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Although suicide remains a leading cause of death for adolescents, risk factors beyond diagnoses and suicide attempt history remain unclear. We examined whether cognitive style and temperament impact risk for an early, yet still clinically relevant and distressing, form of suicidality: active suicidal ideation. We used binary logistic regression to test whether brooding, inattention, and impulsivity predicted significantly increased risk for suicidal ideation in a sample of 134 twins, 46 of whom endorsed active suicidal ideation (i.e., probands), as well as probands' cotwins and matched controls. When comparing probands with controls and controlling for depression diagnoses, brooding (B = 0.73, Odds Ratio [OR] = 2.07, p = 0.021), inattention (B = 1.09, OR = 2.98, p < 0.001), and impulsivity (B = 0.91, OR = 2.47, p = 0.001) differentiated probands from controls, individually. We compared probands with their cotwins using the same approach, which allowed us to account for variance in suicidal ideation risk related to twins' shared, familial characteristics (e.g., prenatal environment, neighborhood); inattention was the only significant predictor of suicidal ideation risk (B = 0.66, OR = 1.93, p = 0.020). We then fit a logistic regression model that included all three predictors. Only inattention predicted significantly increased likelihood of suicidal ideation in proband versus controls and proband versus cotwin comparisons (B = 0.88, OR = 2.40, p = 0.024 and B = 0.67, OR = 1.96, p = 0.045, respectively). These results highlight the potential utility of examining novel, more proximal risk factors for suicidal ideation in addition to more established distal factors, like suicide attempt history and psychiatric diagnoses. [ABSTRACT FROM AUTHOR]

Highlights • We examined nature and construct validity of PTSD-reckless/self-destructive behaviors (RSDBs) typologies. • We found three subgroups: Low vs. High PTSD-RSDBs, and High PTSD-Low RSDBs. • Impairment and depression predicted the High PTSD-Low RSDBs vs. Low PTSD-RSDBs classes. • Impairment, age, gender, and depression predicted the High vs. Low PTSD-RSDBs classes. • Traumas, gender, age, and depression predicted the High vs. High PTSD-Low RSDBs classes. Abstract Posttraumatic stress disorder (PTSD) is comorbid with diverse reckless and self-destructive behaviors (RSDBs). We examined the nature and construct validity (covariates of age, gender, depression severity, number of trauma types, functional impairment) of the optimal class solution categorizing participants based on PTSD symptom and RSDB endorsement. The sample included 417 trauma-exposed individuals recruited through Amazon's MTurk platform who completed the Life Events Checklist for DSM-5, PTSD Checklist for DSM-5, the Posttrauma Risky Behaviors Questionnaire, and Patient Health Questionnaire-9. Latent profile analyses indicated an optimal three-class solution: the Low PTSD-RSDBs, High PTSD-Low RSDBs, and High PTSD-RSDBs classes. Multinomial logistic regression indicated that impairment and depression predicted the High PTSD-Low RSDBs vs. the Low PTSD-RSDBs classes. Impairment, age, being female, and depression predicted the High vs. Low PTSD-RSDBs classes. Number of trauma types, age, being female, and depression predicted the High PTSD-RSDBs vs. High PTSD-Low RSDBs classes. Results support the presence of a reckless behaviors subtype of PTSD (characterized by greater depression, greater impariment, greater number of trauma types, being male, and being younger), conducting comprehensive assessments of RSDBs for individuals reporting PTSD symptoms and of PTSD symptoms for individuals reporting RSDBs, and the need to tailor interventions to treat PTSD and RSDBs concurrently. [ABSTRACT FROM AUTHOR]

We developed algorithms to identify pregnant women with suicidal behavior using information extracted from clinical notes by natural language processing (NLP) in electronic medical records. Using both codified data and NLP applied to unstructured clinical notes, we first screened pregnant women in Partners HealthCare for suicidal behavior. Psychiatrists manually reviewed clinical charts to identify relevant features for suicidal behavior and to obtain gold-standard labels. Using the adaptive elastic net, we developed algorithms to classify suicidal behavior. We then validated algorithms in an independent validation dataset. From 275,843 women with codes related to pregnancy or delivery, 9331 women screened positive for suicidal behavior by either codified data (N = 196) or NLP (N = 9,145). Using expert-curated features, our algorithm achieved an area under the curve of 0.83. By setting a positive predictive value comparable to that of diagnostic codes related to suicidal behavior (0.71), we obtained a sensitivity of 0.34, specificity of 0.96, and negative predictive value of 0.83. The algorithm identified 1423 pregnant women with suicidal behavior among 9331 women screened positive. Mining unstructured clinical notes using NLP resulted in a 11-fold increase in the number of pregnant women identified with suicidal behavior, as compared to solely reliance on diagnostic codes. [ABSTRACT FROM AUTHOR]

