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Background: Rejection sensitivity has a controversial impact on suicidal ideation. However, previous studies have always assessed the relationship between rejection sensitivity and suicidal ideation as a whole based on total scores, which has obscured the fine-grained relationship between them. Objectives: The present study aims to investigate the fine-grained relationship between rejection sensitivity and suicidal ideation in college students based on network analysis, and to provide a theoretical basis for identifying potential targets for psychological intervention on suicidal ideation. Methods: A total of 663 Chinese college students aged 19–28 years from Xian were investigated in an online study. The Tendency to Expect Rejection Scale (TTERS) and Self-rating Idea of Suicide Scale (SIOSS) were selected to investigate rejection sensitivity and suicidal ideation. Rejection sensitivity and suicidal ideation networks were constructed using R4.1.1 software to examine the links between the dimensions and to calculate the bridge expected influence (BEI) of each node. Results: The prevalence of suicidal ideation among college students was 5.6%. The rejection sensitivity and suicide ideation network contained 23 cross-community edges, with the strongest one being the connection between S3 "Despair" and R17 "No confidence". Within the suicidal ideation community, S3 "Despair" had the highest positive BEI value (0.50). In the rejection sensitivity community, R17 "No confidence" exhibited the highest positive BEI value (0.26), whereas R13 "Sense of collectivity" had the highest negative BEI value (-0.08). Conclusions: Complex correlation pathways exist between rejection sensitivity and suicidal ideation. The bridge centrality indicators identified in this study serve as guides for relevant personnel to implement targeted interventions, thereby effectively preventing and mitigating the emergence and persistence of suicidal ideation among college students. [ABSTRACT FROM AUTHOR]

Spontaneous blood oxygen level-dependent signals can be indirectly recorded in different brain regions with functional magnetic resonance imaging. In this study resting-state functional magnetic resonance imaging was used to measure the differences in connectivity and activation seen in major depressive disorder (MDD) patients with and without suicidal ideation and the control group. For our investigation, a brain atlas containing 116 regions of interest was used. We also used four voxel-based connectivity models, including degree centrality, the fractional amplitude of low-frequency fluctuations (fALFF), regional homogeneity, and voxel-mirrored Homotopic Connectivity. Feature selection was conducted using a sequential backward floating selection approach along with a Random Forest Classifier and Elastic Net. While all four models yield significant results, fALFF demonstrated higher accuracy rates in classifying the three groups. Further analysis revealed three features that demonstrated statistically significant differences between these three, resulting in a 90.00% accuracy rate. Prominent features identified from our analysis, with suicide ideation as the key variable, included the Superior frontal gyrus (dorsolateral and orbital parts), the median cingulate, and the paracingulate gyri. These areas are associated with the Central Executive Control Network (ECN), the Default Mode Network, and the ECN, respectively. Comparing the results of MDD patients with suicidal ideation to those without suicidal ideations suggests dysfunctions in decision-making ability, in MDD females suffering from suicidal tendencies. This may be related to a lack of inhibition or emotion regulation capability, which contributes to suicidal ideations. [ABSTRACT FROM AUTHOR]

Objective: The incidence of suicide is high among adolescents and young adults, especially those suffering from psychiatric diseases. Because of the reported association between depression and suicidality, exploring suicide risk factors in depressed patients is crucial for the identification of those at high risk and preventing suicide. In recent decades, electroencephalography parameters have been considered for identifying biomarkers of suicide ideation and attempts in depressed patients. This study aimed to review the available literature on resting-state EEG for suicidality in depressed patients. Method: A systematic search was performed in five electronic databases, including APA PsycINFO, Embase, Medline (via PubMed), Scopus, and Web of Science. Papers with full text available in English in which resting-state EEG was evaluated in depressed patients with suicide ideation or suicide attempts compared to a control group of healthy subjects or non-suicidal depressed patients were included. The risk of bias was assessed by using the Newcastle–Ottawa scale. Results: A total of 4665 references were retrieved from five electronic databases from which eleven studies were included in this systematic review. A meta-analysis was not performed due to the substantial heterogeneity of the studies. Five of the eleven reviewed papers were classified as high-quality, and six had moderate quality. Conclusions: According to the included studies in this review, the EEG signals of depressed patients with suicide ideation or suicide attempts may be different from patients with low risk of suicidality or healthy subjects. Connectivity measures sound more promising parameters than the power spectral analysis and EEG asymmetry. Protocol registration: The protocol of this review was registered in PROSPERO (No. CRD42024502056). [ABSTRACT FROM AUTHOR]

Despite preliminary evidence that links impulsivity to suicide risk among Native American youth, impulsivity has not been directly studied in relation to suicide ideation (SI) or behaviors in this population. We examined indexes of rapid-response impulsivity (RRI) across multiple levels of analysis (self-report, behavioral, neurobiological) and associations with SI among Native American youth ages 9–10 in the Adolescent Brain Cognitive Development Study. Data from the sample (n = 284) included self-report (UPPS-P), behavioral (Stop Signal Task), and neurobiological (right inferior frontal gyrus activation) indicators of RRI. RRI indicators were modeled using variable-centered (i.e., traditional multivariable regression) and person-centered (i.e., clustering analyses) approaches in measuring their association with SI. Logistic regression analysis demonstrated that higher negative urgency was associated with higher odds of SI (Adjusted Odds Ratio = 1.23, p = 0.015). Latent profile analysis clustered youth into five profiles based on within-individual variation in RRI indicators. Youth with an elevated self-reported negative and positive urgency profile had higher odds of reporting SI than "normative" youth (Adjusted Odds Ratio = 2.38, p = 0.019). Limitations of this study include the modest sample size particularly regarding SI (14.1 %), potential bias in estimates of lifetime SI, and generalizability to youth from specific Native American communities. Negative urgency may increase risk for SI among Native American youth in late childhood. Clinical implications, including the potential for person-centered RRI profiles to act as candidate markers of suicide risk and resilience in adolescence and inform safety assessments and planning, are discussed. • 14.1 % of Native American youth ages 9–10 reported lifetime suicide ideation. • Measures of impulsivity showed different clinical utility across levels of analysis. • Negative urgency was linked to suicide ideation in multiple statistical frameworks. • Most youth with higher negative urgency also reported higher positive urgency. [ABSTRACT FROM AUTHOR]

The increase in mental ill-health amongst the working population presents a serious challenge for organisations. Line-managers are an important provider of support to staff with psychological distress (PD), their experiences however, are under-researched. In response, we interviewed 15 line-managers from the private, public, and voluntary sector about their support provision to subordinates with PD. Drawing upon workplace social support and boundary management theory we explored line-manager confidence, boundaries of the manager/subordinate relationship, and how they navigate the competing demands of their role. We found that organisational psychosocial climate and context are key factors: a stressful or demanding working environment, and/or unsupportive colleagues can undermine the capacity of line-managers to provide social support. Theoretical contributions include focusing on the provider, rather than recipient, of social support and integrating social support and boundary management theory. Practical recommendations include removing the onus on line-managers to provide support and advocating shared organisational responsibility for support from multiple sources, underpinned by a wider remit of policies and procedures. This paper includes line-manager narratives around employee mental ill-health including reference to suicide, that some readers may find distressing. [ABSTRACT FROM AUTHOR]

