Hope and suicidal ideation and behaviour

Understanding the factors that protect against suicidal ideation and behaviour may strengthen our ability to identify and support those at risk of death by suicide, above and beyond that which is possible by focusing solely on risk factors. A factor that may confer protection against the development of suicidal ideation and behaviour is hope, a future orientated construct that features within recent theories of suicide. Here, we provide an overview of the literature examining the role of hope in moderating and mediating the relationship between suicide risk factors and suicide ideation and behaviour. Evidence suggests that hope may be important in buffering against suicide ideation and behaviour across different population. Limitations and recommendation for future research are also discussed.

Sexual Assault and Behavioral Health: What Can We Learn From a Probability Sample of Young Sexual Minority Men?

BACKGROUND

Previous research indicates that young sexual minority men (YSMM) are at increased risk of experiencing sexual assault compared to their heterosexual peers. While this increased risk is documented in comparison studies, very little is known about the specific range of sexual assault experiences. The aim of this study was to investigate prevalence of sexual assault experiences and their association with depression and alcohol use for YSMM.

METHODS

In 2017 and 2018, 124 YSMM (18-24 year-olds) were recruited to participate in an online study using probability-based sampling methods, in Los Angeles, CA. Participants answered items about lifetime and recent sexual assault experiences (i.e., unwanted touching, oral rape, penetrative rape), characteristics of the coercive behaviors, recent alcohol use, and depression. Analysis of variance (ANOVAs) and multiple linear regressions investigated the relationships between sexual assault experiences and behavioral health.

RESULTS

The sample reported a range of lifetime sexual assault experiences: 70% unwanted touching and 28% penetrative rape. Fifty-five percent of the sample reported some type of recent sexual assault, with 17% reporting a recent penetrative rape. ANOVAs of the impact of different forms of sexual assault on behavior health indicated that unwanted touching was associated with higher depression and alcohol use. Further investigation of recent unwanted touching indicated that frequency is associated with depression and binge drinking. Of participants who reported experiences of unwanted touching, 61% reported it occurred while they were intoxicated.

DISCUSSION

Findings support previous evidence of high rates of sexual assault among YSMM. Further, the majority of men who reported sexual assault indicated that it occurred while they were intoxicated, suggesting that unwanted touching is occurring while men are drinking alcohol, likely in bars. The culture of gay bars may encourage nonconsensual touching during intoxication and these experiences of sexual assault have consequences (i.e., higher levels of depression and alcohol use).

Role of rumination and hope on negative life events and suicidal ideation under the background of normalization of pandemic prevention and control: A moderated mediation model

Introduction

The study aimed to investigate the impact and mechanism of negative life events on college students' suicidal ideation during the COVID-19 pandemic and the buffering effect of hope under the background of normalization of pandemic.

Methods

A total of 5211 participants took part in this study. Self-reported negative life events, rumination, hope and suicide ideation were measured using a range of questions and scales. Our research demonstrated that the incidence of suicidal ideation among college freshmen in the past week was higher during the COVID-19 pandemic than that before the pandemic. In this study, conditional process model 15 was used to verify the hypothetical model of rumination as a potential mediator and hope as a moderator.

Results

The hypothesized moderated mediation model was verified significant (β = -0.047, 95% CI = [-0.061, -0.035]), and hope was found to moderate the direct effect of negative life events on suicidal ideation (β = -0.039, t = -2.937, 95% CI = [-0.065, -0.013]) as well as the indirect effect of through the mediator rumination (β = -0.134, t = -10.850, 95% CI = [-0.158, -0.110]).

Discussion

We found that rumination partially mediated the effect of negative life events on suicidal ideation, and hope buffered the direct and indirect effect of negative life events on suicidal ideation. The implications of the findings for clinical interventions are discussed, including the importance of hope arousal as a protective factor and rumination as a cognitive mechanism for emotion regulation under the background of normalization of pandemic.

