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Recent work has identified fearlessness about suicide, rather than fearlessness about death, as more theoretically relevant in the assessment of capability for suicide and thus a more appropriate construct of measurement. The aim of the current project was to develop and validate a scale specifically assessing fearlessness about suicide. Across two studies, support for a 7-item, single-factor structure of the Fearlessness About Suicide Scale (FSS) emerged. The FSS factor structure demonstrated a good fit in the first study and was replicated in the second study. Measurement invariance was examined across those identifying as men and women and found to be comparable. The FSS also demonstrated test–rest reliability and good convergent and divergent validity in community and undergraduate samples. Overall, findings indicate that the FSS has a replicable factor structure that generalizes across those identifying as men and women and may better assess components of capability for suicide than existing scales. [ABSTRACT FROM AUTHOR]

Objective: Eating disorder (ED), depression, and anxiety symptoms at admission and discharge were compared, as were admission‐to‐discharge changes, for transgender and gender diverse (TGD), and cisgender adolescents receiving intensive treatment for EDs. Method: Participants were 44 TGD and 573 cisgender adolescents admitted to a treatment facility. Participants completed the Eating Disorder Examination Questionnaire (EDE‐Q), Patient Health Questionnaire‐9 (PHQ‐9), and Generalized Anxiety Disorder‐7 (GAD‐7) at admission and discharge. Results: Both groups had elevated EDE‐Q scores at admission (TGD: M = 3.78, standard deviation [SD] = 1.70; cisgender: M = 3.33, SD = 1.74) that improved by discharge (TGD: M = 2.27, SD = 1.83, Cohen's d =.98; cisgender: M = 2.10, SD = 1.54, Cohen's d =.79); there were no differences in EDE‐Q between groups at admission (p =.09; odds ratio [OR] = 1.18, 95% confidence interval [CI] [.98, 1.44]) or discharge (p =.48; OR = 1.07, 95% CI [.88, 1.30]). On admission, TGD adolescents had higher suicidality, measured by PHQ‐9, item 9 (p <.001; OR = 1.94, 95% CI [1.51, 2.52]), and depression (p <.001; OR = 1.10, 95% CI [1.05, 1.16]) than cisgender participants. Severity decreased over treatment for all measures. Both groups showed similar improvement on suicidality (p =.93; OR =.98, 95% CI [.70,1.36]), depression (p =.42; OR = 1.02, 95% CI [.97, 1.07]), and anxiety (p =.14; OR = 1.05, 95% CI [.99, 1.12]). However, at discharge, suicidality (p =.02; OR = 1.40, 95% CI [1.04, 1.85]), depression (p <.01; OR = 1.06, 95% CI [1.02, 1.11]), and anxiety (p =.02; OR = 1.06, 95% CI [1.01, 1.12]) were higher for TGD adolescents than their cisgender peers. Discussion: All participants had similar ED symptom severity and improvement. Depression, anxiety, and suicidality remained elevated for TGD adolescents compared to their cisgender peers at discharge, suggesting the need for targeted treatment. Public Significance: Transgender and gender diverse (TGD) adolescents have increased risk of eating disorders (EDs); few studies examine how they respond to ED treatment. We examine treatment outcomes of TGD adolescents receiving ED treatment compared to their cisgender peers. We measured ED symptoms along with depression, anxiety, and suicidality at the beginning and end of treatment. While TGD adolescents showed similar improvement in ED symptoms, measures of depression, anxiety, and suicidality remained elevated at the time of discharge. [ABSTRACT FROM AUTHOR]

Active service members and Veterans with a combat-related traumatic brain injury (TBI) are four times more likely to attempt suicide than those without a TBI. TBIs are the signature injuries of the Post-9/11 conflicts and Combat Veterans (i.e., current and former service members who deployed in support of a combat mission) with these injuries are entitled to receive the Purple Heart medal. However, potentially tens of thousands of Combat Veterans did not receive, or were denied the Purple Heart during the first decade of the Global War on Terrorism because a TBI was not documented during the deployment. To our knowledge, this is the first study to explore the meaning of the Purple Heart and examine the impact of the Purple Heart on Army Combat Veterans with a combat-related TBI. Findings from this mixed methods study revealed that not receiving the Purple Heart is associated with increased suicide risk and lower quality of life after a brain injury. Additionally, thwarted belongingness, perceived burdensomeness, and perceived military institutional betrayal are associated with increased suicide risk in Army Combat Veterans with a TBI. This mixed methods study provides important insights into how Army culture is perceived and the power of the Purple Heart among this high-risk group of Combat Veterans. [ABSTRACT FROM AUTHOR]

