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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]

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]

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]

Objective: Suicidal ideation and suicidal behaviors are major public health concerns in the United States and are difficult to treat and predict. Risk factors that are incrementally informative are needed to improve prediction and inform prevention of suicidal thoughts and behaviors. Uncontrollability of suicidal ideation, one parameter of suicidal ideation, is one such candidate. Method: In the current study, we assessed the predictive power of uncontrollability of suicidal ideation, over and above overall suicidal ideation, for future suicidal ideation in a large sample of active‐duty service members. A total of 1044 suicidal military service members completed baseline assessments, of whom 664 (63.6%) completed 3‐month follow‐up assessments. Results: While baseline overall suicidal ideation itself was the strongest predictor of future suicidal ideation, uncontrollability of suicidal ideation added some incremental explanatory power. Conclusion: Further study of uncontrollability of suicidal thought is needed to elucidate its impact on suicidal outcomes. [ABSTRACT FROM AUTHOR]

Objective: This randomized controlled trial of the online intervention, man therapy (MT), evaluated efficacy to reduce suicidal ideation (SI) and depression among working‐aged men. Method: Five‐hundred and fifty‐four men enrolled and 421 completed all surveys. Control Condition men explored the Healthy Men Michigan (HMM) website and Intervention Condition men explored HMM and MT. Hypotheses included men who used MT would report decreased SI and depression over time compared to Control Condition men. Results: Latent growth curve modeling revealed improvements in SI (slope = −0.23, p < 0.001, 95% CI: −0.29, −0.16) and depression (slope = −0.21, p < 0.001, 95% CI: −0.23, −0.18) over time for men in both groups; however, there was no difference in slope based on group assignment. Depression, lifetime suicide attempts, and interpersonal needs were associated with SI. Interpersonal needs and poor mental health were associated with depression. No group differences in change in risk and protective factors over time were observed. MT sub‐group analyses revealed significant improvements in risk and protective factors. Conclusion: While a direct effect of MT versus HMM on SI or depression was not observed, men in both groups improved. Results suggest online screening might play a role in reducing SI and depression among men and there are potential benefits to MT related to mental health, social support, and treatment motivation. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to compare symptom severity of eating disorders (EDs), depression and anxiety at admission and discharge for transgender and nonbinary (TNB) individuals and cisgender adult individuals receiving treatment for EDs at higher levels of care (HLOC), adding to the limited research in this area. Method: Participants were 25 TNB individuals and 376 cisgender individuals admitted to a HLOC ED treatment facility. Participants completed the Eating Disorder Examination Questionnaire (EDE‐Q), Patient Health Questionnaire‐9, and Beck Anxiety Inventory at admission and discharge. Results: TNB individuals showed significant improvements on EDE‐Q global scores between admission and discharge (Cohen's d = 1.27), and showed similar improvements on the EDE‐Q over the course of treatment (Cohen's d = 0.06) when compared to cisgender individuals. TNB individuals had more severe depression at admission (Cohen's d = 0.61). Although depression improved over the course of treatment for both groups, TNB individuals showed less improvement (Cohen's d = 0.59). Suicidality was higher for TNB individuals on admission and discharge and did not improve significantly over the course of treatment (Cohen's d = 0.38). Discussion: This study provides preliminary evidence that TNB and cisgender individuals show similar improvement in ED symptoms during HLOC treatment. However, TNB individuals have more severe depression and less improvement in depression compared to cisgender individuals, without improvement in suicidality. TNB individuals may benefit from care targeting depression and suicidality during ED treatment. Public Significance Statement: TNB individuals have increased risk of EDs. Little research addresses how TNB individuals respond to ED treatment, which was traditionally created for cisgender individuals. We present one of the first studies examining ED treatment outcomes for TNB adults. TNB individuals showed improved ED symptoms with treatment, but less improvement in depression and their suicidality remained elevated. This suggests the need for targeted treatment. [ABSTRACT FROM AUTHOR]

Objectives: Suicidal ideation is a pervasive and painful experience that varies considerably in its phenomenology. Here, we consider how one key risk variable might inform our understanding of variation in suicidal ideation: emotion-related impulsivity, the trait-like tendency towards unconstrained speech, behaviour, and cognition in the face of intense emotions. We hypothesized that emotion-related impulsivity would be tied to specific features, including severity, perceived lack of controllability, more rapidly fluctuating course, higher scores on a measure of acute suicidal affective disturbance, and more emotional and cognitive disturbance as antecedents. Methods: We recruited two samples of adults (Ns = 421, 221) through Amazon Mechanical Turk (MTurk), with oversampling of those with suicidal ideation. Both samples completed psychometrically sound self-report measures online to assess emotion- and non-emotion-related dimensions of impulsivity and characteristics of suicidal ideation. Results: One form of emotion-related impulsivity related to the severity, uncontrollability, dynamic course, and affective and cognitive precursors of ideation. Conclusions: Despite limitations of the cross-sectional design and self-report measures, the current findings highlight the importance of specificity in considering key dimensions of impulsivity and suicidal ideation. [ABSTRACT FROM AUTHOR]

Objective: Suicidality is known to be elevated among people with an eating disorder. The aim of the current study was to examine whether any of three specific behavioral facets of eating disorders (i.e., purging, binge eating, restricting) would be the strongest predictors of suicidal ideation, controlling for one another, in longitudinal analyses from admission to discharge. We hypothesized that purging, above and beyond restricting or binge eating, would be the most important predictor of suicidal ideation. Method: In the present study, patients with an eating disorder (N = 936), the majority of whom met criteria for a current DSM‐5 diagnosis of Anorexia Nervosa (n = 560), completed the Eating Pathology Symptoms Inventory (EPSI) and the Beck Depression Inventory II‐Item 9 suicidal ideation index, at admission and again at discharge. The settings were eating disorder treatment facilities offering inpatient, residential, partial hospitalization program (PHP), and intensive outpatient (IOP) levels of care. We pitted EPSI purging, EPSI restriction, and EPSI binge eating against one another in a regression framework predicting discharge suicidal ideation controlling for suicidal ideation at admission. Results: EPSI Purging significantly predicted both presence/absence of suicidal ideation (β =.22, t = 2.48, p =.01; OR = 1.25, 95% CI [1.05, 1.49]) and intensity of suicidal ideation (β =.04, t = 2.31, p =.02) at discharge, whereas neither EPSI Restricting nor EPSI Binge Eating did (p >.30). Discussion: Study results suggest that purging may have particular relevance in estimating suicide risk in patients with an eating disorder. [ABSTRACT FROM AUTHOR]

