Protective factors against suicide attempt risk among African American women experiencing intimate partner violence

Healing After Violence: The Effect of Perception of Social Support on Posttraumatic Growth in Female University Students

This study investigated the Turkish validity and reliability of the Healing After Gender-based Violence Scale (GBV-Heal) and the relationship between social support perception, posttraumatic growth in university students who are victims of gender-based violence. The study sample consisted of 167 female students who experienced gender-based violence. The Turkish version of GBV-Heal of Kaiser-Meyer-Olkin value was 0.892; the Bartlett Sphericity Test result was determined as χ2  =  195,053, and the obtained variables were found suitable for factor analysis. Perception of social support related to post-violence healing in female university students is effective on posttraumatic growth.

Natural Health Community Program and Well-Being: An Uncontrolled Study of Women Survivors of Domestic Violence

The purpose of this study was to evaluate a local natural healing service program and to explore how engagement in natural healing services related to the well-being of survivors of domestic violence. Using longitudinal secondary data, we conducted t-tests, regression, and correlation analysis on three measures (hope, distress, and empowerment) that were completed by the participants (N = 31). We provided evidence of the positive impact of a community-based natural healing services program on the well-being of survivors of domestic violence, specifically their sense of hope. This research represents the potential for natural healing services provided at the community level.

Development and validation of the Informal Supporter Readiness Inventory (ISRI)

OBJECTIVE

This article outlines the development and validation of the Informal Supporter Readiness Inventory (ISRI), based on the model developed by the present authors in (Davies, 2023). This scale assesses the readiness of informal supporters to intervene or provide support in situations of intimate partner violence (IPV).

METHODS

The research followed a three-phased procedure of item development, scale development, and scale evaluation; adhering to best practice guidelines for psychometric development and validation. This process provided empirical substantiation for the domains of the Model of Informal Supporter Readiness (Davies, 2023).

RESULTS

The 57-item ISRI incorporates four primary factors: normative, individual, goodman-emotional, and situational-assessment. These factors demonstrated robust internal consistency and factor structures. Additionally, the ISRI evidenced strong test-retest reliability, and both convergent and divergent validity. Although aligning closely with the Model of Informal Supporter Readiness, the scale revealed a nuanced bifurcation of situational factors into situational-emotional and situational-assessment.

DISCUSSION

The ISRI offers an important advancement in IPV research by highlighting the multifaceted nature of informal supporter intervention. The findings have several implications, from tailoring individualised supportive interventions to strengthening support networks and empowering survivors. The present study's findings underscore the potential of adopting a social network-oriented approach to interventions in IPV scenarios. Applications for research and practice are discussed.

The role of effective factors on suicidal tendency of women in Turkey

Background/Aim

This study aims to identify the variables that influence the suicidal tendency of women who are married, have had a relationship or are currently in a relationship in Turkey.

Methods

This study uses cross-sectional data from the 2014 Hacettepe University Institute of Population Studies National Research on Domestic Violence Against Women in Turkey. Data from 6,458 women between the ages of 15 and 49 were analyzed in this dataset. Binary logistic regression was used to determine the factors influencing women's suicidal tendencies.

Results

Based on the analysis's findings, age, education level, health status, number of children, the sector in which the spouse/partner works, the drinking status of the spouse/partner, the situation where the spouse/partner fights with another man in a way that involves physical violence, the cheating status of the spouse/partner, the controlling behaviour of the spouse/partner, exposure to various types of violence by both the spouse/partner and someone other than the partner, and the household income level variables were found to be associated with the suicidal tendency of women.

Conclusion

Prioritizing women who are, in particular, between the ages of 15 and 24, live in the south of Turkey, have a high school education, are in poor health, are childless, have low household incomes, live with an unemployed spouse or partner, and are exposed to various forms of violence from their partner or other sources can be achieved more effective results in reducing and preventing women's suicidal behaviors.

Associations of systemic inflammation and social support with suicidal ideation in patients with acute coronary syndrome and stroke

BACKGROUND

This study aimed to investigate associations of serum high-sensitivity C-reactive protein (hsCRP) and social support (SS) levels with suicidal ideation (SI), and to evaluate potential modifying effects of SS on the associations between serum hsCRP levels and SI in two longitudinal cohorts with cardio-/cerebrovascular diseases.

METHODS

1152 acute coronary syndrome (ACS) and 423 stroke patients were recruited at baseline within 2 weeks of disease onset, and evaluated for: i) serum hsCRP levels; ii) SS by the Social Support Scale and Social Undermining Scale; iii) SI by the "suicidal thoughts" item of the Montgomery-Åsberg Depression Rating Scale; and iv) covariates including socio-demographics, depression, vascular risk factors, and index disease severity. At 12-month follow-up, SI was re-evaluated. Logistic regression models were used to adjust for potential covariates.

RESULTS

In the ACS cohort, higher serum hsCRP and lower SS levels were significantly associated with SI at baseline; and only lower SS levels were significantly associated with SI at follow-up. In the stroke cohort, lower SS levels were significantly associated with SI at baseline; but no other association was found. Associations of serum hsCRP levels with SI at both baseline and follow-up were only significant at higher SS levels with significant interaction terms in both cohorts.

LIMITATIONS

This study evaluated SI, but not suicide attempts or death; it also used a single-center design.

CONCLUSIONS

By considering SS evaluations with routine serum hsCRP levels in cardio-/cerebrovascular disease, clinical prediction of SI both at acute and chronic phases of the diseases might be improved.

Protective factors against suicide attempt in Iranian Kurdish women: a qualitative content analysis

BACKGROUND

A proper understanding of the protective factors against suicide attempt can provide the basis for planning preventive interventions. This study aimed to identify protective factors against suicide attempt among women.

METHODS

This qualitative study was conducted in Kermanshah, Iran between January and May 2021. Participants were 20 Kurdish women, survivors of suicide attempt, selected by purposive sampling method. The data collection method was face-to face and audio-recorded semi-structured interview. Qualitative data analysis was done according to Diekelmann 7-step approach.