Background: Substance abusers show extensive self-destructive behavior due to the nature of the disorder and chronic and recurrence conditions. Various plans are presented for treating substance abuse. The purpose of this study is to compare the residential and therapeutic community (TC) centers in preventing substance abuse recurrence and reducing self-destructive behaviors of substance abusers. Methods: The statistical population was all the substance abusers who referred to TC and residential centers that were under the supervision of Welfare Organization of North Khorasan Province, Iran. Five centers were selected by cluster random sampling method. The data colleting tools were self-reporting questionnaires of Resuscitation Predictor Scoring Scale (RPS Scale) and Self-Harm Inventory (SHI) filled out by patients who were staying in treatment for minimum of two weeks. Findings: There was no significant difference between two treatment methods in terms of reducing tendency to use substance. Also in terms of reducing self-destructive behavior, TC was more effective than residential treatment. Conclusion: Considering the positive consequences of TC, motivational programs need to be established in order to increase the longevity of substance abusers in treatment. [ABSTRACT FROM AUTHOR]

The objective of this research was to develop an explicative and predictive model of suicidal ideation in Mexican high school students. The study participants were students of three technical careers from a public education institution in the state of Jalisco, Mexico. The sample consisted of 911 students, selected through nonprobabilistic sampling. The exogenous variables were sex, family social support, adjustment and school victimization, risky eating behavior, dissatisfaction with body image and depression. The instrument for measuring suicidal ideation was the "Suicidal Ideation Scale" developed by Beck, Kovacs and Weissman which measures the characteristics and frequency of thoughts and attitudes about the intentionality of committing suicide. An explicative and predictive model of suicidal ideation was constructed that included the variables of depression, family support and adjustment problems to the school through a Multiple Linear Regression analysis. Based on the findings, it is suggested to develop intervention strategies within the school and family context focused on the variables that predict a significant increase in suicidal ideation. [ABSTRACT FROM AUTHOR]

In this article the author talks about alienated membranes from which the child is separated in the trauma of birth which touches on castration or unconscious repetition. Topics discussed include beyond-of-the-signified and of an emotional relationship to it that the subject keeps its distance and is constituted in a kind of relationship characterized by primary affect, perinatal origin of adult self-destructive behavior; and immense development of the essential character of the maternal.

In recent years, the situation of child and adolescent psychiatry in Poland has dramatically deteriorated. 24-hour psychiatric wards dedicated to minors are overcrowded and it is almost exclusively patients who are a direct threat to their own health or life that are hospitalised. About 20% of children and adolescents have symptoms of various mental disorders, of which 10% (about 400,000) require specialist care. Depression is one of the most common health problems among children and adolescents and its prevalence increases with age and puberty. Depression can be chronic, with constant severity, or recurrent, when symptoms return in the form of mild, moderate or severe episodes. The mood disorders occurring in the developmental period carry many negative consequences in the emotional, social and educational functioning of the patient. They increase the risk of self-destructive behaviours, suicide, abuse of psychoactive substances, as well as later difficulties in many areas of life during adulthood. [ABSTRACT FROM AUTHOR]

The study aimed to analyze the role of attachment in the formation of chronic selfdestructive tendency. It was hypothesized that high levels of attachment anxiety and avoidance impair self-care functions and limit capacities for self-control, which may then lead to the development of an indirect self-destructive personality pattern. The study was conducted among 137 young adults, using the Chronic Self-Destructiveness Scale, Experiences in Close Relationships Scale, Self-Control Scale and Self-Care Competence Questionnaire. The obtained results showed that the relationship between anxiety about rejection and chronic self-destructiveness was only indirect - its influence was primarily through self-control and partly also through self-care functions. With regard to avoidance of intimacy, the analysis revealed it had both direct and mediated effects (through self-care functions and self-control) on chronic self-destructiveness. [ABSTRACT FROM AUTHOR]

