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Spanknebel S, Barton S, Hurlemann R. [Loneliness in times of global polycrises]. DER NERVENARZT 2024:10.1007/s00115-024-01739-w. [PMID: 39269460 DOI: 10.1007/s00115-024-01739-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 09/15/2024]
Abstract
Global polycrises comprise the synchronous or consecutive occurrence of various crises, with no intervening phases of stability, e.g., coronavirus disease 2019 (COVID-19) pandemic, inflation, war and climate crisis. This poses challenges for both society as a whole and its individual members. Polycrises are associated with enormous psychological stress, especially for vulnerable groups. Polycrises also impair social interaction, which can trigger or intensify subjectively stressful loneliness. The aim of this narrative review is to show how loneliness affects social behavior in times of global polycrises and what the consequences are. Loneliness is associated with both mental and physical morbidity and mortality as well as being a significant barrier to recovery. Studies have shown that there is a mutual detrimental influence between mental illness and loneliness. The social behavior of chronically lonely people is characterized by a negative cognitive bias, hypervigilance in the social context and a dysregulated oxytocin system. Furthermore, the quality and quantity of these relationships are significantly impaired. The social consequences of loneliness are, for example, a decrease in social engagement and low voting participation. The phenomenon of loneliness clearly shows that crises can exacerbate latent problems and bring them to the surface; however, crises should also be seen as an opportunity to openly and constructively address shame-laden topics such as loneliness in public discourse and in psychotherapeutic settings.
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Affiliation(s)
- Sebastian Spanknebel
- Universitätsklinik für Psychiatrie & Psychotherapie, Fakultät VI für Medizin & Gesundheitswissenschaften, Carl von Ossietzky Universität Oldenburg, Ammerländer Heerstraße 114-118, 26129, Oldenburg, Deutschland
| | - Simon Barton
- Universitätsklinik für Psychiatrie & Psychotherapie, Fakultät VI für Medizin & Gesundheitswissenschaften, Carl von Ossietzky Universität Oldenburg, Ammerländer Heerstraße 114-118, 26129, Oldenburg, Deutschland
| | - René Hurlemann
- Universitätsklinik für Psychiatrie & Psychotherapie, Fakultät VI für Medizin & Gesundheitswissenschaften, Carl von Ossietzky Universität Oldenburg, Ammerländer Heerstraße 114-118, 26129, Oldenburg, Deutschland.
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Jukić M, Malenica L, Đuričić V, Talapko J, Lukinac J, Jukić M, Škrlec I. Long-Term Consequences of War Captivity in Military Veterans. Healthcare (Basel) 2023; 11:1993. [PMID: 37510434 PMCID: PMC10379024 DOI: 10.3390/healthcare11141993] [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: 05/16/2023] [Revised: 07/02/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
Numerous studies on the health and functioning of veterans and former prisoners of war have shown that the experience of war captivity is one of the most difficult human experiences. Captivity is often characterized by extremely difficult and inhumane conditions, as well as exposure to various forms of both psychological and physical abuse. Such traumatic experiences can lead to serious psychological consequences that can last for years, even decades after release from captivity. The aim of this paper is to present a brief overview of research that points to the specifics of wartime captivity and the long-term psychological consequences in veterans of former camp detainees, as well as the consequences suffered by their families and factors that, apart from the intensity of the trauma, contribute to the emergence and persistence of psychological disorders. From the presented research, it can be concluded that former prisoners of the camp represent an extremely vulnerable group of the social community and require long-term appropriate treatment, while the needs of veterans' families should not be neglected, with the necessity of including spouses and children in psychological and psychosocial treatments.
