Search

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., (© 2022 Wiley Periodicals LLC.)

Objective: The present study directly compared three perspectives of suicidality: Interpersonal Theory of Suicide (IPTS), Hopelessness Theory, and a perspective emphasizing emotion dysregulation., Method: 219 adults seeking outpatient psychological services completed questionnaires during intake between November 2015 and February 2019. Patients were included if they completed surveys related to thwarted belongingness (TB), perceived burdensomeness (PB), hopelessness, depressive symptoms, negative affect, and Borderline Personality Disorder (BPD) symptoms. Analyses tested the ability of TB, PB, depressive symptoms, hopelessness, and emotion dysregulation to relate to total scores on Beck Scale for Suicide Ideation. We employed Pearson's correlations and linear regressions to investigate these relations., Results: Constructs related to emotion dysregulation-negative affect (r = 0.161, p < .05) and Borderline Personality Disorder symptoms (r = 0.284, p < .01)-were significantly correlated with suicidal ideation, as were those relevant to Hopelessness Theory-depressive symptoms (r = 0.46, p < .01) and hopelessness (r = 0.45, p < .01)- and IPTS-TB (r = 0.36, p < .01) and PB (r = 0.43, p < .01). Notably the combinations of constructs as proposed by theories were significantly associated with suicidal ideation, but did not improve upon single constructs. This indicated that theoretically relevant constructs alone were strongly associated with suicidal ideation, but were not bested by interactions., Conclusions: This project compared constructs relevant to three theories of suicidality among a sample of treatment seeking outpatients. Findings indicated that suicidal ideation assessment was similarly informed by Hopelessness Theory and IPTS, and to a lesser degree emotion dysregulation. The cross sectional nature of the data and the reliance upon self-report measures limit the inferences that can be made.

Suicidality disproportionately affects Veterans, and in 2020 the Military Health and Well-Being Project was conducted in part to study the link between risk and protective constructs with suicidality among Veterans. In the present study, we investigate the relative contribution of risk (i.e., military self-stigma, daily stress, combat exposure, substance use, traumatic brain injury, and moral injury) and protective constructs (i.e., social integration, social contribution, public service motivation, purpose and meaning, and help-seeking) with suicidality. Using cross-sectional Pearson correlation and linear regression models, we studied the independent and relative contribution of risk and protective correlates in a sample of 1469 Veterans (male: n = 985, 67.1 %; female: n = 476, 32.4 %; transgender, non-binary, prefer not to say: n = 8, 0.5 %). When we investigated protective constructs individually as well as simultaneously, social contribution (β = −0.39, t = −15.59, p < 0.001) was the strongest protective construct against suicidality. Social integration (β = −0.13, t = −4.88, p < 0.001) additionally accounted for significant reduction in suicidality when all protective constructs were considered together. When we investigated the contribution of risk constructs towards suicidality, moral injury was most strongly associated with suicidality (r = 0.519, p < 0.001), yet when studied simultaneously for their relative contribution none of the constructs accounted for a significant amount of the variance in suicidality (| t |s ≤ 1.98, p s ≥ 0.07). These findings suggest that among Veterans it is possible that social contribution is protective against suicidality and could be a possible treatment target for the prevention or reduction of suicidality among Veterans. • Suicidality disproportionately affects Veterans. • We studied the risk and protective constructs for suicidality in Veterans. • Social contribution was associated with the lowest experience of suicidality. • Moral injury was associated with the greatest experience of suicidality. [ABSTRACT FROM AUTHOR]

