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Robison M, Rogers ML, Robertson L, Duffy ME, Manwaring J, Riddle M, Rienecke RD, Le Grange D, Duffy A, Plotkin M, Blalock DV, Mehler PS, Joiner TE. Avoidant restrictive food intake disorder and suicidal ideation. Psychiatry Res 2022; 317:114925. [PMID: 37732866 DOI: 10.1016/j.psychres.2022.114925] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/14/2022] [Accepted: 10/22/2022] [Indexed: 11/28/2022]
Abstract
Most DSM-5 eating disorder diagnoses are associated with elevated suicide risk; however, little is known about the relationship between Avoidant/Restrictive Food Intake Disorder (ARFID) and suicidal ideation. The aim of the current study was to examine suicidal ideation within an adult ARFID sample. Patients with eating disorders (N = 936), some of whom met criteria for a current DSM-5 diagnosis of ARFID (n = 79), completed the Beck Depression Inventory II Item 9, regarding suicidal ideation. The study was conducted within an eating disorder treatment facility that offers inpatient, residential, partial hospitalization program, and intensive outpatient levels of care. Findings suggest no significant pairwise differences in suicidal ideation prevalence between participants with ARFID and those with any other ED diagnosis. Thorough screening for suicidal thoughts and risk among those with ARFID is warranted at all levels of care. We suggest that future research expand upon this work in a larger adult ARFID sample.
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Affiliation(s)
- Morgan Robison
- Department of Psychology, Florida State University, 616 Wilson Ave, Apt A, Tallahassee, FL 32303, USA.
| | - Megan L Rogers
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Lee Robertson
- Department of Psychology, Florida State University, 616 Wilson Ave, Apt A, Tallahassee, FL 32303, USA
| | - Mary E Duffy
- Department of Psychology, Florida State University, 616 Wilson Ave, Apt A, Tallahassee, FL 32303, USA
| | - Jamie Manwaring
- ACUTE at Denver Health, Denver, CO, USA; Eating Recovery Center and Pathlight Mood and Anxiety Center, Denver, CO, USA
| | - Megan Riddle
- ACUTE at Denver Health, Denver, CO, USA; University of Washington Department of Psychiatry and Behavioral Sciences, Seattle, WA
| | - Renee D Rienecke
- Eating Recovery Center and Pathlight Mood and Anxiety Center, Denver, CO, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA; Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL (Emeritus), USA
| | - Alan Duffy
- Eating Recovery Center and Pathlight Mood and Anxiety Center, Denver, CO, USA
| | - Millie Plotkin
- Eating Recovery Center and Pathlight Mood and Anxiety Center, Denver, CO, USA
| | - Dan V Blalock
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Philip S Mehler
- ACUTE at Denver Health, Denver, CO, USA; Eating Recovery Center and Pathlight Mood and Anxiety Center, Denver, CO, USA; Department of Internal Medicine, University of Colorado School of Medicine, Denver, CO, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, 616 Wilson Ave, Apt A, Tallahassee, FL 32303, USA
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Rogers ML, Jeon ME, Duffy ME, Joiner TE. Thinking too much: Rumination as a catalyst of the real-time associations between affective states and suicidal ideation. J Consult Clin Psychol 2022; 90:670-681. [PMID: 36074616 DOI: 10.1037/ccp0000753] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Affective states and rumination have each been linked to suicidal ideation; however, to our knowledge, no studies have examined their interactive effect in predicting suicidal ideation in the short term. The present study examined the concurrent and short-term prospective relationships between affective states, rumination, and suicidal ideation using ecological momentary assessment (EMA). METHOD A sample of 237 community-based adults at high risk for suicide (Mage = 27.12 years, 61.6% cisgender women) responded to six EMA prompts each day for 2 weeks that assessed their momentary affective states (depression, anxiety, happiness, hopelessness, agitation, irritability), rumination, and suicidal ideation. RESULTS Rumination moderated the relationship between concurrent affective states and suicidal ideation, at both the within-person and between-person levels. Specifically, the relations between affective states and suicidal ideation were stronger at higher levels of rumination. These interaction effects were not found when examining short-term prospective associations. CONCLUSIONS Affective states and rumination may each confer risk for suicidal ideation in the short term, and rumination may serve as a catalyst of the link between affective states and suicidal ideation when examined concurrently. Clinical implications, limitations, and future research directions are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Duffy ME, Buchman-Schmitt JM, McNulty JK, Joiner TE. Eyes Fixed on Heaven's Gate: An Empirical Examination of Blink Rate and Suicide. Arch Suicide Res 2022:1-9. [PMID: 35670415 DOI: 10.1080/13811118.2022.2083536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Anecdotal and theoretical work suggests blink rate as an indicator of imminent suicide risk. We sought to empirically examine whether suicide decedents displayed a reduced blink rate in goodbye videos filmed before death, compared to several control groups. Independent raters coded blink rates from videos of 34 suicide decedents and four comparison groups: "mundane" product review, non-suicidal arousal, non-suicidal depression, and non-imminent risk of suicidal ideation. Mean blink rate was lower in the suicide decedent group relative to all comparison groups (ps < .001), except the depressed (p = .976) and suicidal ideation (p = .393) groups. Findings indicate blink rate may be reduced among individuals at imminent risk for suicide, exhibiting clinically-significant depressive symptoms, or experiencing suicidal ideation.
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Keel PK, Kennedy GA, Rogers ML, Joyner KJ, Bodell LP, Forney KJ, Duffy ME. Reliability and validity of a transdiagnostic measure of reward valuation effort. Psychol Assess 2022; 34:419-430. [PMID: 35025580 PMCID: PMC10026017 DOI: 10.1037/pas0001107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To identify biobehavioral mechanisms underlying excessive reward consumption, reward valuation-effort (RV-E) assessments should (a) parallel measures in basic science to permit translation from preclinical to clinical studies; (b) quantify constructs dimensionally from healthy to disease states; and (c) hold relevance across different diagnostic categories. To address these aims, we developed a progressive ratio (PR) task whereby RV-E is measured as breakpoint when participants worked for access to playing a game. We evaluated test-retest reliability of breakpoint and convergent and discriminant validity of interpretations of this score against an established PR task for food. In Study 1, female undergraduates (N = 71; 33% racial minority; 28% ethnic minority) completed the game and food tasks in fasted and fed states. In Study 2, women (N = 189; 29% racial minority; 27% ethnic minority) with eating disorders (n = 158) were compared to controls (n = 31) on tasks. Game task breakpoint demonstrated excellent test-retest reliability, intraclass correlation coefficient (ICC) = .91, 95% CI [.80, -.96], over 2 weeks and convergent validity with the fasted food task (r = .51, p < .001). Consistent with animal models, breakpoint was lower in fed compared to fasted states across tasks, B (SE) = 321.01 (552.40), p < .001. Finally, the game task demonstrated discriminant validity from measurement of satiation. In Study 2, women with eating disorders demonstrated higher breakpoint on both tasks compared to controls, and game PR task breakpoint decreased from a fasted to fed state. The game PR task offers a novel approach for translating results from animal models of RV-E into testable hypotheses in nonclinical and clinical samples. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Pamela K. Keel
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32304, USA
- Denotes co-first authorship. Corresponding author: Pamela K. Keel, Ph.D., Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306. ; 850-645-9140
| | - Grace A. Kennedy
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32304, USA
- Walter Reed National Military Medical Center, 4494 Palmer Road N, Bethesda, MD 20814
- Denotes co-first authorship. Corresponding author: Pamela K. Keel, Ph.D., Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306. ; 850-645-9140
| | - Megan L. Rogers
- Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York NY, 10003, USA
| | - Keanan J. Joyner
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32304, USA
| | - Lindsay P. Bodell
- Department of Psychology, Western University, 361 Windermere Road, London, Ontario, Canada
| | - K. Jean Forney
- Department of Psychology, Ohio University; 22 Richland Ave, Athens, OH 45701, USA
| | - Mary E. Duffy
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32304, USA
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Daurio AM, Ennis CR, Duffy ME, Taylor J. A comparative study of suicidal and nonsuicidal self-injury characteristics in heterosexual versus sexual minority females. Psychiatry Res 2022; 309:114421. [PMID: 35121340 DOI: 10.1016/j.psychres.2022.114421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 01/23/2022] [Accepted: 01/26/2022] [Indexed: 11/29/2022]
Abstract
Sexual minorities are at heightened risk for nonsuicidal self-injury (NSSI), suicidal ideation and attempts. We tested whether sexual minority and heterosexual females differ on these characteristics. Sexual minority females (n = 45) had higher lifetime frequency of NSSI and higher thwarted belonginess compared to heterosexual females (n = 47). These specific factors may contribute to the higher rates of suicide attempts among sexual minorities than heterosexual individuals.
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Affiliation(s)
| | - Chelsea R Ennis
- Southeast Louisiana Veterans Health Care System (SLVHCS), Florida; South Central Mental Illness Research, Education and Clinical Center (MIRECC), Florida
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Mueller NE, Duffy ME, Stewart RA, Joiner TE, Cougle JR. Quality over quantity? The role of social contact frequency and closeness in suicidal ideation and attempt. J Affect Disord 2022; 298:248-255. [PMID: 34728279 DOI: 10.1016/j.jad.2021.10.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 09/23/2021] [Accepted: 10/23/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Social support has been identified as a protective factor against suicidal thoughts and behaviors. Research has not conclusively identified the component of social support most implicated in suicidal thoughts and behaviors: (1) frequency of social contact or (2) closeness of relationships. This study examined the relationships between these facets of social support and suicidal thoughts and behaviors in two nationally representative samples, as well as subsamples with social anxiety disorder (SAD). METHODS Study 1 variables for lifetime and past-year suicide ideation and attempt, social contact frequency, and closeness were calculated and examined within the National Comorbidity Survey-Replication (NCS-R). Study 2 examined the independent contributions of social contact frequency and closeness to only lifetime suicide attempt in the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). RESULTS In the NCS-R, lower social closeness but not contact frequency was uniquely associated with suicidal ideation and attempt in the general sample and those with SAD. In the NESARC-III, both components of social support were associated with lifetime suicide attempt in the general sample, while only social closeness was uniquely associated with suicide attempt in the SAD subsample. LIMITATIONS This study utilized cross-sectional data and was limited in the validity and specificity of the variables assessed. DISCUSSION Lower social closeness was more strongly associated with suicidality than social contact frequency and merits attention as a potential target for suicide-related interventions. Social closeness may be especially relevant in populations experiencing high rates of suicidal thoughts and behaviors and decreased social support.
