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Objective: The aim of the present study was to compare the effectiveness of transdiagnostic child therapy with and without maternal acceptance and commitment intervention on anxiety and depression in anxious children and obsessive thoughts related to COVID-19 in mothers with corona anxiety. Methods and Materials: The method of this research was a quasi-experimental design with a pre-test-post-test (two experimental groups and one control group) along with a two-month follow-up period. The population included all anxious elementary school students in the second half of the year 2021-2022 in districts 1 and 2 of Sari city whose mothers also had corona anxiety. Transdiagnostic childparent centered intervention combined with acceptance and commitment therapy for the parent was applied in the first group, and transdiagnostic child-parent centered intervention without acceptance and commitment therapy for the parent in the second experimental group, while the control group received no intervention. Sixty participants were selected through purposive sampling. They were then randomly assigned into 3 groups (Group 1; transdiagnostic child-parent centered intervention with parental acceptance and commitment intervention (20 participants), Group 2; transdiagnostic child-centered intervention without parental acceptance and commitment intervention (20 participants), and Group 3; as the control group (20 participants)). For data collection, depression and anxiety questionnaires were used for children, and a practical obsessive-compulsive questionnaire with COVID-19 was used for mothers. For the implementation of interventions, Ehrenreich-May et al.'s (2019) transdiagnostic intervention (12 90- minute group sessions twice a week), and Eifert et al.'s (2017) acceptance and commitment therapy (12 90-minute group sessions twice a week) were utilized. For data analysis, repeated measures ANOVA with SPSS software, version 26 was used. Findings: The results of the repeated measures ANOVA regarding the children showed that the effectiveness of transdiagnostic child therapy combined with maternal acceptance and commitment intervention was significantly greater than transdiagnostic child therapy without acceptance and commitment intervention for the mother, in terms of anxiety and depression. Although anxiety and depression decreased in both experimental groups and were stable over time. The results of the repeated measures ANOVA regarding mothers showed that there was no significant difference in the effectiveness of transdiagnostic child therapy combined with maternal acceptance and commitment intervention with transdiagnostic child therapy without acceptance and commitment intervention for the mother regarding obsessive thoughts, although both interventions showed significant effectiveness over time. Conclusion: Therefore, it is recommended that therapists and counselors use this treatment in conjunction with other therapeutic interventions to improve the interaction between children and parents. [ABSTRACT FROM AUTHOR]

Introduction: This study examined daily fluctuations in the unmet interpersonal needs of thwarted belongingness and perceived burdensomeness in response to daily negative social interactions, as well as the moderating role of respiratory sinus arrhythmia (RSA) across adolescents at lower and higher risk for suicidal ideation. Methods: Fifty five adolescents with major depressive disorder (MDD, i.e., higher‐risk group) and without MDD (i.e., lower‐risk group) completed measures of resting RSA, and daily measures of negative social interactions, perceived burdensomeness, and loneliness, as a proxy for thwarted belongingness, for 10 consecutive days. Within‐person analyses examined the association between daily negative social interactions and unmet interpersonal needs, and the moderating roles of RSA and higher‐risk group status. Between‐person analyses also examined the association between RSA and unmet interpersonal needs across groups. Results: At the within‐person level, participants reported more unmet interpersonal needs on days when they reported more negative social interactions. At the between‐person level, higher RSA was associated with decreased loneliness in both groups, and decreased burdensomeness among the higher‐risk group. Conclusions: Negative social interactions are associated with daily unmet interpersonal needs. Higher RSA may serve as a protective factor mitigating risk for unmet interpersonal needs, particularly burdensomeness, among adolescents at higher risk for suicidal ideation. [ABSTRACT FROM AUTHOR]

Background: Autistic adults experience more frequent suicidal thoughts and mental health difficulties than non‐autistic adults, but research has yet to explain how these experiences are connected. This study explored how anxiety and depression contribute to suicidal thoughts according to the Interpersonal Theory of Suicide for autistic and non‐autistic adults. Methods: Participants (autistic adults n = 463, 61% female; non‐autistic n = 342, 64% female) completed online measures of anxiety, depression, thwarted belonging, and perceived burdensomeness. Network analysis explored whether: (i) being autistic is a risk marker for suicide; and (ii) pathways to suicidal thoughts are consistent for autistic and non‐autistic adults. Results: Being autistic connected closely with feeling like an outsider, anxiety, and movement, which connected to suicidal thoughts through somatic experiences, low mood, and burdensomeness. Networks were largely consistent for autistic and non‐autistic people, but connections from mood symptoms to somatic and thwarted belonging experiences were absent for autistic adults. Conclusion: Autistic people experience more life stressors than non‐autistic people leading to reduced coping, low mood, and suicidal thoughts. Promoting belonging, reducing anxiety, and understanding the role of movement could inform suicide prevention for autistic people. Research should accurately capture autistic lived experience when modeling suicide to ensure suicide prevention meets autistic needs. [ABSTRACT FROM AUTHOR]

