1
|
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.
Collapse
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
| |
Collapse
|
2
|
Hart FG, Stewart JG, Hudson CC, Fan K, Björgvinsson T, Beard C. Fearlessness about death and suicidal ideation: Religious identity matters. Suicide Life Threat Behav 2024; 54:575-583. [PMID: 38414307 DOI: 10.1111/sltb.13069] [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: 11/09/2023] [Revised: 01/20/2024] [Accepted: 02/14/2024] [Indexed: 02/29/2024]
Abstract
INTRODUCTION Religion is a salient aspect of patient background in treatment (The psychology of religion and coping: Theory, research, practice; Guilford Press). However, research investigating the role of religion in suicide is lacking and inconsistent (Journal of Religion and Health, 57, 2478-2499). The current study (1) clarifies the association between religious identity and fearlessness about death in a psychiatric sample and (2) tests whether religious identity moderates the association between fearlessness about death and suicidal ideation. METHODS Participants were 155 patients seeking treatment in a partial hospital program. Religious identity was assessed using the Identities in Treatment Scale (The Behavior Therapist). Fearlessness about death was assessed with two relevant items from the acquired capability with rehearsal for suicide scale (Psychological Assessment, 28, 1452-1464), as in prior studies (Suicide & Le-Threatening Behavior, 50, 1230-1240; Journal of Affective Disorders Reports, 12, 100492). RESULTS Fearlessness about death interacted with religious identity to predict suicidal ideation, b = 0.47, 95% C.I. [0.02, 0.91], p = 0.042. Conditional effects showed that greater fearlessness about death was associated with greater suicidal ideation among non-religious patients, b = -0.56, 95% C.I. [-0.88, -0.24], p = 0.001, but not in religious patients, b = -0.09, 95% C.I. [-0.41, 0.22], p = 0.559. CONCLUSIONS Our results suggest that fearlessness about death is a risk factor for suicidal ideation, but only among those who do not identify as religious. Results from this study inform theories of suicide and elucidate the influence of religious identity on links among suicide risk factors and suicide-related outcomes.
Collapse
Affiliation(s)
| | | | - Chloe C Hudson
- McLean Hospital, Belmont, Massachusetts, USA
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Kailyn Fan
- McLean Hospital, Belmont, Massachusetts, USA
| | - Thröstur Björgvinsson
- McLean Hospital, Belmont, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Courtney Beard
- McLean Hospital, Belmont, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
3
|
Moseley RL, Gregory NJ, Smith P, Allison C, Cassidy S, Baron-Cohen S. Potential Mechanisms Underlying Suicidality in Autistic People with Attention Deficit/Hyperactivity Disorder: Testing Hypotheses from the Interpersonal Theory of Suicide. AUTISM IN ADULTHOOD 2024; 6:9-24. [PMID: 38435325 PMCID: PMC10902282 DOI: 10.1089/aut.2022.0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Background Autistic people with co-occurring attention deficit/hyperactivity disorder (ADHD) appear to be at heightened risk of suicide. To understand why, we explored two explanatory mechanisms from the interpersonal theory of suicide: first, that co-occurring ADHD might be associated with greater risk through greater thwarted belongingness and perceived burdensomeness and, secondly, that hyperactive/impulsive features might incur additional risk through their association with painful and provocative events, which are suggested to create "capability" for suicide. Methods Autistic adults (n = 314) completed an online survey including measures of thwarted belongingness, perceived burdensomeness, painful and provocative events, acquired capability for suicide, and ADHD features. Creating an overall index of likely ADHD, we examined associations between likely ADHD, suicide ideation, and lifetime suicide attempts through the parallel mediators of thwarted belongingness, perceived burdensomeness, anxiety, and depression. In several models, we then examined hyperactive, impulsive, and inattentive features as predictors of exposure to painful and provocative events and subsequent capability for suicide, and examined whether these two variables, sequentially or individually, mediated an association with lifetime suicide attempts. Results Likely ADHD was associated with past-year suicide ideation through greater depression and perceived burdensomeness, which also mediated its association with more suicide attempts. Hyperactive and impulsive features were associated with exposure to painful and provocative events and through this acquired suicide capability. Both features were associated with more numerous suicide attempts through these two mediators sequentially, and through exposure to painful and provocative events alone. Conclusions These data suggest that suicidality in autistic people with ADHD may be partially related to perceived burdensomeness and to acquired suicide capability after exposure to painful and provocative events. However, as we observed a pathway to suicidality associated with painful and provocative events alone, it is likely that there are also other explanatory mechanisms for the influence of traumatic events on suicide risk.