Associations between interpersonal violence victimisation and concussions among US college students

Interpersonal violence is common on college campuses and is associated with many adverse health outcomes; however, it remains unknown whether experiencing interpersonal violence victimisation is associated with concussions. The aim of this study was to estimate the associations between interpersonal violence, including emotional abuse, physical abuse and sexual assault, and concussions among a large, diverse sample of college students. We analysed cross-sectional data from the 2018-2019 national (US) Healthy Minds Study (N = 1,478). Multiple logistic regression analyses were conducted to estimate the association between interpersonal violence victimisation (any violence victimisation, emotional abuse, physical abuse and sexual assault) and concussion history (any concussion, diagnosed concussion and undiagnosed concussion), while adjusting for potential confounders. Analyses were conducted among the overall sample and separately by male and female participants. Results showed patterns of significant associations between interpersonal violence victimisation and concussions among the overall sample and among male and female participants. Among the overall sample, any interpersonal violence victimisation (adjusted odds ratio [AOR] 1.45, 95% confidence interval [CI] 1.13-1.88), emotional abuse (AOR 1.36, 95% CI 1.06-1.76), physical abuse (AOR 1.61, 95% CI 1.07-2.44) and sexual assault (AOR 2.17, 95% CI 1.44-3.26) were associated with higher odds of any concussion history. Sexual assault victimisation had the strongest association with any concussion history among male (AOR 1.96, 95% CI 1.04-3.71) and female (AOR 2.96, 95% CI 1.62-5.43) participants. These results expand on prior interpersonal violence and concussion research by showing an association with multiple victimisation measures among a large and diverse sample of college students. Medical professionals should screen for concussions among college students who experience emotional abuse, physical abuse and sexual assault to provide appropriate guidance. Information on the symptoms of concussions should be incorporated into campus violence awareness and prevention efforts.

"When a Girl Says No, You Should Be Persistent Until She Says Yes": College Students and Their Beliefs About Consent

One in five college women report being sexually assaulted with 23% to 45% of men reporting attempting or completing a sexual assault while attending a university. One important concept in preventing sexual assault is consent. It is important to ensure that when students are being asked to wait for consent, they understand what consent is and the potential ways it could manifest in a sexual situation. In total, 25 female and 20 male college students participated in semistructured focus groups or interviews to gain a better understanding of their perspectives of consent and how they ensure that it has been given. Results demonstrate that college students do not have a consistent, coherent, or precise definition of consent. Participants often described consent using vague language and were only able to clearly identify verbal indicators of consent. Much of the discussion of consent centered around an individual's ability or inability to clearly and directly communicate his or her needs. Data also show that how students communicate about consent is influenced by gender expectations. There are multiple complicating factors when determining consent, including alcohol consumption. Participants discussed not understanding how to navigate sexual encounters when one or both parties had been consuming alcohol. Results also showed that there are multiple factors that may lead women to say yes to sex they don't want, and men to not ask for consent. For college students, consent is a complex concept-a concept they may not have a practical and useful definition of. Sexual assault prevention must take steps to provide college students with a definition of consent informed by their experiences and the reality of their sexual encounters.

The prevalence of hope, subjective well-being, and psychopathology among trauma survivors at community-based clinics in Gauteng

This study examined the prevalence of hope and subjective well-being as well as symptoms of depression and post-traumatic stress disorder among trauma survivors at community-based clinics in Gauteng. We further explored traumatic events and help-seeking behaviour in this context. Using a cross-sectional survey design, we collected demographic information and administered questionnaires measuring hope, well-being, depression, and post-traumatic stress. The sample comprised 120 adults, of whom the majority were Black females. Results showed that participants experienced low levels of hope, positive affect, and life satisfaction as well as high levels of negative affect, depression, and post-traumatic stress. In addition, the majority of participants experienced multiple traumatic events in the past 5 years, which had a negative impact on their well-being. However, receiving professional help and being able to cope in the aftermath of trauma may contribute towards higher levels of well-being and fewer psychopathological symptoms. Our findings thus highlighted the need for effective therapeutic interventions among trauma survivors.