Background: Suicide, defined as the intentional act of self-inflicted death, constitutes a significant global public health burden. Every year, over 700,000 individuals worldwide die by suicide. Studies in Iran have reported an alarming prevalence of suicidal behavior among students, with estimates of suicide attempts ranging from 1.8% to 3.5%, and suicidal ideation rates fluctuating between 6.2% and 42.7%. This complex phenomenon is influenced by a wide array of factors. A major challenge to effective suicide prevention strategies is the limited understanding of the mechanisms that lead from suicidal ideation to actual suicide attempts. Objectives: This study aimed to investigate the relationships between suicidal ideation, suicidal behaviors, and the constructs of the three-step theory within a student population. Methods: A cross-sectional design was employed, with convenience sampling enrolling 260 students from Zanjan University of Medical Sciences. Students consented to participate and completed various questionnaires, including the Beck Suicide Ideation Scale (BSSI), the Inventory of Motivations for Suicide Attempts (IMSA), the Suicidal Behaviors Questionnaire-Revised (SBQ-R), the Symptom Checklist-25 (SCL-25), the Acquired Capability for Suicide Scale (ACSS), and a single-item suicide attempt question. The participants ranged in age from 18 to 52 years (mean: 23.62, standard deviation: 5.48), with 75% of the sample being female, and 85% single. Data analysis was conducted using SPSS 24 and AMOS 24 software. Results: Correlation analysis revealed that psychic pain, hopelessness, and low belongingness were significantly and directly correlated with both suicidal ideations and behaviors (all P-values < 0.05). Structural equation modeling results demonstrated that the combination of pain and hopelessness directly predicted suicidal ideation (β = 0.318, P < 0.001) and low belongingness (β = 0.867, P < 0.001). These factors indirectly predicted suicidal behavior through suicidal ideation, capability for suicide, and low belongingness (β = 0.406, P < 0.001). Additionally, suicidal ideation was a strong direct predictor of suicidal behavior (β = 0.556, P < 0.001), and low belongingness directly predicted suicidal behaviors (β = 0.226, P < 0.001). However, the capability for suicide did not statistically predict suicidal behavior within this student sample. Conclusions: The findings support the validity of the three-step theory in a student population. Pain, hopelessness, and low belongingness were significant predictors of suicidal ideation and attempts among students, while the capability for suicide did not predict suicidal behavior in this context. These results provide a novel perspective by confirming the applicability of the three-step theory in a non-clinical student population, offering valuable insights into the interrelations of the model's key components. [ABSTRACT FROM AUTHOR]

Background: Hereditary angioedema (HAE) in children has specific features and requires multidisciplinary management. Methods: We performed a literature search and underwent in‐depth discussions to provide practical tools for physicians. Results: HAE is a rare, life‐threatening genetic disorder. Its epidemiology is poorly documented in children. Clinical manifestations usually appear during childhood or early adolescence. Classical signs, often preceded by prodromal symptoms, include transient, localized, non‐pitting, non‐pruritic swelling of deep dermal/subcutaneous or mucosal/submucosal tissues, leading to oedema of the extremities, face, lips, tongue, trunk and genitals, recurring gastrointestinal symptoms and laryngeal edema possibly causing asphyxiation and death. Diagnosis is often delayed due to low awareness in the medical community, and particularly challenging in case of isolated abdominal crises or atypical presentation and in neonates or infants. It relies on biological tests (measurement of serum/plasma levels of C1INH function, C1INH protein, and C4), genetic testing in selected cases, and imaging for differential diagnosis of acute abdominal crises. Main differential diagnosis for peripheral oedema is mast cell‐mediated oedema that accounts for 95% of angioedema in clinical practice. Quality of life can be significantly impaired. Disease management includes treatment of attacks, short‐term and long‐term prophylaxis, psychological support, avoidance of triggers, patients' and parents' education and coordination of all stakeholders, ideally within a specialized healthcare network. New plasma kallikrein inhibitors, namely lanadelumab (subcutaneous route) and berotralstat (oral route) have facilitated long‐term prophylaxis thanks to improved usability. Conclusion: Diagnostic and treatment of HAE are particularly challenging in children and require specific management by multiple stakeholders. [ABSTRACT FROM AUTHOR]

Romantic relationships serve as one of the most important relationships in adults' lives, yet the influence of relational dynamics on suicide ideation (SI) is limited and longitudinal associations are unclear. The Interpersonal Theory of Suicide has been applied to romantic relationships broadly and supports motivations of suicide (thwarted belonging and perceived burdensomeness) and relationship satisfaction to be predictors of SI. An online daily diary study (n = 94 adults) was conducted to examine romantic relationship dynamics and mental health indicators in adults over 10 days. Multilevel growth modeling results revealed that higher perceived burdensomeness, but not relational satisfaction or thwarted belonging, was associated with higher initial levels of SI. However, perceived burdensomeness, thwarted belonging, and relationship satisfaction were not associated with rates of change in SI over time. Further, no interaction effects between either relationship satisfaction and thwarted belonging or perceived burdensomeness were found in association with trajectories of SI over the 10-day period. The results of this study indicate that relational satisfaction, through a commonly used global assessment of relational wellbeing, may not have a substantial influence on SI, particularly in individuals with mild SI levels. This may be due to relational satisfaction being relatively consistent, while SI is prone to short-term fluctuations. However, additional research is recommended to address other relational dynamics' influences on SI. [ABSTRACT FROM AUTHOR]

This study explored the factor structures, partial correlational, unique and indirect associations of meaning and purpose with depressive symptoms and suicide ideation in college students (n = 956) and adults with chronic illness (n = 346). Results showed that correlated two-factor models better captured (both absence and presence of) meaning and purpose, compared to the unidimensional models. Although meaning and purpose were strongly associated, they were differentially correlated with and predictive of mental health outcomes. On one hand, while absence of meaning was positively and moderately correlated with and predictive of depressive symptoms and suicide ideation, the associations of absence of purpose were, albeit similar, weak. On the other hand, presence of meaning was negatively and moderately correlated with and predictive of depressive symptoms and suicide ideation, and the presence of purpose only predicted suicide ideation in negligible amounts among students but not adults with chronic illness. In both samples, absence of meaning and purpose were indirectly and positively related to suicide ideation through their positive associations with depressive symptoms; whereas presence of meaning, but not presence of purpose, was indirectly and negatively associated with suicide ideation through its negative associations with depressive symptoms. Conceptual and counseling implications are discussed. [ABSTRACT FROM AUTHOR]

Objectives: This open trial aimed to determine the feasibility and acceptability of a modified version of Mindful Self-Compassion for Teens for transgender adolescents and assess changes in suicide ideation and other measures of emotional well-being. As an exploratory measure, we investigated potential moderators of suicide ideation outcomes, such as self-compassion. Method: Two cohorts of transgender and gender-diverse adolescents recruited from the US and Canada (n = 35; age range 13–17, M = 14.9, SD = 1.19) participated in an eight-session online self-compassion program. Quantitative measures of wellbeing (i.e., suicide ideation, depression, resilience) were collected at baseline, post-intervention, and 2-month follow-up, and qualitative data (through open-ended questions on an electronic form) were collected at post-intervention and 2-month follow-up. Results: Suicide ideation decreased with large effect sizes from baseline to follow-up, and most other measures of wellbeing improved with small to moderate effect sizes. Feasibility was confirmed, and acceptability differed markedly between cohorts, with the cohort with greater acceptability improving in mental health attributes to a greater degree. Self-compassion and thwarted belongingness, a factor related to suicide ideation, moderated suicide ideation such that those with greater self-compassion or less thwarted belongingness experienced less suicide ideation. Conclusions: Self-compassion programs can be beneficial to help transgender adolescents manage the stressors and negative emotional outcomes arising from the anti-trans sociopolitical discourse that has been pervasive in the US. We provide recommendations for future implementations, including that someone who is transgender be part of the instructional staff. Future studies would benefit from larger sample sizes and randomized control trials to confirm the present findings. Preregistration: This study is not preregistered. [ABSTRACT FROM AUTHOR]