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Affiliation(s)
- Melita Jukić
- Department of Psychiatry, National Memorial Hospital Vukovar, 32000 Vukovar, Croatia
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Luka Malenica
- Department of Psychiatry, National Memorial Hospital Vukovar, 32000 Vukovar, Croatia
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Vanja Đuričić
- Department of Psychiatry, National Memorial Hospital Vukovar, 32000 Vukovar, Croatia
| | - Jasminka Talapko
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Jasmina Lukinac
- Faculty of Food Technology Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Marko Jukić
- Faculty of Food Technology Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Ivana Škrlec
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
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Low YS, Bhar SS, Chen WS. Moderators of suicide ideation in Asian international students studying in Australia. AUSTRALIAN PSYCHOLOGIST 2023. [DOI: 10.1080/00050067.2022.2148514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Yin Siu Low
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Sunil S Bhar
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Won Sun Chen
- Department of Health Sciences and Biostatistics, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
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Shoib S, Amanda TW, Saeed F, Ransing R, Bhandari SS, Armiya'u AY, Gürcan A, Chandradasa M. Association Between Loneliness and Suicidal Behaviour: A Scoping Review. TURK PSIKIYATRI DERGISI = TURKISH JOURNAL OF PSYCHIATRY 2023; 34:125-132. [PMID: 37357899 PMCID: PMC10468686 DOI: 10.5080/u27080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
OBJECTIVE Suicide is a public health issue, and there are several factors leading to suicide, like mental illness and psychosocial stressors. Actual loneliness (living alone) and subjective loneliness (feeling of being alone) and different suicidal behaviors have been reported to have some link. This scoping review aimed to assess the association between loneliness and suicidal behaviour by exploring the existing literature. METHODS A scoping review was conducted implementing the appropriate framework and in accord with the PRISMA-ScR extension. A PubMed database search was made using a combination of terms to find publications in English from 2011 to 2021. Studies were included if they reported quantitative outcomes of the association between loneliness and suicidal experiences, including suicidal thoughts, plans, and/or attempts. Screening and data charting of the published literature was conducted by a panel of authors. The accuracy and clarity of extracted data was checked by three reviewers. RESULTS Among 421 articles found, 31 full texts were evaluated based on exclusion and inclusion criteria, out of which, 18 papers that reported quantitative outcomes of the association between loneliness and suicidal experiences were included. We found that association between loneliness and suicidal behaviour is determined by individual, social and cultural factors. Co-existing mental illness, substance use disorder and economic hardship play an important role for the completion of suicide. CONCLUSION Loneliness is correlated with suicide, and the knowledge about this association could assist in the identification of suicidal individuals or those at elevated risk of suicidal behaviour. Future studies should focus on loneliness and its relation to suicidal ideation in individuals with different mental health disorders and personalities.
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Palmer BW, Hussain MA, Lohr JB. Loneliness in Posttraumatic Stress Disorder: A Neglected Factor in Accelerated Aging? JOURNAL OF AGEING AND LONGEVITY 2022; 2:326-339. [PMID: 36567873 PMCID: PMC9783482 DOI: 10.3390/jal2040027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Prior research suggests that people with Posttraumatic Stress Disorder (PTSD) may experience a form of accelerated biological aging. In other populations, loneliness has been shown to elevate risk for many of the same components of accelerated biological aging, and other deleterious outcomes, as seen in people with PTSD. Although standard diagnostic criteria for PTSD include "feelings of detachment or estrangement from others", the relationship of such feelings to the concept of loneliness remains uncertain, in par potentially due to a failure to distinguish between loneliness versus objective social isolation. In order to catalyze wider research attention to loneliness in PTSD, and the potential contribution to accelerated biological aging, the present paper provides three components: (1) a conceptual overview of the relevant constructs and potential interrelationships, (2) a review of the limited extant empirical literature, and (3) suggested directions for future research. The existing empirical literature is too small to support many definitive conclusions, but there is evidence of an association between loneliness and symptoms of PTSD. The nature of this association may be complex, and the causal direction(s) uncertain. Guided by the conceptual overview and review of existing literature, we also highlight key areas for further research. The ultimate goal of this line of work is to elucidate mechanisms underlying any link between loneliness and accelerated aging in PTSD, and to develop, validate, and refine prevention and treatment efforts.
