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Bayliss LT, Lamont-Mills A, du Plessis C. "I Will Die by My Own Hand": Understanding the Development of Suicide Capability in the Narratives of Individuals Who Have Attempted Suicide. QUALITATIVE HEALTH RESEARCH 2024:10497323241235861. [PMID: 38914024 DOI: 10.1177/10497323241235861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Suicide capability is a multidimensional concept that facilitates the movement from suicidal ideation to suicide attempt. The three-step theory of suicide posits that three overarching contributors comprise suicide capability: acquired (fearlessness about death and high pain tolerance), dispositional (genetics), and practical (knowledge and access to lethal means) capability. Although extensive research has investigated relationships between individual contributors of capability and suicide attempts, little research has considered how an individual's capability for suicide develops as a combination of contributors. Given suicide is multifaceted and complex, our understanding of capability development is relatively limited. This potentially negatively impacts prevention and capacity reduction-focused intervention efficacy. Therefore, this study aimed to explore how suicide capability develops. Fourteen community-based suicide attempt survivors were recruited using convenience sampling. Individual narratives were collected using open-ended interviews, and data were analysed using narrative analysis. Results indicated that participant narratives contained two elements. The first included how capability development and suicide attempt facilitation were often underpinned by the relational interplay between acquired and practical contributors. For example, participants without a high pain tolerance seeking attempt methods that were perceived to be painless. The second element contained a novel finding relating to the agentic role of participants when deciding and attempting suicide. Agency was revealed within and across narratives emphasising the active role the individual plays in their movement from ideation-to-action. The role of individual agency in coming to a decision to take one's own life and then acting warrants further consideration within contemporary suicide theories.
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Affiliation(s)
- Luke T Bayliss
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
| | - Andrea Lamont-Mills
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
- Academic Affairs Division, University of Southern Queensland, Ipswich, QLD, Australia
| | - Carol du Plessis
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
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Short R, Jolliffe D, Carter B, Campbell C. Mediators of change in psychological interventions for adult offenders with personality disorders: A scoping review of the literature. Personal Ment Health 2024; 18:177-187. [PMID: 38425242 DOI: 10.1002/pmh.1606] [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] [Received: 11/23/2023] [Revised: 01/09/2024] [Accepted: 01/31/2024] [Indexed: 03/02/2024]
Abstract
Offenders with personality disorder cause disproportionate harm to society and pose significant challenges for those responsible for their care and rehabilitation. Personality disorders are heterogeneous in terms of symptoms, as well as their pathways to offending behaviour. Thus, there is limited evidence regarding effective interventions. One solution might be to focus on how interventions are delivered as well as what is delivered. Within the non-offender personality disorder literature, the identification of potential mediators of change has enabled interventions to focus on 'how' they are delivered (e.g., therapeutic alliance) rather than the intervention itself. We explore the evidence and present a scoping review of the available literature on the mechanisms of change in psychological treatments for offenders with personality disorder. Only one study was found in the scoping review, highlighting a significant gap in the evidence base. We discuss the implications of this finding and potential future directions.
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Affiliation(s)
- Roxanna Short
- Department of Forensic and Neurodevelopmental Sciences, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Darrick Jolliffe
- Department of Law and Criminology, Royal Holloway University of London, Egham, UK
| | - Ben Carter
- Department of Biostatistics and Health Informatics, King's College London, London, UK
| | - Colin Campbell
- Department of Forensic and Neurodevelopmental Sciences, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Vorstenbosch E, Rodríguez-Liron A, Vicens-Pons E, Félez-Nóbrega M, Escuder-Romeva G. Suicide risk in male incarcerated individuals in Spain: clinical, criminological and prison-related correlates. BMC Psychol 2023; 11:282. [PMID: 37735464 PMCID: PMC10514969 DOI: 10.1186/s40359-023-01315-y] [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: 10/04/2022] [Accepted: 09/06/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Prison suicide is a complex phenomenon that may be influenced by individual, clinical, social and environmental factors. In Spain, few studies have explored the relationship with institutional, prison-related variables. The aim of this study is to examine correlates of suicide in a sample of male incarcerated individuals from 5 Spanish penitentiary centers. METHODS This present study entails a secondary data analysis, using data from the Prevalence of mental disorders in prisons study. This is a cross-sectional multicenter study conducted in 2007-2008 across 5 penitentiary centers in Spain. The Spanish version of the Plutchik suicide risk scale was used to assess the risk of suicide (those scoring ≥ 6 were considered to be at risk of suicide). Sociodemographic, clinical, criminological and prison-related data were collected via face-to face interviews and criminological data were confirmed using penitentiary records. RESULTS The final sample included 707 male incarcerated individuals (mean age 36.79 years ± 9.90 years). Several significant correlates associated with higher risk of suicide were identified including criminological factors (having committed a violent offense, being a recidivist), clinical factors (family history of mental disorders, the presence of mental disorders, having physical conditions, contact with a mental health specialist, medication treatment in the last 12 months), and prison-related determinants (workshop/training course participation) was significantly associated with lower suicide risk. CONCLUSIONS Several correlates within a comprehensive range of sociodemographic, criminological, clinical and prison-related variables were identified. This information is primordial for preventing suicide and reducing the existing risk. The findings may contribute to developing effective suicide prevention programs within Spanish prison services. Importantly, future research must continue to investigate the nature of suicidal outcomes among incarcerated individuals.
