What matters for adolescent suicidality: Depressive symptoms or fixed mindsets? Examination of cross-sectional and longitudinal associations between fixed mindsets and suicidal ideation

Modeling the associations between emotion regulation, suicide crisis syndrome and suicidal behavior: Results in community and clinical samples

BACKGROUND

Emotion Regulation (ER) and Suicide Crisis Syndrome (SCS) are psychological processes involved in suicide. Within ER, both the use of rumination and dysfunctional emotion beliefs are associated with suicide. SCS, a pre-suicidal mental state involving cognitive and affective dysregulation, is related to short-term suicide risk.

AIMS

Here, we first examined associations between ER (beliefs about the uncontrollability of emotions and rumination), SCS and suicide behavior, and second, we test a multistep model in which ER factors are linked to suicide behavior through SCS.

MATERIALS & METHODS

We conducted two cross-sectional studies to address this issue by self-reports. Study 1 used a community sample (N = 421). Study 2 used a clinical sample (N = 70).

RESULTS

Results from both studies showed that beliefs about the uncontrollability of emotions and rumination were associated with higher levels of SCS symptoms and suicide behavior, and that SCS was associated with suicide behavior. In addition, path analyses showed that uncontrollability beliefs were linked to rumination, which in turn was associated with SCS, and this variable mediated the association between ER factors and suicide ideation (in both community and clinical samples) and suicide attempts (in the community sample).

DISCUSSION

As we expected, in both samples, uncontrollability of emotions and rumination were positively related with SCS and suicide behavior.

CONCLUSION

We emphasize the importance of addressing uncontrollability beliefs and rumination in suicide prevention.

Single-session intervention on growth mindset on negative emotions for university student mental health (U-SIGMA): a protocol of two-armed randomized controlled trial

BACKGROUND

The university years are a developmentally crucial phase and a peak period for the onset of mental disorders. The beliefs about the changeability of negative emotion may play an important role in help-seeking. The brief digital growth mindset intervention is potentially scalable and acceptable to enhance adaptive coping and help-seeking for mental health needs in university students. We adapted the Single-session Intervention on Growth Mindset for adolescents (SIGMA) to be applied in university students (U-SIGMA). This protocol introduces a two-armed waitlist randomized controlled trial study to examine the effectiveness and acceptability of U-SIGMA in promoting help-seeking among university students in the Greater Bay Area.

METHODS

University students (N = 250, ages 18-25) from universities in the Greater Bay Area will be randomized to either the brief digital growth mindset intervention group or the waitlist control group. Participants will report on the mindsets of negative emotions, perceived control over anxiety, attitude toward help-seeking, physical activity, hopelessness, psychological well-being, depression, anxiety, and perceived stress at baseline and the 2-week and 8-week follow-ups through web-based surveys. A 30-min digital intervention will be implemented in the intervention group, with a pre- and post-intervention survey collecting intervention feedback, while the control group will receive the link for intervention after 8 weeks.

DISCUSSION

This protocol introduces the implementation plan of U-SIMGA in multi-cities of the Greater Bay Area. The findings are expected to help provide pioneer evidence for the effectiveness and acceptability of the brief digital intervention for university students in the Chinese context and beyond and contribute to the development of accessible and effective prevention and early intervention for university students' mental health.

TRIAL REGISTRATION

HKU Clinical Trials Registry: HKUCTR-3012; Registered 14 April 2023.  http://www.hkuctr.com/Study/Show/7a3ffbc0e03f4d1eac0525450fc5187e .

Examination of Web-Based Single-Session Growth Mindset Interventions for Reducing Adolescent Anxiety: Study Protocol of a 3-Arm Cluster Randomized Controlled Trial

BACKGROUND

Anxiety disorders are the most common mental disorders worldwide. In Hong Kong, 7% of adolescents are diagnosed with anxiety disorders, and 1 in every 4 secondary school students reports clinical-level anxiety symptoms. However, 65% of them do not access services. Long waitlists in public services, the high cost of private services, or the fear of being stigmatized can hinder service access. The high prevalence of anxiety and low intervention uptake indicate a pressing need to develop timely, scalable, and potent interventions suitable for adolescents. Single-session interventions (SSIs) have the potential to be scalable interventions for diagnosable or subclinical psychopathology in adolescents. Providing precise and context-adapted intervention is the key to achieving intervention efficacy.

OBJECTIVE

This study aims to compare the effectiveness of three SSIs: single-session intervention of growth mindset on negative emotions (SIGMA), SSI of growth mindset of personality (SSI-GP), and active control, in reducing adolescent anxiety.

METHODS

Adolescents (N=549, ages 12-16 years) from secondary schools will be randomized to 1 of 3 intervention conditions: the SIGMA, SSI-GP, or active control. The implementation of each intervention is approximately 45 minutes in length. Adolescent participants will report anxiety symptoms (primary outcome), perceived control, hopelessness, attitude toward help-seeking, and psychological well-being at preintervention, the 2-week follow-up, and the 8-week follow-up. A pilot test has confirmed the feasibility and acceptability of SIGMA among adolescents. We hypothesized that SIGMA and SSI-GP will result in a larger reduction in anxiety symptoms than the control intervention during the posttest and 8-week follow-up period. We also predict that SIGMA will have a more significant effect than SSI-GP. We will use the intention-to-treat principle and linear regression-based maximum likelihood multilevel models for data analysis.

RESULTS

This study will be conducted from December 2022 to December 2023, with results expected to be available in January 2024.

CONCLUSIONS

This protocol introduces the implementation content and strategies of growth mindset SSIs (consists of 2 forms: SIGMA and SSI-GP) among school students. The study will provide evidence on the efficacy of different growth mindset SSIs for adolescent anxiety. It will also establish implementation strategies for self-administrative SSIs among school students, which can serve as a pioneer implementation of a scalable and self-accessible brief intervention to improve the well-being of young people.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05027880; https://clinicaltrials.gov/ct2/show/NCT05027880.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/41758.

Risk and protective factors in suicidal behaviour among young people in Hong Kong: A comparison study between children and adolescents✰

Suicide is the leading cause of death among young people worldwide. Few studies examined the factors of childhood suicidality and compared them with adolescent suicidality to meet their age-specific needs. We examined the similarities and differences in risk and protective factors of children and adolescent suicidality in Hong Kong. A school-based survey with 541 students in grades 4-6 and 3,061 students in grades 7-11 from 15 schools was conducted. We measured the demographic, familial, school, mental health, and psychological factors of suicidality. Hierarchical binary logistic regressions were performed to examine the association between correlates and child and youth suicidality, and the interaction effects of these factors and school-age groups. Approximately 17.51% and 7.84% of secondary school respondents and 15.76% and 8.17% of primary school respondents reported suicidal ideation and attempt, respectively. Common correlates for suicidal ideation were depression, bullying, loneliness, self-compassion, and growth mindset, while those for suicide attempt were depression and bullying. Secondary school respondents with higher life satisfaction reported less suicidal ideation, while primary school respondents with higher self-control reported fewer suicide attempts. In conclusion, we recommended recognizing the factors of suicidal ideation and attempt in children and adolescents to tailor preventive strategies in a culturally sensitive manner.