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Chabbouh A, Charro E, Al Tekle GA, Soufia M, Hallit S. Psychometric properties of an Arabic translation of the short entrapment scale in a non-clinical sample of young adults. PSICOLOGIA-REFLEXAO E CRITICA 2024; 37:3. [PMID: 38236551 PMCID: PMC10796859 DOI: 10.1186/s41155-024-00286-2] [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: 10/17/2023] [Accepted: 01/06/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Entrapment is the feeling of wanting to leave an unbearable situation but believing that there are no options to do so. An Arabic entrapment Scale will assist healthcare professionals in the region in the prevention of suicide as the tool is tailored to the specific sociocultural context, which would enhance entrapment detection. OBJECTIVE In the current study, we aim to evaluate the psychometric properties of a translated Arabic version of the Entrapment Scale Short Form (E-SF). METHODS Three hundred eighty-nine Lebanese citizens were enrolled in this cross-sectional study. RESULTS The mean age of participants was 23.03 years (SD = 2.93), 69.4% being women. To examine the factor structure of the entrapment scale, we used an exploratory-to-confirmatory factor analysis (EFA-to-CFA) strategy. EFA and CFA results indicated that the fit of the unidimensional model of the Arabic Entrapment Scale (A-ES) was generally acceptable. Composite reliability of scores was adequate in the total sample (ω = .87). All indices suggested that configural, metric, and scalar invariance was supported across genders. Entrapment was positively and significantly correlated with suicidal ideation, alcohol use disorder, psychological distress, and orthorexia nervosa, suggesting convergent and divergent validity. CONCLUSION The A-ES was found to be a valid and reliable tool to assess the degree of entrapment in Lebanese young adults. The A-ES will assist healthcare professionals in the region in the prevention of suicide as the tool is tailored to the specific sociocultural context, which would enhance entrapment detection.
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Affiliation(s)
- Alfred Chabbouh
- Faculty of Medical Sciences, Lebanese University, Hadat, Lebanon
| | - Elie Charro
- Faculty of Medical Sciences, Lebanese University, Hadat, Lebanon
| | - Georges-Alain Al Tekle
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Michel Soufia
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
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Menon V, Balasubramanian I, Rogers ML, Grover S, Lakdawala B, Ranjan R, Sarkhel S, Nebhinani N, Kallivayalil RA, Raghavan V, Mishra KK, Aneja J, Abhivant N, Deep R, Singh LK, De Sousa A, Nongpiur A, Subramanyam AA, Mohapatra D, Kar SK, Dhiman V, Kumar PNS, Shreekantiah U, Bhandari SS, Ransing R, Ramasubramanian V, Praharaj SK. Factor structure, reliability, and validity of the revised Suicide Crisis Inventory in major depression: A multicentric Indian study. J Affect Disord 2024; 345:226-233. [PMID: 37898473 DOI: 10.1016/j.jad.2023.10.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/07/2023] [Accepted: 10/15/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND The revised Suicide Crisis Inventory (SCI)-2 is a self-report measure to assess the suicide crisis syndrome (SCS). We aimed to assess the factor structure, reliability, and validity of SCI-2 among adults with major depression. METHODS Using a cross-sectional design, between November 2021 and August 2022, the Hindi SCI-2, along with other self-report measures, was administered to Indian adult respondents clinically diagnosed with major depression across 24 centers in India. Confirmatory factor analysis was carried out to test the factor structure of SCI-2. Additionally, convergent, discriminant, and criterion validity were tested using bivariate or biserial correlations, as appropriate. RESULTS We obtained responses from 654 participants (Mean age = 36.9 ± 11.9 years, 50.2 % female). The SCI-2 fit both a one-factor (χ2[1769] = 14,150.74, p < .001, CFI = 0.98, RMSEA = 0.10), and five-factor solution (χ2[1759] = 13,130.83, p < .001,CFI = 0.98, RMSEA = 0.10) with the five-factor solution providing a significantly better fit. Internal consistencies of the SCI-2 total and subscale scores ranged from good to excellent. Most subscales significantly converged with each other and with other relevant measures although these associations were weak for thwarted belongingness and goal reengagement subscales. Small to moderate associations were noted in support of discriminant and criterion validity. LIMITATIONS We could not assess the predictive validity of SCI-2 for suicidal behaviors. CONCLUSION Consistent with prior data, the Hindi SCI-2 fit a five-factor solution and showed good psychometric properties. These findings support the use of SCI-2 to assess SCS among Indian adults with major depression.
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Affiliation(s)
- Vikas Menon
- Dept of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India.
| | - Ilambaridhi Balasubramanian
- Dept of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India
| | - Megan L Rogers
- Dept of Psychology, Texas State University, TX 78666 4684, USA
| | - Sandeep Grover
- Dept of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | | | - Rajeev Ranjan
- Dept of Psychiatry, All India Institute of Medical Sciences (AIIMS), Patna 801507, India
| | - Sujit Sarkhel
- Dept of Psychiatry, Institute of Psychiatry, Kolkata 700025, India
| | - Naresh Nebhinani
- Dept of Psychiatry, All India Institute of Medical Sciences (AIIMS), Jodhpur 342005, India
| | - Roy Abraham Kallivayalil
- Dept of Psychiatry, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla 689101, Kerala, India
| | - Vijaya Raghavan
- Dept of Psychiatry, Schizophrenia Research Foundation (SCARF), Chennai 600101, India
| | - Kshirod Kumar Mishra
- Dept of Psychiatry, Mahatma Gandhi Institute of Medical Science (MGIMS), Sevagram, Maharashtra 442102, India
| | - Jitender Aneja
- Dept of Psychiatry, All India Institute of Medical Sciences (AIIMS), Bhatinda, Punjab 151001, India
| | - Niteen Abhivant
- Dept of Psychiatry, Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune 411001, India
| | - Raman Deep
- Dept of Psychiatry, All India Institute of Medical Sciences (AIIMS), Delhi 110029, India
| | - Lokesh Kumar Singh
- Dept of Psychiatry, All India Institute of Medical Sciences (AIIMS), Raipur, Chhattisgarh 492009, India
| | - Avinash De Sousa
- Dept of Psychiatry, Lokmanya Tilak Municipal Medical College (LTMMC), Mumbai 400022, India
| | - Arvind Nongpiur
- Dept of Psychiatry, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya 793018, India
| | - Alka A Subramanyam
- Dept of Psychiatry, Topiwala National Medical College and Bai Yamunabai Laxmanrao (BYL) Nair Charitable Hospital, Mumbai 400008, India
| | - Debadatta Mohapatra
- Dept of Psychiatry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha 751019, India
| | - Sujita Kumar Kar
- Dept of Psychiatry, King George's Medical University (KGMU), Lucknow, Uttar Pradesh 226003, India
| | - Vishal Dhiman
- Dept of Psychiatry, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand 249203, India
| | - P N Suresh Kumar
- Dept of Psychiatry, Iqraa International Hospital and Research Center, Calicut, Kerala 673009, India
| | - Umesh Shreekantiah
- Dept of Psychiatry, Central Institute of Psychiatry (CIP), Ranchi, Jharkhand 834006, India
| | - Samrat Singh Bhandari
- Dept of Psychiatry, Sikkim Manipal Institute of Medical Sciences (SMIMS), Sikkim Manipal University, Tadong, Gangtok, Sikkim 737102, India
| | - Ramdas Ransing
- Dept of Psychiatry, All India Institute of Medical Sciences (AIIMS), Guwahati, Assam 781101, India
| | | | - Samir Kumar Praharaj
- Dept of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India
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Udupa NS, Hanson J, Gutierrez PM, Mandel AA, Johnson SL, Kleiman E, Bryan CJ, Jobes DA, Joiner T. Uncontrollability of suicidal ideation adds incremental explanatory power in prediction of later suicidal ideation. J Clin Psychol 2023; 79:2974-2985. [PMID: 37672631 DOI: 10.1002/jclp.23593] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/21/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVE Suicidal ideation and suicidal behaviors are major public health concerns in the United States and are difficult to treat and predict. Risk factors that are incrementally informative are needed to improve prediction and inform prevention of suicidal thoughts and behaviors. Uncontrollability of suicidal ideation, one parameter of suicidal ideation, is one such candidate. METHOD In the current study, we assessed the predictive power of uncontrollability of suicidal ideation, over and above overall suicidal ideation, for future suicidal ideation in a large sample of active-duty service members. A total of 1044 suicidal military service members completed baseline assessments, of whom 664 (63.6%) completed 3-month follow-up assessments. RESULTS While baseline overall suicidal ideation itself was the strongest predictor of future suicidal ideation, uncontrollability of suicidal ideation added some incremental explanatory power. CONCLUSION Further study of uncontrollability of suicidal thought is needed to elucidate its impact on suicidal outcomes.