FINDINGS

According to the results, the main topic was protective factors against suicide attempt in women, with two categories; "Individual factors" and "Social factors". "Individual factors" had five subcategories including coping strategies, reasons for living, resilience, religious beliefs, and fear of death, and "social factors" had two subcategories including social support and effective communication.

CONCLUSION

This study showed that women who intend to commit suicide may encounter some individual and social factors that play a protective role against suicide. It is recommended to identify and strengthen these protective factors for the effectiveness of suicide prevention interventions.

Intimate partner violence, suicidality, and self-harm: a probability sample survey of the general population in England

BACKGROUND

Intimate partner violence (IPV) is a recognised risk factor for psychiatric disorders. There is little current evidence on IPV and self-harm and suicidality, and we therefore aimed to investigate the associations between experience of lifetime and past-year IPV with suicidal thoughts, suicide attempt, and self-harm in the past year.

METHODS

We analysed the 2014 Adult Psychiatric Morbidity Survey, a cross-sectional survey of 7058 adults (aged ≥16 years) in England, which used a multistage random probability sampling design and involved face-to-face interviews. Participants were asked about experience of physical violence and sexual, economic, and emotional abuse from a current or former partner, and about suicidal thoughts, suicide attempts, and self-harm. Other adversities were recorded through an adapted version of the List of Threatening Experiences. Multivariable logistic regression models quantified associations between different indicators of lifetime and past-year IPV, with past-year non-suicidal self-harm, suicidal thoughts, and suicide attempts. All analyses were weighted.

FINDINGS

Using weighted percentages, we found that a fifth (21·4%) of 7058 adults reported lifetime experience of IPV, and that 27·2% of women and 15·3% of men had experienced IPV. Among women, 19·6% had ever experienced emotional IPV, 18·7% physical IPV, 8·5% economic IPV, and 3·7% sexual IPV, which was higher than in men (8·6%, 9·3%, 3·6%, and 0·3%, respectively). Findings for ethnicity were unclear. Lifetime prevalence of IPV was higher in those living in rented accommodation or deprived neighbourhoods. Among people who had attempted suicide in the past year, 49·7% had ever experienced IPV and 23·1% had experienced IPV in the past year (including 34·8% of women and 9·4% of men). After adjusting for demographics, socioeconomics, and lifetime experience of adversities, the odds ratio of a past-year suicide attempt were 2·82 (95% CI 1·54-5·17) times higher in those who have ever experienced IPV, compared with those who had not. Fully adjusted odds ratios for past-year self-harm (2·20, 95% CI 1·37-3·53) and suicidal thoughts (1·85, 1·39-2·46) were also raised in those who had ever experienced IPV.

INTERPRETATION

IPV is common in England, especially among women, and is strongly associated with self-harm and suicidality. People presenting to services in suicidal distress or after self-harm should be asked about IPV. Interventions designed to reduce the prevalence and duration of IPV might protect and improve the lives of people at risk of self-harm and suicide.

FUNDING

UK Prevention Research Partnership.

Factors precipitating suicide attempts vary across race

OBJECTIVE

Although research has identified interpersonal, intrapersonal, and achievement-related factors that precipitate suicide attempts (SAs), how these factors vary by race/ethnicity is unknown. We examined racial/ethnic differences in SA precipitants in a racially/ethnically diverse sample of young adults (YAs) with a SA history.

METHOD

Two-hundred twenty-nine young adults, ages 18-33 (87% women), reported their method of attempt, and 200 of those reported on their SA precipitants. The latter were coded by three independent judges (Data were collected March 2012-December 2016.).

RESULTS

SAs were most often precipitated by intrapersonal factors, followed by interpersonal factors. Logistic regressions revealed that Hispanic, Asian, and Biracial YAs had higher odds of reporting interpersonal precipitants compared to Black YAs.

CONCLUSION

Suicide prevention and intervention should address both interpersonal and intrapersonal factors that increase vulnerability to SA across racial/ethnic groups, although interventions with Black YAs might focus more on intrapersonal than on interpersonal factors.

Role of Social Support in Women facing Domestic Violence during Lockdown of Covid-19 while Cohabiting with the Abusers: Analysis of Cases Registered with the Family Counseling Centre, Alwar, India

The present study aims to analyze the role of social support in the lives of women survivors of domestic violence who filed a complaint with the Mahila Salah and Suraksha Kendra (MSSK) Alwar, India, while residing with the abusive husband and his family during the lockdown period of COVID-19. The study explores the role of MSSK with extended vulnerability of women during the lockdown period at large. This study adopts an exploratory qualitative method. A total of 36 married women who had filed a complaint with MSSK before and during the lockdown were included. Interviews with the women were held through telephonic conversations on vulnerability, coping mechanism and extent and forms of social support. Thematic content analysis was done in a stepwise manner. Results show that degeneration of social support model is time -bound and the accuracy of applying this model wane under extended condition of vulnerability caused due to COVID-19. MSSK can expand support by creating and integrating virtual community networks to detect and deter violence during the lockdown. The study suggests that the government can ensure and empower bystanders with skills of modern communication. The existing physical institutional delivery mechanism need to evolve strategies that are resilient to emerging threats from the vulnerable ecosystem.

"We Can Be Oppressed but That Does Not Mean We Cannot Fight Oppression": Narratives of Resilience and Advocacy From Survivors of Intimate Partner Violence

Helping others has been identified as an important component in recovery and resilience for women following intimate partner violence (IPV). However, little is known about the experiences of women who are IPV survivors and who also engage in formal and informal violence against women (VAW) advocacy work, such as supporting IPV survivors in a social work role or volunteering on VAW advocacy committees. Using in-depth semistructured interviews with nine "survivor-advocates" who were part of a larger study on IPV and resilience, this study extends the existing literature to examine the multidirectional relationship between IPV, advocacy work, and resilience using narrative analysis. Three distinct narratives were identified in survivor-advocates' accounts of their experiences of abuse and advocacy work. The working through the abuse narrative focused on using the knowledge and experience from advocacy work that began prior to IPV to critically reflect on the abuse and its meaning for women. The second narrative, helping others, focused on using personal experiences of abuse to help other IPV survivors. The third narrative, personal strength, focused on a personal identity as a lifelong advocate and inner strength and determination as central to resilience. The findings of this study demonstrate the multitude of ways that engaging in advocacy work interacts with abuse experiences and women's recovery and resilience processes. The findings of this study can inform approaches for promoting resilience and recovery for IPV survivors and highlight the importance of cultivating a critical understanding of abuse to support resilience and recovery following IPV.

