 95% CI = 0.75-0.97) but more likely to have used hanging/suffocation (IRR = 1.37, 95% CI = 1.13-1.67). The findings show that gun ownership was likely an important factor for firearm use. The high prevalence of depressed mood and/or depression diagnosis among older female suicide decedents at the time of their fatal injury underscores the importance of assessing depression and providing evidence-based depression treatment as an essential suicide prevention approach.
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Affiliation(s)
- Namkee G. Choi
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX 78712, USA
| | - C. Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX 78712, USA
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Nichter B, Hill ML, Fischer I, Panza KE, Kline AC, Na PJ, Norman SB, Rowcliffe M, Pietrzak RH. Firearm storage practices among military veterans in the United States: Findings from a nationally representative survey. J Affect Disord 2024; 351:82-89. [PMID: 38280567 DOI: 10.1016/j.jad.2024.01.179] [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: 09/16/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Unsafe storage of firearms is associated with increased risk of suicide.. However, contemporary population-based data on the prevalence and correlates of firearm storage practices among veterans are limited. METHODS Data were from the 2022 National Health and Resilience in Veterans Study, a nationally representative sample of 2441 veterans. Analyses examined: (1) the prevalence of firearm storage practices; (2) sociodemographic, psychiatric, and clinical characteristics associated with storing firearms loaded and/or in non-secure location; and (3) associations between types of potentially traumatic events and storage practices. RESULTS More than half of veterans reported owning one or more personal firearms (50.9%). Among firearm owners, 52.9% reported some form of unsafe firearm storage practice (i.e., loaded and/or non-secure location), with 39.9% reporting that they stored one or more firearms loaded. After adjusting for sociodemographic characteristics, major depressive, alcohol and drug use disorders, direct trauma exposures, future suicidal intent, and traumatic brain injury were associated with storing firearms loaded and/or in a non-secure location (ORs = 1.09-7.16). Veterans with a history of specific forms of direct trauma exposure (e.g., physical assault) were more likely to store firearms unsafely. LIMITATIONS Cross-sectional design precludes causal inference. CONCLUSIONS Half of U.S. veterans who own firearms store at least one personal firearm loaded and/or in a non-secure location, with approximately four-in-ten keeping a loaded firearm in the home. These high rates underscore the importance of nationwide training initiatives to promote safe firearm storage for all service members and veterans, regardless of risk status, as well as for healthcare professionals working with veterans.
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Affiliation(s)
- Brandon Nichter
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
| | - Melanie L Hill
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Ian Fischer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Kaitlyn E Panza
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA
| | - Alexander C Kline
- Naval Health Research Center, San Diego, CA, USA; Leidos, Reston, VA, USA
| | - Peter J Na
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Sonya B Norman
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA; National Center for PTSD, White River Junction, VT, USA
| | - Mara Rowcliffe
- 321(st) Special Tactics Squadron, U.S. Air Force Special Operations Command, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Conner KR, Peters K, Conwell Y, Hutchison M, Kannan V, Lapham S, Chapman BP. Adolescent Predictors of Firearm Suicide Over Four Decades of Life in U.S. Men. Am J Prev Med 2024; 66:690-697. [PMID: 37979621 PMCID: PMC10957322 DOI: 10.1016/j.amepre.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/20/2023]
Abstract
INTRODUCTION There are meager individual-level data on long-term predictors of firearm suicide. METHODS This was an analysis of males (N=189,558) in the Project Talent cohort, a national probability sample of high school schools in 1960 when students completed a baseline Project Talent self-report inventory. Mortality follow-up was contingent on survival until 1979, the onset of the National Death Index when the cohort had a mean age of 35.7 years. Mortality follow-up continued until death or age 75 years, reached by all surviving members by 2018. Analyses were conducted in 2022, with the main outcome being firearm suicide deaths (n=479). Factor analyses of Project Talent items yielded three key factors: (1) interests in firearm-related professions (i.e., military service, police force), (2) interests in hunting or fishing and knowledge of long guns, and (3) stereotypic masculinity. RESULTS Survival analyses showed that long-term risk for firearm suicide was associated with 1-SD increases in firearm-related vocational interests in adolescence (adjusted hazard ratio [95% CI]=1.23 [1.09, 1.40]) and masculinity (adjusted hazard ratio [95% CI]=1.15 [1.04, 1.28]). Decreased long-term firearm suicide risk was associated with increased hunting interests and knowledge of long guns in adolescence (adjusted hazard ratio [95% CI]=0.86 [0.77, 0.96]) and competitive sports participation, an exploratory variable (adjusted hazard ratio [95% CI]=0.89 [0.80, 0.99]). CONCLUSIONS Prevention efforts are needed to lower long-term firearm suicide risk among adolescent males with high stereotypic masculinity and those interested in military or police service. Potential protective effects of competitive sports participation and socialization to long guns through hunting require further study.