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Affiliation(s)
- Barton W. Palmer
- Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92037, USA
- Mental Illness Research, Education, and Clinical Center, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
| | - Mariam A. Hussain
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92037, USA
- Mental Illness Research, Education, and Clinical Center, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
| | - James B. Lohr
- Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
- Department of Neurosciences, University of California San Diego, La Jolla, CA 92161, USA
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Wang M, Xu M, Sun L. Loneliness and coping skill mediate the association between child maltreatment and depression for rural males and females. BMC Psychiatry 2022; 22:413. [PMID: 35729560 PMCID: PMC9215002 DOI: 10.1186/s12888-022-04056-1] [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: 03/14/2022] [Accepted: 06/06/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Child maltreatment is a prevalent and notable problem in rural China, and the prevalence and severity of depression in rural areas are higher than the national norm. Several studies have found that loneliness and coping skills respectively mediated the relationship between child maltreatment and depression. However, few studies have examined the roles of loneliness and coping skills in child maltreatment and depression based on gender differences. METHODS All participants were from rural communities aged more than 18 years in Shandong province, and 879 valid samples (female:63.4%) ranging in age from 18 to 91 years old were analyzed. The Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Center for Epidemiologic Studies-Depression (CES-D), the Simple Coping Style Questionnaire (SCSQ), and the Emotional and Social Loneliness Scale (ESLS) were used to evaluate child maltreatment, depression, coping skills and loneliness. RESULTS Child maltreatment was more common and severe in males than females (F = 3.99; p < 0.05). Loneliness and coping skills partially mediated the relationship between child maltreatment and depression in males, but loneliness fully mediated the relationship between child maltreatment and depression in females. CONCLUSION In this study, males were more likely to experience child maltreatment. Child maltreatment and depression were correlated. We also found a mediating role of loneliness and coping skills for males and a mediating role of loneliness in females.
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Affiliation(s)
- Meiqi Wang
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174National Health Commission of China, Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012 Shandong China
| | - Meixia Xu
- grid.495262.e0000 0004 1777 7369Shandong Women’s University, Jinan, 250300 China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, Shandong, China. .,National Health Commission of China, Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China.
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Loneliness as a predictor of suicidal ideation and behaviour: a systematic review and meta-analysis of prospective studies. J Affect Disord 2020; 274:880-896. [PMID: 32664029 DOI: 10.1016/j.jad.2020.05.004] [Citation(s) in RCA: 154] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 04/30/2020] [Accepted: 05/05/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Suicide and suicidal behaviour are global health concerns with complex aetiologies. Given the recent research and policy focus on loneliness, this systematic review aimed to determine the extent to which loneliness predicts suicidal ideation and/or behaviour (SIB) over time. METHODS A keyword search of five major databases (CINHAL, Medline, PsychArticles, PsychInfo and Web of Knowledge) was conducted. Papers for inclusion were limited to those using a prospective longitudinal design, written in English and which measured loneliness at baseline and SIB at a later time-point. RESULTS After duplicates were removed, 947 original potential papers were identified, with 22 studies meeting the review criteria. Meta-analysis revealed loneliness was a significant predictor of both suicidal ideation and behaviour and there was evidence that depression acted as a mediator. Furthermore, studies which consisted of predominantly female participants were more likely to report a significant relationship, as were studies where participants were aged 16-20 or >55 years at baseline. LIMITATIONS There was considerable variability in measures, samples and methodologies used across the studies. Middle-aged adults were under-represented, as were individuals from minority ethnic backgrounds. All studies were conducted in countries where self-reliance and independence (i.e. individualism) are the cultural norm. CONCLUSIONS Loneliness predicts later SIB in select populations. However, due to the heterogeneity of the studies further research is needed to draw more robust conclusions. Suicide death also needs to be included as an outcome measure. A focus on more collectivist countries is also required.
