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Pandia V, Fitriana E, Afriandi I, Purba FD, Danasasmita FS, Ichsan A, Pradana K, Santoso AHS, Engellia R, Mardhiyah FS. Psychometric Evaluation of Brief Reason for Living Inventory for Adolescents (BRFL-A) Instrument in the Indonesian Language. Glob Pediatr Health 2024; 11:2333794X241254690. [PMID: 38808325 PMCID: PMC11131399 DOI: 10.1177/2333794x241254690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/20/2024] [Accepted: 04/24/2024] [Indexed: 05/30/2024] Open
Abstract
Objectives. The Brief Reason for Living Inventory for Adolescents (BRFL-A) is used to assess protective factors against suicide in non-clinical settings. This study aimed to validate the psychometric properties of BRFL-A in Bahasa Indonesia. Methods. A total of 728 high-school and university students filled BRFL-A questionnaire and the results were analyzed. The reliability, content, convergent, discriminant, and factorial or construct validity, were investigated using content validity index Cronbach's Alpha, while content validity index (CVI), confirmatory factor analysis, and Pearson product-moment correlation were assesed with MSPSS, SIS, INQ-15, and DASS-18. Results. The results showed that the Indonesian version of BRFL-A had good internal consistency, test-retest reliability, as well as content and concurrent validity, supporting both the 1-factor and the 5-factor model of factorial validity. Conclusions. The Indonesian version of the BRFL-A was valid and reliable to measure protective factors against suicide risk among adolescents and young adults in non-clinical settings.
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Affiliation(s)
- Veranita Pandia
- Department of Psychiatry, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Efi Fitriana
- Department of Psychology, Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia
- Center for Psychometric Studies, Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia
| | - Irvan Afriandi
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Fredrick Dermawan Purba
- Department of Psychology, Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia
- Center for Psychological Innovation and Research, Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia
| | - Febrianti Santiardi Danasasmita
- Department of Psychiatry, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Abdullah Ichsan
- Department of Psychiatry, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Kent Pradana
- Department of Psychiatry, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Alfonso Haris Setia Santoso
- Department of Psychiatry, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Rita Engellia
- Department of Psychiatry, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Fithriani Salma Mardhiyah
- Department of Psychiatry, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
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Chang CJ, Livingston NA, Rashkovsky KT, Harper KL, Kuehn KS, Khalifian C, Harned MS, Tucker RP, Depp CA. A Scoping Review of Suicide Prevention Interventions for Lesbian, Gay, Bisexual, Transgender, Queer, and Other Sexual and Gender Minority Individuals. LGBT Health 2024. [PMID: 38722250 DOI: 10.1089/lgbt.2023.0262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
Purpose: This scoping review summarizes the literature on suicide-specific psychological interventions among lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) people to synthesize existing findings and support future intervention research and dissemination. Methods: Electronic databases PsycInfo and PubMed were searched for reports of psychological intervention studies with suicide-related outcome data among LGBTQ+ people. A total of 1269 articles were screened, and 19 studies met inclusion criteria (k = 3 examined suicide-specific interventions tailored to LGBTQ+ people, k = 4 examined nontailored suicide-specific interventions, k = 11 examined minority stress- or LGBTQ+ interventions that were not suicide-specific, and k = 1 examined other types of interventions). Results: Synthesis of this literature was made challenging by varied study designs, and features limit confidence in the degree of internal and external validity of the interventions evaluated. The only established suicide-specific intervention examined was Dialectical Behavior Therapy, and minority stress- and LGBTQ-specific interventions rarely targeted suicidal thoughts and behaviors (STBs). Nevertheless, most interventions reviewed demonstrated support for feasibility and/or acceptability. Only five studies tested suicide-related outcome differences between an LGBTQ+ group and a cisgender/heterosexual group. These studies did not find significant differences in STBs, but certain subgroups such as bisexual individuals may exhibit specific treatment disparities. Conclusion: Given the dearth of research, more research examining interventions that may reduce STBs among LGBTQ+ people is critically needed to address this public health issue.
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Affiliation(s)
- Cindy J Chang
- Veterans Affairs San Diego Healthcare System, U.S. Department of Veterans Affairs, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Nicholas A Livingston
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Katerine T Rashkovsky
- Veterans Affairs San Diego Healthcare System, U.S. Department of Veterans Affairs, San Diego, California, USA
| | - Kelly L Harper
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Kevin S Kuehn
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - Chandra Khalifian
- Veterans Affairs San Diego Healthcare System, U.S. Department of Veterans Affairs, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Melanie S Harned
- VA Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, Washington, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Raymond P Tucker
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Colin A Depp
- Veterans Affairs San Diego Healthcare System, U.S. Department of Veterans Affairs, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
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Isaeva ER, Ryzhova DM, Stepanova AV, Mitrev IN. Assessment of Suicide Risk in Patients with Depressive Episodes Due to Affective Disorders and Borderline Personality Disorder: A Pilot Comparative Study. Brain Sci 2024; 14:463. [PMID: 38790442 PMCID: PMC11119353 DOI: 10.3390/brainsci14050463] [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: 09/30/2023] [Revised: 03/26/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024] Open
Abstract
This study assessed suicidal risk in patients suffering from non-psychotic depressive disorders within various clinical and nosological forms (F31-F34 mood disorders and F60.31-emotionally unstable personality disorder). Clinical and psychological features were presented, as well as predictors of suicidal risk in patients of these groups. We performed a comparative analysis of the anxiety and depression level, the level of mental pain, fear of death and the severity of anti-suicidal motives in patients with affective disorders and borderline personality disorder (BPD). Based on the results, 100% of patients in these clinical nosological groups were found to have a high level of suicidal risk. Patients with affective disorders have weak anti-suicidal motives and are not fully aware of the consequences of their own death. Patients with BPD have a higher suicidal risk than patients with affective disorders; they are characterized by less pronounced social orientation, demonstrativeness, self-centeredness, less pronounced levels of anxiety and fear of death.
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Affiliation(s)
- Elena Rudolfovna Isaeva
- Department of General and Clinical Psychology, Academician I.P. Pavlov First St. Petersburg State Medical University, 197022 Saint Petersburg, Russia;
| | - Daria Maksimovna Ryzhova
- Department of General and Clinical Psychology, Academician I.P. Pavlov First St. Petersburg State Medical University, 197022 Saint Petersburg, Russia;
| | - Anna Vladimirovna Stepanova
- 10th Department—Center for Treatment of Depression and Anxiety, V. M. Bekhterev Psychiatry and Neurology National Medical Research Center, 192019 Saint Petersburg, Russia;
| | - Ivo Nestorov Mitrev
- Department of Psychiatry and Medical Psychology, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria;
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Camp J, Durante G, Cooper A, Smith P, Rimes KA. Clinical outcomes for sexual and gender minority adolescents in a dialectical behaviour therapy programme. Behav Cogn Psychother 2024:1-19. [PMID: 38586939 DOI: 10.1017/s135246582400016x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
BACKGROUND Sexuality and gender minoritised (SGM) adolescents are at increased risk of self-injury and suicide, and experience barriers to accessing mental health support. Dialectical behaviour therapy (DBT) is an effective treatment for self-injury and emotion dysregulation in adolescent populations, but few studies have published outcomes of DBT for SGM young people. AIMS This study aimed to investigate treatment outcomes and completion for SGM adolescents and their cisgender and heterosexual peers, in the National & Specialist CAMHS, DBT service (UK). METHOD Treatment completion, and opting out before and during treatment were examined for sexual and gender identity groups, as well as changes by the end of treatment in emotion dysregulation, self-injury, in-patient bed-days, emergency department attendances, and borderline personality disorder, depression and anxiety symptoms. RESULTS SGM adolescents were over-represented in this service, even after considering their increased risk for self-injury. No statistically significant differences were found for treatment completion between the sexual orientation and gender identity groups, although there were patterns indicating possible lower treatment uptake and completion that warrant further investigation. Clinical outcomes for treatment-completers showed improvement by the end of DBT for each group, with few exceptions. DISCUSSION These results are from relatively small subsamples, and it was not possible to separate by sex assigned at birth. Findings should be treated tentatively and as early indications of effect sizes to inform future studies. This study suggests that DBT could be a useful treatment for SGM adolescents in a highly specialist treatment setting.
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Affiliation(s)
- J Camp
- National & Specialist CAMHS, DBT Service, South London & Maudsley NHS Foundation Trust, Micheal Rutter Centre, Maudsley Hospital, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - G Durante
- Department of Psychology, Goldsmiths University of London, Lewisham Way, London, UK
| | - A Cooper
- Department of Psychology, Goldsmiths University of London, Lewisham Way, London, UK
| | - P Smith
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - K A Rimes
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
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Gorraiz G, Porta G, McMakin DL, Kennard BD, Douaihy AB, Biernesser C, Foxwell AA, Wolfe K, Goldstein T, Brent DA. Factors Associated With Reasons for Living Among Suicidal Adolescents. Arch Suicide Res 2024; 28:471-481. [PMID: 37013700 PMCID: PMC10548347 DOI: 10.1080/13811118.2023.2190367] [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] [Indexed: 04/05/2023]
Abstract
OBJECTIVE The objective of this study was to identify baseline demographic and clinical factors associated with higher scores on the Reasons for Living Inventory for Adolescents (RFL-A) at baseline and over follow-up. METHOD Using data from a pilot clinical trial of a brief intervention for suicidal youth transitioning from inpatient to outpatient, we identified univariate associations of baseline characteristics with RFL-A and used regression to identify the most parsimonious subset of these variables. Finally, we examined to what extent changes in these characteristics over time were related to changes in RFL-A. RESULTS Univariate analyses found that better external functional emotion regulation and social support were associated with higher RFL-A scores; more self-reported depression, internal dysfunctional emotion regulation, sleep disturbance, anxiety, and distress tolerance were associated with lower RFL-A scores. Multiple linear regression identified internal dysfunctional emotion regulation and external functional emotion regulation as the most parsimonious set of characteristics associated with RFL-A. Improvement in internal emotion regulation, sleep, and depression were related to improvements in RFL-A over time. CONCLUSION Our findings indicate that emotion regulation-specifically maladaptive internal strategies and use of external resources-is strongly associated with RFL-A. Improvements in internal emotion regulation (r = 0.57), sleep (r = -0.45), and depression (r = -0.34) were related to increases in RFL-A.
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Affiliation(s)
- G. Gorraiz
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - G. Porta
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, United States
| | - D. L. McMakin
- Department of Psychology, Florida International University, Miami, FL, United States
| | - B. D. Kennard
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - A. B. Douaihy
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, United States
| | - C. Biernesser
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - A. A. Foxwell
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Children’s Health Medical Center, Dallas, TX, United States
| | - K. Wolfe
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Children’s Health Medical Center, Dallas, TX, United States
| | - T. Goldstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, United States
| | - D. A. Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, United States
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Bronsard G, Leroux PA, Diallo I, Eleuterio J, Le Bihan A, Boyer L, Lavenne-Collot N. Prevalence of mental disorders in closed educational centers in France. L'ENCEPHALE 2024:S0013-7006(24)00016-2. [PMID: 38368185 DOI: 10.1016/j.encep.2023.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 11/09/2023] [Accepted: 11/14/2023] [Indexed: 02/19/2024]
Abstract
INTRODUCTION Closed educational centres (CEC) receive young offenders who most often have a conduct disorder (CD). Mental disorders other than conduct disorder are a negative factor in the effect of educational actions. Moreover, adverse life experiences are frequent vulnerability factors in this population. This article aims to document the prevalence and links between psychiatric disorders, exposure to trauma, and the psycho-behavioural characteristics of adolescents placed in CEC. METHOD We conducted a multicentre epidemiological study on a sample of 101 adolescents placed in nine closed educational centres in France. Psychiatric disorders were measured by the MINI-KID 2 and Conners Rating Scale questionnaires. Several questionnaires were used to collect sociodemographic data and the psychological profile of each adolescent. RESULTS Among the adolescents, 90.2% had at least one mental disorder with a predominance of conduct disorder (80%). Comorbidity was also frequently found: among the subjects with conduct disorder, 37% had at least one other psychiatric disorder. Interestingly, the intensity of conduct disorder and the Adverse Childhood Experiences (ACE) score were significantly correlated. Furthermore, two subgroups were identified: adolescents with isolated conduct disorder (44.6%) and adolescents with other psychiatric disorders (45.7%) with or without conduct disorder. The latter subgroup showed higher vulnerability and poorer outcomes in terms of attachment patterns, feelings of abandonment, hostility and impulsivity. CONCLUSION This study is the first French epidemiological study of mental disorders in juvenile offenders. It suggests that the detection of psychiatric disorders in young people in CEC is an important prerequisite for the implementation of targeted interventions according to different profiles. Furthermore, collaboration between the medical-psychological and judicial fields, in the form of an operational partnership, is necessary to guarantee better support for these young people.
