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Andrewes HE, Cavelti M, Hulbert C, Cotton SM, Betts JK, Jackson HJ, McCutcheon L, Gleeson J, Davey CG, Chanen AM. An analysis of real-time suicidal ideation and its relationship with retrospective reports among young people with borderline personality disorder. Suicide Life Threat Behav 2024; 54:468-478. [PMID: 38375970 DOI: 10.1111/sltb.13058] [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] [Received: 12/05/2022] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/21/2024]
Abstract
INTRODUCTION This study aimed to analyze the real-time variability of suicidal ideation intensity and the relationship between real-time and retrospective reports of suicidal ideation made on the Beck Scale for Suicidal Ideation (BSS), among young people with borderline personality disorder (BPD). METHODS Young people (15-25-year olds) with BPD (N = 46), recruited from two government-funded mental health services, rated the intensity of their suicidal ideation six times per day for 7 days before completing the BSS. RESULTS For 70% of participants, suicidal ideation changed in intensity approximately five times across the week, both within and between days. BSS ratings were most highly correlated with the highest real-time ratings of suicidal ideation. However, this was not significantly different from the relationship between the BSS and both the average and most recent ratings. Median ratings of suicidal ideation intensity were higher on the BSS compared with an equivalent question asked in real time. CONCLUSION Findings suggest that young people with BPD experience high levels of fluctuation in their intensity of suicidal ideation across a week and that retrospective reports of suicidal ideation might be more reflective of the most intense experience of suicidal ideation across the week.
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Affiliation(s)
- Holly E Andrewes
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Marialuisa Cavelti
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Translational Research Centre, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Carol Hulbert
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Susan M Cotton
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer K Betts
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Henry J Jackson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Louise McCutcheon
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - John Gleeson
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Christopher G Davey
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew M Chanen
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
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Omidvar Tehrani S, Rezaei Ardani A, Akhlaghi S, Shayesteh Zarrin M, Talaei A. Long-term detoxification of opioid use disorder with opium tincture assisted treatment. Front Psychiatry 2023; 14:1273587. [PMID: 38144477 PMCID: PMC10748504 DOI: 10.3389/fpsyt.2023.1273587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 11/14/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Retention in treatment, craving, and relapse rate are important indicators of the success rate in addiction maintenance therapy as they evaluate the effectiveness of the therapy and make necessary adjustments to the treatment plan. However, the rate of continuation in the treatment process and the rate of craving in patients with opioid use disorder undergoing maintenance treatment with opium tincture have not been studied. The present study aimed to investigate the rate of relapse, craving, and psychiatric disorders in patients with opioid use disorder undergoing treatment of gradual detoxification with opium tincture. Methods Ninety patients with opioid use disorder who underwent treatment with the gradual detoxification method using opium tincture in the form of Congress 60 for 11 months were enrolled in the study. The level of craving based on the Desire for Drug Questionnaire (DDQ) and patients' self-report of drug use, the level of anxiety, depression, and sleep quality of patients were evaluated using the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Pittsburgh Sleep Quality Index (PSQI), respectively. Also, suicidal thoughts were assessed by Beck Scale for Suicidal Ideation and quality of life by the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). Results The study found that the treatment resulted in a relapse rate of 16.7% for relapse. We also found that all sub-scales of the desire for drug questionnaire (DDQ), depression, and anxiety were significantly lower at the end of the study compared to its beginning. Additionally, quality of life and sleep significantly increased at the end of the study. All areas of craving, anxiety, and depression significantly decreased in all follow-up sessions that took place 1, 5, and 11 months after the start of treatment. Moreover, sleep disorders were improved considerably at the end of the treatment. Conclusion The current study presented a low relapse rate of Iranian patients with opioid use disorder under structured treatment of gradual detoxification with opium tincture in a one-year follow-up period. Opium tincture under the Congress 60 protocol may help to control carving, decrease psychological disorders, improve quality of life, and consequently, lower relapse rate.
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Affiliation(s)
- Sahar Omidvar Tehrani
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Rezaei Ardani
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Akhlaghi
- Department of Psychiatry, Southwest Centre for Forensic Mental Health Care, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
| | - Masood Shayesteh Zarrin
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Talaei
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Finley JCA, Brooks JM, Nili AN, Oh A, VanLandingham HB, Ovsiew GP, Ulrich DM, Resch ZJ, Soble JR. Multivariate examination of embedded indicators of performance validity for ADHD evaluations: A targeted approach. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-14. [PMID: 37703401 DOI: 10.1080/23279095.2023.2256440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
This study investigated the individual and combined utility of 10 embedded validity indicators (EVIs) within executive functioning, attention/working memory, and processing speed measures in 585 adults referred for an attention-deficit/hyperactivity disorder (ADHD) evaluation. Participants were categorized into invalid and valid performance groups as determined by scores from empirical performance validity indicators. Analyses revealed that all of the EVIs could meaningfully discriminate invalid from valid performers (AUCs = .69-.78), with high specificity (≥90%) but low sensitivity (19%-51%). However, none of them explained more than 20% of the variance in validity status. Combining any of these 10 EVIs into a multivariate model significantly improved classification accuracy, explaining up to 36% of the variance in validity status. Integrating six EVIs from the Stroop Color and Word Test, Trail Making Test, Verbal Fluency Test, and Wechsler Adult Intelligence Scale-Fourth Edition was as efficacious (AUC = .86) as using all 10 EVIs together. Failing any two of these six EVIs or any three of the 10 EVIs yielded clinically acceptable specificity (≥90%) with moderate sensitivity (60%). Findings support the use of multivariate models to improve the identification of performance invalidity in ADHD evaluations, but chaining multiple EVIs may only be helpful to an extent.
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Affiliation(s)
- John-Christopher A Finley
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School, Chicago, IL, USA
| | - Julia M Brooks
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Amanda N Nili
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School, Chicago, IL, USA
| | - Alison Oh
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Illinois Institute of Technology Chicago, IL, USA
| | - Hannah B VanLandingham
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Illinois Institute of Technology Chicago, IL, USA
| | - Gabriel P Ovsiew
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Devin M Ulrich
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Zachary J Resch
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
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Augenstein TM, Visser KF, Gallagher K, De Los Reyes A, D'Angelo EJ, Nock MK. Multi-informant reports of depressive symptoms and suicidal ideation among adolescent inpatients. Suicide Life Threat Behav 2022; 52:99-109. [PMID: 34608660 DOI: 10.1111/sltb.12803] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 06/16/2021] [Accepted: 07/16/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Suicide is a leading cause of death among adolescents, and suicidal thoughts represent key predictors to suicidal behavior. Yet, suicidal thoughts can be challenging to accurately assess. Symptoms that commonly co-occur with suicidal thoughts, such as depressive symptoms, may provide valuable information for predicting these thoughts. Although clinicians commonly collect multi-informant reports about adolescent depressive symptoms, these reports often yield discrepant findings as individual predictors of adolescents' suicidal thoughts. METHOD We tested the ability of specific patterns of multi-informant reports to predict adolescents' suicidal thoughts. Ninety adolescent inpatients and their parents (i.e., "dyads") reported on adolescent depressive symptoms, and adolescents completed self-report assessments of suicidal thoughts at baseline and three-month follow-up. RESULTS Dyads displayed variability in reporting patterns, and these patterns uniquely predicted suicidal thoughts. Adolescents reporting elevated depressive symptoms displayed increased concurrent suicidal thoughts relative to adolescents reporting subthreshold depressive symptoms, regardless of parent report. Yet, only adolescents who reported elevated depressive symptoms and whose parents reported subthreshold adolescent depressive symptoms displayed increased future suicidal thoughts. CONCLUSIONS Identifying patterns of multiple informants' reports about adolescent depressive symptoms may improve the prediction of suicidal thoughts. These findings have important implications for assessing adolescents at risk for suicide.
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Affiliation(s)
- Tara M Augenstein
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Katie Gallagher
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Andres De Los Reyes
- Department of Psychology, University of Maryland College Park, College Park, MD, USA
| | - Eugene J D'Angelo
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Matthew K Nock
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychology, Harvard University, Cambridge, MA, USA
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Emotional Schemas Contribute to Suicide Behavior and Self-Harm: Toward Finding Suicidal Emotional Schemas (SESs). Int J Cogn Ther 2021. [DOI: 10.1007/s41811-021-00115-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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6
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Howe SJ, Hewitt K, Baraskewich J, Cassidy S, McMorris CA. Suicidality Among Children and Youth With and Without Autism Spectrum Disorder: A Systematic Review of Existing Risk Assessment Tools. J Autism Dev Disord 2020; 50:3462-3476. [PMID: 32100237 DOI: 10.1007/s10803-020-04394-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Individuals with autism are at heightened risk for experiencing suicidality compared to those without autism. Despite this, it is unknown what tools are used to assess suicide risk in research and clinical practice among children and youth with autism. This systematic review examined tools commonly used to measure suicidality in children and youth with and without autism spectrum disorder. Four databases were searched. We identified five tools (C-SSRS, PSS, SITBI, SIQ-JR, BSS) commonly used with youth in the general population; however, we did not identify any tools that were commonly used autistic children and youth. Results highlight the lack of available tools utilized to measure suicidality in autistic children and youth. We propose a framework to facilitate research to fill this gap.