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Pitman AL, King MB, Marston L, Osborn DPJ. The association of loneliness after sudden bereavement with risk of suicide attempt: a nationwide survey of bereaved adults. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1081-1092. [PMID: 32683472 PMCID: PMC7395013 DOI: 10.1007/s00127-020-01921-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 07/08/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE We aimed to test the hypothesis that among people who experience sudden bereavement, loneliness is associated with post-bereavement suicide attempt and post-bereavement suicidal ideation, even when adjusting for network size. METHODS We analysed cross-sectional data collected in the 2010 UCL Bereavement Study, to identify 3193 respondents who had experienced sudden bereavement. We used multivariable logistic regression to test for an association between loneliness (using a newly-developed eight-item loneliness measure) and post-bereavement suicide attempt and suicidal ideation, adjusting for socio-demographic factors, pre-bereavement depression and self-harm, and network size. RESULTS Among bereaved adults, loneliness was significantly associated with probability of post-bereavement suicide attempt (AOR 1.19; 95% CI 1.14-1.25) and of post-bereavement suicidal ideation (AOR 1.24; 95% CI 1.20-1.28), with estimates unchanged by adding perceived stigma of the bereavement to adjusted models. There was no association between suicide bereavement and loneliness (adjusted coefficient 0.22; 95% CI - 0.12 to 0.45; p = 0.063). The association of loneliness and suicide attempt risk was similar whether participants were bereaved by suicide or not. CONCLUSIONS People who report feeling lonely after sudden bereavement are more likely to make a suicide attempt after their loss, even when taking into account their network size and the perceived stigma of the sudden bereavement. There is no evidence that the effects of loneliness on suicidality are specific to suicide bereavement. This work identifies loneliness as a potential target for suicide prevention interventions among bereaved people. It also fuels interest in longitudinal research investigating loneliness as a putative mediator of suicide risk.
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Affiliation(s)
- Alexandra L Pitman
- UCL Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 Saint Pancras Way, London, NW1 0PE, UK.
| | - Michael B King
- UCL Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Louise Marston
- UCL Research Department of Primary Care and Population Health, University College London, Gower St, London, WC1E 6BT, UK
| | - David P J Osborn
- UCL Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 Saint Pancras Way, London, NW1 0PE, UK
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Hyland P, Shevlin M, Cloitre M, Karatzias T, Vallières F, McGinty G, Fox R, Power JM. Quality not quantity: loneliness subtypes, psychological trauma, and mental health in the US adult population. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1089-1099. [PMID: 30293176 DOI: 10.1007/s00127-018-1597-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 09/18/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Loneliness is a recognised public-health concern that is traditionally regarded as a unidimensional construct. Theories of loneliness predict the existence of subtypes of loneliness. In this study, latent class analysis (LCA) was used to test for the presence of loneliness subtypes and to examine their association with multiple mental health variables. METHODS A nationally representative sample of US adults (N = 1839) completed the De Jong Gierveld Loneliness Scale, along with self-report measures of childhood and adulthood trauma, psychological wellbeing, major depression, and generalized anxiety. RESULTS When treated as a unidimensional construct, 17.1% of US adults aged 18-70 were classified as lonely. However, the LCA results identified four loneliness classes which varied quantitatively and qualitatively: 'low' (52.8%), 'social' (8.2%), 'emotional' (26.6%), and 'social and emotional' (12.4%) loneliness. The 'social and emotional' class were characterised by the highest levels of psychological distress, followed by the 'emotional' class. The 'social' loneliness class had similar mental health scores as the 'low' loneliness class. Childhood and adulthood trauma were independently related to the most distressed loneliness classes. CONCLUSIONS Current findings provide support for the presence of subtypes of loneliness and show that they have unique associations with mental health status. Recognition of these subtypes of loneliness revealed that the number of US adults aged 18-70 experiencing loneliness was twice as high as what was estimated when loneliness was conceptualized as a unidimensional construct. The perceived quality, not the quantity, of interpersonal connections was associated with poor mental health.
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Affiliation(s)
- Philip Hyland
- Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland. .,School of Psychology, Maynooth University, Kildare, Ireland.