The darker side of leadership is unexplored. To help fill this gap, this study focuses on the subordinate's perspective of destructive leadership behaviors. The purpose of this article is to identify the most frequent destructive leadership behaviors in small elementary schools in Chile through a qualitative approach. According to the data, leaders who are frequently labeled as destructive exhibit autocratic leadership, poor communication, inconsistent/erratic behavior, and poor strategic skills. Through an analysis of the idiosyncratic Chilean context, we aim to contribute to the international discussion surrounding the darker side of leadership and suggest theoretical considerations and implications for the field. [ABSTRACT FROM AUTHOR]

While many countries produce suicide rates, within country estimation practices may privilege the dominant society and fail to report suicide estimates for populations historically discriminated against. In Canada, national suicide mortality studies are rarely reported for Indigenous populations. Yet, this population is known for high suicide behavior. Administrative, census and survey data are available but are not systematically or critically analyzed. To address this gap, this paper provides an overview of social-political drivers to improve Indigenous statistics (particularly for suicide) and opportunities to report Indigenous suicide via different data sources in Canada. A case study illustrates the use of multiple data sources to report suicide and its correlates for an Indigenous group residing in the Province of Manitoba (Canada). Recommendations then follow to improve Indigenous statistics for suicide. [ABSTRACT FROM AUTHOR]

Art does not exist without myth. It is what gives meaning to an artwork. It is thinking in its own, and art, always impressing something on someone, avoids strict, rational, but also prone to pressure norms path when we reach sacrum; art is the only language to speak about sacrum. The character of Orpheus has inspired artists of different genres for centuries, but it seems to be seen from only one side. The mythical hero does not break a formal order, but an authentic norm, because he personifies a fact that norms do not exhaust human nature, only regulate life of societies. Thereby an "innocent" hero cannot be mythical. I searched for Orpheus' guilt and Euridice's counterparts in other myths, or even different mythologies. One of them is, then, Lot's wife. I admit, I was inspired by Wisława Szymborska's poem about her. [ABSTRACT FROM AUTHOR]

This essay examines Keats's unique pathological poetics in Isabella. It argues that the destructiveness of the love between Isabella and Lorenzo is not only brought forth by her brothers' violent interference but is already present in their relationship. Apart from the conflict between innocent love and cruel reality, Keats accentuates the innate danger of erotic love, whose power does not lie in the fulfilment of desire and its liberation from moral restraints and class barriers, but in the unhealthy and self-destructive aspects of the human body and psyche. Keats presents this unique phenomenon through a form of pathological poetics, which, at the end of the poem, actualises his concept of the 'material sublime' as pertaining to human suffering, especially in a somatic sense. Such a representation of erotic love corresponds to Keats's understanding of poetic creation. In Isabella, both erotic love and poetic creation are Keatsian experiences of self-annihilation. [ABSTRACT FROM AUTHOR]

Objective: The authors sought to understand why patients may not report suicidal ideation at a health care visit prior to a suicide attempt.Methods: Electronic health record data from Kaiser Permanente Washington were used to identify patients who reported having no suicidal ideation on question 9 of the nine-item Patient Health Questionnaire and who subsequently made a suicide attempt (≤60 days). Semistructured interviews were audio-recorded, transcribed, and analyzed by using a combination of directed (deductive) and conventional (inductive) content analysis to validate and further explore reasons why patients may not report suicidal ideation prior to a suicide attempt.Results: Of 42 adults sampled, 26 agreed to be interviewed, of whom about half were women (N=15) and a majority was white (N=20), with ages ranging from 18 to 63. Key themes were that patients who attempted suicide after having reported no thoughts of self-harm were either not experiencing suicidal ideation at the time of screening or feared the outcome of disclosure, including stigma, overreaction, and loss of autonomy. An additional theme that emerged from the interviews included reports of heavy episodic drinking at the time of the suicide attempt, particularly when suicide was completely unplanned. Patients also identified important aspects of interactions with health care system providers that may facilitate disclosure about suicidal ideation.Conclusions: Nonjudgmental listening and expressions of caring without overreaction among providers may help patients overcome fear of reporting suicidal ideation. Screening for heavy episodic drinking may help identify individuals who make unplanned suicide attempts. [ABSTRACT FROM AUTHOR]