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Affiliation(s)
- Nora E Mueller
- Department of Psychology, Florida State University, PO Box 3064301, Tallahassee, FL 32306, USA
| | - Mary E Duffy
- Department of Psychology, Florida State University, PO Box 3064301, Tallahassee, FL 32306, USA
| | - Rochelle A Stewart
- Department of Psychology, Florida State University, PO Box 3064301, Tallahassee, FL 32306, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, PO Box 3064301, Tallahassee, FL 32306, USA
| | - Jesse R Cougle
- Department of Psychology, Florida State University, PO Box 3064301, Tallahassee, FL 32306, USA.
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Cook B, Mascolo M, Bass G, Duffy ME, Zehring B, Beasley T. Has COVID-19 Complicated Eating Disorder Treatment? An Examination of Comorbidities and Treatment Response Before and During the COVID-19 Pandemic. Prim Care Companion CNS Disord 2022; 24. [PMID: 35052020 DOI: 10.4088/pcc.21m03087] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Objective: Recent evidence suggests psychosocial stressors stemming from coronavirus disease 2019 (COVID-19) exposure and public health recommendations and policies have exacerbated eating disorder symptoms. Consequentially, eating disorder acuity has increased during the COVID-19 pandemic. Currently, it is still unclear how the COVID-19 pandemic may be impacting individuals receiving treatment for eating disorders at higher levels of care. The purpose of this study was to examine the impact of COVID-19 on eating disorder symptoms and associated outcomes in a sample of individuals receiving eating disorder treatment compared to individuals receiving treatment in 2019. Methods: Blinded outcomes data from 272 adults who completed treatment at an eating disorder treatment center between April and October of 2019 (pre-COVID-19 group) and 2020 (COVID-19 group) were examined. Repeated measures analyses of variance with Bonferroni correction were used to examine differences in outcome variables and treatment response. Results: Fewer participants reported trauma in 2020, but symptoms were more severe when present. A significant interaction effect for treatment (eg, admission, discharge) and year (eg, pre-COVID-19, COVID-19) was found for eating disorder and trauma symptoms. Moreover, trauma symptom scores were higher in 2020 than in 2019. The interaction among year, trauma, and treatment was significant (F3,268 = 2.11, P = .027, η2 = 0.034), indicating that individuals with severe trauma in 2020 reported less eating disorder symptom score reduction. Conclusions: Results extend understanding of effects during the COVID-19 pandemic on treatment-seeking individuals with eating disorders. Clinical implications suggest that greater attention to trauma when screening eating disorder patients and selecting treatment approaches are needed, particularly during the COVID-19 pandemic.
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Affiliation(s)
- Brian Cook
- Clinical Department, Alsana, Thousand Oaks, California.,Corresponding author: Brian Cook, PhD, 2545 West Hillcrest Drive, Ste 205, Newbury Park, CA 91320
| | | | - Garrett Bass
- Clinical Department, Alsana, Thousand Oaks, California
| | - Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Brad Zehring
- Medical Department, Alsana, Thousand Oaks, California
| | - Tammy Beasley
- Clinical Department, Alsana, Thousand Oaks, California
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Joiner TE, Jeon ME, Lieberman A, Janakiraman R, Duffy ME, Gai AR, Dougherty SP. On prediction, refutation, and explanatory reach: A consideration of the Interpersonal Theory of Suicidal Behavior. Prev Med 2021; 152:106453. [PMID: 34538380 DOI: 10.1016/j.ypmed.2021.106453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/04/2021] [Accepted: 02/06/2021] [Indexed: 10/20/2022]
Abstract
Theory proposition, empirical evaluation, and resulting support or refutation are core pieces of the scientific process. These steps of theory-testing, however, can be complicated by relative rigidity and dogmatism, in combination with the logistical challenges inherent in conducting comprehensive, real-world tests of theories explicating complex scientific phenomena, especially rare ones. It may be argued that suicide is one such phenomenon, and one for which the field of psychology has struggled to develop satisfactory understanding. One leading theory of suicide, the Interpersonal Theory of Suicide, has garnered attention and, to a considerable degree, has weathered substantial scrutiny. Still, it is arguable that the theory has yet to be tested in full-that is, in accordance with all propositions originally put forth. In this effort, we sought to evaluate the current state of knowledge regarding the Interpersonal Theory of Suicide, as well as to suggest potential directions via which future work may proceed. We draw from the fields of philosophy, psychology, physics, and engineering in the hopes of engendering curiosity and critical thought about the assumptions researchers (ourselves included) bring to their work. We direct particular attention to the role of refutation in theory-testing; the supposed dichotomy of explanatory vs. algorithmic approaches; and the categorization of research programs as progressive vs. degenerative. In doing so, we hope not only to promote these ideas in the study of suicidal behavior but also to empiricists of all creeds and foci. We also include implications for suicide prevention efforts.
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Affiliation(s)
- Thomas E Joiner
- Department of Psychology, Florida State University, United States of America.
| | - Min Eun Jeon
- Department of Psychology, Florida State University, United States of America
| | - Amy Lieberman
- Department of Psychology, Florida State University, United States of America
| | - Roshni Janakiraman
- Department of Psychology, Florida State University, United States of America
| | - Mary E Duffy
- Department of Psychology, Florida State University, United States of America
| | - Anna R Gai
- Department of Psychology, Florida State University, United States of America
| | - Sean P Dougherty
- Department of Psychology, Florida State University, United States of America
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Duffy ME, Smith AR, Joiner TE. Interoceptive dysfunction indicates presence and severity of self-injurious behaviors in a clinically severe transdiagnostic sample. Psychiatry Res 2021; 305:114210. [PMID: 34571405 DOI: 10.1016/j.psychres.2021.114210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 08/03/2021] [Accepted: 09/12/2021] [Indexed: 11/20/2022]
Abstract
Interoceptive dysfunction (ID) is associated with self-injurious behaviors, as disconnection from the body is thought to enable bodily harm. This study tested differences in ID among those with and without history of self-injurious behaviors, as well as the relationship between ID and lethality of past suicide attempts. Adults (N = 344; 61.3% female; mean age 27.68) seeking psychological treatment completed self-report measures and clinical interviews during intake at a community-based clinic. Overall symptom severity was substantial (e.g., approximately 40% reported current suicidal ideation and two-thirds met a clinical cut-off score of ≥ 16 on the Beck Depression Inventory). Orthogonal contrasts were used to test whether mean levels of ID differed across lifetime self-injurious behavior groups. Attempt lethality was regressed on interoceptive dysfunction, covarying depressive symptom severity, age, and gender. Participants with suicide attempt history demonstrated greater ID than those without. Participants who had engaged in non-suicidal self-injury demonstrated greater ID than those with no history of self-injurious behaviors. Greater ID was associated with higher lethality of past suicide attempt, above demographic and clinical covariates. ID may have transdiagnostic relevance for risk assessment and management of self-injurious behaviors.
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Affiliation(s)
- Mary E Duffy
- Department of Psychology, Florida State University, 1107W. Call Street, Tallahassee, FL 32306, USA.
| | - April R Smith
- Department of Psychology, Auburn University, 226 Thatch Hall, Auburn, AL 36849, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, 1107W. Call Street, Tallahassee, FL 32306, USA
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10
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Rogers ML, Duffy ME, Dougherty SP, Joiner TE. Interoception, Pain Tolerance, and Self-Injurious Behaviors: A Multidimensional Assessment. Behav Ther 2021; 52:1055-1066. [PMID: 34452661 DOI: 10.1016/j.beth.2021.02.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 02/22/2021] [Accepted: 02/22/2021] [Indexed: 10/22/2022]
Abstract
Impairments in interoception have been linked to self-injurious behaviors, and capability for suicide may account for this relationship. However, past studies have relied primarily on self-report and unidimensional measures. The present study aimed to replicate and extend previous findings by examining the relationship between interoceptive dysfunction, pain tolerance, and self-injurious behaviors using a multidimensional and multi-method approach. A sample of 245 undergraduate students (Mage = 19.27 years, SD = 2.81; 73.7% female, 72.% White/European American), who reported lifetime suicidal ideation on a screening survey completed a battery of self-report measures, four counterbalanced pain tolerance tasks, and a clinical interview assessing their self-injurious behaviors. A tendency to stay attuned to bodily sensations was significantly related to decreased pain tolerance. Only trust in one's body was significantly related to decreased presence of lifetime suicide attempts. No other facets of interoception or pain tolerance were significantly associated with self-injurious behaviors. Overall, these findings contrast with previous findings that capability for suicide may account for relations between interoceptive dysfunction and self-injurious behaviors. Nonetheless, the results of this study provide important information on the factor structure of interoceptive dysfunction and pain tolerance, and highlight the importance of careful selection of measures and operationalization of key constructs, particularly interoceptive dysfunction and pain tolerance.
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Smith AR, Duffy ME, Joiner TE. Introduction to the Special Issue on Interoception and Suicidality. Behav Ther 2021; 52:1031-1034. [PMID: 34452659 DOI: 10.1016/j.beth.2021.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
Empirically informed theories of suicide highlight the importance of identifying factors that lead from suicide ideation to suicidal behavior. Interoceptive dysfunction may be one such differentiating factor. Interoceptive dysfunction refers to a disconnection from the internal sensations of the body, which can cause difficulty in truly understanding and knowing one's own body. Specifically, interoceptive dysfunction may lead to such disconnection from the self that the body comes to be seen as "other" and potentially even "nonhuman." A burgeoning body of research supports these theoretical links and also highlights the need for methodologically rigorous studies that employ careful measurement of these constructs. Thus, this special section is devoted to articles that advance the understanding of the relationship between interoception and suicidality. A more nuanced understanding of the relationship between interoceptive dysfunction and suicidality is critical for improving suicide prevention and treatment efforts.