A Multisession Evaluation of Sexual Assault Prevention Education: The Unique Effects of Program Participation

One in five college women report being sexually assaulted, while men have the greatest likelihood to commit a sexual assault while attending a university. Because freshmen and sophomore college women are particularly vulnerable to victimization, it is important to provide effective sexual assault prevention education. The current study examines a multisession approach to sexual assault prevention at a southwestern university. This exploratory study assesses scores measuring knowledge of sexual assault, knowledge about healthy sexual relationships, and intent to act to prevent a sexual assault or after one has occurred, after students complete at least one of five sexual assault prevention programs (Community of Care, Consent and Respect, Step Up!, Live Well, or Frisky Business). Results demonstrated that participation in each program had unique effects and the number of programs a student participated in did not significantly affect scores. None of the programs produced significantly higher scores on all three measures. Multiple programs produced significantly higher scores on the knowledge and intervention/resources scales, but none had the same results for the healthy sexual relationships scale. Also, a student's experiences of sexual violence significantly predicted their scores on all three measures. Because each program had different characteristics, the varying results make it difficult to identify the particular factors that led to the best results. Future research must seek to identify the particular combination of factors that produce the best outcomes in terms of changing attitudes and behavior concerning sexual assault and intent to act.

Campus Support Providers' Discussion of Consent in Response to Sexual Assault Disclosure Situations: Understanding of Consent Linked to Resource Referrals

College sexual assault is a widespread issue and the responses of support providers can greatly affect sexual assault survivors' wellbeing after a disclosure. Although "consent" (or, more precisely, the lack thereof) is the defining feature of sexual assault, little is known about how support providers understand consent and draw from this knowledge in their responses to disclosures. This is particularly important in the wake of evolving consent policies in institutions of higher education. University resident assistants (RAs) are an important source of support for students in crisis, functioning as a "first responder" and providing support. Using a sample of 305 RAs, the current study employs a critical discourse analysis to examine how RAs engage with the concept of consent in response to sexual assault disclosure situations. Four types of consent discourses were identified: (a) affirming nonconsent, (b) validating right to consent, (c) questioning nonconsent, and (d) dictating how to consent. Findings provide a novel examination of how consent is understood, communicated, and reinforced in the campus community, and the implications of these discourses for survivors. Results suggest there may be benefit in additional training for support providers around the conceptualization of consent and how to discuss consent with survivors.

The Gray Area of Defining Sexual Assault: An Exploratory Study of College Students' Perceptions

College-age women are disproportionately at risk of experiencing sexual assault. Sexual assault causes tremendous psychological distress for survivors. Therefore, it is imperative to understand the perceptions that affect the perpetration of sexual assault. One of those potential factors is how college students conceptualize and define sexual assault. The current qualitative study demonstrated that college students do not have consistent images of sexual assault and often rely on their own perceptions and experiences to define it. Creating and providing a standard of sexual assault based on the reality of college students can provide a foundation for creating effective prevention strategies.

Trauma and Suicide Risk in College Students: Does Lack of Agency, Lack of Pathways, or Both Add to Further Risk?

The present study sought to examine trauma history and hope as predictors of suicide risk in a sample of 561 college students. Furthermore, authors aimed to understand whether the lack of hope agency and hope pathways contributed to further risk for suicide, above and beyond trauma history. Results suggested that trauma history and hope agency were significant and unique predictors of suicide risk among college students. More specifically, hope agency accounted for additional variance in the prediction model of suicide risk, beyond that accounted for by trauma history. Some implications of the present findings for social work practice are discussed.

"Call for Help Immediately": A Discourse Analysis of Resident Assistants' Responses to Sexual Assault Disclosures

Formal support providers can play a critical role in sexual assault survivors' well-being (e.g., providing resource referrals). In a university setting, resident assistants (RAs) are key support providers with a unique relationship to survivors based on their dual roles as help-provider and peer. We examined 305 RAs' responses to student sexual assault disclosure scenarios. Employing a critical discourse analysis, we identified four discourses used by RAs in their discussion of resources: controlling, gatekeeping, minimizing, and empowering. Due to power dynamics between RAs and residents, we conclude that empowering discourses would facilitate survivors' access to other resources (e.g., sexual assault center).

Identifying suicide risk among college students: A systematic review

Mental health research highlights the need to focus on suicide risk in college students. However, evidence for associated risk and protective factors in this cohort is mixed. This review synthesizes data from 29 independent studies (N = 11,557 participants). Self-reported depression, cumulative stressful life events, sleep difficulties, a disconnection from others, and a sense of hopelessness demonstrated significant associations with heightened suicide risk. Reasons to live and hope provided significant protective effects. The findings highlight key intervention targets, pointing to the importance of cognitive-behavioral interventions to ameliorate suicidal thoughts but also build dispositional hope and goal-directed thinking.