Recent advances in statistical methods and computing power have improved the ability to predict risks associated with mental illness with more efficiency and accuracy. However, integrating statistical prediction into a clinical setting poses new challenges that need creative solutions. A case example explores the challenges and innovations that emerged at a Department of Veterans Affairs hospital while implementing REACH VET (Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment), a suicide prevention program that is based on a predictive model that identifies veterans at statistical risk for suicide. [ABSTRACT FROM AUTHOR]

The article reflects on the role of the human brain in the execution and integration of man's actions. It states that it is the brain that facilitates adaptation while religion is a product of brain's evolution which is to unify experiences. It also discusses man's destructive behavior stating that man's technological activities may result to nature's destruction.

The article presents an essay regarding the technological perplexity or an appraisal of man as a species bent on self-destruction. It examines the effects of atomic bombing in Hiroshima-shi, Japan on August 6, 1945, where tens of thousands were killed and more thousands were grievously injured. It also tries to uncover the liability of man as he achieved the capacity to destroy himself as species. The the author contends that the peacetime employment of nuclear energy poses some interesting philosophical implications. On the other hand, international regulations are urgently imperative if the periods of truce are to remain unpoisoned.

The article presents the findings of а study investigating a relationship between personality types developing under the influence of negative parental messages (injunctions) and different types of self-destructive behaviors in alcohol-dependent patients. The study was carried out in 2009—2012 in Ryazan in a sample of 190 outpatient male clients who received psychotherapy for alcohol-dependence. The authors assumed that the choice of self-destructive behaviors was linked to the alcohol-dependent patients’ personality organization and depended on а combination of different injunctions with the main self-destructive injunction — “Don’t be”. The authors describe parental injunctions, which contributed to the devel- opment of “the alcoholic personality”. The main contributing injunctions were “Don’t be” which formed the basis for self-destructiveness, and “Don’t think”, which reinforced alcohol abuse as a maladaptive coping strategy. The other injunctions, when combined with “Don’t be”, were mediating personality type de- velopment and the related groups of self-destructiveness. The authors identified statistically significant correlations between the most frequent personality types and specific groups of self-destructive behavior in alcohol-dependent patients: thus, borderline personality organization was linked to suicidal behavior, dissocial personality organization — to antisocial behaviors, and narcissistic — to self- destructiveness in the professional sphere.

The rate of suicide among veterans continues to be highly problematic. The widespread adoption and mandated implementation of thinly validated and scripted assessment tools have the potential to increase clinician burnout and erode clinician-patient relationships without reaching the goal of reducing veteran suicides. While further development and widespread use of validated suicide prevention interventions are necessary, the need remains to guard against a reductionistic approach that may marginalize valuable patient narratives in the process. [ABSTRACT FROM AUTHOR]

The article presents the results of the empiric study of cognitive and personal factors of emotion regulation, risk of suicide, psychopathologic symptoms and self-injurious behavior. It is hypothesized that the risk of self-destructive behavior is connected to destructive cognitive strategies, dispositional factors of self-injurious and suicidal behavior and psychopathological symptoms. Participants: N=101, aged 13—21. Results: relations between scales of suicidal risk, psychopathological symptoms, self-injurious behavior and cognitive emotional regulation were revealed; differences between groups of instrumental and somatic self-injurers were shown; predictors of self-destructive behavior were defined by linear regression analysis. Summary: somatization, anxiety and psychoticism were related to factors of self-injurious behavior; connections between methods and factors of self-injurious behavior and factors of suicidal risk were discovered; cognitive emotional disregulation (rumination, self-accusation and accusation of others) were predictors of self-destructive behaviors and psychopathological symptoms.