Background/Objectives: The Ministry of Health, Labor and Welfare in Japan has been promoting physicians' working style reforms since 2019. This study aimed to update the relationship between working hours, depressive symptoms, and suicidal ideation among obstetricians and gynecologists, based on the physicians' working style reforms. Methods: A questionnaire-based survey was conducted among obstetricians and gynecologists, and valid responses were obtained from 1164 physicians. Multivariable logistic regression analysis was performed to identify significant associations. Results: Of the respondents, 49.8% were female, and most physicians were aged 30–39 (32.1%). Precisely, 57.4% worked in public hospitals, and 47.9% worked in urban areas. Physicians working 40 ≤ x < 60 h per week accounted for the largest proportion of physicians. Depressive symptoms and suicidal ideation accounted for 16.4% and 3.6% of participants, respectively. The following factors were significantly associated with depressive symptoms as a dependent variable: other occupation, having two or three children, working 60–80 h or >100 h per week, and working in rural areas. None of these variables was significantly associated with suicidal ideation. Conclusions: The physicians' working style reforms have reduced the number of working hours for obstetricians and gynecologists. However, rates of depressive symptoms and suicidal ideation have not improved. [ABSTRACT FROM AUTHOR]

BackgroundSuicide ideation in adolescent inpatients with depression is a multi-factorial problem， and perceived stress is considered to be closely related to suicide ideation， while its mediating role in suicide ideation among adolescent inpatients with depression remains unclear.ObjectiveTo explore the mediating effect of psychological capital on the relationship between perceived stress and suicide ideation among adolescent inpatients with depression， so as to provide references for preventing the onset of suicide ideation in adolescent inpatients with depression.MethodsA sample of 585 adolescent patients who were hospitalized in Beijing Huilongguan Hospital from June 2021 to March 2023 and fulfilling the International Classification of Diseases， 10th edition （ICD-10） diagnostic criteria for depression were enrolled. All patients were evaluated using self-designed questionnaire， Chinese Perceived Stress Scale （CPSS）， Positive Psychological Capital Questionnaire （PPQ） and Beck Scale for Suicide Ideation-Chinese Version （BSI-CV）. Pearson correlation was used to assess the correlation among the scores of the above scales. Bootstrap method was employed to verify the mediating effect of psychological capital on the relationship between perceived stress and suicide ideation.ResultsCPSS score in adolescent inpatients with depression was positively correlated with BSI-CV score （r=0.375， P

Abstract Background Prior research has demonstrated that people with cataracts are more likely to experience anxiety and depression co-occurring when the condition advances to a degree that impairs vision beyond its physiological effects. According to network theory, there is a connection between the interplay of anxiety and depression and the genesis of comorbidity. Using a network viewpoint, our study examined the network properties of anxiety-depression in cataract patients to pinpoint central and bridge symptoms as well as possible intervention targets for more focused and successful therapies. Method A total of 1,254 cataract patients were enrolled in our study. The Nine-item Patient Health Questionnaire (PHQ-9) and the Seven-item Generalized Anxiety Disorder scale (GAD-7) were used to measure depression and anxiety symptoms, respectively. The R 4.3.3 software was utilized for network model building and descriptive statistics. Furthermore, we displayed a “Thoughts of death” flow network. Result In the network, A5 “Restlessness”- D7 “Concentration difficulties” showed the strongest edge. A2 “Uncontrollable worry” and D2 “Depressed or sad mood” could be identified as the central symptoms. A7 “Afraid something will happen” and D7 “Concentration difficulties” could be identified as bridge symptoms. The strongest edge in the flow network was D9 “Thoughts of death”-D6 “Feeling of worthlessness”. Conclusion “Uncontrollable worry”, “Depressed or sad mood”, “Afraid something will happen” and “Concentration difficulties” could be potential targets for the prevention of anxiety and depression in cataract patients. Furthermore, this study emphasizes how important it is to prevent suicide in cataract patients, and the symptom “Feeling of worthlessness” can be used as an effective target.

IntroductionOfficial statistics indicate that, while the global suicide rate has declined over the past twenty years, Iran has experienced an alarming increase of over 44%. Suicidal ideation is a significant risk factor for suicide. Research has demonstrated that social media relationships can influence the dissemination of suicidal thoughts and behaviors. Despite observable differences in how men and women use social media, as well as mixed findings regarding gender differences in suicidal ideation, there remains a gap in understanding these issues from a sociological perspective that focuses on communication network structures. The interconnected nature of social media facilitates network analysis through big data. Given the rising prevalence of social media usage, this study aimed to provide a sociological analysis of gender differences in suicidal ideation on Instagram. It will leverage Krohn’s network theory and its evolution, employing big data and social network analysis, while also offering policy implications. Materials & MethodsThis study employed an exploratory-quantitative research method, utilizing network analysis with big data sourced from Instagram. The research sample comprised Instagram users, who had made at least 4 posts featuring hashtags related to suicidal ideation, totaling 957 users, of whom 514 had public and accessible accounts. Data collection occurred in 3 phases: Phase 1: Identification of the research sample through posts containing hashtags related to suicidal ideation, resulting in a dataset of 20,223 posts. Phase 2: Compilation of the follower and following lists of the research sample to construct the relationship network, yielding 2,037,883 nodes and 2,269,856 edges. Phase 3: A repeat of the first phase after 1 year to assess changes in the level of suicidal ideation among the research sample, resulting in an additional 8,913 posts. During data collection, the study utilized the Dataak platform, Python, and Ninjagram software. For data cleaning, Excel was employed, while Gephi and R software were used for data analysis to calculate network variables. The hypotheses were tested using SPSS software. In line with the primary research question, the unit of observation included the posts and accounts of Instagram users, the unit of analysis was the individual (Instagram users), and the level of analysis was micro-level. Discussion of Results & ConclusionThe results of the logistic regression analysis revealed that, in terms of their influence on the dependent variable, the following variables were significant: for women, exposure to suicidal ideation, prior suicidal ideation, out-coreness centrality, and closeness centrality; for men, prior suicidal ideation, in-coreness centrality, and intensity (reciprocity); and for the overall sample, prior suicidal ideation, intensity (reciprocity), and exposure to suicidal ideation, all of which had a direct and significant impact on suicidal ideation. The explanatory power of the model was notably higher for women (53 to 31.2%) compared to men (28.3 to 18.2%) and the overall sample (28.3 to 17.9%). These findings suggested that, although there was no significant difference in the prevalence or likelihood of suicidal ideation between women and men in the sample, the mechanisms, by which an individual's position in the communication network surrounding suicidal thoughts and behaviors influenced the likelihood of suicidal ideation, differed by gender. Consequently, it is recommended that preventive interventions be designed with gender considerations in mind. Drawing on the findings of this research, policy implications based on Krohn’s theory and its development at micro, medium, and macro levels are proposed. These interventions aim to reduce the centrality of users within communication networks focused on suicidal ideas, attitudes, and norms.