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Affiliation(s)
- Kenneth R Conner
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York; Department of Psychiatry, University of Rochester Medical Center, Rochester, New York.
| | - Kelly Peters
- American Institutes for Research, Arlington, Virginia
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| | - Morica Hutchison
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| | - Viji Kannan
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| | - Susan Lapham
- American Institutes for Research, Arlington, Virginia
| | - Benjamin P Chapman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
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Knapp S. Lethal Means Counseling for Suicidal Firearm Owners. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2023:1-9. [PMID: 37363717 PMCID: PMC10251328 DOI: 10.1007/s10879-023-09588-5] [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] [Accepted: 05/26/2023] [Indexed: 06/28/2023]
Abstract
The death of a patient by suicide is one of the professional events most feared by psychotherapists and firearms are the most commonly used means of suicide. However, as the number of firearm owners within the United States has increased in recent years, so has the risk of firearm-related suicides. Suicidal patients with easy access to their firearms may give in to the wish to die and end their life with little opportunity for reflection or forethought. Furthermore, because the topic of gun control has become so polarized, patients may not always be open to discussing barriers between themselves and their firearms. Nonetheless, psychotherapists using non-judgmental, respectful, and collaborative lethal means counseling can substantially reduce patient suicides.
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Logan TK, Lynch KR. Increased Risks or Peace of Mind? Exploring Fear, Victimization, and Safety Strategies Among Women Planning to Get a Gun. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP18032-NP18059. [PMID: 34376085 DOI: 10.1177/08862605211035865] [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] [Indexed: 06/13/2023]
Abstract
Much of the research on firearm owners implies that the U.S. population can be divided into two groups-those that own guns and those that do not; however, there is a third group-those thinking of getting a gun and almost nothing is known about this group. A survey on gun ownership, experiences, and behaviors was deployed online via Prolific in June and July 2020 to recruit women from the general U.S. population who were planning on getting a gun (n = 187), who owned a gun (n = 288) and who did not own or plan to own guns (n = 968). Results show that women planning on getting a gun worried more about their personal safety and more had experienced recent interpersonal violence victimization compared to the other two groups. Almost all of the women planning on getting a gun believed that carrying a gun would make them safer. Even though women planning on getting a gun had limited experience with guns, they expressed fewer gun related worries than nongun owners. Additionally, women planning on getting a gun had more depression symptoms and more of them indicated they had thoughts of self-harm in the past two weeks than current gun owners. Depression symptoms were significantly associated with plans to get a gun in the multivariate model. Given the risks associated with having firearms in the household, interventions could target those considering getting a gun as well as educating friends and family about what to say when someone close is considering obtaining a firearm for safety.
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Affiliation(s)
- T K Logan
- University of Kentucky, Lexington, KY, USA
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Ha J, Park D. Suicidal ideation and suicide attempts among university students in South Korea during the COVID-19 pandemic: the application of interpersonal-psychological theory and early maladaptive schema. PeerJ 2022; 10:e13830. [PMID: 35915755 PMCID: PMC9338749 DOI: 10.7717/peerj.13830] [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: 05/23/2022] [Accepted: 07/11/2022] [Indexed: 01/18/2023] Open
Abstract
Background This study examined the application of interpersonal-psychological theory and early maladaptive schema of suicidal ideation and suicide attempts in South Korean university students. Methods In this cross-sectional study, data from 367 university students were surveyed using the Interpersonal Needs Questionnaire, Early Maladaptive Schema, Suicide Ideation Scale, and the Acquired Capability for Suicide Scale. Data were collected between June 21 and July 21, 2021. Results University students' interpersonal needs and early maladaptive schema were significantly associated with suicidal ideation, and influencing suicide attempts. The acquired capability for suicide moderated the relationship between suicidal ideation and attempts. Conclusions In suicide prevention programs for university students, it is critical to consider their interpersonal needs and early maladaptive schema, and the acquired capability for suicide, to prevent suicidal ideation and attempts among them.
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Affiliation(s)
- Jeongmin Ha
- Department of Nursing, Dong-A University, Busan, South Korea
| | - Dahye Park
- Department of Nursing, Semyung University, Jecheon, South Korea
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Bond AE, Anestis MD. Firearm Type and Number: Examining Differences among Firearm Owning Suicide Decedents. Arch Suicide Res 2022; 26:1624-1631. [PMID: 33570007 DOI: 10.1080/13811118.2021.1885536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The present study sought to determine if among a sample of firearm owning suicide decedents, the type and number of firearms owned was associated with dying by suicide using a firearm compared to another method. METHOD Data were collected as part of a larger online study that gathered information on suicide decedents and the context surrounding their death from family members and friends. The present study used data from those who owned at least one firearm (n = 121). Participants in the present study were mostly male and white. RESULTS Among firearm owners, handgun ownership was significantly associated with dying by suicide using a firearm compared to using another method. The number of firearms owned was inversely associated with using a firearm compared to another method in a suicide death. The average number of firearms owned was higher among those who owned shotguns compared to handguns. CONCLUSIONS Handgun ownership, not shotgun ownership, was associated with having died from a self-inflicted gunshot wound. The finding regarding number of firearms should be interpreted with caution. Overall, findings provide insight into what differentiates firearm owners who die by suicide using a firearm compared to another method.