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Affiliation(s)
- Stephanie J Howe
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Katie Hewitt
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Jessica Baraskewich
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Sarah Cassidy
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Carly A McMorris
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada. .,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
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Latif F, Patel S, Badolato G, McKinley K, Chan-Salcedo C, Bannerman R, Schultz TR, Newton J, Schott MM, Tyson CM, Wavra T, Robb AS. Improving Youth Suicide Risk Screening and Assessment in a Pediatric Hospital Setting by Using The Joint Commission Guidelines. Hosp Pediatr 2020; 10:884-892. [PMID: 32928898 DOI: 10.1542/hpeds.2020-0039] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Hospitals accredited by The Joint Commission (TJC) are now required to use a validated screening tool and a standardized method for assessment of suicide risk in all behavioral health patients. Our aims for this study were (1) to implement a TJC-compliant process of suicide risk screening and assessment in the pediatric emergency department (ED) and outpatient behavioral health clinic in a large tertiary care children's hospital, (2) to describe characteristics of this population related to suicide risk, and (3) to report the impact of this new process on ED length of stay (LOS). METHODS A workflow using the Columbia Suicide Severity Rating Scale was developed and implemented. Monthly reviews of compliance with screening and assessment were conducted. Descriptive statistics were used to define the study population, and multivariable regression was used to model factors associated with high suicide risk and discharge from the ED. ED LOS of behavioral health patients was compared before and after implementation. RESULTS Average compliance rates for screening was 83% in the ED and 65% in the outpatient clinics. Compliance with standardized assessments in the ED went from 0% before implementation to 88% after implementation. The analysis revealed that 72% of behavioral health patients in the ED and 18% of patients in behavioral health outpatient clinics had a positive suicide risk. ED LOS did not increase. The majority of patients screening at risk was discharged from the hospital after assessment. CONCLUSIONS A TJC-compliant process for suicide risk screening and assessment was implemented in the ED and outpatient behavioral health clinic for behavioral health patients without increasing ED LOS.
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Affiliation(s)
- Finza Latif
- Children's National Hospital, Washington, District of Columbia; and.,Sidra Medicine and Research Center, Doha, Qatar
| | - Shilpa Patel
- Children's National Hospital, Washington, District of Columbia; and
| | - Gia Badolato
- Children's National Hospital, Washington, District of Columbia; and
| | - Kenneth McKinley
- Children's National Hospital, Washington, District of Columbia; and
| | | | | | | | | | | | - Colby M Tyson
- Children's National Hospital, Washington, District of Columbia; and
| | - Theresa Wavra
- Children's National Hospital, Washington, District of Columbia; and
| | - Adelaide S Robb
- Children's National Hospital, Washington, District of Columbia; and
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Evidencias de validez factorial de la Escala de desesperanza de Beck en español con muestras clínicas y no clínicas. ACTA COLOMBIANA DE PSICOLOGIA 2020. [DOI: 10.14718/acp.2020.23.2.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
El propósito del presente estudio fue evaluar la estructura interna de la adaptación al español de Escala de Desesperanza de Beck et al. (1974), dada su utilidad y relevancia en la predicción de conductas suicidas. Para esto, se analizaron las respuestas a la escala de 1260 estudiantes universitarios (M = 4.79; DT = 4.29) y de una muestra clínica en la que participaron 150 jóvenes con intento de suicidio de alta letalidad (M = 8.51; DT = 2.38). Se examinó la estructura interna por medio del Análisis factorial confirmatorio (AFC) en tres fases: en la primera, se comparó el modelo original con cuatro modelos encontrados en las diferentes adaptaciones al español; en la segunda, se tomaron en cuenta modelos que analizan la aquiescencia; y en la tercera, se hizo una validación cruzada de esos modelos con población clínica. Los resultados señalan que la escala es unidimensional tanto en el caso de las muestras clínicas (χ2 = 154.84, gl = 135, p < 0.001, CFI = 0.99, TLI = 0.99,RMSEA = 0.03) como en la población universitaria; sin embargo, a esta última se le añadió un factor de método para el tratamiento de la aquiescencia (χ2 = 252.14, gl = 134, p < 0.001, CFI = 0.95, TLI = 0.94, RMSEA = 0.03). Los resultados muestran la importancia de utilizar análisis y modelos que consideren la naturaleza de los datos y las características de la muestra para aportar evidencias más sólidas para la validez de constructo.
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Hagan CR, Muehlenkamp JJ. Retracted: The Three-Step Theory of Suicide: An Independent Replication and Conceptual Extension. Suicide Life Threat Behav 2020; 50:751. [PMID: 31566798 DOI: 10.1111/sltb.12590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 06/17/2019] [Indexed: 01/07/2023]
Abstract
Retraction: Christopher R. Hagan PhD, Jennifer J. Muehlenkamp PhD, "The Three-Step Theory of Suicide: An Independent Replication and Conceptual Extension," Suicide and Life-Threatening Behavior, Wiley, © American Association of Suicidology The above article, published online on 30 September 2019 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal Editor in Chief, Thomas Joiner, PhD, and John Wiley and Sons Ltd. The retraction has been agreed due to errors in variable calculation and a post-publication reviewer's concerns that some analyses did not accurately test the theoretical model. An updated version of this article will soon undergo review for publication at Suicide and Life-Threatening Behavior, and if accepted for publication, will be accompanied by an editorial from the Editor-in-Chief.
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Affiliation(s)
- Christopher R Hagan
- Department of Psychology, University of Wisconsin Eau Claire, Eau Claire, WI, USA.,Department of Psychology, Cornell College, Mount Vernon, IA, USA
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Hatkevich C, Venta A, Sharp C. Theory of mind and suicide ideation and attempt in adolescent inpatients. J Affect Disord 2019; 256:17-25. [PMID: 31158712 DOI: 10.1016/j.jad.2019.05.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 04/04/2019] [Accepted: 05/27/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Suicide ideation and attempt are alarmingly prevalent in adolescents, and even more so for youth in psychiatric settings. Interpersonal factors have been emphasized as important in the etiology and maintenance of suicide ideation and attempt in adolescents. Evaluating social cognitive deficits offers important insight into processes underlying interpersonal problems associated with suicide ideation and attempt; however little social-cognitive research has been conducted in this area. The aim of the current study was to explore the relation of theory of mind (ToM) impairments and suicide ideation and attempt among adolescent inpatients. METHODS A sample of 391 adolescent inpatients completed measures on ToM, suicidal ideation and attempt, clinical symptoms and sociodemographics. RESULTS Binary logistic regression analyses revealed significant relations between excessive ToM (hypermentalizing) and two suicide outcome variables (suicide ideation in the past four weeks, suicide attempt in the past year), while covarying for sociodemographics and multiple clinical symptom scales. CONCLUSIONS Excessive ToM, or over-attributing the mental/emotional states of others, appears to share a salient relation to recent suicidal thoughts and behavior in adolescent inpatients. Current findings may indicate that interventions incorporating social cognitive components (e.g., Mentalization Based Therapy and Cognitive Behavioral Therapy) may be of promise to treating youth with suicidal thoughts and behaviors and excessive ToM. LIMITATIONS The current study uses cross-sectional data and discrepancies exist in time periods assessed by primary measures.
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Affiliation(s)
- Claire Hatkevich
- Department of Psychiatry, University of Michigan/Michigan Medicine, Ann Arbor, MI, United States of America
| | - Amanda Venta
- Department of Psychology, Sam Houston State University, Huntsville, TX, United States of America
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, United States of America.
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Roeder KM, Cole DA. Simultaneous Longitudinal Examination of Hopelessness, Thwarted Belongingness, and Perceived Burdensomeness as Predictors of Suicide Ideation. Suicide Life Threat Behav 2019; 49:1058-1071. [PMID: 30099767 DOI: 10.1111/sltb.12508] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/11/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Based on Beck's hopelessness model (Beck, Kovacs, & Weissman, Journal of the American Medical Association, 234, 1975, 1146) and Joiner's (Why people die by suicide, 2005, Harvard University Press, Boston, MA) interpersonal theory of suicide, this study simultaneously examined three cognitive risk factors (hopelessness, thwarted belongingness, and perceived burdensomeness) as predictors of suicide ideation. METHOD The study focused on high school and college students (ns = 192 and 142, respectively), assessed twice 4 months apart. RESULTS When hopelessness, perceived burdensomeness, and thwarted belongingness were examined separately, each cognitive risk factor predicted future suicide ideation in both groups. When the three cognitions were tested simultaneously, none emerged as uniquely predictive of suicide ideation. A longitudinal, latent variable model suggested that a common factor underlying all three types of cognition significantly predicted suicide ideation. Furthermore, thwarted belongingness predicted both hopelessness and perceived burdensomeness over time. CONCLUSIONS Results suggest ways that aspects of Beck's and Joiner's theories complement each other and could be combined to yield a more comprehensive understanding of cognitive factors associated with suicide ideation.
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Affiliation(s)
- Kathryn M Roeder
- Psychology & Human Development, Vanderbilt University, Nashville, TN, USA
| | - David A Cole
- Psychology & Human Development, Vanderbilt University, Nashville, TN, USA
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12
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Chiu YC, Liu SI, Lin CJ, Huang YH, Fang CK, Sun FJ, Kao KL, Huang YP, Wu SI. The Psychometric Properties in the Chinese Version of the Reasons for Living Inventory and the Relationship with Suicidal Behaviors Among Psychiatric Patients in Taiwan. Behav Med 2019; 45:197-209. [PMID: 29558316 DOI: 10.1080/08964289.2018.1444577] [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: 10/17/2022]
Abstract
This study examines the reliability, factor structure, convergent, and construct validities of the Mandarin Chinese version of the Reasons For Living Inventory (RFL) among Taiwanese psychiatric patients. Demographical characteristics of patients who hold these adaptive cognitions and differences on the level of endorsement between suicidal and non-suicidal individuals were also investigated. All adult patients that had visited the psychiatric ambulatory clinic or had been admitted to the psychiatric ward in a general hospital in Taiwan over a 3-month period were consecutively invited to complete an inventory that included background information, the Mandarin Chinese versions of the RFL, the Suicidal Behaviors Questionnaire-Revised (SBQ-R), and the Beck Hopeless Scale (BHS). Of the 254 respondents aged 19 to 65 years, 47.2% had suicidal ideations or attempts within the past year. The original six-factor structure of the American version was confirmed to be acceptable. The Cronbach α was 0.964.Total scores on RFL were inversely and significantly correlated with that from BHS. Multivariate analysis with demographic data and items from SBQ-R revealed that higher scores on the RFL have been associated with married, have children or religious beliefs, fewer past and current suicidal ideations and attempts, fewer histories of suicidal threats, and a less self-reported likelihood of future suicide in our sample. The Mandarin version of the RFL inventory showed acceptable psychometric properties and could distinguish suicidal patients from non-suicidal ones.