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Duffy ME, Calzo JP, Lopez E, Silverstein S, Joiner TE, Gordon AR. Measurement and construct validity of the Eating Disorder Examination Questionnaire Short Form in a transgender and gender diverse community sample. Psychol Assess 2021; 33:459-463. [PMID: 33646808 PMCID: PMC8756775 DOI: 10.1037/pas0000996] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study evaluated the measurement and construct validity of the Eating Disorder Examination Questionnaire Short Form (EDE-QS) in a transgender and gender diverse sample. Participants who self-identified as transgender and gender diverse (N = 71) completed self-report measures of demographics, gender-related experiences, and disordered eating/body image. Analyses comprised evaluation of EDE-QS internal consistency, convergent validity, and specificity for disordered eating. The EDE-QS demonstrated strong internal consistency in the full sample, in participants with and without suspected eating disorders, and in each gender identity group; and correlated significantly with indices of disordered eating and body image. The full scale and each item significantly differentiated between participants with and without suspected eating disorders. This study provides initial evidence for good measurement and construct validity of the EDE-QS as applied to transgender and gender diverse individuals. Findings offer the EDE-QS as a promising, brief tool for screening and/or population-based research related to disordered eating in this high-risk, yet underserved population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Mary E. Duffy
- Florida State University, Tallahassee, FL, United States
| | - Jerel P. Calzo
- San Diego State University, San Diego, CA, United States
| | - Ethan Lopez
- Trans Folx Fighting Eating Disorders, San Diego, CA, United States
| | | | | | - Allegra R. Gordon
- Boston University School of Public Health, Boston, MA, United States
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
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Abstract
Capability for suicide is frequently assessed using the Acquired Capability for Suicide Scale (ACSS) or the Acquired Capability for Suicide Scale-Fearlessness About Death (ACSS-FAD); however, the measurement invariance of these self-report measures across relevant demographic groups has not been tested. The current study aimed to examine the measurement invariance of the ACSS and ACSS-FAD across (a) gender; (b) suicide attempt status; and (c) military deployment history in a sample of 2,551 participants (M = 28.92, SD = 10.73; 56.7% male, 68.5% White) who participated in one of several studies funded by the Military Suicide Research Consortium. Results indicated that the ACSS exhibited poor model fit; thus, further investigation of measurement invariance was not conducted. Furthermore, although partial measurement invariance of the ACSS-FAD was met for gender, scalar invariance was not supported across military deployment history, and no form of measurement invariance was met across suicide attempt status. Overall, given the lack of strong model fit and measurement invariance in the ACSS and ACSS-FAD across several demographic groups, new or modified self-report measures for capability for suicide may be warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Megan L Rogers
- Mount Sinai Beth Israel Hospital Department of Psychiatry, Icahn School of Medicine
| | - Brian W Bauer
- Department of Psychology, University of Southern Mississippi
| | - Anna R Gai
- Department of Psychology, Florida State University
| | - Mary E Duffy
- Department of Psychology, Florida State University
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14
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Lieberman A, Joiner TE, Duffy ME, Wonderlich SA, Crosby RD, Mitchell JE, Crow SJ, Peterson CB, Le Grange D, Bardone-Cone AM. An Examination of the Interpersonal Theory of Suicide's Tenets among Women with Bulimic-Spectrum Pathology. Psychiatry 2021; 84:137-149. [PMID: 33944699 DOI: 10.1080/00332747.2021.1917244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: Suicide attempts and self-injurious behaviors (SIBs) are known to be elevated among people with bulimia nervosa (BN). The aim of the current study was to examine the Interpersonal-Psychological Theory of Suicide (IPTS) as a framework for understanding, assessing, and mitigating suicidal behavior among women with BN. The IPTS suggests that for individuals to enact lethal suicide attempts, they must have both the desire to die (consisting of thwarted belongingness and perceived burdensomeness) as well as the capability to die (often acquired through repeated exposure to provocative or painful experiences).Method: Two-hundred and four women with eating disorders, the majority of whom met criteria for a current DSM-IV diagnosis of BN, completed measures from which proxies for IPTS variables were formed. Bivariate correlations and multiple regressions tested main effects and interactions of study variables. Tests of the difference between dependent correlations probed differential associations between study variables and suicidal ideation versus suicidal behavior.Results and Conclusions: Results yielded considerable but not unalloyed support for the theory, with desire to die variables (particularly perceived burdensomeness) more strongly associating with suicidal ideation than behavior, and the opposite holding true regarding capability. These findings suggest that the IPTS may provide a useful framework for understanding, assessing, and mitigating suicide risk among individuals with BN.
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15
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Duffy ME, Siegfried N, Bass G, Joiner TE. Presence and severity of suicidal thoughts and behaviors across the eating disorder diagnostic spectrum: A pilot study. J Clin Psychol 2020; 77:1045-1053. [PMID: 33296527 DOI: 10.1002/jclp.23095] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/13/2020] [Accepted: 11/23/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES There is a dearth of research on suicidal thoughts and behaviors among eating disorder patients diagnosed with binge eating disorder (BED) or other specified feeding or eating disorder (OSFED). This pilot study evaluated presence and severity of suicidal thoughts and behaviors by eating disorder diagnosis in a transdiagnostic clinical eating disorder sample. METHODS Participants were individuals (N = 257; 91.1% female; 94.6% Caucasian) currently receiving eating disorder treatment for anorexia nervosa (AN), bulimia nervosa (BN), BED, or OSFED. Participants completed online measures of variables. RESULTS Lifetime and current presence and severity of suicidal ideation and suicide attempts were statistically similar among diagnostic groups. CONCLUSION Though largely overlooked, treatment-utilizing individuals with BED and OSFED may experience elevated rates and severity of suicidal thoughts and behaviors, like those with AN and BN. Attention to suicide-related risk assessment and management is needed when treating individuals with eating disorders, regardless of diagnosis.
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Affiliation(s)
- Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | | | | | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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16
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Duffy ME, Rogers ML, Kennedy GA, Keel PK, Joiner TE. Examining the association between body trust and body mass index with quantile regression. Eat Weight Disord 2020; 25:1813-1819. [PMID: 31701379 DOI: 10.1007/s40519-019-00810-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE Schachter's externality theory posits a connection between the inability to eat according to internal cues and higher body mass index (BMI); however, related work has not investigated associations between body trust and the wide range of BMIs found in general samples. This study examined the association between body trust and BMI across levels of BMI to determine whether this relationship differed as a function of BMI level. METHODS Participants were 534 adults (55.4% female), mean age 36 years, BMIs 15.13-67.90 (M = 27.89, SD = 7.25), recruited via MTurk. They completed self-report assessments of body trust, height, and weight. Quantile regression was utilized to estimate effects of body trust on BMI at five equidistant quantiles of BMI. RESULTS Overall linear regression analyses indicated that body trust was significantly negatively associated with BMI. Quantile regression revealed a significant negative relationship at each quantile of BMI, and Wald tests indicated the association was significantly stronger at the 0.7 and 0.9 quantiles than at the 0.1, 0.3, and 0.5 quantiles, which did not differ. CONCLUSIONS Quantile regression identified a stronger relationship between body trust and BMI at 0.7 and 0.9 quantiles than at 0.1, 0.3, and 0.5 quantiles of BMI. Results align with the externality hypothesis, which suggests those at higher weights experience difficulty using internal cues to guide eating. A weaker-than-expected association between body trust and low BMI may be due to restricted range (few low-BMI participants). Replication in eating disorder samples is merited. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Mary E Duffy
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306-4301, USA.
| | - Megan L Rogers
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306-4301, USA
| | - Grace A Kennedy
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306-4301, USA
| | - Pamela K Keel
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306-4301, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306-4301, USA
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17
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Duffy ME, Lieberman A, Wonderlich SA, Crosby RD, Mitchell JE, Crow SJ, Peterson CB, Le Grange D, Bardone-Cone AM, Joiner TE. Identity problems and suicidal ideation severity among women with bulimic-spectrum pathology. Personal Disord 2020; 13:24-29. [PMID: 33211528 DOI: 10.1037/per0000466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Individuals with bulimia nervosa often experience suicidal ideation. Identity disturbance, or unstable sense of self, has been connected both to eating disorders and to suicidality. This study sought to test whether identity problems were related to severity of current suicidal ideation in a sample of women with bulimic-spectrum pathology, above and beyond history of suicidal behavior and several symptoms of borderline personality disorder. Women (N = 204; 90.7% Caucasian; Mage = 25.7 years [SD = 8.8]) with bulimic-spectrum pathology completed self-report personality assessments and items evaluating suicidality. A hierarchical linear regression was utilized to examine the association between identity problems and severity of current suicidal ideation, before and after inclusion of relevant clinical features (i.e., suicide attempt history [Step 2], affective lability, stimulus seeking, and rejection [Step 3]). Identity problems were directly associated with severity of current suicidal ideation (β = .481, p < .001). This relationship retained significance after inclusion of suicide attempt history (β = .335, p < .001) as well as borderline personality disorder symptoms (β = .324, p < .001). Identity problems displayed a robust relationship with suicidal ideation severity in women with bulimic-spectrum pathology. Findings suggest that identity problems may be a specifically relevant personality feature regarding presence and severity of suicidal ideation in this high-risk group, even after considering the contributions of history of suicidal behavior and various symptoms of borderline personality disorder. There may be value in attending to identity problems when considering suicidal ideation in this population. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Mary E Duffy
- Department of Psychology, Florida State University
| | | | | | | | | | - Scott J Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Neurosciences, University of California San Francisco School of Medicine
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18
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Duffy ME, Lieberman A, Siegfried N, Henretty JR, Bass G, Cox SA, Joiner TE. Body Trust, agitation, and suicidal ideation in a clinical eating disorder sample. Int J Eat Disord 2020; 53:1746-1750. [PMID: 33464582 DOI: 10.1002/eat.23352] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/26/2020] [Accepted: 06/27/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Research has established pairwise relationships between suicidal ideation (SI), low Body Trust, elevated agitation, and eating disorders, but knowledge of how these aspects relate in a single model is lacking. This study tested an indirect pathway with low Body Trust relating to severity of SI via agitation in a clinical eating disorder sample. METHOD Participants (N = 319; 92.8% female; 93.4% Caucasian; mean age 21.8 years) were adults currently receiving specialized eating disorder treatment (44.3% intensive outpatient or higher level-of-care) who completed online self-report measures of study variables. The PROCESS macro was utilized to test proposed pathways. RESULTS Low Body Trust was significantly directly associated with increased severity of current SI, both before (B = -.89, p < .001) and after (B = -.51, p = .001) accounting for the indirect effect through agitation, also significant (B = -.37, SE = .06, CI -.52 to -.26). DISCUSSION Perception of the body as unsafe may be related to agitation, and this intolerable sensation of trapped arousal could contribute to a desire to die. Future work should investigate these relationships prospectively to determine the relevance of Body Trust for assessment and treatment of suicide-related factors among individuals with eating disorders.