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Vélez-Grau C, Romanelli M, Lindsey MA. Adolescent suicide attempts in the United States: When suicide ideation and suicide capability interact. Suicide Life Threat Behav 2022; 52:549-566. [PMID: 35156223 DOI: 10.1111/sltb.12845] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 11/15/2021] [Accepted: 11/23/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Guided by the interpersonal theory of suicide, this study examined whether the relationship between level of suicide ideation and attempted suicide varies as a function of suicide capability. METHODS Cross-sectional data were obtained from the 2017 and 2019 Youth Risk Behavior Survey in which 28,442 respondents were sampled. Confirmatory factor analysis was conducted to create a latent suicide capability variable. Structural equation modeling was used to test the moderating effects of suicide capability on the relationship between level of suicide ideation and attempted suicide, adjusting for sociodemographic characteristics, sadness/hopelessness, and the sampling design. RESULTS Compared to adolescent with no reported ideation, those reporting single and dual ideation experienced increased odds of attempted suicide. The relationship between level of suicide ideation and attempted suicide significantly varied as a function of capability. While adolescents with dual suicide ideation experienced higher rates of attempted suicide at increasing levels of capability, faster rates of change of attempted suicide at increasing levels of capability were observed among those with single and no reported ideation. CONCLUSION Capability may heighten the risk of suicide attempts among youth, suggesting that treatment efforts could be directed at reducing exposure to painful and provocative experiences associated with suicide behaviors.
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Affiliation(s)
- Carolina Vélez-Grau
- New York University, NYU McSilver Institute for Poverty Policy and Research, New York, New York, USA
| | - Meghan Romanelli
- University of Washington, NYU McSilver Institute for Poverty Policy and Research, Seattle, Washington, USA
| | - Michael A Lindsey
- New York University Silver School of Social Work, NYU McSilver Institute for Poverty Policy and Research, New York, New York, USA
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Rosen MR, Michael KD, Jameson JP. CALM gatekeeper training is associated with increased confidence in utilizing means reduction approaches to suicide prevention among college resident assistants. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:501-508. [PMID: 32407219 DOI: 10.1080/07448481.2020.1756825] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 02/12/2020] [Accepted: 04/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Most suicide prevention programs focus on increasing knowledge regarding the problem of suicide, yet many fail to include information on the science and application of means reduction approaches. In an attempt to address this gap in practice, the Counseling on Access to Lethal Means (CALM) program was developed to educate clinicians on the importance of means reduction interventions. METHODS In the current study, a gatekeeper CALM training was delivered to 167 resident assistants. Confidence levels regarding suicide prevention and means reduction skills were assessed at baseline, post-training, and after a 6-week follow-up. RESULTS Results were suggestive of medium to large training effects. Though there was a small decay of training effects at follow-up, the effects were durable when compared to baseline levels. CONCLUSION Given these findings, future gatekeeper trainings should be provided more consistently to help sustain the effects and data on the implementation of CALM principles should be measured during follow-up assessments.
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Affiliation(s)
- Melanie R Rosen
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
- Department of Psychology, Appalachian State University, Boone, North Carolina, USA
| | - Kurt D Michael
- Department of Psychology, Appalachian State University, Boone, North Carolina, USA
| | - J P Jameson
- Department of Psychology, Appalachian State University, Boone, North Carolina, USA
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Logan TK, Cole J, Schroeder M. Examining Recovery Status and Supports before and after Substance Abuse Disorder Treatment Among Clients Who Experienced Lifetime and Recent Firearm-Related Threats. JOURNAL OF DRUG ISSUES 2021. [DOI: 10.1177/00220426211056601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Firearm-related risks have often been overlooked in the sequela of substance use and substance use disorders. This study compares adult substance abuse disorder treatment (SADT) clients who experienced recent ( n = 274) and lifetime ( n = 889) firearm threats to adults who were not threatened with a firearm ( n = 2029) before and 12 months after program entry. More men experienced firearm threats (38.8%) than women (34.2%). However, among those with any firearm threats, more women (27.2%) experienced firearm threats in the year before program entry than men (20.2%). Being threatened with a firearm was associated with increased economic vulnerability, criminal justice system involvement, mental health problems, and victimization both before and after SADT program entry. A higher number of adverse childhood experiences were associated with firearm threats and particularly recent firearm threats. Results of this study underscore the importance of screening for firearm-related risks in substance abuse disorder treatment programs.
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Affiliation(s)
- TK Logan
- University of Kentucky, Lexington, KY, USA
| | | | - Maggie Schroeder
- Kentucky Department of Behavioral Health, Developmental and Intellectual Disabilities, Frankfort, KY, USA
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13
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Bock JE, Tucker RP, Brown RP, Harrington EE, Bauer BW, Daruwala SE, Capron DW, Anestis MD. Factors contributing to honor-endorsing men's suicide capability: Firearm ownership, practical capability, and exposure to painful and provocative events. Suicide Life Threat Behav 2021; 51:1247-1258. [PMID: 34608661 DOI: 10.1111/sltb.12807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 07/19/2021] [Accepted: 07/26/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE White men in U.S. cultures of honor die by suicide at greater rates than other demographic groups. This finding has been attributed to factors such as the prevalence and use of firearms in men's suicide in honor states, as well as motivational risk factors (e.g., thwarted belongingness). Other features of honor cultures (e.g., physical aggression, risk-taking behaviors) suggest that honor-endorsing men may frequently experience painful and provocative events (PPEs), which, in turn, may facilitate practical capability for suicide. The present work tested this hypothesis and honor ideology's relationship to firearm ownership and storage practices. METHOD In two samples of mostly White U.S. men-one undergraduate sample (N = 472, Mage = 19.76) and one middle- to older adult sample (N = 419, Mage = 65.17)-we assessed honor ideology endorsement, PPEs, practical capability for suicide, and firearm-related outcomes. RESULTS Honor endorsement was greater among firearm owners (particularly self-protective owners), but it was unrelated to storage practices. Honor endorsement was positively associated with PPEs and practical capability. Additionally, the relationship between honor ideology and practical capability was indirectly explained by PPE exposure. CONCLUSIONS Results highlight multiple avenues-PPEs, practical capability for suicide, (self-protective) firearm ownership-by which masculine honor norms may place men at risk for suicide.