Traumatic events are a serious public health concern, linked cross-sectionally and longitudinally with post-traumatic stress disorder (PTSD) and suicidal ideation (SI). While much research has focused on broadly defined traumatic events as they relate to PTSD and SI, fewer projects have investigated the disparate associations that specific traumatic events have with PTSD and SI. In this study of 1,829 adolescents held at the Cook County Juvenile Temporary Detention Center (measured during adolescence and again nine years later during adulthood), the cross-sectional and prospective links between various traumatic events (i.e. being physically assaulted, threatened with a weapon, sexually assaulted, in a serious accident, seeing someone be killed, experiencing a natural disaster, seeing a dead body, or being forced to fight), PTSD symptoms, and SI were investigated. Findings indicate that every traumatic event endorsed at baseline was cross-sectionally associated with increased PTSD symptoms and SI. Experiencing sexual assault or a serious accident during adolescence predicted greater SI at follow-up. Moreover, the positive association between PTSD symptoms at baseline and SI at follow-up was stronger among individuals who experienced sexual assault or a serious accident versus those who were not trauma exposed. Implications for justice-involved adolescents are discussed. [ABSTRACT FROM AUTHOR]

AbstractSuicide a leading cause of death among adolescents and is nearly always preceded by suicidal ideation (SI). Concerningly, SI during adolescence is not uncommon, as it is reported by as much as 20% of American youth. As such, SI in adolescence has been the subject of substantial research. Literature points to anger in adolescence as a relatively strong correlate of SI. However, work is limited, focusing on cross-sectional associations between anger in adolescence and SI and conceptualizing anger as a broad construct, failing to investigate the many narrow facets that comprise it. We address these gaps by investigating anger in adolescence as a (1) cross-sectional and (2) prospective correlate of SI and (3) investigating broad versus narrow conceptualizations of anger in adolescence as they relate to SI. Among two samples (Study 1, nationally representative community-based youth, n = 1,729; Study 2, high-risk juvenile justice involved youth, n = 1,406), anger in adolescence was cross-sectionally related to SI. However, when controlling for SI at baseline, anger in adolescence was not a prospective risk factor for SI at follow-up, nine years later. Finally, narrow facets of anger (e.g., argumentative, defiant, irritable, resentful, spiteful) were not more closely related than broad conceptualizations of anger to SI. These findings indicate that while anger in adolescence is cross-sectionally associated with SI, it should not necessarily be viewed as a valid risk factor for development of SI over the course of nearly a decade. Further, findings did not elucidate any narrow facets of anger that are particularly linked with SI. [ABSTRACT FROM AUTHOR]

Although suicide is a pervasive public health issue, strong predictors of suicidal thoughts and behaviors (STBs, e.g., passive or active suicidal ideation, suicide plans, suicide attempts, etc.) are lacking. Theory suggests that attentional processes, such as attentional bias and attentional control, may contribute to STBs. Specifically, among individuals with suicidal ideation, attentional biases towards suicide-related information may increase distress. This combined with the inability to disengage and shift attention away from suicidal thoughts (i.e., deficits in attentional control) might contribute to increased risk for negative outcomes (i.e., non-suicidal self-injury, suicidal behavior). Despite this notion, there has been limited research examining associations between attentional risk factors and STBs. Therefore, the purpose of this study was to conduct a meta-analysis to examine possible associations between attentional biases and STBs and attentional control and STBs. A comprehensive literature search was conducted and a total of 20 articles were retained for this meta-analysis. A small, but significant relationship was observed between attentional bias and STBs (r =.09, 95% CI:.06,.13), but not attentional control and STBs (r = -.04, 95% CI: -.21,.12). The limited number of studies identified, and therefore low power, precluded moderator analyses from being conducted. Moreover, additional experimental and longitudinal research with diverse assessments of attentional risk factors is needed. Despite these limitations, the present study provides preliminary evidence for the association between attentional bias and STBs. [ABSTRACT FROM AUTHOR]

