Risk factors for suicide in psychiatric outpatients: a 20-year prospective study

Anxiety, Depression, and the Interpersonal Theory of Suicide in a Community Sample of Adults with Autism Spectrum Disorder

The present study examines occurrence of depression, anxiety, and suicidality in adults with autism spectrum disorder (ASD), relationships between social difficulties and mental health, and application of the Interpersonal Theory of Suicide in this population. Ninety-eight adults with ASD completed an online survey. Data were analyzed using bivariate correlations, independent samples t-tests, and simple mediational analyses. A substantial proportion reported a lifetime history of anxiety (63%), depression (55%), and suicide attempts (19%), as well as recent suicidal ideation (12%). Social difficulty was associated with higher psychiatric concerns. Thwarted belongingness and perceived burdensomeness were associated with social dissatisfaction, current suicidal ideation, and history of depression. Results suggest the need for widespread screening and intervention services for co-occurring psychiatric conditions in this population.

Profiles of Risk for Suicidal Behavior in Past and Current United States Military Personnel: Latent Profile Analysis of Current Risk Factors

Person-centered approaches are underutilized to identify people with shared risk profiles. In this study, an at-risk sample of 773 past/current military personnel (Mage = 31.3 years, SD = 6.8) with current ideation (90.6%) and/or a prior suicide attempt (43.9%) were assessed using latent profile analysis. Variables included prior suicide attempts, suicidal ideation, alcohol/drug use, insomnia, depression, belongingness, burdensomeness, and post-traumatic stress disorder symptoms. Three classes emerged: Low Symptoms (N = 502), Elevated Suicidality (N = 176), and Elevated Substance Use (N = 95). At 1-month follow-up, the Elevated Suicidality and Elevated Substance Use classes had the highest odds of suicidal behavior. The finding concerning the Elevated Substance Use class suggests it may represent a distinct short-term risk group in military personnel.

Typologies of Suicide: A Critical Literature Review

This review highlights proposed suicide typologies and identifies areas of future research. The current study is an illustrative, rather than exhaustive, qualitative review of theoretical and empirically derived typologies of suicide decedents. Theoretical and empirical typologies of suicide delineate between groups of suicide decedents based on individual, motivational, psychiatric, interpersonal, socio-demographic, and other variables. Certain core themes emerge across theoretical typologies including escape, aggression, intrapsychic pain, and relational concerns. Empirical typologies have identified unique patterns of life stressors, mental health history, health care utilization, and suicide method among suicide decedents. Future research should build on existing typological models of suicide to delineate when, and for whom, particular typologies of suicide may inform targeted prevention efforts. Researchers and clinicians should consider the characteristics and needs of particular high-risk groups when translating typological research into meaningful suicide prevention and intervention.

Socioemotional selectivity and psychological health in amyotrophic lateral sclerosis patients and caregivers: a longitudinal, dyadic analysis

Objective: Socioemotional selectivity theory predicts that as the end of life approaches, goals and resources that provide immediate, hedonic reward become more important than those that provide delayed rewards. This study tested whether these goal domains differentially affected psychological health in the context of marital dyads in which one partner had been diagnosed with amyotrophic lateral sclerosis (ALS), a life-limiting disease. Design: ALS patients (N = 102) being treated in three multidisciplinary clinics and their spouses (N = 100) reported their loneliness, financial worry and psychological health every 3 months for up to 18 months. Main Outcome Measure: Psychological health composite. Results: In multilevel dyadic models, patients and spouses had similar levels of financial worry and loneliness. Both patients and spouses had worse psychological health with higher loneliness, but only spouses had worse psychological health with higher financial worry. Significant interactions with age and disease severity indicated that older spouses were more affected by loneliness than were younger spouses, and patients with less severe disease were more affected by financial worry than patients with more severe disease. Conclusion: The results provide good support for socioemotional selectivity theory's implications for psychological health in a strong test of the theory.

Screening to Identify Groups of Pediatric Emergency Department Patients Using Latent Class Analysis of Reported Suicidal Ideation and Behavior and Non-Suicidal Self-Injury

Latent class analysis of medical records data from 3,523 emergency department (ED) patients (ages 14-24; 31% Caucasian; 67% female) distinguished 6 groups with varying histories of suicidal ideation and behavior based on items endorsed on the Behavioral Health Screen, a web based, nurse-initiated screening tool. As expected, the more severe suicidality groups reported higher levels of depressive symptoms, traumatic distress, and substance abuse symptoms. Findings support the validity of the BHS and its utility as a medical decision tool to help ED staff evaluate the severity of patients' suicidality.