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Affiliation(s)
- Ellen Vorstenbosch
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain.
- Instituto de Salud Carlos III, Centre for Biomedical Research On Mental Health (CIBERSAM), C/ Monforte de Lemos 3-5, 28029, Madrid, Spain.
| | - Ariadna Rodríguez-Liron
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
| | - Enric Vicens-Pons
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
| | - Mireia Félez-Nóbrega
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centre for Biomedical Research On Mental Health (CIBERSAM), C/ Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Gemma Escuder-Romeva
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Parc Sanitari Sant Joan de Déu, Penitentiary Psychiatric Hospitalization Unit of Catalonia, Carretera de Martorell a Capellades, Km 23, 08635, Sant Esteve Sesrovires, Spain
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Stoliker BE, Wangler H, Abderhalden FP, Jewell LM. Lifetime and Jail-Specific Suicidal Ideation: Prevalence and Correlates in a Sample of People in Jail in the United States. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023:306624X231170112. [PMID: 37098823 DOI: 10.1177/0306624x231170112] [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
Despite high suicide mortality in U.S. jails, there is limited research into precursors for suicide in this population, such as suicidal ideation. The current study examined the prevalence and correlates of lifetime and jail-specific suicidal ideation among a sample of 196 individuals (137 men) in custody in a U.S. jail. Nearly half the sample had reported lifetime suicidal ideation (45%), whereas 30% had reported jail-specific suicidal ideation. Adjusted correlates of lifetime suicidal ideation included a history of mental illness (OR = 2.79) and drug use (OR = 2.70). Adjusted correlates of jail-specific suicidal ideation included a history of mental illness (OR = 2.74), drug use (OR = 3.16), and a dehumanizing custodial environment (OR = 3.74). Some theoretically and empirically relevant factors were not significantly associated with suicidal ideation. Both expected and unexpected findings are discussed within the context of suicide theory and research, and practical implications are explored.
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Affiliation(s)
- Bryce E Stoliker
- Centre for Forensic Behavioural Science and Justice Studies, University of Saskatchewan, SK, Canada
| | - Haile Wangler
- Centre for Forensic Behavioural Science and Justice Studies, University of Saskatchewan, SK, Canada
| | - Frances P Abderhalden
- School of Criminal Justice and Criminalistics, California State University, Los Angeles, United States
| | - Lisa M Jewell
- Centre for Forensic Behavioural Science and Justice Studies, University of Saskatchewan, SK, Canada
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Mitchell SM, Görgülü T, Dhingra K, Crean HF, Swogger MT. Depressive Symptoms Moderate the Association Between the Recent History of Alcohol Use Severity and Suicide Attempt History Among Adults in a Pretrial Jail Diversion Program. CRISIS 2023; 44:146-153. [PMID: 35086357 PMCID: PMC9329489 DOI: 10.1027/0227-5910/a000847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Justice-involved individuals are at elevated risk for suicidal behavior; however, research examining risk for suicidal behavior in pretrial jail diversion programs (pretrial diversion) is limited. Aims: We aimed to test (1) associations between depressive symptoms and alcohol and drug use, and suicide attempt history (SAH), and (2) interactions between depressive symptoms and alcohol and drug use in relation to SAH among adults in an urban pretrial jail diversion program. Method: The design was cross-sectional, including self-report assessments and file reviews of historical information. Adults (N = 274; Mage = 33.72; 73.7% men; 52.6% non-Hispanic Black) completed assessments within two weeks of beginning the pretrial program. Results: Depressive symptoms were positively associated with SAH after adjusting for other covariates. The significant depressive symptoms by alcohol use interaction indicated that adults with low to average depressive symptoms evidenced a similar likelihood of SAH to those with high depressive symptoms when they also had elevated alcohol use scores. Limitations: We used cross-sectional self-report data. Conclusion: It may be important to conduct suicide risk assessments for justice-involved people who use alcohol even when depressive symptoms are low.