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Affiliation(s)
- Jarrod E Bock
- Department of Psychology, Towson University, Towson, Maryland, USA
| | - Raymond P Tucker
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Ryan P Brown
- The Doerr Institute for New Leaders, Rice University, Houston, Texas, USA
| | - Erin E Harrington
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Brian W Bauer
- Department of Psychology, Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Samantha E Daruwala
- Department of Psychology, Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Daniel W Capron
- Department of Psychology, Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Michael D Anestis
- New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA.,Department of Urban-Global Public Health, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
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14
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Tull MT, Baer MM, Spitzen TL, Lee AA, Vallender EJ, Garrett MR, Anestis MD, Gratz KL. The roles of borderline personality disorder symptoms and dispositional capability for suicide in suicidal ideation and suicide attempts: Examination of the COMT Val158Met polymorphism. Psychiatry Res 2021; 302:114011. [PMID: 34051678 PMCID: PMC8277722 DOI: 10.1016/j.psychres.2021.114011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 05/10/2021] [Indexed: 12/20/2022]
Abstract
There is a need to identify the subset of individuals with borderline personality disorder (BPD) symptoms at greatest risk for transitioning from suicidal ideation to a suicide attempt. Contemporary models of suicide risk propose that the capability for suicide is necessary for moving from suicidal ideation to a suicide attempt. Few studies have examined dispositional capability factors for suicide, especially among individuals with BPD symptoms. One candidate may be the catechol-o-methyltransferase (COMT) Val158Met polymorphism given its influence on pain sensitivity and fear. This study examined the interactive relation of BPD symptoms and the COMT Val158Met polymorphism to suicidal ideation and suicide attempts. Fifty-nine treatment-seeking patients were recruited. Participants were administered a series of clinical interviews to evaluate BPD symptoms and suicidal thoughts and behaviors. Saliva samples were collected for genotyping. The relation between BPD symptoms and suicidal ideation was not influenced by the Val158Met polymorphism. However, among Val/Val carriers, the probability of a lifetime suicide attempt increased as BPD symptom severity increased. Findings provide preliminary support for the Val/Val variant as a dispositional factor that may increase risk for suicide attempts in BPD; however, results must be interpreted with caution until replication of findings occurs in larger samples.
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Affiliation(s)
- Matthew T Tull
- Department of Psychology, University of Toledo, Toledo, OH, United States.
| | - Margaret M Baer
- Department of Psychology, University of Toledo, Toledo, OH, United States
| | - Tara L Spitzen
- Department of Psychology, University of Toledo, Toledo, OH, United States
| | - Aaron A Lee
- Department of Psychology, University of Mississippi, University, MS, United States
| | - Eric J Vallender
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States
| | - Michael R Garrett
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Michael D Anestis
- New Jersey Gun Violence Research Center, Piscataway, NJ, United States; School of Public Health, Rutgers, the State University of New Jersey, Piscataway, NJ, United States
| | - Kim L Gratz
- Department of Psychology, University of Toledo, Toledo, OH, United States
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Gomez D, Saunders N, Greene B, Santiago R, Ahmed N, Baxter NN. Firearm-related injuries and deaths in Ontario, Canada, 2002-2016: a population-based study. CMAJ 2021; 192:E1253-E1263. [PMID: 33077520 DOI: 10.1503/cmaj.200722] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Firearm-related injury is an important and preventable cause of death and disability. We describe the burden, baseline characteristics and regional rates of firearm-related injury and death in Ontario. METHODS We conducted a population-based cross-sectional study using linked data from health administrative data sets held at ICES. We identified residents of Ontario of all ages who were injured or died as a result of a firearm discharge between Apr. 1, 2002, and Dec. 31, 2016. We included injuries classified as assault, unintentional, self-harm or undetermined intent secondary to handguns, rifles, shotguns and larger firearms. The primary outcome was the incidence of nonfatal and fatal injuries resulting in an emergency department visit, hospital admission or death. We also describe regional and temporal rates. RESULTS We identified 6483 firearm-related injuries (annualized injury rate 3.54 per 100 000 population), of which 2723 (42.3%) were fatal. Assault accounted for 40.2% (1494/3715) of nonfatal injuries and 25.5% (694/2723) of deaths. Young men, predominantly in urban neighbourhoods, within the lowest income quintile were overrepresented in this group. Injuries secondary to self-harm accounted for 68.0% (1366/2009) of injuries and occurred predominantly in older men living in rural Ontario across all income quintiles. The case fatality rate of injuries secondary to self-harm was 91.7%. Self-harm accounted for 1842 deaths (67.6%). INTERPRETATION We found that young urban men were most likely to be injured in firearm-related assaults and that more than two-thirds of self-harm-related injuries occurred in older rural-dwelling men, most of whom died from their injuries. This highlights a need for suicide-prevention strategies in rural areas targeted at men aged 45 or older.