Perceived racial discrimination on the change of suicide risk among ethnic minorities in the United States

Objective: Suicide ideation and attempts are serious public health concerns in the U.S. Previous studies focus mainly on individual factors that cause suicide and therefore, it is imperative to examine the impact of the environment on the onset of suicide risk. This study explored the effects of perceived race/ethnicity-based discrimination (PD; perceived institutional discrimination and perceived interpersonal discrimination) on the change in suicidal thoughts and attempts among racial/ethnic minority (REM) participants at risk for depression over time using a longitudinal nationally representative dataset.Design and methods: The sample consisted a total of 1,253 REM participants from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 1 and 2 datasets. Participants were categorized into three conditions: (1) no suicidal thoughts/attempts at Wave 1, who were at risk for onset of suicidal thoughts at Wave 2, (2) no suicidal thoughts/attempts at Wave 1, who were at risk for onset of both suicidal thoughts and attempts at Wave 2, and (3) had suicidal thoughts but no attempts at Wave 1, who were at risk for initiating suicidal attempt at Wave 2. Three logistic regressions were performed to examine the associations between PD and the three suicidal conditions, controlling for sociodemographic factors.Results: Regression results showed that perceived institutional discrimination predicted onset of suicidal thoughts for Condition 1 (OR = 1.67, 95% CI:1.05-2.66) and initiation of suicidal attempts for Condition 2 (OR = 2.67, 95% CI:1.30-5.48), whereas perceived interpersonal discrimination predicted onset of suicidal thoughts and attempts for Condition 1 (OR = 2.34, 95% CI:1.17-4.66).Conclusions: PD may have detrimental effects on suicidal behaviors among REM individuals with depressive symptoms. Development of suicide prevention programs needs to take into account PD and be specific for different at-risk groups. This also foregrounds the importance of promoting anti-discrimination policies/programs as a suicide preventive intervention for REM individuals with depressive symptoms.

Trauma History and Social Support Among American Indian/Alaska Native and Non-Native Survivors of Intimate Partner Violence

Social support (SS) is one of the most important protective factors against the deleterious effects of trauma exposure on mental health, but only a few studies have looked at predictors of SS among trauma-exposed populations. This study examines what predicts SS from friends, family, and other significant individuals in an ethnically diverse group of 61 women residing in Alaskan shelters for women who have experienced Intimate Partner Violence (IPV). Results from bivariate tests indicated that survivors who identified as American Indian or Alaska Native (AIAN) reported significantly higher SS from family (M = 5.04, SD = 1.74) in comparison with those who do not identify as AIAN (M = 3.80, SD = 2.31), t(56) = 2.24, p < .05. Income was positively correlated with higher SS from friends, r(59) = .33, p < .05. Lifetime history of interpersonal trauma was significantly and negatively related to variation in SS across multiple domains. When sociodemographic variables, trauma history, and violent relationship history were entered into a multiple regression, this model predicted 34% (p < .001) of the variance in Overall SS and 22% (p < .01), 32% (p < .001), and 17% (p < .05) of SS from family, friends, and other significant individuals, respectively. Taken together, these preliminary results suggest that income, race, lifetime interpersonal trauma history, and number of violent partners are important predictors of SS among women IPV survivors residing in shelters.

"I forgive myself": The association between self-criticism, self-acceptance, and PTSD in women victims of IPV, and the buffering role of self-efficacy

The effects of intimate partner violence (IPV) concerning specifically posttraumatic stress disorder (PTSD) symptomatology have been widely demonstrated, but the consequences of abuse are not the same for all victims. We know little about the psychological processes that limit these adverse consequences. Therefore, we explored the association between self-criticism felt by abused women and their PTSD, and we investigated self-acceptance as the underlying process explaining this relationship. We also examined self-efficacy as the protective (moderating) factor. The results indicated that self-criticism was indirectly associated with greater PTSD via lower self-acceptance. Critically, the indirect effect only emerged for individuals low in self-efficacy.

Moderating Effects of Resilience on Depression, Psychological Distress, and Suicidal Ideation Associated With Interpersonal Violence

Resilience has been found to attenuate the effects of negative mental health symptomology associated with interpersonal victimization; however, existing research has largely focused on resilience traits, such as individual cognitive and environmental factors that promote resilience. In addition, empirical knowledge on the extent to which resilience mitigates suicidal symptomology associated with interpersonal violence victimization is particularly limited. This study assesses whether the relationship between interpersonal violence (i.e., IPV and nonpartner sexual violence) and mental health symptomology (i.e., depression, psychological distress, and suicidal ideation) is moderated by resilience using a general population sample of women (N = 932). A cross-sectional, observational survey was administered in four U.S. cities (Baltimore, New York City, Philadelphia, and Washington, D.C.). Bivariate results indicated that women exposed to interpersonal violence reported significantly higher rates of suicidal ideation, depression, and psychological distress compared with women without exposure to interpersonal violence. Regression models revealed significant positive associations between interpersonal violence and depression, distress, and suicidal ideation, adjusting for sociodemographics. Resilience did not significantly moderate the relationship between interpersonal violence victimization and any associated mental health outcomes. However, subgroup analyses reveal significant interaction effects between resilience and IPV within specific racial and ethnic minority subgroups, suggesting that attenuating effects of resilience on mental health symptoms (i.e., depression and psychological distress) associated with IPV likely vary across race and ethnicity. Implications for future research and clinical interventions focused on resilience among survivors of interpersonal violence are discussed.