Background: Prior research has demonstrated that people with cataracts are more likely to experience anxiety and depression co-occurring when the condition advances to a degree that impairs vision beyond its physiological effects. According to network theory, there is a connection between the interplay of anxiety and depression and the genesis of comorbidity. Using a network viewpoint, our study examined the network properties of anxiety-depression in cataract patients to pinpoint central and bridge symptoms as well as possible intervention targets for more focused and successful therapies. Method: A total of 1,254 cataract patients were enrolled in our study. The Nine-item Patient Health Questionnaire (PHQ-9) and the Seven-item Generalized Anxiety Disorder scale (GAD-7) were used to measure depression and anxiety symptoms, respectively. The R 4.3.3 software was utilized for network model building and descriptive statistics. Furthermore, we displayed a "Thoughts of death" flow network. Result: In the network, A5 "Restlessness"- D7 "Concentration difficulties" showed the strongest edge. A2 "Uncontrollable worry" and D2 "Depressed or sad mood" could be identified as the central symptoms. A7 "Afraid something will happen" and D7 "Concentration difficulties" could be identified as bridge symptoms. The strongest edge in the flow network was D9 "Thoughts of death"-D6 "Feeling of worthlessness". Conclusion: "Uncontrollable worry", "Depressed or sad mood", "Afraid something will happen" and "Concentration difficulties" could be potential targets for the prevention of anxiety and depression in cataract patients. Furthermore, this study emphasizes how important it is to prevent suicide in cataract patients, and the symptom "Feeling of worthlessness" can be used as an effective target. [ABSTRACT FROM AUTHOR]

College is a critical period that is vulnerable to suicide with a prevalence of suicidal ideation of around 12%. Data reports had suicidal ideation during their lifetime. Suicidal ideation is a desire, wish, or thought to commit suicide, which is the first step to suicide. Interpersonal Theory of Suicide (ITS) by Joiner said that suicidal ideation arises when two interpersonal needs are not met, like thwarted belongingness and perceived burdensomeness. This study was a quantitative research method that examine the role of TB and PB as two factors causing the emergence of suicidal ideation based on the ITS. The results showed a positive relationship between TB and PB with suicidal ideation in college students. This finding indicates that college students who feel socially disconnected and feel a burden to others tend to have higher suicidal ideation. [ABSTRACT FROM AUTHOR]

Background: The linkage between substance use and youth suicidality is less developed due to the predominant focus on certain types of substances (e.g., alcohol consumption, prescription opioid misuse). This study examines polysubstance use and its mutual impact on suicidal thoughts and behaviors among US adolescents. Methods: Data from 2019 Youth Risk Behavior Survey were utilized. Associations between the concurrent use of five substances (cigarette, e-cigarette, alcohol, marijuana, and prescription opioid) and suicidality (suicidal thoughts, suicide plans, and suicide attempts) were measured by logistic regression models. The combined effect of polysubstance use on suicidality was further assessed by structural equation modeling. Results: About two in five (42.1%) adolescents used at least one type of substances in the past month and one in seven (13.5%) used three or more types concurrently (polysubstance use). Adolescents with polysubstance use behaviors were three to five times more likely to experience suicidal thoughts (OR=3.8, p < 0.05), make a suicide plan (OR=3.5, p < 0.05), or attempt suicide (OR=4.6, p < 0.05) than non-users. In the final structural model, polysubstance use and suicidality were significantly correlated with each other (β=0.37, p < 0.05). Collectively, polysubstance use explained about 14% of variance in youth suicidality. Conclusions: Polysubstance use shows a significant impact on youth suicidality. School-based health centers and educational programs are recommended to reduce substance use and suicidal behaviors among adolescents. Accessible mental health services and targeted treatments are needed for polysubstance users to mitigate their risk of suicide. [ABSTRACT FROM AUTHOR]

South Korea has one of the highest suicide rates among countries in the Organisation for Economic Co-Operation and Development, and the suicide rate among people with disabilities is more than twice that of the general population. This study aimed to develop an artificial intelligence-based suicide ideation prediction model for people with disabilities in order to provide a proactive approach for managing high-risk groups and offer evidence for establishing suicide prevention policies. The support vector machine, adaptive boost (AdaBoost), and bidirectional long short-term memory (Bi-LSTM) models were used in this study. Data from the Disability and Life Dynamics Panel for 2018–2021 were used. The performance of the models was evaluated based on the accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). All the prediction models demonstrated excellent performance, with AUC > 0.80 (0.83–0.87). The best-performing models were AdaBoost (0.87) for accuracy, Bi-LSTM (0.90) for sensitivity, and AdaBoost (0.90) for specificity. This study is the first to develop an artificial intelligence-based suicide ideation prediction model for disabled people and is significant in that it suggests ways to pre-emptively manage groups at high risk for suicide, providing evidence for the establishment of suicide prevention policies. [ABSTRACT FROM AUTHOR]

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Introduction Methods Results Conclusion Data from the general population of youth show increases in suicide ideation and attempt in recent years, with rates of increase differing across sex and racial/ethnic groups. This study assessed trends in suicide ideation and attempt from 2016 to 2021 in youth in juvenile detention, across sex, age, and racial/ethnic groups.We leveraged state‐wide suicide screening data of all detained youth (n = 53,769) from 2016 to 2021. We analyzed data for periods defined by statistically significant changes in trends of lifetime suicide attempt, past 6‐month suicide attempt, and current suicide ideation.The prevalence of lifetime, but not past six‐month, attempts increased, whereas the prevalence of current suicide ideation decreased annually from 2016 to 2021. Overall trends were qualified by distinct patterns among subgroups: rates of lifetime attempt increased among male, adolescent, and Black youth, while rates of current ideation decreased among male, adolescent, and White and Hispanic youth.These data document increasing rates of lifetime suicide attempts in detained youth from 2016 to 2021, especially among male and Black adolescents, concomitant with decreasing rates of current suicide ideation. Suicide prevention approaches for detained youth may need to prioritize variables besides or in addition to suicide ideation. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study assessed the effectiveness of a school-based suicide prevention program in Hong Kong. Methods: 105 secondary school students aged 14–16, identified as having high levels of depression and suicidal ideation. Participants were divided into three intervention groups: one for adolescents only, another for adolescents with peers, and a third for adolescents with parental involvement. All groups engaged in weekly online exercises. Repeated measures ANOVA was used to analyze the within-group and between-group differences in the levels of adolescents' suicidal ideation, depression and anxiety. Results: The results indicated a statistically significant reduction in suicidal ideation, depression and anxiety levels after participation in all three groups. No statistically significant between-group differences were identified, meaning the effects of the three interventions on the measured outcomes were similar. Conclusions: This study demonstrates the promise of implementing school-based suicide prevention programs in the Hong Kong context. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsFindingsConclusion\nHIGHLIGHTSThe objectives of this study were to investigate the relationship between perinatal risk factors and suicidal ideation and attempts in young adults in Pelotas, Brazil.The data were collected from the 1993 Pelotas Birth Cohort study. Every pregnant woman who gave birth in one of the hospitals in Pelotas Brazil in 1993 was invited to participate in the study. The current study uses perinatal data collected in 1993, and follow-ups at ages 18 and 22. The primary outcome was lifetime suicide attempts with past month suicide ideation a secondary outcome. The association between perinatal predictors and suicidal ideation or lifetime suicide attempts was investigated using hierarchical logistic regression.There was an analytic sample size of 3493. The perinatal factors association with lifetime suicide attempts were sex (OR = 2.25 CI: 1.76–2.89), paternal education at birth (OR = 0.60, 95%CI: 0.36–0.99), maternal education (9–11 years OR = 2.81, 95%CI: 1.41–5.59, & 0–8 years OR = 2.21, 95%CI: 1.07–4.58), support from friends or neighbors at birth (OR = 0.36 95%CI: 0.17–0.77), and maternal smoking during pregnancy (OR = 1.41, 95%CI: 1.10–1.79). Patterns of associations were broadly similar with suicidal ideation. Interactions between sex and the perinatal factors paternal education, maternal education, smoking and support from friends were assessed and found to be not significant.Several factors during the perinatal period are associated with risk of lifetime suicide attempts and ideation in young adults in Brazil. Early-life factors associated with suicide-related concerns in early adulthood were similar to those observed in studies from high-income settings.Perinatal factors associated with suicidal behaviour were determined using data from upper-middle income setting.Maternal education, and maternal smoking are associated with risk of lifetime suicide attempts.Perinatal factors associated with suicidal ideation were similar to those of suicide attempts, including sex, maternal education, and maternal smoking.Perinatal factors associated with suicidal behaviour were determined using data from upper-middle income setting.Maternal education, and maternal smoking are associated with risk of lifetime suicide attempts.Perinatal factors associated with suicidal ideation were similar to those of suicide attempts, including sex, maternal education, and maternal smoking. [ABSTRACT FROM AUTHOR]