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Affiliation(s)
- Guillaume Bronsard
- Childhood and Adolescent Psychiatry Department, Bohars Hospital, Brest University Hospital, Brest, France; EA7479 SPURBO, University of Western Brittany, Brest, France; EA3279 CEReSS, University of Aix-Marseille, Marseille, France
| | - Pierre-Antoine Leroux
- Childhood and Adolescent Psychiatry Department, Bohars Hospital, Brest University Hospital, Brest, France; EA7479 SPURBO, University of Western Brittany, Brest, France
| | - Issaga Diallo
- EA3279 CEReSS, University of Aix-Marseille, Marseille, France
| | - Jules Eleuterio
- Childhood and Adolescent Psychiatry Department, Bohars Hospital, Brest University Hospital, Brest, France; EA7479 SPURBO, University of Western Brittany, Brest, France
| | - Alban Le Bihan
- Childhood and Adolescent Psychiatry Department, Bohars Hospital, Brest University Hospital, Brest, France; EA7479 SPURBO, University of Western Brittany, Brest, France
| | - Laurent Boyer
- EA3279 CEReSS, University of Aix-Marseille, Marseille, France; Medical Information Department, Public Assistance-Marseille University Hospital, Marseille, France
| | - Nathalie Lavenne-Collot
- Childhood and Adolescent Psychiatry Department, Bohars Hospital, Brest University Hospital, Brest, France; EA7479 SPURBO, University of Western Brittany, Brest, France; Inserm U1101, LATIM, Brest, France.
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Cantrell A, Sworn K, Chambers D, Booth A, Taylor Buck E, Weich S. Factors within the clinical encounter that impact upon risk assessment within child and adolescent mental health services: a rapid realist synthesis. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-107. [PMID: 38314750 DOI: 10.3310/vkty5822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Background Risk assessment is a key process when a child or adolescent presents at risk for self-harm or suicide in a mental health crisis or emergency. Risk assessment by a healthcare professional should be included within a biopsychosocial assessment. However, the predictive value of risk-screening tools for self-harm and suicide in children and adolescents is consistently challenged. A review is needed to explore how best to undertake risk assessment and the appropriate role for tools/checklists within the assessment pathway. Aims To map research relating to risk assessment for child and adolescent mental health and to identify features that relate to a successful risk assessment. Objectives To review factors within the clinical encounter that impact upon risk assessments for self-harm and suicide in children and adolescents: i. to conduct a realist synthesis to understand mechanisms for risk assessment, why they occur and how they vary by context ii. to conduct a mapping review of primary studies/reviews to describe available tools of applicability to the UK. Data sources Databases, including MEDLINE, PsycINFO®, EMBASE, CINAHL, HMIC, Science and Social Sciences Citation Index and the Cochrane Library, were searched (September 2021). Searches were also conducted for reports from websites. Review methods A resource-constrained realist synthesis was conducted exploring factors that impact upon risk assessments for self-harm and suicide. This was accompanied by a mapping review of primary studies/reviews describing risk-assessment tools and approaches used in UK child and adolescent mental health. Following piloting, four reviewers screened retrieved records. Items were coded for the mapping and/or for inclusion in the realist synthesis. The review team examined the validity and limitations of risk-screening tools. In addition, the team identified structured approaches to risk assessment. Reporting of the realist synthesis followed RAMESES guidelines. Results From 4084 unique citations, 249 papers were reviewed and 41 studies (49 tools) were included in the mapping review. Eight reviews were identified following full-text screening. Fifty-seven papers were identified for the realist review. Findings highlight 14 explanations (programme theories) for a successful risk assessment for self-harm and suicide. Forty-nine individual assessment tools/approaches were identified. Few tools were developed in the UK, specifically for children and adolescents. These lacked formal independent evaluation. No risk-screening tool is suitable for risk prediction; optimal approaches incorporate a relationship of trust, involvement of the family, where appropriate, and a patient-centred holistic approach. The objective of risk assessment should be elicitation of information to direct a risk formulation and care plan. Limitations Many identified tools are well-established but lack scientific validity, particularly predictive validity, or clinical utility. Programme theories were generated rapidly from a survey of risk assessment. Conclusions No single checklist/approach meets the needs of risk assessment for self-harm and suicide. A whole-system approach is required, informed by structured clinical judgement. Useful components include a holistic assessment within a climate of trust, facilitated by family involvement. Study registration This study is registered as PROSPERO CRD42021276671. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR135079) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 1. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Anna Cantrell
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Katie Sworn
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Duncan Chambers
- School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Andrew Booth
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | | | - Scott Weich
- School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
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Grunewald W, Perkins NM, Jeon ME, Klonsky ED, Joiner TE, Smith AR. Development and Validation of the Fearlessness About Suicide Scale. Assessment 2023:10731911231200866. [PMID: 37941367 DOI: 10.1177/10731911231200866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Recent work has identified fearlessness about suicide, rather than fearlessness about death, as more theoretically relevant in the assessment of capability for suicide and thus a more appropriate construct of measurement. The aim of the current project was to develop and validate a scale specifically assessing fearlessness about suicide. Across two studies, support for a 7-item, single-factor structure of the Fearlessness About Suicide Scale (FSS) emerged. The FSS factor structure demonstrated a good fit in the first study and was replicated in the second study. Measurement invariance was examined across those identifying as men and women and found to be comparable. The FSS also demonstrated test-rest reliability and good convergent and divergent validity in community and undergraduate samples. Overall, findings indicate that the FSS has a replicable factor structure that generalizes across those identifying as men and women and may better assess components of capability for suicide than existing scales.
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Hari S, Ruch DA, Bridge JA, Brink FW. The evaluation of emotional maltreatment's effect on family dynamics and suicidal behaviors. CHILD ABUSE & NEGLECT 2023; 144:106351. [PMID: 37515917 DOI: 10.1016/j.chiabu.2023.106351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 06/27/2023] [Accepted: 07/10/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Emotional maltreatment and poor family functioning are known risks for youth suicide, but few studies have examined these issues as prospective predictors of future attempts. OBJECTIVES Examine family functioning and suicide risk associated with emotional maltreatment in youth with a lifetime history of major depressive disorder (MDD) and the prospective association of emotional maltreatment and family functioning with future suicide attempts. PARTICIPANTS AND SETTING Participants included 321 youth aged 12-15 years (251 with emotional maltreatment; 70 with no emotional maltreatment) recruited from a metropolitan children's hospital from 2011 to 2018. Prospective analyses included 280 youths (221 with emotional maltreatment; 59 without emotional maltreatment). METHODS Semi-structured interviews and self-reports assessed family functioning and suicidal thoughts and behaviors in youth with and without emotional maltreatment at baseline, 6-month, 1-year, and 2-year follow-up. Multivariate analyses examined whether emotional maltreatment predicted future suicide attempts, beyond the effect of prior suicide attempts. RESULTS Emotionally maltreated youth reported significantly lower scores for family adaptability, cohesion, and family alliance, and higher rates of suicidal ideation and suicide attempts, compared to youth without emotional maltreatment. Youth experiencing multiple forms of abuse were significantly more likely to attempt suicide at future timepoints, however this association was attenuated after controlling for prior suicide attempts. CONCLUSION Youth who experienced emotional maltreatment had a significantly higher percentage of past suicidal thoughts and behaviors and significantly less favorable scores for family functioning associated with an increased suicide risk. Findings support family-focused suicide prevention strategies as a promising approach to reduce youth suicide.
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Affiliation(s)
- Shilpa Hari
- The Center for Family Safety and Healing at Nationwide Children's Hospital, 655 East Livingston Avenue, Columbus, OH 43205, USA.
| | - Donna A Ruch
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 444 Butterfly Gardens Drive, Columbus, OH 43215, USA.
| | - Jeffrey A Bridge
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 444 Butterfly Gardens Drive, Columbus, OH 43215, USA; The Ohio State University College of Medicine, 370 W 9(th) Ave, Columbus, OH 43210, USA.
| | - Farah W Brink
- The Center for Family Safety and Healing at Nationwide Children's Hospital, 655 East Livingston Avenue, Columbus, OH 43205, USA; The Ohio State University College of Medicine, 370 W 9(th) Ave, Columbus, OH 43210, USA.
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Brás M, Elias P, Cunha FF, Martins C, Nunes C, Carmo C. Vulnerability to Suicide Ideation: Comparative Study between Adolescents with and without Psychosocial Risk. Healthcare (Basel) 2023; 11:2663. [PMID: 37830700 PMCID: PMC10572437 DOI: 10.3390/healthcare11192663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/16/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
Adolescents are characterized as a risk group for suicide, being the fourth leading cause of death in young people. The main aim was to compare vulnerability to suicidal ideation in a sample of young people with and without psychosocial risk. The total sample consisted of 137 adolescents, aged between 10 and 19 years (M = 14.76; SD = 1.40), and it was composed of two groups-the psychosocial risk group (n = 60) and general population group (n = 77). In both groups, suicidal ideation correlated positively with negative events and negatively with self-esteem and social support satisfaction. When comparing the two groups, the psychosocial risk group presented significantly higher mean values of negative life events (mainly separations/losses and physical and sexual abuse) and significantly lower mean values of satisfaction with social support (particularly with family and social activities). It was also found that, in the psychosocial risk group, negative life events were the only significant predictors of suicidal ideation. This study allowed identifying the role of risk and protective factors in suicidal ideation, according to the psychosocial risk of adolescents. The practical implications of the findings on adolescents' mental health and the promotion of their well-being are discussed.
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Affiliation(s)
- Marta Brás
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (F.F.C.); (C.M.); (C.N.); (C.C.)
| | - Patrícia Elias
- Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal;
| | - Francisca Ferreira Cunha
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (F.F.C.); (C.M.); (C.N.); (C.C.)
| | - Cátia Martins
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (F.F.C.); (C.M.); (C.N.); (C.C.)
| | - Cristina Nunes
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (F.F.C.); (C.M.); (C.N.); (C.C.)
| | - Cláudia Carmo
- Psychology Research Centre (CIP), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (F.F.C.); (C.M.); (C.N.); (C.C.)
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Gebremeskel TG, Berhe M, Tesfahunegn TB, Gesesew HA, Ward PR. Prevalence and Factors Associated With Suicidal Ideation Among Adult Eritrean Refugees in Northern Ethiopia. Front Public Health 2022; 10:841848. [PMID: 35602160 PMCID: PMC9114296 DOI: 10.3389/fpubh.2022.841848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/14/2022] [Indexed: 11/29/2022] Open
Abstract
Background The present study assessed the prevalence of and factor associated with suicidal ideations among adult Eritrean refugees in Tigray, Ethiopia. Methods A community-based cross-sectional study was carried out among 400 adult refugees living in the Mai-Aini refugee camp in Tigray, Northern Ethiopia from September 2019 to May 2020. The response variable was suicidal ideation and was measured using World Mental Health (WMH) Survey Initiative Version of the World Health Organization Composite International Diagnostic Interview. We applied bivariate and multivariate logistic regression to determine predictors for suicide ideations. Odds ratios and p-values were determined to check the associations between variables, and a p-value <0.05 was considered as a cut-off for statistical significance. Results The prevalence of suicidal ideations was 20.5% (95% CI: 16.4%, 24.5%). Having previous history of trauma [AOR = 2.3, 95% CI: 1.4, 4.5], a history of chronic illness [AOR = 2.9, 95% CI: 1.3, 6.5], a family history of mental disorder [AOR = 3.08, 95% CI: 1.3, 7.06], and history of post-traumatic stress disorder [AOR = 5.7, 95% CI: 2.8, 11.5] were significantly associated with suicidal ideations. Conclusions This study showed that during the stay in the refugee camp, there was a high prevalence of suicide ideations compared to the prevalence of suicide ideations among the general populations of Ethiopia, Europe, and China, and the lifetime pooled prevalence across 17 countries. Having previous history of trauma, a history of chronic illness, a family history of mental disorder, and history of post-traumatic stress disorder were the factors statistically associated with the suicidal ideation.