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Affiliation(s)
- Nikhila S Udupa
- Military Suicide Research Consortium, Tallahassee, Florida, USA
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Jetta Hanson
- Military Suicide Research Consortium, Tallahassee, Florida, USA
- Rocky Mountain Mental Illness Research, Education and Clinical Center, Aurora, Colorado, USA
| | - Peter M Gutierrez
- Military Suicide Research Consortium, Tallahassee, Florida, USA
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
- Rocky Mountain Mental Illness Research, Education and Clinical Center, Aurora, Colorado, USA
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Abby A Mandel
- Department of Psychology, The Catholic University of America, Washington, USA
| | - Sheri L Johnson
- Department of Psychology, University of California Berkeley, Berkeley, California, USA
| | - Evan Kleiman
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Craig J Bryan
- Ohio State University College of Medicine, Columbus, Ohio, USA
| | - David A Jobes
- Department of Psychology, The Catholic University of America, Washington, USA
| | - Thomas Joiner
- Military Suicide Research Consortium, Tallahassee, Florida, USA
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
- Rocky Mountain Mental Illness Research, Education and Clinical Center, Aurora, Colorado, USA
- University of Colorado School of Medicine, Aurora, Colorado, USA
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Rasmussen S, Cramer RJ, Nascimbene L, Robertson RA, Cacace S, Bowling J. A qualitative assessment and short-term mediation analysis of defeat, entrapment, and suicide. Suicide Life Threat Behav 2023; 53:880-892. [PMID: 37571915 DOI: 10.1111/sltb.12990] [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: 01/12/2023] [Revised: 04/27/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVES The Integrated Motivational-Volitional Model (IMV) of Suicide is growing in empirical support. The present study advances IMV research through two aims: (1) to qualitatively probe the subjective experiences of defeat, internal entrapment, and external entrapment, and (2) conducting a 3-month prospective mediation analysis using quantitative and qualitative metrics of defeat and entrapment. METHODS The study featured an online two-point survey separated by 3 months. Participants were 255 adults living in the United Kingdom. RESULTS Persons endorsing qualitative defeat and internal entrapment in their narratives also showed higher quantitative scores on corresponding IMV and suicide-related self-report scales. Internal entrapment mediated the effect of baseline defeat on 3-month suicidal ideation, whereas external entrapment mediated the association of baseline defeat on 3-month suicide attempt likelihood. Quantitative assessment of entrapment was more significantly associated with suicide attempts and ideation within mediation tests compared to corresponding qualitative variables. CONCLUSIONS IMV model principles are largely supported by findings. Mediation results support further consideration of entrapment and defeat within clinical practice and public health-focused suicide research. Understanding the complexity of entrapment narratives represents an important next step for conducting qualitative IMV-focused research with minoritized and high-risk suicide populations.
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Affiliation(s)
- Susan Rasmussen
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Robert J Cramer
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Laura Nascimbene
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Ryan A Robertson
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Sam Cacace
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Jessamyn Bowling
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
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Kissane DW, Bobevski I, Appleton J, Michael N, King T, Moss G, Eng D, White A, Carboon D, Eade R, Keighley L. Real World Experience of Change in Psycho-Existential Symptoms in Palliative Care. J Pain Symptom Manage 2023; 66:212-220.e2. [PMID: 37290732 DOI: 10.1016/j.jpainsymman.2023.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/21/2023] [Accepted: 05/30/2023] [Indexed: 06/10/2023]
Abstract
CONTEXT Psycho-existential symptoms in palliative care are addressed insufficiently. Routine screening, ongoing monitoring and meaningful treatment of psycho-existential symptoms may contribute to the relief of suffering in palliative care. OBJECTIVES We sought to explore longitudinal change in psycho-existential symptoms following the routine implementation of the Psycho-existential Symptom Assessment Scale (PeSAS) in Australian palliative care services. METHODS Using a multisite rolling design, we implemented the PeSAS to longitudinally monitor symptoms in a cohort of 319 patients. We assessed change scores for each symptom in groups with mild (≤3), moderate (4-7) and severe (≥8) symptomatology at baseline. We tested significance between these groups and used regression analyses to identify predictors. RESULTS While one half of patients denied clinically important psycho-existential symptoms, for the remainder, overall, more patients improved than deteriorated. Between 20% and 60% of patients with moderate and severe symptoms improved, while another 5%-25% developed new symptom distress. Patients with severe baseline scores improved significantly more than those with moderate baseline scores. CONCLUSION As we better recognize through screening patients carrying psycho-existential distress in palliative care programs, there is considerable room for improvement in ameliorating this suffering. Inadequate clinical skills, poor psychosocial staffing or a biomedical program culture may all contribute to inadequate symptom control. Person-centered care necessitates greater attention to authentic multidisciplinary care that ameliorates psycho-spiritual and existential distress.
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Affiliation(s)
- David W Kissane
- School of Medicine (D.W.K., I.B., J.A., N.M.), University of Notre Dame Australia, Fremantle, Australia; St. Vincent's Hospital (D.W.K., J.A.), Sydney, New South Wales, Australia; Cabrini Health (D.W.K., I.B., N.M., L.K.), Melbourne, Victoria, Australia; School of Clinical Sciences (D.W.K., I.B., N.M., D.C.), Monash University, Victoria, Australia.
| | - Irene Bobevski
- School of Medicine (D.W.K., I.B., J.A., N.M.), University of Notre Dame Australia, Fremantle, Australia; Cabrini Health (D.W.K., I.B., N.M., L.K.), Melbourne, Victoria, Australia; School of Clinical Sciences (D.W.K., I.B., N.M., D.C.), Monash University, Victoria, Australia
| | - Jane Appleton
- School of Medicine (D.W.K., I.B., J.A., N.M.), University of Notre Dame Australia, Fremantle, Australia; St. Vincent's Hospital (D.W.K., J.A.), Sydney, New South Wales, Australia
| | - Natasha Michael
- School of Medicine (D.W.K., I.B., J.A., N.M.), University of Notre Dame Australia, Fremantle, Australia; Cabrini Health (D.W.K., I.B., N.M., L.K.), Melbourne, Victoria, Australia; School of Clinical Sciences (D.W.K., I.B., N.M., D.C.), Monash University, Victoria, Australia
| | - Tania King
- Eastern Palliative Care (T.K.), Victoria, Australia
| | - Graham Moss
- Clare Holland House (G.M.), Canberra, New South Wales, Australia
| | - Derek Eng
- Royal Perth Hospital (D.E., A.W.), Perth, Australia
| | - Alison White
- Royal Perth Hospital (D.E., A.W.), Perth, Australia; St. John of God Murdoch Community Hospice (A.W.), Murdoch, WA, Australia
| | - Danielle Carboon
- School of Clinical Sciences (D.W.K., I.B., N.M., D.C.), Monash University, Victoria, Australia
| | - Rachel Eade
- Eastern Health (R.E.), Melbourne, Victoria, Australia
| | - Luka Keighley
- Cabrini Health (D.W.K., I.B., N.M., L.K.), Melbourne, Victoria, Australia
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Zhang Y, Ding X, Chen J, Liu Y, Wang G, Hu D. Moderating effects of suicide resilience and meaning in life on the association between entrapment and suicidal ideation in Chinese patients with ovarian cancer: a cross-sectional study. BMC Psychiatry 2023; 23:585. [PMID: 37568099 PMCID: PMC10416398 DOI: 10.1186/s12888-023-05057-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Numerous studies have confirmed that patients with ovarian cancer have a relatively high risk of suicidality. Early identification of psychological factors related to suicidal ideation in patients with ovarian cancer may provide effective information for suicide prevention strategies. This study aimed to investigate whether and how suicide resilience and meaning in life moderate the relationship between entrapment and suicidal ideation in patients with ovarian cancer. METHODS This was a cross-sectional investigation was conducted in 505 Chinese patients with ovarian cancer. Patients completed a battery of self-reported questionnaires that included the General Information Questionnaire, and Chinese versions of the Entrapment Scale, Scale for Suicidal Ideation, Suicide Resilience Inventory-25, and Meaning in Life Scale. Descriptive statistics, Pearson' s chi-square, Pearson' s correlation, and hierarchical multiple linear regression analysis were performed. RESULTS In this study, the prevalence of suicidal ideation reported by patients with ovarian cancer was 32.07%. Patients' suicidal ideation could be explained by the following three predictors: entrapment × suicide resilience × meaning in life (β = -0.169, p < 0.001), entrapment × suicide resilience (β = -0.148, p < 0.001), and entrapment × meaning in life (β = -0.107, p = 0.005). CONCLUSION These findings suggest that ovarian cancer patients are prone to suicidal ideation when they feel a sense of entrapment. Enhancing patients' suicide resilience and meaning in life may be two targeted interventions to reduce suicidal ideation in ovarian cancer patients. In particular, considering both the protective effects of suicide resilience and meaning in life may yield better suicide prevention outcomes than considering only one of these factors.
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Affiliation(s)
- Yinying Zhang
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiaoping Ding
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jie Chen
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yilan Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Gang Wang
- Wuhan Mental Health Center, Wuhan, 430010, China
| | - Deying Hu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Wang C, Keilp JG, Galfalvy H, Bridge JA, Sheftall AH, Szanto K. Entrapment and social problem-solving in suicidal behavior across the adult lifespan. J Affect Disord 2023; 329:176-183. [PMID: 36842650 PMCID: PMC10033364 DOI: 10.1016/j.jad.2023.02.099] [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: 11/21/2022] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 02/28/2023]
Abstract
BACKGROUND Feelings of entrapment and deficits in social problem-solving skills have been associated with risk for suicidal behavior in the context of depression. However, few studies have examined the effect of age on the association between these risk factors and suicidal behavior across most of the adult lifespan. METHODS In a three-site study, we tested interactions of age with feelings of entrapment and social problem-solving style in 105 depressed patients with a recent suicide attempt, 95 depressed patients with no history of suicide attempt, and 97 demographically similar non-psychiatric participants (age 16-80). Attempter/non-attempter differences, age interactions, and the relative contribution of entrapment and social problem-solving style to past attempter were examined. RESULTS Entrapment significantly interacted with age such that it discriminated past attempters from depressed non-attempters better at older ages. Social Problem-Solving Inventory (SPSI) total score and most subscales did not distinguish past attempters, but the SPSI Impulsive Style Problem-Solving was an effective discriminator of past suicide attempts across the full adult lifespan and did not interact with age. In a multipredictor model, both the entrapment by age interaction and SPSI Impulsive Style Problem-Solving score were significant predictors for the classification of attempters. LIMITATIONS The cross-sectional nature of our research design limited conclusions that may be drawn about individual change over time or cohort effects. CONCLUSIONS Entrapment did not distinguish past attempters at younger ages but became a better discriminator in middle to late adulthood. An impulsive problem-solving style was associated with past suicide attempts across the full adult lifespan.
