Suicidal behaviors among American Indian/Alaska Native firefighters: Evidence for the role of painful and provocative events

The complex relationship between NSSI exposure and suicidal risk: Insights from a short-term longitudinal study

OBJECTIVE

Adolescent suicide has become a critical global public health issue. While non-suicidal self-injury (NSSI) is closely associated with suicide, the role of NSSI exposure remains unclear. This study aims to explore possible mechanisms among NSSI exposure, NSSI engagement, and future suicidal risk.

METHOD

A total of 2,155 Chinese middle school students (47.9 % girls; M = 13.38 years, SD = 0.66) participated in the study. During the first survey, they reported demographic information, NSSI exposure, and NSSI engagement. Three months later, they completed follow-up assessments on suicidal risk and depressive symptoms.

RESULTS

Our results revealed three distinct relational patterns between NSSI exposure, NSSI engagement, and future suicidal risk: (1) NSSI exposure is associated with future suicidal risk through the mediating role of NSSI engagement (indirect effect = 0.145, SE = 0.02, 95 % CI [0.107, 0.183]); (2) NSSI exposure independently impact suicidal risk without NSSI engagement (β = 0.046, SE = 0.018, t = 2.299, p < 0.05); (3) NSSI exposure amplifies the predictive effect of NSSI engagement (β = 0.053, SE = 0.014, t = 3.844, p < 0.001, 95 % CI [0.023, 0.010]).

CONCLUSIONS

Our findings highlight the importance of interpersonal exposure, rather than media exposure, in these pathways. This study uncovers multiple pathways through which NSSI exposure influences suicidal risk, offering preliminary evidence for targeted prevention strategies.

Acquired Capability for Suicide: An Evolutionary Concept Analysis

While virtually all suicide attempters experience ideations, not all who think about suicide will attempt or die by suicide. The ideation-to-action framework has led to new theories distinguishing suicide ideators from suicide attempters. The framework suggests that suicide progresses on a spectrum of thoughts and behaviors with different identifiers and explanations. The concept of acquired capability for suicide (ACS), conceptualized by the Interpersonal Psychological Theory of Suicide, is the first to explain the movement from ideation to action. This concept analysis of ACS is timely and relevant for greater clarification of the role ACS has in the movement from ideation to action. Rodgers' evolutionary concept analysis method is used. The six-step evolutionary method highlights the concept's attributes, antecedents, and consequences and provides a basis for further inquiry and development rather than a final definition.

Suicides among American Indian/Alaska Native firefighters: Data from the National Violent Death Reporting System, 2003 - 2017

Suicide is a significant public health problem in the United States and disproportionally affects male American Indian/Alaska Natives (AI/AN). Suicide is particularly problematic among AI/AN firefighters who are more likely to report suicide ideation, planning, attempts, and risk compared to non-Hispanic white (NHW) firefighters. The aim of the current study was to compare non-Hispanic AI/AN firefighter and NHW firefighter suicide decedents by demographics and risk/precipitating factors using National Violent Death Reporting System data for 45 male non-Hispanic AI/AN firefighter and 588 male NHW firefighter decedents who died by suicide. Compared to NHW firefighter decedents, AI/AN firefighter decedents were significantly younger and had significantly higher odds of experiencing alcohol use problems and a recent death/suicide of a family member/friend. AI/AN firefighter decedents had significantly lower odds of documented mental health problems, documented diagnosis of depression/dysthymia, receipt of mental health treatment, or leaving a suicide note compared to NHW firefighter decedents. Results from this study may inform tailored suicide prevention and screening efforts among first responders with the goal of lowering suicide mortality among AI/AN firefighters and fire service as a whole.

Dispositional optimism and suicide among trans and gender diverse adults

Trans and gender diverse adults are at increased suicide risk. Optimism protects against suicide across multiple populations. Applying the Interpersonal-Psychological Theory of Suicide (IPTS), we examined both factors among 237 adults recruited via social media and online platforms, 79.3% of whom reported serious suicide ideation. Dispositional optimism predicted suicidal ideation and behaviors (SIB), but did not moderate the relationship between the IPTS components and SIB. After controlling for depressive symptoms, hormone therapy and gender-affirming surgery did not predict SIB. Promoting dispositional optimism within a therapeutic framework may reduce SIB in this vulnerable population.