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Affiliation(s)
- Sean M. Mitchell
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Tuğba Görgülü
- Department of Psychiatry, University of Rochester Medical Center, NY, USA
- Department of Psychology, Ankara Science University, Turkey
| | - Katie Dhingra
- Department of Criminology, School of Social, Psychological and Communication Sciences, Leeds Beckett University, UK
| | - Hugh F. Crean
- Department of Psychiatry, University of Rochester Medical Center, NY, USA
- School of Nursing, University of Rochester Medical Center, NY, USA
| | - Marc T. Swogger
- Department of Psychiatry, University of Rochester Medical Center, NY, USA
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Freese RA, Canada KE, Nichols PM, McNamara B. Suicide in prisons: describing trends and staff knowledge and preparedness to address suicide. Int J Prison Health 2022; 19:427-439. [PMID: 36449448 DOI: 10.1108/ijph-02-2022-0011] [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: 12/02/2022]
Abstract
PURPOSE Suicide prevention and intervention in prisons is a challenge. Prisons were not designed to be clinical facilities, yet with the growing numbers of people who face mental health challenges in prisons, staff require knowledge and skills to adequately address mental health crises, especially suicide. This study aims to: describe trends in suicide attempts and completions within one state's prison system and measure staff knowledge and preparedness to address suicide. DESIGN/METHODOLOGY/APPROACH This research uses a nonexperimental research design and two data sources. Administrative data from 2000 to 2017 on serious suicide attempts and completions were analyzed, and all correctional staff employed in the state's Department of Corrections were surveyed at one point in time. Univariate and bivariate analyses were conducted. FINDINGS The number of serious suicide attempts trended up but completed suicides decreased. Correctional staff demonstrated high suicide knowledge of risk factors and warning signs of suicide. Staff who viewed a media-based suicide training displayed significantly more knowledge of suicide and perceived greater preparedness compared to staff who did not or did not recall viewing the training. ORIGINALITY/VALUE Corrections staff play a key role in preventing suicides in prison. Innovative intervention is needed to increase suicide awareness, improve communication and enhance prevention skills.
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Affiliation(s)
- Rebekah A Freese
- School of Social Work, University of Missouri, Columbia, Missouri, USA
| | - Kelli E Canada
- School of Social Work, University of Missouri, Columbia, Missouri, USA
| | | | - Brianna McNamara
- School of Social Work, University of Missouri, Columbia, Missouri, USA
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Stijelja S, Mishara BL. Preventing suicidal and self-Injurious behavior in correctional facilities: A systematic literature review and meta-analysis. EClinicalMedicine 2022; 51:101560. [PMID: 35898320 PMCID: PMC9309412 DOI: 10.1016/j.eclinm.2022.101560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Rates of suicide and self-harm are elevated in carceral institutions. Inmates are a vulnerable group since they are exposed to multiple risk factors. This paper critically reviews empirical research on programs to prevent suicidal and self-harmful behaviors in correctional facilities and summarizes effect sizes across studies. METHODS We searched PsychINFO, PubMed, IEEEXPLORE and the CRISE Documentation Centre Database to identify relevant articles published before June 2022. Inclusion criteria were: peer-reviewed and with outcome data on effectiveness of prevention activities. Two reviewers independently assessed 905 articles to determine inclusion eligibility. Quality was assessed by two independent reviewers using the Quality Assessment Tool for Quantitative Studies. Meta-analyses using random-effect models were used to pool effect sizes for each outcome. This review was conducted in accordance with PRISMA guidelines. FINDINGS Twenty-four of the 905 articles, published between 1980 and 2022, were included. Studies were frequently conducted in the United States (n=13; 54%) and used varying study designs; most frequently pre-post with no control group (n=9; 38%). Sample sizes and interventions varied considerably. Most were of moderate quality (n=21; 88%). On average, prevention programs in correctional facilities were effective in decreasing suicide deaths (pooled rate ratio of 0·35 [95% CI 0·23 to 0·55; p<0·001]; I2=68·01%), incidents of self-harm (pooled Hedges'g of -0·54 (95% CI: -1·03 to -0·05; p=0·031]; I2=81·34%), and suicidal ideation (pooled Hedges'g of -0·39 [95% CI: -0·65 to -0·14; p=0·003]; I2=47·09%). INTERPRETATION Prevention activities are effective in reducing suicide death, self-harm and suicidal ideation in correctional settings. Multicomponent programs, which include several preventive activities, seem to be most effective in reducing suicide deaths. Future evaluation studies should control for confounding variables by including control groups, having larger samples and limiting attrition. Standards for suicide prevention in jails and prisons should be included in National suicide prevention strategies. FUNDING None.