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Affiliation(s)
- Yu-Chuan Chiu
- a Department of Medicine, Mackay Medical College , Taipei , Taiwan.,b Department of Psychiatry, Mackay Memorial Hospital , Taipei , Taiwan
| | - Shen-Ing Liu
- a Department of Medicine, Mackay Medical College , Taipei , Taiwan.,b Department of Psychiatry, Mackay Memorial Hospital , Taipei , Taiwan.,c Department of Medical Research, Mackay Memorial Hospital , Taipei , Taiwan
| | - Chen-Ju Lin
- a Department of Medicine, Mackay Medical College , Taipei , Taiwan
| | - Yu-Hsin Huang
- a Department of Medicine, Mackay Medical College , Taipei , Taiwan
| | - Chun-Kai Fang
- a Department of Medicine, Mackay Medical College , Taipei , Taiwan
| | - Fang-Ju Sun
- c Department of Medical Research, Mackay Memorial Hospital , Taipei , Taiwan
| | - Kai-Liang Kao
- d Department of Pediatrics, Far Eastern Memorial Hospital , Taipei , Taiwan
| | - Yo-Ping Huang
- e Department of Electrical Engineering, National Taipei University of Technology , Taipei , Taiwan
| | - Shu-I Wu
- a Department of Medicine, Mackay Medical College , Taipei , Taiwan.,b Department of Psychiatry, Mackay Memorial Hospital , Taipei , Taiwan
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13
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Czyz EK, Horwitz AG, Arango A, King CA. Short-term change and prediction of suicidal ideation among adolescents: a daily diary study following psychiatric hospitalization. J Child Psychol Psychiatry 2019; 60:732-741. [PMID: 30246870 PMCID: PMC6726492 DOI: 10.1111/jcpp.12974] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Our understanding of suicidal ideation (SI) and its risk precursors is largely informed by studies spanning over wide time intervals (weeks, months, years). Little is known about SI as it occurs in daily lives of individuals at risk for suicide, the extent to which suicidal thoughts are dynamic over short periods of time, and the degree to which theoretically informed risk factors predict near-term SI. METHODS Thirty-four adolescents hospitalized due to last-month suicide attempt and/or last-week SI (76% female; ages 13-17) responded to daily surveys sent to their cell phones for four consecutive weeks after discharge (n = 652 observations). RESULTS There was notable variability in day-to-day SI, with half of ideation ratings changing at least one within-person standard deviation from one day to the next. Results of mixed effects models revealed concurrent (same-day), but not short-term prospective (next-day), associations between SI (frequency, duration, urge) and well-established predictors (connectedness, burdensomeness, hopelessness). However, synergistic effects of low connectedness with either high burdensomeness or high hopelessness were reliably associated with more severe same- and next-day suicidal ideation. CONCLUSIONS This study adds to emerging literature indicating that suicidal thoughts fluctuate considerably among individuals at risk for suicide, further extending it by focusing on adolescents in the critical posthospitalization period. Fostering high-risk adolescents' sense of connectedness to others may be an especially promising intervention target. Frequent assessment of SI and its predictors, independently and in combination, could help identify promising predictors of short-term risk and meaningful intervention targets in high-risk teens.
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Affiliation(s)
- E. K. Czyz
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Adam G. Horwitz
- Department of Psychiatry, Rush University Medical Center, Chicago, IL
| | - Alejandra Arango
- Department of Psychiatry, University of Michigan, Ann Arbor, MI,Department of Psychology, University of Michigan, Ann Arbor, MI
| | - C. A. King
- Department of Psychiatry, University of Michigan, Ann Arbor, MI,Department of Psychology, University of Michigan, Ann Arbor, MI
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Roberge EM, Bryan CJ, Peterson A, Rudd MD. Variables associated with reductions in insomnia severity among acutely suicidal patients receiving brief cognitive behavioral therapy for suicide prevention. J Affect Disord 2019; 252:230-236. [PMID: 30986738 DOI: 10.1016/j.jad.2019.04.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/13/2019] [Accepted: 04/07/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION This study compared changes in sleep disturbance over time across brief cognitive behavioral therapy for suicide prevention and treatment as usual and examined the mechanisms that link sleep disturbance with several suicide risk factors. METHOD Active duty U.S. Army soldiers (N = 152) completed a randomized controlled trial to test the efficacy of brief cognitive behavioral therapy (n = 76) or treatment as usual (n = 76). Six assessments of insomnia symptoms, hopelessness, coping, and suicide beliefs were tracked over 24 months. RESULTS Brief cognitive behavioral therapy patients reported a significant decrease in sleep disturbance symptoms over time while treatment as usual patients did not. These improvements were initially observed during treatment and carried over through 12-months. Changes in sleep disturbance predicted changes in suicide risk. Longitudinal growth modeling was used to assess potential mechanisms of this effect. Results suggested that changes in cognitive flexibility, as defined by measures of hopelessness and suicide beliefs, predicted change in sleep disturbance symptoms. These relationships did not differ across treatment groups. LIMITATIONS The participants were active duty military personnel. Therefore, the results may not generalize to other patient populations. A greater number of assessment periods in closer proximity as well as additional measures of constructs of interest would have improved the internal validity of this study. CONCLUSIONS Brief cognitive behavioral therapy significantly reduces sleep disturbance and suicide risk. Changes in cognitive flexibility, in part, explain change in sleep disturbance across both treatments.
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Affiliation(s)
- Erika M Roberge
- National Center for Veterans Studies, Salt Lake City, UT, United States; The University of Utah, Salt Lake City, UT, United States.
| | - Craig J Bryan
- National Center for Veterans Studies, Salt Lake City, UT, United States; The University of Utah, Salt Lake City, UT, United States
| | - Alan Peterson
- University of Texas Health Science Center at San Antonio, San Antonio, TX, United States; South Texas Veterans Health Care System, San Antonio, TX, United States; University of Texas at San Antonio, San Antonio, TX, United States
| | - M David Rudd
- National Center for Veterans Studies, Salt Lake City, UT, United States; University of Memphis, Memphis, TN, United States
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15
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Freed RD, Mehra LM, Laor D, Patel M, Alonso CM, Kim-Schulze S, Gabbay V. Anhedonia as a clinical correlate of inflammation in adolescents across psychiatric conditions. World J Biol Psychiatry 2018; 20:712-722. [PMID: 29843560 PMCID: PMC6377856 DOI: 10.1080/15622975.2018.1482000] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objectives: Peripheral inflammation has been associated with multiple psychiatric disorders, particularly with depression. However, findings remain inconsistent and unreproducible, most likely due to the disorder's heterogeneity in phenotypic presentation. Therefore, in the present study, in an effort to account for inter-individual differences in symptom severity, we utilised a dimensional approach to assess the relationships between a broad panel of inflammatory cytokines and key psychiatric symptoms (i.e. depression, anhedonia, anxiety, fatigue and suicidality) in adolescents across psychiatric disorders. We hypothesised that only anhedonia (reflecting deficits of reward function) will be associated with inflammation.Methods: Participants were 54 psychotropic medication-free adolescents with diverse psychiatric conditions and 22 healthy control (HC) adolescents, aged 12-20. We measured 41 cytokines after in vitro lipopolysaccharide stimulation. Mann-Whitney U and Spearman correlation tests examined group comparison and associations, respectively, while accounting for multiple comparisons and confounds, including depression severity adolescent.Results: There were no group differences in cytokine levels. However, as hypothesised, within the psychiatric group, only anhedonia was associated with 19 cytokines, including haematopoietic growth factors, chemokines, pro-inflammatory cytokines, and anti-inflammatory cytokines.Conclusions: Our findings suggest that general inflammation may induce reward dysfunction, which plays a salient role across psychiatric conditions, rather than be specific to one categorical psychiatric disorder.
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Affiliation(s)
- Rachel D. Freed
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY
| | - Lushna M. Mehra
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY
| | - Daniel Laor
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY
| | - Manishkumar Patel
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY
| | - Carmen M. Alonso
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY
| | | | - Vilma Gabbay
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY,Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY
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16
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Roeder KM, Cole DA. Prospective Relation Between Peer Victimization and Suicidal Ideation: Potential Cognitive Mediators. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9939-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Braden A, Overholser J, Fisher L, Ridley J. Life Meaning is Predictive of Improved Hopelessness and Depression Recovery in Depressed Veterans. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2017. [DOI: 10.1521/jscp.2017.36.8.629] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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18
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Daniel SS, Goldston DB, Erkanli A, Heilbron N, Franklin JC. Prospective Study of Major Loss Life Events and Risk for Suicidal Thoughts and Behaviors Among Adolescents and Young Adults. Suicide Life Threat Behav 2017; 47:436-449. [PMID: 27862201 PMCID: PMC6485934 DOI: 10.1111/sltb.12305] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 06/03/2016] [Indexed: 11/28/2022]
Abstract
This prospective, naturalistic study examined the association between major loss life experiences, other psychiatric risk factors (depression, hopelessness, and anxiety), and suicidal thoughts and behaviors (STBs) among adolescents followed through young adulthood for up to 14 years. Major loss life events were related to subsequent increases in STBs. Major loss life events were primarily related to increases in suicide ideation in the presence of lower levels of other risk factors. There was a bidirectional relationship between major losses and other risk factors. Implications for the association between loss experiences, other risk factors, and future STBs are discussed.