Objective: Suicide is a leading cause of death in the United States. This has prompted the U.S. surgeon general to issue a report describing actionable items to reduce suicide rates, including a recommendation to increase the use of the caring letters intervention. This intervention involves mailing brief, nondemanding messages of care. As part of the Department of Veterans Affairs' (VA's) efforts to reduce suicide rates among veterans, a caring letters project was developed for veterans who contact the Veterans Crisis Line (VCL). This article describes the results of qualitative interviews conducted to better understand the experiences of veterans who received caring letters., Methods: Beginning in 2020, all identifiable veterans who used Veterans Health Administration services and contacted the VCL received nine letters over 1 year, along with a list of mental health resources. Semistructured interviews (N=23) were conducted, and content analysis was used to identify veterans' perspectives and suggestions for improving the intervention., Results: Sixteen men and seven women participated (mean age=53 years). Feedback varied, with most participants reporting that receiving caring letters had a positive impact and others noting aspects that could be improved to enhance the intervention's caring intent. Some also reported that the letters helped them engage with community resources and made them more likely to seek VA care., Conclusions: The caring letters intervention, received after contact with the VCL, was well received by participants. They described feeling appreciated, cared for, encouraged, and connected. The results of this study will inform future evaluation examining veteran outcomes., Competing Interests: Dr. Landes is a consultant for RAND and UTHealth Houston. Dr. Abraham is a consultant for Roche and Strategic Science and Technologies. Dr. Garrido has received grant funding from Arnold Ventures and the Commonwealth Foundation. The other authors report no financial relationships with commercial interests.

The U.S. Department of Veterans Affairs (VA) and Department of Defense clinical practice guideline on the treatment of veterans at risk for suicide recommends considering caring contacts interventions after a psychiatric hospitalization for suicidal ideation or suicide attempt. This quality improvement project examined the implementation of the recommendation at a large VA health care system. The project enrolled 29% of hospitalized veterans (N=135 of 462). Enrollment barriers included lack of staff availability and veteran ineligibility due to homelessness or housing instability. Opportunities to improve the reach of the intervention in future quality improvement processes are discussed, especially because acceptability of the intervention was high among veterans., Competing Interests: The contents of this column do not represent the views of the VA or the U.S. government.The authors report no financial relationships with commercial interests.

In order to identify the basic patterns of behavior that reflect the attitude of Russians to their health, a large corpus of relevant scientific literature was analyzed, as well as actual statistical data and the results of representative sociological studies concerning various aspects of both self-preserving and self-destructive behavior of Russians. As a result, four basic models of behavior were formed and described, which differ in a set of positive and negative attitudes and characteristic lines of behavior in relation to one's health («a convinced healthy lifestyle person», «a beginner healthy lifestyle person», «irresponsible» and «self-destructive»). Based on the analysis of statistics and sociological information, it was concluded that even the behavioral model of a «beginner healthy lifestyle person» is implemented by a very minority of Russians. At best, the majority of the population adheres to the «irresponsible» pattern of behavior that involves refusing or reducing the consumption of alcohol and tobacco, but not assuming a rational diet, adequate sleep, physical and medical activity. Hence the task of everyone who has the opportunity to influence citizens, including medical workers, to convey to them the idea that health and longevity are achieved only through systematic and comprehensive efforts. In addition, a number of common misconceptions and unrealistic expectations related to healthy lifestyles were highlighted. Attention is drawn to the fact that subjects capable of exerting an educational impact on citizens, including medical specialists, should not only provide patients with useful knowledge, but also try to protect them from misconceptions and unfounded expectations.

Background: Anhedonia-impairment related to the experience of pleasure-has been identified as a potential risk factor for suicide, with some mixed findings. The current study sought to clarify the role of acuity of anhedonia in the relationship between anhedonia and suicidal thoughts and behaviors by comparing acutely and chronically anhedonic subjects on severity of suicidal ideation (SI) and suicide attempt (SA) history.Methods: Psychiatric outpatients (N = 395) were administered the Columbia Suicide Severity Rating Scale, the Beck Scale for Suicidal Ideation and a modified version of the Snaith-Hamilton Pleasure Scale (SHPS); SI measures were readministered at a 1-month follow-up (N = 289, 73%). Participants were classified as acutely anhedonic, chronically anhedonic and nonanhedonic based on their responses to the SHPS at initial assessment.Results: Controlling for symptoms of anxiety and depression, acute anhedonia was cross-sectionally and prospectively associated with greater severity of SI compared to the nonanhedonic group; no differences in severity of SI were found between the chronically anhedonic and nonanhedonic group at either time point. Anhedonia grouping was not associated with SA history.Conclusion: Changes in capacity to experience pleasure may be more informative of near-term SI than typically low pleasure levels. Future investigation should focus on the relationship between acute anhedonia and imminent suicidal behavior. [ABSTRACT FROM AUTHOR]

The article addresses self-harm in young women from the perspectives of women who self-identified as having engaged in suicidal behavior. Topics discussed include classification of deliberate self-harm (DSH), gender differences in risk factors for DSH, and interventions for the prevention of self-harm in women.