Collapse
Affiliation(s)
- Rachel L. Moseley
- Department of Psychology, Bournemouth University, Poole, United Kingdom
| | - Nicola J. Gregory
- Department of Psychology, Bournemouth University, Poole, United Kingdom
| | - Paula Smith
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Carrie Allison
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Cassidy
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
4
|
Bayliss LT, Hughes CD, Lamont-Mills A, du Plessis C. Fluidity in capability: Longitudinal assessments of suicide capability using ecological momentary assessments. Suicide Life Threat Behav 2024; 54:138-153. [PMID: 38009897 DOI: 10.1111/sltb.13025] [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: 03/10/2023] [Revised: 11/02/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Suicide capability is posited to facilitate the movement from ideation-to-action. Emerging evidence suggests capability comprises both trait- and state-like facets. This study examined fluctuations in and associations of acquired, dispositional, practical, and perceived capabilities, and suicidal mental imagery, and suicidal ideation. METHOD Seventy-five adults (48 females, Mage = 36.53 years) with lived experience of suicidal ideation and/or attempt responded to four prompts per day for 2 weeks that assessed suicide capability and suicidal ideation. Mean-squared successive differences and probability of acute change indices and multilevel models were used for analyses. RESULTS All facets of suicide capability fluctuated. Acquired and dispositional capabilities were trait-like, with practical and perceived capabilities being state-like. Suicidal mental imagery was the only facet of suicide capability that distinguished participants with a suicide attempt in the past 12 months from participants with a suicide attempt more than 1 year ago and suicide ideators. Suicidal mental imagery was associated with concurrent suicidal ideation and predictive of next assessment suicidal ideation. CONCLUSION Suicidal mental imagery may be uniquely associated with suicide capability. This study suggests there are trait- and state-like facets of capability that can combine to potentially ready an individual to engage in suicidal behaviors.
Collapse
Affiliation(s)
- Luke T Bayliss
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
| | - Christopher D Hughes
- Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Andrea Lamont-Mills
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
- Academic Affairs Division, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Carol du Plessis
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
| |
Collapse
|
5
|
Hill RM, Hussain Z, Vieyra B, Gallagher A. Reporting Ethical Procedures in Suicide Prevention Research: Current Status and Recommendations. Arch Suicide Res 2023; 27:1373-1390. [PMID: 36415164 DOI: 10.1080/13811118.2022.2131493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Ethical concerns frequently arise in suicide prevention research regarding participant safety and confidentiality. Despite a substantial literature on managing and navigating ethical concerns in suicide research, little attention has been paid to the reporting of ethical procedures. Furthermore, standard procedures for reporting ethical risk management procedures have not been developed. METHOD A review of the current literature was performed to examine the current state of reporting of ethical procedures within suicide research. Articles published in 2020 (N = 263) from three suicide-focused publications were screened and then coded (n = 131) to identify reporting of procedures for the ethical conduct of research and suicide risk management steps taken by the research teams. RESULTS The majority of articles reported ethical review or approval (84.7%) and reported the use of an informed consent process (77.9%). Only 28.2% included risk mitigation procedures. Of those 29.7% of those articles reported conducting risk evaluation, 66.7% reported resource dissemination, and 51.4% reported an intervention. CONCLUSION As empirical support for brief interventions accrues, suicide prevention researchers should consider establishing standards for the reporting of procedures to ensure the safety of participants with suicidal risk.HighlightsReporting suicide safety protocols helps ensure high ethical standards in research.Fewer than 1/3 of articles reviewed reported risk mitigation procedures in 2020.Standard procedures for reporting safety protocols in suicide research are needed.