Objectives: Suicidal ideation (SI) nearly always precedes lethal suicide attempts. Anger may play a role in SI, but this appears to vary by gender and nuances in this relationship are unclear. Method: We investigated whether levels of (a) anger and (b) SI vary by gender, (c) the cross‐sectional relationship between anger and SI, and (d) if gender moderates that relationship in two samples: adults seeking care for excessive anger (Study 1) and undergraduates endorsing previous suicide attempt (Study 2). Results: In Study 1, anger was more commonly endorsed in women; however, in Study 2, anger did not vary by gender. In both studies, SI did not vary by gender. Further, in both studies, anger and SI were positively related. The relationship between anger and SI did not vary by gender in either study. Conclusions: The strength of the relationship between anger and SI did not vary by gender. [ABSTRACT FROM AUTHOR]

The exact medical complications, leading to the well‐known high risk of death in patients with anorexia nervosa (AN), remain elusive. Such deaths are often abrupt with no satisfactory explanation. Suspected causes include cardiac QTc prolongation and, in turn, torsade de pointes (TdP). Psychotropic medications often prescribed to these patients are linked to QTc prolongation. AN is also presumed to cause heart failure due to malnutrition with increased susceptibility to QTc prolongation, and TdP, resulting in sudden cardiac death. Recent literature, however, is conflicting, and the likely cause of death may involve other cardiac abnormalities, such as low heart rate, abnormal heart rate variability, or increased QT dispersion. With an ongoing gap in research explaining the high mortality rate in AN, a compelling need to define the exact proximate causes of death in these patients remains. Because low serum potassium is the most common trigger for TdP, we postulate the early signal of sudden cardiac death, especially in patients with AN who purge, is hypokalemia. We also speculate that hypoglycemia could be a major factor in the sudden death of patients with AN as well as bradycardia or sinus arrest. A path forward to elucidate potential causes is offered. [ABSTRACT FROM AUTHOR]

Objectives: Discrepancies persist regarding the extent to which different pain measures provide similar information and relate to capability for suicide and self‐injurious behaviors. This study examined pain threshold, tolerance, and persistence across four modalities (cold, heat, pressure, shock) and assessed associations with self‐reported capability for suicide, non‐suicidal self‐injury (NSSI), and suicide attempts. Methods: A sample of 211 students who reported lifetime suicidal ideation completed four behavioral pain tasks and self‐reported on capability for suicide, NSSI, and self‐injurious behaviors. Results: All pain thresholds, tolerances, and persistences were positively correlated across the four tasks. Pain facets were related to self‐reported capability for suicide with small effect sizes but generally did not differ across suicide attempt or NSSI histories. Conclusions: Pain thresholds, tolerances, and persistences demonstrated convergent validity across the four modalities, suggesting that these tasks provide similar information. Although the relation between pain and self‐injurious behaviors remains unclear, these tasks can generally be used interchangeably. [ABSTRACT FROM AUTHOR]

Suicidal thoughts and behaviors (STBs) are thought to result from, at least in part, abnormalities in various neural systems. Event‐related potentials (ERPs) are a useful method for studying neural activity and can be leveraged to study neural deficits related to STBs; however, it is unknown how effective ERPs are at differentiating various STB groups. The present meta‐analysis examined how well ERPs can differentiate (a) those with and without suicidal ideation, (b) those with and without suicide attempts, (c) those with different levels of suicide risk, and (d) differences between those with suicide attempts versus those with suicidal ideation only. This meta‐analysis included 208 effect sizes from 2,517 participants from 27 studies. We used a random‐effects meta‐analysis using a restricted maximum likelihood estimator with robust variance estimation. We meta‐analyzed ERP‐STB combinations that had at least three effect sizes across two or more studies. A qualitative review found that for each ERP and STB combination, the literature is highly mixed. Our meta‐analyses largely did not find significant relationships between STBs and ERPs. We also found that the literature is likely severely underpowered, with most studies only being sufficiently powered to detect unrealistically large effect sizes. Our results provided little‐to‐no support for a reliable relationship between the ERPs assessed and STBs. However, the current literature is severely underpowered, and there are many methodological weaknesses that must be resolved before making this determination. We recommend large‐scale collaboration and improvements in measurement practices to combat the issues in this literature. Our meta‐analysis is the first to synthesize the literature on the relationship between suicidal thoughts and behaviors (STB) and ERPs. This meta‐analysis provides evidence that ERPs may not be related to STBs. However, the study points toward reforms needed in this field before this conclusion can be drawn, including larger sample sizes, and better measures of STBs. [ABSTRACT FROM AUTHOR]

Objectives: There is a dearth of research on suicidal thoughts and behaviors among eating disorder patients diagnosed with binge eating disorder (BED) or other specified feeding or eating disorder (OSFED). This pilot study evaluated presence and severity of suicidal thoughts and behaviors by eating disorder diagnosis in a transdiagnostic clinical eating disorder sample. Methods: Participants were individuals (N = 257; 91.1% female; 94.6% Caucasian) currently receiving eating disorder treatment for anorexia nervosa (AN), bulimia nervosa (BN), BED, or OSFED. Participants completed online measures of variables. Results: Lifetime and current presence and severity of suicidal ideation and suicide attempts were statistically similar among diagnostic groups. Conclusion: Though largely overlooked, treatment‐utilizing individuals with BED and OSFED may experience elevated rates and severity of suicidal thoughts and behaviors, like those with AN and BN. Attention to suicide‐related risk assessment and management is needed when treating individuals with eating disorders, regardless of diagnosis. [ABSTRACT FROM AUTHOR]