In the frame of the interpersonal psychological theory of suicide (IPTS), Interpersonal Needs Questionnaire (INQ-15) assesses thwarted belongingness (TB) and perceived burdensomeness (PB), related to suicidal ideation (SI); Acquired Capability for Suicide Scale–Fearlessness About Death (ACSS-FAD) measures this component which contributes to lethal self-harm. The objective was to evaluate the psychometric properties of INQ-15 and ACSS-FAD in a population of Italian university students. Since the Italian INQ-15 was already validated, we translated ACSS-FAD through a multistage procedure and administered both to 1,665 Italian university students. Factor analysis confirmed a two-factor-related model of INQ-15, one factor of ACSS-FAD, and good reliability for both. We proved the association between INQ-15 and current SI and between ACSS-FAD and lifetime suicidal planning and/or suicide attempt. The convergent and discriminant validities were in line with those of previous studies. Both tools are valid and reliable to assess the constructs associated with suicide outcomes according to IPTS. [ABSTRACT FROM AUTHOR]

Purpose: Emerging evidence indicates that incarcerated populations' perceptions of dehumanization by officers are prevalent, yet measures of it are few, and to our knowledge, no self‐report measure of dehumanization from officers exists. To fill this gap, we have developed the Perceived Dehumanization from Officers Scale (PDOS), which is designed as a brief measure to assess perception of officer treatment as dehumanizing. Methods: In this article, we provide preliminary evidence from two studies examining the reliability and validity of the PDOS. In study 1, a jail sample (n = 411), we analyzed the exploratory factor structure, internal consistency, and discriminant validity (in relation to procedural justice [PJ]) of the PDOS. Additionally, using a cross‐sectional ordinary least squares (OLS) regression analysis, we related independent variables with the PDOS, the dependent variable. In Study 2, a prison sample (n = 2993), we confirmed the findings from study 1. Results: The PDOS appears to be a psychometrically sound measure of perceived dehumanization from officers with strong association between perceptions of PJ and perceived dehumanization from officers. Conclusions: The PDOS provides opportunity for future research, intervention through rehumanization efforts, and signals the important officer treatment. Importantly We close by discussing implications of these studies, limitations, and future research directions to further develop and test the PDOS. [ABSTRACT FROM AUTHOR]

This integrative review expands on the work of Kramer et al. (2020), by reviewing studies that utilized the Interpersonal Needs Questionnaire (INQ) to examine the interpersonal constructs (thwarted belongingness and perceived burdensomeness) of the Interpersonal Theory of Suicide (ITS) to understand suicidal thoughts and behaviors among service members and Veterans with combat experience. Very few studies (n = 9) in the literature were identified, however important relationships were revealed between combat exposure/experiences, thwarted belongingness, perceived burdensomeness, and suicidal thoughts and behaviors among military samples. Studies also reported risk factors for high levels of thwarted belongingness or perceived burdensomeness in military samples, such as moral injuries, betrayal, and aggression. This review highlights the utility of the INQ to measure ITS constructs among Post-9/11 U.S. Combat Veterans. [ABSTRACT FROM AUTHOR]

Background: Chronic constipation (CC) is defined by symptom criteria reflecting heterogenous physiology. However, many patients with CC have significant psychological comorbidities—an alternative definition using a biopsychosocial classification model could be warranted to inform future treatments. We sought to: (1) empirically derive psychological symptom profiles of patients with CC using latent profile analysis and (2) validate these profiles by comparing them on symptom severity, GI‐specific anxiety, body mass index (BMI), and anorectal manometry findings. Methods: Participants included adults presenting for anorectal manometry for CC (N = 468, 82% female, Mage = 47). Depression/anxiety symptoms and eating disorder (ED) symptoms (EAT‐26) were used as indicators (i.e., variables used to derive profiles) representing unique psychological constructs. Constipation symptoms, GI‐specific anxiety, BMI, and anorectal manometry results were used as validators (i.e., variables used to examine the clinical utility of the resulting profiles). Key Results: A 5‐profile solution provided the best statistical fit, comprising the following latent profiles (LPs): LP1 termed "high dieting, low bulimia;" LP2 termed "high ED symptoms;" LP3 termed "moderate ED symptoms;" LP4 termed "high anxiety and depression, low ED symptoms;" and LP5 termed "low psychological symptoms." The low psychological symptom profile (61% of the sample) had lower abdominal and overall constipation severity and lower GI‐specific anxiety compared to the four profiles characterized by higher psychological symptoms (of any type). Profiles did not significantly differ on BMI or anorectal manometry results. Conclusions and Inferences: Profiles with high psychological symptoms had increased constipation symptom severity and GI‐specific anxiety in adults with CC. Future research should test whether these profiles predict differential treatment outcomes. [ABSTRACT FROM AUTHOR]