Intimate Partner Violence Against Indigenous Women in Sololá, Guatemala: Qualitative Insights Into Perspectives of Service Providers

Over a third of women in Guatemala are subjected to intimate partner violence (IPV). Indigenous Mayan women are particularly vulnerable, due to the intersection of race, gender, and poverty. However, no research exists into the causes of IPV among this group. Our pioneering study addresses this knowledge gap. Our results from in-depth interviews with service providers in Sololá highlight four interlinked causes of IPV: rigid gender roles, lack of awareness of women's rights, use of alcohol by men, and poor reproductive health. From these, we draw implications for service provision to victims of IPV.

Racial/Ethnic Differences in Preceding Circumstances of Suicide and Potential Suicide Misclassification Among US Adolescents

PURPOSE

There is a paucity of research on racial/ethnic differences in preceding circumstances of suicide among adolescents aged 10-19 years and consequential potential misclassification of suicide deaths (i.e., manner of death classified as injury of undetermined intent). This study (1) examined preceding circumstances of suicide among non-Hispanic White, non-Hispanic Black, non-Hispanic Asian/Pacific Islander (A/PI), non-Hispanic American Indian/Alaskan Native (AI/AN), and Hispanic adolescent decedents; and (2) investigated potential suicide misclassification of racial/ethnic minority decedents.

METHODS

We used data from the 2006-2015 National Violent Death Reporting System Restricted Access Database. Multivariable logistic regression analyses examined differences in depressed mood, mental health problem and treatment, crisis in the past 2 weeks, problems with school, intimate partner, family relationship, and other relationships (e.g., friend) among racial/ethnic minority decedents compared to White decedents. A separate logistic regression analysis assessed potential suicide misclassification of racial/ethnic minority decedents relative to White counterparts.

RESULTS

Adjusting for sex and suicide history and circumstances, all racial/ethnic minority decedents had significantly lower odds of documented mental health problem and treatment compared to White decedents. Racial/ethnic differences in relationship problems were also identified. Black decedents had significantly higher odds of manner-of-death classification as undetermined intent than did White decedents, suggesting greater likelihood of suicide misclassification.

CONCLUSIONS

Circumstances contributing to suicide among adolescents differ by race/ethnicity, indicating the need for culturally tailored suicide prevention efforts.

Unrelenting Depression and Suicidality in Women with Autistic Traits

Understanding the cognitive and emotional mechanisms that link autistic traits and risk for suicide is a vital next step for research and clinical practice. This study included a broad sample of adult women (n = 74) who report finding social situations confusing and/or exhausting, and who score high on measures of autistic traits. Regardless of autism diagnostic status, these women reported high rates of suicidal thoughts and behaviors. Depression symptoms were more associated with suicidality than were autistic trait measures of social communication. Measures of neurotypical "imagination" and of repetitive behavior likewise were associated with suicidality risk. Simultaneously feeling sad and feeling stuck or unable to imagine alternate strategies, may uniquely increase suicide risk in autism.

Self-Disgust and Its Relationship With Lifetime Suicidal Ideation and Behavior

Abstract. Background: The emotion disgust is typically directed toward stimuli in the external environment, but sometimes people develop self-directed disgust responses. Aims: The current questionnaire study focused on the role of self-disgust in lifetime suicidal ideation and behavior. Method: A total of 1,167 individuals participated in an Internet-based survey containing self-report measures of self-disgust, externally directed disgust proneness, coping styles, diagnoses of mental disorders, and suicide risk. Hierarchical regression analyses as well as mediation analyses were computed. Results: Self-disgust was the most relevant predictor of suicide risk among the assessed variables. Self-disgust was negatively associated with the use of support by others, and positively associated with evasive coping (self-blame, venting, denial), which in turn was positively associated with suicidality. Limitations: This cross-sectional study provided information on the relationship between self-disgust and suicidality in a self-selected sample. Longitudinal studies are warranted. Conclusion: Future studies are required to replicate these findings. Additionally, stronger research designs are needed in order to investigate whether self-disgust should be targeted in suicide prevention programs and interventions.

Living with suicidality following traumatic brain injury: a qualitative study

PURPOSE

Numbers of traumatic brain injury (TBI) are increasing, and with suicidality post-injury presenting at 3-4 times higher than in the general population, understanding this is crucial in reducing a devastating outcome. Given the lack of literature, this study investigated the experiences of living with suicidality after TBI.

METHODS

Interview data from nineteen participants with TBI from a Brain Injury Rehabilitation Unit (BIRU) in New South Wales (NSW), Australia were collected and thematically analyzed.

FINDINGS

The participants (predominantly male) sustained extremely severe injuries (median PTA 60 [IQR 81.0] days) and were in the chronic phase post-injury (median 8.0 [IQR 9.0] years). Six main themes were identified; Loss of sense of self, TBI as a hidden disability, Chronic but transient suicidality, Reliance, Protective factors, and Hope. Tentative relationships between themes and subthemes were identified.

CONCLUSION

Chronic suicidality after TBI was demonstrated consistently regardless of receiving long-term support. However, their engagement with protective factors such as social support, spirituality and positive personal qualities was identified. Implementing these as coping strategies during long-term rehabilitation may reduce the levels of suicidal distress. Implications, methodological considerations and future research were discussed, with the aim of improving experiences of individuals with TBI to reduce suicidality.

Coping strategies of women survivors of domestic violence residing with an abusive partner after registered complaint with the family counseling center at Alwar, India

Coping is one of the most important and widely studied aspects of domestic violence (DV). Women adopt a wide variety of coping strategies to manage abuse, ranging from individual estrangement to institutional entitlements. The condition of women becomes complex when they seek institutional support while living with an abusive husband and his family under the common hearth. The present study aims to analyze the coping strategy of mediation between informal and formal justice while residing with an abusive husband and his family. Further, the study explores the coping strategy as an outcome of the contextual factor and associated psychological distress. It is a prospective intervention study with a 4-month span building awareness, counseling (individual, couple, and family counseling), and case-specific advice (safety plan, choice-making, and problem-solving). A baseline and endline assessment with SRQ-20 and in-depth interviews were carried out on 299 married women who had registered a complaint with a family counseling center (FCC); Mahila Suraksha Evam Salah Kendra (MSSK) in Alwar district, India. To understand the context and the coping strategy adopted by women, in-depth interviews were carried out. The results show that there is a differential impact of DV, psychological distress, and coping strategy based on contextual factor; women having an informal support system have a better result in coping; and intervention at the formal system resulted in improving coping strategy and simultaneously reducing psychological distress. As the mediation period is interminable and traumatic, the institutional support to women survivors of DV is an important policy alternative for improving survivors' well-being, especially in an unsupportive informal context.