Objective: The Interpersonal Needs Questionnaire (INQ‐15) is a self‐report measure of thwarted belongingness and perceived burdensomeness, two constructs associated with suicidal ideation. The objective of the current study was to translate the INQ‐15 from English to Italian (INQ‐15‐I) and to test its factor structure, reliability, and validity in Italian samples. Method: We examined (a) whether the components of the hypothesized two‐factor measurement model are invariant across a community sample (N = 510) and a clinical sample (N = 259); (b) the relations between the INQ‐15‐I factors and measures of depression (Beck Depression Inventory‐II), hopelessness (Beck Hopelessness Scale), and suicidal ideation (Beck Scale for Suicide Ideation); (c) the reliability and psychometric properties of the INQ‐15‐I. Results: Results from multigroup confirmatory factor analyses supported the adequacy of the two‐factor model to represent thwarted belongingness and perceived burdensomeness. The model is invariant across community and clinical groups, showing excellent fit. The two INQ‐15‐I scales measure highly intercorrelated constructs. Both significantly correlate with depression, hopelessness, and suicidal ideation, and correlations are high in the clinical sample. Conclusion: The INQ‐15‐I is a valid and reliable measure of thwarted belongingness and perceived burdensomeness. Implications for research, assessment, and intervention in suicidal ideation are discussed. [ABSTRACT FROM AUTHOR]

Objective: This study aims to document the impact of the COVID‐19 pandemic on mental health. Method: We compared a nationally representative online sample of 2,032 U.S. adults in late April 2020 to 19,330 U.S. adult internet users who participated in the 2018 National Health Interview Survey (NHIS) using the Kessler‐6 scale of mental distress in the last 30 days. Results: Compared to the 2018 NHIS sample, U.S. adults in April 2020 were eight times more likely to fit criteria for serious mental distress (27.7% vs. 3.4%) and three times more likely to fit criteria for moderate or serious mental distress (70.4% vs. 22.0%). Differences between the 2018 and 2020 samples appeared across all demographic groups, with larger differences among younger adults and those with children in the household. Conclusions: These considerable levels of mental distress may portend substantial increases in diagnosed mental disorders and in their associated morbidity and mortality. [ABSTRACT FROM AUTHOR]

Objective: The Suicide Risk Assessment and Management Decision Tree (DT) is a clinician‐administered assessment that leads to risk categorizations that correspond with actionable strata. This study investigated the construct validity and test–retest reliability of the DT risk categories across two time points. Method: Outpatients (N = 731) completed a battery of self‐report measures. Spearman's correlations were used to examine the relationships between DT suicide risk level and suicidal symptoms, theory‐based risk factors, psychiatric correlates, and DT suicide risk level at Timepoint 2. Correlations were analyzed for significant differences to examine the divergent validity of the DT. Results: Results, overall, were in line with hypotheses, with the exception of depression and thwarted belongingness. Conclusions: Findings provide evidence for the reliability, convergent validity, and discriminant validity of the DT. This clinician‐administered suicide risk assessment may be useful for standardization of the assessment and management of suicide risk in outpatient clinical settings. [ABSTRACT FROM AUTHOR]

Objective: Amidst restrictions to reduce the spread of COVID‐19, jokes have surfaced regarding weight gain during the pandemic. The current study documents perceived changes since COVID‐19 and compares these to observed longitudinal changes in reported weight, BMI, and how college students described their weight from January to April 2020. Method: Undergraduates (N = 90; 88% female) completed on‐line assessments before and after students were required to leave campus due to COVID‐19. Time 1 and Time 2 surveys collected demographic information, height, weight, and a Likert‐scale rating to describe perceived weight, ranging from 1 = very underweight to 5 = very overweight (weight description). Time 2 surveys added questions for perceived changes since COVID‐19 in body weight, eating, physical activity, various forms of screen time, and concerns about weight, shape, and eating. Results: Time 2 surveys indicated perceived increases in body weight, eating, and screen time, and decreases in physical activity along with increased concerns about weight, shape and eating since COVID‐19. Longitudinal data indicated no significant change in weight, body mass index (BMI), or BMI category, but how participants described their weight changed significantly from January to April 2020. Compared to longitudinal changes in BMI category, students' weight description was significantly more likely to fall into a higher category from Time 1 to Time 2. Discussion Shifts in how body weight is experienced in the wake of COVID‐19 that do not align with observed changes in reported weight may reflect cognitive distortions that could increase risk for disordered eating in some individuals. [ABSTRACT FROM AUTHOR]

Objective: Research has established pairwise relationships between suicidal ideation (SI), low Body Trust, elevated agitation, and eating disorders, but knowledge of how these aspects relate in a single model is lacking. This study tested an indirect pathway with low Body Trust relating to severity of SI via agitation in a clinical eating disorder sample. Method: Participants (N = 319; 92.8% female; 93.4% Caucasian; mean age 21.8 years) were adults currently receiving specialized eating disorder treatment (44.3% intensive outpatient or higher level‐of‐care) who completed online self‐report measures of study variables. The PROCESS macro was utilized to test proposed pathways. Results: Low Body Trust was significantly directly associated with increased severity of current SI, both before (B = −.89, p <.001) and after (B = −.51, p =.001) accounting for the indirect effect through agitation, also significant (B = −.37, SE =.06, CI −.52 to −.26). Discussion Perception of the body as unsafe may be related to agitation, and this intolerable sensation of trapped arousal could contribute to a desire to die. Future work should investigate these relationships prospectively to determine the relevance of Body Trust for assessment and treatment of suicide‐related factors among individuals with eating disorders. [ABSTRACT FROM AUTHOR]