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Affiliation(s)
- David Gomez
- Division of General Surgery (Gomez, Greene, Ahmed), Department of Surgery, University of Toronto; Division of General Surgery (Gomez, Ahmed), St. Michael's Hospital, Unity Health Toronto; Li Ka Shing Knowledge Institute (Gomez, Ahmed, Baxter), St. Michael's Hospital, Unity Health Toronto; ICES (Gomez, Saunders, Santiago, Baxter); Division of Pediatric Medicine (Saunders), The Hospital for Sick Children; Department of Pediatrics (Saunders), University of Toronto; Institute of Health Policy, Management and Evaluation (Saunders, Baxter), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Melbourne School of Population and Global Health (Baxter), University of Melbourne, Melbourne, Australia
| | - Natasha Saunders
- Division of General Surgery (Gomez, Greene, Ahmed), Department of Surgery, University of Toronto; Division of General Surgery (Gomez, Ahmed), St. Michael's Hospital, Unity Health Toronto; Li Ka Shing Knowledge Institute (Gomez, Ahmed, Baxter), St. Michael's Hospital, Unity Health Toronto; ICES (Gomez, Saunders, Santiago, Baxter); Division of Pediatric Medicine (Saunders), The Hospital for Sick Children; Department of Pediatrics (Saunders), University of Toronto; Institute of Health Policy, Management and Evaluation (Saunders, Baxter), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Melbourne School of Population and Global Health (Baxter), University of Melbourne, Melbourne, Australia
| | - Brittany Greene
- Division of General Surgery (Gomez, Greene, Ahmed), Department of Surgery, University of Toronto; Division of General Surgery (Gomez, Ahmed), St. Michael's Hospital, Unity Health Toronto; Li Ka Shing Knowledge Institute (Gomez, Ahmed, Baxter), St. Michael's Hospital, Unity Health Toronto; ICES (Gomez, Saunders, Santiago, Baxter); Division of Pediatric Medicine (Saunders), The Hospital for Sick Children; Department of Pediatrics (Saunders), University of Toronto; Institute of Health Policy, Management and Evaluation (Saunders, Baxter), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Melbourne School of Population and Global Health (Baxter), University of Melbourne, Melbourne, Australia
| | - Robin Santiago
- Division of General Surgery (Gomez, Greene, Ahmed), Department of Surgery, University of Toronto; Division of General Surgery (Gomez, Ahmed), St. Michael's Hospital, Unity Health Toronto; Li Ka Shing Knowledge Institute (Gomez, Ahmed, Baxter), St. Michael's Hospital, Unity Health Toronto; ICES (Gomez, Saunders, Santiago, Baxter); Division of Pediatric Medicine (Saunders), The Hospital for Sick Children; Department of Pediatrics (Saunders), University of Toronto; Institute of Health Policy, Management and Evaluation (Saunders, Baxter), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Melbourne School of Population and Global Health (Baxter), University of Melbourne, Melbourne, Australia
| | - Najma Ahmed
- Division of General Surgery (Gomez, Greene, Ahmed), Department of Surgery, University of Toronto; Division of General Surgery (Gomez, Ahmed), St. Michael's Hospital, Unity Health Toronto; Li Ka Shing Knowledge Institute (Gomez, Ahmed, Baxter), St. Michael's Hospital, Unity Health Toronto; ICES (Gomez, Saunders, Santiago, Baxter); Division of Pediatric Medicine (Saunders), The Hospital for Sick Children; Department of Pediatrics (Saunders), University of Toronto; Institute of Health Policy, Management and Evaluation (Saunders, Baxter), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Melbourne School of Population and Global Health (Baxter), University of Melbourne, Melbourne, Australia
| | - Nancy N Baxter
- Division of General Surgery (Gomez, Greene, Ahmed), Department of Surgery, University of Toronto; Division of General Surgery (Gomez, Ahmed), St. Michael's Hospital, Unity Health Toronto; Li Ka Shing Knowledge Institute (Gomez, Ahmed, Baxter), St. Michael's Hospital, Unity Health Toronto; ICES (Gomez, Saunders, Santiago, Baxter); Division of Pediatric Medicine (Saunders), The Hospital for Sick Children; Department of Pediatrics (Saunders), University of Toronto; Institute of Health Policy, Management and Evaluation (Saunders, Baxter), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Melbourne School of Population and Global Health (Baxter), University of Melbourne, Melbourne, Australia
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Rabasco A, Andover M. Suicidal ideation among transgender and gender diverse adults: A longitudinal study of risk and protective factors. J Affect Disord 2021; 278:136-143. [PMID: 32961408 DOI: 10.1016/j.jad.2020.09.052] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 07/18/2020] [Accepted: 09/11/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Transgender and gender-diverse (TGD) people experience greatly heightened levels of suicidal ideation (SI) compared to the general population. Therefore, it is imperative to understand the risk and protective factors for SI within this population. METHODS The present study explored how victimization, discrimination, community connectedness, and pride impact SI cross-sectionally and longitudinally in a sample of TGD adults (N = 180, 55% transgender women, 76.7% Caucasian, M age = 26.01 years). RESULTS Cross-sectional results showed that experiencing more types of victimization and discrimination at baseline predicted higher SI severity at baseline, while community connectedness and pride at baseline were not predictive of SI severity at baseline. Longitudinal analyses showed that experiencing fewer types of victimization and discrimination during the 1-month follow-up period were associated with a decrease in SI severity from baseline to follow-up. Medium and high levels of community connectedness were also associated with a decrease in SI severity from baseline to follow-up. Pride was not associated with change in SI from baseline to follow-up. LIMITATIONS Limitations include the limited racial/ethnic diversity of the sample and that frequency of experiencing victimization and discrimination was not assessed. CONCLUSIONS These results suggest victimization and discrimination are strong predictors of SI severity within this population, and the factors of victimization, discrimination, and TGD-community connectedness impact change in SI severity across time. These findings provide evidence for the importance of anti-discrimination laws that apply to TGD people, as well as the utility of connecting TGD clients to the TGD community.