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland, UK
| | - Marylene Cloitre
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Science, Stanford University, Palo Alto, CA, USA
| | - Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK.,Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
| | - Frédérique Vallières
- Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Gráinne McGinty
- School of Business, National College of Ireland, Dublin, Ireland
| | - Robert Fox
- School of Psychology, Maynooth University, Kildare, Ireland
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Zerach G, Levi-Belz Y. Intolerance of Uncertainty Moderates the Association Between Potentially Morally Injurious Events and Suicide Ideation and Behavior Among Combat Veterans. J Trauma Stress 2019; 32:424-436. [PMID: 30720890 DOI: 10.1002/jts.22366] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 07/05/2018] [Accepted: 07/07/2018] [Indexed: 12/31/2022]
Abstract
Exposure to potentially morally injurious events (PMIEs) among combat veterans has been acknowledged as significant stressful combat events that may lead to mental health problems, including self-injurious thoughts and behavior (SITB). However, few studies have examined the risk and protective factors that can explain the conditions in which PMIEs may contribute to the development and maintenance of SITB. In the current study, we aimed to examine the association between PMIEs and SITB among combat veterans and explore the moderating roles of intolerance of uncertainty (IU) in this association. A volunteer sample of 191 Israeli combat veterans was recruited during 2017. Participants completed validated self-report questionnaires in a cross-sectional study. Results indicated that two separate measures of PMIEs, the Perceived Perpetration by Oneself and Others subscale of the Moral Injury Events Scale (MIES) and the Causes subscale of the Moral Injury Questionnaire (MIQ-Causes), were positively associated with higher levels of SITB. Moreover, beyond the contributions of reserve duty, posttraumatic stress symptoms, and depressive symptoms, MIQ-Causes scores significantly predicted current SITB. Importantly, under low and average levels of inhibitory IU, significant positive effects were revealed for the MIQ-Causes on current SITB, R² = .34. Although veterans exposed to PMIEs are more prone to SITB, even years after their release from military service, their IU may temper the link between experiences of PMIEs and SITB.
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Affiliation(s)
- Gadi Zerach
- Department of Behavioral Sciences and Psychology, Ariel University, Ariel, Israel
| | - Yossi Levi-Belz
- Department of Behavioral Sciences, Ruppin Academic Center, Emek-Hefer, Israel
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Levi-Belz Y, Gvion Y, Levi U, Apter A. Beyond the mental pain: A case-control study on the contribution of schizoid personality disorder symptoms to medically serious suicide attempts. Compr Psychiatry 2019; 90:102-109. [PMID: 30852349 DOI: 10.1016/j.comppsych.2019.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 01/12/2019] [Accepted: 02/15/2019] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Clinical and research findings have highlighted the role of interpersonal factors in suicidal behavior with high levels of intent and lethality. Schizoid personality disorder (SPD) is at the extreme end of interpersonal difficulties. Thus, we aimed to understand the contribution of SPD symptoms to suicide behavior and specifically to more lethal suicide attempts. METHOD Four groups were investigated (N = 338): medically serious suicide attempters, medically non-serious suicide attempters, psychiatric and healthy controls. SPD symptoms, mental pain variants, and clinical characteristics were assessed. RESULTS Overall, attempters were characterized by higher levels of most SPD symptoms. Solitary lifestyle and emotional detachment were higher among medically serious suicide attempters relative to less-serious attempters. Emotional detachment doubled the risk for high lethality, beyond mental pain variables. CONCLUSIONS SPD symptoms of interpersonal difficulties and low levels of emotional expressions are important risk factors for more severe suicidal behavior. Implications for identification of at-risk groups for suicide are discussed.
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Affiliation(s)
- Y Levi-Belz
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel; The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel.
| | - Y Gvion
- Department of Child Clinical Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - U Levi
- Department of Behavioral Sciences, Peres Academic Center, Rehovot, Israel
| | - A Apter
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel; Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petach Tikvah, Israel
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