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Affiliation(s)
- C Wang
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - J G Keilp
- Columbia University, Department of Psychiatry, New York, NY, USA; Columbia University, Department of Biostatistics, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - H Galfalvy
- Columbia University, Department of Psychiatry, New York, NY, USA; Columbia University, Department of Biostatistics, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - J A Bridge
- The Abigail Wexner Research Institute at Nationwide Children's and The Ohio State University College of Medicine, Departments of Pediatrics and Psychiatry & Behavioral Health, Columbus, OH, USA
| | - A H Sheftall
- University of Rochester Medical Center, School of Medicine and Dentistry, Department of Psychiatry, Rochester, NY, USA
| | - K Szanto
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA.
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Rogers ML, Jeon ME, Zheng S, Richards JA, Joiner TE, Galynker I. Two sides of the same coin? Empirical examination of two proposed characterizations of acute suicidal crises: Suicide crisis syndrome and acute suicidal affective disturbance. J Psychiatr Res 2023; 162:123-131. [PMID: 37149921 DOI: 10.1016/j.jpsychires.2023.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/11/2023] [Accepted: 05/01/2023] [Indexed: 05/09/2023]
Abstract
Two proposed suicide-specific diagnoses, with accumulating research support, characterize the phenomenology of acute suicidal crises: Suicide Crisis Syndrome (SCS) and Acute Suicidal Affective Disturbance (ASAD). Despite conceptual overlap and some similar criteria, the two syndromes have never been compared empirically. The present study addressed this gap by examining SCS and ASAD utilizing a network analysis approach. A sample of 1568 community-based adults (87.6% cisgender women, 90.7% White, Mage = 25.60 years, SD = 6.59) in the United States completed an online battery of self-report measures. SCS and ASAD were first examined in individual network models, followed by a combined network to determine changes in network structure, as well as identify bridge symptoms that connected SCS and ASAD. The proposed criteria of SCS and ASAD formed sparse network structures that were largely unaffected by the influence of the other syndrome in a combined network. Social disconnection/withdrawal and manifestations of overarousal-particularly agitation, insomnia, and irritability-emerged as bridge symptoms that may connect SCS and ASAD. Our findings indicate the network structures of SCS and ASAD exhibit patterns of independence, alongside interdependence between overlapping symptom domains (i.e., social withdrawal, overarousal). Future work should examine SCS and ASAD prospectively to better understand their temporal dynamics and predictive utility in relation to imminent suicide risk.
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Affiliation(s)
| | - Min Eun Jeon
- Department of Psychology, Florida State University, USA
| | - Sifan Zheng
- Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, USA
| | | | | | - Igor Galynker
- Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, USA
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9
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Park JY, Rogers ML, Bloch-Elkouby S, Richards JA, Lee S, Galynker I, You S. Factor Structure and Validation of the Revised Suicide Crisis Inventory in a Korean Population. Psychiatry Investig 2023; 20:162-173. [PMID: 36891601 PMCID: PMC9996151 DOI: 10.30773/pi.2022.0208] [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: 07/19/2022] [Accepted: 12/07/2022] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE Because of the exceptionally high suicide rates in South Korea, new assessment methods are needed to improve suicide prevention. The current study aims to validate the revised Suicide Crisis Inventory-2 (SCI-2), a self-report measure that assesses a cognitiveaffective pre-suicidal state in a Korean sample. METHODS With data from 1,061 community adults in South Korea, confirmatory factor analyses were first conducted to test the proposed one-factor and five-factor structures of the SCI-2. Also, an exploratory factor analysis (EFA) was performed to examine possible alternative factor structure of the inventory. RESULTS The one-factor model of the SCI-2 resulted in good model fit and similarly, the five-factor model also exhibited strong fit. Comparing the two models, the five-factor was evaluated as the superior model fit. An alternative 4-factor model derived from EFA exhibited a comparable model fit. The Korean version of the SCI-2 had high internal consistency and strong concurrent validity in relation to symptoms of suicidal ideation, depression, and anxiety. CONCLUSION The SCI-2 is an appropriate and a valid tool for measuring one's proximity to imminent suicide risk. However, the exact factor structure of the SCI-2 may be culture-sensitive and warrants further study.
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Affiliation(s)
- Ji Yoon Park
- Icahn School of Medicine, Mount Sinai Beth Israel, New York, NY, USA.,Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Megan L Rogers
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | | | | | - Sungwoo Lee
- Department of Psychology, Chungbuk National University, Cheongju, Republic of Korea
| | - Igor Galynker
- Icahn School of Medicine, Mount Sinai Beth Israel, New York, NY, USA
| | - Sungeun You
- Department of Psychology, Chungbuk National University, Cheongju, Republic of Korea
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Wang S, Wei T, Zhu R, Li S, Liu X, Cai Y, Gong R. Perceived entrapment predicts first-onset suicidal ideation: A longitudinal study among medical students in China. Front Public Health 2023; 10:1049975. [PMID: 36743178 PMCID: PMC9892625 DOI: 10.3389/fpubh.2022.1049975] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction The prevalence of suicidal ideation among medical students is high. Evidence indicates that feelings of entrapment are a predictor of suicidal ideation. In this study, we aimed to (1) investigate the prevalence of first-onset suicidal ideation among Chinese medical students and (2) explore the predictive effects of perceived entrapment on first-onset suicidal ideation. Methods This longitudinal study was conducted between 2018 and 2019 among 211 newly enrolled medical students in Shanghai. Using an anonymous questionnaire, we collected information on sociodemographic (sex, major, parents' income, and academic performance) and psychological (entrapment, depression, loneliness, defeat, social support, and interpersonal needs) variables as well as suicidal ideation. Participants were divided into four subgroups based on their exposure to entrapment (control, new-onset, reduced, and persistent). The primary outcome, first-onset suicidal ideation, was defined as suicidal ideation absent at baseline but present at follow-up. Results In total, 54.98% of participants (116/211) were women, and 76.78% (162/211) majored in clinical medicine. In the follow-up survey, 6.16% of participants (16/211) reported first-onset suicidal ideation, 17.54% (37/211) reported new-onset entrapment, and 12.80% (27/211) reported persistent entrapment during follow-up. Compared with the control group who reported no perceived entrapment at baseline and follow-up, participants who reported new-onset entrapment had the highest risk of new-onset suicidal ideation [odds ratio (OR) = 14.700, 95% confidence interval (CI) = 2.906-74.364; adjusted OR = 8.798; 95% CI = 1.588-48.757; multivariate OR = 8.238, 95% CI = 1.394-48.693). Conclusion New-onset entrapment can significantly predict suicidal ideation. Therefore, greater attention is needed for new-onset entrapment, such as intervention for suicidal ideation.
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Affiliation(s)
- Suping Wang
- Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ting Wei
- Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Rui Zhu
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Sicong Li
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xinyi Liu
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yong Cai
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Community Health Care, Hospital Development Institute Shanghai Jiao Tong University, Shanghai, China
| | - Ruijie Gong
- Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department Immunization Program, Xuhui Center for Disease Control and Prevention, Shanghai, China
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Bafna A, Rogers ML, Galynker II. Predictive validity and symptom configuration of proposed diagnostic criteria for the Suicide Crisis Syndrome: A replication study. J Psychiatr Res 2022; 156:228-235. [PMID: 36270061 DOI: 10.1016/j.jpsychires.2022.10.027] [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: 04/15/2022] [Revised: 08/13/2022] [Accepted: 10/06/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The Suicide Crisis Syndrome (SCS) is a new proposed suicide-specific diagnosis. In the present large replication study, we examine SCS diagnostic criteria to determine which configuration of symptoms demonstrates the strongest convergent and predictive validity for near-term suicidal behaviour. METHODS We conducted confirmatory factor analysis (CFA) to examine the factor structure of the proxy-SCS variables derived from an extensive self-report test battery and administered to 903 psychiatric patients (age (M = 36.70, SD = 13.91); gender (64.0% female)) at intake and 4-8-week follow-up assessments. Convergent and predictive validity of five configurations of the proposed SCS diagnostic criteria for suicidal ideation (SI) and attempts (SA) were examined using regression analyses. The new clinician-rated SCS-Checklist was piloted with 68 participants. RESULTS Both the one-factor and the five-factor models of proxy-SCS variables exhibited strong model fit, supporting the uni-dimensionality as well as the five-criteria structure of the SCS. All four configurations were uniquely related to the presence of a suicide attempt at follow-up when controlling for intake SI, lifetime SA, age, and gender, but none were significantly associated with intake SA when controlling for intake SI, age, and gender. All bivariate correlations between proxy-assessed and checklist-assessed SCS symptom configurations were significant and positive. CONCLUSION The proposed five-symptom structure of the SCS diagnostic criteria was supported and appears to describe a clinically meaningful syndrome specifically related to near-term suicidal behaviour. SCS assessment may significantly improve clinical evaluation of imminent suicide risk. Future studies are needed to assess the utility of the syndrome in clinical settings.
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Affiliation(s)
- Anokhi Bafna
- Gordon F. Derner School of Psychology, Adelphi University, Garden City, NY, USA; Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA.
| | - Megan L Rogers
- Department of Psychology, Texas State University, San Marcos, TX, USA.
| | - Igor I Galynker
- Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA.