Purpose: Rural communities in Australia have an elevated risk of suicide. The aim of the current study was to evaluate a well‐being and suicide prevention education workshop, SCARF (Suspect, Connect, Ask, Refer, Follow‐Up) developed for Australian farming and rural communities. Methods: The SCARF program was delivered to 14 groups, a convenience sample including frontline agricultural workers and farmers from New South Wales. The Literacy of Suicide Scale, Stigma of Suicide Scale, and items assessing confidence to assist others were administered immediately before and after the workshop, and at 3‐month follow‐up. The Warwick Edinburgh Mental Wellbeing Scale was given immediately before and at 3‐month follow‐up. In total, 255 agreed to participate in the study, with 127 completing 3‐month follow‐up. Data were analyzed using linear mixed‐effects regression. Findings: There was a significant increase in suicide literacy and confidence to assist others immediately after the workshop, which remained significant at 3‐month follow‐up. Mental well‐being significantly improved at 3‐month follow‐up. Conclusion: The SCARF program is unique for its brevity, cultural specificity, focus on health, and incorporation of the biopsycho‐ecological model and the Interpersonal Theory of Suicide. It represents a useful program for Australian farming and rural communities to improve mental well‐being, suicide literacy, and confidence to recognize and respond to suicidality. [ABSTRACT FROM AUTHOR]

We review the theoretical and empirical literature on the role of self-concept in suicidal behavior in the context of mood disorders (i.e., unipolar depression and bipolar spectrum disorders). The main themes emanating from this review are then juxtaposed against (a) the Interpersonal-Psychological Theory of Suicide and (b) biological research on the role of inflammatory processes in suicidality. Such a juxtaposition paves the way for a bio-cognitive-interpersonal hypothesis. Pathologies of the self-concept-primarily self-criticism-propel mood disorder sufferers to generate interpersonal stress that culminates in two proximal causes of suicidality: thwarted belongingness and perceived burdensomeness. In turn, these two interpersonal conditions set in motion systemic biosystemic inflammation, serving as a proximal cause for suicidality in mood disorders. We conclude by describing a research project aimed at testing this hypothesis, and by outlining pertinent implications for assessment, treatment, and prevention. [ABSTRACT FROM AUTHOR]

Objectives: Suicide attempts (SAs), by definition, represent a risk for serious injury or death; thus, one's SA may contribute to the development of posttraumatic stress disorder (PTSD). Yet, empirical data on this topic are lacking. This study aimed to characterize the phenomenology, rate, and associated features of PTSD following one's SA. Method: A total of 386 adult SA survivors recruited from web‐based sources participated. Results: Overall, 27.5% (95% confidence interval = 23.1–31.9%) of SA survivors screened positive for a probable SA‐related PTSD diagnosis. Individuals with a probable SA‐related PTSD diagnosis reported greater current suicidal intent than those without this probable diagnosis; this association was significant at low, but not high, levels of depression symptoms. Conclusions: A substantial proportion of SA survivors may experience SA‐related PTSD. SA‐related PTSD may be a viable assessment and intervention target to improve the quality of life and to reduce future suicide risk among SA survivors. [ABSTRACT FROM AUTHOR]

Objective: Utilizing a sample of military service members at risk of suicide, this study aimed to: (a) identify patterns of suicide attempt (SA) history reporting across five measures and (b) evaluate whether consistent SA reporters (i.e., individuals who consistently report an SA history across measures) differ from inconsistent SA reporters on other clinical severity indices. Method: Participants (N = 984) completed five validated SA history measures and self‐report psychiatric symptom measures. Results: Of the sample, 35.4% inconsistently responded to SA history measures. Inconsistent reporters disclosed more severe suicide threat histories than consistent reporters. On all other clinical severity indices, inconsistent reporters evinced either less severe or comparable symptom levels. Conclusions: A nontrivial portion of service members may respond inconsistently to different assessments of SA history. Research is needed to identify factors that account for inconsistent SA history reporting and to improve the accuracy of SA history assessments among military personnel. [ABSTRACT FROM AUTHOR]

Objective: Here we argue for the necessity, validity, and clinical utility of a new diagnostic entity, acute suicidal affective disturbance (ASAD). Method: We expand on the conceptual, clinical, and practical rationale for ASAD, propose its defining features, describe research results to date, and suggest avenues for future research. Results: There is accruing evidence for the existence of a previously unclassified, rapid‐onset mood disturbance that geometrically escalates and regularly results in life‐threatening behavior. Conclusions: ASAD research may not only improve the field's understanding of suicidal behavior but also enhance clinical effectiveness and save lives. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to explore associations between specific types of hallucinations and delusions and suicidal ideation in a sample of children and adolescents with bipolar I disorder. Methods: Participants (N = 379) were children and adolescents aged 6‐15 years (M = 10.2, SD = 2.7) with DSM‐IV diagnoses of bipolar I disorder, mixed or manic phase. The study sample was 53.8% female and primarily White (73.6% White, 17.9% Black, and 8.5% Other). Presence and nature of psychotic symptoms, suicidal ideation, and functioning level were assessed through clinician‐administered measures. A series of logistic regressions was performed to assess the contribution of each subtype of psychotic symptom to the presence of suicidal ideation above and beyond age, sex, socio‐economic status, age at bipolar disorder onset, and global level of functioning. Results: Hallucinations overall, delusions of guilt, and number of different psychotic symptom types were uniquely associated with increased odds of suicidal ideation after accounting for covariates. Other forms of delusions (eg, grandiose) and specific types of hallucinations (eg, auditory) were not significantly uniquely associated with the presence of suicidal ideation. Conclusions: Findings of this study suggest the presence of hallucinations as a whole, delusions of guilt specifically, and having multiple concurrent types of psychotic symptoms are associated with the presence of suicidal ideation in children and adolescents with bipolar I disorder. Psychotic symptom subtypes, as opposed to psychosis as a whole, are an under‐examined, potentially important, area for consideration regarding suicidal ideation in pediatric bipolar I disorder. [ABSTRACT FROM AUTHOR]