Suicide is a widespread public health concern, including among military Veterans. Traumatic brain injuries (TBIs) and lack of social integration have both been shown to increase risk for suicidality, an outcome that includes, among other suicide-related variables, suicidal ideation, suicide attempts, and suicide death. Interestingly, TBIs have also been identified as a risk factor for social integration problems. In this cross-sectional study we investigated associations between TBI, social integration, and suicidality. Additionally, mediation analysis was used to test whether social integration mediated the association between TBI and suicidality. A sample of 1469 military Veterans (male, n = 1004, 67.2 %; female, n = 457, 32.3 %; transgender/non-binary/prefer not to say, n = 8, 0.5 %) completed an online survey as part of the Military Health and Well-Being Project. TBI was negatively associated with social integration (r = −0.084, p <.001) and positively with suicidality (r = 0.205, p <.001). Social integration was negatively associated with suicidality (r = −0.161, p <.001). Finally, social integration partially mediated the relationship between TBI and social integration (B = 0.121, 95 % CI [0.031–0.23]). This work shows that in the context of TBI, lack of social integration may promote suicidality. It provides support for many theories of suicide which propose social problems as a risk factor of suicide-related outcomes. It further highlights social integration as potential fodder for novel interventions for suicidality, an approach that would have transtheoretical support. • Suicide is a leading cause of death in military Veterans. • Social integration and traumatic brain injuries both confer risk for suicidality. • Social integration partially mediates the link between traumatic brain injuries and suicidality. • Social integration could be a point of treatment for Veterans presenting with comorbid TBI and suicidality. [ABSTRACT FROM AUTHOR]

Suicide is the tenth leading cause of death in America. Particularly at risk, Veterans are 1.5 times more likely to die by suicide than non-Veterans, and the suicide rate among service members has risen over the last decade. In the present study, we (1) assessed risk factors for suicidal ideation, suicide attempts, and suicide death within and between Veterans and service members, (2) identified the most commonly studied and (3) the strongest risk factors for suicide-related outcomes among Veterans and service members, and (4) compared overall and risk factor-specific meta-analytic prediction of suicide-related outcomes in Veterans and service members, as determined in the present meta-analysis, to that of the general population. Authors harvested longitudinal effects predicting suicidal ideation, suicide attempts, or suicide deaths in Veterans or service members until May 1, 2020. Traumatic Brain Injury, substance/alcohol use disorders, prior Self-Injurious Thoughts and Behavior, PTSD, and depressive symptoms were among the most commonly studied risk factors. Anger/aggression was particularly strong risk factors, providing a source for future study and intervention efforts. When combined, risk factors conferred similar risk for suicide attempts and suicide death among Veterans, service members, and the general population. However, when analyzing p-values, factors conferred significantly more risk of suicidal ideation among Veterans and service members as compared to the general population. That is, p-values for risk factors were lower in an absolute sense but not necessarily to a statistically significant degree. [ABSTRACT FROM AUTHOR]

Theoretically-driven models of suicide have long guided suicidology; however, an approach employing machine learning models has recently emerged in the field. Some have suggested that machine learning models yield improved prediction as compared to theoretical approaches, but to date, this has not been investigated in a systematic manner. The present work directly compares widely researched theories of suicide (i.e., BioSocial, Biological, Ideation-to-Action, and Hopelessness Theories) to machine learning models, comparing the accuracy between the two differing approaches. We conducted literature searches using PubMed, PsycINFO, and Google Scholar, gathering effect sizes from theoretically-relevant constructs and machine learning models. Eligible studies were longitudinal research articles that predicted suicide ideation, attempts, or death published prior to May 1, 2020. 124 studies met inclusion criteria, corresponding to 330 effect sizes. Theoretically-driven models demonstrated suboptimal prediction of ideation (wOR = 2.87; 95% CI, 2.65–3.09; k = 87), attempts (wOR = 1.43; 95% CI, 1.34–1.51; k = 98), and death (wOR = 1.08; 95% CI, 1.01–1.15; k = 78). Generally, Ideation-to-Action (wOR = 2.41, 95% CI = 2.21–2.64, k = 60) outperformed Hopelessness (wOR = 1.83, 95% CI 1.71–1.96, k = 98), Biological (wOR = 1.04; 95% CI.97–1.11, k = 100), and BioSocial (wOR = 1.32, 95% CI 1.11–1.58, k = 6) theories. Machine learning provided superior prediction of ideation (wOR = 13.84; 95% CI, 11.95–16.03; k = 33), attempts (wOR = 99.01; 95% CI, 68.10–142.54; k = 27), and death (wOR = 17.29; 95% CI, 12.85–23.27; k = 7). Findings from our study indicated that across all theoretically-driven models, prediction of suicide-related outcomes was suboptimal. Notably, among theories of suicide, theories within the Ideation-to-Action framework provided the most accurate prediction of suicide-related outcomes. When compared to theoretically-driven models, machine learning models provided superior prediction of suicide ideation, attempts, and death. [ABSTRACT FROM AUTHOR]