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Monéger J, Chatard A, Selimbegović L. The defeated self: Evidence that entrapment moderates first name priming effects on failure-thought accessibility. SELF AND IDENTITY 2022. [DOI: 10.1080/15298868.2022.2099454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Jean Monéger
- Department of psychology, University of Poitiers, Poitiers, France
- Research Center on Cognition and Learning, CNRS, Poitiers, France
| | - Armand Chatard
- Department of psychology, University of Poitiers, Poitiers, France
- Research Center on Cognition and Learning, CNRS, Poitiers, France
- Clinical Research Unit, Centre Hospitalier Laborit, Poitiers, France
| | - Leila Selimbegović
- Department of psychology, University of Poitiers, Poitiers, France
- Research Center on Cognition and Learning, CNRS, Poitiers, France
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Eskin M, Baydar N, Moosa Khan M, El-Nayal M, Hamdan M, Al Buhairan F, Mechri A, Abdel-Khalek AM, Rezaeian M, Harlak H, Isayeva U, Noor IM, Khan A, Khader Y, Al Sayyari A, Khader A, Behzadi B, Öztürk CŞ, Hendarmin LA, Asad N, Khatib S. Are Nonfatal Suicide Attempts Instrumental in Achieving Personal and Interpersonal Goals? Behav Ther 2022; 53:725-737. [PMID: 35697434 DOI: 10.1016/j.beth.2022.02.003] [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: 09/25/2021] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 11/02/2022]
Abstract
This study focused on the well-being of the survivors of suicide attempts and the well-being of their interpersonal relationships after the attempt. The data came from a sample of 392 college students from 10 Muslim majority countries who reported having attempted suicide in the last 4 years. Suicide was conceptualized as a goal-directed behavior embedded in a sociocultural context and motivated by personal or interpersonal goals. We tested a process that linked culturally shaped self-construal to the postsuicidal personal and interpersonal well-being. We posited that this process would operate through the attitudes towards suicide, motives for suicide, the strength of the intention to die. Our model indicated that the acceptability of suicide was positively associated with escape motives, and this association was even stronger for the individuals with interdependent self-construals. Escape motives were negatively associated with postsuicidal personal and interpersonal well-being, but communication motives were not associated with these outcomes. We also found evidence that having an interdependent self-construal might be beneficial for postsuicidal personal and interpersonal well-being. Our results further suggested that the postsuicidal personal and interpersonal well-being of highly interdependent individuals may depend on the interpretation of their act of suicide by their close others.
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Affiliation(s)
| | | | | | | | | | | | - Anwar Mechri
- University Hospital of Monastir, Monastir, Tunisia
| | | | | | | | | | | | - Aqeel Khan
- Universiti Teknologi Malaysia, Faculty of Social Sciences & Humanities
| | | | - Alaa Al Sayyari
- The Center for Health Research Studies, Saudi Health Council, Riyadh; King Abdullah International Medical Research Center / King Saud Bin Abdulaziz University for Health Sciences, Population Health Research Section-Hospital-MNGHA, Riyadh
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14
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Schechter M, Goldblatt MJ, Ronningstam E, Herbstman B. The Psychoanalytic Study of Suicide, Part I: An Integration of Contemporary Theory and Research. J Am Psychoanal Assoc 2022; 70:103-137. [PMID: 35451317 DOI: 10.1177/00030651221086622] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Psychodynamic psychotherapy has an important role in suicide prevention. The psychoanalytic study of suicide has taught us a great deal about the human experience and the process of suicidality. There is also much to be learned from other fields of study and from empirical research that can be integrated into psychoanalytic therapies. Central to the psychoanalytic approach to suicide has been understanding the patient's internal subjective experience of unbearable emotional or psychic pain and the urgent need for relief. Emotional pain can include intense affects such as shame, humiliation, self-hate, and rage. Factors that can increase vulnerability to suicidal states include problems with early attunement, dissociation and deficits in bodily love and protection, conscious and unconscious fantasy, and certain character traits and dynamics. Empirical research has confirmed many basic psychoanalytic concepts about suicide, including escape from unbearable pain as the primary driver of suicidal behavior, the role of dissociation in increasing risk of bodily attack, and the importance of unconscious processes. Further research into implicit processes and their role in the suicidal process holds potential to improve suicide risk assessment and to enhance psychotherapy by bringing otherwise inaccessible material into the treatment.
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Rogers ML, Vespa A, Bloch-Elkouby S, Galynker I. Validity of the modular assessment of risk for imminent suicide in predicting short-term suicidality. Acta Psychiatr Scand 2021; 144:563-577. [PMID: 34333759 DOI: 10.1111/acps.13354] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/29/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The Modular Assessment of Risk for Imminent Suicide (MARIS) is a clinical assessment tool, consisting of four modules assessing (1) a pre-suicidal cognitive-affective state (Module 1); (2) patients' attitudes toward suicide (Module 2); (3) clinicians' assessment of suicide risk factors (Module 3); and (4) clinicians' emotional responses to patients (Module 4) that assesses short-term suicide risk. Initial evidence provided evidence for its reliability and concurrent validity. The present study extended these findings by examining the MARIS's predictive validity in relation to suicidal thoughts and behaviors at one-month follow-up. METHODS A sample of 1039 psychiatric patients (378 inpatients, 661 outpatients) and their clinicians (N = 144) completed a battery of measures at baseline; 670 patients completed the one-month follow-up assessment. RESULTS MARIS total scores predicted suicidal thoughts and behaviors at one-month follow-up, even after controlling for baseline suicidal thoughts and behaviors. Moreover, both Module 1 and the Distress subscale of Module 4 were uniquely associated with suicidal thoughts and behaviors at one-month follow-up, controlling for baseline suicidal thoughts and behaviors. Modules 2 and 3, on the other hand, exhibited poor internal consistency. CONCLUSION Overall, both patient- and clinician-rated indices are uniquely predictive of suicidal thoughts and behaviors at one-month follow-up, highlighting the need for integrating clinicians' emotional responses into suicide risk assessment. Pending replication and extension of these findings in external samples, a briefer, two-module version of MARIS (MARIS-2) may be such an integrative, psychometrically sound, and clinically useful instrument that can be utilized to assess short-term suicide risk.
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Affiliation(s)
- Megan L Rogers
- Icahn School of Medicine, Mount Sinai Beth Israel, New York, New York, USA
| | - Allison Vespa
- Icahn School of Medicine, Mount Sinai Beth Israel, New York, New York, USA
| | | | - Igor Galynker
- Icahn School of Medicine, Mount Sinai Beth Israel, New York, New York, USA
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16
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Bloch-Elkouby S, Barzilay S, Gorman BS, Lawrence OC, Rogers ML, Richards J, Cohen LJ, Johnson BN, Galynker I. The revised suicide crisis inventory (SCI-2): Validation and assessment of prospective suicidal outcomes at one month follow-up. J Affect Disord 2021; 295:1280-1291. [PMID: 34706442 DOI: 10.1016/j.jad.2021.08.048] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/10/2021] [Accepted: 08/21/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIM The Suicide Crisis Syndrome (SCS) is an evidence-based pre-suicidal cognitive and affective state predictive of short-term suicide risk. The most recent SCS formulation, proposed as a suicide-specific DSM diagnosis, features a feeling of Entrapment accompanied by four additional symptom clusters: Affective Disturbance; Loss of Cognitive Control; Hyperarousal; and Social Withdrawal. The aim of the present study was to revise the Suicide Crisis Inventory (SCI; Barzilay et al., 2020), a self-report measure assessing the presence of the SCS,in accordance with the current SCS formulation, as well as to assess the psychometric properties and clinical utility of its revised version, the Suicide Crisis Inventory-2 (SCI-2). METHODS The SCI-2, a 61-item self-report questionnaire, was administered to 421 psychiatric inpatients and outpatients at baseline. Prospective suicidal outcomes including suicidal ideation, preparatory acts, and suicidal attempts were assessed after one month. Internal structure and consistency were assessed with confirmatory factor analysis, convergent, discriminant, and current criterion validity. Receiver-operating characteristic (ROC) curves with Area under the Curve (AUC) were used to examine the predictive validity of the SCI-2 to prospective outcomes. Exploratory analyses assessed the predictive validity of the five SCI-2 dimensions. RESULTS The SCI-2 demonstrated excellent internal consistency (Cronbach's α = 0.971), good convergent, discriminant, and current criterion validity. The SCI-2 significantly predicted all three outcomes, and was the only significant predictor of suicidal attempts with AUC = 0.883. DISCUSSION The results of this study indicate that the SCI-2 is a valid and reliable tool to assess the presence and intensity of the Suicide Crisis Syndrome and to predict short-term prospective suicidal behaviors and attempts among psychiatric outpatients and inpatients regardless of patients' readiness to disclose suicidal ideation.
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Affiliation(s)
- Sarah Bloch-Elkouby
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States.
| | - Shira Barzilay
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Bernard S Gorman
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Olivia C Lawrence
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Megan L Rogers
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Jenelle Richards
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Lisa J Cohen
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Benjamin N Johnson
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Igor Galynker
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
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The Mental Health and Syndemic Effect on Suicidal Ideation among Migrant Workers in China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111363. [PMID: 34769881 PMCID: PMC8583422 DOI: 10.3390/ijerph182111363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022]
Abstract
Background: Migrant workers are in a socially disadvantaged position and thus suffer from more stress and mental health disorders, resulting in a high risk of suicidal ideation. This study aimed to explore the association between psychosocial problems and suicidal ideation, and the syndemic effect of concurrent psychosocial problems on suicidal ideation among migrant workers. Methods: We conducted a cross-sectional study and recruited 1805 migrant workers in Shenzhen, China. Each participant completed a self-administered questionnaire to report sociodemographic information and mental health status. Univariate and multivariate logistic regression were used to explore the association between psychosocial variables and suicidal ideation, and their syndemic effect on suicidal ideation. Results: The prevalence of suicidal ideation among migrant workers was 7.5%. All selected psychosocial variables were independently associated with suicidal ideation. Multivariate logistic regression analysis showed that three psychosocial variables were associated with suicidal ideation: anxiety (ORm: 1783, 95% CI: 1.089–2.920), entrapment (ORm: 2.064, 95% CI: 1.257–3.388), and defeat (ORm: 2.572, 95% CI: 1.612–4.103). Various mental health issues can exist simultaneously to increase the risk of suicidal ideation (AOR: 5.762, 95% CI: 3.773–8.802). Workers with more psychosocial problems were more likely to have suicidal ideation. Conclusions: The association between poor mental health and suicidal ideation should not be overlooked among migrant workers. The co-occurring or syndemic effect of psychosocial problems may increase the risk of suicidal ideation.