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Affiliation(s)
- Stephanie S. Daniel
- Family and Community Medicine; Wake Forest School of Medicine; Winston-Salem NC USA
| | - David B. Goldston
- Psychiatry and Behavioral Sciences; Duke University School of Medicine; Durham NC USA
| | | | - Nicole Heilbron
- Psychiatry and Behavioral Sciences; Duke University School of Medicine; Durham NC USA
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Sinniah A, Oei TPS, Maniam T, Subramaniam P. Positive effects of Individual Cognitive Behavior Therapy for patients with unipolar mood disorders with suicidal ideation in Malaysia: A randomised controlled trial. Psychiatry Res 2017; 254:179-189. [PMID: 28463716 DOI: 10.1016/j.psychres.2017.04.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 03/25/2017] [Accepted: 04/15/2017] [Indexed: 11/29/2022]
Abstract
The aim of this study was to investigate the effectiveness of Individual Cognitive Behavior Therapy (ICBT) in treating patients with mood disorders with suicidal ideation. A total of 69 patients (48 females, 21 males) with the diagnoses above were randomly allocated to either the group of Treatment As Usual (TAU)+ICBT (n=33) or the TAU group (n=36). All participants completed the Beck Depression Inventory (BDI), Beck Scale for Suicide Ideation (BSS), Positive and Negative Suicide Ideation Inventory (PANSI), Beck Hopelessness Scale (BHS), and Depression Anxiety Stress Scale-21 (DASS-21). These questionnaires were administered at pre-treatment, midway through treatment (week 4), post-treatment (week 8), and at follow-ups after three months (week 20) and six months (week 32). Factorial ANOVA results showed that the TAU+ICBT patients improved significantly and at faster rate as compared to the TAU group, which showed improvement only from pre to mid treatment on DASS-D and BHS-T measures. The effect size (Cohen's d), for the TAU+ICBT group showed large effect (1.47) for depressive symptoms and suicidal ideation (1.00). These findings suggest that ICBT used in addition to the TAU, was effective in enhancing treatment outcome of patients with unipolar mood disorders as well as, reducing risk for suicide behavior.
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Affiliation(s)
- Aishvarya Sinniah
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia; University of Queensland, Australia
| | - T P S Oei
- University of Queensland, Australia; James Cook University, Singapore; Nanjing University, PR China
| | - T Maniam
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
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20
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Abstract
The objective of this study was to test the hypothesis that sleep quality mediates the association between traumatic brain injury (TBI) history and current suicidal ideation. Measures of TBI history, sleep quality, and suicidal ideation were administered to 130 Iraq/Afghanistan veterans. As expected, sleep quality mediated the effect of TBI history on current suicidal ideation (indirect effect, 0.0082; 95% confidence interval, 0.0019-0.0196), such that history of TBI was associated with worse sleep quality, which was, in turn, associated with increased suicidal ideation. These findings highlight the importance of assessing TBI history and sleep quality during suicide risk assessments for veterans.
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21
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Musyimi CW, Mutiso VN, Nayak SS, Ndetei DM, Henderson DC, Bunders J. Quality of life of depressed and suicidal patients seeking services from traditional and faith healers in rural Kenya. Health Qual Life Outcomes 2017; 15:95. [PMID: 28482849 PMCID: PMC5422872 DOI: 10.1186/s12955-017-0657-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 04/13/2017] [Indexed: 11/27/2022] Open
Abstract
Background In rural Kenya, traditional and faith healers provide an alternative pathway to health care, including mental health care. However, not much is known about the characteristics of the populations they serve. The purpose of this study was to determine the relationship between depression, suicidal ideation, and socio-demographic variables with Quality of Life (QoL) indicators in a sample seeking mental health services from traditional and faith healers in rural Kenya. Understanding QoL in this sample can help develop mental health policy and training to improve the well-being of this population. Method This was a cross-sectional epidemiological survey (n = 443) conducted over a period of 3 months among adult patients seeking care from traditional and faith healers in rural Kenya. Data were collected using the Beck Depression Inventory II (BDI-II), Beck Scale for Suicide Ideation (BSS) and WHO Quality of Life Survey- BREF (WHOQOL-BREF), and analyzed using correlation analyses, parametric tests, and regression analyses. Results Increasing levels of depression were associated with lower QoL among patients seeking care from traditional and faith healers. BSS scores were significantly negatively correlated with overall, physical, psychological, and environmental QoL, p < .05. There was a statistically significant difference between mean scores for overall QoL between depressed (M = 2.35, SD = 0.76) and non-depressed participants (M = 3.03, SD = 0.67), t(441) = 8.899, p < .001. Overall life satisfaction for depressed participants (M = 2.23, SD = 0.69) was significantly lower than non-depressed participants. Regression analyses indicated that depression, suicidal ideation, and being married predicted lower overall QoL controlling for other variables. Post hoc tests and subgroup analysis by gender revealed significant differences for females only. Depression, and older age predicted lower life satisfaction whereas being self-employed predicted higher life satisfaction, when controlling for other variables. Conclusion This study sheds light on correlates of QoL in depressed and non-depressed patients in rural Kenya. Evidence suggests that traditional and faith healers treat patients with a variety of QoL issues. Further research should focus on understanding how these issues tie into QoL, and how these healers can target these to improve care.
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Affiliation(s)
- Christine W Musyimi
- Africa Mental Health Foundation, Nairobi, Kenya.,Vrije Universiteit, Amsterdam, Netherlands
| | | | | | - David M Ndetei
- Africa Mental Health Foundation, Nairobi, Kenya. .,University of Nairobi, Nairobi, Kenya.
| | - David C Henderson
- Boston University School of Medicine, Boston, USA.,Harvard Medical School, Boston, USA
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The psychometric characteristics of the 4-item Suicidal Behaviors Questionnaire-Revised (SBQ-R) as a screening tool in a non-clinical sample of Nigerian university students. Asian J Psychiatr 2017; 26:46-51. [PMID: 28483090 DOI: 10.1016/j.ajp.2017.01.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/29/2016] [Accepted: 01/16/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Suicide is a major contribution to mortality among university students in developed countries. There is no reliable and validated self-report suicide assessment scale with adequate sensitivity and specificity for the identification of Nigerian university students who are at risk of future suicidal behaviors. OBJECTIVE The objective of this study was to examine the psychometric characteristics of the 4 item Suicidal Behaviors Questionnaire-Revised (SBQ-R) as a screening tool for suicide risk assessment among university undergraduate students in South-western Nigeria. METHOD This is a cross-sectional descriptive study involving 536 undergraduate Nigerian students. The students completed the SBQ-R, in addition to a sociodemographic and academic related questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the 12 item General Health Questionnaire (GHQ-12). Suicidal risk categories among the students were determined by interviewing them with the items of the suicidality module section of the Mini International Neuropsychiatric Interview (MINI). RESULTS Cronbach's alpha for the SBQ-R items was 0.80. Construct validity was supported through significant positive correlations with the HADS-Anxiety and Depression subscales, and the GHQ-12. Receiver Operating Characteristics (ROC) curve evaluation suggests that the best cut-off total score with the optimal sensitivity (0.882), specificity (0.875) and highest accuracy (0.879) was 8 in terms of identifying the students at high risk of suicide (Area Under the Curve=0.928; 95% Confidence Interval=0.890-0.966; Standard Error=0.019). CONCLUSIONS The use of the SBQ-R may be an important and vital step in the prevention of suicidal attempts among Nigerian university students.
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23
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Tian L, Yang Y, Yang H, Huebner ES. Prevalence of Suicidal Ideation and Its Association with Positive Affect in Working Women: A Day Reconstruction Study. Front Psychol 2017; 8:285. [PMID: 28377731 PMCID: PMC5359223 DOI: 10.3389/fpsyg.2017.00285] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 02/14/2017] [Indexed: 12/04/2022] Open
Abstract
The suicide rate for females in China is the second highest worldwide, and China is the only country in the world in which the rate of suicides is higher for women than men. Affective instability has been shown to be a strong predictor of suicidal ideation, particularly among women. However, prior research has mainly focused on the impact of women's negative affect on suicidal ideation, ignoring the influence of positive affect on suicidal ideation. Studies have revealed that hopelessness, which is 1.3 times more important than depression for explaining suicidal ideation, is driven more by low levels of positive affect than by high levels of negative affect. Although positive affect has also been found to be related to suicidal ideation, and it demonstrates independent, beneficial effects on mental health, much remains to be learned about the association between positive affective instability and suicidal ideation. Therefore, we investigated the prevalence of suicidal ideation among Chinese working women and explored the differences between working women with and without suicidal ideation in the intensity and daily variability of positive affect. A total of 222 young working women of ages 22–36 years (M = 27.64, SD = 3.73) were recruited from a free weekend psychology lecture. The women subsequently completed a daily diary Day Reconstruction Method (DRM) as well as a suicidal ideation questionnaire. We used hierarchical linear modeling (HLM) to analyze the data, and the results showed that: (1) 10.81% of participates reported suicidal ideation, the intensity of positive affect (happiness, warmth/friendliness, interest and relaxation/calmness) was significantly lower for women with suicidal ideation compared to women without suicidal ideation; (2) differing diurnal patterns of positive emotions were observed between women with and without suicidal ideation; women with suicidal ideation demonstrated a significantly lower trend of growth and a higher volatility in happiness, warmth/friendliness, relaxation/calmness. Given that lower intensity of positive affect and greater affective instability significantly predicted suicidal ideation in Chinese women, researchers should pay more attention to the role of positive affect in female suicide prevention research and intervention efforts in the future.