Research on the relationship between neighborhood characteristics and adolescents' risk of nonfatal suicidal behavior is scarce. We used California survey data to examine associations between measures of objective neighborhood quality (levels of violent crime, property crime, and socioeconomic disadvantage) and subjective neighborhood quality (perceptions of neighborhood safety and social cohesion) and adolescents' self-reported suicidal ideation and suicide attempt. Objective measures of neighborhood quality were unrelated to adolescents' risk of suicidal behavior. However, adolescents who perceived their neighborhoods to be less safe and less cohesive were 20%-45% more likely than nonsuicidal peers to report suicidal ideation and attempt. [ABSTRACT FROM AUTHOR]

This study (a) provides descriptive information about the personal technology use of a suicide sample of active-duty military personnel and (b) uses a traditional and a technology-based measure of social connectedness to examine their relation to suicide ideation and behaviors. Higher thwarted belongingness, and therefore lower perceived social connectedness, was associated with higher current and worst suicide ideation and a greater lifetime self-directed violence regardless of intent to die. Higher social connectedness based on personal technology usage was associated with higher current suicide ideation and a higher number of lifetime self-directed violence and suicide attempts. [ABSTRACT FROM AUTHOR]

Firearms account for half of all U.S. suicide deaths, but research on mechanisms through which firearms confer risk is limited. Although research has indicated firearm ownership and the unsafe storage of firearms are associated with an elevated risk of suicide, such research cannot provide insight into the extent to which a history of using a gun plays a role. We recruited a community sample (N = 100; 76% female; 44% Black) oversampled for prior suicidal behavior in a high gun ownership state (Mississippi). Consistent with hypotheses, a greater number of lifetime experiences of firing a gun were associated with elements of the capability for suicide (fearlessness about death, pain tolerance, pain persistence) and lifetime suicide attempts, but not with suicide ideation or simple pain detection. These findings indicate that guns may confer risk of suicide in part through increased comfort and aptitude with the weapon, a notion consistent with the construct of practical capability. Furthermore, these findings are consistent with research indicating that guns do not cause healthy individuals to become suicidal, but rather increase risk among already suicidal individuals. Overall, our findings highlight the importance of considering practical experience with guns as well as simple ownership and storage methods. [ABSTRACT FROM AUTHOR]

Objective: The main goal of this article is the construction and initial validation of an instrument to evaluate selfcare patterns. Method: An initial questionnaire was designed and analyzed, which led to revisions in the items and the scoring scale. Five new items were added. All 46 items were evaluated again in a sample of 270 psychiatric outpatients. Results: The final version of the scale includes 31 items. Cronbach's alpha is 0.91. Six factors have been identified: self-destructive behavior, difficulty in asking for and accepting help, resentment about not receiving reciprocity, absence of positive activities, not taking into account one's own needs, and lack of tolerance for shared positive affect. Conclusions: The Self-Care Scale is presented as a specific instrument to measure self-care patterns with a multidimensional definition. It has shown good reliability and validity in this clinical sample. [ABSTRACT FROM AUTHOR]