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18
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You B, Wen H, Jackson T. Identifying resting state differences salient for resilience to chronic pain based on machine learning multivariate pattern analysis. Psychophysiology 2021; 58:e13921. [PMID: 34383330 DOI: 10.1111/psyp.13921] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 06/27/2021] [Accepted: 07/21/2021] [Indexed: 11/30/2022]
Abstract
Studies have documented behavior differences between more versus less resilient adults with chronic pain (CP), but the presence and nature of underlying neurophysiological differences have received scant attention. In this study, we attempted to identify regions of interest (ROIs) in which resting state (Rs) brain activity discriminated more from less resilient CP subgroups based on multiple kernel learning (MKL). More and less resilient community-dwellers with chronic musculoskeletal pain (70 women, 39 men) engaged in structural and functional magnetic resonance imaging (MRI) scans, wherein MKL assessed Rs activity based on amplitude of low frequency fluctuations (ALFF), fractional amplitudes of low frequency fluctuations (fALFF), and regional homogeneity (ReHo) modalities to identify ROIs most salient for discriminating more versus less resilient subgroups. Compared to classification based on single modalities, multi-modal classification based on combined fALFF and ReHo features achieved a substantially higher classification accuracy rate (79%). Brain regions with the best discriminative power included those implicated in pain processing, reward, executive function, goal-directed action, emotion regulation and resilience to mood disorders though variation trends were not consistent between more and less resilient subgroups. Results revealed patterns of Rs activity that serve as possible biomarkers for resilience to chronic musculoskeletal pain.
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Affiliation(s)
- Beibei You
- Key Laboratory of Cognition and Personality (Ministry of Education), Faculty of Psychology, Southwest University, Chongqing, China.,School of Nursing, Guizhou Medical University, Guizhou, China
| | - Hongwei Wen
- Key Laboratory of Cognition and Personality (Ministry of Education), Faculty of Psychology, Southwest University, Chongqing, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Taipa, China
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Ying G, Chennapragada L, Musser ED, Galynker I. Behind therapists' emotional responses to suicidal patients: A study of the narrative crisis model of suicide and clinicians' emotions. Suicide Life Threat Behav 2021; 51:684-695. [PMID: 33486794 PMCID: PMC8693386 DOI: 10.1111/sltb.12730] [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: 06/03/2020] [Revised: 09/01/2020] [Accepted: 11/20/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Clinicians' negative emotional responses to suicidal patients are predictive of near-term suicidality. This study aimed to explore the underlying pathway of this association by investigating the potential relationship between clinicians' emotional responses and the Narrative Crisis Model of suicide, which comprises long-term risk factors (LTRF) of suicidal thoughts and behaviors, Suicidal Narrative, and the Suicide Crisis Syndrome (SCS), a presuicidal affective state. METHOD One thousand and One patient participants and 169 clinician participants were recruited. Patients' Suicidal Narrative, SCS, and LTRF were assessed at intake using the Suicidal Narrative Inventory (SNI), the Suicide Crisis Inventory, and a composite score of three separate scales, respectively. Clinicians' emotional responses were measured immediately after patient intake using the Therapist Response Questionnaire-Suicide Form (TRQ-SF). RESULTS Multilevel regression analyses, which controlled for clinician differences, found that only patients' SNI total score and perceived burdensomeness subscale score were significantly associated with clinicians' TRQ-SF total score. Furthermore, a higher SNI total score was significantly related to higher distress and lower affiliation scores among clinicians. CONCLUSIONS Clinicians appear to respond emotionally to patients' Suicidal Narrative, and thus, future investigation of Suicidal Narrative and its potential to improve imminent suicide risk assessment is warranted.
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Affiliation(s)
- Gelan Ying
- Department of Psychiatry and Behavioral Health, Mount Sinai Beth Israel Medical Center, New York City, NY, USA
| | - Lakshmi Chennapragada
- Department of Psychiatry and Behavioral Health, Mount Sinai Beth Israel Medical Center, New York City, NY, USA
| | - Erica D. Musser
- Division of Clinical Science, Department of Psychology, Florida International University, Miami, FL, USA
| | - Igor Galynker
- Department of Psychiatry and Behavioral Health, Mount Sinai Beth Israel Medical Center, New York City, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
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20
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Xu C, Yu X, Tsamlag L, Zhang S, Chang R, Wang H, Liu S, Wang Y, Cai Y. Evaluating the validity and reliability of the Chinese entrapment scale and the relationship to depression among men who have sex with men in Shanghai, China. BMC Psychiatry 2021; 21:328. [PMID: 34215241 PMCID: PMC8254295 DOI: 10.1186/s12888-021-03333-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 06/18/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Perception of entrapment can emerge when someone feels trapped in an aversive situation and incapable of escape. Depression is closely related to the construct of entrapment. In China, men who have sex with men (MSM) have a high prevalence of depression; therefore, a tool to evaluate entrapment in this population is needed. We evaluated the validity and reliability of the Chinese version of the entrapment scale (ES) and the relationship to depression among MSM in Shanghai, China. METHODS We recruited 304 MSM from four districts in Shanghai, China. Participants completed health behavior questionnaires that included baseline information and psychological measurements such as the ES and Patient Health Questionnaire (PHQ-9). The sample was randomly divided into two groups for exploratory factor analysis (n = 143) and confirmatory factor analysis (n = 161). Criterion validity was tested to explore the correlation between the ES and PHQ-9 scores. The reliability of the ES was evaluated with internal consistency reliability (Cronbach's α coefficient) and split-half reliability (Spearman-Brown coefficient). We performed hierarchical regression analysis to determine the variance explained of entrapment to predicting depressive symptoms after adjusting for sociodemographic factors. Finally, receiver operator characteristic curve analysis was performed to measure the optimal ES cut-off value for predicting depression. RESULTS Factor analysis showed the ES had one principal component, and one-dimensional scale had more acceptable model fit indices than two-dimensional model. The correlation coefficient between the ES and PHQ-9 scores was 0.756 (P < 0.01). The Cronbach's α coefficient was 0.970 and the Spearman-Brown coefficient was 0.976. ES scores significantly predicted an additional 45.1% of depressive symptoms after controlling for sociodemographic characteristics in the MSM population (β = 0.689, P < 0.001). The optimum cut-off value was 23, which had a sensitivity of 70% and a specificity of 85.4%. CONCLUSIONS The Chinese version of the ES has good validity and reliability in the MSM population in Shanghai, and can be used to evaluate perception of entrapment among MSM. The findings confirmed an association between entrapment and depression.
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Affiliation(s)
- Chen Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227, South Chongqing Road, Shanghai, 200025, People's Republic of China
| | - Xiaoyue Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227, South Chongqing Road, Shanghai, 200025, People's Republic of China
| | - Lhakpa Tsamlag
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227, South Chongqing Road, Shanghai, 200025, People's Republic of China
| | - Shuxian Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227, South Chongqing Road, Shanghai, 200025, People's Republic of China
| | - Ruijie Chang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227, South Chongqing Road, Shanghai, 200025, People's Republic of China
| | - Huwen Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227, South Chongqing Road, Shanghai, 200025, People's Republic of China
| | - Shangbin Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227, South Chongqing Road, Shanghai, 200025, People's Republic of China
| | - Ying Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227, South Chongqing Road, Shanghai, 200025, People's Republic of China.
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227, South Chongqing Road, Shanghai, 200025, People's Republic of China.
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Denollet J, Trompetter HR, Kupper N. A review and conceptual model of the association of Type D personality with suicide risk. J Psychiatr Res 2021; 138:291-300. [PMID: 33882425 DOI: 10.1016/j.jpsychires.2021.03.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 12/31/2022]
Abstract
The role of personality as distal risk factor for suicidal thoughts and behavior is still unclear. This review aims to propose two conceptual models that explain the psychological plausibility of Type D personality as distal risk factor and contributor to the transition from general to suicide distress. To support this aim, we performed a systematic review of existing studies on the association between Type D personality and suicidal distress. A systematic search yielded eight studies that reported on Type D personality and suicidal distress. Type D personality was robustly associated with suicidal thoughts and behaviors, across populations and countries. Type D was related to the level/frequency of suicidal ideation in seven studies, and suicide attempt in two studies. Our first theoretical model identifies intra-psychic (depression, alcohol misuse, posttraumatic stress) and interpersonal (low belonging, social isolation, lack of support) vulnerabilities of individuals with Type D that may fuel the development of suicidal thoughts and behaviors. Type D by itself will not account for why people become suicidal, but our second theoretical model suggests that the avoidant-passive tendencies of Type D individuals may result in persistent problem-solving deficits, and, eventually, feelings of entrapment that may contribute to the desire to escape from pain. We conclude that empirical evidence supports the hypothesized link between Type D personality, and suicidal thoughts and behaviors. Our conceptual models - albeit often supported by indirect evidence - further substantiate the plausibility of this link, and offer concrete guidance for future studies. Primarily, more longitudinal research is necessary.