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Affiliation(s)
- Lili Tian
- School of Psychology, South China Normal UniversityGuangzhou, China; Center for Studies of Psychological Application, South China Normal UniversityGuangzhou, China; Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal UniversityGuangzhou, China
| | - Ying Yang
- School of Psychology, South China Normal UniversityGuangzhou, China; Center for Studies of Psychological Application, South China Normal UniversityGuangzhou, China; Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal UniversityGuangzhou, China
| | - Huijing Yang
- School of Psychology, South China Normal UniversityGuangzhou, China; Center for Studies of Psychological Application, South China Normal UniversityGuangzhou, China; Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal UniversityGuangzhou, China
| | - E Scott Huebner
- Department of Psychology, University of South Carolina Columbia, SC, USA
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Sokol Y, Serper M. Temporal self appraisal and continuous identity: Associations with depression and hopelessness. J Affect Disord 2017; 208:503-511. [PMID: 27832930 DOI: 10.1016/j.jad.2016.10.033] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 10/17/2016] [Accepted: 10/22/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND While depression is associated with decreased self-worth, less is known about how depression relates to the degree of perceived unity of the self over time (CI; continuous identity) and appraisal of past and future selves (temporal self-appraisal). In Study 1, we examined the relationship between depression severity and temporal self-appraisal. In Study 2, we examined depression and hopelessness severity as it relates to temporal self-appraisal and continuous identity. It was hypothesized that individuals with significant levels of depressed mood would report lower self appraisals of current and future selves and that hopelessness about the future would be associated with disturbances in perception of self over time (CI; continuous identity) and temporal self-appraisal. METHODS Study 1 examined depressed mood (n=75) and non-depressed mood (n=144) individuals to determine their self-rated personal attributes for their past, present and future selves using a validated task of temporal self-appraisal. Study 2 examined an independent sample of subjects. Based on cutoff scores for clinically significant depression and hopelessness, Depressed/Hopeless (n=63) and Non-Depressed /Non-Hopeless (n=168) subjects were asked complete the validated task of temporal self-appraisal and also complete a validated task to assess their continuous identity. RESULTS In Study 1, a significant difference was found between the depressed mood group and the non-depressed mood group in how they see themselves changing over time. The non-depressed group perceived themselves increasing in positive personal attributes from past, to present, to future self. The depressed mood group perceived themselves as deteriorating from the past to the present in terms of positive attributes about their self-identity. However, contrary to expectations, the depressed group perceived their future self as improved from their present self. Subjects' past and future selves were at a similar level and both were significantly higher than perception of their present self-worth. Study 2 replicated these findings and also found severity of depression was significantly related to lower levels of CI. Additionally, it was found that the severity of hopelessness was minimally associated with continuous identity and temporal self-appraisal ratings. CONCLUSION These results suggests that even people with depressed mood have an instinctive grasp of the possibility to an improved future self-worth despite the negative cognitions associated with present self-worth and hopeless expectations about the future. While depressed and hopeless individuals may view the world negatively and feel hopeless about their general future, these results suggest that depressed individuals distinguish between hopelessness about future external success and future self-improvement. Despite perceiving their past and future selves to be more positive, depression severity was associated with less continuous identity. Since depressed individuals perceive a future self as a return to or a recovery of a past self, therapeutic strategies may focus on improving a sense of continuous identity with past and future selves and focusing on deriving meaning from current life difficulties to improve beyond a past self, growing to a superior future self. LIMITATIONS AND FUTURE RESEARCH Limitations include using self-report measures of depression and hopelessness. Future studies may wish to use individuals who were diagnosed with depression to explore further how depressed people see themselves changing from the present to the future. Additionally, future studies could determine if depressed individuals who do not perceive their future self to be improved are at higher risk for adverse outcomes.
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Affiliation(s)
- Yosef Sokol
- Department of Psychology, Hofstra University, United States
| | - Mark Serper
- Department of Psychology, Hofstra University, United States; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States.
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Domino G, Su A, Lee Johnson S. Psychosocial Correlates of Suicide Ideation: A Comparison of Chinese and U.S. Rural Women. OMEGA-JOURNAL OF DEATH AND DYING 2016. [DOI: 10.2190/drpt-vw8g-d1p1-qxw7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
China is the only country in the world where the suicide rate for women is higher than that for men. In particular there is current concern about a high suicide rate for women living in rural areas. In this study, two samples of young women ages 20 to 35, one from rural China ( n=52) and one from rural United States ( n=52) were interviewed as to suicide ideation and suicide risk, as related to psychosocial variables of self-esteem, coping, social support, and attitudes toward suicide. Significant mean differences were obtained between samples on all eleven variables. The pattern of intercorrelations between variables showed both similarities and differences in the two samples. A stepwise multiple-regression analysis indicated that the same four variables, albeit in different order, were predictive of suicide: these variables were self-esteem, instrumental support, the attitude that suicide is morally bad, and an overall rating of coping.
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Liu RX. The Conditional Effects of Gender and Delinquency on the Relationship Between Emotional Distress and Suicidal Ideation or Attempt Among Youth. JOURNAL OF ADOLESCENT RESEARCH 2016. [DOI: 10.1177/0743558403260020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Using data provided by a national sample of youth studied at two points in time (N = 4,221), this study assesses the independent and interactive effects of emotional distress and delinquency involvement on suicidal gestures (i.e., ideation and attempt), and gender differences in these interrelationships. Logistic regression analyses produced results generally consistent with the hypothesized relationships: (a) Experience of emotional distress predicts subsequent suicidal ideation or attempt while controlling for initial suicidal attempt and other common antecedent variables; (b) delinquency involvement also predicts suicidal gestures among girls. For boys, however, these effects are in the same direction but not statistically significant; (c) furthermore, adolescent girls who experience emotional distress but are simultaneously antisocial or delinquent are less suicidal than those who experience distress but are conforming to social rules. For boys, the effects are much weaker and not statistically significant. These findings are discussed in light of theoretical importance and policy implications.
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Bardhoshi G, Duncan K, Erford BT. Psychometric Meta-Analysis of the English Version of the Beck Anxiety Inventory. JOURNAL OF COUNSELING AND DEVELOPMENT 2016. [DOI: 10.1002/jcad.12090] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Gerta Bardhoshi
- Division of Counseling and Psychology; University of South Dakota
- Now at Department of Rehabilitation and Counselor Education; University of Iowa
| | - Kelly Duncan
- Division of Counseling and Psychology; University of South Dakota
- Now at School of Education; Northern State University
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Sinniah A, Oei TPS, Chinna K, Shah SA, Maniam T, Subramaniam P. Psychometric Properties and Validation of the Positive and Negative Suicide Ideation (PANSI) Inventory in an Outpatient Clinical Population in Malaysia. Front Psychol 2016; 6:1934. [PMID: 26733920 PMCID: PMC4685108 DOI: 10.3389/fpsyg.2015.01934] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 12/01/2015] [Indexed: 11/13/2022] Open
Abstract
The PANSI is a measure designed to assess the risk and protective factors related to suicidal behaviors. The present study evaluated the psychometric properties and factor structure of the Positive and Negative Suicide Ideation (PANSI) Inventory in a sample of clinical outpatients at a major hospital in Malaysia. In this study, 283 psychiatric patients and 200 medical (non-psychiatric) patients participated. All the patients completed the PANSI and seven other self-report instruments. Confirmative factor analysis supported the 2-factor oblique model. The internal consistency of the two subscales of PANSI-Negative and the PANSI-Positive were 0.93 and 0.84, respectively. In testing construct validity, PANSI showed sizable correlation with the other seven scales. Criterion validity was supported by scores on PANSI which differentiated psychiatric patients from medical patients. Logistic regression analyses showed PANSI can be used to classify the patients into suicidal or non-suicidal. The PANSI is a reliable and valid instrument to measure the severity of suicidal ideation among clinical outpatients in Malaysia.
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Affiliation(s)
- Aishvarya Sinniah
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical CentreKuala Lumpur, Malaysia; School of Psychology, The University of QueenslandBrisbane, QLD, Australia
| | - Tian P S Oei
- School of Psychology, The University of QueenslandBrisbane, QLD, Australia; Department of Psychology, James Cook University SingaporeSingapore, Singapore; Department of Psychology, School of Social and Behavioural Sciences, Nanjing UniversityNanjing, China
| | - Karuthan Chinna
- Department of Social and Preventive Medicine, Julius Centre University of Malaya, University of Malaya Kuala Lumpur, Malaysia
| | - Shamsul A Shah
- Department of Community Medicine, Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur, Malaysia
| | - T Maniam
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur, Malaysia
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Abstract
Passive suicidal ideation is an important indicator of suicide risk because it is associated with significantly high levels of depression and suicidality, comparable to individuals experiencing active suicidal ideation. Passive suicidal ideation, or a passive desire to die, can be differentiated from active suicidal ideation (where individuals have a specific plan and intent to die). The present study examined passive suicidal ideation to determine how it relates to suicide risk and depression severity in 140 veterans from a psychiatric outpatient program at a local Veterans Affairs Medical Center. Participants were assessed for a depressive disorder using a structured clinical interview and completed self-report measures. Individuals with passive suicidal ideation scored similarly to active ideators and significantly higher than nonsuicidal ideators on measures of depression, suicidal behavior, and hopelessness. Asking about passive suicidal ideation in suicide risk assessment may allow clinicians to intervene earlier and decrease the likelihood of a suicide attempt.