A comprehensive understanding of how suicidal risk factors interact with one another to increase the frequency of suicide ideation and attempted suicide is critical for improving theoretical models of suicide and prevention efforts. The aim of the present study was to explore the prediction of suicide ideation formation and its transition to suicide attempt through the interactions of the constructs suggested by the IPTS, IMV and 3ST theories, as well as other clinical factors. The core constructs of several theoretical models were assessed using a battery of scales administered to 909 Iranian college students. The results supported Klonsky's 3ST and O'Connor's IMV models and, in addition, the relevance of non-suicidal self-injury, the acquired capacity for self-harm, sexual abuse, and exposure to family self-harm for the transition from suicide ideation to a suicide attempt. Depression and PTSD were background factors rather than risk factors for suicide ideation or suicide attempt. Limitations were that the information provided by students may have been biased due to the stigma surrounding suicide in Iranian culture, and the proportion of female students was high. [ABSTRACT FROM AUTHOR]

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The death/suicide implicit association test (IAT) may be more resilient to accurately assess suicide risk than self-reports. We examined the IAT in 130 patients with depression and 125 healthy controls, along with self-reported suicidal ideation. IAT could differentiate patients with suicide attempts from patients without suicide attempts and controls. IAT measures were significantly correlated to explicit suicidal ideation and clinical symptoms in patients. Moreover, the IAT-symptom correlations were significant in female but not male patients. The IAT showed promise as a valid tool to estimate suicide risk in patients with depression and may be particularly useful in female patients. [ABSTRACT FROM AUTHOR]

The current study examined hypotheses related to the development of suicidal ideation as directed by the interpersonal theory within a sample of acutely suicidal psychiatric inpatients. Consistent with ideation-to-action models, we distinguished suicidal desire from resolved plans and preparations. Although thwarted belongingness and perceived burdensomeness were correlated with suicidal desire, only perceived burdensomeness was associated with suicidal desire controlling for depression and thwarted belongingness. Depression alone was related to plans and preparations. Findings are interpreted as challenging the mechanisms hypothesis of the interpersonal theory and suggest that alternative conceptualizations of the development of suicidal desire may be warranted. [ABSTRACT FROM AUTHOR]

Introduction: Existing CBT protocols for internalizing disorders target thoughts and behaviors related to anxiety and/or depression, but do not explicitly target other identified risk factors for suicide ideation, including perceived burdensomeness toward others. The aims of the current study were to (1) develop a novel, brief module (the "Give program") targeting perceived burdensomeness toward others that can be embedded within existing CBT protocols for youth internalizing disorders, (2) evaluate the acceptability and feasibility of the module with an eye toward intervention refinement, and (3) examine reductions in perceived burdensomeness. Methods: Participants were 18 clinic‐referred youths with anxiety or depressive disorders who endorsed burdensomeness. We used a quasi‐experimental interrupted time‐series design to evaluate changes in burdensomeness scores following the administration of the module. Results: The module was clinically feasible and well‐accepted. Youth burdensomeness scores increased in the first half of the CBT protocol and decreased immediately following the administration of the Give program module. Burdensomeness scores were significantly associated with suicide ideation. Conclusion: The current study is the first to develop and evaluate a module targeting burdensomeness in at‐risk youth in an outpatient setting, demonstrating that burdensomeness can be efficiently and effectively targeted within existing evidence‐based treatment protocols for internalizing disorders in youth. [ABSTRACT FROM AUTHOR]

Objectives: Although frequently discussed within the scope of transdiagnostic psychotherapy protocols, limited data are available on their efficacy in patients with a principal diagnosis of major depressive disorder. The present study attempted to address that gap in the literature through a randomized clinical trial comparing transdiagnostic behavior therapy (TBT) to behavioral activation treatment for depression (BATD). Methods: Forty veterans with principal major depressive disorder were randomized into either 12 sessions of individual TBT or BATD, with symptom measures collected at baseline and posttreatment. Process variables for treatment engagement and completion also were recorded. Results: Participants reported similar symptom improvements in depression, stress, anhedonia, and impairment across both treatments. Clinician‐rated treatment improvements favored TBT. Participants in TBT also attended more appointments, canceled or missed fewer appointments, and completed the protocol at a higher rate than participants that received BATD. Conclusions: The present findings support TBT as an efficacious treatment for principal major depressive disorder, with potentially superior coverage of comorbid anxiety symptomatology and improved treatment adherence and completion compared to BATD. Pending replication in larger samples, TBT and other similar transdiagnostic psychotherapies should be considered for implementation across the anxiety and depressive disorders to simplify dissemination efforts for evidence‐based psychotherapies and potentially improve coverage of comorbidity. [ABSTRACT FROM AUTHOR]