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Affiliation(s)
- Teferi Gebru Gebremeskel
- Department of Reproductive Health, College of Health Sciences, Aksum University, Aksum, Ethiopia.,Discipline of Public Health, Flinders University, Adelaide, SA, Australia
| | - Mulaw Berhe
- Department of Public Health, College of Health Sciences, Aksum University, Aksum, Ethiopia
| | - Tadis Brhane Tesfahunegn
- Department of Reproductive Health, College of Health Sciences, Aksum University, Aksum, Ethiopia
| | - Hailay Abrha Gesesew
- Centre for Research on Health Policy, Torrens University, Adelaide, SA, Australia.,Departments of Epidemiology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Paul R Ward
- Centre for Research on Health Policy, Torrens University, Adelaide, SA, Australia
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Kirchner S, Till B, Plöderl M, Niederkrotenthaler T. Effects of "It Gets Better" Suicide Prevention Videos on Youth Identifying as Lesbian, Gay, Bisexual, Transgender, Queer, or Other Sexual or Gender Minorities: A Randomized Controlled Trial. LGBT Health 2022; 9:436-446. [PMID: 35575732 PMCID: PMC9499448 DOI: 10.1089/lgbt.2021.0383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose: The “It Gets Better” project (IGBP) features video narratives of lesbian, gay, bisexual, transgender, queer persons or persons with other sexual or gender minority identities (LGBTQ+) of overcoming coming-out-related difficulties. This is the first experimental study investigating effects of these videos. Methods: We conducted a double-blind randomized controlled trial on-site in Austria and online in German-language settings from January to November 2020 with LGBTQ+ youth (14–22 years; n = 483), randomized to an IGBP (n = 242) or control video (n = 241). Suicidal ideation (primary outcome), help-seeking intentions, hopelessness, mood, and sexual identity were assessed at baseline (T1), postexposure (T2), and 4-week follow-up (T3). We assessed differences among gender identities, sexual orientations, with regard to depressive symptoms, and the role of identification. Data were analyzed with linear mixed models and mediation analysis. Results: There was no overall effect on suicidal ideation, but nonbinary/transgender individuals experienced a small-sized improvement (T2: mean change [MC] from baseline MC = −0.06 [95% confidence interval {CI} −0.16 to 0.05], p = 0.60; mean difference [MD] to controls MD = −0.42 [95% CI −0.79 to −0.06], p = 0.02, d = −0.10). An indirect preventive effect on suicidal ideation at T2 through the degree of identification with the protagonist in the video was observed. There was improvement in help-seeking intentions in the intervention group (T2: MC = 0.25 [95% CI 0.15 to 0.35], p < 0.001; MD = 0.28 [95% CI 0.01 to 0.54], p < 0.05, d = 0.09). Conclusion: Video narratives featuring coping might have some potential to decrease suicidal ideation and encourage help-seeking among vulnerable youth identifying with videos, but effects are small and short-lived. Study Registration: German Clinical Trial Registry (DRKS00019913).
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Affiliation(s)
- Stefanie Kirchner
- Unit Suicide Research and Mental Health Promotion, Department for Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Benedikt Till
- Unit Suicide Research and Mental Health Promotion, Department for Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Martin Plöderl
- Department for Crisis Intervention and Suicide Prevention, University Clinic for Psychiatry, Psychotherapy, and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
| | - Thomas Niederkrotenthaler
- Unit Suicide Research and Mental Health Promotion, Department for Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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13
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Thomas AL, Brausch AM. Family and peer support moderates the relationship between distress tolerance and suicide risk in black college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1138-1145. [PMID: 32669061 DOI: 10.1080/07448481.2020.1786096] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/11/2020] [Accepted: 06/12/2020] [Indexed: 06/11/2023]
Abstract
ObjectivesThe relationship between distress tolerance and suicide risk was examined in black college students, as well as the moderating role of family and peer support in this relationship. Parent and peer support were studied separately in their relationship to overall suicidality.MethodOne-hundred twenty-five Black undergraduate students completed self-report measures that assessed study variables.ResultsUsing moderation analyses, distress tolerance was significantly associated with overall suicidality, such that increased tolerance was associated with decreased risk. Higher family support was significantly associated with decreased suicide risk, while peer support was not. However, both family and peer support significantly moderated the relationship between distress tolerance and suicide risk. For both types of support, the relationship between distress tolerance and suicide risk was significant when support was low.ConclusionsSocial support appears to be an important protective factor for suicide risk in black college students.
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Affiliation(s)
- Anisha L Thomas
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, Kentucky, USA
- Department of Psychology, Mississippi State University, Starkville, Mississippi, USA
| | - Amy M Brausch
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, Kentucky, USA
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14
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Gebremeskel TG, Berhe M, Tesfa Berhe E. Suicide Attempts Among Adult Eritrean Refugees in Tigray, Ethiopia: Prevalence and Associated Factors. Risk Manag Healthc Policy 2022; 15:133-140. [PMID: 35140534 PMCID: PMC8819699 DOI: 10.2147/rmhp.s311335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 11/15/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The present study assessed the prevalence of and factors associated with suicide attempts among adult Eritrean refugees in Tigray, Ethiopia. Methods A community-based cross-sectional study was carried out among adult refugees from February 2020 to April 2020. The exposure variables included socio-demographic, clinically related, and psychosocial characteristics, and substance use-related factors. We included 400 participants and recruited them via a systematic random sampling technique. The study participants were between 18 and 60 years old. Data were collected using a structured interviewer-administered questionnaire. We applied bivariable and multivariable logistic regression to determine predictors for suicide attempts. Multicollinearity was checked to test correlations among predictor variables, and the Hosmer and Lemeshow test (p>0.2) was conducted to check the fitness of the model. Odds ratios and p-values were determined to check the associations between variables, and a p-value <0.05 was considered as a cut-off for statistical significance. Results The prevalence of suicide attempts was 7.3% (95% CI: 4.8%, 9.8%). Having current symptoms of trauma (AOR=5.6, 95% CI: 2.1, 14.9), a family history of mental disorder (AOR=3.02, 95% CI: 1.01, 9.07), a history of post-traumatic stress disorder (PTSD) (AOR=2.7, 95% CI: 1.01, 7.4), and severe hopelessness (AOR=3.9, 95% CI: 1.3, 12.7) were significantly associated with suicide attempts. Conclusion This study showed that during the stay in the refugee camp, there was a high prevalence of suicide attempts compared to the prevalence of suicide attempts among the general populations of Ethiopia, Europe, and China, and the lifetime pooled prevalence across 17 countries. Current symptoms of trauma, PTSD, a family history of mental illness, and hopelessness were the factors statistically associated with the suicide attempt. Early screening, detection, and management of suicidal behavior, as well as appropriate mental healthcare, are warranted in refugee camps to reduce the number of suicide attempts.
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Affiliation(s)
- Teferi Gebru Gebremeskel
- Department of Reproductive Health, College of Health Sciences, Aksum University, Aksum, Ethiopia
- Discipline of Public Health, Flinders University, Adelaide, SA, Australia
- Correspondence: Teferi Gebru Gebremeskel Email
| | - Mulaw Berhe
- Department of Public Health, College of Health Sciences, Aksum University, Aksum, Ethiopia
| | - Elsa Tesfa Berhe
- Department of Reproductive Health, College of Health Sciences, Aksum University, Aksum, Ethiopia
- Sexual Reproductive Health Department, Medicine Sans Frontier MSFUM Rakuba Project in Gedarif State, Gedarif, Sudan
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15
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Braun M, Till B, Pirkis J, Niederkrotenthaler T. Effects of suicide prevention videos developed by and targeting adolescents: a randomized controlled trial. Eur Child Adolesc Psychiatry 2021; 32:847-857. [PMID: 34817663 PMCID: PMC8611173 DOI: 10.1007/s00787-021-01911-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/08/2021] [Indexed: 11/25/2022]
Abstract
Suicide prevention videos featuring young people's personal narratives of hope and recovery are increasingly used in suicide prevention, but research on their effects is scarce. A double-blind randomized controlled trial was conducted to test the effects of a suicide prevention video featuring an adolescent mastering his suicidal ideation by getting help on 14 to 19-year-olds. N = 299 adolescents were randomly allocated to watch the intervention video (n = 148) or a control video unrelated to mental health (n = 151). Questionnaire data were collected before (T1) and immediately after exposure (T2), and 4 weeks later (T3). Data were analyzed with a repeated-measures ANCOVA. The primary outcome was suicidal ideation, assessed with the Reasons for Living Inventory for Adolescents. Secondary outcomes were help-seeking intentions, attitudes towards suicide, stigmatization of suicidality, and mood. There was an immediate beneficial effect of the intervention on suicidal ideation (T2 mean change from baseline within intervention group MChange = - 0.16 [95% CI - 0.20 to - 0.12], mean difference compared to control group MDiff = - 0.09 [95% CI - 0.15 to - 0.03], ηp2 = 0.03), which was not maintained at T3. Participants reported significantly higher help-seeking intentions, which was maintained at 4-week follow-up. They also reported a sustained reduction of favorable attitudes to suicide. Effects on suicidal ideation were mediated by identification with the featured protagonist. Adolescents appear to benefit from suicide prevention narratives featuring personal stories from peers on coping with suicidal ideation and help-seeking.Trial registration DRKS00017405; 24/09/19; retrospectively registered.
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Affiliation(s)
- Marlies Braun
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
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16
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Rozek DC, Crawford JN, LoSavio ST, Myers US, Dabovich P, Warnecke A, Smith NB, Bryan CJ. The protective role of reasons for living on suicidal cognitions for military affiliated individuals with a positive PTSD screen in primary care settings. J Affect Disord 2021; 292:424-429. [PMID: 34144367 DOI: 10.1016/j.jad.2021.05.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/31/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Identifying and enhancing protective beliefs is essential in reducing suicide risk among military-affiliated individuals. The goal of this study was to examine if specific reasons for living impact the relationship between PTSD and suicidal cognitions among military-affiliated individuals in primary care settings. METHODS Participants included 2,685 U.S. military personnel and their adult beneficiaries recruited from primary care clinics. Participants completed the Primary Care Posttraumatic Stress Disorder Screen, Suicide Cognitions Scale, and Brief Reasons for Living Inventory. RESULTS Responsibility to family and survival and coping beliefs-were related to suicidal cognitions with higher levels associated with less suicidal cognitions and a weaker relationship between PTSD and suicidal cognitions. By contrast, fear of suicide and fear of social disapproval were associated with more suicidal cognitions, and the link between positive PTSD screen and suicidal cognitions was stronger for individuals with higher levels of fear of social disapproval. Moral objection did not predict suicidal cognitions and did not moderate the relationship between PTSD and suicidal cognitions. LIMITATIONS The limitations of the study include that measures were done in primary care and brief screeners were often used. Additionally, the study is cross-sectional in nature, whereas some of the symptoms and outcome variables likely fluctuate over time. CONCLUSIONS Findings suggest not all reasons for living are not equally influential and, among military-affiliated individuals with a positive PTSD screen, bolstering reasons for living related to responsibility to family and survival and coping skills could be particularly impactful in reducing suicide cognitions.
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Affiliation(s)
- David C Rozek
- UCF RESTORES & Department of Psychology, University of Central Florida, Orlando, FL, USA.
| | - Jennifer N Crawford
- Department of Psychiatry & Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Stefanie T LoSavio
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Ursula S Myers
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA; Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Paula Dabovich
- School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, SA, Australia
| | - Ashlee Warnecke
- Battle Creek Veterans Affairs Medical Center, Battle Creek, MI, USA
| | - Noelle B Smith
- Northeast Program Evaluation Center, Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Craig J Bryan
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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17
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Testoni I, Piol S, De Leo D. Suicide Prevention: University Students' Narratives on Their Reasons for Living and for Dying. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8029. [PMID: 34360323 PMCID: PMC8345779 DOI: 10.3390/ijerph18158029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/24/2021] [Accepted: 07/25/2021] [Indexed: 11/16/2022]
Abstract
Social isolation and loneliness are increasing in our contemporary western society and seem to correlate with suicide in adolescents and young adults. Social Workers are a potential resource to create such initiatives and projects that promote inclusion and cohesion within communities, a protective factor against suicide. Sixty-two Social Work BA students participated in a Death Education course based on education on suicide prevention. Participants carried out two activities. First, they were invited to complete two written semi-structured interviews on young people's reasons for living and dying. Second, they were invited to design suicide prevention interventions targeted at their peers and adolescents. Data were analyzed qualitatively within the Thematic Analysis framework. As regards the first activity, four main themes were identified: (1) Internet and social media; (2) social isolation and loneliness; (3) the importance of proximal relationships; and, (4) the importance of networking between proximal relationships, educational institutions and mental health services. Whereas, as for suicide prevention interventions, three main ideas were identified: (1) suicide prevention through community and networking between services; (2) academic institutions: high schools and universities; and, (3) suicide prevention through new technologies. To conclude, Death Education as education on suicide prevention can offer young people a space in which to voice their and their peers' reasons for living and dying and to reflect upon their contribution to suicide prevention as students and as future professionals.