Collapse
|
6
|
Wang S, Kennedy SH, Salomons TV, Ceniti AK, McInerney SJ, Bergmans Y, Pizzagalli DA, Farb N, Turecki G, Schweizer TA, Churchill N, Sinyor M, Rizvi SJ. Resting-state neural mechanisms of capability for suicide and their interaction with pain - A CAN-BIND-05 Study. J Affect Disord 2023; 330:139-147. [PMID: 36878406 DOI: 10.1016/j.jad.2023.02.147] [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: 10/18/2022] [Revised: 02/13/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Suicidal ideation is highly prevalent in Major Depressive Disorder (MDD). However, the factors determining who will transition from ideation to attempt are not established. Emerging research points to suicide capability (SC), which reflects fearlessness of death and increased pain tolerance, as a construct mediating this transition. This Canadian Biomarker Integration Network in Depression study (CANBIND-5) aimed to identify the neural basis of SC and its interaction with pain as a marker of suicide attempt. METHODS MDD patients (n = 20) with suicide risk and healthy controls (n = 21) completed a self-report SC scale and a cold pressor task measuring pain threshold, tolerance, endurance, and intensity at threshold and tolerance. All participants underwent a resting-state brain scan and functional connectivity was examined for 4 regions: anterior insula (aIC), posterior insula (pIC), anterior mid-cingulate cortex (aMCC) and subgenual anterior cingulate cortex (sgACC). RESULTS In MDD, SC correlated positively with pain endurance and negatively with threshold intensity. Furthermore, SC correlated with the connectivity of aIC to the supramarginal gyrus, pIC to the paracingulate gyrus, aMCC to the paracingulate gyrus, and sgACC to the dorsolateral prefrontal cortex. These correlations were stronger in MDD compared to controls. Only threshold intensity mediated the correlation between SC and connectivity strength. LIMITATIONS Resting-state scans provided an indirect assessment of SC and the pain network. CONCLUSIONS These findings highlight point to a neural network underlying SC that is associated with pain processing. This supports the potential clinical utility of pain response measurement as a method to investigate markers of suicide risk.
Collapse
Affiliation(s)
- Shijing Wang
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Sidney H Kennedy
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Tim V Salomons
- Department of Psychology, Queen's University, Kingston, Canada
| | - Amanda K Ceniti
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Shane J McInerney
- Department of Psychiatry, National University of Ireland, Galway, Ireland
| | - Yvonne Bergmans
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Norman Farb
- Department of Psychology, University of Toronto Mississauga, Mississauga, Canada
| | - Gustavo Turecki
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Tom A Schweizer
- Institute of Medical Science, University of Toronto, Toronto, Canada; Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Toronto, Canada
| | - Nathan Churchill
- Neuroscience Research Program, St. Michael's Hospital, Toronto, Canada
| | - Mark Sinyor
- Department of Psychiatry, University of Toronto, Toronto, Canada; Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Sakina J Rizvi
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
| |
Collapse
|
7
|
Stewart JG, Meddaoui B, Kaufman EA, Björgvinsson T, Beard C. Changes in suicide capability during short-term partial hospital treatment. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
|
8
|
Moseley RL, Gregory NJ, Smith P, Allison C, Cassidy S, Baron-Cohen S. Non-suicidal self-injury and its relation to suicide through acquired capability: investigating this causal mechanism in a mainly late-diagnosed autistic sample. Mol Autism 2022; 13:45. [PMID: 36371252 PMCID: PMC9655904 DOI: 10.1186/s13229-022-00522-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) has been linked with a higher risk of suicide attempts in autistic and non-autistic people. In the general population, NSSI may confer acquired capability for suicide by eroding one's fear and avoidance of pain and death. The present study aimed to explore acquired capability as the mediator of increased suicide risk conferred by NSSI in autistic and non-autistic adults. METHODS Autistic and non-autistic adults (n = 314, n = 312) completed an online survey exploring lifetime suicide attempts, experience with NSSI, and acquired capability for suicide. We explored relationships between lifetime incidence of NSSI and lifetime suicide attempts via three facets of acquired