Few clinical practices are as important for simultaneously augmenting patient safety and mitigating legal risk as the judicious evaluation and stratification of a patient's risk for suicide, proportionate clinical actions based thereon taken by the healthcare provider, and contemporaneous documentation of the foregoing. In this article, we draw from our combined decades of multidisciplinary experience as a clinical psychologist, forensic psychiatrist, medical malpractice attorney, and clinical psychology trainee to discuss the documentation of suicide risk assessment and management as a conduit to patient safety and legal risk mitigation. We additionally highlight documentation as a core clinical competency across disciplines and note areas of improvement, such as increased training, to bolster documentation practices. [ABSTRACT FROM AUTHOR]

Objective: Posttraumatic stress disorder (PTSD) symptoms are associated with increased suicide risk among firefighters. Few studies have examined modifiable factors, such as mindfulness facets, that might attenuate this association. This study examined the interactive effects of PTSD symptoms and mindfulness facets in relation to suicide risk among firefighters. Method: Overall, 831 career firefighters were assessed for PTSD symptoms, mindfulness facets, and suicide risk via the PTSD Checklist for DSM‐5, Five Facet Mindfulness Questionnaire, and Suicidal Behaviors Questionnaire—Revised, respectively. Results: Greater PTSD symptoms were associated with more severe suicide risk; however, higher levels of two specific mindfulness facets, acting with awareness and nonjudging of inner experience, attenuated this association. By contrast, higher levels of the observing facet of mindfulness potentiated the association between PTSD symptoms and suicide risk. Conclusions: Suicide prevention initiatives among firefighters, particularly those experiencing trauma‐related sequelae, might benefit from the inclusion of mindfulness‐based practices alongside frontline empirically‐supported approaches. [ABSTRACT FROM AUTHOR]

Objective: This study examined a hypothesized pathway by which interoceptive dysfunction accounted for associations between personality features (harm avoidance, self‐directedness, and perfectionism) and anorexia nervosa (AN) severity (indicated by drive for thinness, eating disorder‐related preoccupations and rituals, and body mass index). Method: The study sample (n = 270, mean age = 28.47, 95.2% female, 98% White/Caucasian) consisted of probands and biological relatives who met DSM‐IV criteria for lifetime diagnoses of AN (omitting criterion D, amenorrhea) drawn from the Price Foundation Anorexia Nervosa Affected Relative Pairs Study (AN‐ARP). Participants completed measures assessing personality, interoceptive dysfunction, and eating pathology. Results: Associations between personality features of low self‐directedness and high perfectionism and indicators of AN severity (drive for thinness and eating disorder‐related preoccupations and rituals) were significant, as were the hypothesized indirect pathways through interoceptive dysfunction. Neither harm avoidance nor body mass index was significantly related to other study variables, and the proposed indirect pathways involving these variables were not significant. Discussion: Findings suggest that certain personality features may relate to AN severity, in part, through their associations with interoceptive dysfunction. Future research should examine prospective associations and the value of interventions targeting interoceptive dysfunction for interrupting the link between personality and AN severity. [ABSTRACT FROM AUTHOR]

Objective: Exercise dependence has been linked to capability for suicide and suicidal behavior; however, less understood are which facets of exercise dependence confer risk for suicidal behavior and the potential mechanisms of this association. This study examined relationships between exercise dependence, capability for suicide, and past suicidal behavior. Methods: A sample of 540 individuals recruited via MTurk completed online measures of their exercise dependence, capability for suicide, and history of suicidal behavior. Results: Suicide attempters reported higher levels of continuance in exercise despite physical or psychological consequences, lack of control over exercise, and reductions in other activities due to exercise than nonattempters. Capability for suicide accounted for the relationship between continuance in exercise despite adverse consequences and lifetime number of suicide attempts. Conclusions: When exercise becomes pathological in the form of exercise dependence, steps should be taken to reduce such engagement due to its observed association with suicidal behavior. [ABSTRACT FROM AUTHOR]

Objective: To examine experiences with suicide exposure and bereavement among women firefighters. Methods: Women firefighters (N = 266, Mage = 37.64y) completed self‐report measures assessing their experiences with suicide exposure, history of suicidality, current psychiatric symptoms, and suicide risk. Results: Three‐fourths (74.4%) of participants reported knowing someone who had died by suicide; of these participants, 31.3% reported losing a fellow firefighter to suicide. Exposure to suicide during one's firefighting career was associated with more severe psychiatric symptoms and suicide risk. Greater impact of a suicide death was significantly associated with more severe current suicide risk, even after controlling for prior suicidality and other psychiatric symptoms. Conclusions: Women firefighters exposed to suicide during their careers may experience more severe psychiatric symptoms and increased suicide risk as compared to their counterparts without this exposure. In particular, women firefighters who are more severely impacted by a suicide loss may be at increased suicide risk. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Interoception deficits have been associated with various points on the suicidality continuum. Most research, however, has focused on general, rather than specific facets of, interoception. This study compared individuals with lifetime suicidal ideation, plans, and attempts using a multidimensional assessment of interoception. Method: A total of 537 adults completed measures of their interoception and lifetime suicide histories. Results: Individuals with lifetime suicidal ideation reported more worry about their bodily sensations. Those with lifetime suicide attempts reported a greater tendency to distract themselves from bodily sensations and less self‐regulation using bodily sensations. Individuals at all points of the suicidality continuum reported less trust of their bodily sensations. Conclusion: These findings suggest that interoception may be impaired in those with a history of suicidal thoughts and behaviors. Longitudinal designs are needed to parse apart the interplay of these variables and directionality of these relationships. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate the characteristics of suicide risk assessments completed using the Decision Tree framework both in and between psychotherapy sessions, clinical features of patients for whom between‐session assessments are indicated, and data collected across assessments. Method: Data were collected from 1,358 suicide risk assessments conducted with psychiatric outpatients (N = 41) at elevated suicide risk engaged in care at a psychology training clinic. Results: Participants completed an average of 4.75 (standard deviation = 4.95) suicide risk assessments (2.81 ± 4.43 between‐session assessments) per each month in treatment. Assessment frequency and patient ratings of suicidal desire and intent were each significantly associated with therapist risk level categorizations. Conclusion: The Decision Tree framework's in‐ and between‐session assessments have the potential to be implemented in a routinized format among psychiatric outpatients at elevated suicide risk. Additional research is needed to establish the feasibility and clinical utility of this framework across samples and providers. [ABSTRACT FROM AUTHOR]

