Suicidal Self-Directed Violence Among Homeless US Veterans: A Systematic Review

A systematic review of the literature was conducted to investigate suicidal self-directed violence and homelessness among US military veterans, and identify existing suicide prevention strategies. In November 2015, MEDLINE, EMBASE, PsycInfo, CINAHL, Web of Science, Cochrane Library, Google, and Google Scholar were searched. Articles published since 1990 investigating self-directed violence among homeless veterans were identified. Data were extracted and synthesized qualitatively. Nineteen observational studies were included. Suicide ideation rates were 1.3% (current), 7.0% (past week), 12.1%-18% (past 30 days), and 74% (lifetime). Suicide attempt rates were 0%-6% (past 30 days), 30.7%-31.5% (past 5 years), and 15%-46.6% (lifetime). Death by suicide rate was 81.0 per 100,000. No interventional studies to prevent self-directed violence among homeless veterans were identified. Homeless veterans are at risk for self-directed violence, suggesting the need for research to examine preventive strategies. A comprehensive public health approach to suicide prevention needs to focus on vulnerable populations, including homeless veterans.

The Relationship Between Sense of Coherence and Attribution of Responsibility for Problems and Their Solutions, and Cessation of Substance Abuse Over Time

The present study deals with personal and psychological characteristics of addicts coping with abstinence from drugs in various stages of recovery. The study focuses primarily on two personal variables: attribution of responsibility for the problem and its solution, and the sense of coherence. Additional factors that were examined in the study are demographic variables, which include those related to drug addiction. The sample included 128 short-term abstinent patients in the early stages of recovery after detoxification, and 40 long-term abstinent former addicts, who have abstained from the use of drugs for two to eight years. The results indicate a higher level of sense of coherence among the long-term abstinent subjects relating to their inner resources. On the other hand, much similarity was found between the groups in relation to the attribution of responsibility variable. In both groups, the majority reports that they attribute responsibility for the solution of the problem to themselves. The findings underscored the significant link between personality variables and coping with the processes of recovery, while an analysis of demographic and addiction variables did not show a significant distinction between the group of long-term abstinent subjects and the short-term abstinent subjects.

Predictors of reported current and lifetime substance abuse problems among a national sample of U.S. homeless

Using the National Survey of Homeless Assistance Providers and Clients (NSHAPC), this study examined predictors of alcohol and drug problems among a national probability sample of homeless and previously homeless adults in the United States. Consistent with research, about one third and one quarter of the respondents reported a current alcohol and drug problem, respectively. A larger proportion reported lifetime substance abuse problems. As hypothesized, males, younger respondents, veterans, and those with mental and physical health problems were at greater risk. Results reveal that substance abuse treatment and prevention programs for the homeless should take into consideration these characteristics to maximize effectiveness.

Depression, Negative Self-Image, and Suicidal Attempts as Effects of Substance Use and Substance Dependence

The main purpose of this study was to compare, separately by gender, the degree to which cocaine use/abuse, marijuana use/ abuse, and alcohol use/abuse each predict to developing either: a state of depression, or a negative self-image, or a negative personal outlook or for making a suicidal attempt. The study sample of 431 inner-city, African-American subjects, derived from the National Collaborative Perinatal Project (NCPP), were retrieved for the fourth time, at average age 37.

RESULTS

(1) For the female sample, there were more predictions and relatively stronger predictions from the use/abuse of and from the dependence on illicit drugs, to a subsequent negative self-image and to a negative personal outlook. For the male sample, there were relatively more predictions to making suicide attempts. (2) Of the three types of substances, cocaine use/abuse predicted to the greatest number of negative outcomes; and alcohol use/abuse predicted to no negative outcomes.