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Affiliation(s)
- Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Amy Lieberman
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | | | | | - Garrett Bass
- Alsana Treatment Centers, Birmingham, Alabama, USA
| | - Shelbi A Cox
- Center For Discovery, Los Alamitos, California, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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19
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Khan ZM, Real AM, Marsiglia WM, Chow A, Duffy ME, Yerabolu JR, Scopton AP, Dar AC. Structural basis for the action of the drug trametinib at KSR-bound MEK. Nature 2020; 588:509-514. [PMID: 32927473 PMCID: PMC7746607 DOI: 10.1038/s41586-020-2760-4] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 09/04/2020] [Indexed: 12/21/2022]
Abstract
The MAPK/ERK Kinase MEK is a shared effector of the frequent cancer drivers KRAS and BRAF that has long been pursued as a drug target in oncology1, and more recently in immunotherapy2,3 and aging4. However, many MEK inhibitors (MEKi) are limited due to on-target toxicities5–7 and drug resistance8–10. Accordingly, a molecular understanding of the structure and function of MEK within physiological complexes could provide a template for the design of safer and more effective therapies. Here we report X-ray crystal structures of MEK bound to the scaffold KSR (Kinase Suppressor of Ras) with various MEKi, including the clinical drug trametinib. The structures reveal an unexpected mode of binding in which trametinib directly engages KSR at the MEK interface. Through complexation, KSR remodels the prototypical MEKi allosteric pocket thereby impacting binding and kinetics, including drug residence time. Moreover, trametinib binds KSR-MEK but disrupts the related RAF-MEK complex through a mechanism that exploits evolutionarily conserved interface residues that distinguish these subcomplexes. Based on these insights we created trametiglue, which limits adaptive resistance to MEKi through enhanced interfacial binding. Together, our results reveal the plasticity of an interface pocket within MEK subcomplexes that has implications for the design of next generation drugs targeting the RAS pathway.
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Affiliation(s)
- Zaigham M Khan
- Department of Oncological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pharmacological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexander M Real
- Department of Oncological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pharmacological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - William M Marsiglia
- Department of Oncological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pharmacological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Arthur Chow
- Department of Oncological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pharmacological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mary E Duffy
- Department of Oncological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pharmacological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jayasudhan R Yerabolu
- Department of Oncological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pharmacological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alex P Scopton
- Department of Oncological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pharmacological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Arvin C Dar
- Department of Oncological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Department of Pharmacological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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20
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Smith AR, Forrest LN, Duffy ME, Jones PJ, Joiner TE, Pisetsky EM. Identifying bridge pathways between eating disorder symptoms and suicidal ideation across three samples. J Abnorm Psychol 2020; 129:724-736. [PMID: 32463262 DOI: 10.1037/abn0000553] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
People with eating disorders (ED) have elevated rates of suicidal thoughts and behaviors. We used network analysis to identify symptoms that bridge EDs and suicidality, as well as central symptoms within the network, among 3 groups of adults. Participants were either (a) clinical psychiatric outpatients without current EDs (n = 538), (b) clinical psychiatric outpatients with a lifetime suicide attempt (n = 166), or (c) people with current EDs (n = 238). Networks were jointly estimated among groups. Within the Suicide Attempt and ED groups, interoceptive deficits and pain tolerance emerged as important bridge symptoms, whereas feeling inadequate was an important bridge symptom in the Clinical Outpatient group. Within all groups, having thoughts of killing oneself and feeling inadequate were central, meaning that they were most strongly connected to all other symptoms in the networks. Further, results indicate that a similar problem-interoceptive impairment-may link ED symptoms and suicidality both within people with EDs and people with suicide attempts. Overall, these findings are consistent with the notion that EDs and suicidality may bidirectionally influence one another, possibly through shared mechanisms (e.g., interoceptive impairment) or direct pathways (e.g., suicidal ideation being strongly connected to ED symptoms), though prospective work is needed to test these possibilities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | - Mary E Duffy
- Department of Psychology, Florida State University
| | | | | | - Emily M Pisetsky
- Department of Psychology and Behavioral Sciences, University of Minnesota
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21
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Bauer BW, Gai AR, Duffy ME, Rogers ML, Khazem LR, Martin RL, Joiner TE, Capron DW. Fearlessness about death does not differ by suicide attempt method. J Psychiatr Res 2020; 124:42-49. [PMID: 32114031 DOI: 10.1016/j.jpsychires.2020.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/10/2020] [Accepted: 02/15/2020] [Indexed: 10/24/2022]
Abstract
Modern theories of suicide, such as the Interpersonal Theory of Suicide, have overcome past conceptual limitations within suicide research by examining factors that help differentiate suicide attempters from those who experience suicidal ideation, but never attempt suicide. One such factor that has been studied extensively is fearlessness about death. Given the varying levels of lethality for different methods used in suicide attempts, an important question is if different levels of fearlessness about death are needed for specific methods. The central aim of this study was to test whether various methods for suicide are associated with different levels of fearlessness about death in a large sample of suicide attempt survivors. Participants were 620 suicide attempt survivors from active military, veteran, and civilian populations. Suicide attempt status was confirmed by two independent raters coding qualitative accounts and participants indicating at least one past attempt with intent to die on other survey items. Results indicated that fearlessness about death does not differ by attempt method and that nearly all methods are statistically equivalent to one another. Despite several methods requiring significantly more time facing mortal fear and severe physical anguish (e.g., cutting, hanging/asphyxiation), as well as certain means being much more lethal (e.g., firearm), differences in ability to enact a suicide attempt with a particular method was not associated with fearlessness about death. This may further indicate the importance of clinicians focusing on practical capability aspects (e.g., means safety, access, comfort with method) with patients at an increased risk for suicide.
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Affiliation(s)
- Brian W Bauer
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA.
| | - Anna R Gai
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Megan L Rogers
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Lauren R Khazem
- Department of Psychology, University of Utah, Salt Lake City, UT, USA; National Center for Veterans Studies, Salt Lake City, UT, USA
| | - Rachel L Martin
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Daniel W Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
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22
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Duffy ME, Mueller NE, Cougle JR, Joiner TE. Perceived burdensomeness uniquely accounts for suicidal ideation severity in social anxiety disorder. J Affect Disord 2020; 266:43-48. [PMID: 32056911 DOI: 10.1016/j.jad.2020.01.116] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 12/18/2019] [Accepted: 01/20/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND High rates of suicidal ideation in those with social anxiety disorder (SAD) have been attributed to feelings of thwarted belongingness and perceived burdensomeness, but most work has been in non-clinical samples. We assessed the contributions of thwarted belongingness and perceived burdensomeness to suicidal ideation severity, over clinical covariates, in individuals diagnosed with SAD. METHODS Participants were 58 adult outpatients (mean age 25.62 years, 69% female) with SAD. Hierarchical linear regression assessed contributions of thwarted belongingness and perceived burdensomeness to suicidal ideation, before and after covarying other potential explanatory variables (depression, agitation, brooding rumination). RESULTS Perceived burdensomeness was significantly positively related to suicidal ideation severity (p < .001) above thwarted belongingness, which was not incremental (p = .791). The same pattern was found after inclusion of additional covariates (perceived burdensomeness p = .006; thwarted belongingness p = .757). Greater agitation also uniquely accounted for more severe suicidal ideation (p = .001). LIMITATIONS This study was cross-sectional, did not assess all potential confounding variables, and utilized a treatment-seeking sample. CONCLUSIONS Results suggest perceived burdensomeness is independently related to suicidal ideation severity in SAD, over thwarted belongingness and other clinical features. Future work should seek to replicate these findings and evaluate causal, longitudinal relationships among perceived burdensomeness, agitation, and severity of suicidal ideation in those with SAD in order to determine whether these may be clinically-relevant mechanisms.
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Affiliation(s)
- Mary E Duffy
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306, USA.
| | - Nora E Mueller
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306, USA
| | - Jesse R Cougle
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306, USA
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23
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Abstract
Research has linked agitation and low body trust to suicidal thoughts and behaviors. We investigated a pathway with agitation accounting for the relationship between body trust and suicidality. 511 individuals recruited via MTurk (Study 1) and 167 undergraduate students (62.9% with suicide attempt history) (Study 2) completed measures of study variables. For ideation, the proposed pathway was significant across samples, as was a pathway with agitation predicting and body trust mediating. In Study 1, agitation explained the relationship between body trust and attempt history. In Study 2, neither independent variable was related to attempt history. Results suggest body trust is independently associated with suicidal ideation. Results were discrepant regarding suicide attempt history, necessitating future studies.