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Affiliation(s)
- Ines Testoni
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova, 35131 Padova, Italy;
- Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa 3498838, Israel
| | - Silvia Piol
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova, 35131 Padova, Italy;
| | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane 4122, Australia;
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18
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Manning JC, Carter T, Walker G, Coad J, Aubeeluck A. Assessing risk of self-harm in acute paediatric settings: a multicentre exploratory evaluation of the CYP-MH SAPhE instrument. BMJ Open 2021; 11:e043762. [PMID: 34049904 PMCID: PMC8166599 DOI: 10.1136/bmjopen-2020-043762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To psychometrically assess the Children and Young People-Mental Health Self-harm Assessment in Paediatric healthcare Environments (CYP-MH SAPhE) instrument for the identification of immediate risk of self-harm in CYP, aged 10-19 years, in acute paediatric wards or emergency departments. DESIGN The CYP-MH SAPhE Instrument was developed through a robust scoping review and Delphi consensus with 30 clinicians/topic experts. To evaluate the psychometric properties, a multicentre exploratory study was conducted. SETTING Three acute hospitals in the UK. PARTICIPANTS 163 CYP presenting at acute hospital settings with primary mental health (cases) or physical health (non-cases) conditions. PRIMARY AND SECONDARY OUTCOME MEASURES Psychometric properties of the CYP-MH SAPhE instrument were evaluated through Principle Axis Factoring (PAF) with Oblimin (Kaiser normalisation) alongside measures of internal consistency (Cronbach's α), convergent, discriminant and face validity. RESULTS PAF of the dichotomous items (n=9) loaded onto three factors (1) behaviours and intentions; (2) suicidality and (3) self-harm. Factors 1 (Cronbach's α=0.960) and 3 (Cronbach's α=1) had high internal consistency. There was: good level of agreement between raters (kappa=0.65); a moderately positive correlation between the CYP-MH SAPhE instrument and the Columbia-Suicide Severity Rating Scale; and discrimination between cases and non-cases across the three factors (factor 1: m=88 vs 70; factor 2: m=102 vs 70; factor 3: m=104 vs 68). Assessment of face validity resulted in six items being removed, culminating in an eight question, rapid assessment instrument. CONCLUSIONS The results support the CYP-MH SAPhE Tool as a potentially reliable and valid instrument to identify immediate risk of self-harm in CYP presenting to acute paediatric healthcare environments, which is a burgeoning and significant global health issue.
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Affiliation(s)
- Joseph C Manning
- Children and Young People Health Research, School of Health Sciences, University of Nottingham, Nottingham, UK
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Tim Carter
- Children and Young People Health Research, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Gemma Walker
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jane Coad
- Children and Young People Health Research, School of Health Sciences, University of Nottingham, Nottingham, UK
- NUH Institute of Nursing and Midwifery Care Excellence, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Aimee Aubeeluck
- School of Health Sciences, University of Nottingham, Nottingham, UK
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19
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Witt KG, Hetrick SE, Rajaram G, Hazell P, Taylor Salisbury TL, Townsend E, Hawton K. Interventions for self-harm in children and adolescents. Cochrane Database Syst Rev 2021; 3:CD013667. [PMID: 33677832 PMCID: PMC8094399 DOI: 10.1002/14651858.cd013667.pub2] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Self-harm (SH; intentional self-poisoning or self-injury regardless of degree of suicidal intent or other types of motivation) is a growing problem in most countries, often repeated, and associated with suicide. Evidence assessing the effectiveness of interventions in the treatment of SH in children and adolescents is lacking, especially when compared with the evidence for psychosocial interventions in adults. This review therefore updates a previous Cochrane Review (last published in 2015) on the role of interventions for SH in children and adolescents. OBJECTIVES To assess the effects of psychosocial interventions or pharmacological agents or natural products for SH compared to comparison types of care (e.g. treatment-as-usual, routine psychiatric care, enhanced usual care, active comparator, placebo, alternative pharmacological treatment, or a combination of these) for children and adolescents (up to 18 years of age) who engage in SH. SEARCH METHODS We searched the Cochrane Common Mental Disorders Specialized Register, the Cochrane Library (Central Register of Controlled Trials [CENTRAL] and Cochrane Database of Systematic Reviews [CDSR]), together with MEDLINE, Ovid Embase, and PsycINFO (to 4 July 2020). SELECTION CRITERIA We included all randomised controlled trials (RCTs) comparing specific psychosocial interventions or pharmacological agents or natural products with treatment-as-usual (TAU), routine psychiatric care, enhanced usual care (EUC), active comparator, placebo, alternative pharmacological treatment, or a combination of these, in children and adolescents with a recent (within six months of trial entry) episode of SH resulting in presentation to hospital or clinical services. The primary outcome was the occurrence of a repeated episode of SH over a maximum follow-up period of two years. Secondary outcomes included treatment adherence, depression, hopelessness, general functioning, social functioning, suicidal ideation, and suicide. DATA COLLECTION AND ANALYSIS We independently selected trials, extracted data, and appraised trial quality. For binary outcomes, we calculated odds ratios (ORs) and their 95% confidence internals (CIs). For continuous outcomes, we calculated the mean difference (MD) or standardised mean difference (SMD) and 95% CIs. The overall quality of evidence for the primary outcome (i.e. repetition of SH at post-intervention) was appraised for each intervention using the GRADE approach. MAIN RESULTS We included data from 17 trials with a total of 2280 participants. Participants in these trials were predominately female (87.6%) with a mean age of 14.7 years (standard deviation (SD) 1.5 years). The trials included in this review investigated the effectiveness of various forms of psychosocial interventions. None of the included trials evaluated the effectiveness of pharmacological agents in this clinical population. There was a lower rate of SH repetition for DBT-A (30%) as compared to TAU, EUC, or alternative psychotherapy (43%) on repetition of SH at post-intervention in four trials (OR 0.46, 95% CI 0.26 to 0.82; N = 270; k = 4; high-certainty evidence). There may be no evidence of a difference for individual cognitive behavioural therapy (CBT)-based psychotherapy and TAU for repetition of SH at post-intervention (OR 0.93, 95% CI 0.12 to 7.24; N = 51; k = 2; low-certainty evidence). We are uncertain whether mentalisation based therapy for adolescents (MBT-A) reduces repetition of SH at post-intervention as compared to TAU (OR 0.70, 95% CI 0.06 to 8.46; N = 85; k = 2; very low-certainty evidence). Heterogeneity for this outcome was substantial ( I² = 68%). There is probably no evidence of a difference between family therapy and either TAU or EUC on repetition of SH at post-intervention (OR 1.00, 95% CI 0.49 to 2.07; N = 191; k = 2; moderate-certainty evidence). However, there was no evidence of a difference for compliance enhancement approaches on repetition of SH by the six-month follow-up assessment, for group-based psychotherapy at the six- or 12-month follow-up assessments, for a remote contact intervention (emergency cards) at the 12-month assessment, or for therapeutic assessment at the 12- or 24-month follow-up assessments. AUTHORS' CONCLUSIONS Given the moderate or very low quality of the available evidence, and the small number of trials identified, there is only uncertain evidence regarding a number of psychosocial interventions in children and adolescents who engage in SH. Further evaluation of DBT-A is warranted. Given the evidence for its benefit in adults who engage in SH, individual CBT-based psychotherapy should also be further developed and evaluated in children and adolescents.
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Affiliation(s)
- Katrina G Witt
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Sarah E Hetrick
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Children and Young People Satellite, Cochrane Common Mental Disorders, The University of Auckland, Auckland, New Zealand
| | - Gowri Rajaram
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Philip Hazell
- Speciality of Psychiatry, University of Sydney School of Medicine, Sydney, Australia
| | - Tatiana L Taylor Salisbury
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ellen Townsend
- Self-Harm Research Group, School of Psychology, University of Nottingham, Nottingham, UK
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, UK
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20
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Bronsard G, Cohen D, Diallo I, Pellerin H, Varnoux A, Podlipski MA, Gerardin P, Boyer L, Campelo N. Adolescents Engaged in Radicalisation and Terrorism: A Dimensional and Categorical Assessment. Front Psychiatry 2021; 12:774063. [PMID: 35095595 PMCID: PMC8795583 DOI: 10.3389/fpsyt.2021.774063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
Since 2010 and the founding of the Islamic State, the radicalisation phenomenon in Europe has involved more adolescents and converts to Islam than in previous Islamist terrorist group movements (e.g., Al-Qaeda). In most cases, these adolescents are "homegrown terrorists," a challenging difference, as they are in confrontation with their home and societal environment. As a new and emerging phenomenon, radicalisation leads to many questions. Are empathic capacities altered? Are they presenting psychiatric pathologies or suicidal tendencies that explain why they put themselves in serious dangers? Are they just young delinquents who simply met a radical ideology? In January 2018, by special Justice Department authorisation, we contacted all minors (N = 31) convicted in France for "criminal association to commit terrorism." We assessed several sociodemographic, clinical and psychological variables, including empathy and suicidality, in half of them (N = 15) and compared them with 101 teenagers convicted for non-terrorist delinquency who were placed in Closed Educational Centres (CEC). The results show that adolescents engaged in radicalisation and terrorism do not have a significant prevalence of psychiatric disorders, suicidal tendencies or lack of empathy. It also appears that they have different psychological profiles than delinquent adolescents. "Radicalised" adolescents show better intellectual skills, insight capacities and coping strategies. In addition, the manifestation of their difficulties is less externalised than adolescents from the CEC, having committed very few delinquent acts.
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Affiliation(s)
- Guillaume Bronsard
- Service de Psychiatrie de l'Enfant et de l'Adolescent, CHRU Brest, Brest, France.,Département de Sciences Humaines et Sociales, EA 7479, UFR médecine et santé UBO, EA 3279 (CEReSS, AMU), Brest, France
| | - David Cohen
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Hôpital Pitié-Salpêtrière, Paris, France.,Institut des Systèmes Intelligents et Robotiques, Sorbonne Université, Paris, France
| | - Issaga Diallo
- Hôpitaux Universitaires Pitié Salpêtrière, Paris, France
| | - Hugues Pellerin
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Hôpital Pitié-Salpêtrière, Paris, France
| | | | | | | | - Laurent Boyer
- Département de Sciences Humaines et Sociales, EA 7479, UFR médecine et santé UBO, EA 3279 (CEReSS, AMU), Brest, France.,Médecine de Santé Publique, CHRU Marseille, Marseille, France
| | - Nicolas Campelo
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Hôpital Pitié-Salpêtrière, Paris, France.,Laboratoire PCPP-EA 4056, Institut de Psychologie, Université de Paris, Paris, France
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21
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Mirkovic B, Cohen D, Garny de la Rivière S, Pellerin H, Guilé JM, Consoli A, Gerardin P. Repeating a suicide attempt during adolescence: risk and protective factors 12 months after hospitalization. Eur Child Adolesc Psychiatry 2020; 29:1729-1740. [PMID: 32052175 DOI: 10.1007/s00787-020-01491-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 02/04/2020] [Indexed: 11/25/2022]
Abstract
Suicide attempts (SAs) are a public health concern in adolescence. A brief hospitalization is recommended, but access to inpatient wards is often not available. In addition, numerous risk factors for SA recurrence have been identified, but few studies have explored protective factors. Here, we aimed to assess the role of both risk and protective factors on SA relapse in a context of free access to inpatient services. We performed a prospective follow-up study of 320 adolescents who were hospitalized for an SA between January 2011 and December 2014 in France. Assessments at baseline included socio-demographics, clinical characteristics, temperament, reasons for living, spirituality, and coping. Patients were re-evaluated at 6 months and 12 months for depression severity and SA relapse. A total of 135 and 91 patients (78 girls, 12 boys, aged 13-17) were followed up at 6 and 12 months, respectively. At the 12-month follow-up, 28 (30%) subjects had repeated an SA. Adolescents who either had a history of SA or were receiving psychotropic treatment at baseline were at higher risk of recurrence. Several variables had a protective effect: (1) productive coping skills, namely, working hard and achieving, physical recreation, and seeking relaxing diversions; (2) a particular temperament trait, namely, cooperativeness; and (3) having experienced more life events. We also found a significant interaction: the higher the depression score during follow-up, the lower the protective effect of productive coping. Our findings confirm that a history of SA and seeking psychiatric care with medication are risk factors for SA relapse. However, productive coping strategies and cooperativeness are protective factors, and the improvement of such strategies as well as treatment of persisting depression should be a goal of psychotherapy treatment offered to suicidal adolescents.