Text Mining Mental Health Reports for Issues Impacting Today's College Students: Qualitative Study

BACKGROUND

A growing number of college students are experiencing personal circumstances or encountering situations that feel overwhelming and negatively affect their academic studies and other aspects of life on campus. To meet this growing demand for counseling services, US colleges and universities are offering a growing variety of mental health services that provide support and services to students in distress.

OBJECTIVE

In this study, we explore mental health issues impacting college students using a corpus of news articles, foundation reports, and media stories. Mental health concerns within this population have been on the rise. Uncovering the most salient themes articulated in current news and literature reports can better enable higher education institutions to provide health services to its students.

METHODS

We used SAS Text Miner to analyze 165 references that were published from 2010 to 2015 and focused on mental health among college students. Key clusters were identified to reveal the themes that were most significant to the topic.

RESULTS

The final cluster analysis yielded six themes in students' mental health experiences in higher education (ie, age, race, crime, student services, aftermath, victim). Two themes, increasing demand for student services provided by campus counseling centers (113/165, 68.5%) and the increased mental health risks faced by racial and ethnic minorities (30/165, 18.2%), dominated the discourse.

CONCLUSIONS

Higher education institutions are actively engaged in extending mental health services and offering targeted outreach to students of color. Cluster analysis identified that institutions are devoting more and innovative resources in response to the growing number students who experience mental health concerns. However, there is a need to focus on proactive approaches to mitigate the causes of mental health and the aftermath of a negative experience, particularly violence and sexual assault. Such strategies can potentially influence how students navigate their health information seeking and how information and communication technologies, including mobile apps, can partially address the needs of college students.

Suicidal ideation among adults with a recent sexual assault: Prescription opioid use and prior sexual assault

INTRODUCTION

Sexual assault (SA) is common, and recent sexual assault is associated with suicidal ideation and prescription opioid (PO) use. PO use is also associated with increased risk of suicidal ideation. The current study examined suicidal ideation among adults seeking medical and psychological follow-up care after a SA medical forensic examination based on PO use and prior SA.

METHODS

Adults (n = 60) who received a SA medical forensic exam at the emergency room within 120 h of a SA were invited to receive medical and psychological follow-up care, which included a questionnaire about current mental health symptoms.

RESULTS

Results from a linear regression model revealed that more acute stress symptoms were associated with higher suicidal ideation. Further, there was a significant association between PO use and suicidal ideation among those with a prior SA such that those with a prior SA and who used POs reported more severe suicidal ideation than those with a prior SA who did not use POs.

CONCLUSIONS

Routine screening at the emergency department for PO use and prior SA may help prevention efforts for suicide among adults who recently experienced SA.

Presence of trauma and suicide risk: Personal control as a moderator

Given past findings that have linked trauma and lack of personal control to greater suicidal risk in adults, the present study examined how trauma presence and personal control are uniquely involved in predicting suicidal risk in a sample of 469 college students. Regression analyses indicated that both trauma presence and personal control were significant predictors of suicidal risk, as was their interaction. The present findings suggest a need to consider both trauma presence and low personal control in assessing for suicidal risk in college students.

Hope and hopelessness as predictors of suicide ideation in Hungarian college students

This study investigated whether hopelessness and dispositional hope predict suicide ideation in 395 Hungarian college students. Both hopelessness and hope uniquely predicted suicide ideation, a pattern that remained unchanged even after controlling for psychological symptoms. Moreover, a significant Hopelessness × Hope interaction predicted suicide ideation. Present findings highlight how hope buffers the association between hopelessness and suicide risk in college students.

"It Happens to Girls All the Time": Examining Sexual Assault Survivors' Reasons for Not Using Campus Supports

Sexual assault is a prevalent problem in higher education, and despite the increasing availability of formal supports on college campuses, few sexual assault survivors use them. Experiencing sexual assault can have devastating consequences on survivors' psychological and educational wellbeing, which may intensify if survivors do not receive adequate care. Drawing from existing theoretical frameworks and empirical research, this study used a mixed methodological approach to examine why survivors did not use three key campus supports-the Title IX Office, the sexual assault center, and housing staff-and if these reasons differed across the three supports. Using data from 284 women who experienced sexual assault in college, our qualitative findings identified four overarching themes, including logistical issues (e.g., lacking time and knowledge), feelings, beliefs, and responses that made it seem unacceptable to use campus supports, judgments about the appropriateness of the support, and alternative methods of coping. Quantitative findings revealed that survivors' reasons for not seeking help differed across supports. Collectively, our findings suggest that community norms and institutional policies can make it challenging for survivors to use campus supports. We propose several suggestions for institutional change (e.g., taking a stronger stance against "less serious" forms of sexual assault, reducing a quasi-criminal justice approach to investigation and adjudication, limiting mandated reporting).