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Affiliation(s)
- Christine N. May
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - James C. Overholser
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | | | - Danielle Raymond
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
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30
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Hannigan B, Edwards D, Evans N, Gillen E, Longo M, Pryjmachuk S, Trainor G. An evidence synthesis of risk identification, assessment and management for young people using tier 4 inpatient child and adolescent mental health services. HEALTH SERVICES AND DELIVERY RESEARCH 2015. [DOI: 10.3310/hsdr03220] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BackgroundInpatient child and adolescent mental health services are one part of a complex system, and exist to meet the needs of young people with the greatest mental health difficulties.ObjectivesThe research question was ‘What is known about the identification, assessment and management of risk (where “risk” is broadly conceived) in young people (aged 11–18 years) with complex mental health needs entering, using and exiting inpatient child and adolescent mental health services in the UK?’Data sourcesThe two-phase Evidence for Policy and Practice Information and Co-ordinating Centre approach was used. In phase 1, scoping searches were made using two databases with an end date of March 2013. Phase 2 centred on the search for citations relating to the risks to young people of ‘dislocation’ and ‘contagion’. Searches were made using 17 databases, with time limits from 1995 to September 2013. Websites were searched, a call for evidence circulated and references of included citations reviewed.Review methodsPriority risk areas for phase 2 were decided in collaboration with stakeholders including through consultations with young people and the mother of a child who had been in hospital. All types of evidence relating to outcomes, views and experiences, costs and cost-effectiveness, policies, and service and practice responses in the areas of ‘dislocation’ and ‘contagion’ for young people (11–18 years) using inpatient mental health services were considered. A staged approach to screening was used. Data were extracted into tables following guidance from the Centre for Reviews and Dissemination or tables developed for the review. Quality was assessed using appraisal checklists from the Effective Public Health Practice Project or the Critical Skills Appraisal Programme or devised by previous reviewers. No papers were excluded on the grounds of quality, and all materials identified were narratively synthesised.ResultsIn phase 1, 4539 citations were found and 124 included. Most were concerned with clinical risks. In phase 2, 15,662 citations were found and 40 addressing the less obvious risks of ‘dislocation’ and ‘contagion’ were included, supplemented by 20 policy and guidance documents. These were synthesised using these categories: Dislocation: Normal Life; Dislocation: Identity; Dislocation: Friends; Dislocation: Stigma; Dislocation: Education; Dislocation: Families; and Contagion. No studies included an economic analysis or economic evaluation. The importance to stakeholders of these less obvious risks contrasted with the limited quantity and quality of research capable of informing policy, services and practice in these areas.LimitationsIncluded studies were of variable quality. Data derived could not be used to inform an economic modelling of NHS costs or to analyse cost-effectiveness. Other limitations were the search for only English-language materials and the use of umbrella concepts (‘dislocation’ and ‘contagion’).ConclusionsThe less obvious risks are important, but little evidence exists to support their identification, assessment and management. This has implications for services, and a programme of research is recommended to generate new knowledge.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Ben Hannigan
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Deborah Edwards
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Nicola Evans
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | | | - Mirella Longo
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Steven Pryjmachuk
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - Gemma Trainor
- Greater Manchester West Mental Health NHS Foundation Trust, Prestwich, UK
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31
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Capron DW, Allan NP, Ialongo NS, Leen-Feldner E, Schmidt NB. The depression distress amplification model in adolescents: A longitudinal examination of anxiety sensitivity cognitive concerns, depression and suicidal ideation. J Adolesc 2015; 41:17-24. [PMID: 25754194 DOI: 10.1016/j.adolescence.2015.02.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 01/14/2015] [Accepted: 02/13/2015] [Indexed: 11/17/2022]
Abstract
Adolescents with comorbid anxiety and depression are at significantly increased risk of suicide. The recently proposed depression distress amplification model appears to have promise for explaining the relations between anxiety, depression, and suicidality, but it has not been tested in adolescents. Participants were 524 adolescents followed over two years. Baseline data for the current report were collected by trained interviewers while the adolescents were in eighth grade. Data were obtained in the same manner when the adolescents were in tenth grade. Baseline anxiety sensitivity cognitive concerns significantly predicted suicidal ideation two years later, above and beyond baseline suicidal ideation and depression. Further, consistent with the depression distress amplification model, anxiety sensitivity cognitive concerns interacted with depressive symptoms to predict suicidal ideation. This report extends the empirical and theoretical support for a relationship between anxiety sensitivity cognitive concerns and suicidality.
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Affiliation(s)
- Daniel W Capron
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA.
| | - Nicholas P Allan
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA
| | - Nicholas S Ialongo
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA
| | | | - Norman B Schmidt
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA
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KIM KERRIL, GALVAN THANIA, PUZIA MEGANE, CUSHMAN GRACEK, SEYMOUR KARENE, VANMALI ROSHANI, JONES RICHARDN, SPIRITO ANTHONY, DICKSTEIN DANIELP. Psychiatric and self-injury profiles of adolescent suicide attempters versus adolescents engaged in nonsuicidal self-injury. Suicide Life Threat Behav 2015; 45:37-50. [PMID: 25060743 PMCID: PMC6538394 DOI: 10.1111/sltb.12110] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 03/20/2014] [Indexed: 11/26/2022]
Abstract
To better delineate the unique correlates of self-injurious behaviors (SIB), psychiatric profiles of mutually exclusive groups of adolescents who made a suicide attempt (SA) versus those engaged in nonsuicidal self-injury (NSSI) were examined. Contrary to hypotheses, the NSSI group endorsed earlier onsets of SIB and suicidal ideation (SI), as well as higher rates of depression and anxiety compared with their SA counterparts. Future work is warranted to understand the role of SI, including duration of SI and anxiety in the development of NSSI, and to identify risk and resiliency factors useful in predicting an adolescent's SIB status.
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Affiliation(s)
- KERRI L. KIM
- Bradley Hospital’s Pediatric, Mood, Imaging and NeuroDevelopment (PediMIND) Program, Alpert Medical School of Brown University, Providence, RI, USA
| | - THANIA GALVAN
- Bradley Hospital’s Pediatric, Mood, Imaging and NeuroDevelopment (PediMIND) Program, Alpert Medical School of Brown University, Providence, RI, USA
| | - MEGAN E. PUZIA
- Bradley Hospital’s Pediatric, Mood, Imaging and NeuroDevelopment (PediMIND) Program, Alpert Medical School of Brown University, Providence, RI, USA
| | - GRACE K. CUSHMAN
- Bradley Hospital’s Pediatric, Mood, Imaging and NeuroDevelopment (PediMIND) Program, Alpert Medical School of Brown University, Providence, RI, USA
| | - KAREN E. SEYMOUR
- Bradley Hospital’s Pediatric, Mood, Imaging and NeuroDevelopment (PediMIND) Program, Alpert Medical School of Brown University, Providence, RI, USA
| | - ROSHANI VANMALI
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - RICHARD N. JONES
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA, and Department of Neurology, Alpert Medical School of Brown University, Providence, RI, USA
| | - ANTHONY SPIRITO
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - DANIEL P. DICKSTEIN
- Bradley Hospital’s Pediatric, Mood, Imaging and NeuroDevelopment (PediMIND) Program, Alpert Medical School of Brown University, Providence, RI, USA
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33
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Braden A, Overholser J, Fisher L, Ridley J. Life meaning is associated with suicidal ideation among depressed veterans. DEATH STUDIES 2015; 39:24-29. [PMID: 24932674 DOI: 10.1080/07481187.2013.871604] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Suicide is a major public health concern among U.S. veterans. Even when asked directly, veterans who die by suicide have been found to deny suicidal thoughts. Psychological assessment needs to go beyond the current risk factors and evaluate underlying factors that may increase suicide risk. In the present study, diagnostic interviews and self-report questionnaires were used to measure life meaning and suicidal ideation in a sample of 110 depressed veterans. Life meaning was significantly associated with suicidal ideation, even after accounting for depression and suicide history. Life meaning may be an important, previously ignored indicator of suicide risk.
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Affiliation(s)
- Abby Braden
- a Department of Pediatrics , University of California , San Diego , California , USA
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34
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DeBeer BB, Kimbrel NA, Meyer EC, Gulliver SB, Morissette SB. Combined PTSD and depressive symptoms interact with post-deployment social support to predict suicidal ideation in Operation Enduring Freedom and Operation Iraqi Freedom veterans. Psychiatry Res 2014; 216:357-62. [PMID: 24612971 PMCID: PMC5032640 DOI: 10.1016/j.psychres.2014.02.010] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 02/04/2014] [Accepted: 02/07/2014] [Indexed: 11/24/2022]
Abstract
Rates of suicide are alarmingly high in military and veteran samples. Suicide rates are particularly elevated among those with post-traumatic stress disorder (PTSD) and depression, which share overlapping symptoms and frequently co-occur. Identifying and confirming factors that reduce, suicide risk among veterans with PTSD and depression is imperative. The proposed study evaluated, whether post-deployment social support moderated the influence of PTSD-depression symptoms on, suicidal ideation among Veterans returning from Iraq and Afghanistan using state of the art clinical, diagnostic interviews and self-report measures. Operations Enduring and Iraqi Freedom (OEF/OIF) Veterans (n=145) were invited to, participate in a study evaluating returning Veterans׳ experiences. As predicted, PTSD-depression, symptoms had almost no effect on suicidal ideation (SI) when post-deployment social support was high; however, when, post-deployment social support was low, PTSD-depression symptoms were positively associated with, SI. Thus, social support may be an important factor for clinicians to assess in the context of PTSD and, depressive symptoms. Future research is needed to prospectively examine the inter-relationship, between PTSD/depression and social support on suicidal risk, as well as whether interventions to, improve social support result in decreased suicidality.
