Suicidal behaviors among clients at an outpatient psychology clinic versus the general population

Emotional distress and dysregulation as treatment targets to reduce suicide in psychosis: a scoping review

There is a pressing need for effective treatments that address the high rate of suicide observed among people with psychosis. In this scoping review we highlight two suicidogenic treatment targets that have been relatively neglected in people with psychotic disorders: emotional distress and emotion dysregulation. We review the research on these constructs in psychosis and their relationship to suicide in this population, and then make clinical recommendations based on research findings. Emotional distress and emotional dysregulation may be promising treatment targets for suicide among people with psychosis.

Correlates of Suicidal Ideation and/or Behavior in Bariatric-Surgery-Seeking Individuals With Severe Obesity

Background: Approximately 10% of severely obese bariatric-surgery-seeking individuals report a lifetime history of suicide attempts, a higher rate than in the general community. Being overweight is associated with weight-related stigma, making an individual more vulnerable to social isolation, a potential risk factor for suicidal ideation and/or behavior. Aims: In this cross-sectional study of surgery-seeking adults with severe obesity, we examined whether weight-related stigma increases (1) the likelihood of suicidal ideation and/or behavior or (2) the degree of loneliness; and whether hypotheses (1) and (2) are supported (3) if loneliness mediates the effect of weight-related stigma on suicidal ideation and/or behavior. Methods: Online questionnaires were administered to 301 women and 95 men seeking bariatric surgery. Results: Approximately 30.3% reported having at least a passing thought of suicide, and 5.55% a suicide attempt during their lifetime. The suicide attempt rate appears lower than other bariatric surgery samples, but possibly higher than community and other surgery sample rates. For severely obese surgery-seeking women, weight-related stigma was associated with suicidal ideation and/or behavior, though this was not mediated by loneliness. Conclusions: Future studies are needed to model and compare suicidal ideation and/or behavior in bariatric-surgery-seeking individuals and control groups.

Suicide fantasy as a life-sustaining recourse

The suicide literature tends to lump all suicidal ideation together, thereby implying that it is all functionally equivalent. However obvious the claim that suicidal ideation is usually a prelude to suicidal action, some suicidal daydreaming tends to inhibit suicidal action. How are we to distinguish between those daydreams that augur an impending attempt from those that help patients calm down?

The Material Culture of Suicidal Fantasies

In this study, the author examined the content of impulsive suicidal fantasies among U.S. undergraduates. Of 546 participants, 45.6% reported incidents in which they fantasized about killing themselves. Most fantasies (95%) included explicit references to suicide methods, and most of those fantasies (98%) involved human-made tools or materials (e.g., drugs, cutlery, firearms). The methods reported in most suicidal fantasies seem to have been suggested by the mass media. The findings suggest that suicidal thoughts do not occur without explicit and detailed information about suicide methods involving material culture.

Sex, gender role orientation, gender role attitudes and suicidal thoughts in three generations. A general population study

BACKGROUND

Suicide and other suicidal behaviours are markedly (though differently) patterned by gender. The increase in young male suicide rates in many countries has heightened interest in whether suicidal behaviours and ideation (thoughts) are related to masculinity. Relatively little research has explored the relationship between gender role attitudes and orientation and suicidal behaviours and ideation. Most research in this area has been conducted with young people.

OBJECTIVE

We investigated whether gender role orientation (masculinity and femininity scores) and gender role attitudes were related to the reporting of serious suicidal thoughts in three generations (early adulthood, and early and late middle age) in a community sample.

METHODS

Subjects (653 men and women aged around 23 years, 754 aged around 43 years, 722 aged around 63 years) completed home interviews with nurses as part of an ongoing longitudinal community-based study of social factors and health. These included measures of suicidal ideation (thoughts), attitudes to traditional gender roles, and a validated measure of gender role orientation (masculinity and femininity scores).

RESULTS

The prevalence of serious suicidal thoughts was higher in early adulthood (10% men, 15% women) than in early (4% men, 8% women) and late (6% men, 5% women) middle age. In early adulthood only sex was significantly related to suicidal thoughts, with women at higher risk (adjusted OR 1.74, 95% CI 1.01-3.00). In early middle age masculinity scores were negatively related to suicidal thoughts (adjusted OR for each unit increase in score 0.65: 95% CI 0.46-0.93), and more traditional views on gender roles were positively associated with suicidal thoughts (adjusted OR 1.48: 95% CI 1.07-2.04). In late middle age trends were in the same direction as in early middle age, but were not statistically significant. Femininity scores were unrelated to serious suicidal thoughts at any age.

CONCLUSION

The high rates of suicidal thoughts amongst men and women in early adulthood point to the importance of understanding mental health problems at this age. The results raise a number of questions and suggest that suicide researchers should pay more attention to gender roles and attitudes in older adults.

Psychological autopsy study of suicides by people aged under 35

BACKGROUND

In the past two decades the suicide rate in young people has risen in the UK and other countries.

AIMS

To identify the characteristics of people aged under 35 who commit suicide.

METHOD

Psychological autopsy study with case-control design. Cases were 84 suicides and probable suicides (open verdicts). Controls were 64 age- and gender-matched non-suicides obtained through the general practices of the matched cases.

MAIN VARIABLES

social, including employment status, marital status and living circumstances; life events and interpersonal difficulties; clinical, including current psychiatric disorder, alcohol and drug misuse, previous self-harm and personality disorder.

RESULTS

A large number of highly significant social, interpersonal and clinical differences between suicides and controls was found. Factor analysis identified two groups of variables within each of the social, interpersonal and clinical domains which were independently linked to suicide, corresponding to: acute, severe mental disorder and chronic disorder of behaviour; rootlessness and social withdrawal; chronic and recent interpersonal problems.

CONCLUSIONS

A broad prevention strategy is needed to reverse the recent rise in the suicide rate in young people.

Perception of behavioral contagion of adolescent suicide

In order to assess perceptions of behavioral contagion of suicide (what people thought a disturbed adolescent would do if the teen knew about a suicide in the community), and to assess actor-observer differences in such perceptions, 142 college students were asked to view a videotaped vignette of a distressed high school student, and then to assess her potential for committing suicide, running away, entering therapy, or abusing alcohol. Subjects who were told that the teenager knew of two recent suicides in the community (contagion group) rated the young woman as more likely to commit suicide or run away than did the subjects who were not told of the suicides (noncontagion group). Subjects who were instructed to imagine that they were the teenager (actors) blamed situational factors, and in particular the teen's parents, more for her distress than did subjects who were instructed just to rate the teenager on the videotape (observers). Contagion/actors rated suicide as more likely than did any other group. Apparently, people believe that behavioral contagion occurs when a suicide is reported, and they especially perceive themselves to be influenced by such information.