The Experience of Sexual Stigma and the Increased Risk of Attempted Suicide in Young Brazilian People from Low Socioeconomic Group

This study was intended to analyze the intersection of experience of sexual stigma low-socioeconomic status, and suicide attempt amongst young Brazilians (11–24 years old). In each of the data collection periods (2004–2006: n = 7185; 2010–2012: n = 2734), participants completed a questionnaire-based instrument. Network analysis provided support for a Minority Stress Model, oriented around whether participants had experienced sexual stigma. Although suicide attempts decreased by 20% for participants who had not experienced sexual stigma, there was a 60% increase for those who had experienced sexual stigma. Of particular note were the increases in rates of reported community and familial physical assault, molestation, and rape for those who had experienced sexual stigma. An analysis of centrality statistics demonstrated that both experiences of this Minority Stress Model were fundamentally different, and that those disparities increased over the time frame observed in this study. At the center of this model, shortest paths statistics exhibited a direct conditioned connection between experiencing sexual stigma and suicide attempts. We discuss the social and historical contexts that contributed to these dynamics, and emphasize the need for policy change.

Sexual Assault and Sexual Risk Behaviors Among Lower-Income Rural Women: The Mediating Role of Self-Worth

Sexual victimization is associated with risky sexual behaviors. Limited research has examined mechanisms via which victimization affects risk behaviors, particularly following different types of sexual victimization. This study examined self-worth as a mediator of the relationship between sexual victimization history: contact childhood sexual abuse (CSA), completed rape in adolescence/adulthood (adolescent/adulthood sexual assault [ASA]), and combined CSA/ASA, and two sexual risk behaviors: past year partners and one-time encounters. Participants were diverse (57.9% African American), low-income women recruited from an OB-GYN waiting room (n = 646). Women with a history of sexual victimization, 29.8% (n = 186) reported lower self-worth, t(586) = 5.26, p < .001, and more partners, t(612) = 2.45, p < .01, than nonvictims. Self-worth was a significant mediator only among women with combined CSA/ASA histories in both risk behavior models.

Victimization and suicidality among female college students

OBJECTIVE

To investigate the predictive role of victimization in suicidality among college women.

PARTICIPANTS

Female respondents to the American College Health Association National College Health Assessment II (N = 258).

METHODS

Multivariate logistic regression analyses examined the relationship between victimization and suicidality.

RESULTS

Emotional victimization (odds ratio [OR] = 11.79, 95% confidence interval [CI] = 2.43, 57.19, p < .01), physical victimization (OR = 6.10, 95% CI = 1.49, 25.08, p < .05), and sexual victimization (OR = 7.53, 95% CI = 2.06, 27.50, p < .01) were all significantly associated with an increased odds of suicidality even after considering the role of depression, anxiety, and stress.

CONCLUSIONS

Victimization is a significant and independent predictor of suicidality among college women. Controlling for relevant psychological health-related variables, college women who reported any of the 3 types of victimization had more than 8 times the odds of suicidality compared with nonvictims.

Loneliness and Negative Affective Conditions in Adults: Is There Any Room for Hope in Predicting Anxiety and Depressive Symptoms?

This study examined the role of hope in understanding the link between loneliness and negative affective conditions (viz., anxiety and depressive symptoms) in a sample of 318 adults. As expected, loneliness was found to be a significant predictor of both anxiety and depressive symptoms. Noteworthy, hope was found to significantly augment the prediction of depressive symptoms, even after accounting for loneliness. Furthermore, we found evidence for a significant Loneliness × Hope interaction effect in predicting anxiety. A plot of the interaction confirmed that the association between loneliness and anxiety was weaker among high, compared to low, hope adults. Some implications of the present findings are discussed.