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Affiliation(s)
- Bojan Mirkovic
- Department of Child and Adolescent Psychiatry, CHU Charles-Nicolle-CH Le Rouvray, Université Rouen Normandie, 1 Rue de Germont, 76000, Rouen, France.
- Unité de Recherche EA4047 (HANDIReSP), University of Versailles Saint-Quentin-en-Yvelines, Versailles, France.
| | - David Cohen
- Department of Child and Adolescent Psychiatry, CHU Charles-Nicolle-CH Le Rouvray, Université Rouen Normandie, 1 Rue de Germont, 76000, Rouen, France
- CNRS, UMR 7222, Institut des Systèmes Intelligents et Robotiques, University Pierre and Marie Curie, Paris, France
| | - Sébastien Garny de la Rivière
- Department of Child and Adolescent Psychiatry, University Hospital of Amiens, University Picardie Jules Verne, Amiens, France
| | - Hugues Pellerin
- Department of Child and Adolescent Psychiatry, CHU Charles-Nicolle-CH Le Rouvray, Université Rouen Normandie, 1 Rue de Germont, 76000, Rouen, France
| | - Jean-Marc Guilé
- Department of Child and Adolescent Psychiatry, University Hospital of Amiens, University Picardie Jules Verne, Amiens, France
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Angèle Consoli
- Department of Child and Adolescent Psychiatry, CHU Charles-Nicolle-CH Le Rouvray, Université Rouen Normandie, 1 Rue de Germont, 76000, Rouen, France
| | - Priscille Gerardin
- Department of Child and Adolescent Psychiatry, CHU Charles-Nicolle-CH Le Rouvray, Université Rouen Normandie, 1 Rue de Germont, 76000, Rouen, France
- Laboratoire CRFDP, University of Normandie, Rouen, France
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22
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Madeira ARSR, Janeiro LDB, Carmo CIG, Brás MSV. Reasons for Living Inventory for Young Adults: Psychometric Properties Among Portuguese Sample. OMEGA-JOURNAL OF DEATH AND DYING 2020; 85:887-903. [PMID: 32938306 DOI: 10.1177/0030222820959940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A main protective factor against suicide in young adults is their reasons for living; therefore, suicide risk screening should consider these reasons. However, few psychometric instruments assess reasons for living, and none have been adapted for young adults in Portugal. Thus, we assess the psychometric characteristics of the Reasons for Living Inventory for Young Adults-II (RFL-YA-II) in participants (n = 936; Mage = 21.77; SD = 2.88) from Portugal. Participants answered measures concerning suicidal ideation, depression, hopelessness, and positive and negative affect. The results of an exploratory factorial analysis replicated the original 4-factor model of the RFL-YA-II, and a confirmatory factorial analysis indicated satisfactory indices. In terms of reliability and convergent, discriminant, and concurrent validity, our results are consistent with previous research. Moreover, our results indicate that the RFL-YA-II is a valid and reliable instrument to study the protective factors against suicidal behavior in Portuguese young adults, and should thus be integrated into preventive strategies.
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Affiliation(s)
| | - Luís de Brito Janeiro
- Psychology and Educational Sciences Department, Faculty of Humanities and Social Sciences, University of Algarve, Algarve, Portugal.,Psychology Department, Autonomous University of Lisbon Centre for Research in Psychology, Lisboa, Portugal
| | - Cláudia Isabel Guerreiro Carmo
- Psychology and Educational Sciences Department, Faculty of Humanities and Social Sciences, University of Algarve, Algarve, Portugal.,Psychology Department, Autonomous University of Lisbon Centre for Research in Psychology, Lisboa, Portugal
| | - Marta Sofia Ventosa Brás
- Psychology and Educational Sciences Department, Faculty of Humanities and Social Sciences, University of Algarve, Algarve, Portugal.,Psychology Department, Autonomous University of Lisbon Centre for Research in Psychology, Lisboa, Portugal
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23
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McClay MM, Brausch AM, O'Connor SS. Social Support Mediates the Association between Disclosure of Suicide Attempt and Depression, Perceived Burdensomeness, and Thwarted Belongingness. Suicide Life Threat Behav 2020; 50:884-898. [PMID: 32053246 DOI: 10.1111/sltb.12622] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 01/11/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Prior research has found disclosure of concealable stigmatized statuses, including suicide attempt survivorship, to be associated with positive mental health outcomes. This study sought to test the mediating effect of self-reported social support on the association between disclosure of suicide attempt and suicide risk factors in a sample of undergraduate college students. METHOD Data were analyzed from 149 undergraduate college students with a history of one or more suicide attempts. Three parallel mediation analyses tested the simultaneous mediating effect of family social support and peer social support on the association between suicide attempt disclosure and suicide risk factors. RESULTS Significant total indirect effects in all models indicated family social support and peer social support simultaneously mediated the association between disclosure of suicide attempt and depression, perceived burdensomeness, and thwarted belongingness. The indirect effect on thwarted belongingness via peer social support was stronger than the indirect effect via family social support. CONCLUSIONS Disclosure of suicide attempt was associated with higher social support, which was associated with lower suicide risk factors. In a therapeutic context, it is important to consider social support when discussing disclosure of suicide attempt.
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Affiliation(s)
- Michael M McClay
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY, USA
| | - Amy M Brausch
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY, USA
| | - Stephen S O'Connor
- Department of Psychiatry and Behavioral Sciences, University of Louisville, Louisville, KY, USA
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24
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Owusu-Ansah FE, Addae AA, Peasah BO, Oppong Asante K, Osafo J. Suicide among university students: prevalence, risks and protective factors. Health Psychol Behav Med 2020; 8:220-233. [PMID: 34040869 PMCID: PMC8114407 DOI: 10.1080/21642850.2020.1766978] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background: Research evidence on suicide in Ghana so far has focused mostly on suicide in the adult population and less work on the younger population such as university students and other vulnerable groups such as children, youth and the aged. Aims: This study was conducted to determine lifetime and current prevalence of suicidal ideation or attempts and identify the associated risks and protective factors among university students in Ghana. Methods: Using a cross-sectional design, 1003 university students (507 males and 496 females) with a mean age of 20.5 years (SD = 5.95) were administered questionnaires that measured suicide, psychological distress, self-esteem and subjective wellbeing. Results: We found the following prevalence rates of suicidal behaviours: ideations 15.2%, attempted 6.3%, death wishes 24.3% and suicidal plan 6.8%. Psychological distress was a risk factor for both suicidal ideation and suicidal attempt. Subjective wellbeing was protective of suicide attempt while self-esteem was protective of suicidal ideation. Conclusions: These findings underscore the need for school-based mental health-promoting programmes that enhance young people's self-esteem, reduce psychological distress and boost subjective wellbeing.
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Affiliation(s)
- Frances Emily Owusu-Ansah
- Counselling Centre, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Behavioural Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Akua Afriyie Addae
- Counselling Centre, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Accra, Ghana.,Department of Psychology, University of the Free State, Bloemfontein, South Africa
| | - Joseph Osafo
- Department of Psychology, University of Ghana, Accra, Ghana
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25
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Brausch AM, O'Connor SS, Powers JT, McClay MM, Gregory JA, Jobes DA. Validating the Suicide Status Form for the Collaborative Assessment and Management of Suicidality in a Psychiatric Adolescent Sample. Suicide Life Threat Behav 2020; 50:263-276. [PMID: 31532846 DOI: 10.1111/sltb.12587] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 06/03/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND For adults, the Collaborative Assessment and Management of Suicidality (CAMS; Jobes, (2006, Managing suicidal risk: A collaborative approach, New York, Guilford) and Jobes, (2016, Managing suicidal risk: A collaborative approach, New York, Guilford)) is a treatment framework with replicated evidenced-based support for effectiveness. The current study is a psychometric validation of the Suicide Status Form (SSF-IV), the main assessment and treatment planning tool for CAMS, in an adolescent psychiatric sample. METHODS Data were collected from 100 adolescents, aged 12-17, in inpatient settings (mean age = 14.6; 67.5% female, 80% white). Adolescents were administered Part A of the SSF-IV, as well as measures of overall suicide risk (both explicit and implicit), mental pain, Stress, Agitation, reasons for living, and self-esteem. RESULTS Confirmatory factor analysis found a two-factor model to fit the data best, with Psychological Pain, Stress, and Agitation loading on one factor, and Hopelessness and Self-Hate on another. All of the core SSF constructs except Stress were significantly correlated with concurrent measures, and SSF overall suicide risk was significantly correlated with self-reported and implicit suicidality. Adolescents with suicide attempt history reported significantly higher scores on most core SSF items compared to no attempt history. CONCLUSIONS These results provide initial psychometric validation of the SSF for use with adolescents and indicate that it does not need to be adapted or modified for this age group.
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Affiliation(s)
- Amy M Brausch
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY, USA
| | - Stephen S O'Connor
- Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA
| | - Jeffrey T Powers
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY, USA
| | - Michael M McClay
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Jordan A Gregory
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY, USA
| | - David A Jobes
- Department of Psychology, The Catholic University of America, Washington, DC, USA
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26
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Wadhwa S, Heisel MJ. Enhancing the Assessment of Resiliency to Suicide Ideation among Older Adults: The Development and Initial Validation of the Reasons for Living-Suicide Resiliency Scale (RFL-SR). Clin Gerontol 2020; 43:61-75. [PMID: 31635560 DOI: 10.1080/07317115.2019.1675840] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objectives: To derive a brief late-life suicide resiliency scale from the 69-item Reasons for Living Scale-Older Adult version (RFL-OA).Methods: We conducted a series of secondary analyses of RFL-OA data (N = 204) from a dataset combining: 1. A follow-up assessment of nursing home residents in the Geriatric Suicide Ideation Scale (GSIS) development study; 2. A trial of Interpersonal Psychotherapy (IPT) with suicidal older adults; 3. A longitudinal study of risk and resiliency to late-life suicide ideation. We specifically assessed the distributions of RFL-OA items and their associations with suicide ideation and behavior to create an RFL-Suicide Resiliency subscale (RFL-SR); we then tested the psychometric properties of this measure's items drawn from the larger RFL-OA.Results: Nine RFL-OA items were significantly associated with suicide ideation and history of suicide behavior and were not highly correlated with social desirability. Psychometric analyses supported the internal consistency, test-retest reliability, and construct validity of this scale.Conclusions: The items of the RFL-SR demonstrated strong psychometric properties with older adults in clinical and community settings.Clinical Implications: The RFL-SR may make a useful addition to suicide risk assessment in gerontological research and clinical practice.
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Affiliation(s)
- Sonia Wadhwa
- Department of Psychiatry, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Marnin J Heisel
- Department of Psychiatry, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.,Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Center for the Study and Prevention of Suicide, University of Rochester Medical Center, Rochester, New York, USA
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27
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Rufino NC, Mirkovic B, Consoli A, Pellerin H, Santos JPM, Fidalgo TM, Gerardin P, Silveira DX, Cohen D. Suicide Attempts Among French and Brazilian Adolescents Admitted to an Emergency Room. A Comparative Study of Risk and Protective Factors. Front Psychiatry 2020; 11:742. [PMID: 32848921 PMCID: PMC7424044 DOI: 10.3389/fpsyt.2020.00742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 07/15/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Suicide is the second most common cause of preventable mortality among Brazilian and French adolescents. The aim of the current study was to compare the main risk and protective factors associated with a suicide attempt (SA) and to highlight differences based on geographical characteristics. METHOD We compared a Brazilian sample (N = 45) of adolescents admitted to the emergency room of a public hospital in São Paulo for SA to a French sample (N = 320) of adolescents hospitalized for SA across 5 paediatric departments. Then, we ran several multivariate models to examine how each selected variable was related to geographic origin and to the other selected variables linked to geographic origin. RESULTS The two samples presented no significant differences regarding gender, age or schooling. Both samples had high rates of depressive disorders, anxiety disorders, substance use, disruptive disorders, borderline psychopathology, and lifetime SAs. However, the Brazilian sample presented significantly higher levels of psychopathology and had more insecure attachment relationships (fearful and detached), whereas the French sample had a more secure attachment style. Brazilian adolescents had more recourse to spiritual beliefs and spiritual support, whereas the French adolescents had higher scores on the Reasons for Living Inventory and used more help-seeking strategies from their social network, mainly close friends. Multivariate models showed that two productive coping strategies (seeking spiritual support and social action) and the dependence score were significantly associated with membership in the Brazilian cohort, whereas a secure attachment style and depression severity (evaluated by the Beck Depression Inventory) were significantly associated with membership in the French cohort. CONCLUSION Despite presenting similar psychopathologies, Brazilian adolescents presented a more insecure attachment style and used the religious kind of coping more commonly than their French counterparts. We hypothesize that religion may compensate for the social vulnerabilities present in a middle-income country such as Brazil. More transcultural studies may help to elucidate this phenomenon.