Objective: This study examined characteristics of online-only friendships among suicidal and non-suicidal adolescents. In addition, the extent to which adolescents' online-only friendships may offer a protective function, buffering the effects of peer stressors (i.e., friendship stress, relational victimization) on prospective suicidal ideation, was examined. Method: Adolescents aged 10 to 14 (n = 630) were assessed at baseline (Time 1) and one-year follow-up (Time 2). Measures of suicidal ideation, sociometric relational victimization, friendship stress, depressive symptoms, online-only friendship status and quality, and online-only friendship quality compared to in-person friendship quality, were obtained at Time 1 using sociometric procedures and self-report questionnaires. Self-report measures of suicidal ideation were collected at Time 2. Results: Descriptive results suggested that online-only friendships are relatively common among youth (38.3%), particularly for those experiencing suicidal ideation (46.3%). Suicidal and non-suicidal adolescents reported comparable levels of intimate disclosure within their online-only friendships. Although adolescents without suicidal ideation endorsed more support from in-person friendships, suicidal adolescents endorsed similar levels of support from their online-only and in-person friendships. Moderation analyses indicated that the association between both relational victimization and friendship stress and prospective suicidal ideation was attenuated among youth who reported having one or more online-only friend. Conclusion: Online-only friendships are common and may offer protective benefits for youth, particularly those experiencing suicidal ideation. Future studies should examine the specific mechanisms by which online-only friendships may confer this benefit. [ABSTRACT FROM AUTHOR]

Objective: This study examined whether the working alliance mediated the effect of therapist competence on subsequent depression symptomology during Cognitive Behavioral Therapy (CBT). We also tested the potential moderation effect of alliance on subsequent depressive symptomology, based on participants' cognitive aptitude. Method: A total of 86 sessions were coded as the prediction interval across 50 patient-therapist dyads (age M = 39.22, SD = 8.78; 76% female). While accounting for prior depression, competence, and alliance levels, predictors were assessed early treatment (session 1; n = 45 sessions), mid-treatment (session 12; n = 41 sessions), and depressive symptomology was assessed at the subsequent session to the predictor assessments to investigate within-session variability of process variables. Results: Mediation analysis revealed that the effect of early treatment therapist competence on symptom change was mediated by alliance (indirect effect: β = −.17, 95% percentile bootstrap CI [−.32, −.01]). The positive association involving early treatment alliance and next session outcome was conditional upon low cognitive aptitude levels. Conclusions: Our result offers preliminary support for alliance as a mediator of the effect of competence, and that alliance-outcome relations vary as a function of client aptitude. These novel findings require replication and extension. [ABSTRACT FROM AUTHOR]

A substantial proportion of suicide attempts seem to be realized in a sudden manner. However, it is unclear how suicide attempters showing a rapid transition from the decision to die to acting differ from suicide attempters showing a slower transition regarding their suicidal history. The main aim of this study was to determine the proportion of suicide attempters, who reported a rapid transition (≤5, ≤10, ≤180 min) between their decision to die and their actual attempt. Furthermore, attempter groups (≤ vs. >5, ≤ vs. >10 and ≤ vs. >180 min) were compared regarding suicidal history (ideation, plans, and number of lifetime as well as 12 month suicide attempts) as well as depression, hopelessness and trait impulsivity. In total, 118 inpatients (62.7% female; age: M = 38.71, SD = 14.71) hospitalized due to a recent suicide attempt were assessed using structured clinical interview measures assessing suicidal history and self‐report instruments. Thirty‐six percent reported a time period of ≤5 min, 44% a time period of ≤10 min and 73% a time period of ≤180 min between their decision to die and their attempt. Participants with a rapid transition (≤5, ≤10, ≤180 min) did not differ from participants with a slower transition (>5, >10, >180 min) regarding suicidal history, depression, hopelessness and trait impulsivity. Taken together, a rapid transition seems common, but nevertheless, rapidly realized suicide attempts cannot necessarily be characterized as impulsive. [ABSTRACT FROM AUTHOR]

Across two countries and two languages, this research examined the multidimensional associations of suicide behaviors (i.e., life-time attempts, life-time communication of intent to others, life-time self-harming, life-time suicide notes, and current suicide ideation) and empirically relevant psychological risk factors (i.e., different facets of mental pain, perceived burdensomeness, thwarted belongingness, and acquired capability), controlling for depressive symptoms. For the Portuguese sample, two underlying dimensions emerged: an ideation dimension and a behavioral dimension, and for the Canadian sample, three dimensions emerged: an ideation dimension and two behavioral dimensions that can be viewed as a splitting of the Portuguese second dimension. Results highlight possible cultural differences between the two countries and that suicide behaviors should be viewed as a multidimensional phenomenon not as a one-dimensional continuum. [ABSTRACT FROM AUTHOR]