capability (pain tolerance, reduced fear of death, and mental rehearsal of suicide). In self-harming participants (224 autistic and 156 non-autistic), we explored whether particular types and features of NSSI might be especially associated with capability and through that with suicide: namely engagement in scratching, cutting, and self-hitting, and engaging in more numerous forms of NSSI. RESULTS While a higher frequency of NSSI was associated with all three facets of acquired capability, only reduced fear of death and mental rehearsal of suicide mediated an indirect relationship with lifetime suicide attempts. NSSI also directly predicted more numerous suicide attempts. Autistic people tended towards reduced fear of death and mental rehearsal regardless of NSSI status. Among self-harming autistic and non-autistic participants, cutting and an increased number of NSSI behaviours were associated with lifetime suicide attempts directly and indirectly via acquired capability. In both groups, self-hitting was associated with lifetime suicide attempts only via acquired capability. LIMITATIONS Our cross-sectional methodology negates inferences of directionality. While we controlled for age, our samples were poorly matched, with the autistic group two times older on average. The autistic sample, predominantly late-diagnosed, female and highly qualified, were unrepresentative of the whole autistic community. CONCLUSIONS Our data suggest that acquired capability, as measured herein, is an incomplete explanation for the association between NSSI and suicide risk. A broader construct with stable and transient facets may offer greater explanatory power, but it is probable that other variables explain or provide additional means through which this association arises.
Collapse
Affiliation(s)
- Rachel L. Moseley
- grid.17236.310000 0001 0728 4630Department of Psychology, Bournemouth University, Talbot Campus, Fern Barrow, Poole, Dorset, BH12 5BB UK
| | - Nicola J. Gregory
- grid.17236.310000 0001 0728 4630Department of Psychology, Bournemouth University, Talbot Campus, Fern Barrow, Poole, Dorset, BH12 5BB UK
| | - Paula Smith
- grid.5335.00000000121885934Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Carrie Allison
- grid.5335.00000000121885934Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Sarah Cassidy
- grid.4563.40000 0004 1936 8868School of Psychology, University of Nottingham, Nottingham, UK
| | - Simon Baron-Cohen
- grid.5335.00000000121885934Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| |
Collapse
|
9
|
Bayliss LT, Christensen S, Lamont-Mills A, du Plessis C. Suicide capability within the ideation-to-action framework: A systematic scoping review. PLoS One 2022; 17:e0276070. [PMID: 36301944 PMCID: PMC9612581 DOI: 10.1371/journal.pone.0276070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/28/2022] [Indexed: 11/19/2022] Open
Abstract
Suicide capability is theorised to facilitate the movement from suicidal ideation to suicide attempt. Three types of contributors are posited to comprise suicide capability: acquired, dispositional, and practical. Despite suicide capability being critical in the movement from ideation-to-attempt, there has been no systematic synthesis of empirical evidence relating to suicide capability that would enable further development and refinement of the concept. This study sought to address this synthesis gap. A scoping review was conducted on suicide capability studies published January 2005 to January 2022. Eleven electronic databases and grey literature sources were searched returning 5,212 potential studies. After exclusion criteria application, 90 studies were included for final analysis. Results synthesis followed a textual narrative approach allocating studies based on contributors of suicide capability. Most studies focused on investigating only one factor within contributors. Painful and provocative events appear to contribute to acquired capability more so than fearlessness about death. Whilst emerging evidence for dispositional and practical contributors is promising, the small number of studies prevents further conclusions from being drawn. An unexpected additional cognitive contributor was identified. The focus of a single factor from most studies and the limited number of studies on contributors other than acquired capability limits the theoretical development and practical application of suicide capability knowledge. Given that suicide is a complex and multifaceted behaviour, future research that incorporates a combination of contributors is more likely to advance our understandings of suicide capability.