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Affiliation(s)
- Ana Rabasco
- Department of Psychology, Fordham University, United States
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Anestis MD, Bandel SL, Butterworth SE, Bond AE, Daruwala SE, Bryan CJ. Suicide risk and firearm ownership and storage behavior in a large military sample. Psychiatry Res 2020; 291:113277. [PMID: 32886959 DOI: 10.1016/j.psychres.2020.113277] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 11/28/2022]
Abstract
Firearms account for the majority of suicide deaths in the United States military and access to firearms is a risk factor for suicide. Prior research has shown service members tend to store firearms unsafely, with some research indicating this is particularly true among those with elevated suicide risk. Existing research has focused on individuals at known risk for suicide; however, those who die by suicide using a firearm are prone to avoiding mental healthcare and underreporting suicidal ideation, thereby necessitating an understanding of this phenomenon among firearm owners outside of the mental healthcare system. The present study examined firearm storage and suicide risk in a large nonclinical sample of service members (total sample n = 953; firearm owning sample = 473). Lifetime suicidal ideation, current depressive symptoms, and perceived likelihood of making a future suicide attempt were associated with unsafe firearm storage. In contrast, lifetime suicidal ideation was not associated with a greater likelihood to own firearms. These findings suggest those at risk of suicide are more likely to store firearms unsafely, which increases ease of access to firearms. These findings reiterate the importance of means safety as a suicide prevention strategy.
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Affiliation(s)
- Michael D Anestis
- New Jersey Gun Violence Research Center, United States; School of Public Health, Rutgers, The State University of New Jersey, United States.
| | - Shelby L Bandel
- School of Psychology, University of Southern Mississippi, United States
| | | | - Allison E Bond
- School of Psychology, University of Southern Mississippi, United States
| | | | - Craig J Bryan
- Department of Psychiatry & Behavioral Health, The Ohio State University, United States
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18
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19
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Lew B, Osman A, Huen JMY, Siau CS, Talib MA, Cunxian J, Chan CMH, Leung ANM. A comparison between American and Chinese college students on suicide-related behavior parameters. Int J Clin Health Psychol 2020; 20:108-117. [PMID: 32550850 PMCID: PMC7296251 DOI: 10.1016/j.ijchp.2020.03.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 03/27/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/OBJECTIVE The United States (US) and China are the two largest economies, but recent and directly comparable studies on suicide-related behaviors in the two countries are lacking. By using the Suicidal Behaviors Questionnaire-Revised (SBQ-R), item-level comparison was performed in assessing self-reported suicide-related behaviors between the US and Chinese undergraduates. METHOD This study involved a total of 3,185 college students aged between 18 to 24 years (1,185 US college students, and 2,000 Chinese students who were randomly selected from a large sample of 11,806 Chinese college students). Participants filled out the 4-item SBQ-R. RESULTS Participants' responses were compared by country and sex. There was a higher overall risk of suicide-related behaviors among US students (24.3%) compared to Chinese students (17.0%). US students also reported higher lifetime attempt, past-year ideation, and lifetime threat. US female college students reported the highest suicide-related behaviors compared to other sub-groups. CONCLUSIONS There is a need to tailor specific interventions to alleviate college students' suicide-related behaviors in the US and China, with a particular focus on US females.
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Affiliation(s)
- Bob Lew
- Department of Social Psychology, Faculty of Human Ecology, Putra University of Malaysia, Serdang, Selangor, Malaysia
| | - Augustine Osman
- Department of Psychology, University of Texas at San Antonio, Texas, United States
| | - Jenny Mei Yiu Huen
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Ching Sin Siau
- Faculty of Social Sciences & Liberal Arts, UCSI University, Kuala Lumpur, Malaysia
| | - Mansor Abu Talib
- Department of Human Development and Family Studies, Putra University of Malaysia, Serdang, Selangor, Malaysia
| | - Jia Cunxian
- Department of Epidemiology, School of Public Health, Shandong University & Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Caryn Mei Hsien Chan
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Bangi Selangor, Malaysia
| | - Angel Nga Man Leung
- Department of Psychology andCentre for Psychosocial Health, The Education University of Hong Kong, Hong Kong, China
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Goldberg SB, Tucker RP, Abbas M, Schultz ME, Hiserodt M, Thomas KA, Anestis MD, Wyman MF. Firearm Ownership and Capability for Suicide in Post-Deployment National Guard Service Members. Suicide Life Threat Behav 2019; 49:1668-1679. [PMID: 31002425 DOI: 10.1111/sltb.12551] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 01/25/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE National Guard service members demonstrate increased suicide risk relative to the civilian population. One potential mechanism for this increased risk may be familiarity with and access to firearms following deployment. This study examined the association between firearm ownership, reasons for ownership, and firearm familiarity with a widely studied suicide risk factor-capability for suicide-among National Guard service members. METHOD Data were drawn from a cross-sectional survey of National Guard service members conducted immediately post-deployment in 2010. Service members (n = 2,292) completed measures of firearm ownership, firearm familiarity, and capability for suicide. RESULTS Firearm ownership and increased firearm familiarity were associated with capability for suicide (d = 0.47 and r = .25, for firearm ownership and familiarity, respectively). When examined separately based on reason for ownership, owning a firearm for self-protection (d = 0.33) or owning a military weapon (d = 0.27) remained significantly associated with capability for suicide. In contrast, owning a firearm for hobby purposes did not (d = -0.07). CONCLUSION Our findings support theories emphasizing practical aspects of suicide (e.g., three-step theory) and suggest that owning firearms, in particular for self-protection, along with familiarity using firearms may be associated with greater capability for suicide.