Background: Clinical guidelines suggest that psychological interventions specifically aimed at reducing suicidality may be beneficial. We examined the impact of two depression treatments, cognitive therapy (CT) and interpersonal psychotherapy (IPT) on suicidal ideation (SI) and explored the temporal associations between depression and SI over the course of therapy. Methods: Ninety‐one adult (18–65) depressed outpatients from a large randomized controlled trial who were treated with CT (n = 37) and IPT (n = 54) and scored at least ≥1 on the Beck Depression Inventory II (BDI‐II) suicide item were included. Linear (two‐level) mixed effects models were used to evaluate the impact of depression treatments on SI. Mixed‐effects time‐lagged models were applied to examine temporal relations between the change in depressive symptoms and the change in SI. Results: SI decreased significantly during treatment and there were no differential effects between the two intervention groups (B = −0.007, p =.35). Depressive symptoms at the previous session did not predict higher levels of SI at the current session (B = 0.016, p =.16). However, SI measured at the previous session significantly predicted depressive symptoms at the current session (B = 2.06, p <.001). Conclusions: Both depression treatments seemed to have a direct association with SI. The temporal association between SI and depression was unidirectional with SI predicting future depressive symptoms during treatment. Our findings suggest that it may be most beneficial to treat SI first. [ABSTRACT FROM AUTHOR]

The aim of the current study was to validate the Interpersonal Needs Questionnaire (INQ‐15) and to test its reliability in Persian‐speaking Iranian undergraduate students. In this cross‐sectional study, 485 undergraduate students (age: 20.66 ± 1.42, 60% female) were assessed on the two subscales of perceived burdensomeness (PB) and thwarted belongingness (TB) and the Suicide Behavior Questionnaire‐Revised (SBQ‐R). Exploratory structural equation modelling (ESEM) confirmed the construct validity of INQ‐14, excluding INQ#9. In addition, INQ#8, articulated in an equivalent Persian phrasing, loaded well on TB. The measurement model tested by confirmatory factor analysis (CFA) suggested INQ#11 to be eliminated, resulting in INQ‐13‐P to consist of PB and TB‐7. The internal consistency and convergent/discriminant validity were established. The concurrent validity of PB was solidly established in terms of past year suicidal ideation (PY‐SI) above and beyond anxiety, depression, prior suicidality, and TB‐7. The effect of PB on PY‐SI was stronger, where prior suicidality had already occurred or the perceived likelihood of future suicide (PLFS) was high. Moreover, TB‐7 could only indicate PY‐SI, where prior suicidality had already occurred or PLFS was high, albeit when PB was omitted. The interaction term was significant; however, beyond anxiety and depression, the effect of TB‐7 on PY‐SI was significant where PB was very high (n = 40, 8.25%). Therefore, future studies can utilize INQ‐13‐P as a valid and reliable instrument in Persian‐speaking populations. However, further studies should examine the construct validity of TB and its relationship with suicide ideation in different populations. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the factor structure, internal consistency reliability, construct and criterion validity, and measurement invariance of the Interpersonal Needs Questionnaire (INQ) among adolescents. Method: Participants (N = 539) included three distinct samples of youth drawn from two outpatient psychology clinics and an inpatient psychiatric unit. The combined sample was 63.3% female and had a mean age of 14.95 years (SD = 1.31 years). All participants completed the INQ as well as measures of depressive symptoms and suicide ideation. Results: Confirmatory factor analyses indicated that the removal of three items from the thwarted belongingness subscale of the INQ was needed to achieve acceptable model fit. The resulting combined 12‐item scale demonstrated good factor structure, internal consistency reliability, construct validity, and criterion validity. The modified 12‐item INQ also demonstrated scalar invariance across subgroups defined by sex, race, and age. Conclusions: Findings support the use of this reduced 12‐item version of the INQ among adolescents. Youth may have difficulty accurately responding to changes in item valence; thus, future research with youth should consider using a 12‐item version of the INQ that avoids valence changes within subscales. [ABSTRACT FROM AUTHOR]

Objective: The current study examines components of the Interpersonal Theory of Suicide as mediators of the association between attention‐deficit/hyperactivity disorder (ADHD) symptoms and suicide ideation in college students with elevated depressive symptoms. Specifically, indirect effects of perceived burdensomeness and thwarted belongingness were simultaneously evaluated on the association between self‐reported ADHD symptoms and suicide ideation, controlling for gender and levels of depression. Method: Participants were 217 college students with elevated depressive symptoms (Mage = 20.72 years old; SD = 3.74) who participated in a larger study on mood and well‐being. The sample was predominantly female (77.9% female) and Hispanic (72.7%). Results: In a multivariate mediation model controlling for gender and depressive symptoms, there were significant indirect effects of perceived burdensomeness and thwarted belongingness on the association between self‐reported ADHD symptoms and suicide ideation. Conclusion: Perceived burdensomeness and thwarted belongingness may represent promising targets for preventing suicide ideation in individuals with elevated ADHD symptoms. [ABSTRACT FROM AUTHOR]

The article offers information on relationships between loneliness, depression, and suicide ideation have been well established in the literature and no research has examined how feelings of existential isolation, a form of interpersonal isolation conceptually similar, but distinct from loneliness, relates to depressive symptomology or suicide ideation. Topics include the depression being one of the most common mental disorders with a point prevalence.