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Affiliation(s)
- Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Megan L Rogers
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Austin J Gallyer
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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24
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Hom MA, Duffy ME, Rogers ML, Hanson JE, Gutierrez PM, Joiner TE. Examining the link between prior suicidality and subsequent suicidal ideation among high-risk US military service members. Psychol Med 2019; 49:2237-2246. [PMID: 30355371 DOI: 10.1017/s0033291718003124] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Research is needed to identify the factors that explain the link between prior and future suicidality. This study evaluated possible mediators of the relationship between: (1) the severity of prior suicidality and (2) suicidal ideation severity at 3-month follow-up among a sample of high-risk military personnel. METHODS US military service members referred to or seeking care for suicide risk (N = 624) completed self-report psychiatric domain measures and a clinician interview assessing prior suicidality severity at baseline. Three months later, participants completed a self-report measure of suicidal ideation severity. Three separate percentile bootstrap mediation models were used to examine psychiatric factors (i.e. alcohol abuse, anxiety sensitivity, hopelessness, insomnia, posttraumatic stress symptoms, suicidal ideation, and thwarted belongingness) as parallel mediators of the relationship between prior suicidality severity (specifically, suicidal ideation, suicide attempt, and overall suicidality - i.e. ideation/attempt severity combined) at baseline and suicidal ideation severity at follow-up. RESULTS Hopelessness, specifically, and the total effect of all mediators, each significantly accounted for the relationship between prior suicidality severity and subsequent ideation severity across models. In the models with attempt severity and overall suicidality severity as predictors, thwarted belongingness was also a significant mediator. CONCLUSIONS Hopelessness, thwarted belongingness, and overall severity of psychiatric indices may explain the relationship between prior suicidality severity and future suicidal ideation severity among service members at elevated suicide risk. Research is needed to replicate these findings and examine other possible mediators.
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Affiliation(s)
- Melanie A Hom
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Megan L Rogers
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Jetta E Hanson
- Rocky Mountain Mental Illness Research, Education and Clinical Center, Aurora, CO, USA
| | - Peter M Gutierrez
- Rocky Mountain Mental Illness Research, Education and Clinical Center, Aurora, CO, USA
- Denver Veterans Affairs Medical Center, Aurora, CO, USA
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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25
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Yu JX, Craig AJ, Duffy ME, Villacorta-Martin C, Miguela V, Ruiz de Galarreta M, Scopton AP, Silber L, Maldonado AY, Rialdi A, Guccione E, Lujambio A, Villanueva A, Dar AC. Phenotype-Based Screens with Conformation-Specific Inhibitors Reveal p38 Gamma and Delta as Targets for HCC Polypharmacology. Mol Cancer Ther 2019; 18:1506-1519. [PMID: 31213506 PMCID: PMC7017390 DOI: 10.1158/1535-7163.mct-18-0571] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 03/14/2019] [Accepted: 06/12/2019] [Indexed: 12/24/2022]
Abstract
The approved kinase inhibitors for hepatocellular carcinoma (HCC) are not matched to specific mutations within tumors. This has presented a daunting challenge; without a clear target or mechanism, no straightforward path has existed to guide the development of improved therapies for HCC. Here, we combine phenotypic screens with a class of conformation-specific kinase inhibitors termed type II to identify a multikinase inhibitor, AD80, with antitumoral activity across a variety of HCC preclinical models, including mouse xenografts. Mass spectrometry profiling found a number of kinases as putative targets for AD80, including several receptor and cytoplasmic protein kinases. Among these, we found p38 gamma and delta as direct targets of AD80. Notably, a closely related analog of AD80 lacking p38δ/γ activity, but retaining several other off-target kinases, lost significant activity in several HCC models. Moreover, forced and sustained MKK6 → p38→ATF2 signaling led to a significant reduction of AD80 activity within HCC cell lines. Together with HCC survival data in The Cancer Genome Atlas and RNA-seq analysis, we suggest p38 delta and gamma as therapeutic targets in HCC and an "AD80 inhibition signature" as identifying those patients with best clinical outcomes.
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Affiliation(s)
- Jia Xin Yu
- Department of Oncological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Pharmacological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
- Graduate School of Biomedical Sciences at Icahn School of Medicine at Mount Sinai, New York, New York
| | - Amanda J Craig
- Graduate School of Biomedical Sciences at Icahn School of Medicine at Mount Sinai, New York, New York
- Liver Cancer Program, Division of Liver Diseases, Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mary E Duffy
- Department of Oncological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Pharmacological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
- Graduate School of Biomedical Sciences at Icahn School of Medicine at Mount Sinai, New York, New York
| | - Carlos Villacorta-Martin
- Liver Cancer Program, Division of Liver Diseases, Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Verónica Miguela
- Department of Oncological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
- Liver Cancer Program, Division of Liver Diseases, Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Precision Immunology Institute at Icahn School of Medicine at Mount Sinai, New York, New York
| | - Marina Ruiz de Galarreta
- Department of Oncological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
- Liver Cancer Program, Division of Liver Diseases, Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Precision Immunology Institute at Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alexander P Scopton
- Department of Oncological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Pharmacological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lisa Silber
- Department of Oncological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Pharmacological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
| | - Andres Y Maldonado
- Department of Oncological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Pharmacological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alexander Rialdi
- Department of Oncological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
- Graduate School of Biomedical Sciences at Icahn School of Medicine at Mount Sinai, New York, New York
- Liver Cancer Program, Division of Liver Diseases, Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ernesto Guccione
- Department of Oncological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
- Graduate School of Biomedical Sciences at Icahn School of Medicine at Mount Sinai, New York, New York
- Liver Cancer Program, Division of Liver Diseases, Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Amaia Lujambio
- Department of Oncological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York.
- Graduate School of Biomedical Sciences at Icahn School of Medicine at Mount Sinai, New York, New York
- Liver Cancer Program, Division of Liver Diseases, Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Precision Immunology Institute at Icahn School of Medicine at Mount Sinai, New York, New York
| | - Augusto Villanueva
- Graduate School of Biomedical Sciences at Icahn School of Medicine at Mount Sinai, New York, New York.
- Liver Cancer Program, Division of Liver Diseases, Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Division of Hematology and Medical Oncology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Arvin C Dar
- Department of Oncological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York.
- Department of Pharmacological Sciences, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, New York
- Graduate School of Biomedical Sciences at Icahn School of Medicine at Mount Sinai, New York, New York
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26
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Clarke DJB, Kuleshov MV, Schilder BM, Torre D, Duffy ME, Keenan AB, Lachmann A, Feldmann AS, Gundersen GW, Silverstein MC, Wang Z, Ma'ayan A. eXpression2Kinases (X2K) Web: linking expression signatures to upstream cell signaling networks. Nucleic Acids Res 2019; 46:W171-W179. [PMID: 29800326 PMCID: PMC6030863 DOI: 10.1093/nar/gky458] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/14/2018] [Indexed: 11/13/2022] Open
Abstract
While gene expression data at the mRNA level can be globally and accurately measured, profiling the activity of cell signaling pathways is currently much more difficult. eXpression2Kinases (X2K) computationally predicts involvement of upstream cell signaling pathways, given a signature of differentially expressed genes. X2K first computes enrichment for transcription factors likely to regulate the expression of the differentially expressed genes. The next step of X2K connects these enriched transcription factors through known protein–protein interactions (PPIs) to construct a subnetwork. The final step performs kinase enrichment analysis on the members of the subnetwork. X2K Web is a new implementation of the original eXpression2Kinases algorithm with important enhancements. X2K Web includes many new transcription factor and kinase libraries, and PPI networks. For demonstration, thousands of gene expression signatures induced by kinase inhibitors, applied to six breast cancer cell lines, are provided for fetching directly into X2K Web. The results are displayed as interactive downloadable vector graphic network images and bar graphs. Benchmarking various settings via random permutations enabled the identification of an optimal set of parameters to be used as the default settings in X2K Web. X2K Web is freely available from http://X2K.cloud.
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Affiliation(s)
- Daniel J B Clarke
- DBD2K-LINCS Data Coordination and Integration Center; Knowledge Management Center for the Illuminating the Druggable Genome; Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1603, New York, NY 10029, USA
| | - Maxim V Kuleshov
- DBD2K-LINCS Data Coordination and Integration Center; Knowledge Management Center for the Illuminating the Druggable Genome; Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1603, New York, NY 10029, USA
| | - Brian M Schilder
- DBD2K-LINCS Data Coordination and Integration Center; Knowledge Management Center for the Illuminating the Druggable Genome; Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1603, New York, NY 10029, USA
| | - Denis Torre
- DBD2K-LINCS Data Coordination and Integration Center; Knowledge Management Center for the Illuminating the Druggable Genome; Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1603, New York, NY 10029, USA
| | - Mary E Duffy
- DBD2K-LINCS Data Coordination and Integration Center; Knowledge Management Center for the Illuminating the Druggable Genome; Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1603, New York, NY 10029, USA
| | - Alexandra B Keenan
- DBD2K-LINCS Data Coordination and Integration Center; Knowledge Management Center for the Illuminating the Druggable Genome; Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1603, New York, NY 10029, USA
| | - Alexander Lachmann
- DBD2K-LINCS Data Coordination and Integration Center; Knowledge Management Center for the Illuminating the Druggable Genome; Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1603, New York, NY 10029, USA
| | - Axel S Feldmann
- DBD2K-LINCS Data Coordination and Integration Center; Knowledge Management Center for the Illuminating the Druggable Genome; Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1603, New York, NY 10029, USA
| | - Gregory W Gundersen
- DBD2K-LINCS Data Coordination and Integration Center; Knowledge Management Center for the Illuminating the Druggable Genome; Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1603, New York, NY 10029, USA
| | - Moshe C Silverstein
- DBD2K-LINCS Data Coordination and Integration Center; Knowledge Management Center for the Illuminating the Druggable Genome; Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1603, New York, NY 10029, USA
| | - Zichen Wang
- DBD2K-LINCS Data Coordination and Integration Center; Knowledge Management Center for the Illuminating the Druggable Genome; Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1603, New York, NY 10029, USA
| | - Avi Ma'ayan
- DBD2K-LINCS Data Coordination and Integration Center; Knowledge Management Center for the Illuminating the Druggable Genome; Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1603, New York, NY 10029, USA
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27
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Duffy ME, Gai AR, Rogers ML, Joiner TE, Luby JL, Joshi PT, Wagner KD, Emslie GJ, Walkup JT, Axelson D. Psychotic symptoms and suicidal ideation in child and adolescent bipolar I disorder. Bipolar Disord 2019; 21:342-349. [PMID: 31025487 PMCID: PMC6597286 DOI: 10.1111/bdi.12789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The purpose of this study was to explore associations between specific types of hallucinations and delusions and suicidal ideation in a sample of children and adolescents with bipolar I disorder. METHODS Participants (N = 379) were children and adolescents aged 6-15 years (M = 10.2, SD = 2.7) with DSM-IV diagnoses of bipolar I disorder, mixed or manic phase. The study sample was 53.8% female and primarily White (73.6% White, 17.9% Black, and 8.5% Other). Presence and nature of psychotic symptoms, suicidal ideation, and functioning level were assessed through clinician-administered measures. A series of logistic regressions was performed to assess the contribution of each subtype of psychotic symptom to the presence of suicidal ideation above and beyond age, sex, socio-economic status, age at bipolar disorder onset, and global level of functioning. RESULTS Hallucinations overall, delusions of guilt, and number of different psychotic symptom types were uniquely associated with increased odds of suicidal ideation after accounting for covariates. Other forms of delusions (eg, grandiose) and specific types of hallucinations (eg, auditory) were not significantly uniquely associated with the presence of suicidal ideation. CONCLUSIONS Findings of this study suggest the presence of hallucinations as a whole, delusions of guilt specifically, and having multiple concurrent types of psychotic symptoms are associated with the presence of suicidal ideation in children and adolescents with bipolar I disorder. Psychotic symptom subtypes, as opposed to psychosis as a whole, are an under-examined, potentially important, area for consideration regarding suicidal ideation in pediatric bipolar I disorder.