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Affiliation(s)
- Simon B Goldberg
- Department of Counseling Psychology, University of Wisconsin - Madison, Madison, WI, USA
| | - Raymond P Tucker
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Maleeha Abbas
- Department of Counseling Psychology, University of Wisconsin - Madison, Madison, WI, USA.,VA Puget Sound Health Care System, Seattle, WA, USA
| | - Megan E Schultz
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Michele Hiserodt
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Kathryn A Thomas
- Department of Counseling Psychology, University of Wisconsin - Madison, Madison, WI, USA.,William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | | | - Mary F Wyman
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.,School of Medicine & Public Health, University of Wisconsin - Madison, Madison, WI, USA
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21
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Anestis MD, Tull MT, Butterworth SE, Richmond JR, Houtsma C, Forbes CN, Gratz KL. The Role of Opioid Use in Distinguishing between Suicidal Ideation and Attempts. Suicide Life Threat Behav 2019; 49:1680-1692. [PMID: 31141194 DOI: 10.1111/sltb.12557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 01/29/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Opioid use disorders are associated with heightened suicidal ideation, suicide attempts, and suicide death. This study aimed to examine the extent to which opioid differentiates between those with suicide attempts from those with lifetime suicidal ideation but no history of attempt. METHODS Participants were drawn from the US National Guard and a residential substance use treatment facility. Multinomial logistic regression was utilized to determine the extent to which a lifetime history of nonmedical opioid use differentiated between (1) individuals with no lifetime history of suicidal ideation or attempt, (2) individuals with a history of suicidal ideation but no attempt, and (3) individuals with a history of at least one suicide attempt. RESULTS History of opioid use among National Guard personnel and opioid use disorders among substance-dependent patients were associated with an increased likelihood of having at least one suicide attempt relative to both a history of suicidal ideation but no attempts and no history of ideation or attempts. Findings held when accounting for lifetime nonmedical use of other substances and the presence of other lifetime substance use disorders. CONCLUSIONS Results highlight the importance of assessing for suicide risk among opioid users.
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Affiliation(s)
- Michael D Anestis
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Matthew T Tull
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | - Sarah E Butterworth
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | | | - Claire Houtsma
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | | | - Kim L Gratz
- Department of Psychology, University of Toledo, Toledo, OH, USA
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22
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Anestis MD, Daruwala S, Capron DW. Firearm Ownership, Means Safety, and Suicidality. Suicide Life Threat Behav 2019; 49:1044-1057. [PMID: 30117194 DOI: 10.1111/sltb.12509] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/27/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Means safety interventions are effective at reducing suicide rates. This study examined beliefs about firearm ownership or storage and suicide risk, lifetime suicidal thoughts, and openness to means safety. METHOD A community sample of 107 American adult firearm owners (51.4% male; 82.2% White; m age = 37.46) completed a series of self-report questionnaires via Amazon's Mechanical Turk. RESULTS Hierarchical linear regressions indicated that beliefs regarding firearm ownership or storage were associated with openness to means safety measures to prevent a suicide attempt by someone else, but not to prevent one's own suicide attempt. Additionally, results from analyses of covariance indicated that firearm owners with lifetime ideation had stronger beliefs regarding the association between firearm ownership or storage and suicide risk. CONCLUSIONS Findings indicate firearm owners' willingness to engage in means safety may be influenced by the degree to which they believe firearm storage is associated with suicide. Furthermore, firearm owners with prior suicide ideation are more open to the idea that firearm ownership and storage are related to suicide risk. Viewing suicide as salient to one's own life may serve as a focal point in efforts to increase openness to means safety among firearm owners.