Objective Some researchers have claimed that former National Football League (NFL) players are at increased risk for suicide as a clinical feature of chronic traumatic encephalopathy (CTE). This review examines the literature on risk for suicide in former professional football players, and the association between suicide and CTE. Method A narrative review of the literature published between 1928 and 2018. Results Between 1928 and 2009, suicide was not considered to be a clinical feature of CTE in the literature. The best available evidence from epidemiological studies suggests that former NFL football players are at lesser risk for suicide, not greater risk, compared to men in the general population. However, surveys have revealed that a substantial minority of former NFL players have depression and other mental health problems, chronic pain and opioid use is relatively common, and those with depression and chronic pain also have greater life stress and financial difficulties. That minority would be at increased risk for suicidal thoughts and behaviors. Conclusions Researchers and clinicians are encouraged to be cautious and circumspect when considering the clinical presentation of former athletes, and to not assume that depression and suicidality are caused by specific types of neuropathology. This represents a reductionistic and Procrustean view. Some former football players have mental health problems, but it should not be assumed uncritically that the underlying cause is an inexorably progressive neurodegenerative disease. Providing evidence-informed and evidence-supported treatments for depression and suicidality might reduce suffering and improve their functioning. [ABSTRACT FROM AUTHOR]

Persons living with HIV/AIDS (PLHIV) disproportionately suffer from anxiety and depressive symptoms and disorders. Although past work has examined the efficacy of cognitive-behavioral therapy (CBT) for depression, and to a lesser extent anxiety, among PLHIV, little is known regarding potential mechanisms underlying improvement in anxiety/depression among this group. Anxiety sensitivity is a well-established risk/maintenance factor for anxiety and depressive disorders and is hypothesized to play an important role in maintaining anxiety among PLHIV. Past work has identified anxiety sensitivity as a mechanism of action underlying changes in various anxiety domains yet it is unknown whether changes in anxiety sensitivity relate to changes in anxiety symptoms among PLHIV undergoing transdiagnostic CBT for anxiety. The current study sought to examine treatment-related changes in anxiety sensitivity and how the trajectory of change relates to anxiety and depressive symptoms as well as overall quality of life. Individuals (n = 35) with HIV/AIDS and elevated anxiety symptoms received CBT for anxiety. Results indicated that reductions in anxiety sensitivity were significantly related to changes in anxiety, depression, and quality of life. Together, these data suggest that changes in anxiety sensitivity are significantly related to changes in anxiety/depression and quality of life among PLHIV seeking treatment. [ABSTRACT FROM AUTHOR]

Recent standardized nomenclature has suggested distinctions among aborted, interrupted, and actual suicide attempts. This study examined differences in self-reported symptoms among individuals with a history of aborted, interrupted, and actual suicide attempts. 167 young adults with a history of suicidality completed self-report measures of suicide attempt history and current symptoms, a clinical interview assessing past suicidal behavior, and a pain tolerance task. Only 78.8% of participants who initially reported a suicide attempt history were classified as suicide attempters following the clinical interview. Individuals who reported only aborted attempts during the clinical interview reported less severe clinical symptoms than those reporting a history of at least one actual attempt. Individuals with a history of actual suicide attempts may represent a more clinically severe group than those with a history of aborted attempts only. [ABSTRACT FROM AUTHOR]

The identification of theoretically and empirically supported correlates of suicide ideation is important to improve treatment approaches to suicide. This study sought to examine the association between interpersonal trust (theoretically conceptualized as a distal risk marker) and suicide ideation in adolescence. Specifically, it was hypothesized that interpersonal trust would be negatively associated with suicide ideation via perceived burdensomeness and thwarted belongingness (conceptualized as more proximal risk markers). Data were drawn from a cross-sectional sample of 387 adolescent inpatients between the ages of 12 and 17 years (M = 14.72, SD = 1.49). The sample was 63.6% female, 37.5% Hispanic, 26.9% African American/Black, and 25.8% Caucasian. Adolescents completed a series of self-report measures to assess thwarted belongingness, perceived burdensomeness, interpersonal trust, depressive symptoms, and suicide ideation. A structural equation model was fit to the data, and results demonstrated a significant indirect path from interpersonal trust to suicide ideation via perceived burdensomeness, but not thwarted belongingness. Results suggest that interpersonal trust may be a distal risk marker for suicide ideation and that interventions to increase interpersonal trust may help prevent the development of thwarted belongingness, perceived burdensomeness, and suicide ideation. [ABSTRACT FROM AUTHOR]