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Affiliation(s)
- Stefan Stijelja
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Brian L. Mishara
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
- Corresponding author at: CRISE-UQAM, C.P. 8888, Succ. Centre-ville, Montréal, Québec H3C 3P8, Canada.
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8
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Violence in Incarcerated Populations: a Review of the Literature. CURRENT TRAUMA REPORTS 2022. [DOI: 10.1007/s40719-022-00234-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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9
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Steel CMS, Newman E, O’Rourke S, Quayle E. Suicidal ideation in offenders convicted of child sexual exploitation material offences. BEHAVIORAL SCIENCES & THE LAW 2022; 40:365-378. [PMID: 35043473 PMCID: PMC9541809 DOI: 10.1002/bsl.2560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/07/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Abstract
Understanding the prevalence of suicidal ideation in Child Sexual Exploitation Material (CSEM) offenders and their psychological concerns provides the basis for early treatment and intervention. This research solicited responses (n = 78) via an anonymous, web-based survey from adults in the United States previously convicted of CSEM offences. Significant suicidal ideation was present in 73% of respondents (n = 57), and 19% (n = 15) reported attempting suicide after they were made aware of an investigation, with 41% (n = 32) stating they would have been likely to seek counselling if provided a contact. Most of the respondents felt they were not treated with fairness, understanding, and compassion by investigators, and that their primary psychological strains were going to jail and their families finding out. This research highlights the need for more empathetic investigative approaches, as well as the need for more rapid assessment and treatment of proximal suicide risk in this population.
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Affiliation(s)
- Chad M. S. Steel
- University of EdinburghEdinburghUK
- MS 2B5George Mason UniversityFairfaxVirginiaUSA
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10
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Sun L, Li K, Zhang Y, Zhang L. Differentiating the associations between sleep quality and suicide behaviors: A population-based study in China. J Affect Disord 2022; 297:553-558. [PMID: 34728292 DOI: 10.1016/j.jad.2021.10.126] [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: 06/29/2021] [Revised: 09/16/2021] [Accepted: 10/20/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although the association between sleep problems and suicidal behaviors were found in many studies, their associations are not built until now. One of the reasons may be the identified differences among different suicide behaviors, which also implied that sleep quality may play different roles on these suicidal behaviors. However, absent study explores the possible distinguishing associations between sleep quality and different suicidal behaviors. METHODS This is a population-based study conducted in Hebei province, China. Totally, 21,376 valid questionnaires were analyzed in this study. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Suicidal behaviors, living alone, and social-demographic variables were assessed for all the participants. RESULTS The prevalence of suicidal ideation, plan, and attempt were 1.4%, 0.3%, and 0.2%, respectively. The PSQI scores were separately associated with suicidal ideation (OR=1.25, p<0.001), plan (OR=1.19, p<0.001), and attempt (OR=1.18, p<0.001). The similar results were also supported when we compared conditional suicidal behaviors with general population without any suicidal behaviors. However, when we compared suicide attempters with suicidal ideators (with or without suicide plan), the associations between PSQI scores and suicide attempt were not supported (OR=1.93, P>0.05 or OR=1.02, p>0.05). LIMITATIONS The cross-sectional design made us cannot get any causal relationships. The self-reported sleep quality may also produce some influence on the results. CONCLUSION The results imply us that improving sleep quality may be not effective to control further suicidal behaviors, when people have considered or planned to suicide. The findings also can be translated into the clinical and preventive practice for suicide control.