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Adolescent non-suicidal self-injury (aNSSI) is associated with abnormal scores on personality traits, such as high neuroticism. However, no studies to date have examined personality facets of self-injury in a cohort younger than college-age. Plus, adolescent psychopathologies, especially Depressive Disorders, are associated with a similar personality profile and are highly comorbid with aNSSI. Consequently, it remains unclear whether personality provides insights about aNSSI in youth beyond that due to underlying psychopathology. 550 community-dwelling 13- to 15-year-old never-depressed adolescent girls were interviewed for lifetime aNSSI and lifetime psychopathology. Personality traits, broad domains and specific facets, were assessed by self-report. Never-depressed adolescent girls who endorse aNSSI often met lifetime criteria for psychiatric disorders (NSSI: 20/43; 46.5% vs. non-aNSSI: 131/507; 26.1%). aNSSI and lifetime psychopathology were each independently associated with several traits (e.g., high neuroticism and conscientiousness), whereas some traits only discriminated aNSSI (e.g., high melancholia, a facet of neuroticism related to sadness and negative self-evaluation) or lifetime psychopathology independent of each other (e.g., low positive emotionality; low agreeableness). Furthermore, a multivariate model identified high melancholia, high openness to experience, and low conscientiousness as incrementally independent correlates of lifetime aNSSI over and above psychiatric illness. Proneness to melancholia, interest in new things, and poor self-control incrementally track aNSSI in never-depressed adolescent girls. Importantly, this emerges early in course (13-15 years of age) and is independent of lifetime psychiatric diagnosis. Implications for updating etiological models and clinical utility of personality assessment are discussed. [ABSTRACT FROM AUTHOR]

The fluidity of same-sex experience (SSE) can be conceptualized as both a risk and a resource that impacts suicidal ideation over time. Considering whether SSE occurs in adolescence, adulthood, or both, this study suggests that SSE in both adolescence and adulthood is associated with depression and low self-esteem throughout the life course, resulting in chronic susceptibility to suicidal ideation. Yet due to variation in both accumulation of risk and resources over time, trajectories of suicidal ideation during the transition to adulthood likely vary by timing of SSE. To test these hypotheses, we fit latent growth curve models to a gender-stratified sample taken from the National Longitudinal Study of Adolescent to Adult Health (7608 men, 8070 women). We created four groups of SSE: no SSE (6322 men, 5981 women), SSE in adolescence only (634 men, 480 women), SSE in adulthood only (372 men, 1081 women), and SSE in adolescence and adulthood (280 men, 528 women). Men and women with SSE in both life stages had the greatest risk of suicidal ideation in adolescence and in adulthood. Yet women with first SSE in adulthood had less of a decline in suicidal ideation over time, relative to those with no SSE and those with SSE in adolescence only, and this was partially due to higher depression and lower self-esteem. Results suggest greater support is needed for adolescents expressing non-normative sexualities and for those with first SSE in adulthood, a group that is more difficult to identify in schools. [ABSTRACT FROM AUTHOR]

• Over half of a community sample of transgender people reported a lifetime history of NSSI. • Rates of past year NSSI did not differ between transmasculine and transfeminine groups. • Younger age, felt stigma, and gender dysphoria were associated with past year NSSI. • Enacted stigma was not associated with past year NSSI. Abstract We investigated rates of nonsuicidal self-injury (NSSI) and correlates of past-year NSSI among transgender people to better understand factors contributing to this health disparity. A community-based sample of 332 transgender people participated in quantitative in-person interviews. The mean age of participants was 34.56 years (SD = 13.78, range = 16–87). The sample was evenly divided between transfeminine spectrum (50.3%) and transmasculine spectrum identities (49.7%) and was diverse in race/ethnicity. We evaluated associations between sociodemographic characteristics, stigma, hypothesized resilience factors, and identity variables with past-year NSSI. 53.3% of participants reported ever having self-injured in their lifetime. Past-year NSSI was reported by 22.3% of the sample and did not significantly differ based on gender identity. In logistic regression models, past-year NSSI was associated with younger age and felt stigma (perceived or anticipated rejection), but not enacted stigma (actual experiences of discrimination), and with gender dysphoria. Efforts to address the high rates of NSSI among transgender people should aim to reduce felt stigma and gender dysphoria, and promote transgender congruence. Future research using a developmental approach to assess variations in NSSI across the life course and in relation to transgender identity development may illuminate additional processes that affect NSSI in this population. [ABSTRACT FROM AUTHOR]