Suicide is a leading cause of death worldwide. Suicide ideation (SI) is a known risk factor for suicide behaviour (SB). The current psychobiology and genetic predisposition to SI and SB are poorly defined. Despite convincing relevance of a genetic background for SI, there is no current implementable knowledge about the genetic makeup that identifies subjects at risk for it. One of the possible reasons for the absence of a clear-cut evidence is the polygenetic nature of SI along with the very large sample sizes that are needed to observe significant genetic association result. The CATIE sample was instrumental to the analysis. SI was retrieved as measured by the Calgary test. Clinical possible covariates were identified by a nested regression model. A principal component analysis helped in defining the possible genetic stratification factors. A GWAS analysis, polygenic risk score associated with a random forest analysis and a molecular pathway analysis were undertaken to identify the genetic contribution to SI. As a result, 741 Schizophrenic individuals from the CATIE were available for the genetic analysis, including 166,325 SNPs after quality control and pruning. No GWAS significant result was found. The random forest analysis conducted by combining the polygenic risk score and several clinical variables resulted in a possibly overfitting model (OOB error rate < 1%). The molecular pathway analysis revealed several molecular pathways possibly involved in SI, of which those involved in microglia functioning were of particular interest. A medium-small sample of SKZ individuals was analyzed to shed a light on the genetic of SI. As an expected result from the underpowered sample, no GWAS positive result was retrieved, but the molecular pathway analysis indicated a possible role of microglia and neurodevelopment in SI. [ABSTRACT FROM AUTHOR]

Background: In recent years, suicidal thoughts and behaviors have become increasingly common among children and adolescents, leading to an elevation in the number of visits to emergency departments in pediatric hospitals. In Israel, the rising demand for mental health treatment due to suicidal distress is also salient, creating prolonged wait periods and low case acceptance rates. Addressing the urgent need for streamlined interventions, the present study outlines the design and results of a non-inferiority effectiveness trial of an ultra-brief suicide crisis intervention based on Interpersonal Psychotherapy for Adolescents (IPT-A-SCI). Methods: 309 children and adolescents presenting to the Depression and Suicide Clinic at Schneider Children's Medical Center of Israel with depressive and anxiety symptoms and/or suicidal ideation/behavior were assigned to either IPT-A-SCI, Treatment as Usual (TAU), or waitlist condition. Assessments were conducted pre- and post-intervention/after five sessions/five weeks (as secondary assessments) in accordance with group assignment. Results: At secondary assessment, post IPT-A-SCI, suicide ideation, and behavior as well as depression and anxiety symptoms significantly decreased, with no group differences observed between IPT-A-SCI, TAU, and control groups. Conclusion: IPT-A-SCI is feasible and as effective as the standard treatment in reducing suicidal, depressive, and anxiety symptoms among children and adolescents. [ABSTRACT FROM AUTHOR]

Implicit identification with death (i.e., subconsciously self-associating oneself with death), measured by the Death-Suicide Implicit Association Test (D/S-IAT), is associated with Suicide Ideation (SI). Our understanding of the mechanisms underlying this association is limited. The current study examined (1) the mediating role of depression between D/S-IAT and recent SI and (2) the association between SI, D/S-IAT, and clinician evaluation of SI among a clinical sample of adolescents. 148 adolescents aged 10–18 years (69.4% female) from two outpatient clinics were assessed at intake. Participants completed D/S-IAT and self-report measures for recent SI and depression during intake. Findings indicate that depression is a mediator between D/S-IAT and recent SI, controlling for gender, site differences, and past suicidal thoughts and behaviors. D/S-IAT and clinician evaluation were correlated with recent SI but not beyond depression. Our findings highlight the importance of examining the underlying psychological mechanisms regarding the association between D/S-IAT and suicide. [ABSTRACT FROM AUTHOR]

Objective: Suicide ideation (SI) is prevalent among college students, and suicide disclosure (SD) is critical for crisis intervention. However, students with SI may worry about stigmatizing responses to their disclosure. To better understand the mechanism of stigmatizing responses to SD, we investigated the effects of a hypothetical classmate's SD on college students' emotions and reasoning when providing advice to a distressed classmate. Method: In a randomized controlled experiment, students wrote advice to a hypothetical classmate who recently failed in his pursuit of a romantic relationship with a peer. The experimental/control group also learned he wanted to either commit suicide/quit school. When typing the advice, participants' facial expressions were recorded and analyzed by Facereader7.1. After advising, participants reported their sadness, joy, fear, anger, surprise, and disgust when advising. Finally, trained coders coded the common themes of their advice and rated the wise reasoning involved. Additionally, two experts in suicide prevention rated the helpfulness of their advice for the classmate. Results: The experimental group showed significantly fewer facial expressions of happiness, reported higher sadness and fear, provided less helpful advice, and mentioned "confronting reality" less during advising. The difference in disgust and wise reasoning was nonsignificant. Conclusion: Learning of a classmate's SI may increase fear and sadness among recipients and reduce the helpfulness of their advice. Increased psychoeducation for students that focuses on improving emotional regulation (especially facial expressions) during SI may reduce the stigma surrounding SI and prevent perceived burdensomeness among individuals with SI after SD. HIGHLIGHTS: Hearing a peer's SI reduced listeners' happiness and increased sadness and fear. Listeners' disgust did not change significantly after learning of a classmate's SI. Learning of a classmate's SI reduced the helpfulness of listeners' advice. [ABSTRACT FROM AUTHOR]

There might be differential characteristics between those who have attempted suicide once in their lifetime (single attempters) and those who have attempted suicide two or more times (multiple attempters). We aimed to identify the factors that differentiate single and multiple attempters in child and adolescents. This study was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, and the review protocol was registered in PROSPERO. We conducted a systematic literature search in three databases to identify original studies exploring the characteristics of single attempters vs. multiple attempters among adolescents. We considered a wide range for the definition of adolescent, following most recent recommendations: 10–24 years. We carried out a meta-analysis. Fourteen studies were included in the systematic review and 13 in the meta-analysis with a total sample of with a total of 4286 participants. The factors statistically significantly associated with being a multiple attempter in the meta-analysis were: anxiety disorders, depression severity, alcohol abuse, substance abuse, aggressiveness, and hopelessness. Multiple attempters have a more severe clinical profile, with greater severity of symptoms. Knowledge of the risk factors associated with being a multiple attempter could help us to predict which patients are more likely to reattempt suicide and need further monitoring and a tailored treatment. Prevention programs tailored for the adolescent population, along with identification of early risk factors, could help to prevent suicidal behavior among this vulnerable population. [ABSTRACT FROM AUTHOR]