Mental Health Symptomatology and Exposure to Non-Fatal Suicidal Behavior: Factors That Predict Vulnerability and Resilience Among College Students

Despite efforts to identify risk factors following exposure to completed suicide, research has paid less attention to the associations between exposure to non-fatal suicide behavior (NFSB) and mental health symptomatology-factors that may underlie one's susceptibility to future suicidal thoughts and behaviors. This study examined differences in mental health symptomatology among 192 college students exposed to NFSB and 202 exposed to general stressors. Results indicated that students exposed to NFSB had significantly higher levels of depression and anxiety compared to those exposed to a variety of other stressors but not NFSB. Furthermore, among those exposed, a number of risk and protective factors emerged in relation to psychological sequelae, such as emotional stability, social support, and the quality of the relationship between the exposed and suicidal individual. These findings highlight the importance of enhancing provisions of support for those exposed to NFSB.

Posttraumatic Stress Disorder and Suicidal Behavior: Indirect Effects of Impaired Social Functioning

Social functioning is negatively impacted by the presence of PTSD, while increasing risk of suicidal behavior among individuals with PTSD. However, little research has examined the specific role of social functioning in the association between PTSD and suicidal behavior. Parallel multiple indirect effects analyses were performed to understand the unique indirect effects of four aspects of social functioning. Indirect effects of PTSD on suicidal ideation were significant through three pathways: interpersonal conflict, perceived family support, and interpersonal apprehension. Perceived family support was the only indirect pathway significantly associated with suicide attempt. Findings suggest that social functioning should be assessed and potentially targeted during treatment to help modify the risk for suicidal behavior among individuals with PTSD.

The Web-Based Assessment of Suicidal and Suicide-Related Symptoms: Factors Associated With Disclosing Identifying Information to Receive Study Compensation

With the increasing utilization of Web-based surveys for suicide and suicide-related research, it is critical to understand factors that affect participants' decision to request study compensation (and thus potentially reveal their identity) or remain anonymous. This study evaluated differences in demographics, suicidal symptoms, and suicide-related constructs between participants electing and declining to provide identifying information to receive study compensation. A sample of 931 firefighters (91.5% male) participated in a Web-based mental health survey; on survey completion, individuals had the option to provide contact information to receive a $10 gift card. Logistic regression analyses were employed to investigate differences between those who did and did not provide this information. Overall, 82.8% provided identifying information, with younger individuals significantly more likely to do so. Participants reporting more severe suicidal symptoms and greater levels of suicide-related constructs appeared equally, and in some cases, significantly more, willing to provide identifying information. Findings indicate that individuals reporting more sensitive or stigmatizing experiences might not systematically opt out of receiving study compensation to remain anonymous on Web-based surveys. Additional research is warranted to replicate these findings in more representative samples and further delineate personality and other factors influencing the disclosure of contact information to receive study compensation.

Current Suicidal Ideation among Treatment-Engaged Active Duty Soldiers and Marines

We examined suicidal ideation among 399 active duty Soldiers and Marines engaged in mental health treatment. Using a generalized linear model controlling for demographic and military factors, depression, and positive traumatic brain injury screen, we confirmed our hypothesis that self-report measures of current PTSD symptoms uniquely predicted suicidal ideation. The association between PTSD severity and suicidal ideation was moderated by gender with women at higher risk as PTSD severity increased. Female Soldiers and Marines with high levels of PTSD should receive additional monitoring and intervention. Self-report measures may aid with risk assessment and identify symptom-related distress associated with suicide risk.

Evaluation of a depression case management service: Improving depression care and impact on suicide assessment

Introduction

Suicide is a leading cause of death in the US. Many factors impact suicide and suicide prevention; however, improved awareness, recognition, and depression management account for some of the best suicide prevention strategies.

Methods

A depression case management service, compared to usual care, was evaluated for its ongoing assessment of patients with depression and improvements in care.

Results

Case management demonstrates improved documentation of PHQ9 scores, response rates, and remission rates when compared to usual care.

Discussion

Additional benefits of case management are seen in improved suicide assessment and potential for intervention and access to care.

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

Differences in emotion modulation using cognitive reappraisal in individuals with and without suicidal ideation: An ERP study

Difficulties in emotion regulation have been associated with increased suicidal thoughts and behaviours. The majority of studies have examined self-reported use of emotion regulation strategies. In contrast, the current study focused on a direct measure of individuals' ability to use a specific emotion regulation strategy, cognitive reappraisal, using the late positive potential (LPP), an event-related potential component that reflects attention to emotional stimuli. Specifically, the cognitive reappraisal ability of 33 undergraduate students was assessed via an image-viewing task during which the participants had to passively view, increase or reduce their emotions in response to looking at neutral, positive or dysphoric images. We found that participants with a history of suicidal ideation (SI) had significantly higher LPP when asked to reduce negative emotion in response to dysphoric images, compared to individuals with no history of SI. These findings suggest that difficulties with using cognitive reappraisal, specifically to decrease negative affect, might be linked to suicide risk.