Objective: Numerous risk factors have been identified for suicidal ideation, including perceived burdensomeness, thwarted belongingness, agitation, insomnia, nightmares, cognitive anxiety sensitivity, and rumination. However, the complexity of these associations has not been well studied; the magnitude of these effects may vary at differing levels of suicidal ideation. The present study reexamined established risk factors for suicidal ideation using quantile regression, a statistical technique that calculates the effect at numerous quantiles of suicidal ideation, as opposed to the average effect across all quantiles. Method: A sample of 354 psychiatric outpatients (61.3% female, meanage = 27.01 years, standard deviation = 10.40) completed self‐report measures of their suicidal ideation and related risk factors prior to their initial intake appointments. Results: The relationship between each suicide risk factor and suicidal ideation was strongest at higher (.9 quantile), as opposed to nonexistent (.5 quantile) and low‐moderate (.7 quantile), levels of suicidal ideation. The interaction proposed by the interpersonal theory of suicide was significant at nonexistent and low‐moderate, but not high, levels of suicidal ideation. Conclusion: Our findings indicated that predictors of suicidal ideation differed in magnitude at varying levels of suicidal ideation. Implications, limitations, and future research directions are discussed. [ABSTRACT FROM AUTHOR]

Background Psychological autopsy studies consistently report that the rate of detected mental disorders among suicide decedents is below 100%. This implies three possibilities: (a) a subset of suicide decedents did not have a mental disorder at the time of death; (b) all suicide decedents suffered from a mental disorder, but some were undetected due to methodological limitations; and/or (c) suicide decedents with an undetected mental disorder displayed significant and perhaps subclinical features of a mental disorder. Objective In this article, we examined these possibilities by evaluating the differences in symptoms and stressors between suicide decedents who were undiagnosed and those diagnosed with a mental disorder at the time of death. Method We reviewed 130 case studies of community-based suicide decedents originally described in Robins' (1981) psychological autopsy study. Results Without exception, suicide decedents in Robins' sample suffered either from a clearly diagnosable mental disorder or displayed features indicative of a significant, even if subclinical, presentation of a mental disorder. Undiagnosed and diagnosed suicide decedents did not significantly differ with regards to demographics, violence of suicide method, suicide attempt history, the number and intensity of stressful life events preceding death, and whether their death was a murder-suicide. Conclusion Although clearly not all who suffer from mental disorders will die by suicide, these findings imply that all who die by suicide appear to exhibit, at minimum, subclinical psychiatric symptoms with the great majority showing prominent clinical symptoms. We conclude with clinical implications and recommendations for future study. [ABSTRACT FROM AUTHOR]

Objective This study aimed to examine if levels of thwarted belongingness, perceived burdensomeness, and acquired capability significantly differed between guardsmen and active duty soldiers. Method Multivariate analysis of covariance was used to test for differences between active duty Army ( n = 1,393) and Army National Guard ( n = 623) groups, before and after controlling for the effects of age, gender, race, marital status, level of education, and deployment history. Results Guardsmen reported significantly higher mean levels of thwarted belongingness and perceived burdensomeness than did active duty soldiers, even after adjusting for demographic differences. Guardsmen also reported slightly lower levels of acquired capability, though this effect was accounted for by demographic differences. Conclusion These findings support the notion that National Guard and active duty soldiers differ on perceived burdensomeness and thwarted belongingness. Additional research investigating sources of perceived burdensomeness and thwarted belongingness among guardsmen is needed. [ABSTRACT FROM AUTHOR]

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Insomnia symptoms are a known predictor of suicide; however, less is known about the relationship between hypersomnia and suicide, and how total sleep time may better account for suicidal ideation compared with subjective reports of insomnia symptoms. In the present secondary data analysis, a squared term confirmed the importance of both short and long total sleep time on suicidal behaviour. Total sleep time had a significant positive direct effect on suicidal behaviour ( b = 0.20, SE = 0.08, P < 0.05), significant negative direct effects on insomnia symptoms ( b = −1.67, SE = 0.13, P < 0.0001) and on depressive symptoms ( b = −1.76, SE = 0.29, P < 0.0001). Depression had a significant positive effect on suicidal behaviour ( b = 0.17, SE = 0.01, P < 0.0001), and significantly mediated the relationship between total sleep time and suicidal behaviour, but insomnia symptoms did not. Total sleep time squared had a significant positive relationship with suicidal behaviour ( b = 0.02, SE = 0.01, P < 0.05), significant negative direct effects on insomnia symptoms ( b = −0.12, SE = 0.01, P < 0.0001) and on depressive symptoms ( b = −0.12, SE = 0.02, P < 0.0001). Depression had a significant positive effect on suicidal behaviour ( b = 0.17, SE = 0.01, P < 0.0001), and significantly mediated the relationship between total sleep time and suicidal behaviour. These results suggest the importance of assessing for total sleep time in clinical settings with regard to suicide risk. [ABSTRACT FROM AUTHOR]