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Affiliation(s)
- Michael D Anestis
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Samantha Daruwala
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Daniel W Capron
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
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23
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Dempsey CL, Benedek DM, Zuromski KL, Riggs-Donovan C, Ng THH, Nock MK, Kessler RC, Ursano RJ. Association of Firearm Ownership, Use, Accessibility, and Storage Practices With Suicide Risk Among US Army Soldiers. JAMA Netw Open 2019; 2:e195383. [PMID: 31173124 PMCID: PMC6563574 DOI: 10.1001/jamanetworkopen.2019.5383] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/23/2019] [Indexed: 11/14/2022] Open
Abstract
Importance Since 2004, the suicide rate among US Army soldiers has exceeded the rate of death from combat injury. It is critical to establish factors that increase the risk of acting on suicidal thoughts to guide early intervention and suicide prevention. Objective To assess whether firearm ownership, use, storage practices, and accessibility are associated with increased risk of suicide. Design, Setting, and Participants In this case-control study, suicide cases (n = 135) were defined as US Army soldiers who died by suicide while on active duty between August 1, 2011, and November 1, 2013. Next-of-kin and Army supervisors of soldiers who died by suicide (n = 168) were compared with propensity-matched controls (n = 137); those soldiers with a suicidal ideation in the past year (n = 118) provided structured interview data. Data were analyzed from April 5, 2018, to April 2, 2019. Main Outcomes and Measures Firearm ownership, storage, and accessibility were assessed by using items from the World Health Organization Composite International Diagnostic Interview screening scales along with items created for the purpose of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) study. Results Among the 135 suicide decedents, next-of-kin reported that they had greater accessibility to firearms compared with propensity-matched controls. Specifically, suicide decedents were more likely to own 1 or more handguns compared with propensity-matched controls (odds ratio [OR], 1.9; 95% CI, 1.0-3.7; χ21 = 4.2; false discovery rate [FDR] P = .08), store a loaded gun at home (OR, 4.1; 95% CI, 1.9-9.1; χ21 = 12.2; FDR P = .003), and publicly carry a gun when not required for military duty (OR, 3.2; 95% CI, 1.4-7.3; χ21 = 7.4; FDR P = .02). The combination of these 3 items was associated with a 3-fold increase in the odds of suicide death (OR, 3.4; 95% CI, 1.2-9.4; χ21 = 5.4; FDR P = .05). Storing a loaded gun with ammunition at home or publicly carrying a gun when not on duty was associated with a 4-fold increase in the odds of suicide death (OR, 3.9; 95% CI, 1.9-7.9; χ21 = 14.1; FDR P = .002). Conclusions and Relevance In this study, in addition to gun ownership, ease and immediacy of firearm access were associated with increased suicide risk. Discussion with family members and supervisors about limiting firearm accessibility should be evaluated for potential intervention.
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Affiliation(s)
- Catherine L. Dempsey
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - David M. Benedek
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Kelly L. Zuromski
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Charlotte Riggs-Donovan
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Tsz Hin H. Ng
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Matthew K. Nock
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Ronald C. Kessler
- Department of Healthcare Policy, Harvard Medical School, Boston, Massachusetts
| | - Robert J. Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Mintz S, Jamison E, Bol K. Suicide Among Health Care Practitioners and Technicians in Colorado: An Epidemiological Study. Suicide Life Threat Behav 2019. [PMID: 29512834 DOI: 10.1111/sltb.12449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Suicide is a public health concern with risks that vary between occupation groups. Many suicide victims with a health care occupation die by poisoning, but few studies have epidemiologically studied this association. The objective of this study was to quantify the increased risk of suicide death by poisoning among health care professionals in Colorado. Eleven years (2004-2014, N = 8,753) of suicide deaths in Colorado were compiled from the Colorado Violent Death Reporting System. A retrospective cohort study using multivariate logistic regression was conducted to examine the risk associated with having a health care occupation and eventual suicide death by poisoning, compared independently to firearm and hanging methods. Suicide victims with a health care occupation were more likely to die by poisoning rather than by hanging (RR 1.54, 95% CI: 1.41-1.68) or firearm (RR 1.79, 95% CI: 1.60-2.01), when compared to suicide victims without a health care occupation. The association between health care occupation and suicide method was significantly (p = .032) modified by gender. The results show that health care workers who die by suicide have an increased risk of eventual suicide death by poisoning rather than by firearm or hanging. These results can be used to inform tailored suicide prevention efforts in health care professionals.
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Affiliation(s)
- Sasha Mintz
- Colorado Department of Public Health and Environment, Denver, CO, USA
| | - Ethan Jamison
- Colorado Department of Public Health and Environment, Denver, CO, USA
| | - Kirk Bol
- Colorado Department of Public Health and Environment, Denver, CO, USA
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Houtsma C, Butterworth SE, Anestis MD. Firearm suicide: pathways to risk and methods of prevention. Curr Opin Psychol 2017; 22:7-11. [PMID: 30122279 DOI: 10.1016/j.copsyc.2017.07.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 07/10/2017] [Indexed: 11/17/2022]
Abstract
Firearms are utilized in approximately half of all US suicides, making them a serious public health concern and a target of suicide prevention efforts. Practical capability influences the transition from suicidal ideation to action and is particularly relevant to firearm suicide. Firearm ownership, experience using firearms, unsafe firearm storage, and high cultural acceptability of firearms increase risk for death by firearm suicide. Means safety strategies, which emphasize the reduction of practical capability for suicide through the limitation of access to and safe storage of firearms, are effective in preventing suicide and include interventions such as lethal means counseling, firearm legislation, and promoting safe storage practices. Public health interventions aimed at reducing firearm suicide are critical topics for continued research.
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Affiliation(s)
- Claire Houtsma
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA.
| | - Sarah E Butterworth
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Michael D Anestis
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
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