A recent shift in the conceptualization of both depressive and anxiety disorders supports the notion that these disorders may best fall under a single classification of “emotional disorders.” This understanding has resulted in the development of various transdiagnostic cognitive behavioral therapy (tCBT) protocols to address underlying core pathology shared by emotional disorders. While there is evidence to suggest tCBT is effective in reducing co-occurring depression, research into the efficacy of face-to-face tCBT has generally focused on the delivery of tCBT to individuals with predominantly anxiety diagnoses. The current case study aims to expand the research by examining the impact of group tCBT for individuals with a principal depressive diagnosis. A session-by-session explanation of a 12-week group tCBT protocol designed to treat a heterogeneous group of individuals diagnosed with an emotional disorder is provided in detail and accompanied by a quantitative case study of a recently delivered treatment group. The case study demonstrates the feasibility and pragmatic application of the group tCBT treatment approach. Data presented support the continued research of transdiagnostic interventions for the treatment of emotional disorders and justify future randomized controlled trials to further evaluate the presented intervention. [ABSTRACT FROM AUTHOR]

A relationship between anxiety disorders and suicide-related behaviors has been demonstrated in adolescents, with a paucity of research examining mediators of this association. The present study hypothesized that anxiety would be associated with suicidal ideation via a serial mediation pathway through depressive symptoms and perceived burdensomeness and/or thwarted belongingness. A sample of 80 adolescents (68.8% female, 65.8% Hispanic), 13-19 years of age (mean = 16.93, SD = 1.66), completed 3 interviews as part of a randomized controlled trial. Results indicated a significant serial mediation from anxiety to suicidal ideation via depressive symptoms and perceived burdensomeness, but not thwarted belongingness. Clinicians and mental health service providers working with adolescents experiencing elevated anxiety should regularly assess for perceived burdensomeness and suicidal ideation. [ABSTRACT FROM AUTHOR]

Although childhood abuse is a well-known risk factor for suicide, no studies have investigated the role of interpersonal-psychological (Joiner, 2005), constructs in this association. This study examined whether childhood physical, sexual, and emotional abuse were associated with IPTS constructs, and whether depressive symptoms mediated these associations. Ninety-one participants completed self-report measures. Emotional abuse predicted perceived burdensomeness and thwarted belongingness, and depressive symptoms mediated these associations. Physical abuse predicted the acquired capability for suicide, although depression did not mediate this association. These findings suggest that specific types of abuse differentially predict IPTS components and underscore depression as a potential mechanism. [ABSTRACT FROM AUTHOR]

Suicide has become an issue of great concern within the U.S. military in recent years, with recent reports indicating that suicide has surpassed combat related deaths as the leading cause of death. One concern regarding suicide risk in the military is that existing self-report measures allow service members to conceal or misrepresent current suicidal ideation or suicide plans and preparations. Implicit association tests (IATs) are computer-based, reaction time measures that have been shown to be resilient to such masking of symptoms. The death/suicide implicit association test (d/s-IAT) is an empirically supported IAT that is specific to death and suicide. The present study examined whether the performance of 1,548 U.S. military service members on the d/s-IAT significantly predicted lifetime suicidal ideation and depression. Zero-inflated negative binomial regression analyses were used to test these associations. Results indicated that the d/s-IAT was neither associated with history of suicidal ideation nor history of depression. [ABSTRACT FROM AUTHOR]

Depression and suicide ideation are common in student populations across the world. The present study investigated factors buffering the association between depression and suicide ideation. A total of 2,687 Chinese students and 601 German students took part in the investigation. Social support, satisfaction with life, self‐efficacy, psychosocial stress resistance, and positive mental health were considered as resilience factors moderating the association between depressive symptoms and suicide ideation within both samples. Positive mental health moderated the impact of depressive symptoms on suicide ideation in German and Chinese students. Life satisfaction moderated the impact of depressive symptoms on suicide ideation in German students. Social support moderated the impact of depressive symptoms on suicide ideation in Chinese students. No interaction effects were found for self‐efficacy and psychosocial stress resistance. Positive mental health, satisfaction with life, and perceived social support seem to confer resilience and should be taken into account, when assessing individuals for suicide risk. [ABSTRACT FROM AUTHOR]