Objective To characterize individuals' prior experiences with being asked whether they are having thoughts of suicide and to understand factors that affected their response accuracy. Method Undergraduates ( N = 306) reporting a lifetime history of suicidal ideation completed a web-based survey about their experiences being probed about suicidal thoughts. Results Nearly two-thirds of participants (63.1%) reported having been previously asked whether they were having thoughts of suicide, with health care providers comprising the plurality of probers. Individuals reported the greatest accuracy of ideation disclosure to mental health professionals. Stigma-related concerns were the most common barriers to accurate disclosure of ideation, whereas wanting emotional support and the prober to understand them were cited as facilitators for accurately responding. Conclusion A number of factors influence the accurate and inaccurate disclosure of suicidal ideation. Further research is needed to understand how to facilitate accurate disclosure of suicidal ideation across settings and populations. [ABSTRACT FROM AUTHOR]

Objective Although the interpersonal theory of suicide may explain the elevated suicide risk among military service members, past explorations have been equivocal. This study aimed to investigate the propositions of the interpersonal theory in a sample of U.S. Army recruiters. Method Participants ( N = 3,428) completed self-report measures assessing the interpersonal theory's constructs (i.e., thwarted belongingness (TB), perceived burdensomeness (PB), acquired capability for suicide), current suicidal ideation, agitation, and insomnia. History of depression was obtained from medical records. Results Hierarchical multiple regression analyses revealed that the interaction between TB and PB was associated with current suicidal ideation, controlling for depression, agitation, and insomnia. This effect was especially notable among those with high capability for suicide. Conclusion Findings provide support for the interpersonal theory in a large, diverse military sample. It may be advantageous to assess and therapeutically address TB and PB among at-risk service members. [ABSTRACT FROM AUTHOR]

Objective To identify demographic, diagnostic, and personality factors that predict treatment dropout in a sample of outpatients with clinically significant suicidal ideation. Method A total of 287 adult outpatients at elevated risk for suicide completed self-report measures of demographics, suicidal and depression symptoms, and personality characteristics at treatment intake. Clinician-assessed psychiatric diagnoses and ratings of overall functioning also were collected. Results Lower overall functioning (odds ratio [OR] = .947; 95% confidence interval [CI] [.909, .987]) and the presence of a substance use disorder (OR = 4.543; 95% CI [1.058, 19.499]) were the most robust predictors of attrition. Dropouts also were more likely to have a depressive disorder, more comorbid diagnoses, and more severe depression and suicidal symptoms. Conclusions Findings suggest that clinician-assessed poorer overall functioning and a substance use disorder diagnosis are risk factors for attrition among suicidal individuals, above and beyond other symptom measures. Further research is warranted to investigate attrition in additional outpatient samples. [ABSTRACT FROM AUTHOR]

Background Research regarding suicide mortality among firefighters within the U.S. has been sparse and has yielded inconsistent findings. This study aimed to: (i) describe suicide rates within a large, urban fire department; and (ii) compare firefighter suicide rates with demographically adjusted general population suicide rates. Methods Rosters were obtained from the Philadelphia Fire Department (PFD) for all members employed by or separated from the department between 1993 and 2014 (N = 4,395). Vital statistics for each member were obtained from the CDC's National Death Index. Results Overall, 272 deaths were recorded; 11 (4.0%) were certified as suicides. The overall suicide rate among firefighter affiliates of the PFD between 1993 and 2014 was 11.61 per 100,000 person-years. Conclusions The suicide rate among firefighters appears comparable to, and perhaps lower than, demographically adjusted general population estimates. Infrastructure to triangulate and monitor suicide rates from multiple departments, both career and volunteer, is needed to derive a more representative and informative estimate of firefighter suicide rates. Am. J. Ind. Med. 59:942-947, 2016. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

An introduction to articles published within the issue is presented, including one on the applications of machine learning in suicide research and clinical practice, another on the near-term risk factors for suicide and the phenomenology of an acute suicidal crisis, and another on an examination of an instrument designed to measure the severity of suicidal behavior via self-poisoning.

This study was based on a sample of male high school students who completed National Longitudinal Adolescent Health Surveys in 1994, 1995, and 2001. We studied these students prospectively, comparing those who later died by suicide (n = 21) with those who were still living (n = 10,101). We employed chi-square and analysis of variance tests for statistical significance between suicide decedents and living respondents. Results showed suicide decedents were more likely to have experienced the suicide loss of another family member, to have been expelled from school, to have engaged in more delinquent actions including fighting, and to have greater involvement with the criminal justice system. Although one might have expected suicide casualties to have exhibited a greater amount of suicidal thoughts, attempts, and higher incidences of suicidality among their friends, our analyses did not find that these factors were associated with actual suicides. Should these findings be replicated, this would point to a need to refine youth suicide risk assessments. Collecting life histories, as well as identifying patterns of delinquency and fighting, may serve as more potentially fruitful means for assessing genuine suicide risk than some traditional risk assessment methods.z. [ABSTRACT FROM AUTHOR]

Objective: Financial incentives may have utility in promoting psychotherapy attendance and adherence, leading to improved clinical functioning. This study presents results from a novel application of financial incentives--a progressively lowered pay scale that rewards therapy attendance and adherence. Method: Overall, 110 outpatients participated; 56 patients (51%) were enrolled in the financial incentives condition and received a 5% fee discount--applied iteratively across sessions--if they followed defined criteria (e.g., completed homework). Results: There were no statistically significant differences between groups in terms of the number of sessions attended, therapy duration, and number of no-shows and cancellations. However, adjusting for Global Assessment of Functioning (GAF) at intake, patients receiving the financial incentives had significantly higher GAF rating at termination compared with those who did not receive the intervention. Conclusions: Financial incentives that reward therapy attendance and adherence with discounted fees is associated with improved clinical functioning. [ABSTRACT FROM AUTHOR]