Background: Ambivalence in attitudes towards life and death are associated with suicide ideation (SI) among adolescents. However, previous research was mainly cross‐sectional and did not examine through which psychopathological mechanisms (such as depression) attitudes towards life and death are associated with SI. Objective: The current longitudinal study examined the mediating role of depression at follow‐up in the association between attitudes towards life and death at baseline and SI at follow‐up among at‐risk adolescents referred to an outpatient psychiatric clinic. Methods: 129 adolescents aged 10–18 years (75.2% females) with a history of suicidal thoughts and behaviors were assessed at clinic intake and 1 month follow‐up (80% retention rate at follow‐up). All participants completed a questionnaire assessing attitudes towards life and death and SI severity at clinic intake, and depression and SI severity at 1 month follow‐up. Results: While controlling for SI severity at intake, attraction towards life at baseline, rather than attraction and repulsion towards death at baseline, led to higher SI severity at follow‐up, while depression at follow‐up fully mediated this association. Conclusions: Attitudes towards life, as well as depression play critical roles in the development of SI among adolescents. Interventions targeting reasons for living and promoting meaning of life may be beneficial in preventing depression and SI. [ABSTRACT FROM AUTHOR]

Issues Addressed: There is a paucity of data regarding depression and thoughts of self‐harm or suicide among gender and sexually diverse (GSD) people living within Australian regional/rural locations. This study aims to elucidate these issues and fill a critical gap. Methods: The sample included 91 GSD people from a regional community in South‐West Queensland utilising the PHQ‐9 to determine presence/severity of depression and self‐harm/suicide ideation. These data were drawn from a larger health and wellbeing survey. Raw mean scores were calculated to determine prevalence/severity of clinical symptoms. Bayesian ordinal regression models were employed to analyse between‐subgroup differences in depression and self‐harm/suicide ideation. Results: Overall, 80.2% of GSD sample experienced depression (35.2% severe, 45.1% mild/moderate) and 41.8% experienced self‐harm/suicide ideation in the past two‐weeks. Trans and nonbinary people experienced higher levels of depressions than sexually diverse cisgender people. Pansexual and bisexual people experienced higher levels of depression than gay people. Trans people experienced higher prevalence of self‐harm/suicide ideation than cisgender and nonbinary people, with no differences between sexuality subgroups. Conclusions: These findings contribute to deeper and more nuanced insights regarding clinically salient depressive and self‐harm/suicide ideation symptoms among trans, nonbinary, bisexual, pansexual and queer people in regional Australian communities, with the aim to ultimately reduce mental health prevalence, improve mental health outcomes and health promotion among GSD people. So What?: The current findings revealed GSD people experience high prevalence of depression and self‐harm/suicide ideation indicating tailored mental health awareness‐raising, training and health promotion is warranted to enhance psychological support. [ABSTRACT FROM AUTHOR]

Official statistics indicate that, while the global suicide rate has declined over the past twenty years, Iran has experienced an alarming increase of over 44%. Suicidal ideation is a significant risk factor for suicide. Research has demonstrated that social media relationships can influence the dissemination of suicidal thoughts and behaviors. Despite observable differences in how men and women use social media, as well as mixed findings regarding gender differences in suicidal ideation, there remains a gap in understanding these issues from a sociological perspective that focuses on communication network structures. The interconnected nature of social media facilitates network analysis through big data. Given the rising prevalence of social media usage, this study aimed to provide a sociological analysis of gender differences in suicidal ideation on Instagram. It will leverage Krohn’s network theory and its evolution, employing big data and social network analysis, while also offering policy implications. [ABSTRACT FROM AUTHOR]

ABSTRACT Self‐harm and suicide ideation are global health concerns, significantly impacting culturally and linguistically diverse (CALD) populations. Emergency departments (EDs) play a role in intervening following such presentations, yet there is limited research focusing on the CALD population's use of these services in Australia. This study aimed to explore patterns in ED use for self‐harm and suicide ideation, comparing CALD and non‐CALD persons in terms of service use, presentation themes and likelihood of repeat presentations. This was a cross‐sectional analysis of data from presentations for self‐harm and suicide ideation to the ED of a major metropolitan hospital in Victoria, Australia, from 2012 to 2019. The study used thematic analysis of triage notes, recurrent event analysis and logistic and linear regressions to compare CALD and non‐CALD presentations. CALD presentations comprised 1.3% (n = 202) of the total (n = 15 606). CALD presentations were more likely to occur during business hours, less likely to be triaged as urgent and more likely to result in ward admission. Occupation stressors were more common in CALD presentations. A lower likelihood of repeat presentations was observed among CALD persons. The study also highlighted the limitations of current data collection practices in capturing the full spectrum of CALD presentations. This study found variability in the recording of CALD status, warranting further investigation into how data collection in EDs may be improved. Increased ward admission rate and lower likelihood of repeat presentation by CALD persons also indicate that further research is required to understand help‐seeking and clinical decision‐making in the CALD population. [ABSTRACT FROM AUTHOR]

Suicidal behavior and Non-Suicidal Self-Injuries (NSSIs) are a major health problem in the adolescent population. New technologies can contribute to the development of innovative interventions in suicide prevention. Here, we present the SmartCrisis-Teen study protocol. The study consists of a randomized clinical trial which aims to evaluate the effectiveness of a digital safety plan to prevent suicidal behavior and NSSIs in adolescents. This is a multicentric study which will be conducted among the adolescent population, both in clinical and student settings, with a target sample of 1080 participants. The intervention group will receive an Ecological Momentary Intervention (EMI) consisting of a digital safety plan on their mobile phone. All participants will receive their Treatment As Usual (TAU). Participants will be followed for six months, with weekly and monthly telephone visits and face-to-face visits at three and six months. Participants will be assessed using traditional questionnaires as well as Ecological Momentary Assessment (EMA) and Implicit Association Tests (IATs). With this intervention, we expect a reduction in NSSIs through the acquisition of coping strategies and a decrease in suicidal behavior over the course of follow-up. This study provides a novel, scalable digital intervention for preventing suicidal behavior and NSSIs in adolescents, which could contribute to improving adolescent mental health outcomes globally. [ABSTRACT FROM AUTHOR]

Adolescent suicidality is associated with negative outcomes in adulthood. Suicide prevention has traditionally focused on identifying risk factors, yet suicide rates have remained stable. With suicidality often going undetected—especially suicidal ideation, further knowledge about protective factors is needed. The main objective of this study was to investigate potential protective factors for suicidal ideation from adolescence to adulthood. The study employed longitudinal population survey data, "Youth and Mental Health Study" consisting of self-reports at two-time points (mean age 14.9, SD = 0.6 and 27.2, SD = 0.6) (n = 2423 and n = 1198). Protective factors (at individual, social and environmental level) were selected based on a priori knowledge. Internal consistency of scales was analyzed using McDonald's omega. We used a linear mixed model with suicidal ideation as the dependent variable, time-points, a protective factor variable and their interaction as covariates, and individual participant as random effects. We adjusted for sex and also conducted separate analyses for males and females. The Benjamini–Hochberg procedure was used to adjust p-values for multiple hypotheses. Investigated protective factors were associated with temporal change in suicidal ideation (significant interactions). For both sexes, less emotion-orientated coping, higher self-perception scores, greater levels of physical activity and higher school wellbeing/connectedness were protective factors for suicidal ideations. Secure attachment and higher family function were protective factors for females only. The effects in adolescence were mostly maintained in adulthood. In this study, several protective factors for suicidal ideation persisted into adulthood, with distinct differences between males and females. [ABSTRACT FROM AUTHOR]