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Affiliation(s)
- Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Anna R Gai
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Megan L Rogers
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Paramjit T Joshi
- Department of Psychiatry, University of California, Irvine, California
| | - Karen D Wagner
- Department of Psychiatry, University of Texas Medical Branch, Galveston, Texas
| | - Graham J Emslie
- Division of Child and Adolescent Psychiatry, Children's Medical Center, Dallas, Texas
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - John T Walkup
- Department of Psychiatry, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - David Axelson
- Nationwide Children's Hospital Research Institute, The Ohio State University College of Medicine, Columbus, Ohio
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28
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Hom MA, Stanley IH, Duffy ME, Rogers ML, Hanson JE, Gutierrez PM, Joiner TE. Investigating the reliability of suicide attempt history reporting across five measures: A study of US military service members at risk of suicide. J Clin Psychol 2019; 75:1332-1349. [PMID: 30990892 DOI: 10.1002/jclp.22776] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/21/2019] [Accepted: 03/11/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Utilizing a sample of military service members at risk of suicide, this study aimed to: (a) identify patterns of suicide attempt (SA) history reporting across five measures and (b) evaluate whether consistent SA reporters (i.e., individuals who consistently report an SA history across measures) differ from inconsistent SA reporters on other clinical severity indices. METHOD Participants (N = 984) completed five validated SA history measures and self-report psychiatric symptom measures. RESULTS Of the sample, 35.4% inconsistently responded to SA history measures. Inconsistent reporters disclosed more severe suicide threat histories than consistent reporters. On all other clinical severity indices, inconsistent reporters evinced either less severe or comparable symptom levels. CONCLUSIONS A nontrivial portion of service members may respond inconsistently to different assessments of SA history. Research is needed to identify factors that account for inconsistent SA history reporting and to improve the accuracy of SA history assessments among military personnel.
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Affiliation(s)
- Melanie A Hom
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Ian H Stanley
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Megan L Rogers
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Jetta E Hanson
- U.S. Department of Veterans Affairs, Rocky Mountain Mental Illness Research, Education and Clinical Center, Aurora, Colorado
| | - Peter M Gutierrez
- U.S. Department of Veterans Affairs, Rocky Mountain Mental Illness Research, Education and Clinical Center, Aurora, Colorado.,Denver Veterans Affairs Medical Center and Department of Psychiatry, University of Colorado School of Medicine, Denver, Colorado
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida
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29
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Duffy ME, Henkel KE, Joiner TE. Prevalence of Self-Injurious Thoughts and Behaviors in Transgender Individuals With Eating Disorders: A National Study. J Adolesc Health 2019; 64:461-466. [PMID: 30314865 DOI: 10.1016/j.jadohealth.2018.07.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/18/2018] [Accepted: 07/18/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE This study examined prevalence of self-injurious thoughts and behaviors (SITBs) in transgender individuals with eating disorders, as compared to cisgender individuals with eating disorders and transgender individuals without eating disorders. METHODS Data were analyzed from 365,749 individuals (median age 21 years, 71.8% White/Caucasian, 34.9% male, 64.9% female, and 0.2% transgender) who participated in American College Health Association-National College Health Assessment, an annual national assessment of college student health, from 2008 to 2011. RESULTS Rates of past-year nonsuicidal self-injury, suicidal ideation, and suicide attempts were elevated in transgender participants with eating disorders (74.8%, 75.2%, and 74.8%, respectively), as compared to cisgender participants with eating disorders and transgender participants without eating disorders. Follow-up logistic regression analyses indicated these differences were statistically significant above and beyond the effects of demographic variables and depression. CONCLUSIONS Results found extremely high rates of SITBs in transgender individuals with eating disorders. This combination of identities, each associated with SITBs, may have a compounding effect.
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Affiliation(s)
- Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, Florida; Department of Psychology, University of Saint Joseph, West Hartford, Connecticut.
| | - Kristin E Henkel
- Department of Psychology, University of Saint Joseph, West Hartford, Connecticut
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida
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30
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Twenge JM, Cooper AB, Joiner TE, Duffy ME, Binau SG. Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005-2017. J Abnorm Psychol 2019; 128:185-199. [PMID: 30869927 DOI: 10.1037/abn0000410] [Citation(s) in RCA: 526] [Impact Index Per Article: 105.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Drawing from the National Survey on Drug Use and Health (NSDUH; N = 611,880), a nationally representative survey of U.S. adolescents and adults, we assess age, period, and cohort trends in mood disorders and suicide-related outcomes since the mid-2000s. Rates of major depressive episode in the last year increased 52% 2005-2017 (from 8.7% to 13.2%) among adolescents aged 12 to 17 and 63% 2009-2017 (from 8.1% to 13.2%) among young adults 18-25. Serious psychological distress in the last month and suicide-related outcomes (suicidal ideation, plans, attempts, and deaths by suicide) in the last year also increased among young adults 18-25 from 2008-2017 (with a 71% increase in serious psychological distress), with less consistent and weaker increases among adults ages 26 and over. Hierarchical linear modeling analyses separating the effects of age, period, and birth cohort suggest the trends among adults are primarily due to cohort, with a steady rise in mood disorder and suicide-related outcomes between cohorts born from the early 1980s (Millennials) to the late 1990s (iGen). Cultural trends contributing to an increase in mood disorders and suicidal thoughts and behaviors since the mid-2000s, including the rise of electronic communication and digital media and declines in sleep duration, may have had a larger impact on younger people, creating a cohort effect. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Jean M Twenge
- Department of Psychology, San Diego State University
| | | | | | - Mary E Duffy
- Department of Psychology, Florida State University
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31
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Duffy ME, Rogers ML, Joiner TE, Bergen AW, Berrettini W, Bulik CM, Brandt H, Crawford S, Crow S, Fichter M, Halmi K, Kaplan AS, Klump KL, Lilenfeld L, Magistretti PJ, Mitchell J, Schork NJ, Strober M, Thornton LM, Treasure J, Woodside B, Kaye WH, Keel PK. An investigation of indirect effects of personality features on anorexia nervosa severity through interoceptive dysfunction in individuals with lifetime anorexia nervosa diagnoses. Int J Eat Disord 2019; 52:200-205. [PMID: 30636025 DOI: 10.1002/eat.23008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 12/08/2018] [Accepted: 12/09/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study examined a hypothesized pathway by which interoceptive dysfunction accounted for associations between personality features (harm avoidance, self-directedness, and perfectionism) and anorexia nervosa (AN) severity (indicated by drive for thinness, eating disorder-related preoccupations and rituals, and body mass index). METHOD The study sample (n = 270, mean age = 28.47, 95.2% female, 98% White/Caucasian) consisted of probands and biological relatives who met DSM-IV criteria for lifetime diagnoses of AN (omitting criterion D, amenorrhea) drawn from the Price Foundation Anorexia Nervosa Affected Relative Pairs Study (AN-ARP). Participants completed measures assessing personality, interoceptive dysfunction, and eating pathology. RESULTS Associations between personality features of low self-directedness and high perfectionism and indicators of AN severity (drive for thinness and eating disorder-related preoccupations and rituals) were significant, as were the hypothesized indirect pathways through interoceptive dysfunction. Neither harm avoidance nor body mass index was significantly related to other study variables, and the proposed indirect pathways involving these variables were not significant. DISCUSSION Findings suggest that certain personality features may relate to AN severity, in part, through their associations with interoceptive dysfunction. Future research should examine prospective associations and the value of interventions targeting interoceptive dysfunction for interrupting the link between personality and AN severity.