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Affiliation(s)
- Natalia C Rufino
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Bojan Mirkovic
- Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU Charles Nicolle/CH Le Rouvray, Normandie Université, Rouen, France
| | - Angèle Consoli
- Département de Psychiatrie de l'Enfant et de l'Adolescent, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,GRC-15, Approche dimensionnelle des épisodes psychotiques de l'enfant et de l'adolescent, Faculté de Médecine, UPMC, Sorbonne Université, Paris, France
| | - Hugues Pellerin
- Département de Psychiatrie de l'Enfant et de l'Adolescent, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Juliana P M Santos
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Thiago M Fidalgo
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Priscille Gerardin
- Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU Charles Nicolle/CH Le Rouvray, Normandie Université, Rouen, France
| | - Dartiu X Silveira
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - David Cohen
- Département de Psychiatrie de l'Enfant et de l'Adolescent, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,GRC-15, Approche dimensionnelle des épisodes psychotiques de l'enfant et de l'adolescent, Faculté de Médecine, UPMC, Sorbonne Université, Paris, France.,CNRS UMR 7222 "Institut des Systèmes Intelligents et Robotiques", Sorbonne Université, Paris, France
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28
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Carter T, Walker GM, Aubeeluck A, Manning JC. Assessment tools of immediate risk of self-harm and suicide in children and young people: A scoping review. J Child Health Care 2019; 23:178-199. [PMID: 30058359 DOI: 10.1177/1367493518787925] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
There are increasing numbers of children presenting to paediatric hospital settings in mental health crisis. Typically, non-mental health professionals are responsible for the initial assessment of these children and are required to identify immediate physical and emotional health needs. To ensure the safety of these children, immediate risk of suicide and self-harm should be assessed. However, no standardized assessment tool is used in clinical practice, and for those tools that are used, their validity and reliability is unclear. A scoping review was conducted to identify the existing assessment tools of immediate self-harm and suicide risk. Searches of electronic databases and relevant reference lists were undertaken. Twenty-two tools were identified and most assessed acute risk of suicide with only four tools incorporating a self-harm assessment. The tools varied in number of items (4-146), subscales (0-11) and total scores (16-192). Half incorporated Likert-type scales, and most were completed via self-report. Many tools were subject to limited psychometric testing, and no single tool was valid or reliable for use with children presenting in mental health crisis to non-mental health settings. As such, a clinically appropriate, valid and reliable tool that assesses immediate risk of self-harm and suicide in paediatric settings should be developed.
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Affiliation(s)
- Tim Carter
- 1 School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Gemma M Walker
- 2 Nottingham Children's Hospital and Neonatal Services, Family Health Division, Nottingham University Hospitals, Nottingham, UK
| | - Aimee Aubeeluck
- 1 School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Joseph C Manning
- 1 School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.,2 Nottingham Children's Hospital and Neonatal Services, Family Health Division, Nottingham University Hospitals, Nottingham, UK.,3 Children and Families Research, Centre for Technology Enabled Health Research, Coventry University, Coventry, UK
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29
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Abstract
OBJECTIVE In current practice, treatment as usual (TAU) for suicidal adolescents includes evaluation, with little or no intervention provided in the emergency department (ED), and disposition, usually to an inpatient psychiatry unit. The family-based crisis intervention (FBCI) is an emergency psychiatry intervention designed to sufficiently stabilize suicidal adolescents within a single ED visit so that they may return home safely with their families. The objective of this article is to report efficacy outcomes related to FBCI for suicidal adolescents and their families. METHODS A total of 142 suicidal adolescents (age, 13-18 years) and their families presenting for psychiatric evaluation to a large pediatric ED were randomized to receive FBCI or TAU. Patients and caregivers completed self-report measures of suicidality, family empowerment, and satisfaction with care provided at pretest, posttest, and 3 follow-up time points over a 1-month period. RESULTS Patients randomized to FBCI were significantly more likely to be discharged home with outpatient follow-up care compared with their TAU counterparts (P < 0.001). Families randomized to the FBCI condition reported significantly higher levels of family empowerment and client satisfaction with care at posttest compared with their TAU counterparts. Gains were maintained over the follow-up period. No completed suicides were reported during the study period in either condition. CONCLUSIONS Family-based crisis intervention is a model of care for suicidal adolescents that may be a viable alternative to traditional ED care that involves inpatient psychiatric hospitalization.
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30
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Ventosa Brás MS, Guerreiro Carmo CI, de Jesus SN. Reasons for Living Inventory for Adolescents: Psychometric Properties Among Portuguese Adolescents. OMEGA-JOURNAL OF DEATH AND DYING 2018; 82:527-547. [PMID: 30577719 DOI: 10.1177/0030222818819340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Reasons for living are protective factors against suicidal behavior in adolescents. One of the most useful measures to assess them is the Reasons for Living Inventory for Adolescents (RFL-A) developed by Osman et al. The goal of this study was to examine the psychometric properties of its Portuguese version of the RFL-A. To this end, we recruited 512 high school adolescents (mean age = 16.7 years), who completed the RFL-A, a Suicidal Ideation Questionnaire, and a hopelessness scale. Exploratory factor analysis replicated the original five-factor model and confirmatory factor analysis obtained satisfactory adjustment values. The RFL-A shows good reliability (internal consistency and temporal stability) as well as good convergent, discriminant, and concurrent validities. These results indicate that the RFL-A is a valid and reliable measure to study protective factors against suicidal behaviors in Portuguese adolescents.
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Affiliation(s)
- Marta Sofia Ventosa Brás
- Psychology and Educational Department, Faculty of Human and Social Sciences, University of the Algarve, Faro, Portugal
| | | | - Saul Neves de Jesus
- Psychology and Educational Department, Faculty of Human and Social Sciences, University of the Algarve, Faro, Portugal
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31
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Hu CS, Huang J, Ferrari M, Wang Q, Xie D, Zhang H. Sadder but wiser: Emotional reactions and wisdom in a simulated suicide intervention. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2018; 54:791-799. [PMID: 30288744 DOI: 10.1002/ijop.12536] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 08/15/2018] [Indexed: 11/05/2022]
Abstract
Scholars within the Berlin paradigm have analysed participants' responses to a hypothetical vignette about a friend's suicide ideation. However, no study has yet focused on participants' emotional reactions to this scenario, an important aspect of wisdom performance. We conducted a Thin-Slice Wisdom study where participants were asked to give advice to a hypothetical friend contemplating suicide. We analysed their emotional profiles using facial expression analysis software (FACET2.1 and FACEREADER7.1). Participants' verbal responses were also transcribed and then scored by 10 raters using the Berlin criteria. Results revealed that the sadder the participants felt, the wiser their performance. Wiser participants may have been better at exploring this sad, but true, existential human dilemma.
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Affiliation(s)
- Chao S Hu
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Jinhao Huang
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Michel Ferrari
- Applied Psychology & Human Development Department, University of Toronto, Toronto, Canada
| | - Qiandong Wang
- Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Dong Xie
- Department of Psychology and Counseling, University of Central Arkansas, Conway, AR, USA
| | - Haotian Zhang
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
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32
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Kennard BD, Goldstein T, Foxwell AA, McMakin DL, Wolfe K, Biernesser C, Moorehead A, Douaihy A, Zullo L, Wentroble E, Owen V, Zelazny J, Iyengar S, Porta G, Brent D. As Safe as Possible (ASAP): A Brief App-Supported Inpatient Intervention to Prevent Postdischarge Suicidal Behavior in Hospitalized, Suicidal Adolescents. Am J Psychiatry 2018; 175:864-872. [PMID: 30021457 PMCID: PMC6169524 DOI: 10.1176/appi.ajp.2018.17101151] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The authors report on a pilot study of an inpatient intervention for suicidal adolescents, As Safe as Possible (ASAP), supported by a smartphone app (BRITE) to reduce suicide attempts following hospital discharge. METHOD Across two sites, 66 adolescents hospitalized for suicidal ideation (N=26) or a recent suicide attempt (N=40) were randomly assigned to the ASAP intervention program plus treatment as usual or to treatment as usual alone. ASAP, which focuses on emotion regulation and safety planning, is a 3-hour intervention delivered on the inpatient unit. The BRITE app prompted participants to rate their level of emotional distress on a daily basis and provided personalized strategies for emotion regulation and safety planning. A blind, independent evaluator assessed suicide attempts following hospital discharge and suicidal ideation at 4, 12, and 24 weeks after discharge. RESULTS The ASAP intervention did not have a statistically significant effect on suicide attempt, although findings were in the hypothesized direction for occurrence of an attempt (16% compared with 31%; χ2=1.86, df=1, g=-0.36) and time to an attempt (hazard ratio=0.49, 95% CI=0.16, 1.47). Past history of a suicide attempt was a significant moderator of treatment outcome, with a stronger, albeit nonsignificant, effect of the ASAP intervention among participants with a history of suicide attempt (hazard ratio=0.23, 95% CI=0.05, 1.09). There were no treatment effects on suicidal ideation. The majority of participants (70%) used the BRITE app (median usage, 19 times). Participants reported high satisfaction with both the intervention and the app. CONCLUSIONS The ASAP intervention program shows promise in reducing the incidence of postdischarge suicide attempts among adolescents hospitalized for suicidality and merits further study.
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Affiliation(s)
- Betsy D. Kennard
- Department of Psychiatry, University of Texas Southwestern Medical Center
- Children’s Health of Dallas
| | - Tina Goldstein
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
| | - Aleksandra A. Foxwell
- Department of Psychiatry, University of Texas Southwestern Medical Center
- Children’s Health of Dallas
| | | | - Kristin Wolfe
- Department of Psychiatry, University of Texas Southwestern Medical Center
- Children’s Health of Dallas
| | - Candice Biernesser
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
| | - Alexandra Moorehead
- Department of Psychiatry, University of Texas Southwestern Medical Center
- Children’s Health of Dallas
| | - Antoine Douaihy
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
| | - Lucas Zullo
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | - Erin Wentroble
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
| | - Victoria Owen
- Department of Psychiatry, University of Texas Southwestern Medical Center
- Children’s Health of Dallas
| | - Jamie Zelazny
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
| | | | - Giovanna Porta
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
| | - David Brent
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
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Nuij C, van Ballegooijen W, Ruwaard J, de Beurs D, Mokkenstorm J, van Duijn E, de Winter RF, O'Connor RC, Smit JH, Riper H, Kerkhof A. Smartphone-based safety planning and self-monitoring for suicidal patients: Rationale and study protocol of the CASPAR (Continuous Assessment for Suicide Prevention And Research) study. Internet Interv 2018; 13:16-23. [PMID: 30206514 PMCID: PMC6112103 DOI: 10.1016/j.invent.2018.04.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 04/25/2018] [Accepted: 04/30/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND It remains difficult to predict and prevent suicidal behaviour, despite growing understanding of the aetiology of suicidality. Clinical guidelines recommend that health care professionals develop a safety plan in collaboration with their high-risk patients, to lower the imminent risk of suicidal behaviour. Mobile health applications provide new opportunities for safety planning, and enable daily self-monitoring of suicide-related symptoms that may enhance safety planning. This paper presents the rationale and protocol of the Continuous Assessment for Suicide Prevention And Research (CASPAR) study. The aim of the study is two-fold: to evaluate the feasibility of mobile safety planning and daily mobile self-monitoring in routine care treatment for suicidal patients, and to conduct fundamental research on suicidal processes. METHODS The study is an adaptive single cohort design among 80 adult outpatients or day-care patients, with the main diagnosis of major depressive disorder or dysthymia, who have an increased risk for suicidal behaviours. There are three measurement points, at baseline, at 1 and 3 months after baseline. Patients are instructed to use their mobile safety plan when necessary and monitor their suicidal symptoms daily. Both these apps will be used in treatment with their clinician. CONCLUSION The results from this study will provide insight into the feasibility of mobile safety planning and self-monitoring in treatment of suicidal patients. Furthermore, knowledge of the suicidal process will be enhanced, especially regarding the transition from suicidal ideation to behaviour.The study protocol is currently under revision for medical ethics approval by the medical ethics board of the Vrije Universiteit Medical centre Amsterdam (METc number 2017.512/NL62795.029.17).