Risk Factors for and Mental Well-Being Outcomes of Economic Abuse in Hong Kong Chinese Population

Although economic abuse is one of the major tactics of intimate partner violence, there has been a lack of empirical evidence on the factors associated with economic abuse and its mental well-being outcomes in Chinese population. This study aimed to identify risk factors for and mental well-being of economic abuse in Chinese population. This was a cross-sectional household survey with 504 Chinese adults in Hong Kong. It was found that unmarried individuals and individuals with tertiary education or above were at risk of economic abuse. Moreover, there were significant association between economic abuse experience and anxiety, depression, and psychosomatic symptoms. Resilience was the protective factor against anxiety, depression, and psychosomatic symptoms. The findings were discussed alongside with Chinese culture.

Associations Between Two Domains of Social Adversity and Recovery Among Persons with Serious Mental Illnesses Being Treated in Community Mental Health Centers

As mental health services are increasingly embracing the recovery model, we conducted a study to better understand how social adversity impacts recovery. We also examined how associations between social adversity and recovery are influenced (moderated or mediated) by symptom severity. Data on seven social adversity measures, eight recovery measures, and symptom severity were collected from 300 English-speaking participants, ages 18-65 years, with a diagnosis of a psychotic or mood disorder, from five community mental health agencies in diverse neighborhoods in Washington, D.C. We employed standard correlation, exploratory factor analyses, analysis of variance, and hierarchic regression procedures. Diagnostic category and gender impacted Home Environment Adversities (e.g., food insecurity, perceived neighborhood disorder), the diagnostic category-by-gender interaction influenced Social and Economic Adversities (e.g., years of education and income), and gender affected Recovery. Controlling for diagnostic category and gender, Social and Economic Adversities accounted for 1.7% of variance in Recovery, while Home Environment Adversities accounted for 8.6% (their joint influence was 3.4%). Although symptom severity did not moderate these associations, it partially mediated the effect of Social and Economic Adversities on Recovery, and substantially mediated the effect of Home Environment Adversities on Recovery. The extent to which patients with serious mental illnesses experience recovery may be meaningfully influenced not only by symptoms, but by their social and environmental circumstances.

The effect of intimate partner violence on women's mental distress: a prospective cohort study of 3010 rural Indian women

PURPOSE

Intimate partner violence (IPV) encompasses physical, sexual, and psychological abuse, as well as controlling behavior. Most research focuses on physical and sexual abuse, and other aspects of IPV are rarely investigated. We estimated the effect of these neglected aspects of IPV on women's mental distress.

METHODS

We used data from 3010 women living in rural tribal communities in Rajasthan, India. Women completed baseline interviews and were re-interviewed approximately 1.5 years later. We measured IPV with questions adopted from the Demographic and Health Survey's Domestic Violence Module, which asked seven questions about physical abuse, three questions about psychological abuse, and five questions about partner controlling behavior. Mental distress was measured with the 12-item General Health Questionnaire (score range 0-12). We used Poisson regression models to estimate the relation between changes in IPV and mental distress, accounting for time-fixed characteristics of individuals using individual fixed effects.

RESULTS

Women reported an average of 2.1 distress symptoms during baseline interviews. In models that controlled for time-varying confounding (e.g., wealth, other types of abuse), experiencing psychological abuse was associated with an increase of 0.65 distress symptoms (95% CI 0.32, 0.98), and experiencing controlling behavior was associated with an increase of 0.31 distress symptoms (95% CI 0.18, 0.44). However, experiencing physical abuse was not associated with an increase in distress symptoms (mean difference = - 0.15, 95% CI - 0.45, 0.15).

CONCLUSIONS

Psychological abuse and controlling behavior may be important drivers of the relation between IPV and women's mental health.

Resilience as a focus of suicide research and prevention

Suicide is a major medical and social problem. Decades of suicide research have mostly focused on risk factors for suicidal behaviour while overlooking protective factors such as resilience that may help to address this important public health issue. Resilience is the capacity and dynamic process of adaptively overcoming stress and adversity while maintaining normal psychological and physical functioning. Studies conducted over the past 10-15 years suggest that resilience is a protective factor against suicide risk. Resilience is becoming a focus of suicide research and prevention. Building resilience should be a part of universal, selective, and indicated suicide prevention interventions. Promoting resilience may reduce suicide risk in the general population, in groups at elevated suicide risk, and among high-risk individuals. Building resilience in the general population may reduce the incidence of stress-related disorders and, consequently, suicidal behaviour. Improving resilience should be a part of a treatment plan of every psychiatric patient. Mental health professionals will probably have the best success in reducing suicide risk in psychiatric patients if they actively concentrate on increasing stress resilience using both psychosocial and pharmacological interventions. It is critically important to move forward the development of pharmacological and psychological interventions for enhancing resilience.

Predicting Depression Among Jewish and Arab Israeli Women Who Are Victims of Intimate Partner Violence

This study examined whether there were differences in levels of depression between Arab and Jewish Israeli female victims of intimate partner violence (IPV) and how various personal and environmental variables contributed to depression. A total of 303 women were selected. T tests were conducted, and no significant differences were revealed. Hierarchical regressions were also conducted. Background variables (violence in childhood and employment status) and psychiatric treatment contributed significantly to the variance in depression, and a negative contribution was made by personal and environmental variables (sense of mastery and social support). The interaction between ethnic origin and psychiatric treatment was also found to be significant. The discussion highlights the theoretical contribution and implications for practice in the field.