Collapse
|
10
|
DeMello AS, Peskin MF, Hill RM, Casarez RL, Santa Maria DM. The Impact of Bullying Victimization and Sexual Orientation on the Severity of Suicidal Behavior. VIOLENCE AND VICTIMS 2022; 37:641-658. [PMID: 36192122 DOI: 10.1891/vv-2021-0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background: Lesbian, gay, and bisexual youth face a disproportionate risk of suicidal ideation and attempt compared to heterosexual counterparts. Escalation from ideation to attempt can occur quickly, and youth who survive suicide attempts are likely to pursue subsequent, riskier attempts. This study examines the effects of bullying and sexual orientation on suicidal outcomes. Methods: Data came from the national, school-administered 2017 Youth Risk Behavior Survey (N = 14,765). Bivariate associations, binomial logistic regressions, and ordinal logistic regressions were performed. Results: Lesbian/gay, bisexual, and unsure youth reported greater odds of ideation and attempts compared to heterosexual youth. For ideation, increased effects were inconsistent across bullying types and significant interactions were found for bisexual youth who were bullied in school, and for lesbian/gay youth who were cyberbullied. Conclusion: These results underscore the need to understand bullying victimization for lesbian, gay, and bisexual youth. Awareness of increasing cyberbullying and creating school environments of no-bullying tolerance in the post-pandemic era are among the challenges ahead.
Collapse
Affiliation(s)
- Annalyn S DeMello
- The University of Texas, Medical Branch, School of Nursing, Galveston, Texas, USA
| | - Melissa F Peskin
- The University of Texas Health Science Center, School of Public Health, Houston, Texas, USA
| | - Ryan M Hill
- Baylor College of Medicine and Texas Children's Hospital, Section of Psychology, Houston, Texas, USA
| | - Rebecca L Casarez
- The University of Texas Health Science Center, Cizik School of Nursing, Houston, Texas, USA
| | - Diane M Santa Maria
- The University of Texas Health Science Center, Cizik School of Nursing, Houston, Texas, USA
| |
Collapse
|
11
|
Ahmadboukani S, Ghamari Kivi H, Kiani A, Rezaeisharif A. Structural validity of the Persian version of the Suicide Capacity Scale among Iranian college students. Perspect Psychiatr Care 2022; 58:2190-2198. [PMID: 35141900 DOI: 10.1111/ppc.13046] [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: 10/05/2021] [Revised: 01/25/2022] [Accepted: 01/29/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This study was the first step in translating the Suicide Capacity scale (SCS-3) from English to Persian and then determining its structural validity in a sample of Iranian students. METHODS The sample consisted of 600 participants selected by the convenience sampling method and answered the questionnaires of the Suicide Behaviors Questionnaire-Revised (SBQ-R) Depressive Symptom Index-Suicidality Subscale (DSI-SS), suicide attempt, and suicidal capacity(SCS-3). RESULTS The single-group factor analysis suggested that the three-factor model shows the goodness of fit with the data. PRACTICAL IMPLICATIONS Suicide capacity is a psychometric tool that can be included in public health studies, health psychology, and empirical research to identify suicide-related behaviors in different populations.
Collapse
Affiliation(s)
- Soliman Ahmadboukani
- Department of Counseling, Faculty of Education and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Hosein Ghamari Kivi
- Department of Counseling, Faculty of Education and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Ahmadreza Kiani
- Department of Counseling, Faculty of Education and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Ali Rezaeisharif
- Department of Counseling, Faculty of Education and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| |
Collapse
|
12
|
The relevance of the interpersonal theory of suicide for predicting past-year and lifetime suicidality in autistic adults. Mol Autism 2022; 13:14. [PMID: 35313974 PMCID: PMC8935684 DOI: 10.1186/s13229-022-00495-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 03/10/2022] [Indexed: 12/19/2022] Open
Abstract
Background While there are known risk factors for suicidality in autistic adults, these are often unconnected from theoretical frameworks that might explain why risk is elevated and guide clinical interventions. The present study investigated the relevance of constructs from the Interpersonal Theory of Suicide (ITS), including perceived burdensomeness, thwarted belongingness and acquired capability for suicide, and explored mechanisms through which certain risk factors (relationship status, age at diagnosis) might elevate suicide risk. Methods Autistic adults (n = 314) completed an online study including measures of depression, anxiety and constructs from the ITS. Linear and multinomial regression analysis disentangled contributions of ITS variables from effects of depression and anxiety for past-year suicide ideation, past-year and lifetime suicide attempts. Mediation analyses examined associations between risk factors and these suicide outcomes via mechanisms proposed by the ITS. Results Past-year suicide ideation was associated with burdensomeness, mental rehearsal of suicide plans (a facet of acquired capability), and depression. Greater feelings of burdensomeness, and reduced fear of death, marked out participants who had attempted suicide in comparison to those who had experienced suicide ideation in the past year. Relationship status was indirectly associated with past-year suicide ideation via the mediators of depression and burdensomeness, and was associated with past-year attempts via its effect on ideation. Age at diagnosis was unrelated to any variables. Limitations Cross-sectional research is insensitive to causality and temporal dynamics, which is likely why interaction hypotheses from the ITS were unsupported. Normative measures may be invalid in autistic samples. There was no control group. The autistic sample was unrepresentative of the whole population, particularly autistic people with intellectual disabilities, ethnic/racial minorities, and gender minorities. Conclusions Perceived burdensomeness and acquired capability appear potentially important to suicide in autistic people, and may mediate the effects of some risk factors. Future research should explore the temporal dynamics of suicide trajectories in longitudinal, prospective designs. Supplementary Information The online version contains supplementary material available at 10.1186/s13229-022-00495-5.