Previous suicide attempts, psychopathology symptoms, and pain significantly increase risk of suicide, a leading cause of death. It is possible that patients across these three groups exhibit key differences that could provide insights into unique interventions for suicide-related outcomes. Data were collected using a standardized form at 432 emergency departments (EDs; 14,018 participants [females, n = 8,042; 57.4%; males, n = 5,976; 42.6%]). We conducted a series of ANOVAs to investigate if patients presenting for (1) suicide attempts (n = 33; 0.2%), (2) psychopathology symptoms (n = 1,104; 7.9%), or (3) pain (n = 12,881; 91.9%) varied across a variety of healthcare-relevant variables. Findings indicated that patients presenting with suicide attempts were seen with more urgency (F[2,12054] = 66.41, p <.001) and were more likely to be admitted to hospitalization (F[2,14015] = 187.296, p <.001), observation unit overall (F[2,14015] = 78.572, p <.001), or transferred to another hospital (F[2,14015] = 406.568, p <.001); they also required longer visits (F [2, 12054] = 66.41, p <.001) as compared to patients with psychopathology symptoms or pain. Notably, potentially important similarities between groups emerged: groups did not differ across leaving without medical screening, leaving against medical advice, or contact with healthcare providers in the long-term (i.e., twelve months) or short-term (i.e., 72 hours) preceding ED admission. These findings in particular indicate that there could be ample time (1) prior to admission to intervene and (2) during care in EDs to connect patients to goal-oriented, time-limited evidence based psychotherapies at a time when they may be particularly willing to engage in care. [ABSTRACT FROM AUTHOR]

Individuals with schizophrenia are at increased risk for suicide, and the Demoralization Hypothesis states that non-delusional awareness of one's social, cognitive, or occupational deterioration elicits depression and hopelessness. Both depression and hopelessness are established risk factors for suicide and are features of schizophrenia. The present study investigated whether insight into one's schizophrenia yields suicidal ideation, specifically by way of thwarted belongingness and perceived burdensomeness, which are constructs related to demoralization and measured by the Interpersonal Needs Questionnaire (INQ). Three separate models explored the mediating role of INQ scores on suicidal ideation in 99 participants with schizophrenia. With suicidal ideation entered as the dependent variable and INQ scores entered as the mediator, the first model included insight as the independent variable, the second included cognitive functioning, and the third included cognitive deterioration post-illness-onset. Consistent with our hypothesis, INQ scores related to suicidal ideation (B =.03, SE =.01, p <.001). However, neither insight, cognitive functioning, nor cognitive deterioration predicted INQ scores or suicidal ideation. Additionally, INQ scores did not mediate relationships with suicidal, ideation. Although INQ scores led to increased suicidal ideation, neither insight into illness, current cognitive functioning, nor shift in functioning led to increased INQ scores. Implications are discussed, and future directions are proposed. [ABSTRACT FROM AUTHOR]