Transgender and gender diverse (TGD) youth experience chronic and acute stress associated with their gender identity contributing to their increased risk of suicide and suicide ideation (SI) compared to non-TGD peers. This study examined how invalidating and accepting gender-related experiences with a parent impact SI severity among TGD adolescents cross-sectionally and longitudinally, within-person. Participants were 15 TGD adolescents with past month SI recruited across community and clinical settings. Adolescents completed a baseline assessment of validated interviews and self-report measures on parental invalidation and SI severity. Over a 14-day follow-up period, adolescents reported instances of parental gender invalidation and acceptance, relative stress of those experiences, and SI severity multiple times/day via ecological momentary assessment (EMA). Bivariate associations of parental invalidation and acceptance with SI were examined at baseline, while multilevel models examined the relationship within-person over follow-up. Cross-sectionally, greater perceived invalidation and non-affirmation by their parents was associated with more severe SI. Over the follow up, instances of perceived parental invalidation were associated with passive SI within-person. Findings partially support the minority stress theory and social safety perspective by showing that perceived gender-invalidation from parents affects SI in TGD adolescents, both cross-sectionally and longitudinally. Further research is needed to identify specific emotional and cognitive factors, such as perceived stress, that contribute to the risk of SI among TGD youth and inform the development of targeted interventions for this vulnerable population. [ABSTRACT FROM AUTHOR]

Caregiving burden is set to increase with the rising incidence of cancer globally. The meta-analysis seeks to investigate the prevalence of suicide, suicidal ideation and self-harm among the caregivers of patients with cancer (CPCs). This PRISMA-adherent systematic review involved a systematic search of PubMed, Embase, Cochrane and PsycINFO for all studies that evaluated the prevalence of suicide, suicidal ideation and self-harm in CPCs. Random effects meta-analyses were used for primary analysis. Eleven studies were included. Meta-analyses indicated that the prevalence of suicidal ideation in CPCs was 11% (95%CI:6–18), suicide prevalence was 6% (95%CI:3–12), and self-harm prevalence was 15% (95%CI:8–26). Subgroup analyses revealed that CPCs above the age of 50 experienced a greater prevalence of suicidal ideation (17%, 95%CI:10–28) as compared to CPCs below 50 (6%, 95%CI:3–12). Family caregivers particularly spouses were also found to have a higher prevalence of suicidal ideation (17%, 95%CI:13–23), as compared to children (5%, 95%CI:2–10) or mothers (3%, 95%CI:1–8). Systematic review found that having a pre-existing mental health condition and lower socioeconomic status increased likelihood of suicidality. We highlight the need for more support of CPCs at risk of suicidality. Additional research is warranted to identify other risk and protective factors. • Statistically high prevalence of suicide ideation, suicide and self-harm in caregivers of cancer patients. • Cancer caregivers above 50 years old compared to those below 50 experienced greater suicide ideation. • Family caregivers particularly spouses compared to children or mothers experienced greater suicide ideation. • Pre-existing mental health condition and lower socioeconomic status increased the likelihood of suicidality. [ABSTRACT FROM AUTHOR]

Suicide is a serious public health problem and is the fourth leading cause of death among adolescents. Suicide ideation is the most significant predictor of suicide. However, few empirical studies have examined the relationship between stressful life events, insomnia, depression symptoms, self‐esteem, and suicide ideation among college students. This study builds on O'Connor's The integrated motivational‐volitional model of suicidal behavior theory will verify the relationship between these five factors through a large data study among college students, and further reveal the mechanisms and interventions of suicide ideation among college students. A total of 2717 (mean age = 19.81 years, 22.49% male) college students from South China participated in this behavioral and health survey. Using self‐reported questionnaires which were Adolescent Self Rating Life Events Check‐list, MINI‐C, Insomnia Severity Index, PHQ‐9, and Self‐Esteem Scale to assess the subjects' demographic information, suicide ideation, stressful life events, insomnia, depressive symptoms, and self‐esteem levels as comprehensively as possible. A moderated chain mediation model was used to validate their relationship. The results showed that stressful life events significant positively predicted insomnia symptoms, depressive symptoms, and suicide ideation. The mediating effect of depression between stressful life events and suicide ideation was significant. The chain mediating effect of insomnia and depression between stressful life events and suicide ideation was significant. However, the mediating effect of insomnia between stressful life events and suicide ideation was not significant. Also, the positive prediction of stressful life events and depression on suicide ideation was weaker when the individual's self‐esteem level was higher, and the moderated chain mediating effect was significant. This study developed a moderated chain mediation model, and proposes a new integrated stress coping‐self‐perception model of suicide ideation to discover the important role of self‐esteem levels in adolescent suicide prevention. Practitioner Points: Examined the relationship between stressful life events, suicidal ideation, insomnia, depression, and self‐esteem.Data from 2717 (mean age = 19.81 years, 22.49% male) college students were included.Proposed a new integrated stress coping‐self‐perception model of suicide ideation. [ABSTRACT FROM AUTHOR]

Spontaneous blood oxygen level-dependent signals can be indirectly recorded in different brain regions with functional magnetic resonance imaging. In this study resting-state functional magnetic resonance imaging was used to measure the differences in connectivity and activation seen in major depressive disorder (MDD) patients with and without suicidal ideation and the control group. For our investigation, a brain atlas containing 116 regions of interest was used. We also used four voxel-based connectivity models, including degree centrality, the fractional amplitude of low-frequency fluctuations (fALFF), regional homogeneity, and voxel-mirrored Homotopic Connectivity. Feature selection was conducted using a sequential backward floating selection approach along with a Random Forest Classifier and Elastic Net. While all four models yield significant results, fALFF demonstrated higher accuracy rates in classifying the three groups. Further analysis revealed three features that demonstrated statistically significant differences between these three, resulting in a 90.00% accuracy rate. Prominent features identified from our analysis, with suicide ideation as the key variable, included the Superior frontal gyrus (dorsolateral and orbital parts), the median cingulate, and the paracingulate gyri. These areas are associated with the Central Executive Control Network (ECN), the Default Mode Network, and the ECN, respectively. Comparing the results of MDD patients with suicidal ideation to those without suicidal ideations suggests dysfunctions in decision-making ability, in MDD females suffering from suicidal tendencies. This may be related to a lack of inhibition or emotion regulation capability, which contributes to suicidal ideations.

This paper identifies rates of suicidal ideation by certain demographic variables and selected mental health conditions. Analyses utilize medical claims data for adult employees aged 18-64 years in a large corporation during 2017-2021. Rates are calculated and adjusted by age, sex, and marital status. Among employees, significantly higher rates of suicidal ideation are in ages 18-39 years, women, and singles. Significantly higher rates also occur in those experiencing one of several mental health conditions, after adjusting for demographic variables. Associations involving ADHD and OCD become insignificant after further adjustment for comorbid mental illness. The higher rate of suicidal ideation for women is not significant in ages 50-64 and significantly decreases for anxiety and depression with older age. Further, the associations involving age, adjustment disorders, and schizophrenia significantly depend on sex. Suicidal ideation rates are significantly lower in ages 50-64 for women, and the higher rates of suicidal ideation for employees with adjustment disorders or schizophrenia are significantly greater for men than women. Higher rates of suicidal ideation occur in younger age, women, and singles. Adjustment disorders, anxiety, depression, bipolar disorder, and schizophrenia are associated with suicidal ideation after adjusting for demographic variables and comorbid mental health conditions. The strongest associations involve depression and schizophrenia.