Collapse
|
13
|
Krantz SM, Heerschap J, Balzen KM, Sachs R, Kennard BD, Emslie GJ, Stewart SM. Fearlessness about death and suicide planning predict lethality of adolescent suicide attempts during and following treatment. J Clin Psychol 2022; 78:1540-1553. [PMID: 35118642 DOI: 10.1002/jclp.23324] [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: 08/30/2021] [Revised: 12/14/2021] [Accepted: 01/22/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The rate of adolescent suicide attempt has increased drastically over the past 10 years. However, little is known regarding what predicts a more versus less lethal attempt, which is of critical interest to clinicians managing this at-risk population. We sought to extend the study of lethality in adolescents by exploring its relationship with two recognized risk-factors for suicide attempt: fearlessness about death (FAD) and suicide planning. METHODS Participants (N = 254) were administered measures of FAD and depressive symptoms upon entering intensive outpatient treatment for adolescents exhibiting suicidal thoughts and behaviors. Attempts made between treatment entry and 6 months following discharge (n = 47) were scored on a 4-point ordinal scale of lethality. The resulting continuum ranged from no attempt to attempts of low to moderate levels of lethality. RESULTS FAD and suicide planning distinguished between levels of lethality of future attempt at the bivariate and multivariate level. FAD's predictive relationship with lethality while controlling for age, sex, depression, and prior attempt diminished when suicide planning was covaried. CONCLUSION FAD and suicide planning significantly predicted more versus less lethal future attempts in our sample of adolescents in a clinical setting. Our findings suggest that FAD influences the lethality of a future attempt by promoting planning for suicide. More studies are needed to assess whether the brief FAD scale might be a valuable adjunct in the clinical management of youth with suicidal thoughts and behaviors.
Collapse
Affiliation(s)
- Savannah M Krantz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jessica Heerschap
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Division of Psychology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Psychiatry, Children's Health Children's Medical Center, Dallas, Texas, USA
| | - Kennedy M Balzen
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Raney Sachs
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Betsy D Kennard
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Division of Psychology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Psychiatry, Children's Health Children's Medical Center, Dallas, Texas, USA
| | - Graham J Emslie
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Psychiatry, Children's Health Children's Medical Center, Dallas, Texas, USA
| | - Sunita M Stewart
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Division of Psychology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Psychiatry, Children's Health Children's Medical Center, Dallas, Texas, USA
| |
Collapse
|
14
|
Pan YJ, Loi MX, Lan YH, Chen CL, Cheng IC. Perceptions towards charcoal-burning suicide and the surge of this lethal method in Taiwan. PLoS One 2022; 17:e0262384. [PMID: 35061796 PMCID: PMC8782296 DOI: 10.1371/journal.pone.0262384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/23/2021] [Indexed: 11/18/2022] Open
Abstract
Objective
Whether sociocultural perceptions of charcoal-burning suicide have influenced its rapid increase in prevalence is unclear. We aimed to explore perceptions of Taiwan’s general population regarding charcoal-burning suicide, their personal belief in life after death, and related feelings of thoughts associated with those who attempt charcoal-burning suicide.