A Sample of Predominately African American Domestic Violence Victims' Responses to Objective Risk Assessments

One area of significant concern for researchers of domestic violence is identifying the utility of objective risk assessment tools on diverse samples. This study included a sample of predominately African American women (n = 57) living in a domestic violence shelter. The study compared the Danger Assessment (DA) and the Ontario Domestic Assault Risk Assessment (ODARA) to evaluate their responses of their risk for re-abuse. Results revealed a moderate to strong correlation between the DA and ODARA (r = .73). Offender's age, habitation, and pregnancy status were not related to the victim's perceptions of risk for future abuse. Implications of these findings are discussed.

Individual and social factors related to attempted suicide among women: A qualitative study from Iran

The researchers conducted this study as a phenomenological research to understand the individual and social factors related to attempted suicide phenomenon among women of Gilan-e Gharb. Participants of the study are comprised of 17 women survivors of attempted suicide selected by purposive sampling or snowball method. To gather the data, we conducted semi-structured interviews in face-to-face and audio-recorded methods from February to April 2017. Researchers transcribed verbatim and analyzed the content of the interviews thematically. The main issues in this study were three main themes including the "personal factors", "social factors", and "other issues related to attempted suicide" with seven sub-themes. We concluded that both personal and social factors contribute to the suicide attempts in female subjects. Also, we found that the majority of participants did not want to die by the attempted suicide.

Protective factors for older suicide attempters: Finding reasons and experiences to live

This paper describes the nature and scope of protective factors that give older people reasons and experiences to live following a suicide attempt. In order to understand more about what protective factors influenced them, we conducted a multiple-case study of seven older people who attempted suicide. The main category from the within-case analysis was the self. Between-case analysis identified four main categories: interpersonal relationships, meaningful activities and interests, community engagement, and involvement of mental health services staff. These findings offer valuable insight into the meanings behind the reasons and experiences that promote survival of older people following a suicide attempt.

“I can’t decide, and it upsets me”: assessing self-critical cognition, indecision, and hope among young adults

Background

Decisional procrastination, or indecision, is the maladaptive postponing of decision-making when faced with conflicts or choic-es. In the present exploratory study, we examined two factors of a psychological model toward understanding the underpinnings of indecision, namely: self-critical cognition as a predisposition to indecision and decreased hope as a post-decision behavior of indecision. Self-critical cognition is the tendency for self-related thoughts to be critical and defeating. It is hypothesized to pre-dict indecision as self-critical individuals are likely to also doubt their competence at tasks such as decision-making and may, in turn, delay. Decreased hope is hypothesized to be an outcome of indecision as the latter is related to anxiety, worry, and life regret.

Participants and procedure

Participants were 327 undergraduate students from a large Midwestern university (242 women, 82 men; M_age = 20.31 years old). They completed the self-report measures in an online survey and received class credit for participation.

Results

Using a bootstrap analysis of the indirect effect, the results showed that indecision mediates the relationship between self-critical cognition and decreased hope among emerging adults.

Conclusions

Implications for future research and potential interventions to alter the pattern of indecision and to increase hope are discussed. This study moves forward the literature of indecision by examining a new predictor and outcome of indecision.

Longitudinal Investigation of Depression, Intimate Partner Violence, and Supports Among Vulnerable Families

Intimate partner violence (IPV) affects nearly 12 million individuals and their families each year in the United States. Many negative outcomes are associated with IPV, with depression being one of the most prevalent mental health problems. Most previous studies on IPV have used cross-sectional designs to examine the potential protective effects of support on depression. The current study fills this gap by conducting a longitudinal investigation of the roles of social support and family resources on depression among caregivers of young children. The study sample consisted of 548 female caregivers. Findings suggest that among those with an IPV history, those with higher social support reported lower depressive symptoms than those with less social support. No significant interaction was found for family resources and IPV. Rather, family resources had a main effect on depressive symptoms with no differential impact based on IPV status. Findings suggest the importance of connecting vulnerable families to supports such as social support and family resources to help mitigate depressive symptoms. Future research should consider the underlying mechanisms of social support as a protective factor among IPV victims with depression.

Psychological and genetic risk factors associated with suicidal behavior in Korean patients with mood disorders

INTRODUCTION

To prevent suicide, a nationwide important issue in Korea, understanding its etiology is essential. This study aimed to delineate the risk factors for suicidal behavior in mood disorder patients in Korea.

METHODS

216 patients with mood disorders were recruited. We measured suicidal ideation (SI) and suicide attempt (SA) history and the association of six gene polymorphisms with SB: COMT (rs4680), HTR1A (rs6295), TPH1 (rs1800532), BDNF (rs6265), SLC1A3 (rs2269272), and SLC1A2 (rs4755404).

RESULTS

Patients in the high-SI and SA groups reported more severe depressive, hopelessness, and anxiety symptoms and lower resilience and used less social support-seeking coping than those in the non-significant SI and non-SA groups. Multivariate logistic analysis revealed that depressive disorder, depressive symptoms, poor social support, and less social support-seeking coping were significant independent predictors of suicidal ideation. After adjustment for covariates, age, alcohol consumption, and the rs4680 AA genotype in the COMT gene were associated with suicide attempt.

LIMITATIONS

The modest sample size and a relatively few candidate genes are limitations of the study. In addition, there is no normal control group and the retrospective evaluation of SA limits the interpretation of the causal relationship with factors affecting SA.

CONCLUSIONS

Suicidal behavior in Korean patients with mood disorders may be associated with younger age, alcohol consumption, depressive symptoms, poor social support, less social support-seeking coping, and the COMT rs4680 Met/Met genotype.

Spiritual Well-Being and Psychological Adjustment: Mediated by Interpersonal Needs?