Objective: Theory suggests that attentional processes, such as attentional bias and attentional control, may contribute to suicidal thoughts and behaviors (STBs). Specifically, among individuals with suicidal ideation, attentional biases towards suicide-related information may increase distress. This combined with the inability to disengage and shift attention away from suicidal thoughts (i.e., deficits in attentional control) might contribute to increased risk for suicidal behavior. Despite this, there has been limited research examining associations between attentional biases and STBs or attentional control and STBs. Method: We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Search terms used to identify articles included: ("attention* bias" or "attentional control") AND (suicid*). The search returned 77 articles, 49 when duplicates were removed. Following full text reviews, a total of 16 articles were retained for meta-analysis. Results: A significant relationship was observed between attentional bias and STBs (r = 0.10, 95% CI: 0.05, 0.15), but not attentional control and STBs (r = −0.07, 95% CI: −0.24, 0.10). The funnel plot for attentional bias and STBs suggested low risk of publication bias. The limited number of studies identified, and therefore low power, precluded moderator analyses from being conducted. Conclusions: Additional experimental and longitudinal research with diverse assessments of attentional risk factors (e.g., dot probe, eye tracking) is needed. Despite these limitations, the present study provides preliminary evidence for the association between attentional bias and STBs. [ABSTRACT FROM AUTHOR]

Suicide is the second leading cause of death in adolescents; a frequent precursor of suicide is suicidal ideation (SI). Literature indicates that Post-Traumatic Stress Disorder (PTSD) and SI are robust cross-sectional correlates of one another, with PTSD often being conceptualized as a risk factor (i.e., conferring risk) for SI. Indeed, PTSD is a well-established risk factor for SI; however, SI is an understudied risk factor for PTSD. It is possible that, yet unknown if, PTSD and SI promote each other over time in a bidirectional fashion. We investigated the bidirectional longitudinal associations between PTSD and SI in a large, diverse sample, who at baseline were adolescents. Participants were interviewed between 1995 and 1998 and again between 2004 and 2008. We hypothesized that PTSD and SI would be cross-sectionally, longitudinally, and bidirectionally related and that the number of traumas endorsed at baseline would be positively associated with PTSD and SI at baseline and follow-up. Indeed, PTSD and SI were cross-sectionally correlated at baseline, but not follow-up. PTSD predicted SI over nine years; however, SI during adolescence did not predict PTSD in adulthood. Finally, poly-trauma endorsed at baseline was associated with increased risk of SI, but not PTSD, over nine years. • PTSD and suicidal ideation were cross-sectionally related during adolescence. • PTSD and suicidal ideation were not cross-sectionally related during adulthood. • PTSD predicted suicidal ideation over the nine year follow-up period. • Suicidal ideation did not predict suicidal ideation over the nine-year follow-up. [ABSTRACT FROM AUTHOR]

Safety planning interventions have demonstrated efficacy in reducing suicidal ideation, suicide attempts, and death by suicide. Less is known, however, about potential mechanisms underlying the effectiveness of safety plans. The present manuscript provides an overview of the steps involved in safety planning, reviews literature demonstrating its efficacy, and proposes seven potential factors that may explain why safety planning works: providing distraction, increasing connection, promoting autonomy, building competence, reducing engagement in impulsive urges, hindering engagement in suicidal behavior, and reducing cognitive load. By improving our understanding of why safety planning is effective, future work may be able to enhance, or augment, safety planning to further increase its efficacy and, ultimately, to save lives. [ABSTRACT FROM AUTHOR]