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Affiliation(s)
- Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Megan L Rogers
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Andrew W Bergen
- BioRealm, LLC, Walnut, California.,Oregon Research Institute, Eugene, Oregon
| | - Wade Berrettini
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Scott Crow
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota.,The Emily Program, St. Paul, Minnesota
| | - Manfred Fichter
- Roseneck Hospital for Behavioral Medicine, affiliated with the University of Munich (LMU), Germany
| | - Katherine Halmi
- New York Presbyterian Hospital-Westchester Division, Weill Medical College of Cornell University, White Plains, New York
| | - Allan S Kaplan
- Centre for Addiction and Mental Health, Department of Psychiatry, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, Michigan
| | - Lisa Lilenfeld
- Department of Psychology, American School of Professional Psychology at Argosy University, Arlington, Virginia
| | - Pierre J Magistretti
- Department of Psychiatry, CHUY/University of Lausenne, Switzerland.,Brain Mind Institute, Switzerland
| | - James Mitchell
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Nicholas J Schork
- Department of Quantitative Medicine, The Translational Genomics Research Institute, Phoenix, Arizona.,Human Biology, The J. Craig Venter Institute, La Jolla, California
| | - Michael Strober
- Department of Psychiatry, University of California Los Angeles, Los Angeles, California
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Blake Woodside
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Program for Eating Disorders, Toronto General Hospital, Toronto, Ontario, Canada
| | - Walter H Kaye
- Department of Psychiatry, University of California at San Diego, San Diego, California
| | - Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, Florida
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32
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Hom MA, Stanley IH, Duffy ME, Davis L, Joiner TE. Examining the Relationship Between Attitudes Toward Suicide and Suicide Attempt History. Crisis 2018; 40:265-272. [PMID: 30474408 DOI: 10.1027/0227-5910/a000564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Relatively little is known regarding the relationship between attitudes toward suicide, suicide attempt (SA) history, and future suicidal behaviors. Aims: Utilizing a sample of firefighters, this study compared attitudes toward suicide between individuals with/without a career SA history and evaluated whether certain attitudes toward suicide are associated with a greater self-reported likelihood of making a future SA. Method: US firefighters (N = 818) completed self-report measures. One-way ANOVAs and linear regression analyses were utilized to address study aims. Results: Firefighters with a career SA reported significantly greater normalization/glorification of suicide - yet lower attributions of suicide to isolation/depression - than those without this history. More stigmatizing attitudes toward suicide and greater normalization/glorification of suicide were each significantly associated with greater self-reported future SA likelihood. Limitations: Data were cross-sectional and findings may not be generalizable. Conclusion: Firefighters who have made an SA during their firefighting careers may normalize and glorify suicide more than those who have not. These attitudes may be associated with greater self-perceived risk for future SAs. Research is needed to replicate findings and evaluate strategies for targeting potentially harmful beliefs about suicide among SA survivors.
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Affiliation(s)
- Melanie A Hom
- 1 Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Ian H Stanley
- 1 Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Mary E Duffy
- 1 Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Lisa Davis
- 2 Didi Hirsch Mental Health Services, Culver City, CA, USA
| | - Thomas E Joiner
- 1 Department of Psychology, Florida State University, Tallahassee, FL, USA
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33
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Rogers ML, Duffy ME, Buchman-Schmitt JM, Datoc AE, Joiner TE. Exercise dependence: Associations with capability for suicide and past suicidal behavior. J Clin Psychol 2018; 75:165-177. [PMID: 30368806 DOI: 10.1002/jclp.22696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 06/11/2018] [Accepted: 07/21/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Exercise dependence has been linked to capability for suicide and suicidal behavior; however, less understood are which facets of exercise dependence confer risk for suicidal behavior and the potential mechanisms of this association. This study examined relationships between exercise dependence, capability for suicide, and past suicidal behavior. METHODS A sample of 540 individuals recruited via MTurk completed online measures of their exercise dependence, capability for suicide, and history of suicidal behavior. RESULTS Suicide attempters reported higher levels of continuance in exercise despite physical or psychological consequences, lack of control over exercise, and reductions in other activities due to exercise than nonattempters. Capability for suicide accounted for the relationship between continuance in exercise despite adverse consequences and lifetime number of suicide attempts. CONCLUSIONS When exercise becomes pathological in the form of exercise dependence, steps should be taken to reduce such engagement due to its observed association with suicidal behavior.
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Affiliation(s)
- Megan L Rogers
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, Florida
| | | | - Alison E Datoc
- Department of Psychology, Nova Southeastern University, Fort Lauderdale, Florida
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida
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34
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Gallyer AJ, Dougherty SP, Gai AR, Stanley IH, Hom MA, Rogers ML, Duffy ME, Buchman-Schmitt JM, Spencer-Thomas S, Joiner TE. Problematic alcohol use and suicidal ideation among firefighters: A multi-study investigation of the explanatory roles of perceived burdensomeness and thwarted belongingness. J Affect Disord 2018; 238:281-288. [PMID: 29898427 DOI: 10.1016/j.jad.2018.05.045] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 04/18/2018] [Accepted: 05/27/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Firefighters are at increased risk for both problematic alcohol use and suicidality. Research has found that problematic alcohol use is related to suicidality among this population; however, limited data exist regarding what might account for this association. The present two-study investigation (1) examined the association between suicidality and problematic alcohol use among two large samples of firefighters and (2) tested whether interpersonal theory of suicide constructs-perceived burdensomeness (PB) and thwarted belongingness (TB)-serve as indirect indicators of this relationship. METHODS Participants in Study 1 were 944 U.S. firefighters (12.5% female); participants in Study 2 were 241 U.S. women firefighters. Participants completed the Interpersonal Needs Questionnaire, Alcohol Use Disorders Identification Test, and the Depressive Symptom Inventory-Suicidality Subscale (Study 1) or the Self-Injurious Thoughts and Behaviors Interview-Short Form (Study 2). Bias-corrected bootstrap indirect effects path analyses were utilized. RESULTS In Study 1, more problematic alcohol use was significantly associated with more severe career suicidal ideation via PB but not TB. In Study 2, problematic alcohol use was associated with career suicidal ideation via both PB and TB. PB seems to account for the relationship between problematic alcohol use and career suicidal ideation among male and female firefighters. LIMITATIONS Limitations include use of a cross-sectional design, use of retrospective measures of suicidal ideation, and our findings derived from subsamples of two existing datasets. CONCLUSIONS Findings suggest that PB and TB may explain the relationship between problematic alcohol use and suicidal ideation, but that this effect is discrepant based on gender.
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Affiliation(s)
- Austin J Gallyer
- Department of Psychology, Florida State University, Tallahassee, FL, United States.
| | - Sean P Dougherty
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Anna R Gai
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Ian H Stanley
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Melanie A Hom
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Megan L Rogers
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | | | | | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, FL, United States
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Duffy ME, Rogers ML, Joiner TE. Body trust as a moderator of the association between exercise dependence and suicidality. Compr Psychiatry 2018; 85:30-35. [PMID: 29957375 DOI: 10.1016/j.comppsych.2018.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 05/31/2018] [Accepted: 06/13/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Exercise dependence and interoceptive deficits, particularly low body trust, have been associated with suicidality. This study tested whether low body trust predicted current suicidal ideation and past suicide attempts in individuals exhibiting symptoms of exercise dependence. METHODS 540 individuals (55.6% female, mean age 36) recruited via MTurk completed online measures of exercise dependence, interoception, and history of suicidal ideation and attempts. RESULTS Exercise dependence symptoms and low body trust were associated with suicidal ideation. Body trust moderated the relationship between exercise dependence symptoms and suicidal ideation. Continuance in exercise despite adverse consequences and low body trust were associated with past suicide attempts. CONCLUSIONS Body trust was associated with suicidal ideation and suicide attempts in individuals with exercise dependence symptoms, and the associations strengthened as body trust decreased. The experience of not trusting one's own body may exacerbate suicide risk in at-risk individuals.
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Affiliation(s)
- Mary E Duffy
- Department of Psychology, Florida State University, United States of America.
| | - Megan L Rogers
- Department of Psychology, Florida State University, United States of America
| | - Thomas E Joiner
- Department of Psychology, Florida State University, United States of America
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Ward MJ, Dowling GA, Duffy ME, Imle MA. Methods/Instrument Testing. West J Nurs Res 2016. [DOI: 10.1177/019394598400600317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mary Jane Ward
- School of Nursing, University of Colorado, Denver, Colorado
| | - Glenna A. Dowling
- School of Nursing, Office of Research Development and Utilization, Oregon Health Sciences University Portland, Oregon
| | | | - Margaret A. Imle
- Department of Family Nursing, The Oregon Health Sciences University, Portland, Oregon
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Duffy ME, Henkel KE, Earnshaw VA. Transgender Clients’ Experiences of Eating Disorder Treatment. Journal of LGBT Issues in Counseling 2016; 10:136-149. [DOI: 10.1080/15538605.2016.1177806] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
This study examined the effect of a short-term passive intervention on nursing students' beliefs about eating disorders (EDs). Before and after a weeklong ED education poster campaign, participants completed questionnaires assessing their attitudes about individuals with EDs. Results showed a reduction in the belief that people with EDs are almost always women, increased attribution to biological and genetic factors, and decreased attribution to society's thin ideal. Personal connection moderated response to the items: [people with EDs] "are putting their lives at risk" and "would not improve with treatment." This intervention shows promise for reducing ED-associated stereotype endorsement among medical professionals.
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Affiliation(s)
- Mary E Duffy
- a Department of Psychology , University of Saint Joseph , West Hartford , Connecticut , USA
| | - Kristin E Henkel
- a Department of Psychology , University of Saint Joseph , West Hartford , Connecticut , USA
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Abstract
To examine the effects of terminology on affect, 110 women with eating disorders were randomly assigned to read a manufactured discussion thread with uses of the term "acting out," a thread with clinical terms, or were assigned to a no-reading control. An interaction effect was found in which participants who were treated at a day or inpatient level and were in the "acting out" condition experienced reductions in shame and guilt, while those in the clinical term condition experienced increases in shame and guilt, relative to control participants. The ability of terminology to moderate shame and guilt in this population has implications for clinical practice.
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Affiliation(s)
- Mary E Duffy
- a Department of Psychology , University of Saint Joseph , West Hartford , Connecticut , USA
| | - Kristin E Henkel
- a Department of Psychology , University of Saint Joseph , West Hartford , Connecticut , USA
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Duffy ME, Specht A, Hill RC. Comparison between Urine Protein: Creatinine Ratios of Samples Obtained from Dogs in Home and Hospital Settings. J Vet Intern Med 2015; 29:1029-35. [PMID: 26059431 PMCID: PMC4895355 DOI: 10.1111/jvim.12836] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 02/25/2015] [Accepted: 04/22/2015] [Indexed: 12/17/2022] Open
Abstract
Background The urine protein:creatinine ratio (UPC) is used to quantify urine protein excretion and guide recommendations for monitoring and treatment of proteinuria. Hypothesis/Objectives Home urine samples will have lower UPCs than hospital samples. The objectives were to compare UPCs of samples collected in each setting and to determine whether environment of sample collection might affect staging, monitoring or treatment recommendations. Animals Twenty‐four client‐owned dogs. Methods Prospective, nonmasked study. Clients collected a urine sample from their dog at home and a second sample was collected at the hospital. Dogs receiving corticosteroids or angiotensin‐converting enzyme inhibitors were excluded, as were those with urine samples of inadequate volume, no protein on dipstick analysis, or active urine sediment. Samples were refrigerated after collection, dipstick and sediment evaluations were completed and each sample was frozen at −80°C within 12 hours. UPCs were performed on frozen samples within 2 months. Results From 81 paired samples, 57 were excluded. Of the remaining 24, 12/24 (50%) had higher hospital sample UPCs, 9/24 (38%) had identical UPCs, and 3/24 (12%) had lower hospital UPCs. The UPCs of hospital samples were higher than home samples for the total population (P = .005) and the subset with UPC > 0.5 (P = .001). Conclusions Setting and related circumstances of urine collection in dogs is associated with UPC differences; results are usually higher in hospital than in home samples. This difference has the potential to affect clinical interpretation.