BackgroundSuicidal ideation serves as a sensitive predictive indicator for non-suicidal self-injury （NSSI） behavior， and NSSI behavior brings profound effects to both mental and physical health of senior high school students. Existing studies have made exploration on the relationship among insomnia， anxiety and NSSI behavior in the general population， but the internal mechanism of NSSI behavior in senior high school students with suicidal ideation requires further study.ObjectiveTo explore the pathway of anxiety between insomnia and NSSI behavior in senior high school students， so as to provide references for the intervention on NSSI behavior in such demographic.MethodsFrom December 10 to 15， 2021， cluster sampling was adopted to select 2 572 senior high school students across three senior high schools in Hubei Province as the research objects. Assessment was conducted by using Insomnia Severity Index （ISI）， Generalized Anxiety Disorder Scale-7 item （GAD-7） and Adolescents Self-Harm Scale. Spearman correlation analysis was conducted to examine the correlation among scores of scales finished by senior high school students with suicidal ideation. Model 4 from the SPSS 20.0 Process 4.2 was employed to test the mediating path of anxiety between insomnia and NSSI behavior.ResultsA total of 2 421 valid questionnaires （94.13%） were recovered， which revealed 554 cases （22.88%） with suicidal ideation and 408 cases （16.85%） with NSSI behavior. The scores of ISI， GAD-7 and Adolescents Self-Harm Scale of senior high school students with suicidal ideation were higher than those of students without suicidal ideation （Z=17.124， 20.611， 21.314， P

Suicidality poses a significant public health threat and stands as a leading cause of death and disability. Aside from committed suicides, a substantial portion of suicidal behaviors comprises suicide attempts and suicidal ideation. These events may be characterized by a non-fatal outcome, shedding light on the possibility of recurrence. The objectives of the present study were to assess hospitalization rate trends related to any suicidal event and to elucidate the risk factors associated with recurrent suicidal behaviors. In this population-based study, an observational descriptive analysis was conducted on all hospital discharge forms (HDRs, Italian SDO) registered for the residents of the Veneto Region from 2012 to 2021. Cases of attempted suicide (AS) and suicidal ideation (SI) were defined according to ICD coding. Age-standardized hospitalization rates were computed with the direct method. Join Point Regression was used to assess the significance of variations in trends. Factor risks for the reiteration of suicidal behaviors were assessed by multivariate logistic regression. Higher prevalence of SI occurred among individuals under 40 years of age and those affected by psychiatric disorders. Conversely, among individuals aged 60 and above, AS was more common. SI turned out to be associated with a higher likelihood of reiteration compared to AS. Individuals suffering from personality disorders and those with a history of AS as index case exhibited increased risk for the reiteration of AS. Females, younger individuals, and individuals experiencing SI as first episode were instead identified as more likely to repeat this form of suicidal behavior. Contemporary economic and environmental crises, a recent pandemic, and numerous conflicts represent significant additional menaces to mental well-being. Our analysis highlights a concerning positive trend in suicide attempts and ideations, underscoring the imperative for Public Health Systems to implement targeted preventive strategies and mental health promotion campaigns. In the absence of structured suicide registries, we demonstrated that HDRs can serve as an invaluable foundation for preventionists to address the phenomenon and strategically plan interventions.

Abstract Aim There is limited evidence regarding predictors of changes in suicidal ideation (SI) in patients with major depressive disorder (MDD). The objective of this study was to describe changes in SI over a 6‐month period and identify their predictors from naturalistic observations of MDD patients. Methods In the cross‐sectional analysis, we examined 257 patients with MDD at the first‐visit assessment. Among the patients, 119 who completed the 6‐month assessment (completers) were included in the longitudinal analysis. For the evaluation of depressive symptoms, including SI, the Quick Inventory of Depressive Symptomatology‐Japanese version was administered at both the first‐visit and follow‐up assessments. At baseline, we also administered the Japanese version of the Ten Item Personality Inventory to assess personality traits and the PRIME Screen‐Revised to assess psychotic symptoms. Results In the cross‐sectional analysis of first‐visit patients, 36.2% (93/257) exhibited SI. Among completers, 14.3% (17/119) had prolonged SI. Among the completers with SI at the first‐visit assessment, 38.6% (17/44) had SI at the follow‐up assessment (prolonged SI). In linear regression models including all completers, prolonged SI was positively associated with endorsement of suspiciousness/persecutory ideas and negatively associated with higher age. Conclusion More than one‐third of completers who had SI at the first‐visit assessment experienced prolonged SI (SI at follow‐up). Our findings can help clinicians predict the course of MDD by identifying associated demographic and clinical characteristics.

Introduction Methods Results Conclusion Despite evidence that participation in suicide research is not associated with worsening ideation, behaviors, or intent, the rise of intensive longitudinal methods to assess ideation and behaviors necessitates further investigation for potential iatrogenic effects. The present study assessed rates of change in suicide ideation (SI) in a 10‐day daily diary study.Seventy‐two adult participants with ongoing SI participated in 10 daily diary surveys and three follow‐up assessments. One open‐ended item was included to address participant experiences in the study.A multilevel piecewise growth model revealed steady declines in SI for participants over the 10 days. However, rates of SI increased during the follow‐up assessments, indicating that participation in the daily surveys was associated with general reductions in SI. Further, qualitative analyses of experiences in the study revealed the following themes: Useful (n = 34), Heightened Awareness (n = 21), Functional (n = 6), Not Useful (n = 6), and Beneficence (n = 4).This study demonstrated that participation in suicide research, including intensive longitudinal methods such as daily diary studies, did not have iatrogenic effects on participants with SI. Qualitative results demonstrated the numerous benefits participants derived while taking part in this study. [ABSTRACT FROM AUTHOR]

Introduction: Suicide risk assessment based on self-report questionnaires is considered as problematic because risk states are dynamic and at-risk individuals may conceal suicidal intentions for several reasons. Therefore, recent research efforts increasingly focus on implicit risk markers such as the suicide attentional bias (SAB) measured with the Suicide Stroop Task (SST). However, most SST studies failed to demonstrate a SAB in individuals with suicide risk and repeatedly demonstrated insufficient psychometrics of the SST. This study aimed to investigate a SAB using a modified SST (M-SST) and to test its psychometric properties. Method: We compared n = 61 healthy controls and a high-risk inpatient sample of n = 40 suicide ideators and n = 40 suicide attempters regarding interference scores of positive, negative and suicide-related words. Interference scores were calculated by subtracting the mean reaction time (mean RT) of the neutral words from the mean RT of the suicide-related words (mean RT Suicide-mean RT Neutral), resulting in a suicide-specific interference score. Similarly, interference scores were calculated for the positive and negative words by subtracting the mean RT of neutral words from the mean RT of positive and negative words. Results: A Group x Interference ANOVA showed a significant interaction effect (p <.001, ηp2 = .09), indicating that group effects significantly vary across interference type. Post hoc comparisons revealed that both ideators and attempters demonstrated greater interferences only for suicide-related words compared to healthy controls, indicating a SAB in patients, while a difference between ideators and attempters was lacking. The suicide interference score classified with an AUC = 0.73, 95% CI [0.65 - 0.82], p <.001, between controls and patients with STBs. The M-SST demonstrated good internal consistency and convergent validity. Discussion: The study adds evidence to the assumptions of the Cognitive Model of Suicide, viewing a SAB as a cognitive marker of suicide vulnerability independently of the engagement in suicidal behavior. The results' clinical implications are discussed in the context of recommended intervention strategies during an acute suicidal state. Future studies with the M-SST should include non-suicidal patient controls to investigate whether a SAB is uniquely related to suicidality. [ABSTRACT FROM AUTHOR]