Venlafaxine controlled drug delivery systems using different matrixes have been tested to reduce undesirable side effects in the treatment of depression. The legal status of chitosan (Cs) in Pharmacy has dramatically improved after its acceptance as excipient in several Pharmacopeias and, therefore, there is great interest in pharmaceutical formulations based on this polymer. In this paper, chitosan microcapsules cross-linked with sodium tripolyphosphate (TPP) for oral delivery of venlafaxine were formulated using the spray drying technique. The effect of chitosan physico-chemical properties, TPP concentration and TPP/Cs ratio on drug release was evaluated. The microcapsules were characterized in terms of size, zeta potential and morphology. The physical state of the drug was determined by X-ray diffraction (XRD) and the drug release from the microcapsules was studied in simulated gastric and intestinal fluids. The release pattern fitted well to the Peppas-Koersmeyer model with n exponents indicating anomalous transport. [ABSTRACT FROM AUTHOR]

A conceptual model in which the associations between perceived burdensomeness and suicide ideation, and between thwarted belongingness and suicide ideation, are moderated by mindfulness was examined. Participants were 218 undergraduates (mean age = 20.81) with moderate-to-severe depressive symptoms. Mindfulness significantly moderated the association between perceived burdensomeness and suicide ideation; participants with thoughts of burdensomeness experienced lower levels of suicide ideation if they were high, as opposed to low, in mindfulness. Mindfulness did not significantly moderate the association between thwarted belongingness and suicide ideation. Implications for intervention and elaboration of the interpersonal psychological theory of suicide are discussed. [ABSTRACT FROM AUTHOR]

To date, no study has examined rates of suicide ideation or theory-based risk factors for suicide ideation among bondage and discipline, dominance and submission, and sadomasochism (BDSM) practitioners. Participants were 321 adults that endorsed BDSM involvement. Thirty-seven percent of the sample indicated a nonzero level of suicide ideation. Thwarted belongingness and perceived burdensomeness (PB) were positively associated with suicide ideation and their interactive effect predicted additional variance in suicide ideation after adjusting for depressive symptoms. Overall, shame and guilt were positively associated with suicide ideation and these relations were mediated by thwarted belongingness and PB in parallel adjusting for depressive symptoms; however, there were some differences between demographic subgroups. Among BDSM practitioners, stigma-related internalized feelings (i.e., shame and guilt) may be associated with increased thwarted belongingness and PB, which are associated with suicide ideation. [ABSTRACT FROM AUTHOR]

Emotional trust is conceptualized as an individual's belief that others are not critical of personal disclosures and will maintain their confidentiality. Accordingly, adolescents who hold high emotional trust in their parents are inclined to disclose troubling thoughts (e.g., those related to depression or suicide), and in turn receive emotional support as well as practical assistance in managing these thoughts, thereby mitigating the risk of suicide attempts. To date, emotional trust has not been examined in the context of depression and suicide attempts; the broad aim of the present study was to examine this relationship. Three hundred and twenty-one adolescents were administered measures of emotional trust in mothers, depressive symptoms, and suicide attempts. Negative Binomial regression analyses indicated that adolescents' emotional trust in mothers moderated the relation between depressive symptoms and suicide attempts. When emotional trust in mothers was low or medium, depressive symptoms were positively associated with suicide attempts, but, when emotional trust in mothers was high, there was not a significant relation between depressive symptoms and suicide attempts. Conversely adolescents experiencing elevated depressive symptoms who had low emotional trust in mothers reported the highest number of suicide attempts, presumably because their low trust has precluded self-disclosure and, thus, suicidal and depressive thoughts could not be resolved by maternal discussion and support. Results suggest that interventions promoting adolescents' emotional trust in their mothers may be effective in reducing the risk of suicide attempts for adolescents with psychiatric disorders, particularly depression. [ABSTRACT FROM AUTHOR]

The current study examined suicidal ideation (SI) and depression outcomes among Veterans receiving Cognitive Behavioral Therapy for depression (CBT–D) throughout the Department of Veterans Affairs health care system. Patient outcomes included Beck Depression Inventory–II total score and SI item. Of 902 patients, 427 (47%) had no SI, 405 (45%) had SI but no suicidal intent, 26 (3%) indicated suicidal desire, 8 (1%) indicated suicide intent if they had the chance, and 36 (4%) did not answer this question at session one. The odds of SI decreased by 64% from 1.03 at session one to 0.37 at final assessment (OR = 0.36; 95% CI: 0.31, 0.43). Findings reveal that CBT–D was associated with significant decreases in SI and depression among Veterans. [ABSTRACT FROM PUBLISHER]