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Affiliation(s)
- Johan Denollet
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, the Netherlands
| | - Hester R Trompetter
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, the Netherlands.
| | - Nina Kupper
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, the Netherlands
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Werbart Törnblom A, Sorjonen K, Runeson B, Rydelius PA. Life Events and Coping Strategies Among Young People Who Died by Suicide or Sudden Violent Death. Front Psychiatry 2021; 12:670246. [PMID: 34512410 PMCID: PMC8429488 DOI: 10.3389/fpsyt.2021.670246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 08/02/2021] [Indexed: 12/21/2022] Open
Abstract
Objective: Most empirically anchored psychological models of suicide focus either on the perceived situational stress or on vulnerability factors and coping deficits. The interaction between life stressors and vulnerability factors is less explored. Methods: This case-control study examines interactions between life events and coping strategies in three groups of young people: cases of suicide, cases of other sudden violent death (SVD), and control cases. Results: Four coping strategies, two more adaptive and two more maladaptive, were identified. Distinctive of the suicide and the SVD group was significantly less Planful Problem-Solving, and more Escape-Avoidance and Confrontive Coping than among the controls. Furthermore, Confrontive Coping had significantly higher level in the SVD group than in the suicide group. Between-group differences were partly accounted for differences in negative life events, early and late in life. Both target groups experienced significantly more adverse childhood experiences and recent stressful life events than the controls-the suicide group being more exposed to recent stressful life events even in comparison with the SVD group. This might indicate that adverse childhood experiences are a risk factor for both causes of death, whereas proximal stressful life events are a risk factor for death by suicide to a higher degree than for SVD. Conclusions: Improved understanding of the interplay between life events, both in the far past and present, and coping styles, may facilitate the identification of young people at risk of suicide and violent death.
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Affiliation(s)
- Annelie Werbart Törnblom
- Department of Women's and Children's Health, Centre for Psychiatry Research, Karolinska Institutet, Stockholm County Council, Stockholm, Sweden
| | - Kimmo Sorjonen
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Bo Runeson
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm County Council, Stockholm, Sweden
| | - Per-Anders Rydelius
- Department of Women's and Children's Health, Centre for Psychiatry Research, Karolinska Institutet, Stockholm County Council, Stockholm, Sweden
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Morales S, Barros J. Mental Pain Surrounding Suicidal Behaviour: A Review of What Has Been Described and Clinical Recommendations for Help. Front Psychiatry 2021; 12:750651. [PMID: 35153847 PMCID: PMC8828913 DOI: 10.3389/fpsyt.2021.750651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/21/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To conduct a comprehensive review of scientific publications related to mental pain and suicide risk in order to deepen relevant aspects to guide clinical interventions. METHOD Using a text analysis tool, we collected the terms most frequently linked with that situation in published results of research using various tools to evaluate mental pain or psychache. DISCUSSION We propose clinical interventions for the clinical conditions most commonly associated with mental pain.
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Affiliation(s)
- Susana Morales
- Psychiatry Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| | - Jorge Barros
- Psychiatry Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
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24
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Jelinek L, Peth J, Runde A, Arlt S, Scheunemann J, Gallinat J. Metacognitive Training for Depression: Feasibility, safety and acceptability of two new treatment modules to reduce suicidality. Clin Psychol Psychother 2020; 28:669-681. [PMID: 33169467 DOI: 10.1002/cpp.2529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/03/2020] [Accepted: 10/28/2020] [Indexed: 01/22/2023]
Abstract
Recent evidence favours psychological interventions explicitly targeting suicidality; however, group treatments on suicidality are rare and are assumed to have unfavourable effects. We developed two modules specifically addressing suicidality that replace two existing modules in the Metacognitive Training for Depression (D-MCT). The aim of the current study was to examine the feasibility, safety, and acceptability of this intervention (D-MCT/S). Forty-eight inpatients with depression received eight sessions of D-MCT/S over 4 weeks in addition to standard treatment. Patients were assessed before the training, 4 and 8 weeks later regarding suicidality (primary outcome: Beck Suicide Scale [BSS]), hopelessness, depression (e.g. Hamilton Depression Rating Scale [HDRS]), dysfunctional attitudes, and self-esteem. Negative effects of the modules and subjective appraisal were assessed. Suicidality, hopelessness, and depression decreased over time. Whereas the effects on the BSS only reached trend level, a large effect was observed when the suicide item of the HDRS was used. Two of the 46 patients (4%) reported a deterioration in their symptoms, but this was not associated with the D-MCT/S. Negative effects of the general training were rather low, and acceptability was high. In general, patients evaluated the two new modules on suicidality similarly to the established modules. However, both modules were assessed as distressing by 39% of the patients. When we addressed suicidality in the D-MCT/S, we did not observe any contagious effects. In fact, the pilot versions of the two modules on suicidality are promising in terms of feasibility, safety, and acceptability. The results will be used to improve current shortcomings. The trial was registered with the German Clinical Trials Register (#DRKS-ID: DRKS00010543) on 23 August 2016.
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Affiliation(s)
- Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Judith Peth
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Runde
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sönke Arlt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry and Psychotherapy, Evangelical Hospital Alsterdorf, Hamburg, Germany
| | - Jakob Scheunemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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25
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Ying G, Cohen LJ, Lloveras L, Barzilay S, Galynker I. Multi-informant prediction of near-term suicidal behavior independent of suicidal ideation. Psychiatry Res 2020; 291:113169. [PMID: 32562934 DOI: 10.1016/j.psychres.2020.113169] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/29/2020] [Accepted: 05/30/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Both the Suicide Crisis Syndrome (SCS) and clinicians' emotional responses to suicidal patients are predictive of near-term suicidal behaviors. Thus, we tested predictive validity of a combination of the proposed Diagnostic and Statistical Manual SCS criteria and the Therapist Response Questionnaire Suicide Form (TRQ-SF) for near-term suicidal behavior. METHODS The presence of SCS in adult psychiatric outpatients (N=451) was assessed using relevant items from validated psychometric assessments. Clinicians completed the TRQ-SF immediately after patient intake. Suicide attempts (SA) and a combination of suicide plans and attempts (SPA) were measured at one month follow-up (N=359). RESULTS At follow-up nine patients reported having SPA and seven reported SA. Meeting the SCS criteria were associated with near-term SA (χ2=5.987, p<0.01), while high TRQ-SF scores were associated with both near-term SA (χ2=5.971, p<0.05) and SPA (χ2=7.069, p<0.01). Meeting either the SCS or having high TRQ-SF scores, but not both, was associated with near-term SA (χ2=11.893, p<0.01) and SPA (χ2=11.449, p<0.01). Incremental predictive validity over standard suicide risk factors and individual scales was demonstrated in logistic regressions. CONCLUSIONS Multi-informant risk assessment not reliant on patient self-reported ideation appear to enhance predictive power of traditional risk assessments in identifying imminent suicide risk.
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Affiliation(s)
- Gelan Ying
- Mount Sinai Beth Israel Department of Psychiatry.
| | - Lisa J Cohen
- Mount Sinai Beth Israel Department of Psychiatry
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26
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Andrews S, Hanna P. Investigating the psychological mechanisms underlying the relationship between nightmares, suicide and self-harm. Sleep Med Rev 2020; 54:101352. [PMID: 32739825 DOI: 10.1016/j.smrv.2020.101352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 10/23/2022]
Abstract
Evidence suggests that nightmares increase the risk of suicide and self-harm, independently of insomnia, PTSD, anxiety and depression. A better understanding of this relationship is vital for the development of effective suicide and self-harm interventions. A systematic review of the research investigating the mechanisms underlying the nightmare and suicide/self-harm relationship was therefore conducted. Findings from twelve studies were critically appraised and synthesised under the headings of affect/emotion regulation, cognitive appraisals, psychosocial factors, acquired capability and depression. Despite clear variability in the methodology employed by the studies, the initial evidence suggests cognitive appraisals and affect/emotion regulation play a key role in the nightmare and suicide/self-harm relationship. Consideration is given for the first time to the differences in the mechanisms underlying the relationship between nightmares and suicide. In order to further elucidate and support these findings however, future research utilising longitudinal designs, objective measures of sleep disturbance and investigating the emotional content of nightmares is vital. There is also a call for studies investigating the impact of nightmare interventions on subsequent suicidal thoughts and behaviours, and self-harm. This is especially so given that individuals might find it easier to seek help for nightmares than for suicidality or self-harm.
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27
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Guzmán EM, Tezanos KM, Chang BP, Cha CB. Examining the impact of emergency care settings on suicidal patients: A call to action. Gen Hosp Psychiatry 2020; 63:9-13. [PMID: 30077397 DOI: 10.1016/j.genhosppsych.2018.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 07/15/2018] [Accepted: 07/19/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The emergency department (ED) offers a critical and unique opportunity to assess and intervene on suicide risk. Despite its potential benefits, the ED setting presents several potential sources of stress. The present paper calls attention to how suicidal patients may be especially vulnerable to stressful ED experiences. METHOD This research synthesis cites the growing literature on ED-related stressors, as they have been shown to affect both psychiatric and nonpsychiatric patient populations. RESULTS We identified specific interpersonal, physical, and temporal features of the ED that have been shown to affect multiple patient populations, including suicidal individuals. Beyond this, there appears to be broad underutilization of therapeutic care in ED settings. CONCLUSIONS It is important to consider how the ED setting may be both helpful and harmful toward suicidal patients. We conclude with recommended domains of study and methodological considerations when pursuing these future directions. The proposed research agenda would help address this known high risk period around hospitalization and discharge, and ultimately optimize suicide prevention efforts.
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Affiliation(s)
- Eleonora M Guzmán
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, United States of America
| | - Katherine M Tezanos
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, United States of America
| | - Bernard P Chang
- Department of Emergency Medicine, Columbia University Medical Center, United States of America
| | - Christine B Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, United States of America.