Abstract\nPUBLIC SIGNIFICANCE STATEMENTSelf-dehumanization, a phenomenon relevant to social psychology, has been somewhat absent from clinical psychology research. Furthermore, measures of self-dehumanization are few, and to our knowledge, no validated and generalizable self-report measure exists. To address this gap, we present a Self-Dehumanization Scale (SDS). This work incorporates evidence from three studies examining the reliability, validity, and factor structure of the SDS in an undergraduate sample, a clinically relevant community sample, and a sample with at least one minoritized identity. The SDS was derived from dehumanization theory and was developed to measure animalistic and mechanistic self-dehumanization. All studies suggested an 8-item SDS, with Study 1 suggesting a single-factor solution with, however, some indication of a two-factor structure, and Studies 2 and 3 affirming a two-factor solution. The SDS, and its respective factors, generally showed discriminant validity from related, yet distinct, measures of self-hate, self-esteem (Study 2), dissociation, and measures of discrimination (in Study 3). Finally, animalistic and mechanistic SDS showed somewhat mixed but promising evidence regarding their associations to minoritized identities and to symptoms of depression, and suicide risk, above and beyond each study’s fairly stringent control variables. Thus, self-dehumanization may prove to be a clinically promising leverage point in assessing psychopathology, particularly among minoritized communities.This work develops and tests a generalizable measure of self-dehumanization, perceiving oneself as nonhuman, as a tool to further understand and assess psychopathology. Findings indicate a validated scale that shares relations to minoritized identity and to symptoms of depression and suicide risk above and beyond known risk factors. [ABSTRACT FROM AUTHOR]

Background and ObjectivesDesignMethodsResultsConclusionsSuicidal ideation (SI) during the postpartum phase is linked with suicide, a leading cause of death during this period. Antenatal depression and anxiety symptoms have both been linked with increased risk for postpartum SI. However, research aimed at examining the relative contributions of antenatal anxiety and depression symptoms towards postpartum SI remains nascent. In this study, we investigated the relative contribution of antenatal anxiety symptoms, depression symptoms, and SI towards postpartum SI.These data are from a longitudinal study in which American mothers were assessed during pregnancy and again at six- to eight weeks postpartum.Data were analyzed using correlations and logistic regression models.Antenatal anxiety symptoms and antenatal depression symptoms were significantly correlated with postpartum SI. Results from a logistic regression model indicated that antenatal anxiety symptoms (T1; OR = 1.185 [1.125, 1.245], p = .004), but not antenatal depression symptoms (T1; OR = 1.018 [0.943, 1.093], p = .812) or antenatal SI (T1; OR = 1.58 [0.11, 22.29], p = 0.73), were significantly associated with postpartum SI.Antenatal anxiety symptoms, depression symptoms, and SI were positively associated with postpartum SI. When examined simultaneously, anxiety symptoms during the antenatal phase (but not depression symptoms or SI) predicted SI in the postpartum phase. [ABSTRACT FROM AUTHOR]

We lack knowledge about the short-term predictors of suicide attempts (SAs) among treatment-seeking individuals. The current study evaluated whether (a) interpersonal difficulties, hopelessness, and affective states are associated with an increased risk of SAs on the same and the next day; (b) these daily states are interconnected differently over time among inpatients who attempt suicide compared to those who do not. In total, 110 psychiatric inpatients who attempted suicide during their stay at a psychiatric hospital self-reported their suicidal ideation, negative affect, positive affect, wish to live, interpersonal needs, and hopelessness each day (3,018 daily reports). Multilevel structural equation modeling was used to examine same-day and next-day predictors of SAs. Multilevel temporal network models assessed interconnectedness between daily predictors and were compared to network models from a matched sample of 110 psychiatric inpatients who did not attempt suicide. In multivariate models, increases in perceived burdensomeness were significantly associated with same-day SAs, whereas increased hopelessness was associated with next-day SAs. Network models for patients who attempted suicide indicated that hopelessness and suicidal ideation were central to change, leading to next-day deteriorations in mental health. In subsequent models, feeling calm and relaxed, and feeling fresh and rested were centrally connected to other variables. The centrality of these metrics tended to be higher than in the network models for patients who did not attempt suicide, suggesting differences in the interplay between risk and protective factors. This study suggests routinely monitoring interpersonal factors and hopelessness may help identify increased short-term risk of SAs among psychiatric inpatients. General Scientific Summary: Daily fluctuations in cognitive–affective states, such as interpersonal difficulties and hopelessness, may signal short-term risk for suicide attempts beyond reported levels of suicidal ideation. Hopelessness in particular exhibits high interconnectedness with other risk factors, potentially making it an effective target for interventions. [ABSTRACT FROM AUTHOR]