Spiritual well-being has been shown to reduce suicidal behavior, depressive symptoms, and hopelessness. Thwarted interpersonal needs have been shown to increase risk of suicidal behavior. This paper aims to explore the interrelationships among spiritual well-being, thwarted interpersonal needs, and negative outcomes including suicidal ideation, hopelessness, and depressive symptoms among African American women. Sixty-six African American women (M = 36.18; SD = 11.70), from a larger study of women who had experienced interpersonal violence within the past year, completed self-report questionnaires. Mediation analyses revealed that thwarted belongingness, but not perceived burdensomeness, significantly mediated the relations between spiritual well-being and the three outcomes. This study provides the first examination of the role of thwarted interpersonal needs on the link between spiritual well-being and negative psychological outcomes. Spiritual well-being serves a protective role against feelings of social isolation, which may reduce one's risk of negative psychological outcomes. Treatments that bolster a sense of spirituality and social connectedness may reduce suicidal ideation, hopelessness, and depressive symptoms.

Risk and protective factors underlying depression and suicidal ideation in Autism Spectrum Disorder

BACKGROUND

People with Autism Spectrum Disorder (ASD) are at significantly increased risk of suicidal thoughts and behavior. Given that social difficulties in ASD often lead to social isolation, which can in turn increase the risk for depression, this study examined loneliness and social support as potential risk and protective factors associated with depression and suicidal ideation.

METHOD

The sample comprised 185 people (92 females) with ASD aged 14 to 80 years who were participating in a national survey.

RESULTS

Forty-nine percent of participants returned scores in the clinical range for depression and 36% reported recent suicidal ideation. Females, comprising almost 50% of the sample, returned higher depression scores than males, however no differences were identified between males and females in terms of suicidal ideation. Regression analyses revealed that loneliness, satisfaction with social support, and ASD traits predicted depression scores. Satisfaction with social support predicted suicidal ideation, however, it was no longer a significant predictor after the effects of depression were taken into account. Path analysis showed that ASD trait severity was independently related to depression, that the effect of number of social supports on depression was mediated by loneliness and satisfaction with social support, and that effects of loneliness and satisfaction with social support on suicidal ideation were mediated by depression. The pattern of relationships was nearly identical for males and females.

CONCLUSIONS

This study supports a model whereby loneliness and social support operate respectively as protective and risk factors for depression and suicidal ideation in ASD.

The Relationship Between Domestic Partner Violence and Suicidal Behaviors in an Adult Community Sample: Examining Hope Agency and Pathways as Protective Factors

We examined an additive and interactive model involving domestic partner violence (DPV) and hope in accounting for suicidal behaviors in a sample of 98 community adults. Results showed that DPV accounted for a significant amount of variance in suicidal behaviors. Hope further augmented the prediction model and accounted for suicidal behaviors beyond DPV. Finally, we found that DPV significantly interacted with both dimensions of hope to further account for additional variance in suicidal behaviors above and beyond the independent effects of DPV and hope. Implications for the role of hope in the relationship between DPV and suicidal behaviors are discussed.

The Relationship Between Expressed Emotion and the Probability of Suicide Among Turkish Psychiatric Outpatients: A Descriptive Cross-sectional Survey

The purpose of this study is to examine expressed emotion and the relationship between expressed emotion and suicide probability in psychiatric outpatients (N = 350). Patients who did not receive support from anyone scored higher on the Level of Expressed Emotion (LEE) Scale than those who were supported by family, friends, or their physician provider. Scores by patients, who selected their spouse as a key person, scored higher on the LEE than those who chose one of their children. Spouses on the LEE were often depicted as being more intrusive, reactive, and intolerant when compared with their children. The probability of suicide increased as the LEE scores on expressed emotion increased.

Meaning in Life Buffers the Association Between Risk Factors for Suicide and Hopelessness in Participants With Mental Disorders

OBJECTIVE

Hopelessness is a proximal risk factor of suicide. Meaning in life has been found to be a protective factor against suicidal ideation; however, the majority of studies that have explored the role of meaning in life in the context of suicidality have been conducted in nonclinical populations. The aim of this study was to investigate whether meaning in life can moderate and buffer the association between suicide risk factors and hopelessness in a clinical sample with a heightened risk of suicide.

METHOD

A total of 224 participants diagnosed with mental disorders completed self-report measures of suicide risk factors, hopelessness, and meaning in life.

RESULTS

The main result from this study was that meaning in life moderated the association between suicide risk factors and hopelessness.

CONCLUSION

Meaning in life is an important variable in the prevention and treatment of people at risk of suicide.

Association of trait and specific hopes: cross sectional study on students and workers of health professions in Split, Croatia

Introduction. Hope (hoping) is most commonly assessed as a dispositional trait and associated with quality of life, self-care agency and non-attempts of suicide. However, little research has been conducted on hoping for specific events.

Materials and Methods. We distributed a survey consisting of Integrative Hope Scale (IHS) and visual analogue scales on which respondents could declare their levels (intensity) of hope for specific events, to all first year health students enrolled at the University Department of Health Studies, Split, Croatia in 2011/2012, as well as to working health professionals attending a nursing conference in April 2012.

Results. A total of 161 (89.4%) students and 88 (89.8%) working health professionals returned the completed questionnaires. We found high trait hope scores of students and working health professionals (Md = 111, 95% CI [109–113] vs. Md = 115, 95% CI [112–119]; U = 5,353, P = 0.065), and weak to moderate correlations of trait and specific hopes (r = 0.18–0.48, Spearman’s rank correlation coefficient). Students and workers reported 31 different things they hoped for most in life, of which the most prevalent were being healthy and happy. There was very little agreement between participants’ reported influence of the four factors compromising the trait hope (self-confidence, ambition, optimism, and social support) on their specific hopes.

Conclusions. Our findings, while strengthening the validity of hope as a trait, indicate that specific hopes of individuals are moderated by factors not captured by the IHS trait scale. Further research should explore specific hoping in detail, as well as the effectiveness of interventions aimed at increasing specific or generalized hoping.