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28
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Pia T, Galynker I, Schuck A, Sinclair C, Ying G, Calati R. Perfectionism and Prospective Near-Term Suicidal Thoughts and Behaviors: The Mediation of Fear of Humiliation and Suicide Crisis Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041424. [PMID: 32098414 PMCID: PMC7068323 DOI: 10.3390/ijerph17041424] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 02/07/2020] [Accepted: 02/18/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Perfectionism has been linked to suicide. According to the Narrative-Crisis Model of suicide, individuals with trait vulnerabilities are prone to develop a certain mindset, known as a Suicidal Narrative, which may precipitate the Suicide Crisis Syndrome (SCS), culminating in suicide. The purpose of this study was to investigate the association between perfectionism (trait vulnerability), fear of humiliation (component of the Suicidal Narrative), SCS, and prospective near-term suicidal thoughts and behaviors (STB). METHODS Adult psychiatric outpatient participants (N = 336) were assessed at baseline with the Suicidal Narrative Inventory for perfectionism and fear of humiliation. The questions used to assess perfectionism were adapted from the Multidimensional Perfectionism Scale. The severity of the SCS was calculated using the Suicide Crisis Inventory. STB were assessed at baseline and after one month using the Columbia Suicide Severity Rating Scale. Serial mediation analyses were conducted using PROCESS version 3.3 in SPSS. RESULTS While the direct effect of perfectionism on prospective STB was not significant (b = 0.01, p = 0.19), the indirect effect of perfectionism on STB, through serial mediation by fear of humiliation and the SCS, was significant (indirect effect p = 0.007, 95% CI [0.003,0.013]). The indirect effect was not significant for models that did not include both mediators. LIMITATIONS Variables were assessed at one time only. CONCLUSION Perfectionism did not directly modulate STB. Perfectionism may be related to suicidal behavior through fear of humiliation, leading to the SCS. These results support the Narrative-Crisis Model of suicide and clarify the role of perfectionism in the etiology of suicide.
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Affiliation(s)
- Tyler Pia
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA; (T.P.); (I.G.); (A.S.); (C.S.); (G.Y.)
| | - Igor Galynker
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA; (T.P.); (I.G.); (A.S.); (C.S.); (G.Y.)
- Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA
| | - Allison Schuck
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA; (T.P.); (I.G.); (A.S.); (C.S.); (G.Y.)
| | - Courtney Sinclair
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA; (T.P.); (I.G.); (A.S.); (C.S.); (G.Y.)
| | - Gelan Ying
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA; (T.P.); (I.G.); (A.S.); (C.S.); (G.Y.)
| | - Raffaella Calati
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA; (T.P.); (I.G.); (A.S.); (C.S.); (G.Y.)
- Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA
- Department of Psychology, University of Milan-Bicocca, 20126 Milan, Italy
- Department of Adult Psychiatry, Nîmes University Hospital, 30029 Nîmes, France
- Correspondence:
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Cramer RJ, Rasmussen S, Tucker RP. An examination of the Entrapment Scale: Factor structure, correlates, and implications for suicide prevention. Psychiatry Res 2019; 282:112550. [PMID: 31522892 DOI: 10.1016/j.psychres.2019.112550] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/21/2019] [Accepted: 08/31/2019] [Indexed: 02/08/2023]
Abstract
Entrapment is an emerging theoretical and empirical factor associated with suicide. The current study expanded our understanding of entrapment by examining the Entrapment Scale factor structure, demographic correlates, and association with suicidal thoughts and behaviors (STBs). Data from an online cross-national study of suicide were analyzed from two samples of young adults aged 18-34 (United Kingdom [U.K.] sample N = 418; United States [U.S.] N = 414). Primary findings included: (1) factor-analytic support for a two factor (i.e., internal and external) Entrapment Scale structure; (2) variation in external entrapment subscale factor loadings by sample; (3) significant demographic correlates of elevated entrapment of younger age, female gender, and U.S. sample; (4) significant convergent positive associations for both entrapment types with cognitive (e.g., perceived burdensomeness), mental health (e.g., anxiety), and STB correlates; and (5) significant, robust associations of internal entrapment and perceived burdensomeness with STBs in the U.K. sample. Implications are reviewed for suicide prevention theory, research and practice.
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Affiliation(s)
- Robert J Cramer
- Department of Public Health Sciences, University of North Carolina at Charlotte, CHHS Building 354, 9201 University City Blvd., Charlotte, NC 28223, USA.
| | - Susan Rasmussen
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Raymond P Tucker
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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Calati R, Nemeroff CB, Lopez-Castroman J, Cohen LJ, Galynker I. Candidate Biomarkers of Suicide Crisis Syndrome: What to Test Next? A Concept Paper. Int J Neuropsychopharmacol 2019; 23:192-205. [PMID: 31781761 PMCID: PMC7171927 DOI: 10.1093/ijnp/pyz063] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/25/2019] [Accepted: 11/27/2019] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND There has been increasing interest in both suicide-specific diagnoses within the psychiatric nomenclature and related biomarkers. Because the Suicide Crisis Syndrome-an emotional crescendo of several interrelated symptoms-seems to be promising for the identification of individuals at risk of suicide, the aim of the present paper is to review the putative biological underpinnings of the Suicide Crisis Syndrome symptoms (entrapment, affective disturbance, loss of cognitive control, hyperarousal, social withdrawal). METHODS A PubMed literature search was performed to identify studies reporting a link between each of the 5 Suicide Crisis Syndrome symptoms and biomarkers previously reported to be associated with suicidal outcomes. RESULTS Disturbances in the hypothalamic-pituitary-adrenal axis, with dysregulated corticotropin-releasing hormone and cortisol levels, may be linked to a sense of entrapment. Affective disturbance is likely mediated by alterations in dopaminergic circuits involved in reward and antireward systems as well as endogenous opioids. Loss of cognitive control is linked to altered neurocognitive function in the areas of executive function, attention, and decision-making. Hyperarousal is linked to autonomic dysregulation, which may be characterized by a reduction in both heart rate variability and electrodermal activity. Social withdrawal has been associated with oxytocin availability. There is also evidence that inflammatory processes may contribute to individual Suicide Crisis Syndrome symptoms. CONCLUSION The Suicide Crisis Syndrome is a complex syndrome that is likely the consequence of distinct changes in interconnected neural, neuroendocrine, and autonomic systems. Available clinical and research data allow for development of empirically testable hypotheses and experimental paradigms to scrutinize the biological substrates of the Suicide Crisis Syndrome.
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Affiliation(s)
- Raffaella Calati
- Department of Psychiatry, Mount Sinai Beth Israel, New York, New York,Icahn School of Medicine at Mount Sinai, New York, New York,Department of Psychology, University of Milan-Bicocca, Milan, Italy,Department of Adult Psychiatry, Nîmes University Hospital, Nîmes, France,Correspondence: Raffaella Calati, PsyD, PhD, Department of Psychology, University of Milan-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126, Milan, Italy ()
| | - Charles B Nemeroff
- Department of Psychiatry, University of Texas Dell Medical School, Austin, Texas
| | - Jorge Lopez-Castroman
- Department of Adult Psychiatry, Nîmes University Hospital, Nîmes, France,INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Lisa J Cohen
- Department of Psychiatry, Mount Sinai Beth Israel, New York, New York,Icahn School of Medicine at Mount Sinai, New York, New York
| | - Igor Galynker
- Department of Psychiatry, Mount Sinai Beth Israel, New York, New York,Icahn School of Medicine at Mount Sinai, New York, New York
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31
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Bonsu K, Kugbey N, Ayanore MA, Atefoe EA. Mediation effects of depression and anxiety on social support and quality of life among caregivers of persons with severe burns injury. BMC Res Notes 2019; 12:772. [PMID: 31775897 PMCID: PMC6882198 DOI: 10.1186/s13104-019-4761-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/24/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Caregiving is associated with several psychosocial challenges including stress, depression and anxiety. These challenges have been found to have significant negative impacts on the health and wellbeing of caregivers, but the mechanisms of these effects are poorly understood. This study examined whether depression and anxiety serve as mediators between social support and quality of life caregivers of persons with severe burns injury. RESULTS A sample of 100 caregivers of persons with severe burns injury were administered questionnaires to assess their depression, anxiety, social support and quality of life. Findings show that depression and anxiety were negatively correlated with quality of life whereas social support was positively correlated with quality of life. Results further showed that only depression significantly mediated the link between social support and quality of life among the caregivers. These findings emphasize the need to screen caregivers for common mental health problems and provide them support in the caregiving process to promote their health and wellbeing.
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Affiliation(s)
- Kevin Bonsu
- Clinical Psychology Unit, 37 Military Hospital, Accra, Ghana
| | - Nuworza Kugbey
- School of Public Health, University of Health and Allied Sciences, Ho, Volta Region Ghana
| | - Martin Amogre Ayanore
- School of Public Health, University of Health and Allied Sciences, Ho, Volta Region Ghana
| | - Ethel Akpene Atefoe
- School of Medicine, University of Health and Allied Sciences, Ho, Volta Region Ghana
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32
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Tzur Bitan D, Otmazgin A, Shani Sela M, Segev A. The Role of Entrapment in Crisis-Focused Psychotherapy Delivered in Psychiatric Emergency Settings: A Comparative Study. Front Psychol 2019; 10:2600. [PMID: 31803124 PMCID: PMC6873799 DOI: 10.3389/fpsyg.2019.02600] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 11/01/2019] [Indexed: 11/19/2022] Open
Abstract
Although many mental health centers offer crisis intervention services as part of their psychiatric emergency facilities, studies assessing outcome, and process of crisis intervention psychotherapy are scarce. One potential psychological construct that might be unique to crisis intervention psychotherapy is entrapment, a psychological construct which reflects an individual's subjective perception of being in uncontrollable, unremitting, and inescapable circumstances. In this study we aimed to investigate whether changes in entrapment affect the process and outcome of crisis intervention psychotherapy, as compared to its effect in short-term psychotherapy delivered in outpatient units. Sixty-nine patients were recruited for the study. Patients were assessed for level of entrapment, symptoms, well-being, and the working alliance at three time points. The moderating effect of the type of therapy on the associations between changes in entrapment and changes in symptoms, well-being, and the working alliance were assessed using the Hayes process script. The dynamics of change following crisis intervention psychotherapy, as well as the effect of changes in entrapment on symptomatic relief, were illustrated using a clinical vignette of a patient treated in the crisis unit. Results of the moderation analyses indicated that entrapment had a more substantial effect on symptom distress in crisis intervention psychotherapy as compared to its effect in the short-term psychotherapy. Further, the difference in the effect of entrapment across the study groups was manifested primarily in internal entrapment, whereas no moderating effect was found for external entrapment. Clinical vignettes demonstrated the dynamics through which crisis intervention psychotherapy produces changes in entrapment by offering potential outlets from internal thoughts and interpretations of life circumstances. These results suggest that entrapment is a potential underlying process unique to crisis intervention psychotherapy. Limitations, directions for future research, and clinical implications are discussed.
