Refining Psychological, Substance Use, and Sociodemographic Predictors of Suicide Ideation and Attempts in a National Multiethnic Sample of Adults, 2008-2013

Examining the relationship between subtypes of rumination and non-suicidal self-injury: A meta-analytic review

INTRODUCTION

Non-suicidal self-injury (NSSI) is a highly prevalent maladaptive behavior, often used to cope with intense negative affect. Rumination is an emotion regulation strategy that leads to fixation on and exacerbation of (typically) negative affective states. However, studies examining the relationship between rumination and NSSI have yielded mixed results, showing high degrees of heterogeneity.

METHODS

The present study conducted meta-analyses (k = 50) of the association between overall rumination and NSSI, and independent meta-analyses for each of four subtypes of rumination (general, depressive, brooding, reflection rumination). Potential moderators that may influence the magnitude of these relationships were also examined.

RESULTS

A small-to-moderate positive association between rumination and NSSI was found independent of rumination subtype. Moderating effects included NSSI outcome measure and study design for overall rumination and general rumination, respectively. Race was found to moderate the relationships between both brooding and depressive rumination and NSSI, though in inverse directions. An analysis of effect heterogeneity across studies suggested that undetected moderators may be present.

CONCLUSION

Results of this study support the relationships between rumination subtypes and NSSI and identify factors that may impact these relationships. Continued research is needed to understand this association, particularly in more varied subtypes of rumination and cognitive-affective moderators.

Suicide Attempts Among Racial and Ethnic Groups in a Nationally Representative Sample

OBJECTIVE

Evaluate suicide attempt prevalence and potentially related sociodemographic and psychiatric factors among racial and ethnic groups.

METHODS

Between 2012 and 2013, the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) conducted semi-structured interviews with 36,309 adults in the USA. We identified lifetime suicide attempt prevalence and significant predictors for each racial/ethnic group using stratified logistic regressions. Analyses were exploratory without a priori hypotheses.

RESULTS

Asian/Native Hawaiian/other Pacific Islander and Black individuals had the lowest prevalence of suicide attempts while Alaska Native/American Indian and White individuals had the highest prevalence. Identifying as female and meeting criteria for psychiatric diagnoses featuring mood regulation difficulties (depression, borderline personality disorder, bipolar I disorder) were consistently related to a suicide attempt history across racial and ethnic groups, whereas substance abuse disorders and other sociodemographic factors differed between racial and ethnic groups in their associations with suicide attempt history.

CONCLUSIONS

Although several factors were consistently related to suicide risk across racial and ethnic groups, the prevalence of suicide attempts and overall pattern of related factors were not uniform between racial and ethnic groups.

POLICY IMPLICATIONS

Study findings highlight the importance of considering suicide risk within the context of race and ethnicity both regarding the overall prevalence of risk and in determining personal factors associated with elevated risk. A failure to appreciate experiences related to race and ethnicity may adversely impact suicide risk assessment and treatment, ultimately contributing to health disparities. Results suggest that additional research is warranted.

Changes After Emergency Assessment of Suicidal Patients: An Unexpected Outcome

INTRODUCTION

Acute Suicide Risk (ASR) is widely evaluated at Emergency Departments (ED). Little is known about follow-up of ASR after psychiatric ED evaluation, and if there are differences within No ASR (NASR) counterparts at baseline and afterwards.

METHOD

We developed a naturalistic, 3-month follow-up study of adult patients from a psychiatric ED in Mexico City. Depressive patients who asked voluntarily for an emergency consultation from July 1 to December 1, 2014, were included. We compared depression severity, suicidal ideation, adherence to treatment, and perceived social support scales both in ASR and NASR participants at baseline and follow-up interviews.

RESULTS

Participants (n = 120) were divided into ASR or NASR groups (n = 60 each). The ASR group obtained more negative scores in all scales at baseline evaluation. After three months, 85% (n = 51) of ASR and 75% (n = 45) of NASR completed the second interview. 5.21% (n = 3) of participants showed new suicidal behavior. At follow-up, the ASR group showed a higher relative response in depression scales and treatment adherence (p = 0.036), and lower scores in suicidal ideation scales than NASR group (p = 0.012). Perceived support from family was significantly higher in the NASR group (p = 0.016).

DISCUSSION

These relative higher responses in clinical scales suggest a paradoxical advantage of ASR over NASR patients, suggesting a hypothetical phenomenon similar to "The Tortoise and the Hare" effect. However, it is not applicable for all ASR patients. Results suggest suicidal patients experience stigma from their families. Further research and public health programs for ASR at ED should be implemented.

Negative Employment Changes During the COVID-19 Pandemic and Psychological Distress: Evidence From a Nationally Representative Survey in the U.S

OBJECTIVE

We examined associations of negative employment changes during the COVID-19 pandemic with mental health in a national sample of U.S. workers, and whether the associations differed by race.

METHODS

Data were from the Health, Ethnicity, and Pandemic Study, a cross-sectional survey. The effects of negative employment changes on psychological distress in 1510 workers were examined via linear regression, and stratified analyses were conducted across racial subgroups.

RESULTS

After adjustment for covariates, compared to workers with no change in employment, those who experienced permanent job loss had the highest psychological distress (β and 95% CI = 3.27 [1.89, 4.65]). Permanent job loss had the greatest effect on psychological distress in Blacks and Asians.

CONCLUSION

Negative employment changes related to the pandemic may have deleterious impacts on workers' mental health, with disproportionate effects on racial minorities.

Race, Ethnicity, and Clinical Features of Alcohol Use Disorder Among US Military Veterans: Results From the National Health and Resilience in Veterans Study

BACKGROUND AND OBJECTIVES

Alcohol use disorder (AUD) is highly prevalent in US military veterans, though little is known about whether the psychiatric comorbidities and functional outcomes (ie, clinical features) of AUD differ across race/ethnic groups. We aimed to identify differences in the clinical features of veterans with AUD by race/ethnicity.

METHODS

In a sample of veterans with AUD (n = 1212) from the nationally representative National Health and Resilience in Veterans Study, we compared the clinical features associated with AUD across racial/ethnic groups using analysis of covariance and logistic regression.

RESULTS

Black veterans (n = 60, 34.0%) were less likely to screen positive for lifetime AUD compared with white (n = 1099, 42.7%) and Hispanic (n = 53, 41.5%) veterans. Among those with lifetime AUD, Hispanic veterans were more likely than white veterans to have lifetime and current mood or anxiety disorders (adjusted odds ratio range [AORR] = 2.21-2.52, P < .05). Black veterans were more likely than white veterans to have current mood and anxiety disorders (AORR = 2.01-3.07, P < .05). Hispanic veterans reported poorer functioning and quality of life than white and black veterans (Cohen's d range = 0.12-0.37, P < .05).

DISCUSSION AND CONCLUSIONS

Black and Hispanic veterans with lifetime AUD may experience a higher disease burden relative to white veterans. Results underscore the importance of race/ethnicity-sensitive assessment, monitoring, and treatment of AUD for veterans.

SCIENTIFIC SIGNIFICANCE

This is the first known study to examine differences by race/ethnicity in the clinical features of Veterans with AUD in a nationally representative sample. Findings suggest higher disease burden for racial/ethnic minority veterans. (Am J Addict 2021;30:26-33).