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Affiliation(s)
- Bryann B. DeBeer
- Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA,Texas A&M Health Science Center, College Station, TX, USA
| | - Nathan A. Kimbrel
- Durham Veterans Affairs Medical Center, Durham, NC, USA,VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, NC, USA
| | - Eric C. Meyer
- Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA,Texas A&M Health Science Center, College Station, TX, USA
| | - Suzy B. Gulliver
- Texas A&M Health Science Center, College Station, TX, USA,Scott and White Healthcare System, Waco, TX, USA
| | - Sandra B. Morissette
- Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA,Texas A&M Health Science Center, College Station, TX, USA
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35
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Steele GI, Edwards DJA. Development and Validation of the Xhosa Translations of the Beck Inventories: 2. Item Analysis, Internal Consistency and Factor Analysis. JOURNAL OF PSYCHOLOGY IN AFRICA 2014. [DOI: 10.1080/14330237.2008.10820189] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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36
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Edwards DJA, Steele GI. Development and Validation of the Xhosa Translations of the Beck Inventories: 3. Concurrent and Convergent Validity. JOURNAL OF PSYCHOLOGY IN AFRICA 2014. [DOI: 10.1080/14330237.2008.10820190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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37
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Bijanki KCR, Stillman AN, Arndt S, Magnotta VA, Fiedorowicz JG, Haynes WG, Matsui JT, Johnson HJ, Moser DJ. White matter fractional anisotropy is inversely related to anxious symptoms in older adults with atherosclerosis. Int J Geriatr Psychiatry 2013; 28:1069-76. [PMID: 23348834 PMCID: PMC3690172 DOI: 10.1002/gps.3930] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 12/20/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Clinical anxiety disorders are associated with white matter hyperintensities and diffusion abnormalities measured using diffusion tensor imaging. However, it is not known if this association extends into individuals with mild anxious symptoms without formal diagnosis, in those who are older, or in those who have atherosclerosis. The current study explores whether white matter integrity and/or organization significantly associates with anxious symptoms in older adults with and without atherosclerosis. METHODS We recruited older adults (ages 55-90 years); 35 with clinically diagnosed atherosclerotic vascular disease (AVD) and 22 without AVD. Anxious symptoms were measured using the validated Symptom Checklist-90-Revised. Fractional anisotropy (FA), a proxy for white matter organization and health, was measured in the white matter globally, by lobe, and in several smaller regions of interest suggested by the literature. Partial correlations between anxious symptoms and FA were calculated, controlling for significant covariates. RESULTS Participants with and without AVD did not differ in severity of anxious symptom endorsement. There was a unique inverse relationship between white matter health and anxious symptoms in the AVD participants, but not in healthy comparisons. Significant relationships were observed in the superior longitudinal fasciculus (r = -0.476, df = 32, p = 0.004), as well as the cingulum bundle, the frontal lobes, and the parietal lobes. CONCLUSIONS Anxiety symptoms uniquely correlated with low FA in older adults with atherosclerosis. These findings may have implications for future research on the topic of anxiety in aging and vascular disease and warrant replication.
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Affiliation(s)
- Kelly C. R. Bijanki
- Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Ashley N. Stillman
- Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Stephan Arndt
- Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, United States,Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, United States
| | - Vincent A. Magnotta
- Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, United States,Department of Radiology, The University of Iowa Carver College of Medicine, Iowa City, IA, United States,Department of Biomedical Engineering, University of Iowa College of Engineering, Iowa City, IA, United States
| | - Jess G. Fiedorowicz
- Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, United States,Department of Internal Medicine, The University of Iowa Carver College of Medicine, Iowa City, IA, United States,Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, United States
| | - William G. Haynes
- Department of Internal Medicine, The University of Iowa Carver College of Medicine, Iowa City, IA, United States,Institute for Clinical and Translational Sciences, The University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Joy T. Matsui
- Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, United States,Department of Biomedical Engineering, University of Iowa College of Engineering, Iowa City, IA, United States
| | - Hans J. Johnson
- Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, United States,Department of Biomedical Engineering, University of Iowa College of Engineering, Iowa City, IA, United States
| | - David J. Moser
- Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, United States,Corresponding Author: David J. Moser, W278 General Hospital, 200 Hawkins Dr., Iowa City, IA 52242. Telephone: 1-319-384-9211, Fax: 1-319-353-8656,
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38
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Abstract
The diagnosis of borderline personality disorder (BPD) in adolescents has been controversial. Thus, few studies have examined BPD in suicidal adolescents, even though it is strongly associated with suicidal behaviours in adults. This study examines differences between suicidal adolescents with (n = 47) and without (n = 72) BPD on history and characteristics of suicidal behaviour, Axis I co-morbidity, affect regulation and aggression. Assessments were completed with both adolescents and parents, and consensus ratings based on best available data were analysed. BPD participants were more likely to have a history of suicide attempts and to have been admitted because of a suicide attempt (vs. suicidal ideation). There were no significant differences in self-injurious behaviours or degree of suicidal ideation. BPD participants also had more psychiatric co-morbidity and higher aggression scores but no significant differences in affective dysregulation compared with suicidal adolescents without BPD. Diagnostic stability over 6 months was modest. Our results demonstrate that, compared with other acutely suicidal adolescents, the clinical profile of BPD participants is unique and suggests an increased risk for suicidal behaviours. This extends upon other studies that support the construct validity of BPD during adolescence and suggests that BPD should be considered in suicide risk assessment for adolescents.
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Affiliation(s)
- Shirley Yen
- Brown University, Department of Psychiatry and Human Behavior, Providence, RI, USA
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39
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Labelle R, Breton JJ, Pouliot L, Dufresne MJ, Berthiaume C. Cognitive correlates of serious suicidal ideation in a community sample of adolescents. J Affect Disord 2013; 145:370-7. [PMID: 23102862 DOI: 10.1016/j.jad.2012.08.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 08/20/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Studies indicate that a dysfunctional attributional style, problem-solving deficits and hopelessness place youths at risk of developing suicidal thoughts and engaging in suicidal behaviour. However, in the realm of suicidality in adolescent, no study has examined the linkages between these three cognitive variables and suicidal ideation in non-clinical samples while taking into account the moderating role of gender on the relationships and controlling for depression. METHODS In this community study of 712 adolescents 14-18 years of age, through a multivariate approach, the interaction between the cognitive variables, depression and gender was examined with depression controlled in the analyses. RESULTS Problem-solving deficits and hopelessness proved predictive of such ideation whether or not depressive symptoms were controlled in the analyses. Negative problem orientation/avoidant style was more predictive of ideation in boys than in girls. On the other hand, hopelessness was more predictive for girls than boys. LIMITATIONS Results were based on a convenience community sample of adolescents and a cross-sectional survey. CONCLUSIONS Results suggest that a unique explanatory model of the suicide process in adolescence that fails to take account of gender would be ill informed. Suicide prevention strategies should be differentiated according to gender with a stronger emphasis in hopelessness in female adolescents, and problem-solving deficits in male adolescents.
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Affiliation(s)
- Réal Labelle
- Center for Research and Intervention on Suicide and Euthanasia, Université du Québec à Montréal, Canada.
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40
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Abstract
Children and adolescents with intellectual disabilities (IDs), often diagnosed with comorbid psychiatric disorders, are a vulnerable population who may be at risk for developing suicidal thoughts and behaviors. Previous research has demonstrated that direct suicide screening can rapidly and effectively detect suicide risk and facilitate further clinical evaluation and management. Currently, there are no measures that screen for suicide risk designed specifically for individuals with ID. A review of the literature was conducted to (1) estimate the prevalence of suicidal thoughts, behaviors, and deaths by suicide in children and adolescents with ID; (2) describe associations between youth with ID and suicide risk; and (3) identify the limitations of commonly used suicide screening measures developed for non-ID youth. The literature review confirms that suicide risk exists in this population; youth with ID think about, attempt, and die by suicide. Standardized suicide risk screening is challenged by the lack of measures developed for this population. A summary of the findings is followed by a discussion of the practical clinical considerations surrounding the assessment of suicide risk in youth with ID.
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41
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Hill RM, Castellanos D, Pettit JW. Suicide-related behaviors and anxiety in children and adolescents: a review. Clin Psychol Rev 2011; 31:1133-44. [PMID: 21851804 DOI: 10.1016/j.cpr.2011.07.008] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 07/19/2011] [Accepted: 07/20/2011] [Indexed: 11/26/2022]
Abstract
This paper reviews empirical evidence of the association between suicide-related behaviors and anxiety among children and adolescents. It begins with a review of suicide-related behaviors and anxiety, discusses methodological issues related to measurement, and reviews empirical findings published since the last review of this topic in 1988. Evidence is summarized on four criteria necessary to establish anxiety as a causal risk factor for suicide-related behaviors among children and adolescents. There is consistent evidence for a significant association between anxiety and suicide-related behaviors (Criterion 1). Evidence that the influence of anxiety on suicide-related behaviors is not due to a third variable (Criterion 2) is mixed and hindered by methodological limitations. The literature is also unclear as to whether anxiety temporally precedes suicide-related behaviors (Criterion 3). Finally, this review found no evidence to support or refute anxiety's stability independent of and across instances of suicide-related behaviors (Criterion 4). Theoretical and clinical implications of these findings and directions for future research are discussed.