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Affiliation(s)
- Dana Tzur Bitan
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
- Shalvata Mental Health Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adi Otmazgin
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Mirit Shani Sela
- Shalvata Mental Health Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviv Segev
- Shalvata Mental Health Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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33
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Yaseen ZS, Molina N, Hawes M, Barzilay S, Galynker I. Suicide Risk and Emotional Responses to Thoughts of Death: The Response to Morbid Ideations Questionnaire. Suicide Life Threat Behav 2019; 49:1209-1219. [PMID: 30298945 DOI: 10.1111/sltb.12520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 07/15/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is need for deeper understanding of the processes by which suicidal thoughts lead to action. Examination of morbid ideation and the emotional sequelae of such ideation that may feed suicide ideation (SI) and attempts (SA) have been limited. METHOD Adult psychiatric outpatients (N = 385) were administered the Response to Morbid Ideation Questionnaire (RMI-Q) and measures of SI, suicidal thoughts and behaviors (STB), and other psychiatric symptom severity. We examined (1) incidence and prevalence in mentation of morbid ideations and emotional responses to these ideations, (2) differences in emotional responses between individuals of varying levels of suicide history, and (3) the relationships of different types of morbid ideations and emotional responses with concurrent SI and symptom severity. RESULTS Morbid ideation was reported by 87.5% of participants and associated with lifetime and concurrent levels of SI/STB. Calm/relieved emotional responses were associated with lifetime and concurrent levels of SI/STB, while negative-valence responses to morbid ideations were associated with concurrent severity of psychopathology. CONCLUSIONS Our results suggest that the role of morbid ideation and its emotional sequelae in the development of suicidal motivation and action deserves further attention and may be a treatment target for suicide risk reduction.
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Affiliation(s)
- Zimri S Yaseen
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Psychiatry and Behavioral Health, Mount Sinai Beth Israel Medical Center, New York, NY, USA
| | - Nicolette Molina
- Department of Psychiatry and Behavioral Health, Mount Sinai Beth Israel Medical Center, New York, NY, USA
| | - Mariah Hawes
- Department of Psychiatry and Behavioral Health, Mount Sinai Beth Israel Medical Center, New York, NY, USA
| | - Shira Barzilay
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Igor Galynker
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Psychiatry and Behavioral Health, Mount Sinai Beth Israel Medical Center, New York, NY, USA
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Yaseen ZS, Hawes M, Barzilay S, Galynker I. Predictive Validity of Proposed Diagnostic Criteria for the Suicide Crisis Syndrome: An Acute Presuicidal State. Suicide Life Threat Behav 2019; 49:1124-1135. [PMID: 30073686 DOI: 10.1111/sltb.12495] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 07/13/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Determining imminent risk of suicide continues to challenge psychiatrists. To this end, we test the clinical utility of a proposed set of diagnostic criteria for the suicide crisis syndrome (SCS) for prediction of imminent suicidal thoughts and behaviors prospectively. METHOD One hundred and seventy individuals hospitalized for suicidal thoughts and behaviors (STB) were evaluated within 72 hr of admission with measures assessing symptoms of the proposed SCS, history of STB, current ideation, and depression severity. Four-eight weeks following discharge, STB were reassessed. Associations between SCS and postdischarge attempts were examined using chi-square and logistic regression analyses. The receiver operator characteristic analysis was used to test the optimal number of symptoms required to meet proposed SCS criteria. RESULTS The syndrome was maximally informative about short-term risk of postdischarge suicide behavior when all criteria were met. The syndrome conferred a sevenfold increase in risk of postdischarge suicide attempt, and significantly improved prediction by standard risk factors, which was null to limited. CONCLUSIONS The SCS diagnostic criteria are supported and appear to describe a clinically meaningful syndrome in a high-risk population. Assessment of SCS may meaningfully improve clinical assessment of imminent suicide risk. Further study is needed to better understand the syndrome and its applicability in low-risk populations.
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Affiliation(s)
- Zimri S Yaseen
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
| | - Mariah Hawes
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
| | - Shira Barzilay
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
| | - Igor Galynker
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
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Schuck A, Calati R, Barzilay S, Bloch-Elkouby S, Galynker I. Suicide Crisis Syndrome: A review of supporting evidence for a new suicide-specific diagnosis. BEHAVIORAL SCIENCES & THE LAW 2019; 37:223-239. [PMID: 30900347 DOI: 10.1002/bsl.2397] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/21/2018] [Accepted: 12/22/2018] [Indexed: 06/09/2023]
Abstract
Suicide is a major public health problem, and suicide rates are still on the rise. Current strategies for identifying individuals at risk for suicide, such as the use of a patient's self-reported suicidal ideation or evidence of past suicide attempts, have not been sufficient in reducing suicide rates. Recently, research groups have been focused on determining the acute mental state preceding a suicide attempt. The development of an acute suicidal diagnosis, the Suicide Crisis Syndrome (SCS), is aimed at capturing this state to better treat individuals. The SCS has five main evidence-based components-entrapment, affective disturbance, loss of cognitive control, hyperarousal, and social withdrawal. The SCS may provide clinicians with the ability to identify individuals who are experiencing an acute pre-suicidal mental state, regardless of their self-reported suicidal ideation. Future research leading to the incorporation of this diagnosis into clinical practice could improve the quality of care and reduce the personal, societal, and legal burden of suicide.
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Affiliation(s)
- Allison Schuck
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
| | - Raffaella Calati
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
| | - Shira Barzilay
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Igor Galynker
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Molaie AM, Chiu CY, Habib Z, Galynker I, Briggs J, Rosenfield PJ, Calati R, Yaseen ZS. Emotional Pain Mediates the Link Between Preoccupied Attachment and Non-suicidal Self-Injury in High Suicide Risk Psychiatric Inpatients. Front Psychol 2019; 10:289. [PMID: 30846949 PMCID: PMC6393353 DOI: 10.3389/fpsyg.2019.00289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/29/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Non-suicidal self-injury (NSSI) is a risk factor for suicide attempts (SA). Both attachment disturbances and cognitive and emotional problems (e.g., emotional pain) have been associated with SA history. This study sought to determine differential contributions of attachment styles and cognitive and emotional states associated with SA to lifetime NSSI occurrence among adults hospitalized for suicide risk. Sampling and Methods: Adult psychiatric inpatients (n = 200) were assessed for attachment style, cognitive and emotional states, and lifetime NSSI within 72 h of hospitalization. Binary logistic regression and mediation analyses were performed. Results: Preoccupied attachment and emotional pain at admission were independently associated with lifetime NSSI. Emotional pain partially mediated the relationship between preoccupied attachment and lifetime NSSI. Limitations: The cross-sectional nature of the study and the use of a dichotomous (yes/no) measure of NSSI, not specifically designed for its assessment. Conclusions: Preoccupied attachment and emotional pain are associated with NSSI and may be useful targets for assessing risk of NSSI.
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Affiliation(s)
- Ali M Molaie
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, United States
| | - Chih-Yun Chiu
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, United States
| | - Zara Habib
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, United States
| | - Igor Galynker
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, United States
| | - Jessica Briggs
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, United States
| | - Paul J Rosenfield
- Department of Psychiatry, Mount Sinai St. Luke's and Mount Sinai West, New York, NY, United States
| | - Raffaella Calati
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, United States
| | - Zimri S Yaseen
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, United States
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O'Connor RC, Kirtley OJ. The integrated motivational-volitional model of suicidal behaviour. Philos Trans R Soc Lond B Biol Sci 2018; 373:20170268. [PMID: 30012735 PMCID: PMC6053985 DOI: 10.1098/rstb.2017.0268] [Citation(s) in RCA: 578] [Impact Index Per Article: 96.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2018] [Indexed: 12/14/2022] Open
Abstract
Suicide is a major public health concern accounting for 800 000 deaths globally each year. Although there have been many advances in understanding suicide risk in recent decades, our ability to predict suicide is no better now than it was 50 years ago. There are many potential explanations for this lack of progress, but the absence, until recently, of comprehensive theoretical models that predict the emergence of suicidal ideation distinct from the transition between suicidal ideation and suicide attempts/suicide is key to this lack of progress. The current article presents the integrated motivational-volitional (IMV) model of suicidal behaviour, one such theoretical model. We propose that defeat and entrapment drive the emergence of suicidal ideation and that a group of factors, entitled volitional moderators (VMs), govern the transition from suicidal ideation to suicidal behaviour. According to the IMV model, VMs include access to the means of suicide, exposure to suicidal behaviour, capability for suicide (fearlessness about death and increased physical pain tolerance), planning, impulsivity, mental imagery and past suicidal behaviour. In this article, we describe the theoretical origins of the IMV model, the key premises underpinning the model, empirical tests of the model and future research directions.This article is part of the theme issue 'Evolutionary thanatology: impacts of the dead on the living in humans and other animals'.
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Affiliation(s)
- Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow G12 0XH, UK
| | - Olivia J Kirtley
- Center for Contextual Psychiatry, Department of Neuroscience, KU Leuven, 3000 Leuven, Belgium
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