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Affiliation(s)
- Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, China.; National Health Commission of China Key Lab for Health Economics and Policy Research (Shandong University), China
| | - Keqing Li
- Hebei Provincial Sixth People's Hospital, Hebei, China
| | - Yunshu Zhang
- Hebei Provincial Sixth People's Hospital, Hebei, China..
| | - Lili Zhang
- Hebei Provincial Sixth People's Hospital, Hebei, China
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Fedock G, Garthe R, Higgins GE, Lewis C, Blank Wilson A. Health care disparities for incarcerated adults after a suicide attempt. Suicide Life Threat Behav 2021; 51:931-939. [PMID: 34184788 DOI: 10.1111/sltb.12776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/13/2021] [Accepted: 04/04/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Incarcerated adults have high rates of fatal and nonfatal suicidal behaviors. Suicide prevention recommendations stress the need for the provision of health care for incarcerated adults after suicide attempts, yet prison policies and practices often focus instead on punitive responses to suicidal behaviors. Existing research is limited regarding factors that predict the provision of health care to incarcerated adults post-suicide attempt. The current study examined individual, incident, and institutional factors as predictors of health care to incarcerated adults post-suicide attempt. METHOD We used data from critical incidents reports for suicide attempts (N = 495) to conduct mixed-effects logistical regression models. RESULTS Staff responded to suicide attempts by placing incarcerated adults under direct observation (with no care) or in segregation at odds two and three times higher than of providing health care, particularly in prisons for men. Race was a significant factor; incidents involving Black men were less likely than incidents involving white men to include staff requesting health care, and incidents involving Black women were less likely than incidents involving white women to include requesting and providing health care. CONCLUSIONS This study's findings highlight factors predicting health care responses to suicide attempts and the need to address and prevent health care disparities in prisons.
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Affiliation(s)
- Gina Fedock
- University of Chicago Crown Family School of Social Work, Policy, and Practice, Chicago, Illinois, USA
| | - Rachel Garthe
- University of Illinois at Urbana-Champaign, School of Social Work, Urbana, Illinois, USA
| | - George E Higgins
- Department of Criminal Justice, University of Louisville, Louisville, Kentucky, USA
| | - Cashell Lewis
- University of Chicago Crown Family School of Social Work, Policy, and Practice, Chicago, Illinois, USA
| | - Amy Blank Wilson
- University of North Carolina System, Chapel Hill, North Carolina, USA
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Stoliker BE, Abderhalden FP. People in Custody With a Suicidal History: An Ideation-to-Action Perspective Involving Individuals Incarcerated in Two U.S. Jails. Arch Suicide Res 2021; 27:231-245. [PMID: 34582321 DOI: 10.1080/13811118.2021.1982095] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Despite high suicide mortality in U.S. jails, little is known about the cognitive (ideation) and behavioral (attempt) spectrum of suicide risk in this population. Identifying factors associated with the development of suicidal ideation, as well as the translation of thoughts to acts of suicide, is important for suicide prevention. METHOD Using data from a cross-sectional study conducted in 2018-2019, we investigated suicidal ideation and attempt among 548 individuals incarcerated in jail in the United States. Specifically, we compared those with suicidal ideation (n = 212) to those without suicidal ideation (n = 336), as well as compared those who had experienced suicidal ideation and attempted suicide (n = 114) to those who thought about suicide without making an attempt (n = 98), on a range of sociodemographic and clinical factors. RESULTS Over one-third (38.7%) of participants had a history of suicidal ideation, whereas 23.3% had attempted suicide. In the adjusted analyses, a family history of suicide (OR = 2.09), drug use (OR = 2.26), social support (OR = 0.61), and self-harm (OR = 24.93) were linked to suicidal ideation. No wish to live (OR = 5.26) and interpersonal violence while intoxicated (OR = 2.41) were associated with the progression from suicidal ideation to a suicide attempt. CONCLUSIONS Consistent with extant theoretical and empirical work, findings suggest that factors linked to the development of suicidal cognitions differ from those underlying the progression from suicidal ideation to a (non-lethal) suicide attempt.HIGHLIGHTSSuicidal risk is particularly high among individuals who are incarcerated in jail.Factors linked to suicidal ideation differ from those underlying acts of suicide.Ideators and attempters possess a different set of targets for intervention.
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13
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Kim SB, Jeong IS. Building and evaluating suicide attempt prediction models using risk factors. Nurs Health Sci 2021; 23:925-935. [PMID: 34561951 DOI: 10.1111/nhs.12883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 11/29/2022]
Abstract
This study identified risk factors of suicide attempts for the purpose of building prediction models and evaluating their performance. The participants of this secondary data analysis study were 11 671 adults aged 19 years or older. The prediction models consisted of risk factors identified through multiple logistic regression analysis, and performance was analyzed in terms of calibration, discrimination, and clinical usefulness. The risk factors for suicide attempts were suicide plan and suicidal ideation for males, and suicide plan and depression diagnosis for females. The prediction models constructed with these risk factors showed good calibration and discrimination, with over 0.90 of the area under the curves. At the cutoff point of 0.5%, the sensitivity of the full model was 90.9% for males and 82.4% for females. The net benefit was positive at a threshold probability under 30% for males and 40% for females. Given the acceptable performance of the suicide attempt prediction models, they can be used to assess suicide attempt risk and detect the population at high risk in the community at an early stage, with limited human resources.