Objective: Empirically informed suicide risk assessment frameworks are useful in guiding the evaluation and treatment of individuals presenting with suicidal symptoms. Joiner et al. (1999) formulated one such framework, which has provided a concise heuristic for the assessment of suicide risk. The purpose of this review is to ensure compatibility of this suicide risk assessment framework with the growing literature on suicide-related behaviors. Methods: This review integrates recent literature on suicide risk factors and clinical applications into the existing model. Further, we present a review of risk factors not previously included in the Joiner et al. (1999) framework, such as the interpersonal theory of suicide variables of perceived burdensomeness, thwarted belongingness, and capability for suicide (Joiner, 2005; Van Orden et al., 2010) and acute symptoms of suicidality (i.e., agitation, irritability, weight loss, sleep disturbances, severe affective states, and social withdrawal). Results: These additional indicators of suicide risk further facilitate the classification of patients into standardized categories of suicide risk severity and the critical clinical decision making needed for the management of such risk. Conclusions: To increase the accessibility of empirically informed risk assessment protocols for suicide prevention and treatment, an updated suicide risk assessment form and decision tree are provided. [ABSTRACT FROM AUTHOR]

Disgust has been implicated as a factor that maintains and exacerbates eating disorder (ED) symptoms. Emerging research suggests that disgust may be a risk factor for suicidality. Given the high rates of suicidality among individuals with EDs, we propose that disgust may contribute to the link between EDs and suicidality. To test this hypothesis, self-report data were collected from 341 young adults (66% women). Cross-sectional associations between disgust with the self, others and the world and disgust sensitivity and propensity, ED symptoms and suicidal ideation were examined using multivariate regression analyses. ED symptoms and body dissatisfaction were associated with increased suicidal ideation at high levels of disgust with the self and the world; at low levels of disgust, ED symptoms and body dissatisfaction did not significantly relate to suicidal ideation. Disgust may indicate risk for suicidal ideation among individuals with eating psychopathology. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to identify personality traits and psychiatric comorbidities associated with a lifetime history of a suicide attempt in women with bulimia nervosa (BN). Method Data from two samples of women with BN ( n = 204 and n = 133) were examined. Participants in both samples completed the Dimensional Assessment of Personality Pathology-Basic Questionnaire and reported whether they had ever had a lifetime suicide attempt. Comorbid psychopathology was based on self-reported questionnaire and interview data. Univariate and multivariate logistic regression analyses were run, predicting a lifetime suicide attempt. Results Based on the Dimensional Assessment of Personality Pathology-Basic Questionnaire, identity problems were associated with a lifetime suicide attempt in both samples; cognitive dysregulation, anxiousness and insecure attachment were associated with a lifetime suicide attempt in one but not both samples. Lifetime anxiety disorder was associated with a lifetime suicide attempt in one sample, and depression was associated with a lifetime suicide attempt in both samples. Multivariate analyses revealed that only depression was uniquely associated with a lifetime suicide attempt in both samples. Discussion Although personality traits associated with aspects of emotion dysregulation were associated with a lifetime suicide attempt, depression was found to have the strongest association with a lifetime suicide attempt in two samples of women with BN. These findings suggest that depression severity may be the most important target of treatment and suicide prevention efforts in women with BN. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the association of the serotonin transporter gene to family history of suicidality. Forty-seven volunteers responded to questionnaires about family history of suicide, and provided buccal swabs for analysis of the polymorphism. Allelic homozygocity (the short variant) was associated with family history of suicidality. These data, to be interpreted with the study's limitations in mind, suggest a link between the serotonin transporter gene polymorphism and suicide-related variables, which should be the focus of future research. [ABSTRACT FROM AUTHOR]

Objective Media reporting guidelines exist for suicide-related content; however, no experimental studies have examined the impact of guideline violations. As such, we utilized an experimental design to determine whether reading an article about suicide that violated guidelines would impact mood and suicidality relative to the same article without violations and to an article detailing death by cancer, both immediately and during 1-month follow-up. Method 273 students were randomly assigned to read one of three articles (1) an article that violated suicide reporting guidelines, (2) the same article with violations removed, or (3) an article that details death by cancer. Results Individuals assigned to read the original suicide article were no more upset immediately afterwards or during 1-month follow-up. Amongst participants with prior ideation, those who read the original article reported a lower likelihood of future attempt relative to either other condition. Conclusion Results indicate some reporting guidelines may be unnecessary. Amongst individuals at risk for suicide, some guideline violations may be associated with a decreased likelihood of future attempt and result in a decrease in negative affect. Clinically, these results highlight the potential utility of exposing clients to in depth educational materials about suicide while mitigating concerns regarding certain aspects of the content. [ABSTRACT FROM AUTHOR]

Objective: The current study aimed to investigate whether perceived burdensomeness and thwarted belongingness (i.e., suicide risk factors) were associated with excessive reassurance seeking (a behavior linked to rejection). It was predicted that perceived burdensomeness and thwarted belongingness would predict higher levels of excessive reassurance seeking, controlling for depressive symptoms and global functioning. Method: A cross-sectional sample of 415 clinical outpatients (62% female; mean age = 28) was examined. Results: Perceived burdensomeness and thwarted belongingness significantly predicted excessive reassurance seeking, controlling for depressive symptoms and global functioning. Conclusions: Perceived burdensomeness and thwarted belongingness predicted excessive reassurance seeking, suggesting that it would be beneficial for clinicians to assess for and target excessive reassurance seeking among individuals experiencing perceived burdensomeness and thwarted belongingness so that excessive reassurance seeking does not elicit interpersonal rejection. [ABSTRACT FROM AUTHOR]