Religion and Suicide Risk: A Systematic Review

Although religion is reported to be protective against suicide, the empirical evidence is inconsistent. Research is complicated by the fact that there are many dimensions to religion (affiliation, participation, doctrine) and suicide (ideation, attempt, completion). We systematically reviewed the literature on religion and suicide over the last 10 years (89 articles) with a goal of identifying what specific dimensions of religion are associated with specific aspects of suicide. We found that religious affiliation does not necessarily protect against suicidal ideation, but does protect against suicide attempts. Whether religious affiliation protects against suicide attempts may depend on the culture-specific implications of affiliating with a particular religion, since minority religious groups can feel socially isolated. After adjusting for social support measures, religious service attendance is not especially protective against suicidal ideation, but does protect against suicide attempts, and possibly protects against suicide. Future qualitative studies might further clarify these associations.

The Experience of Resilience for Adult Female Survivors of Intimate Partner Violence: A Phenomenological Inquiry

While resilience research in the context of intimate partner violence (IPV) is increasing, there remains little known about women's lived experience of resilience. Using a phenomenological approach, this study examined the experience of resilience for adult female survivors of IPV. Sixteen women who were currently experiencing or had previously experienced abuse by an intimate partner participated in semi-structured interviews. Resilience was experienced as multiple cognitive, emotional, and behavioral shifts across three theme areas: toward resistance, in the experience of control, and toward positivity. The results of this study suggest a number of applications for clinical practice and intervention.

Ethnic Differences in Correlates of Suicidal Behavior Among Women Seeking Help for Intimate Partner Violence

Abstract. Background: Women abused by an intimate partner are at risk of engaging in nonfatal suicidal behavior and suicidal communication (NSBSC). No studies have examined ethnic differences in correlates of NSBSC among abused women. Aims: This secondary data analytic study examined whether correlates of NSBSC previously reported among a mixed ethnic sample of women seeking help for abuse by a male intimate partner differed for those who self-identified as Latina (N = 340), African American (N = 184), or European American (N = 67). Method: Logistic regression was used to examine correlates of NSBSC separately among Latina, African American, and European American women. Results: More severe violence by a male intimate partner, having a chronic or disabling illness, being younger, and being unemployed were positively associated with NSBSC in bivariate analyses among Latina women, but unemployment did not remain significantly associated with NSBSC in the multiple logistic regression. There were no significant correlates of NSBSC for African American women. Having a chronic illness was significantly associated with NSBSC among European American women. Conclusion: Findings suggest the need for culturally tailored suicide prevention interventions and studies that examine risk and protective factors for NSBSC among a diversity of women abused by male intimate partners

Impulsivity and reasons for living among African American youth: a risk-protection framework of suicidal ideation

This study aims to explore the impact of specific facets of impulsivity as measured by the UPPS Impulsive Behavior Scale (UPPS), as well as reasons for living in predicting suicidal ideation among African American college-aged students. The incremental validity of each facet of the UPPS interacting with reasons for living, a construct meant to buffer against risk for suicide, was explored in a sample of African American students (N = 130; ages 18-24). Results revealed significant interactions between reasons for living and two factors of impulsivity, (lack of) premeditation and sensation seeking. Higher levels of sensation seeking and lack of premeditation in conjunction with lower reasons for living was associated with increased suicidal ideation. Neither urgency nor (lack of) perseverance significantly interacted with reasons for living in association with suicidal ideation. These results suggest including elements of impulsivity, specifically sensation seeking and (lack of) premeditation, when screening for suicidal ideation among African American youth. Future investigations should continue to integrate factors of both risk and protection when determining risk for suicide.

Suicidal ideation in gay men and lesbians in South Korea: a test of the interpersonal-psychological model

Gay men and lesbians in South Korea are alienated and stigmatized due to the country's low tolerance of social differences, resulting in distress and suicidal impulses. This study investigated the predictors of suicidal ideation in a gay and lesbian group in South Korea based on the interpersonal-psychological theory of suicide. Differences between the gay and lesbian group and the heterosexual group were found in the direct path between perceived burdensomeness and suicidal ideation. The relationship was significant for both groups, but the path coefficient was greater for lesbians and gay men than for heterosexuals. These findings imply that perceived burdensomeness may be a more critical factor in suicidal ideation of lesbians and gay men.

Construct validity of a short, self report instrument assessing emotional dysregulation

There is a need for a brief measure of emotion dysregulation that can be used in large-scale studies. This study evaluated the construct validity of a short, self-report instrument of emotion dysregulation. Subjects (N=2197) were recruited from primary care clinics of an urban public hospital as part of a study of trauma-related risk and resilience. Emotion dysregulation was measured using the Emotion Dysregulation Scale, short version (EDS-short), a12-item self-report measure assessing emotional experiencing, cognition, and behavior. EDS-short was first compared with the Difficulties in Emotion Regulation Scale (DERS). Then, the construct validity of the EDS-short in predicting depression, posttraumatic stress, substance abuse, borderline pathology, suicide attempts, psychiatric hospitalizations, positive affect, and resiliency was assessed. We found a significant positive correlation between EDS-short and DERS. The EDS-short was significantly predictive of higher reported depressive, posttraumatic stress, substance abuse, and borderline symptoms, and lower reported positive affect and resiliency, over and above demographic characteristics and negative affect. Our results demonstrate that the EDS-short is a useful instrument for measuring emotion dysregulation in traumatized populations. A brief measure of emotion dysregulation is critical as the field moves forward in studying the wide ranging negative effects of emotion dysregulation across psychiatric disorders and outcomes.

Integration of Religion and Spirituality Into Trauma Psychotherapy: An Example in Sufism?

Bilateral stimulation (BLS) is of significant importance to eye movement desensitization and reprocessing (EMDR) therapy. Eye movements seem to be the most effective form of BLS in EMDR. A brief summary of the cultural applicability of EMDR is provided, and research which showed the value of incorporating religion and/or spirituality into psychotherapy is highlighted. Islamic Sufism, in common with other traditional religions, has long been known to have a psychotherapeutic perspective and has been used over time to help people to overcome trauma and stress. This article argues that the ritual movements associated with the Sufi Dhikr may involve a form of BLS and that this might underline some of the therapeutic effectiveness of Dhikr and Sufism. The authors recommend investigating if the Sufi Dhikr element could be incorporated into a modified EMDR protocol. We anticipate that this would give EMDR an even wider and more popular acceptance in the Middle East and the Muslim world.