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Affiliation(s)
- Seol Bin Kim
- College of Nursing, Pusan National University, Yangsan-si, South Korea
| | - Ihn Sook Jeong
- College of Nursing, Pusan National University, Yangsan-si, South Korea
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Favril L, O’Connor RC, Hawton K, Vander Laenen F. Factors associated with the transition from suicidal ideation to suicide attempt in prison. Eur Psychiatry 2020; 63:e101. [PMID: 33183374 PMCID: PMC7737175 DOI: 10.1192/j.eurpsy.2020.101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Although research has identified a wide range of risk factors for suicidal behavior in prisoners, it does not establish who is most likely to act on their suicidal thoughts while incarcerated. METHODS Self-report data were collected from a random sample of 1,203 adult men incarcerated across 15 prisons in Belgium, who represent 12% of all male prisoners nationwide. RESULTS One-third (33%) of participants reported having suicidal thoughts during their incarceration, of whom 26% attempted suicide in prison (9% of all prisoners). Factors independently associated with suicide attempt among prisoners with suicidal ideation were violent offending (adjusted odds ratio [aOR] = 2.64, 95% confidence interval [CI] 1.33-5.23), in-prison drug use (aOR = 2.30, 95% CI 1.25-4.22), exposure to suicidal behavior (aOR = 1.96, 95% CI 1.04-3.68), and a lifetime history of nonsuicidal self-injury (aOR = 1.90, 95% CI 1.08-3.36). While related to suicidal thoughts, markers of psychiatric morbidity and aspects of the prison regime were not associated with the progression to suicide attempt. CONCLUSIONS Many prisoners who think about suicide do not attempt suicide while incarcerated. Factors associated with suicidal ideation are distinct from those that govern the transition to suicidal behavior. Our findings lend support to the hypothesis that behavioral disinhibition might act as a catalyst in the translation of suicidal thoughts into action.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Rory C. O’Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Freya Vander Laenen
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
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Stoliker BE, Verdun-Jones SN, Vaughan AD. The relationship between age and suicidal thoughts and attempted suicide among prisoners. HEALTH & JUSTICE 2020; 8:14. [PMID: 32572829 PMCID: PMC7310337 DOI: 10.1186/s40352-020-00117-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/11/2020] [Indexed: 05/30/2023]
Abstract
BACKGROUND Suicide is a major problem across the lifespan, yet rates are highest among middle-aged and older adults; a trend which remains relatively stable across varying sociological settings, including prisons. Despite this understanding, there is limited knowledge on the nature of suicidal thoughts and attempts among older prisoners, especially with respect to how they compare to younger counterparts. The present study aimed to increase insight into the relationship between age and suicidal thoughts and attempted suicide among prisoners, with particular focus on factors that may explain age-based variability. RESULTS Cross-sectional data were drawn from a nationally representative sample of 18,185 prisoners housed within 326 prisons across the United States. In general, analyses revealed that: (a) attempted suicide was more commonly reported among younger prisoners, while suicidal ideation was more commonly reported among older prisoners; (b) the relationship between age and probability of reporting suicidal thoughts and behavior is curvilinear; (c) younger and older prisoners exhibit somewhat differing predictive patterns of suicidal thoughts and behavior (e.g., physical illness is directly associated with suicidal history for younger prisoners, whereas the effect of physical illness on suicidal history for older prisoners is mediated by depression). CONCLUSIONS There is evidence to suggest that suicidal thoughts and behavior may manifest differently for younger and older prisoners, with differing patterns of risk. More research is needed on age-based variability in suicidal thoughts and attempted suicide among prisoners, as well as those factors that might explain this variability. Importantly, future research must continue to investigate the nature of suicidal thoughts and behavior among older prisoners.
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Affiliation(s)
- Bryce E Stoliker
- School of Criminology, Simon Fraser University, Burnaby, British Columbia, V5A 1S6, Canada.
| | - Simon N Verdun-Jones
- School of Criminology, Simon Fraser University, Burnaby, British Columbia, V5A 1S6, Canada
| | - Adam D Vaughan
- School of Criminal Justice, Texas State University, San Marcos, TX, 78666, USA
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