With approximately 20 veteran suicide deaths per day, suicidal ideation (SI) among veterans is an important concern. Posttraumatic stress disorder (PTSD) is associated with SI among veterans, yet mechanisms of this relationship remain unclear. Negative posttraumatic cognitions contribute to the development and maintenance of PTSD, yet no studies have prospectively examined the relationship between posttraumatic cognitions and SI. Veterans (N = 177; 66% Male) participating in a 3-week intensive outpatient program for PTSD completed assessments of PTSD severity, depressive symptoms, SI, and posttraumatic cognitions. Negative posttraumatic cognitions about the self significantly predicted SI at posttreatment, controlling for pretreatment levels of SI, depression, and PTSD symptom severity. Self-blame and negative posttraumatic cognitions about others/world did not predict SI prospectively. Negative posttraumatic cognitions about the self appear to be an important factor in the manifestation of SI among veterans with PTSD and should be monitored as a potential indicator of suicide risk. [ABSTRACT FROM AUTHOR]

The article focuses on issues about assisted suicide and euthanasia, which are reportedly being lauded as necessary to ensure human dignity. Information about the history of the movement to legalize assisted suicide and euthanasia as well as the reasons for choosing assisted suicide, which are often the same as those leading to suicide, or suicide contagion is presented.

Through a one-year follow-up design, this study examined whether distress tolerance would increase the risk for nonsuicidal self-injury (NSSI), mediated through depression in a representative sample of adolescents. Participants (N = 2,170) were recruited from senior high schools throughout Taiwan using both stratified and cluster sampling in time 1 (T1), and 1,832 students were followed-up one year later (T2). Structure equation modeling results revealed that after controlling NSSI measured at T1, NSSI (T2) was significantly predicted by distress tolerance (T1) and fully mediated through depression (T2). The mediating role of depression in the relationship between distress tolerance and NSSI are discussed. [ABSTRACT FROM AUTHOR]

In recent years, there has been growing attention to the distinction between acute and long-term suicidal risk factors. We have previously characterized an acute, negative affect state, termed the suicide crisis syndrome (SCS), as a marker of near-term suicidal risk. Here, we test whether documented long-term risk factors (i.e., trait vulnerabilities), including perfectionism, impulsivity, chronic substance abuse, insecure attachment, poor social support, and childhood trauma, associate to suicidal phenomena through a pathway of the SCS. A sample of 207 psychiatric inpatients were administered a battery of eight scales, including the Suicide Trigger Scale (STS-3) as a measure of the SCS. While both STS-3 and all trait vulnerabilities were associated with lifetime suicidal ideation and attempts, only STS-3 was related to pre-admission suicide attempts. The STS-3 significantly mediated the effect of each trait vulnerability on lifetime suicidal phenomena (combining ideation and behavior), with the proportion of mediating effect ranging from .29 to .56. Reverse mediation analyses were only significant for insecure attachment, supporting a largely unidirectional mediation effect. The SCS appears to serve as an acute risk factor for suicidal behavior in psychiatric inpatients and may act as a mechanism by which long-term risk factors increase suicidal risk. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify risk factors distinguishing inmates who attempt suicide from inmates who complete suicide. Compared with attempters, completers tended to be older, male, more educated, and married or separated/divorced; pretrial, committed for a violent crime, incarcerated in jail, housed in an inpatient mental health unit or protective custody setting, living in a single cell, not on suicide precautions, not previously under close observation; and more likely to act during overnight hours and die by hanging/self-strangulation. Targeted assessment of a broad range of risk factors is necessary to inform suicide prevention efforts in correctional facilities. [ABSTRACT FROM AUTHOR]

Suicide in rural areas has not received significant attention in the research literature to this point, although suicide rates are higher among adults and older adults in rural areas than in urban areas. The aims of the study were as follows: (1) establish the feasibility of assessing suicide ideation and history of suicidal behavior; (2) determine preliminary estimates of the prevalence of suicide ideation, and history of suicide attempts; and (3) examine the effectiveness and acceptability of safety and referral plans for individuals whose responses indicated elevated suicide risk, in rural communities with limited access to referral care. Participants were 96 adults aged 40 to 85 years old (M = 57.34, SD = 11.47) residing in West Texas. Our results indicate that 26% of participants endorsed a lifetime history of suicide ideation and/or suicide attempt(s) and 12.5% reported suicide ideation in the past year. In addition, 93.4% of participants reported that participation in our suicide-focused study was an excellent or good experience. Results suggest that individuals in rural communities are willing to talk about suicide, found the experience helpful, and were satisfied with the referral process. [ABSTRACT FROM AUTHOR]