There is a growing body of literature suggesting that reactions to stressful life events, such as intrusive thoughts, physiological hyperarousal, and cognitive/behavioral avoidance (i.e., stress-related symptoms) may increase risk for thinking about and attempting suicide. Cognitive vulnerability models have identified rumination (i.e., perseverating on a negative mood) as a maladaptive response that may increase risk for suicidal behavior, as it has also been linked to depression. The present study examined the direct and indirect effects of stress-related symptoms on suicidal ideation through rumination and depressive symptoms. Participants were 1375 young adults, primarily non-White (78 %) females (72 %), recruited from a public university in the Northeastern U.S., who completed measures of stress-related symptoms (as a response to a stressful event), rumination, depressive symptoms, and suicidal ideation. The relation between stress-related symptoms and suicidal ideation was accounted for by the brooding subtype of rumination and depressive symptoms among females. Depressive symptoms, but not rumination, better accounted for suicidal ideation among males. These findings suggest that the role of brooding and depressive symptoms in the relationship between stress-related symptoms and suicidal ideation may vary by gender. [ABSTRACT FROM AUTHOR]

The present prospective study tested a portion of the interpersonal-psychological theory of suicide (IPTS) in an adolescent clinical sample. Participants were 143 adolescents consecutively admitted to a partial hospitalization program who completed assessments at intake and discharge from the program. Results partially supported the IPTS and suggest that (1) perceived burdensomeness may be an important socially based cognition for understanding concurrent risk for suicidal ideation (SI); (2) thwarted belongingness affects depression symptom severity over time, which indirectly predicts SI over a short follow-up time frame; and (3) the IPTS constructs may function differently in a high-risk clinical adolescent sample, compared to adults, although findings are preliminary. [ABSTRACT FROM AUTHOR]

Objective Research suggests that being unable to generate solutions to problems in times of distress may contribute to suicidal thoughts and behavior, and that depression is associated with problem-solving deficits. This study examined active and passive problem solving as moderators of the association between depressive symptoms and future suicidal ideation among suicide attempters and nonattempters. Method Young adults ( n = 324, 73% female, mean age = 19, standard deviation = 2.22) with ( n = 78) and without ( n = 246) a suicide attempt history completed a problem-solving task, self-report measures of hopelessness, depression, and suicidal ideation at baseline, and a self-report measure of suicidal ideation at 6-month follow-up. Results Passive problem solving was higher among suicide attempters but did not moderate the association between depressive symptoms and future suicidal ideation. Among attempters, active problem solving buffered against depressive symptoms in predicting future suicidal ideation. Conclusions Suicide prevention should foster active problem solving, especially among suicide attempters. [ABSTRACT FROM AUTHOR]

For many suicidal people, the desire to die is moderated by a competing desire to live. This study aimed to demonstrate the ability of a wish-to-live versus wish-to-die index score to measure ambivalence and trichotomize suicidal inpatients into distinct stratified risk groups. Analyses revealed that index scores calculated for patients at treatment start significantly discriminated among the groups at index and uniquely predicted suicidal ideation, hopelessness, and depression scores across treatment. On average, patients with wish-to-live and wish-to-die orientations resolved suicidal ideation by discharge. Changes in suicidal ideation among ambivalently oriented patients were more variable. Clinical and research implications are discussed. [ABSTRACT FROM AUTHOR]

Severity of depressive symptoms, hopelessness, and suicidal ideation were examined to determine whether they were significantly associated with the accuracy of suicidal adolescents' ratings of stressful life events. The sample included 130 inpatient adolescents who endorsed suicide-related behaviors. Stress interviews were administered, and the severity of stressful events was rated separately by adolescents and an independent team. A residualized cognitive bias score was created by regressing adolescents' severity ratings to the independent team's severity ratings of the same events. Depressive symptoms, but not hopelessness or suicidal ideation, were significantly associated with cognitive bias scores. A negative cognitive bias in adolescents' reports of life stress may be present at higher levels of depression relative to minimal levels of depression. Further research on the relations between stress and suicide-related behaviors is encouraged to include independent ratings of stress severity. [ABSTRACT FROM AUTHOR]

Developing and testing theoretical models of suicidal processes is an important step towards designing appropriately targeted interventions. Though numerous correlates of suicidal ideation have been identified, little theory articulates exactly how suicidal ideation arises in such contexts. Drawing on empirical and theoretical literature, we present the rationale for a stress-coping model to explain the development of suicidal ideation within an individual (the emotion self-confidence model of suicidal ideation). Negative emotionality is viewed as an internal contextual stressor, potentially leading to the coping response of suicidal ideation, depending on how well an individual believes he/she can cope with or change the negative emotionality (emotion self-confidence). In particular, high levels of negative emotionality coupled with low emotion self-confidence would be expected to predispose towards thoughts of suicide. We discuss the relationship between emotion self-confidence and processes associated with suicidal ideation, such as depression and hopelessness, as well as how emotion self-confidence relates to broader cognitive behavioral constructs involving coping expectations. Accordingly, we outline the benefits of conceptualizing the model within Lazarus and Folkman's (1984; Lazarus, 1999) stress-coping framework. [ABSTRACT FROM AUTHOR]