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Affiliation(s)
- Chani Nuij
- Department of Clinical Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Wouter van Ballegooijen
- Department of Clinical Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam Public Health research institute, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
- Department of Research and Innovation, GGZ Ingeest, Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Jeroen Ruwaard
- Department of Psychiatry, Amsterdam Public Health research institute, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
- Department of Research and Innovation, GGZ Ingeest, Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Derek de Beurs
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Jan Mokkenstorm
- Department of Psychiatry, Amsterdam Public Health research institute, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
- Department of Research and Innovation, GGZ Ingeest, Specialized Mental Health Care, Amsterdam, The Netherlands
- 113 Suicide Prevention, Amsterdam, The Netherlands
| | | | - Remco F.P. de Winter
- Department of Clinical Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, The Netherlands
- Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Rory C. O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jan H. Smit
- Department of Psychiatry, Amsterdam Public Health research institute, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
- Department of Research and Innovation, GGZ Ingeest, Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Heleen Riper
- Department of Clinical Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam Public Health research institute, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
- Department of Research and Innovation, GGZ Ingeest, Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Ad Kerkhof
- Department of Clinical Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, The Netherlands
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Brausch AM, Perkins NM. Nonsuicidal self-injury and disordered eating: Differences in acquired capability and suicide attempt severity. Psychiatry Res 2018; 266:72-78. [PMID: 29857291 DOI: 10.1016/j.psychres.2018.05.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 12/13/2022]
Abstract
Nonsuicidal self-injury (NSSI) and eating disorders are both strongly related to suicide behaviors, and both can be conceptualized as painful and provocative events that associate with acquired capability for suicide. Individuals who self-injure report greater acquired capability than those who do not engage in these behaviors, but results are mixed in eating disorder samples. Given that NSSI and disordered eating (DE) commonly co-occur, it is important to examine how acquired capability for suicide and suicide attempt severity may differ between individuals who engage in either, both, or neither of these behaviors. It was expected that individuals with both NSSI and DE would report the greatest acquired capability, assessed by fearlessness about death and fear about suicide, and suicide attempt severity, compared to NSSI only, DE only, and controls. In a sample of 1179 undergraduates, results indicated no differences on fearlessness about death, but the NSSI + DE group reported the lowest scores on fear of suicide and greatest suicide attempt severity compared to the other groups. Differences between fearlessness about death and fear about suicide are discussed, as well as the possible additive effect of engaging in both direct (NSSI) and indirect (DE) self-harm on fear about suicide and suicide risk.
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Affiliation(s)
- Amy M Brausch
- Department of Psychological Sciences, Western Kentucky University, 1906 College Heights Blvd, Bowling Green, KY 42101, United States.
| | - Natalie M Perkins
- Department of Psychological Sciences, Western Kentucky University, 1906 College Heights Blvd, Bowling Green, KY 42101, United States
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Gallagher ML, Miller AB. Suicidal Thoughts and Behavior in Children and Adolescents: An Ecological Model of Resilience. ADOLESCENT RESEARCH REVIEW 2018; 3:123-154. [PMID: 29904718 PMCID: PMC5995470 DOI: 10.1007/s40894-017-0066-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Manning JC, Walker GM, Carter T, Aubeeluck A, Witchell M, Coad J. Children and Young People-Mental Health Safety Assessment Tool (CYP-MH SAT) study: Protocol for the development and psychometric evaluation of an assessment tool to identify immediate risk of self-harm and suicide in children and young people (10-19 years) in acute paediatric hospital settings. BMJ Open 2018; 8:e020964. [PMID: 29654046 PMCID: PMC5898360 DOI: 10.1136/bmjopen-2017-020964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Currently, no standardised, evidence-based assessment tool for assessing immediate self-harm and suicide in acute paediatric inpatient settings exists. AIM The aim of this study is to develop and test the psychometric properties of an assessment tool that identifies immediate risk of self-harm and suicide in children and young people (10-19 years) in acute paediatric hospital settings. METHODS AND ANALYSIS Development phase: This phase involved a scoping review of the literature to identify and extract items from previously published suicide and self-harm risk assessment scales. Using a modified electronic Delphi approach, these items will then be rated according to their relevance for assessment of immediate suicide or self-harm risk by expert professionals. Inclusion of items will be determined by 65%-70% consensus between raters. Subsequently, a panel of expert members will convene to determine the face validity, appropriate phrasing, item order and response format for the finalised items.Psychometric testing phase: The finalised items will be tested for validity and reliability through a multicentre, psychometric evaluation. Psychometric testing will be undertaken to determine the following: internal consistency, inter-rater reliability, convergent, divergent validity and concurrent validity. ETHICS AND DISSEMINATION Ethical approval was provided by the National Health Service East Midlands-Derby Research Ethics Committee (17/EM/0347) and full governance clearance received by the Health Research Authority and local participating sites. Findings from this study will be disseminated to professionals and the public via peer-reviewed journal publications, popular social media and conference presentations.
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Affiliation(s)
- Joseph C Manning
- Family Health Division, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
- Centre for Innovative Research Across a Life Course, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
- Institute of Nursing and Midwifery Care Excellence, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Gemma M Walker
- Family Health Division, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Tim Carter
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Aimee Aubeeluck
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Miranda Witchell
- Family Health Division, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jane Coad
- Centre for Innovative Research Across a Life Course, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
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Erford BT, Jackson J, Bardhoshi G, Duncan K, Atalay Z. Selecting Suicide Ideation Assessment Instruments: A Meta-Analytic Review. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2017. [DOI: 10.1080/07481756.2017.1358062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Bradley T. Erford
- Peabody College at Vanderbilt University, Human and Organizational Development, Nashville, TN, USA
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Andreasson K, Krogh J, Bech P, Frandsen H, Buus N, Stanley B, Kerkhof A, Nordentoft M, Erlangsen A. MYPLAN -mobile phone application to manage crisis of persons at risk of suicide: study protocol for a randomized controlled trial. Trials 2017; 18:171. [PMID: 28399909 PMCID: PMC5387214 DOI: 10.1186/s13063-017-1876-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 03/03/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Persons with a past episode of self-harm or severe suicidal ideation are at elevated risk of self-harm as well as dying by suicide. It is well established that suicidal ideation fluctuates over time. Previous studies have shown that a personal safety plan can assist in providing support, when a person experiences suicide ideation, and help seeking professional assistance if needed. The aim of the trial is to determine whether a newly developed safety mobile app is more effective in reducing suicide ideation and other symptoms, compared to a safety plan on paper. METHODS/DESIGN The trial is designed as a two-arm, observer-blinded, parallel-group randomized clinical superiority trial, where participants will either receive: (1) Experimental intervention: the safety plan provided as the app MyPlan, or (2) Treatment as Usual: the safety plan in the original paper format. Based on a power calculation, a total of 546 participants, 273 in each arm will be included. They will be recruited from Danish Suicide Prevention Clinics. Both groups will receive standard psychosocial therapeutic care, up to 8-10 sessions of supportive psychotherapy. Primary outcome will be reduction in suicide ideation after 12 months. Follow-up interviews will be conducted at 3, 6, 9, and 12 months after date of inclusion. DISCUSSION A safety plan is a mandatory part of the treatment in the Suicide Prevention Clinics in Demark. There are no studies investigating the effectiveness of a safety plan app compared to a safety plan on paper on reducing suicide ideation in patients with suicide ideation and suicidal behavior. The trial will gain new knowledge of whether modern technology can augment the effects of traditional personalized safety planning. TRIAL REGISTRATION ClinicalTrials.gov, NCT02877316 . Registered on 19 August 2016.
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Affiliation(s)
- Kate Andreasson
- Psychiatric Centre North Zealand, University Hospital of Hillerød, Hillerød, Denmark
| | - Jesper Krogh
- Mental Health Centre Copenhagen, Copenhagen, Denmark
| | - Per Bech
- Psychiatric Centre North Zealand, University Hospital of Hillerød, Hillerød, Denmark
| | | | - Niels Buus
- Faculty of Nursing and Midwifery, University of Sydney, St. Vincent’s Hospital Sydney & St. Vincent Private Hospital Sydney, Sydney, Australia
| | - Barbara Stanley
- Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY USA
| | - Ad Kerkhof
- Department of Clinical Psychology, Vrije University, Amsterdam, The Netherlands
| | - Merete Nordentoft
- Mental Health Centre Copenhagen, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Annette Erlangsen
- Mental Health Centre Copenhagen, Copenhagen, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
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Swank JM, Gagnon JC. A National Survey of Mental Health Screening and Assessment Practices in Juvenile Correctional Facilities. CHILD & YOUTH CARE FORUM 2016. [DOI: 10.1007/s10566-016-9379-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sheftall AH, Schoppe-Sullivan SJ, Bridge JA. Insecure attachment and suicidal behavior in adolescents. CRISIS 2016; 35:426-30. [PMID: 25231855 DOI: 10.1027/0227-5910/a000273] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Suicide among adolescents is an important public health problem. One risk factor for youth suicidal behavior that has been underexplored is insecure attachment. AIMS To investigate the association between attachment avoidance/anxiety and suicidal behavior in an adolescent sample. METHOD This study examined attachment insecurity in 40 adolescents who had attempted suicide and 40 never-suicidal demographically matched youths. Adolescents completed self-report measures of attachment style, family alliance, and depressive symptoms. RESULTS Suicide attempters reported significantly higher attachment avoidance and anxiety. Attachment avoidance, but not anxiety, predicted suicide attempt status in a conditional logistic regression analysis that controlled for depressive symptoms and family alliance. CONCLUSION Future research should determine the relative utility of attachment insecurity in prospectively predicting suicide attempts and investigate potential mediators and moderators of this association. Implications for clinicians working with suicidal youth with insecure attachment styles are discussed.
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Affiliation(s)
- Arielle H Sheftall
- The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Jeffrey A Bridge
- The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
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Kohrt BK, Lincoln TM, Brambila AD. Embedding DBT Skills Training Within a Transactional-Ecological Framework to Reduce Suicidality in a Navajo Adolescent Female. Clin Case Stud 2016. [DOI: 10.1177/1534650116668271] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
American Indian/Alaska Native (AI/AN) youth have higher rates of suicidality than any other ethnic or cultural group in the United States. Dialectical behavior therapy (DBT) is an evidence-based treatment that has been found to reduce suicidality in adolescents, but there is little literature speaking to its efficacy with the AI/AN population. The transactional-ecological model of suicidality helps identify protective factors that can be bolstered at the individual, familial, community, and spiritual levels to reduce suicidality and suicidal contagion in AI/AN youth. The current study examines a case where DBT was culturally adapted and embedded within a transactional-ecological framework to treat a 14-year-old Navajo female with Major Depressive Disorder with psychotic features who presented to a psychiatric inpatient facility following a suicide attempt. The patient’s wish to die was motivated by her belief that her death could lead to positive changes in an extended family system plagued by historical trauma, alcoholism, suicide, and domestic violence. Ongoing assessment was conducted using the Suicide Status Form (SSF), Suicide Probability Scale (SPS), Reasons for Living Scale for Adolescents (RFL-A), and the DBT diary card. Navajo healing traditions were used in conjunction with DBT skills training and enhancement of ecological protective factors. Initial reduction in depression and suicidality was complicated by an increase in homicidal ideation. A comprehensive psychiatric evaluation was completed, and treatment was modified through medication changes, increased mindfulness practice, bolstering support systems, and engagement in a Navajo healing ceremony. Implications for clinicians treating suicidality in Navajo youth are discussed.
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Osman A, Gutierrez PM, Muehlenkamp JJ, Dix-Richardson F, Barrios FX, Kopper BA. Suicide Resilience Inventory–25: Development and Preliminary Psychometric Properties. Psychol Rep 2016; 94:1349-60. [PMID: 15362416 DOI: 10.2466/pr0.94.3c.1349-1360] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This manuscript describes the development of the Suicide Resilience Inventory–25, used to assess factors that help defend against suicidal thoughts and behaviors. We used multiple sources to generate and evaluate initial items (Study 1), then conducted an iterated principal-axis factor analysis with data from a combined sample of 540 adolescents and young adults. This identified three correlated factors, named Internal Protective, Emotional Stability, and External Protective. Estimated alpha for the total inventory and scales was high (.90 to .95). In Study 1, scores on the inventory significantly differentiated between the responses of adolescents and young adults. In Study 2, the inventory scores significantly differentiated between participants who reported (a) no prior suicide thoughts or attempts (145 men and 153 women), (b) brief suicidal thoughts (55 men and 110 women), and (c) prior suicide plans or attempts (22 men and 55 women). Results of the two studies suggest the inventory is useful for assessing the construct of suicide resilience in terms of these three operationally defined dimensions.