Background: DSM-5 differentiates avoidant/restrictive food intake disorder (ARFID) from other eating disorders (EDs) by a lack of overvaluation of body weight/shape driving restrictive eating. However, clinical observations and research demonstrate ARFID and shape/weight motivations sometimes co-occur. To inform classification, we: (1) derived profiles underlying restriction motivation and examined their validity and (2) described diagnostic characterizations of individuals in each profile to explore whether findings support current diagnostic schemes. We expected, consistent with DSM-5 , that profiles would comprise individuals endorsing solely ARFID or restraint (i.e. trying to eat less to control shape/weight) motivations., Methods: We applied latent profile analysis to 202 treatment-seeking individuals (ages 10-79 years [ M = 26, s.d. = 14], 76% female) with ARFID or a non-ARFID ED, using the Nine-Item ARFID Screen (Picky, Appetite, and Fear subscales) and the Eating Disorder Examination-Questionnaire Restraint subscale as indicators., Results: A 5-profile solution emerged: Restraint/ARFID-Mixed ( n = 24; 8% [ n = 2] with ARFID diagnosis); ARFID-2 (with Picky/Appetite; n = 56; 82% ARFID); ARFID-3 (with Picky/Appetite/Fear; n = 40; 68% ARFID); Restraint ( n = 45; 11% ARFID); and Non-Endorsers ( n = 37; 2% ARFID). Two profiles comprised individuals endorsing solely ARFID motivations (ARFID-2, ARFID-3) and one comprising solely restraint motivations (Restraint), consistent with DSM-5 . However, Restraint/ARFID-Mixed (92% non-ARFID ED diagnoses, comprising 18% of those with non-ARFID ED diagnoses in the full sample) endorsed ARFID and restraint motivations., Conclusions: The heterogeneous profiles identified suggest ARFID and restraint motivations for dietary restriction may overlap somewhat and that individuals with non-ARFID EDs can also endorse high ARFID symptoms. Future research should clarify diagnostic boundaries between ARFID and non-ARFID EDs.

Objective: Suicidal thoughts and behaviors (STBs) are a serious public health problem in the United States and of particular concern among active-duty service members and veterans. Research indicates hyperarousal, through its relevance across other disorder constructs and correlations with risk factors, may confer suicide risk in this population. Investigation of hyperarousal's connection with STBs and risk factors relevant to military mental health may be illuminating., Method: A network analysis was conducted to examine whether hyperarousal transdiagnostically linked STBs with psychopathology symptoms and relevant correlates (i.e., alcohol use disorder symptoms, substance abuse, insomnia, and cognitive anxiety sensitivity [AS]) in a sample of active-duty service members and veterans ( N = 1,050)., Results: Hyperarousal shared direct associations with suicidal ideation, suicidal intent, and lifetime history of suicide attempts when examined in independence. It indirectly correlated with STBs via cognitive AS and insomnia when psychopathology symptoms and relevant correlates were included in the network. The network structure did not differ between active-duty personnel and veterans., Conclusions: Hyperarousal examined in independence may appear to directly correlate with STBs but this relationship may be better accounted for by cognitive AS and insomnia. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Emerging evidence indicates that a nontrivial proportion of suicide attempt (SA) survivors develop clinically significant posttraumatic stress disorder (PTSD) symptoms related to their suicide attempt (SA-PTSD). However, SA-PTSD is rarely assessed in either clinical practice or research studies, due at least in part to a lack of research examining approaches to assessing SA-PTSD. This study examined the factor structure, internal consistency, and concurrent validity of scores on a version of the PTSD Checklist for DSM-5 (PCL-5) specifically anchored to one's own SA (PCL-5-SA)., Method: We recruited a sample of 386 SA survivors who completed the PCL-5-SA and related self-report measures., Results: A confirmatory factor analysis (CFA) that specified a 4-factor model consistent with the DSM-5 conceptualization of PTSD indicated that the PCL-5-SA had acceptable fit in our sample, χ ²(161) = 758.03, RMSEA = 0.10, 90% CI =[0.09-0.11], CFI = 0.90, and SRMR = 0.06. The PCL-5-SA total and subfactor scores demonstrated good internal consistency (ωs = 0.88-0.95). Significant positive correlations of PCL-5-SA scores with anxiety sensitivity cognitive concerns, expressive suppression, depression symptoms, and negative affect provided evidence for concurrent validity ( r s = .25-.62)., Conclusion: Results suggest that SA-PTSD, when measured with a specific version of the PCL-5, is a conceptually coherent construct that operates consistent with the DSM-5 conceptualization of PTSD stemming from other traumatic events. (PsycInfo Database Record (c) 2024 APA, all rights reserved).