Methods
An online web-based survey, focussing on sociocultural attitudes towards death, as well as perceptions towards charcoal-burning suicide, and those who attempt charcoal-burning suicide, was conducted from 14 January to 14 June 2016.
Results
In total, 1343 adults completed the online survey (mean age of 33.46; 66.6% women). Notably, 90.3% of participants considered charcoal burning to be an easily accessible suicide method. Multivariable analyses revealed that among the examined factors, the perceived ‘painlessness’ of charcoal-burning suicide was associated with an over seven-fold increased risk of choosing charcoal-burning suicide (OR = 7.394; p < 0.001; 95% CI: 2.614–20.912).
Conclusion
As reflected in this study, charcoal-burning suicide is perceived as easily accessible and painless. The perceived ‘painlessness’ may be the factor that distinguishes the choice of charcoal-burning suicide from that of other suicide methods. Future efforts to target these perceptions regarding charcoal-burning suicide may be warranted in both media reporting and suicide prevention programmes.
Collapse
Affiliation(s)
- Yi-Ju Pan
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- * E-mail: ,
| | - Mei-Xian Loi
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yin-Hsiang Lan
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chun-Lin Chen
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Center for General Education, Taipei Medical University, Taipei, Taiwan
| | - I-Chih Cheng
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| |
Collapse
|
15
|
Bond AE, Anestis MD. Understanding Capability and Suicidal Ideation among First Responders. Arch Suicide Res 2021; 27:295-306. [PMID: 34699734 DOI: 10.1080/13811118.2021.1993397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The present study seeks to determine differences in lifetime suicidal ideation, dispositional capability, acquired capability, and practical capability among those who have and have not served as first responders, and among subgroups of first responders. METHODS Data were collected as part of a large online (n = 3,500) study seeking to understand firearm ownership in the United States. Participants were recruited via Qualtrics Panels and were demographically matched to the 2010 US census. Binary logistic regressions and an exploratory multinomial logistic regression examined differences between first responders and non-first responders and among subgroups of first responders. RESULTS First responders reported more lifetime suicidal ideation and higher acquired, practical, and dispositional capability than did non-first responders. Findings indicated that first responders with and without military affiliation did not differ in terms of suicidal ideation or capability for suicide. Lastly, law enforcement officers (LEOs) reported more lifetime suicidal ideation than emergency medical technicians (EMTs). LEOs, EMTs, and firefighters did not differ in terms of capability for suicide. DISCUSSION The findings highlight that suicidal ideation and capability for suicide differ between first responders and non-first responders and among subgroups of first responders. The mechanisms driving the increased rates of suicidal ideation and capability among first responders are unknown; however, it is likely due to a combination of personal and occupational factors. Although not without its limitations, the present study provides an understanding of suicide risk among first responders.
Collapse
|
16
|
Shahnaz A, Klonsky ED. Clarifying the association of eating disorder features to suicide ideation and attempts. J Clin Psychol 2021; 77:2965-2977. [PMID: 34668573 DOI: 10.1002/jclp.23266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/01/2021] [Accepted: 10/06/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE We examine the relationships of eight eating disorder (ED) features to histories of suicide ideation and suicide attempts. METHOD Participants were 387 adults (62% female, mean age = 36 years) recruited via an online platform, and oversampled for the presence of ED features, who completed standardized self-report measures of study variables. RESULTS Different ED features predicted suicide ideation versus attempts. Specifically, Restrictive Eating (d = 0.44), Purging (d = 0.30), and Body Dissatisfaction (d = 0.27) were higher among ideators compared to nonsuicidal participants. In contrast, Muscle Building (d = 0.31), Excessive Exercise (d = 0.26), Cognitive Restraint (d = 0.23), and Restrictive Eating (d = 0.20) were higher among attempters compared to ideators-however, we note that the p-values for these effects range between 0.02 and 0.04 and it is unclear if they would replicate. Independent replication is important. CONCLUSION Findings have implications for the conceptualization of suicide risk in individuals with EDs.
Collapse
Affiliation(s)
- Arezoo Shahnaz
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - E David Klonsky
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|