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Affiliation(s)
- Augustine Osman
- University of Northern Iowa, Department of Psychology, Cedar Falls, 50614-0505, USA.
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Heisel MJ, Neufeld E, Flett GL. Reasons for living, meaning in life, and suicide ideation: investigating the roles of key positive psychological factors in reducing suicide risk in community-residing older adults. Aging Ment Health 2016; 20:195-207. [PMID: 26305088 DOI: 10.1080/13607863.2015.1078279] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate the roles of reasons for living (RFL) and meaning in life (MIL) in potentially promoting mental health and well-being and protecting against suicide ideation among community-residing older adults and to investigate the psychometric properties of the Reasons for Living Scale-Older Adult version (RFL-OA). METHOD Of 173 older adults initially recruited into a longitudinal study on late-life suicide ideation, 109 completed the RFL-OA and measures of cognitive and physical functioning and positive and negative psychological factors at a two-year follow-up assessment. We tested a model in which RFL and MIL protect against suicide ideation, controlling for demographic and clinical factors. We also assessed the psychometric properties of the RFL-OA in community-residing older adults, investigating its internal consistency and its convergent (MIL, perceived social support, and life satisfaction), divergent (loneliness, depressive symptom severity, and suicide ideation), and discriminant validity (cognitive and physical functioning). RESULTS RFL-OA scores explained significant variance in suicide ideation, controlling for age, sex, depressive symptom severity, and loneliness. MIL explained significant unique variance in suicide ideation, controlling for these factors and RFL, and MIL significantly mediated the association between RFL and suicide ideation. Psychometric analyses indicated strong internal consistency (α = .94), convergent, divergent, and discriminant validity for the RFL-OA relative to positive and negative psychological factors and cognitive and physical functioning. CONCLUSION These findings add to a growing body of literature suggesting merit in investigating positive psychological factors together with negative factors when assessing suicide risk and planning psychological services for older adults.
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Affiliation(s)
- Marnin J Heisel
- a Departments of Psychiatry and of Epidemiology & Biostatistics , Schulich School of Medicine and Dentistry, The University of Western Ontario , London , Canada.,b Lawson Health Research Institute , London , Canada.,c Center for the Study and Prevention of Suicide , University of Rochester Medical Center , Rochester , NY , USA
| | - Eva Neufeld
- d Centre for Rural and Northern Health Research , Laurentian University , Sudbury , Canada
| | - Gordon L Flett
- e Department of Psychology , York University , Toronto , Canada
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Ducher JL, de Chazeron I, Llorca PM. Suicide et évaluation. Revue des outils disponibles en français : approche non dimensionnelle et autoquestionnaires. L'ENCEPHALE 2016; 42:242-7. [DOI: 10.1016/j.encep.2015.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 11/27/2014] [Indexed: 11/15/2022]
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Kang NR, Chung US, Kwack YS. Impact of Peer’s Suicide on Mental Health of Adolescents. Soa Chongsonyon Chongsin Uihak 2015. [DOI: 10.5765/jkacap.2015.26.4.266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Na Ri Kang
- Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
| | - Un Sun Chung
- Department of Psychiatry, Kyungpook National University School of Medicine, Deagu, Korea
| | - Young Sook Kwack
- Department of Psychiatry, Jeju National University School of Medicine, Jeju, Korea
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Hawton K, Witt KG, Taylor Salisbury TL, Arensman E, Gunnell D, Townsend E, van Heeringen K, Hazell P. Interventions for self-harm in children and adolescents. Cochrane Database Syst Rev 2015; 2015:CD012013. [PMID: 26688129 PMCID: PMC8786270 DOI: 10.1002/14651858.cd012013] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Self-harm (SH; intentional self-poisoning or self-injury) is common in children and adolescents, often repeated, and strongly associated with suicide. This is an update of a broader Cochrane review on psychosocial and pharmacological treatments for deliberate SH first published in 1998 and previously updated in 1999. We have now divided the review into three separate reviews; this review is focused on psychosocial and pharmacological interventions for SH in children and adolescents. OBJECTIVES To identify all randomised controlled trials of psychosocial interventions, pharmacological agents, or natural products for SH in children and adolescents, and to conduct meta-analyses (where possible) to compare the effects of specific treatments with comparison types of treatment (e.g., treatment as usual (TAU), placebo, or alternative pharmacological treatment) for children and adolescents who SH. SEARCH METHODS For this update the Cochrane Depression, Anxiety and Neurosis Group (CCDAN) Trials Search Co-ordinator searched the CCDAN Specialised Register (30 January 2015). SELECTION CRITERIA We included randomised controlled trials comparing psychosocial or pharmacological treatments with treatment as usual, alternative treatments, or placebo or alternative pharmacological treatment in children and adolescents (up to 18 years of age) with a recent (within six months) episode of SH resulting in presentation to clinical services. DATA COLLECTION AND ANALYSIS Two reviewers independently selected trials, extracted data, and appraised study quality, with consensus. For binary outcomes, we calculated odds ratios (OR) and their 95% confidence intervals (CI). For continuous outcomes measured using the same scale we calculated the mean difference (MD) and 95% CI; for those measured using different scales we calculated the standard mean difference (SMD) and 95% CI. Meta-analysis was only possible for two interventions: dialectical behaviour therapy for adolescents and group-based psychotherapy. For these analyses, we pooled data using a random-effects model. MAIN RESULTS We included 11 trials, with a total of 1,126 participants. The majority of participants were female (mean = 80.6% in 10 trials reporting gender). All trials were of psychosocial interventions; there were none of pharmacological treatments. With the exception of dialectical behaviour therapy for adolescents (DBT-A) and group-based therapy, assessments of specific interventions were based on single trials. We downgraded the quality of evidence owing to risk of bias or imprecision for many outcomes.Therapeutic assessment appeared to increase adherence with subsequent treatment compared with TAU (i.e., standard assessment; n = 70; k = 1; OR = 5.12, 95% CI 1.70 to 15.39), but this had no apparent impact on repetition of SH at either 12 (n = 69; k = 1; OR 0.75, 95% CI 0.18 to 3.06; GRADE: low quality) or 24 months (n = 69; k = 1; OR = 0.69, 05% CI 0.23 to 2.14; GRADE: low quality evidence). These results are based on a single cluster randomised trial, which may overestimate the effectiveness of the intervention.For patients with multiple episodes of SH or emerging personality problems, mentalisation therapy was associated with fewer adolescents scoring above the cut-off for repetition of SH based on the Risk-Taking and Self-Harm Inventory 12 months post-intervention (n = 71; k = 1; OR = 0.26, 95% CI 0.09 to 0.78; GRADE: moderate quality). DBT-A was not associated with a reduction in the proportion of adolescents repeating SH when compared to either TAU or enhanced usual care (n = 104; k = 2; OR 0.72, 95% CI 0.12 to 4.40; GRADE: low quality). In the latter trial, however, the authors reported a significantly greater reduction over time in frequency of repeated SH in adolescents in the DBT condition, in whom there were also significantly greater reductions in depression, hopelessness, and suicidal ideation.We found no significant treatment effects for group-based therapy on repetition of SH for individuals with multiple episodes of SH at either the six (n = 430; k = 2; OR 1.72, 95% CI 0.56 to 5.24; GRADE: low quality) or 12 month (n = 490; k = 3; OR 0.80, 95% CI 0.22 to 2.97; GRADE: low quality) assessments, although considerable heterogeneity was associated with both (I(2) = 65% and 77% respectively). We also found no significant differences between the following treatments and TAU in terms of reduced repetition of SH: compliance enhancement (three month follow-up assessment: n = 63; k = 1; OR = 0.67, 95% CI 0.15 to 3.08; GRADE: very low quality), CBT-based psychotherapy (six month follow-up assessment: n = 39; k = 1; OR = 1.88, 95% CI 0.30 to 11.73; GRADE: very low quality), home-based family intervention (six month follow-up assessment: n = 149; k = 1; OR = 1.02, 95% CI 0.41 to 2.51; GRADE: low quality), and provision of an emergency card (12 month follow-up assessment: n = 105, k = 1; OR = 0.50, 95% CI 0.12 to 2.04; GRADE: very low quality). No data on adverse effects, other than the planned outcomes relating to suicidal behaviour, were reported. AUTHORS' CONCLUSIONS There are relatively few trials of interventions for children and adolescents who have engaged in SH, and only single trials contributed to all but two comparisons in this review. The quality of evidence according to GRADE criteria was mostly very low. There is little support for the effectiveness of group-based psychotherapy for adolescents with multiple episodes of SH based on the results of three trials, the evidence from which was of very low quality according to GRADE criteria. Results for therapeutic assessment, mentalisation, and dialectical behaviour therapy indicated that these approaches warrant further evaluation. Despite the scale of the problem of SH in children and adolescents there is a paucity of evidence of effective interventions. Further large-scale trials, with a range of outcome measures including adverse events, and investigation of therapeutic mechanisms underpinning these interventions, are required. It is increasingly apparent that development of new interventions should be done in collaboration with patients to ensure that these are likely to meet their needs. Use of an agreed set of outcome measures would assist evaluation and both comparison and meta-analysis of trials.
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Affiliation(s)
- Keith Hawton
- Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford, UK, OX3 7JX
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Brausch AM, Holaday TC. Suicide-Related Concerns as a Mediator Between Physical Abuse and Self-Harm Behaviors in College Students. CRISIS 2015; 36:440-6. [DOI: 10.1027/0227-5910/a000349] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Multiple studies have found correlations between history of abuse and self-harm behaviors, but few have examined potential mediators. Studying suicide-related concerns as a mediator in this relationship could inform the interpersonal theory of suicide by identifying acquired capability as a necessary component in self-harm behavior. Aims: This study examined the link between childhood physical abuse, self-injurious behaviors, and suicide-related concerns in young adults. It was hypothesized that more physical abuse and fewer suicide-related concerns would predict self-harm behaviors, and that suicide-related concerns would mediate this relationship. Method: A sample of 212 university students completed self-report measures that assessed self-harm behavior history, reasons for living, and childhood physical abuse. Results: Results supported the hypothesis that more instances of abuse and less concern about pain and death were significantly associated with greater self-harm history. Suicide-related concerns also mediated the relationship between physical abuse and self-harm behaviors. Conclusion: These results support recent theories that habituation to painful and provocative events is an important mechanism in explaining why people engage in self-injurious acts, and provides initial evidence for cognitive mediators between physical abuse and self-harm.
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Affiliation(s)
- Amy M. Brausch
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY, USA
| | - Tara C. Holaday
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY, USA
- Morehead State University, Morehead, KY, USA
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Testoni I, Ancona D, Ronconi L. The Ontological Representation of Death: A Scale to Measure the Idea of Annihilation Versus Passage. OMEGA-JOURNAL OF DEATH AND DYING 2015; 71:60-81. [PMID: 26152027 DOI: 10.1177/0030222814568289] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Since the borders between natural life and death have been blurred by technique, in Western societies discussions and practices regarding death have became infinite. The studies in this area include all the most important topics of psychology, sociology, and philosophy. From a psychological point of view, the research has created many instruments for measuring death anxiety, fear, threat, depression, meaning of life, and among them, the profiles on death attitude are innumerable. This research presents the validation of a new attitude scale, which conjoins psychological dimensions and philosophical ones. This scale may be useful because the ontological idea of death has not yet been considered in research. The hypothesis is that it is different to believe that death is absolute annihilation than to be sure that it is a passage or a transformation of one's personal identity. The hypothetical difference results in a greater inner suffering caused by the former idea. In order to measure this possibility, we analyzed the correlation between Testoni Death Representation Scale and Beck Hopelessness Scale, Suicide Resilience Inventory-25, and Reasons for Living Inventory. The results confirm the hypothesis, showing that the representation of death as total annihilation is positively correlated to hopelessness and negatively correlated to resilience.
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50
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Chang EC, Yu T, Jilani Z, Fowler EE, Yu EA, Lin J, Hirsch JK. Hope Under Assault: Understanding the Impact of Sexual Assault on the Relation Between Hope and Suicidal Risk in College Students. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2015. [DOI: 10.1521/jscp.2015.34.3.221] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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