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Affiliation(s)
- M E Duffy
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL
| | - A Specht
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL
| | - R C Hill
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL
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Cousins A, Freizinger M, Duffy ME, Gregas M, Wolfe BE. Self-report of eating disorder symptoms among women with and without infertility. J Obstet Gynecol Neonatal Nurs 2015; 44:380-8. [PMID: 25819743 DOI: 10.1111/1552-6909.12573] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To compare eating disorder (ED) symptoms in women seeking treatment for infertility to women receiving routine primary care. DESIGN A cross-sectional comparative design. SETTING Women were recruited from two infertility centers and a general hospital primary care setting. PARTICIPANTS Participants included 51 women seeking treatment for ovulatory and unexplained infertility and 34 women attending routine primary care. MEASURES Participants completed a battery of standardized rating scales measuring self-reported ED symptoms, drive for thinness, bulimic symptoms, body dissatisfaction, and related clinical characteristics. RESULTS Multivariate analysis of covariance confirmed that women seeking treatment for infertility had significantly greater scores on measures of drive for thinness (p = .001) and bulimic symptoms (p = .002) than those receiving routine primary care. However, the comparison group had significantly greater scores on measures of body dissatisfaction (p < .001) and dietary restraint (p = .001) than the infertility group. Both groups had elevated rates of lifetime ED diagnoses compared to national prevalence rates. CONCLUSIONS Results demonstrated that women seeking treatment for ovulatory and unexplained infertility have greater drive for thinness and bulimic symptoms but not body dissatisfaction or dietary restraint compared to women seeking primary care. The results suggest that infertility and routine health care visits may provide opportunities for early identification and treatment of women with ED symptomatology. Future studies may benefit from further elucidation of the potential role of ED symptoms in the etiology and maintenance of infertility in, particularly, normal-weight women.
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Horvath KJ, Trudeau SA, Rudolph JL, Trudeau PA, Duffy ME, Berlowitz D. Clinical trial of a home safety toolkit for Alzheimer's disease. Int J Alzheimers Dis 2013; 2013:913606. [PMID: 24195007 PMCID: PMC3804449 DOI: 10.1155/2013/913606] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 08/08/2013] [Accepted: 08/16/2013] [Indexed: 11/17/2022] Open
Abstract
This randomized clinical trial tested a new self-directed educational intervention to improve caregiver competence to create a safer home environment for persons with dementia living in the community. The sample included 108 patient/caregiver dyads: the intervention group (n = 60) received the Home Safety Toolkit (HST), including a new booklet based on health literacy principles, and sample safety items to enhance self-efficacy to make home safety modifications. The control group (n = 48) received customary care. Participants completed measures at baseline and at twelve-week follow-up. Multivariate Analysis of Covariance (MANCOVA) was used to test for significant group differences. All caregiver outcome variables improved in the intervention group more than in the control. Home safety was significant at P ≤ 0.001, caregiver strain at P ≤ 0.001, and caregiver self-efficacy at P = 0.002. Similarly, the care receiver outcome of risky behaviors and accidents was lower in the intervention group (P ≤ 0.001). The self-directed use of this Home Safety Toolkit activated the primary family caregiver to make the home safer for the person with dementia of Alzheimer's type (DAT) or related disorder. Improving the competence of informal caregivers is especially important for patients with DAT in light of all stakeholders reliance on their unpaid care.
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Affiliation(s)
- Kathy J. Horvath
- VA New England Geriatric Research Education & Clinical Center, Bedford, MA 01730, USA
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA
- Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA 02118, USA
- VA Center for Health Quality Outcomes and Economics Research, Bedford, MA 01730, USA
| | - Scott A. Trudeau
- VA New England Geriatric Research Education & Clinical Center, Bedford, MA 01730, USA
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA
- Department of Occupational Therapy, Tufts University, Medford, MA 02155, USA
| | - James L. Rudolph
- VA New England Geriatric Research Education & Clinical Center, Bedford, MA 01730, USA
- VA Boston Healthcare System, Boston, MA 02130, USA
| | - Paulette A. Trudeau
- VA Center for Health Quality Outcomes and Economics Research, Bedford, MA 01730, USA
| | - Mary E. Duffy
- Massachusetts General Hospital Yvonne L. Munn Center for Nursing Research, Boston, MA 02114, USA
| | - Dan Berlowitz
- VA Center for Health Quality Outcomes and Economics Research, Bedford, MA 01730, USA
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Jones D, Duffy ME, Flanagan J, Foster F. Psychometric Evaluation of the Functional Health Pattern Assessment Screening Tool (FHPAST). Int J Nurs Knowl 2012; 23:140-5. [DOI: 10.1111/j.2047-3095.2012.01224.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vanderboom TL, Arcari PM, Duffy ME, Somarouthu B, Rabinov JD, Yoo AJ, Hirsch JA. Effects of a music intervention on patients undergoing cerebral angiography: a pilot study. J Neurointerv Surg 2011; 4:229-33. [DOI: 10.1136/neurintsurg-2011-010052] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
BACKGROUND Therapeutic Touch (TT) is a complementary modality that has been demonstrated to reduce psychological distress and help patients to relax. It is unclear if there is an impact of TT on biobehavioral markers such as cortisol and natural killer cells (NKCs). There is some preliminary evidence that suggests relaxation may have positive effects on the immune system. PURPOSE To test the efficacy of TT on pain and biobehavioral markers in patients recovering from vascular surgery. FRAMEWORK The study was grounded in a psychoneuroimmunology framework to address how complementary therapies affect pain and biobehavioral markers associated with recovery in surgical patients. DESIGN This was a between-subjects intervention study. SAMPLE Twenty-one postoperative surgical patients. MEASURES Measures of level of pain and levels of cortisol and NKCs were obtained before and after a TT treatment. RESULTS Compared with those who received usual care, participants who received TT had significantly lower level of pain, lower cortisol level, and higher NKC level. CONCLUSIONS AND IMPLICATIONS Evidence supports TT as a beneficial intervention with patients. Future research on TT is still needed to learn more about how it functions. However, there is evidence to support incorporating TT into nursing practice.
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Abstract
AIM This paper is a report of the development and initial psychometric evaluation of the Pregnant Women with HIV Attitude Scale. BACKGROUND Previous research has identified that attitudes toward persons with HIV/AIDS have been judgmental and could affect clinical care and outcomes. Stigma towards persons with HIV has persisted as a barrier to nursing care globally. Women are more vulnerable during pregnancy. An instrument to specifically measure obstetric care provider's attitudes toward this population is needed to target identified gaps in providing respectful care. METHODS Existing literature and instruments were analysed and two existing measures, the Attitudes about People with HIV Scale and the Attitudes toward Women with HIV Scale, were combined to create an initial item pool to address attitudes toward HIV-positive pregnant women. The data were collected in 2003 with obstetric nurses attending a national conference in the United States of America (N = 210). Content validity was used for item pool development and principal component analysis and analysis of variance were used to determine construct validity. Reliability was analysed using Cronbach's Alpha. RESULTS The new measure demonstrated high internal consistency (alpha estimates = 0.89). Principal component analysis yielded a two-component structure that accounted for 45% of the total variance: Mothering-Choice (alpha estimates = 0.89) and Sympathy-Rights (alpha estimates = 0.72). CONCLUSION These data provided initial evidence of the psychometric properties of the Pregnant Women with HIV Attitude Scale. Further analysis is required of the validity of the constructs of this scale and its reliability with various obstetric care providers.
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Affiliation(s)
- Lynda A Tyer-Viola
- Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA.
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Dykes PC, Hurley A, Cashen M, Bakken S, Duffy ME. Development and psychometric evaluation of the Impact of Health Information Technology (I-HIT) scale. J Am Med Inform Assoc 2007; 14:507-14. [PMID: 17460123 PMCID: PMC2244896 DOI: 10.1197/jamia.m2367] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2007] [Accepted: 03/28/2007] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The use of health information technology (HIT) for the support of communication processes and data and information access in acute care settings is a relatively new phenomenon. A means of evaluating the impact of HIT in hospital settings is needed. The purpose of this research was to design and psychometrically evaluate the Impact of Health Information Technology scale (I-HIT). I-HIT was designed to measure the perception of nurses regarding the ways in which HIT influences interdisciplinary communication and workflow patterns and nurses' satisfaction with HIT applications and tools. DESIGN Content for a 43-item tool was derived from the literature, and supported theoretically by the Coiera model and by nurse informaticists. Internal consistency reliability analysis using Cronbach's alpha was conducted on the 43-item scale to initiate the item reduction process. Items with an item total correlation of less than 0.35 were removed, leaving a total of 29 items. MEASUREMENTS Item analysis, exploratory principal component analysis and internal consistency reliability using Cronbach's alpha were used to confirm the 29-item scale. RESULTS Principal components analysis with Varimax rotation produced a four-factor solution that explained 58.5% of total variance (general advantages, information tools to support information needs, information tools to support communication needs, and workflow implications). Internal consistency of the total scale was 0.95 and ranged from 0.80-0.89 for four subscales. CONCLUSION I-HIT demonstrated psychometric adequacy and is recommended to measure the impact of HIT on nursing practice in acute care settings.
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Affiliation(s)
- Patricia C Dykes
- Partners HealthCare, Clinical Informatics Research and Development, 93 Worcester St, Wellesley, MA 02481, USA.
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