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Affiliation(s)
- Ryan M Hill
- Florida International University, Department of Psychology, 11200 SW 8th Street, AHC1 room 140, Miami, FL 33199, United States
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42
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Sargalska J, Miranda R, Marroquín B. Being Certain about an Absence of the Positive: Specificity in Relation to Hopelessness and Suicidal Ideation. Int J Cogn Ther 2011. [DOI: 10.1521/ijct.2011.4.1.104] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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43
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Machado CL, de Azevedo RC, Facuri CO, Vieira MJN, Fernandes AMS. Posttraumatic stress disorder, depression, and hopelessness in women who are victims of sexual violence. Int J Gynaecol Obstet 2011; 113:58-62. [DOI: 10.1016/j.ijgo.2010.10.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2010] [Revised: 10/20/2010] [Accepted: 12/15/2010] [Indexed: 10/18/2022]
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44
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The relationship among classroom community, attitude toward parents, anxiety disorders and depression with adolescent suicide probability. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.sbspro.2011.03.134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ginsburg GS, Silva SG, Jacobs RH, Tonev S, Hoyle RH, Kingery JN, Reinecke MA, Curry JF, March JS. Cognitive measures of adolescent depression: unique or unitary constructs? JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2010; 38:790-802. [PMID: 20183663 DOI: 10.1080/15374410903259015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The factor structure of several self-report questionnaires assessing depression-relevant cognitions frequently employed in clinical research was examined in a sample of 390 adolescents (M age = 14.54; 216 girls; 74% Caucasian) with current major depressive disorder enrolled in the Treatment of Adolescents with Depression Study. A four-factor solution resulted, accounting for 65% of the total variance. The factors were labeled (a) Cognitive Distortions and Maladaptive Beliefs, (b) Cognitive Avoidance, (c) Positive Outlook, and (d) Solution-Focused Thinking. Internal consistencies for the factor-based composite scores were .83, .85, .84, and .82, respectively. Girls endorsed more negative cognitions than boys on three of the four factors. Maladaptive cognitions were positively related to severity of depression and predicted treatment response. Taken together, findings indicated that there are four distinct domains of cognitions that are present among adolescents with depression that are tapped by several widely used self-report measures of cognitions.
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Affiliation(s)
- Golda S Ginsburg
- Johns Hopkins University School of Medicine, Baltimore, MD 21287-3325, USA.
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46
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Kingery JN, Kepley HO, Ginsburg GS, Walkup JT, Silva SG, Hoyle RH, Reinecke MA, March JS. Factor Structure and Psychometric Properties of the Children's Negative Cognitive Error Questionnaire with a Clinically Depressed Adolescent Sample. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2009; 38:768-80. [DOI: 10.1080/15374410903297130] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pettit JW, Garza MJ, Grover KE, Schatte DJ, Morgan ST, Harper A, Saunders AE. Factor structure and psychometric properties of the Modified Scale for Suicidal Ideation among suicidal youth. Depress Anxiety 2009; 26:769-74. [PMID: 19434622 DOI: 10.1002/da.20575] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Although suicidal behaviors occur at a high rate in adolescence, relatively few interview-based measures are available to assess suicidal ideation among youth. Existing interview measures are limited by a paucity of empirical study, a failure to conform to standard suicide nomenclature, or a lengthy administration time. This study presents data on the psychometric properties and factor structure of the brief, layperson-administered Modified Scale for Suicidal Ideation (MSSI) among suicidal youth. METHODS The MSSI was administered to an inpatient sample of 102 suicidal youth aged 13-17 years. Additional interview and self-report measures were administered to examine the convergent validity of the MSSI. RESULTS Consistent with previous findings among suicidal adults, the MSSI displayed good internal consistency and expected patterns of convergent validity. Principal component analysis revealed a bidimensional structure, with factors corresponding to (1) Desire and Ideation and (2) Plans and Preparations. Each factor displayed acceptable internal consistency and expected patterns of convergent validity via associations with hopelessness, depressive symptoms, impulsivity, and a self-report measure of suicidal behaviors. The Plans and Preparations factor significantly associated with the presence of a current suicide attempt and with greater suicide intent among attempters, whereas the Desire and Ideation factor did not. CONCLUSIONS The MSSI appears to be a reliable and valid instrument to assess suicidal ideation among distressed youth. Clinicians are encouraged to pay particular attention to responses on the Plans and Preparations factor given its stronger association with suicide attempt and more serious suicide intent.
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Affiliation(s)
- Jeremy W Pettit
- Department of Psychology, University of Houston, Houston, Texas 77204-5022, USA.
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King CA, O'Mara RM, Hayward CN, Cunningham RM. Adolescent suicide risk screening in the emergency department. Acad Emerg Med 2009; 16:1234-41. [PMID: 19845554 DOI: 10.1111/j.1553-2712.2009.00500.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Many adolescents who die by suicide have never obtained mental health services. In response to this, the National Strategy for Suicide Prevention recommends screening for elevated suicide risk in emergency departments (EDs). This cross-sectional study was designed to examine 1) the concurrent validity and utility of an adolescent suicide risk screen for use in general medical EDs and 2) the prevalence of positive screens for adolescent males and females using two different sets of screening criteria. METHODS Participants were 298 adolescents seeking pediatric or psychiatric emergency services (50% male; 83% white, 16% black or African American, 5.4% Hispanic). The inclusion criterion was age 13 to 17 years. Exclusion criteria were severe cognitive impairment, no parent or legal guardian present to provide consent, or abnormal vital signs. Parent or guardian consent and adolescent assent were obtained for 61% of consecutively eligible adolescents. Elevated risk was defined as 1) Suicidal Ideation Questionnaire-Junior [SIQ-JR] score of > or =31 or suicide attempt in the past 3 months or 2) alcohol abuse plus depression (Alcohol Use Disorders Identification Test-3 [AUDIT-3] score of > or =3, Reynolds Adolescent Depression Scale-2 [RADS-2] score of > or =76). The Beck Hopelessness Scale (BHS) and Problem Oriented Screening Instrument for Teenagers (POSIT) were used to ascertain concurrent validity. RESULTS Sixteen percent (n = 48) of adolescents screened positive for elevated suicide risk. Within this group, 98% reported severe suicide ideation or a recent suicide attempt (46% attempt and ideation, 10% attempt only, 42% ideation only) and 27% reported alcohol abuse and depression. Nineteen percent of adolescents who screened positive presented for nonpsychiatric reasons. One-third of adolescents with positive screens were not receiving any mental health or substance use treatment. Demonstrating concurrent validity, the BHS scores of adolescents with positive screens and the POSIT scores of those with positive screens due to alcohol abuse and depression indicated substantial impairment. The addition of alcohol abuse with co-occurring depression as a positive screen criterion did not result in improved case identification. Among the subgroup screening positive due to depression plus alcohol abuse, all but one (>90%) also reported severe suicide ideation and/or a recent suicide attempt. This subgroup (approximately 17% of adolescents who screened positive) also reported significantly more impulsivity than other adolescents who screened positive. CONCLUSIONS The suicide risk screen showed evidence of concurrent validity. It also demonstrated utility in identifying 1) adolescents at elevated risk for suicide who presented to the ED with unrelated medical concerns and 2) a subgroup of adolescents who may be at highly elevated risk for suicide due to the combination of depression, alcohol abuse, suicidality, and impulsivity.
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Affiliation(s)
- Cheryl A King
- Department of Psychiatry, University of Michigan, and the University of Michigan Depression Center, Ann Arbor, MI, USA.
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Bongiovi-Garcia ME, Merville J, Almeida MG, Burke A, Ellis S, Stanley BH, Posner K, Mann JJ, Oquendo MA. Comparison of clinical and research assessments of diagnosis, suicide attempt history and suicidal ideation in major depression. J Affect Disord 2009; 115:183-8. [PMID: 18814917 PMCID: PMC3785082 DOI: 10.1016/j.jad.2008.07.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Revised: 07/30/2008] [Accepted: 07/30/2008] [Indexed: 11/30/2022]
Abstract
A number of studies have compared clinical diagnostic and suicide assessments to standardized schedules to determine the level of agreement. At best there is only moderate diagnostic agreement, but most often it is fair. There are only a few reports comparing clinical assessments for suicidal behavior with standardized schedules. We present the data from 201 inpatient admissions for major depression that had both clinical diagnostic and suicide evaluations by PGYII resident physicians under supervision from an attending psychiatrist and research evaluations using standardized schedules for diagnosis and suicide by at least masters' level clinicians. There was moderate agreement for diagnosis and suicide attempt history but only fair agreement for the presence of suicidal ideation using Cohen's kappa statistic. In regards to suicide attempt history a cross-tabulation demonstrated that 18.7% of those patients identified by a research schedule as having a past suicide attempt were not identified as such by the clinicians. A cross-tabulation demonstrated that 29.7% of those patients identified by structured interview as having suicidal ideation were not identified as such by the clinician. There was a statistically significant difference in the level of agreement for suicide attempt history between clinical and research assessments for attempts within a year of admission and those beyond a year. These findings suggest the importance of adding a structured diagnostic and suicide assessment to routine clinical care to improve the reliability and validity of clinical evaluations and to inform treatment planning to benefit our patients.
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Affiliation(s)
- Mary E Bongiovi-Garcia
- New York State Psychiatric Institute and Columbia University 1051 Riverside Drive NY, NY 10032, United States.
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Abstract
BACKGROUND Factors that distinguish depressed individuals who become hopeless from those who do not are poorly understood. METHOD In this study, predictors of hopelessness were examined in a sample of 439 clinically depressed adolescents participating in the Treatment for Adolescents with Depression Study (TADS). The total score of the Beck Hopelessness Scale (BHS) was used to assess hopelessness at baseline. Multiple regression and logistic regression analyses were conducted to evaluate the extent to which variables were associated with hopelessness and determine which cluster of measures best predicted clinically significantly hopelessness. RESULTS Hopelessness was associated with greater depression severity, poor social problem-solving, cognitive distortions, and family conflict. View of self, view of the world, internal attributional style, need for social approval, positive problem-solving orientation, and family problems consistently emerged as the best predictors of hopelessness in depressed youth. CONCLUSIONS Cognitive and familial factors predict those depressed youth who have high levels of hopelessness.
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